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andersa · 5 years

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The clinical picture of cystic fibrosis (CF) can vary considerably. The most common symptoms are malnutrition and rapidly progressive obstructive lung disease, which for most CF sufferers can entail respiratory insufficiency, secondary heart disease (corpulmonale) and the need for lung transplantation. At present, treatment is only symptomatic and is aimed at slowing the rapid advancement of the disease. With optimal treatment, individuals with CF can live well into their adult years. Half of all patients with CF in Sweden and Norway are now older than 18 years, meaning that CF is no longer only a childhood disease. Since the beginning of the 1980s, fitness, strength and flexibility training have become an important part of the basic treatment. The choice of exercises, intensity, duration and frequency must be adapted to the individual’s requirements, conditions and current situation. For most patients, it is the continuing deterioration of lung function that gradually becomes the limiting factor for physical capacity, but all patients with CF can perform some kind of physical activity and training. Definition Cystic fibrosis (CF) is the most common hereditary (autosomal recessive) and potentially deadly disease in the white population (1–3), but occurs in all races. A recent estimate of the incidence in Sweden was approximately 1/5600 infants (4) and the incidence in Norway is estimated to be about the same. Cystic fibrosis is a disease that attacks several organs in the body and is due to disorders in salt transport across cell membranes. CF affects the body’s exocrine glands (mucous and pancreatic glands), affecting the transport of sodium 22. cystic fibrosis 301 and chloride through the cell membrane, which in turn leads to very thick, sticky mucus (1–3). Disorders in the transport system of salt also affect the patient’s sweat, which contains high levels of salt. The diagnosis is made on the basis of clinical symptoms with the aid of a sweat test (1) and can now often be confirmed with gene analysis. Symptoms Symptoms present primarily in the lungs and gastrointestinal tract but may also occur in other parts of the body. The changed environment in the airways of the lungs leads to the mucociliary clearance system not working properly. Peripherally, that is, behind the “mucus plugs”, this creates a deoxygenated environment, which serves as a breeding ground for the bacteria chronically found in colonised CF lungs. Studies have shown that seemingly asymptomatic infants have signs of infection and inflammation already at 4–6 weeks of age. Most of these children become chronic carriers of one or more types of bacteria found in our environment that do not affect healthy individuals. Stagnated secretions, inflammation and chronic bacterial infections of the pulmonary airways are the most common symptoms (1, 3). Without treatment, the disease leads to malnutrition, chronic obstructive bronchitis, repeated cases of pneumonia and destruction of the lung tissue in the form of bronchiectasis, fibrosis and emphysema (1). This leads to escalating impairment of lung function, which in time can lead to respiratory insufficiency and cor pulmonale. At this point, lung transplantation is the only possible treatment option. The chronic obstruction can be caused by a number of different factors such as bronchial spasms, swelling of the mucous membrane, a collection of mucus and instability of the airways. In some patients there may also be an element of bronchial hyperresponsiveness or an asthmatic component (3). The risk of losing fitness, mobility and muscle strength increases as lung function deteriorates. Some patients also suffer from chronic infections and sinusitis. Spontaneous rib fractures can occur secondary to frequent coughing, as can problems with incontinence, especially in women, even in younger years. Herniation of the abdominal muscle wall or the groin can also occur. The obstructive respiratory pattern and pulmonary hyperinflation can lead to a stiff thorax, straining of the muscles used for inspiration and coughing, and rupturing of the intercostal muscles. Spontaneous pneumothorax can occur, as can haemoptysis, ranging from small harmless streaks of blood in the sputum to severe bleedings that require acute treatment. In the gastrointestinal tract, the viscous secretion of the pancreas inhibits normal secretion of digestive enzymes, resulting in malabsorption of fat and fat-soluble vitamins (3), which also leads to vitamin- and mineral deficiencies. Left untreated, malnutrition in the childhood years leads to stunted growth and in adults to increasing weight loss. An obstructive respiratory pattern and increased respiratory exertion, chronically activated immune defenses and constant inflammation of the mucous membrane of the airways causes great expenditure of energy (7–9). The increased consumption of energy combined with malnutrition leads to increasing muscle atrophy (10). Osteopenia (diminished bone density) occurs as early as the late teens, with some individuals also developing osteoporosis (11). With age, CF-related diabetes may develop (3). 302 physical activity in the prevention and treatment of disease The clinical picture varies considerably. The disease is progressive in nature and treatment is symptomatic but primarily preventive. The rate of progression is also individual and varies between different periods of life in the same individual. Treatment and its goals There is at present no treatment that will cure CF, but symptomatic treatment is being developed continually (2). The goal of treatment is to prevent destruction of the lung tissue and to slow the disease’s rate of progression by controlling symptoms and maintaining good physical function of the patient (12). Treatment includes both short- and long-term goals and involves active daily intervention. Achieving good compliance with treatment requires active support and ongoing education of patients and their families. The physiotherapist must be able to define immediate and long-range problems and needs, and be able to present these in a positive manner. In order to maintain lung function and physical capacity in the long term, a practical and motivated treatment therapy must be the goal for every individual. To achieve good compliance, the agreed-upon treatment must be followed up, reviewed and evaluated frequently. The patient and physiotherapist always arrive at such agreements together, with both parties equal participants and willing to compromise. This is an important requirement to be able to achieve a high level of compliance with daily treatment (13–16). The basic treatment aims at the following: • Nutritional status The impaired ability to absorb nutrients (malabsorption) is treated by adding digestive enzymes, energy-rich food, vitamins and minerals. Active supervision of nutritional status is crucial, as are different types of nutritional supplements where needed (12). • Lung function Inhalation of bronchodilators, mucolytic and anti-inflammatory drugs are often part of the treatment. Treatment to mobilise and clear the mucus from the airways helps to prevent stagnation of secreted mucus and mucus plugs, to keep all airways ventilated. The bacteria of chronically colonised airways cannot be eliminated, but the numbers can be minimised and the chronic inflammation caused by the infection held to a minimum. The bacteria growth is controlled in part by mucus mobilising treatment/ physical exercise and in part with antibiotics. CF treatment incorporates a generous amount of antibiotics, given in tablet form, intravenously or via inhalation, as decided by using subjective and objective parameters (12). 22. cystic fibrosis 303 The mucus mobilising portion of the treatment is very time-consuming. There are many different techniques today to loosen, transport and evacuate the viscous sputum from the airways (17). It is important to find a technique or combination of techniques that suits the particular individual. It is also important for people with CF to learn to control their cough, both to avoid urinary incontinence as well as for social purposes. In order to achieve optimal effect, the inhalation and mucus evacuation treatment for each individual should be planned strategically. The goal is for the treatment to be as gentle and effective as possible, from both a short- and long-term standpoint, in addition to encouraging the independence of the patient (13). • Fitness, mobility and strength Physical training is carried out to maintain good functional status and counteract loss of fitness, poor posture, and to reduce the risk of a stiff chest (12, 13, 17). How the training is carried out varies according to the individual’s age, symptoms, personality and interests. Treatment outcomes and prognosis Treatment concentrated to CF centres has shown good (2, 4, 12). Breathing exercises and physical training are considered the cornerstones of the treatment, along with medical treatment and nutritional supplements (5, 12, 17–23). Treatment outcomes have improved markedly in recent decades (2, 4). In Sweden, there are currently some 535 people between the ages of 0–65 years living with CF, half of whom are over 18 years. The corresponding figure for Norway is 260 people, where similarly more than half are over the age of 18 years. Recent estimates regarding the prognosis for children with CF born in 1991 or later is that 95 per cent will live to be more than 25 years old (4). Thus, CF is no longer only a childhood disease, but also a concern for adult medicine. With adequate treatment and good support, most people with CF can live a fulfilling life of a good quality well into their adult years. Many manage to maintain a good functional capacity and lung function. Despite poor lung function, others still have a good physical capacity. A survey study from 1998 showed that 75 per cent of adult CF patients who had finished school were working, and 39 (26 women and 13 men) had children (4). Effects of physical activity The objective of physical training for individuals with CF is to: • Stimulate the respiratory apparatus and intervene with resting respiratory patterns to increase the ventilation volume and/or distribution of the ventilation, and to stimulate mucociliary clearance and mobilise the mucus. • Maintain normal working capacity. A high level of fitness reduces the risk of worsening in connection with exacerbations (deterioration), and makes recovery easier. Despite poor lung function, fitness may be good. 304 physical activity in the prevention and treatment of disease • Maintain good mobility, primarily of the thorax (24). Mobility of the thorax, back and shoulders must be maintained in order to perform effective mucus evacuation therapy (16). Stretching tense structures is time-consuming, painful and often unpleasant – preventing stiffness is easier and much more pleasant. • Maintain good muscle strength. Strength training for the postural muscles helps to preserve mobility and avoid thoracic kyphosis. Good posture also helps patients to maintain the image of looking like everyone else, despite their advanced lung disease. • Avoid osteopenia and osteoporosis. • Improve/maintain good body awareness. • Learn to coordinate muscle contractions to avoid urinary incontinence in connection with coughing or other physical exertion. • Learn to distinguish between acceptable shortness of breath and abnormal dyspnoea and be able to manage these conditions. • Increase self-confidence (25). Strength and endurance of the peripheral skeletal muscles can be impaired in patients with lung disease (10). Both oxygen transport and energy metabolism in the muscle cells are worse than in healthy individuals for many reasons, including a change in the distribution of different types of muscle cells, a low capillary density, and biomechanical changes. Possible causes are the effects of chronic inflammation, malnutrition, hypoxia (decreased concentration of oxygen in the body’s tissues), hypercapnia (increased concentration of carbon dioxide in the blood), use of corticosteroids and low level of physical activity. Strength training that focuses on peripheral skeletal muscles has, however, shown to be effective. Improved oxidative capacity reduces the production of carbon dioxide, which in turn reduces respiratory need, dyspnoea and muscular fatigability . Physical activity affects both circulation and ventilation . Many individuals experience a mucus-mobilising effect in connection with activity. This effect can likely be attributed to the increased ventilation, both general and regional, increased tidal volume, increased rate of air flow and a temporary elevation of functional residual capacity (FRC) during physical exertion in individuals with obstructive pulmonary disease (28). Blocked airways are thus opened, and mucus dislodged and transported to larger airways. An increase in mucociliary clearance and positive biochemical factors such as less viscous mucus also likely play a role (29). During regular breaks in the physical activity, for example, in interval or circuit training, or after an exercise session, the loosened mucus may be evacuated. The combination must be stressed, however, in order to achieve mucus evacuation (13). This method of managing the mucus-mobilising part of treatment has been shown to be equally effective (18), and in certain cases more effective than other respiratory exercises, and is associated with the following advantages: • It is effective from a time standpoint as well, also providing fitness training, mobility training and training of muscle strength. • Anyone can take part as long as the objectives are maintained – not only CF patients benefit from physical exercise, which can improve compliance with the treatment. 22. cystic fibrosis 305 • It can easily be changed and adapted according to the severity of the disease, the individual’s interests and moods, location, weather, etc. • It is easy to “take with you” to school, work, on holidays, etc. • It can be done on one’s own and thereby gives independence. • It is, for the most part, stimulating and fun. A high level of fitness impacts both survival and quality of life, helps individuals with CF to function like others, and enables them to function at work and have a family (21–23, 30, 31). Patients with a well-functioning basic therapy can, however, not expect to see further improvement in lung function from the increase in physical exercise. For these individuals, unchanged lung function values in the long term are seen as a positive outcome. However, if the current “treatment package” is insufficient, improvements in lung function can be achieved when treatment is optimised. Improved work capacity thus depends on the frequency, intensity and duration of the exercise training, similarly as in healthy individuals. Prescription Physical activity and training is an established and important part of the daily treatment of CF today. Physical activity/training should be carried out during antibiotic treatment despite the presence of chronic infection. Physical activity/training can serve as a part in mucus-mobilising treatment to increase ventilation and loosen secretions ) and/or as a supplement to other therapies . Treatment plans are holistic and include different types of strength training, for the core muscles as well as large and small muscle groups in both the upper and lower extremities, and exercises for the pelvic floor. Individual adaptation and dosage Physical activity/exercise must be adapted to the individual. Factors of importance for the type and dosage relate firstly to age, nutritional and functional status, lung condition, with special regard to the degree of obstruction, amount of secretion, and presence of hyperresponsiveness or instability of the airways. Exercise training can have an impact on the acceptable intensity level and perceived dyspnoea, while these are also dependent on daily condition and personality. Finding an exercise regime that can be tolerated in the patient’s current state and is perceived as positive is essential to achieve a high level of compliance (16, 31). The need for pre-medicating with inhaled bronchodilation therapy should be evaluated, as well as the warm-up before exercise sessions, whenever treatment or the requirements and conditions for treatment change. For patients who desaturate (oxygen saturation decreases) during physical exercise, the need for providing oxygen during training should be evaluated in order to maintain a saturation of more than 90 per cent in the blood. This helps to reduce ventilatory and cardiovascular demands during training. An alternative can be to control the exercise intensity to maintain oxygen saturation over 306 physical activity in the prevention and treatment of disease 90 per cent (32). Many patients benefit from “pursed-lip” breathing to lower the respiratory level, increase the size of each breath, and thereby improve gas exchange in the lungs. Constant optimisation of the treatment in cooperation with the patient strengthens the daily routines. Close follow-up and evaluation is required to motivate the patient to comply with the treatment. Options for using physical activity/exercise as a part of mucus-mobilising therapy There are four main ways of using physical activity/exercise for patients with CF to mobilise mucus with a loose delineation between them (13, 14). The factors that determine the option chosen for a particular individual are mainly age, amount of mucus in the airways, lung function, possible complications, and what subsequently proves to be the most effective (15). The choices are: • Alternate dislodging, moving and evacuating of mucus with physical activity/exercise This option involves short intervals of physical activity/exercise to loosen the mucus and breaks between the intervals to assess the amount of secretion/expectorate the mucus. The intensity of the intervals should be tailored to the individual, with high intensity activities having proven to be effective. The breaks can include careful chest compression and manual coughing support for the very young, followed by specific coughing technique, huffing and coughing. • Dislodge the mucus during physical/exercise and move and evacuate it afterwards This option involves 30 minutes of individually tailored physical activity/exercise to loosen the mucus, followed by cycles of individually tested mucus-mobilising techniques to evacuate the mucus using specific coughing technique, huffing and coughing. • Dislodge, move and evacuate the mucus before physical activity/exercise This option is for patients with large amounts of mucus who have a need for individually tested mucus-mobilising treatment before physical activity/exercise. • Dislodge, move and expectorate the mucus while conducting endurance training This option involves patients with small amounts of mucus and slightly reduced lung function being able to take short breaks to assess and expectorate possible mucus. The short breaks need not necessarily affect the intensity. Physical activity/exercise can affect mucus-mobilisation by, for example, opening blocked airways and getting air in “behind” the mucus as well as increasing the breathing movements (respiratory pump) of the thorax. This helps to loosen and transport the mucus from the small airways into the larger ones. Physical activity/exercise combined with a specific coughing technique, huffing and coughing, is then used as a mucus-mobilising treatment option. This treatment option is often the first choice for children since it can be perceived as a natural approach when it comes to treatment. 22. cystic fibrosis 307 One or more test treatments should be carried out to evaluate the individual effect of the physical activity/exercise. Evaluation of the response and effect determines whether physical activity/exercise can be used as part of the mucus-mobilising treatment for that individual. The trial treatment should provide an answer regarding the level and type of physical activity/exercise that will contribute to the treatment and, based on this, needs, possibilities/limitations and dosage can be determined (13). Patients with CF perform inhalation and mucus-mobilising therapy 1–3 times per day according to their individual needs. Seemingly symptom-free patients are generally treated once a day. Physical activity/exercise is part of the main therapy. For patients with more pronounced symptoms, additional treatment sequences on the same day can comprise inhalation combined with other mucus-mobilising techniques. Age-related treatment plans Physical activity for very young children, age 0 to 1 year, comprise motor stimulation according to the child’s motor development and activation of motor reflexes. Positive stimulation and activation of reflexes is done in different body positions with the aim of influencing the breathing pattern, increasing the amount of inspired air, affecting the ventilation distribution, and increasing the demands on the respiratory apparatus. The flow of exhalation can be increased with careful chest compressions to loosen and transport the mucus to the central airways. The compressions must be carried out with appropriate force during exhalation with the aim of increasing the expiratory flow and enabling the child to prolong exhalation. The compressions must also follow the breathing pattern, frequency and exhalation movement. Mobilised mucus induces a coughing reflex and the force of the cough can be enhanced manually. All of these techniques require education and training as the dosage of force must be such that it does not give the opposite effect. From the age of 1 to about 4 years, the physical activity/training comprises chasing games and other active play. These games should also include fun “exercises” for strength and mobility. Those conducting the physical activity and exercise training with the children must learn what games are suitable. At 2–3 years of age many children can begin to lengthen exhalation and hold obstructed airways open by playing “blowing” games. The children are made aware of coughing and coughing technique. “Steaming up the mirror” can be used as a starting point for later learning the huffing technique. The chest compressions can then be replaced by specific coughing technique, huffing and coughing (14). In time, most 4- and 5-year-olds will be able to control their breathing technique, huff effectively, control the strength of their cough and achieve peak expiratory flow (PEF). At 5–10 years old, the physical activity/training can be scheduled as various gym games or as relays and obstacle courses. The training should include fun exercises for fitness, strength and mobility. Breaks in the training are used for cycles of specific coughing technique, huffing and coughing to move and evacuate the loosened mucus. Those who began physical activity early are now well-developed from a motor standpoint and win over their peers, siblings, parents, the physiotherapist and physician, which as a rule creates selfconfidence and is a good investment for future treatment. 308 physical activity in the prevention and treatment of disease After the age of 10 years, the physical training can be planned as circuit training with various content. A combination of low and high intensity exercises is recommended, often in the form of interval training. This training includes exercises to maintain mobility and strengthen the muscles of the thorax. Breaks in the training are used for cycles of specific coughing technique, huffing and coughing to move and evacuate the loosened mucus. This type of exercise can be alternated with running with an adult. Running gradually becomes popular with some people since it is perceived as the most time-efficient and “normal”. Running can be complemented with simple mobility and strength exercises. Specific coughing, huffing and coughing are done at the end when the exercising is finished. Physical training as a complement to mucus-mobilising therapy All individuals with CF can perform physical training of some type regardless of their symptoms. For those with normal or slightly reduced lung function, training schedules, including intensity, are the same as for healthy individuals. In order to achieve as wide an effect as possible, a combination of different types of training should be used. Both high and low intensity training should be used. An effective way to exercise oxidative capacity is to perform high intensity training in intervals of 30 seconds at maximal exertion and 30 seconds at rest, for 30 minutes, or perhaps 3 minutes of intensive exertion and 3 minutes of rest, for 3–5 repetitions. All-round strength training and mobility training should also be included. A good starting point for many people is to find, early on, a type of physical training that is also socially stimulating and that can be done with friends, such as playing football, field or ice hockey, bandy, horseback riding, jogging, Nordic walking, swimming, spinning, etc. This activity can then be complemented with strength and mobility exercises. Many patients choose to go with their friends, spouse or partner to fitness, aerobics or other exercise classes that offer aerobic, strength and flexibility training. For others, in-home exercise programmes using simple aids such as an exercise ball, Bobath ball, trampoline, exercise bike, weights, Thera-bands, wall bars, etc., may be a better option. The programme is planned by the physiotherapist in cooperation with the patient/parents. 22. cystic fibrosis 309 Table 1. Specialised training/physical activity for different stages of cystic fibrosis. Status Training Normal lung function/strength/flexibility. No restrictions. Regular aerobic fitness and strength training principles. Enjoyable sports activities. CF-specific mobility and strength training. Normal or slightly reduced lung function – FEV1* > 70% of expected value – oxygen saturation does not decrease during exertion. As above. Close follow-up. Moderately reduced lung function – FEV1* 40–70% of expected value – risk for desaturation at night and during exertion – possibly dependent on supplemental O2 during sleep High intensity interval training with long breaks, and low intensity training. Flexibility training, above all for back, chest and shoulders. Strength training, above all for postural muscles and pelvic floor. Evaluate need for supplemental O2 during training. Severely reduced lung function – FEV1* < 40% of expected value – high risk for desaturation at rest – evaluate 24-hour dependency on supplemental O2. High intensity interval training with shorter training intervals and longer breaks, and low intensity training. Flexibility training, above all for back, chest and shoulders. Strength training, above all for postural muscles and pelvic floor. Need for supplemental O2 during training. Respiratory insufficiency while awaiting lung transplantation. Light physical exercise. Flexibility training, above all for back, chest and shoulders. Adequate strength training, above all for postural muscles and pelvic floor. Requires supplemental O2 during training. * FEV1 = Forced Expiratory Volume in one second. There are many examples of adults with CF who have been able to take part in sports at a high level. It has also been shown that patients with CF can run a marathon with normal biochemical, metabolic and endocrinological response (36, 37). Special considerations Pronounced dyspnoea Patients must be trained to distinguish between acceptable shortness of breath and abnormal dyspnoea, and to manage their shortness of breath and to recognise dyspnoea that can lead to panic and anxiety early. Training intensity, equipment and aids should be adapted to the individual’s level of function and ability. Acute infection and fever Temporarily stop physical exercise and strength training that give rise to an increased heart rate. Flexibility training can still be carried out. 310 physical activity in the prevention and treatment of disease Nutritional status and energy balance In the case of malnutrition, physical activity/training contributes to further weight loss and muscle atrophy. The need for proper nutritional support combined with dosage of physical activity/training is assessed in cooperation with a dietitian/nutritional physiologist and physician, in order to build up muscle mass and muscle function (38). Asthma or bronchial hyperresponsiveness The need for pre-medication is assessed with a reversibility test, both at work and in connection with exertion. The test should be repeated when the symptom picture changes. Diabetes Patients with CF-related diabetes can experience a substantial drop in blood sugar during physical activity/training, which they must learn to manage in cooperation with the dietitian/nutritional physiologist and physician. Over-exertion All-round training is recommended to avoid over-exertion and to enable optimal function in day-to-day life. Decrease in oxygen saturation of the blood The need for supplementation is determined with the help of an oxygen saturation meter (SpO2). Oxygen saturation < 90 per cent, measured as SpO2, should be avoided. Training intensity and/or oxygen supplementation during training is determined in relation to SpO2. Joint problems and arthritis (joint inflammation) The need for alternative forms of training and relief is assessed. Reduced spleen or liver function Avoid physical activity/training that can lead to trauma to the abdomen/back. Salt and mineral deficiencies Excess sweating can result in symptoms of extensive loss of fluids and salts (39). Ample fluids and salt tablets should be administered for long sessions of high-intensity physical training. Haemoptysis In the case of minor symptoms (streaks of blood in the sputum or small bloody expectorations), stop the training session. In the case of massive haemoptysis (large amounts of coughed up blood), seek emergency medical attention. 22. cystic fibrosis 311 Pneumothorax In the case of sudden, increased dyspnoea and chest pain, pneumothorax may be suspected. Stop the training session and seek medical attention immediately. Functional tests Patients usually visit the clinic every six weeks, and every visit includes contact with the physiotherapist. In Sweden, meeting with the physiotherapist always includes at least one treatment session, where evaluation of the prescribed inhalation therapy, mucus-expectoration treatment and compliance occurs. A spirometric examination and functional tests are also conducted, in which chest flexibility, muscle strength and work capacity are followed up. Many also have an out-patient visit to the physiotherapist in between. Once a year an extensive lung function test is carried out, at a clinical physiology laboratory, which includes both static and dynamic volumes, as well as maximal exercise test (12, 40, 41). The treatment is continually adjusted to the measured outcomes and compliance. The testing programme in Norway includes spirometry at every visit to the clinic. The physiotherapist evaluates and follows up the different parts of the pulmonary physiotherapy, that is, mucus evacuation therapy and physical function, posture, work capacity and work tolerance. When necessary, the patient is referred to a specialist in manual therapy. Every or every second year, an extensive 3-day cross-disciplinary review is conducted, covering lung function exams and maximal exercise tests. Interactions with drug therapy Many patients use inhaled beta-2 agonists, which have a heart rate-increasing effect. This seldom has significance for the planning of physical training or its outcomes, but be known for the evaluations. Insulin has a blood glucose-lowering effect as does physical training. Consideration should be given to the balance between blood glucose-lowering effect and food intake, especially in intensive and/or extended training. In connection with lung transplantation CF is a chronic destructive disease whose progression cannot always be slowed despite intensive treatment. Lung transplantation may ultimately be the only remaining treatment option. In this case, physical training is of utmost importance so that the patient will be in optimal physical condition before this big operation. The training does not differ from that described earlier however (see Table 1). Even patients being treated with non-invasive ventilation should engage in physical exercise. For the period immediately post-lung transplantation, the physical training is different than for other intensive care patients. Even patients who need extended assisted ventilation 312 physical activity in the prevention and treatment of disease should perform physical training. The goal is to successively regain normal physical function. The physical training can then be carried out according to the usual principles. Maximal oxygen uptake (> 30 ml/kg/min) is seldom attained, however, despite normal lung function. Many patients are limited by accumulation of lactic acid, experienced as tiredness in the legs, due to changes in muscle metabolism. A few individuals have taken part in a marathon race (37). The lungs are large organs and therefore require large doses of immunesuppressing drugs. Despite the lungs being extremely vulnerable to the environment, the immune defense against bacteria remain intact. Patients may, however,be more susceptible to occasional infections.

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pratikwadekar2 · 4 years

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Oxygen Therapy Equipment Market Shows Strong Growth with Leading Players | Chart Industries Inc. (U.S.),Becton, Dickinson and Company (U.S.),Teleflex Incorporated (U.S.).

Oxygen Therapy Equipment Market is utilized for treating various sorts of respiratory illnesses because of its helpful palliative and supplementary part. It has turned into a vital component for precise management of different illnesses such as respiratory pain disorder,asthma, chronic obstructive pulmonary disease and many more.Advantages from oxygen therapy do enhance breathing pattern increase mental stamina and prevention from heart failure.

The Global Oxygen Therapy Equipment Market accounted to USD 2.61 billion in 2016 growing at a CAGR of 9.0%during the forecast period of 2017 to 2024. The upcoming market report contains data for historic year 2015, the base year of calculation is 2016 and the forecast period is 2017 to 2024.

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Competitive Analysis: Global Oxygen Therapy Equipment Market

Few of the major competitors currently working in Global Oxygen Therapy Equipment Market are Linde Healthcare (Germany),Invacare Corporation (U.S.),Philips Healthcare (Netherlands),Chart Industries, Inc. (U.S.),Becton, Dickinson and Company (U.S.),Teleflex Incorporated (U.S.),Smiths Medical (U.S.), Fisher & Paykel Healthcare Corporation Limited (New Zealand),Drägerwerk AG & Co. KGaA (Germany),Inogen, Inc. (U.S.),Messer Medical Austria GmbH (Germany),HERSILL, S.L. (Spain),GCE Holding AB (Sweden),Allied Healthcare Products Inc. (U.S.),Respan Products Inc. (Canada), and DeVilbiss Healthcare (U.S.) among others.

Key Pointers Covered in the Global Oxygen Therapy Equipment Market Trends and Forecast to 2026

Global Oxygen Therapy Equipment Market New Sales Volumes

Global Oxygen Therapy Equipment Market Replacement Sales Volumes

Global Oxygen Therapy Equipment Market Installed Base

Global Oxygen Therapy Equipment Market By Brands

Global Oxygen Therapy Equipment Market Size

Global Oxygen Therapy Equipment Market Procedure Volumes

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Global Oxygen Therapy Equipment Market Regulatory Framework and Changes

Global Oxygen Therapy Equipment Market Prices and Reimbursement Analysis

Global Oxygen Therapy Equipment Market Shares in Different Regions

Recent Developments for Global Oxygen Therapy Equipment Market Competitors

Global Oxygen Therapy Equipment Market Upcoming Applications

Global Oxygen Therapy Equipment Market Innovators Study

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Segmentation: Oxygen Therapy Equipment Market

On the basis of product, global oxygen therapy equipment market is segmented into oxygen source and delivery devices. Oxygen source is further segmented into concentrator and cylinder. Oxygen source equipment is expected to dominate the market in the forecast period 2017-2024 due to increasing incidence of respiratory disorders and technological advancements.

On the basis of portability, global oxygen therapy equipment market is segmented into stationary and portable.Stationary devices segment is expected to account the largest market in the forecast period due to respiratory disorders and increasing geriatric population.

On the basis of application,global oxygen therapy equipment market is segmented into chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis and pneumonia.

On the basis of end user,global oxygen therapy equipment market is segmented into hospital and home care.

On the basis of geography, global oxygen therapy equipment market report covers data points for 28 countries across multiple geographies such as North America & South America, Europe, Asia-Pacific, and Middle East & Africa. Some of the major countries covered in this report are U.S., Canada, Germany, France, U.K., Netherlands, Switzerland, Turkey, Russia, China, India, South Korea, Japan, Australia, Singapore, Saudi Arabia, South Africa, and Brazil among others. In 2017, North America is expected to dominate the market.

Major Market Drivers and Restraints:

Increasing prevalence of respiratory disorders,

Rise in geriatric population

Growth in technological advancement

Increase prevalence of tobacco smoking

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Complete and distinct analysis of the market drivers and restraints

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Research Methodology: Oxygen Therapy Equipment Market

Data collection and base year analysis is done using data collection modules with large sample sizes. The market data is analyzed and forecasted using market statistical and coherent models. Also market share analysis and key trend analysis are the major success factors in the market report. To know more please Request an Analyst Call or drop down your inquiry.

Demand Side Primary Contributors: Doctors, Surgeons, Medical Consultants, Nurses, Hospital Buyers, Group Purchasing Organizations, Associations, Insurers, Medical Payers, Healthcare Authorities, Universities, Technological Writers, Scientists, Promoters, and Investors among others.

Supply Side Primary Contributors: Product Managers, Marketing Managers, C-Level Executives, Distributors, Market Intelligence, and Regulatory Affairs Managers among others.

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supermarkettrends · 4 years

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Oxygen Therapy Equipment Market Shows Strong Growth with Leading Players | Chart Industries Inc. (U.S.),Becton, Dickinson and Company.

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Competitive Analysis: Global Oxygen Therapy Equipment Market

Key Pointers Covered in the Global Oxygen Therapy Equipment Market Trends and Forecast to 2026

Global Oxygen Therapy Equipment Market New Sales Volumes

Global Oxygen Therapy Equipment Market Replacement Sales Volumes

Global Oxygen Therapy Equipment Market Installed Base

Global Oxygen Therapy Equipment Market By Brands

Global Oxygen Therapy Equipment Market Size

Global Oxygen Therapy Equipment Market Procedure Volumes

Global Oxygen Therapy Equipment Market Product Price Analysis

Global Oxygen Therapy Equipment Market Healthcare Outcomes

Global Oxygen Therapy Equipment Market Cost of Care Analysis

Global Oxygen Therapy Equipment Market Regulatory Framework and Changes

Global Oxygen Therapy Equipment Market Prices and Reimbursement Analysis

Global Oxygen Therapy Equipment Market Shares in Different Regions

Recent Developments for Global Oxygen Therapy Equipment Market Competitors

Global Oxygen Therapy Equipment Market Upcoming Applications

Global Oxygen Therapy Equipment Market Innovators Study

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Segmentation: Oxygen Therapy Equipment Market

On the basis of application,global oxygen therapy equipment market is segmented into chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis and pneumonia.

On the basis of end user,global oxygen therapy equipment market is segmented into hospital and home care.

Major Market Drivers and Restraints:

Increasing prevalence of respiratory disorders,

Rise in geriatric population

Growth in technological advancement

Increase prevalence of tobacco smoking

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Key insights in the report:

Complete and distinct analysis of the market drivers and restraints

Key Market players involved in this industry

Detailed analysis of the Market Segmentation

Competitive analysis of the key players involved

Research Methodology: Oxygen Therapy Equipment Market

Supply Side Primary Contributors: Product Managers, Marketing Managers, C-Level Executives, Distributors, Market Intelligence, and Regulatory Affairs Managers among others.

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rootindiahealthcare · 5 years

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Smoking: causes damage to almost every organ in the body and is directly responsible for a number of diseases.

Every year, more than 9080,000 people die in the Globally due to tobacco-related diseases. That is around 1 in 5 of all deaths in the U.S. annually. It is estimated that 1 out of 2 smokers will die from a smoking-related disease. Smoking causes more deaths in the U.S. each year than the following combined: Alcohol use firearm-related incidents HIV illegal drug use motor vehicle incidents Smoking shortens the life of a male by about 12 years and the life of a female by around 11 years. Two poisons in tobacco that affect peoples' health are:

Carbon monoxide is found in car exhaust fumes and is fatal in large doses. It replaces oxygen in the blood and starves organs of oxygen and stops them being able to function properly. Taris a sticky, brown substance that coats the lungs and affects breathing. The impact of smoking: Brain Bones Heart and circulation Immune system Lungs Mouth Reproduction and fertility Skin Cancer Health risks associated with smoking Smoking affects many different areas of the body. Below, we cover each part of the body in turn: Brain Smoking can increase the likelihood of having a stroke by 2 to 4 times. Strokes can cause brain damage and death. One way that stroke can cause brain injury is through a brain aneurysm, which occurs when the wall of the blood vessel weakens and creates a bulge. This bulge can then burst and lead to a serious condition called a subarachnoid haemorrhage. Bones Smoking affects the bones as weakest & brittle, whereas especially this is dangerous for women, who are more prone to osteoporosis and broken bones.

Heart and circulation

Smoking causes plaque to build up in the blood. Plaque sticks to the walls of arteries (atherosclerosis), making them narrower; this reduces blood flow and increases the risk of clotting. Smoking also narrows the arteries, making it harder for blood to flow, as well as increasing blood pressure and heart rate. And chemicals in tobacco smoke increase the chance of cardiovascular disease & heart problems Some of the most common are: Coronary heart disease- narrow or blocked arteries around the heart. It is among the leading causes of death in the U.S. Heart attack- smokers are twice as likely to have a heart attack. Heart-related chest pain. Carbon monoxide & nicotine in cigarettes make the heart work difficult as harder and reduce the speed also. This means that smokers will find it more difficult to exercise. Even smokers who smoke 5 or fewer cigarettes a day can have early signs of cardiovascular disease. Immune system The immune system protects the body against infection and disease. Smoking compromises this and can lead to autoimmune diseases, such as Crohn's disease and rheumatoid arthritis. Smoking has also been linked to type 2 diabetes. Lungs Smoking can cause a variety of lung problems. Perhaps the most obvious part of the body affected by smoking is the lungs. This is also true that smoking can impact the lungs in a number of different ways. Primarily, smoking damages the airways and air sacs (known as alveoli) in the lungs. Sometime, lung disease caused by smoking can take years to become notice-able, this means it is often not diagnosed until it is quite advanced. It has been proved that so many lung and respiratory problems caused by smoking; below are three of the most common in the American population: Chronic obstructive pulmonary disease (COPD): This is a long-term disease that worsens over time. It causes wheezing, shortness of breath, and chest tightness. It is the third leading cause of death in the U.S. There is no treatment and or cure. Chronic bronchitis: This occurs when the airways produce too much mucus, leading to a cough. The airways then become inflamed, and the cough is long-lasting. In time, scar tissue and mucus can completely block the airways and cause infection. As yet there is no cure, but quitting smoking can reduce symptoms. Emphysema: This is a type of COPD that reduces the number of sacs in the lungs and breaks down the walls in between. This also destroys the ability of person to breathe well, even when resting. In the latter stages, it become dangerous commonly, patients often can only breathe using an oxygen mask. Sadly there is no cure, and it cannot be reversed or repaired. Other diseases caused by smoking include pneumonia, asthma, and tuberculosis. Mouth Smoking can cause bad breath and stained teeth, as well as gum disease, tooth loss, and damage to the sense of taste.

Reproduction and fertility

If female who smoke can find it more difficult to become pregnant. Women who smoke when pregnant increase a number of risks for the baby, including:

premature birth miscarriage stillbirth low birth weight sudden infant death syndrome infant illnesses Smoking can cause impotence in men because it damages blood vessels in the penis. It can also damage sperm and affect sperm count. Men who smoke have a lower sperm count than men who are non-smokers. Skin Smoking decreases the amount of oxygen that can reach the skin, which speeds up the aging process of the skin and can make it dull and grey. Smoking increase ageing problem as the skin by 10-20 years and makes facial wrinkling, particularly around the eyes and mouth, three times more likely. Cancer Smoking causes around 40% of all cancer deaths in the world. In the case of lung cancer, around 80% of all deaths are caused by smoking. Lung cancer is the main which leads cause of cancer death in both men and women; it is extremely difficult to reverse. You will be surprised by knowing that Tobacco smoke has around 7,000 chemicals in it, and around 70 of those are directly linked to causing cancer. As the lungs, smoking is also a risk factor for these types of cancer, among others: mouth larynx (voice box) pharynx (throat) oesophagus (swallowing tube) kidney cervix liver bladder pancreas stomach colon/rectum myeloid leukaemia Cigars, pipe-smoking, menthol cigarettes, chewing tobacco, and other forms of tobacco all cause cancer and other health problems. There is no safe way to use tobacco. Read the full article

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siva3155 · 5 years

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300+ TOP MEDICAL SCIENCE Objective Questions and Answers

MEDICAL SCIENCE Multiple Choice Questions :-

1) Regarding serratus anterior muscle which is incorrect? A. Multipinnate muscle B. Lifts arm above the shoulder C. Supplied by long thoracic nerve D. Originates from lower eight ribs Ans: D 2) The treatment of choice for atticoantral variety of chronic suppurative otitis media is: A. Mastoidectomy B. Medical management C. Underlay myringoplasty D. Insertion of ventilation tube Ans:A 3) All of the following are the complications in the new born of a diabetic mother except? A. Hyperbilirubinemia B. Hyperglycemia C. Hypocalcemia D. Hypomagnesemia Ans:B 4) The correct line of management in child who has swallowed a coin is? A. Fiber optic endoscopy B. Rigid endoscopy C. Laparotomy D. Wait and Watch Ans: D 5)Helper cells belong to? A. T cells B. Macrophages C. B cells D. Monocytes Ans:A 6)Mac Ewen's triangle can be felt through the? A. Superior conchae B. Cymba conchae C. Middle conchae D. Posterior part of auricle Ans:B 7)Most common strain of E.coil giving rise to traveller's diarrhoea is? A. Entero-invasive E.coil B. Entero-pathogenic E.coil C. Entero-toxigenic E.coil D. Entero-aggregative E.coil Ans:C 8)With urine turning green on ferric chloride test, the diagnosis is: A. Phenylketonuria B. Alkaptonuria C. Multiple carboxylase deficiency D. Glutaric aciduria Ans:A 9)For assessing the ability of protein utilisation the best index is? A. Urea B. Uric acid C. Blood ammonia D. Urinary nitrogen content Ans:D 10)Screening test is not useful when? A. Incidence of the disease B. Incidence is low in the community C. Early detection leads to favorable outcome D. The disease has a lead time Ans:B

MEDICAL SCIENCE MCQs 11)Nerve not related to humerus is? A. Radial B. Median C. Axillary D. Musculocutaneous Ans:D 12)What is the percentage of chances of hydatidiform mole to develop choriocarcinoma? A. 5% B. 15% C. 50% D. 80% Ans:B 13)Vasomotor reversal of Dale is because of? A. Block of alpha receptors B. Block of alpha & beta receptors C. Agonistic action on alpha receptors D. Adrenaline only Ans:A 14)Primary visual field is situated around the ______ sulcus? A. Central B. Calcarine C. Superior temporal D. Inferior occipital Ans:B 15)Medical treatment for BPH includes? A. Finesteride B. Methyl testosterone C. Oestrogens D. Osmic acid Ans:A 16)Anterior dislocation of shoulder causes all except? A. Circumflex artery injury B. Avascular necrosis head of humerous C. Brachial plexus injury D. Chip fracture scapula Ans:D 17)HIV is a? A. Retrovirus B. Flavivirus C. Oncovirus D. Arbovirus Ans:A 18)In shigella dysentery associated hemolytic uremic syndrome, the false statement is? A. Leucocytosis B. Neurological abnormalities C. Hepatic failure D. Thrombotic angiopathy Ans:C 19)Dengue hemorrhagic fever is caused by? A. Type I secrotype B. Re-infection with the same serotype of dengue virus C. Re-infection with the different serotype of the dengue virus D. Re-infection in immunocompromised host Ans:C 20)When the sample size is less than 30, one of the following modifications is made in the formula of standard deviation? A. Numerator is increased B. Denominator is decreased C. Both numerator and denominator are changed D. Numerator is decreased Ans:B 21)Oesophagus receives blood supply from all except? A. Inferior thyroid artery B. Inferior phrenic artery C. Internal mammary artery D. Bronchial artery Ans:C 22)All are pencillinase resistant except? A. Methicillin B. Nafcillin C. Penicillin D. Dicioxacillin Ans:C 23)Mild hemolyti anaemia is associated with vitamin.. . Deficiency? A. B6 B. E C. A D. C Ans:B 24)Trimethoprim acts by? A. Inhibiting DHFR B. Inhibiting cell metabolism C. Inhibiting DNA D. Inhibiting RNA Ans:A 25)Paradoxically split second heart sound signifies severe? A. Pulmonary stenosis B. Mitral stenosis C. aortic stenosis D. tricuspid stenosis Ans:C 26)Riboflavin nutritional status is assessed by? A. Xanthine oxidase levels in RBC's B. Glutathione reductase activation in RBC's C. Urine excretion of Riboflavin D. Cytochrome- C-reductase levels in kidneys Ans:B 27)Provision of free medical care to the people at government expense is known as? A. State medicine B. Social therapy C. Social medicine D. Social insurance programme Ans:A 28)Shortest sacrocotyloid diameter causing narrowing of pelvis is a feature of which type of maternal pelvis? A. Android B. Gynaecoid C. Platypelloid D. Anthropoid Ans:C 29)What is Bennett's fracture? A. Fracture dislocation of base of first metacarpal B. Fracture dislocation of base of first metatarsal C. Fracture of first metatarsal D. Fracture of first metacarpal Ans:B 30)All the following techniques are helpful in the diagnosis of haemoglobinopathies, except? A. Alkali denaturation test B. Cellulose acetate electrophoric C. Sickling test D. Osmotic fragility test Ans:D 31)Which of the following is not likely in patients taking amiodarone? A. Pulmonary fibrosis B. Hypothyroidism C. Hyperthyroidism D. Gynaecomastia Ans:D 32)Which of the following helps in preventing colon cancer? A. High fiber diet B. Selenium C. Antioxidants D. Fatty food Ans:A 33) Size of ovary, above which considered to be malignant? A. 2 cm B. 5 cm C. 8 cm D. 10 cm 34)Cadaveric spasm A. Instant in onset B. Confined to small group of muscles C. Occurs only in voluntary muscles D. All of the above Ans:D 35)The radionuclide used for ventriculography is A. Thallium B. Technetium C. Gallium D. Pottasium Ans:B 36)"Signet ring cells" are seen in? A. Carcinoma cervix B. Carcinoma endometrium C. Krukkenberg tumour D. Carcinoma vulva Ans:C 37)Cimetidine was synthesized by? A. Black B. Upjohn C. Lindsay D. Lilly Ans:A 38)Nutritional status of children between 0-4 years in a community can be assesed by all except? A. Mortality in 0-4 years B. Birth weight of less than 2.5 gm C. Maternal Hb D. Height and weight of all preschool children Ans:C 39)Pulmonary fibrosis in Bronchogenic carcinoma of lung may follow exposure to? A. Coal dust B. Silica C. Asbestos D. Bagasse Ans:C 40)Ejection fraction increases with? A. Decrease end-systolic volume B. Decrease end-diastolic volume C. Decreased peripheral resistance D. Venodilation Ans: A 41)Which is NOT visualized on posterior rhinoscopy? A. Eustachian tube B. Inferior meatus C. Middle turbinate D. Posterior border of nasal septum Ans:B 42)Which one of the following would cause a metabolic acidosis is with a normal anion gap? A. Renal tubular acidosis B. Acute renal failure C. Diabetic ketoacidosis D. Aspirin overdose Ans: A 43)All of the following organs contain aneurysm in polyarteritis nodosa except? A. Liver B. Lung C. Kidney D. Pancreas Ans: C 44)Diphtheria toxin acts by? A. Inhibiting Acetyl Choline release B. Inhibiting glucose transport C. Increasing levels of Cyclic AMP D. Inhibiting protein synthesis Ans:D 45)Smokeless gun powder is composed of? A. KMno4 B. HCN C. Nitrocellulose D. Sulphur Ans:C 46)Cetuximab (an EGFR antagonist) can be used in? A. Palliation in head and neck cancer B. Anal canal carcinoma C. Gastric cancer D. Small cell lung carcinoma Ans:A 47)The formula showing relations of pressure, thickness and radius? A. Laplace formula B. Ohm's law C. Pascal's law D. Poisseulle's formula Ans:A 48)Dapsone is useful for treating all except? A. Leprosy B. Dermatitis Herpetiformis C. Madura Foot D. Lymphoma Ans:D 49)The most important factor to overcome protein energy malnuntrition in children less than 3yrs is; A. Suply of subsidized food from ration shop B. Early supplimentation of solids in infants C. immunization to the child D. Treatment of anaemia and pneumonia in infant and toddlers Ans:B 50)The binding of 2,3 BPG to Hemoglobin is to? A. Carboxyterminal B. Amino terminal C. Sulphydryl groups D. None of the above Ans:B MEDICAL SCIENCE Objective type Questions with Answers 51)Dissociate anaesthesia is described with which of the following? A. Propofol B. ketamine C. Thipental D. Halothane Ans:B 52)In colour Doppler the colour depends upon? A. Strength of returning echo B. Relation of transducer to blood flow C. Frequency of Doppler used D. Type of Doppler machine used Ans:B 53)The commonest cause of breech presentation is: A. Prematuarity B. Hydrocephalus C. Placenta praevia D. Polyhydramnios Ans:A 54)Which of the following pathologic processes in an example of dysplasia? A. Actinic keratosis B. Chronic cystitis C. Chronic bronchitis D. Ulcerative colitis Ans:A 55)True regarding tubercular meningitis: A. Generally occurs as dissemination of a miliary tuberculosis B. The cranial nerves frequently are involved C. The most common affected leptomeninges are at the base of the brain D. Communicating and obstructive hydrocephalus cortical abscesses, and empyemas are very uncommon complications Ans:D 56)Haemostasis means? A. Coagulation B. Maintenance of electrolyte balance C. Sufficient hydration D. Arrest of bleeding Ans:D 57)The average coronary blood flow in human being at rest is _ % of cardiac output ? A. 4.5% B. 5-10% C. 10-15% D. 15-20% Ans:A 58)Rigor mortis first starts in? A. Upper eyelids B. Lower eyelids C. Lower limbs D. Fingers Ans:A 59)Madura foot is caused by? A. Blastomycosis B. Nocardia C. Candida albicans D. Tinea versicolor Ans:B 60)Population of 10000, birth rate 36 per 1000, 5 maternal deaths, the MMR is? A. 14.5 B. 13.8 C. 20 D. 5 Ans:B 61)Which of the following is not in WHO surveillance? A. Rabies B. Influenza C. Malaraia D. Varicella Ans:D 62)The cause of breech presentation are all except? A. Previous caesarean section B. Placenta previa C. Contracted pelvis D. Oligohydramnios Ans:A 63)True about minoxidil is? A. Increases hair growth B. Antihypertensive C. Both D. None Ans:C 64)Cold agglutinins are seen in? A. Mycoplasma pneumonia B. Psittacosis C. Legionella pneumonia D. TB Ans:A 65)No. of negative stools mandatory to release a case from isolation in typhoid? A. 3 samples same day B. 2 samples on first day and 1 sample on the second day C. 1 sample of first day and 2 samples on the second day D. 3 samples on 3 separate days Ans:D 66)The most specific feature of death due to hanging is? A. Tardieu spots B. Ligature mark C. Fracture of thyroid cartilage D. Dribbling of saliva Ans:D 67)Cauliflower ear is due to? A. Haematoma B. Carcinoma C. Fungal infection D. Herpes Ans:A 68)Following agents have effects on the NMJ, EXCEPT A. Curare B. Decamethonium C. Succinylcholine D. Hexamethonium Ans:D 69)Entamoeba, which is not found in gut? A. E.coli B. E.histolytica C. E.gingivalis D. E.nana Ans:C 70)most deaths involving placenta previa result from? A. Infection B. Toxemia C. Hemorrhage D. Thrombophlebitis Ans:C 71)Tympanic plexus is formed by? A. Tympanic branch of glossopharyngeal nerve B. Vagus nerve C. Facial nerve D. mandibular nerve Ans:A 72)Prolactin? A. Facilitates B. Prevents ovulation in lactating women C. In responsible for formation of corpus luteum D. Is responsible for progesterone secretion Ans:B 73)Herpes zoster involves? A. Otic ganglion B. Gasserian ganlion C. Geniculate D. Celiac ganglion Ans:B 74)In wolf- parkinson white syndrome, there exist a connection between atria and? A. Bundle of His B. Ventricles C. A-V node D. Purknje fibres Ans:B 75)Polyhydramnios is seen in all the following except: A. Diabetes B. Renal agenesis C. Esophageal atresia D. Hydronephrosis Ans:B 76)Following is the adjuvant for the treatment of nephrotic syndrome? A. levamisole as immunomodulant B. B.complex C. cyclosporin D. steroid Ans:D 77)Subarachnoid Haemorrhage is diagnosed by? A. Lumbar puncture B. CT scan C. MRI D. X-ray skull Ans:A 78)Disturbances of affect include all except? A. Panic B. Apathy C. Phobia D. Obsession Ans:D 79)Deep transverse arrest is seen in? A. Occipito-posterior position B. Occipito-anterior position C. Breech delivery D. Face presentation Ans:A 80)Kallu, a 25 yr male pt.presented with a red eye and complains of pain, photophobia ,watering and blurred vision. He gives a history of trauma to his eye with a vegetable matter. Corneal examination shows a dendritic ulcer. A corneal scraping was taken and A. Herpes simplex B. Acanthambea C. Candida D. Aeno virus Ans:B 81)Glass vessels and syringes are best sterilised by A. Hot air oven B. Autoclaving C. Irradiation D. Ethylene oxide Ans: A 82)Management of extradural hemorrhage is: A. Immediate evacuation B. Evacuation after 24 hrs C. Antibiotics D. Observation Ans:A 83)A Post- Thyroidectomy patient develops signs and symptoms of Tetany. The management is? A. I.v.Calcium gluconate B. Bicarbonate C. Calcitonin D. Vitamin D Ans:A 84)The most effective treatment in the early stages of trachoma is? A. Penicillin locally B. Choromycetin systemically C. Sulphonamides systemically D. Soframycin locally Ans:C 85)Ideal treatment of Tinosporidiosis is: A. Rifamipicin B. Excision with cautery at base C. Dapsone D. Laser Ans:B 86)Epithelium of cornea is? A. Pseudostratified B. Transitional C. Stratified squamous keratinized D. Stratified squamous non-keratinised Ans:D 87)Bagasosis can be prevented by spraying Bagasse with? A. 10% acetic acid B. 5% acetic acid C. 1% propionic acid D. 2% propionic acid Ans:D 88)Mc Ardles disease is due to the deficiency of? A. Glu 1 phosphatase B. Gluc1, 6 diphosphatase C. Gluc 6 phosphatase D. Myophosphorylase Ans:D 89) Satiety center in hypothalamus is regulated by? A. Gastric dilatation B. Blood glucose levels C. Blood insulin levels D. All of the above Ans:B 90)Coagulative necrosis is seen in all except? A. Myocardial infarction B. Burns C. Tuberculosis D. Zenker's degeneration Ans:D 91)The relationship between incidence and prevalence can be expressed as the? A. Product of incidence and mean duration of disease B. Divident of incidence and mean duration of disease C. Sum of incidence and mean duration of disease D. Difference of incidence and mean duration of disease Ans:A 92)In twin pregnancy, treatment of choice when first baby is in transverse lie is: A. Home delivery B. Cesarean section C. High forceps D. Low forceps after external rotation Ans:B 93)Coose among the following the most important lab finding in nephrotic syndrome? A. B-J protine B. hyperkalemia C. hypoalbuminemia D. hypertension Ans:C 94)Which statement is not true regarding Cryptic military Tuberculosis? A. X-ray diagnsis is possible B. It is seen in PEM Children C. Mntoux test is negative D. Leucocytosis is seen Ans:B 95)Commonest histology of carcinoma of endometrium is? A. Squamous cell B. Clear cell C. Adeno carcinoma D. Anaplastic carcinoma Ans:C 96)True regarding Felty's syndrome is all EXCEPT A. Splenomegaly B. Rheumatoid arthritis C. Neutropenia D. Nephropathy Ans:D 97)The true statement about Zenker's diverticulum is; A. It is outpouching of ant.pharyngeal wall above the cricopharyngeus muscle B. Barium swallow lateral view for diagnosis is the best investigation C. it is a true diverticulum D. it is congenital Ans: A 98)Which of the following statements about aging is true? A. Zoo animals have shorter lifespans than animals in their normal habitat B. All animal species have approximately the same lifespan C. Men are programmed to live longer than women. D. Identical twins have a natural lifespan of approximately similar duration Ans:D 99)Characteristic features of kwashiorkor include following EXEPT? A. Anorexia B. Flaky paint dematosis C. Hepatomegaly D. Splenomegaly Ans:D 100)Most common site of obstruction in gallstone ileus is? A. Colon B. Illeum C. Jejunum D. Duodenum Ans: B MEDICAL SCIENCE Questions and Answers pdf Download Read the full article

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healthcare00897 · 5 years

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Respiratory Syncytial Virus Diagnostics Market - North America and APAC Is Envisaged to Leverage Its Significant CAGR Gain

Respiratory Syncytial Virus (RSV) is responsible for many chronic conditions such as pneumonia, bronchitis, asthma, and respiratory disease. It primarily affects neonates, infants and adults and is responsible for outpatient visits, hospitalization and death in some cases. Therefore, diagnosis of RSV- associated diseases is crucial to avoid further medical severity.

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Symptoms of RSV presence include, rhinorrhea, cough, wheeze, respiratory distress, and hypoxemia. Molecular diagnostic is most widely used techniques for diagnosing RSV.

Respiratory Syncytial Virus Diagnostics Market - Market Dynamics

High prevalence of respiratory infections due to RSV is a major factor driving growth of the respiratory syncytial virus diagnostics market. According to a report by the Lancet, 2017, around 33·1 million episodes of RSV induced acute lower respiratory infections that resulted in around 3·2 million hospitalizations and around 59,600 in-hospital deaths in children younger than 5 years of age, worldwide, in 2015. Moreover, the report stated that the overall RSV- acute lower respiratory infections- related mortality was around 118200 in 2015.

Furthermore, high prevalence of several chronic conditions such as pneumonia and other respiratory tract infections due to RSV is a major factor contributing to growth of the market over the forecast period. For instance, according to a report by World Health Organization (WHO), May 2018, chronic obstructive pulmonary disease (COPD) and lower respiratory tract infection are amongst top five chronic diseases with highest mortality rate, worldwide. The report stated that around 3 million each deaths were registered due to COPD and lower respiratory tract infection in 2016, worldwide.

Respiratory Syncytial Virus Diagnostics Market - Regional Insights

On the basis of Geography, respiratory syncytial virus diagnostics market is segmented into North America, Latin America, Europe, Asia Pacific, Middle East, and Africa. North America is expected to be dominant in the respiratory syncytial virus diagnostics market over the forecast period.

According to study published in journal American Family Physician in 2017, around 2% to 3% of infants, younger than 12 months are hospitalized with an RSV infection, annually, in the U.S. As per same source, Around 57,500 hospitalizations and 2.1 million outpatient visits are associated with RSV infections in children younger than five years, annually, in the U.S. It can be concluded from epidemiological data that the U.S. has high potential for respiratory syncytial virus diagnostics market. Presence of key players and their products in North America would be another important driver for the market growth.

Asia Pacific and Latin America would witness highest CAGR in respiratory syncytial virus diagnostics market. According to study published in the Lancet in September 2017, lower middle income countries witnessed around 43,600 deaths due to RSV-ALRI whereas upper middle income countries witnessed around 17900 deaths, in 2015.

Furthermore, children in this region often do not receive adequate vaccination, which leads to frequent infection incidences from variety of diseases including RSV. According to World Health Organization (WHO) 2018, worldwide, around 86% of infants are vaccinated against 26 diseases. However, around 19.5 million children remain unvaccinated that leads to around 2-3 million deaths, annually, of which around 90% belong to low and middle income countries.

WHO is running the pilot projects of vaccination in countries of developing regions such Latin America, Africa, and Asia Pacific to achieve100% detection of the RSV infections amongst infants, neonates and children under five years of age.This is expected to reduce the mortality rate and hospitalization from RSV associated acute lower respiratory infections (ALRI). It would also establish RSV diagnostic centers over the forecast period in these regions.

Respiratory Syncytial Virus Diagnostics Market - Competitive Landscape

Key players operating in the respiratory syncytial virus diagnostics market include, F. Hoffmann La-Roche AG , Becton, Dickinson and Company, Novartis AG, Abbott Laboratories, Ortho Clinical Diagnostics, Thermo Fisher Scientific Inc., Bio-Rad Laboratories Inc., BioMerieux, DiaSorin SPA, Millipore-sigma, Quidel Corporation, Alere Inc., Coris BioConcept, Fast-track Diagnostics, and Quest Diagnostics.

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Moreover, the key players are focused on new product launches to expand their market share. For instance,

In October 2017, Abbott Laboratories completed acquisition of the Alere, Inc. which provides RSV diagnostic system such as ALERE i RSV.

Respiratory Syncytial Virus Diagnostics Market - Market Taxonomy

On the basis of diagnostic techniques, the global respiratory syncytial virus diagnostics market is segmented into:

Molecular Diagnostics

Direct Fluorescent Antibody (DFA) Method

Rapid Antigen Diagnostic Test

Monoclonal Antibodies

Flow Cytometry

Diagnostic Imaging

Immnunochromgraphic Assay

Gel Microdroplets

Others

On the basis of end user, the global respiratory syncytial virus diagnostics market is segmented into:

Hospitals

Diagnostic Centers

Commercial Radioisotope Manufacturers

On the basis of region, the global respiratory syncytial virus diagnostics market is segmented into:

North America

Latin America

Europe

Asia Pacific

Middle East

Africa

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#Respiratory Syncytial Virus Diagnostics MarketRespiratory Syncytial Virus Diagnostics trendsRespiratory Syncytial Virus Diagnostics growthRe

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myabhijitr · 5 years

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Respiratory Syncytial Virus Diagnostics Market- Size, Share, Outlook, and Analysis, 2018–2026

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In 2016, BD (Becton, Dickinson and Company) launched its wireless rapid diagnostic system named—Veritor Plus— for detection of respiratory syncytial virus (RSV), influenza A and B, and group A strep—with new traceability and secure patient-health record documentation features and functionality. In October 2017, Abbott Laboratories completed acquisition of the Alere, Inc. which provides RSV diagnostic system such as ALERE i RSV.

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#respiratory syncytial virus diagnostics market #respiratory syncytial virus diagnostics market size #respiratory syncytial virus diagnostics market share

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themoldguy-blog · 4 years

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The Asbestos of the 2000’s, Black Mold

What the CDC isn’t telling us, and what you can do about it.

In 1997, a surge of news reports were flooding the headlines regarding several rare deaths caused by mold illness. The CDC and the EPA both responded by shutting down the supposed conspiracy theories surrounding the suspicious causes of deaths. Years later, a flurry of reports came in regarding a similar string of deaths again citing mold toxicity. Yet these headlines are not getting the attention they should be.

It began in Cleveland, Ohio at Rainbow Babies and Children's Hospital. Dr. Dorr Dearborn noticed a pattern between infant patients and started piecing together what was causing their symptoms. At first glance, it seemed each patient’s lungs were bleeding for no apparent reason. Bleeding lungs afflict one in four million children, however, Cleveland was seeing one in every thousand babies affected.

That made the incidence rate in Cleveland the highest in the world. Seeing so many cases in one city, all clustered within a six-mile radius of Rainbow Hospital, convinced Dearborn that he had an epidemic on his hands.

"I knew the disease should only affect one in four million," Dearborn says. "So I called the CDC."

Ruth Etzel, the CDC's former chief of air pollution and respiratory health, was on a flight to Cleveland the next day. Dearborn saw two more cases in December, which brought the total number of impacted babies to ten. Records showed that some of the infants had improved in the hospital and been sent home, only to return after suffering subsequent bleeding episodes. This led the researchers to suspect an environmental problem in the home.

When the CDC revealed the supposed link of pulmonary hemosiderosis to black mold in the Morbidity and Mortality Weekly Report in January 1997, a virtual media panic descended on the city. The conducted study had found an association between the ‘black mold ‘Stachybotrys chartarum, also known as Stachybotrys atra, and the infant bleeding-lung disease. Dearborn would need to prove the mold caused the illness in laboratory research or show evidence of mold spores or toxins in the sick babies.

Etzel was researching mycotoxins, and turned up evidence that Stachybotrys had caused hemorrhaging in farm animals in Europe. She returned to Cleveland with a mycologist who found Stachybotrys in five case homes. The excessive rainfall in the summer of 1994 and recurrent plumbing problems contributed to the water damage sustained by some of the case homes, creating a favorable environment for Stachybotrys growth.

Investigators discovered that all the infants lived in homes older than sixty years, all of which had recent water damage. They found the case infants were more likely to live in homes with larger quantities of Stachybotrys chartarum and other molds than were the control infants.

Driven by concern for the public health and leaks to the press, Dearborn and Etzel went public with their findings in early 1995.

A number of other mold scares had been reported around the country. The Tottenville Branch Library on Staten Island, which had a particularly damp basement, was shut after a staff member had trouble breathing, and Stachybotrys was reportedly found. Panic began to spread and insurance companies joined in the pandemonium.

Fear of lawsuits caused schools, libraries, and other buildings across the country to be closed and cleaned, at great expense, when even small traces of Stachybotrys were found. The mold was responsible for closing a branch of the New York City Library in 1997 and chasing the American Red Cross out of its headquarters in Minneapolis earlier this month. A case in Texas made national headlines when a woman was awarded $32 million after she sued her insurance company because it didn't cover mold damage claims.Thousands of people were filing suits over toxic mold.

In 1997, the Centers for Disease Control (CDC) found an apparent link between mold contamination in the homes and cases of infant pulmonary hemorrhage.

Stachybotrys chartarum appears slimy and black, possibly with white edges. It looks like any black mold that grows in wet places.Stachybotrys requires water-soaked cellulose material and can produce toxins, called trichothecenes, which are highly dangerous to humans and have been used to produce chemical and biological weapons.

Once inhaled, the toxins are thought to attack the immune system. Studies have shown that adults who have had chronic exposure to Stachybotrys have reported a variety of ailments, including flu symptoms, dermatitis, and fatigue. The effect on infants, as suggested by the Cleveland study, seems much more severe, because their lungs are still developing. The Stachybotrys toxins may disrupt the development of the capillary walls, enabling any kind of stress factor, such as a simple cough, to cause the capillaries to rupture and the lungs to bleed.

One question, in particular, which researchers could not answer with any degree of certainty, has also become a chief criticism: Stachybotrys is common in water-damaged buildings throughout the country, so why has this cluster of rare, unexplained lung bleeding occurred only in Cleveland? The answer is, it wasn’t and it’s still ongoing.

One of the most troubling aspects of the controversy is the reluctance of the CDC to reveal any information about its review of the Cleveland study or its position on whether it still believes that unexplained pulmonary hemosiderosis is linked to the black mold. The CDC did not set up interviews with any of its staff experts, despite repeated calls to the agency's press office over a two-week period and discussions with three different spokespeople. Calls to CDC epidemiologist, who was reportedly on the review committee, were not returned.

In 2002, the U.S. International Trade Commission reported that according to one estimate, US insurers paid over $3 billion in mold-related lawsuits, more than double the previous year's total. According to the Insurance Information Institute, in 2003 there were over 10,000 mold-related lawsuits pending in US state courts. Most were filed in states with high humidity, but suits were on the rise in other states as well. By 2004, many mold litigation settlements were for amounts well past $100,000. In 2005, the U.S. International Trade Commission reported that toxic mold showed signs of being the "new asbestos" in terms of claims paid. However, in 2007 laws began to change.

Farmers Insurance, for instance, has said that it will stop selling new homeowner's policies that include water-damage coverage. In addition, it has asked the Department of Insurance to allow the company to exclude mold damage from its policies entirely, even mold that results from a covered event.

23 years later, deaths and cover-ups are still ongoing. Mysteries seem to stir around the investigations started, the findings and conclusions of the mold epidemic.

Respiratory disorders are the most common of all mold illnesses. That’s because tiny mold spores easily become airborne and then can be inhaled by anyone in the vicinity. Some of the lung problems caused by mold, other than pulmonary hemorrhage, include:

Shortness of breath

Wheezing

Coughing

Respiratory infections, including pneumonia and bronchitis

Hypersensitivity pneumonitis (a lung disease similar to bacterial pneumonia)

Worsening of symptoms in people with asthma

Development of asthma-like symptoms in people not previously diagnosed with the condition

Other Mold Illnesses

Other health problems sometimes caused by exposure to household mold include:

Headaches, migraines

Chronic sinus infections

Allergic reactions

Sore throat

Runny nose or stuffed up nose

Red, itchy, watery eyes

Skin rashes

Chronic fatigue

Depression

A flood of reports trickle through media and then fall in between cracks just like the initial 1997 reports from Dr. Dearborn. Cases of severe lung infections, damages, personal injury, pulmonary hemorrhages, and even death have been ongoing.

In 2003, a physician whose name remains anonymous released her case that connected mold and pulmonary hemorrhage.

In 2001, a jury awarded a couple and their eight-year-old son $2.7 million, plus attorney’s fees and costs, in a toxic mold-related personal injury lawsuit against the owners and managers of their apartment in Sacramento, California.

In 2003, The Tonight Show co-host Ed McMahon received $7.2 million from insurers and others to settle his lawsuit alleging that toxic mold in his Beverly Hills home made him and his wife ill and killed their dog. That same year environmental activist Erin Brockovich received settlements of $430,000 from two parties and an undisclosed amount from a third party to settle her lawsuit alleging toxic mold in her Agoura Hills, California, home.

In 2004, the Institute of Medicine released a report finding evidence of a link between certain species of mold exposure and severe respiratory illnesses. A later review of research conducted by the World Health Organization reached the same conclusion, and called attention to findings that mold exposure appears to lead to an increase in the chances of children developing and dying from asthma.

In 2006, a Manhattan Beach, California family received a $22.6 million settlement in a toxic mold case. The family had asserted that that moldy lumber had caused severe medical problems in their child. That same year, Hilton Hotels received $25 million in settlement of its lawsuit over mold growth in the Hilton Hawaiian Village's Kalia Tower.

In 2010, a jury awarded $1.2 million in damages in a lawsuit against a landlord for neglecting to repair a mold-infested house in Laguna Beach, California. The lawsuit asserted that a child in the home suffered from severe respiratory problems for several years as a result of the mold.

In 2011, in North Pocono, Pennsylvania, a jury awarded two homeowners $4.3 million in a toxic mold verdict.

Between October 2014 and January 2017, five mold-infection-related deaths occurred at two UPMC hospitals. Several related lawsuits have been filed against the hospital system, which settled with two of the patients for $1.35 million each.

In 2019, Months after a mold infection killed a pediatric patient at Seattle Children's Hospital, its CEO has revealed that fourteen patients have become ill from the same infection since 2001. The hospital shuttered eleven operating rooms twice, first in May and again this month, after it detected the common mold Aspergillus in the air. As of February 2020, seven of the fourteen patients have passed away.

Mold exposure represents a major public health issue worldwide. Yet, the CDC still states that mold is not serious and should not be tested.

According to the World Health Organization, 7 million deaths per year are linked to indoor and outdoor air pollution. For years, people complaining about the effects of living or working in damp, mold-filled environments has not been taken seriously. Nothing is scarier than knowing something is making you and your family sick, and not being able to figure out what it is. The anxiety caused by an unseen danger like toxic mold can feel overwhelming.

There is currently no standard for indoor air quality, meaning, there’s no safe and unsafe levels of mold. Both the EPA and the CDC advise against testing seemingly because they are unwilling to set a baseline of limitations for indoor mold that can affect insurance companies bottom lines. It’s time for both of these organizations to change this.

The CDC needs to reopen it’s investigation and reconsider this as a serious public health concern. To put an end to these preventable deaths the following link is a petition to for the Centers for Disease Control and Prevention to finally set a federal standard for indoor molds in medical facilities.

Please sign this petition if you want to have indoor air quality standards.

[See a history of publications: History Of Mold 1837 - 2001]

Source:

Sprouse A. Integrative Sexual Health, Chapter 10, Toxins: A Pervasive 21st-Century Problem for Health and Sexuality. Oxford University Press. March 14, 2018. (Sprouse treatment: mold avoidance, infusions of intravenous nutrients, sauna detoxification, heavy metal chelation).

U.S. Army Medical Research and Development Command, with the College of Veterinary Medicine, University of Illinois. Toxicologic and Analytical Studies with T-2 and Related Trichothecene Mycotoxins (3-year study on the inhalation effects of mycotoxins). August 20, 1985, Contract No. DAMD17-82-C-2179.

World Health Organization (WHO). WHO Guidelines for Indoor Air Quality – Dampness and Mould. http://www.who.int/indoorair/publications/7989289041683/en/. Published 2009.

Ammann HM. Indoor Mold Contamination--a Threat to Health? J Environ Health. 2002;64(6):43.

Ammann HM. Indoor Mold Contamination--a Threat to Health? Part Two. J Environ Health. 2003 Sep 1;66(2):47.

Daschner A. An Evolutionary-Based Framework for Analyzing Mold and Dampness-Associated Symptoms in DMHS. Front Immunol. January 2017;7(672). https://doi.org/10.3389/fimmu.2016.00672.

McMahon SW, Hope JH, Thrasher JD, Rea WJ, Vinitsky AR, Gray MR. Global Indoor Health Network (GIHN). Common Toxins in Our Homes, Schools and Businesses. December 17, 2012. (This 2012 position statement by GIHN has been replaced with new papers on individual topics.)

International Society for Environmentally Acquired Illness (ISEAI). https://iseai.org.

Weblinks:

https://realtimelab.com/mold-statistics/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC145304/

https://www.aafp.org/afp/2005/1001/p1253.html

https://www.cdc.gov/mold/pdfs/hemorrhage_report.pdf

http://www.asthmacommunitynetwork.org/system/files/webinar/pdf/HHDeck_3_18_13.pd

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC145304/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1566217/pdf/envhper00520-0107.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1566692/pdf/envhper00516-0113.pdf

https://academic.oup.com/toxsci/article/84/2/408/1692272

https://www.everydayhealth.com/columns/health-answers/mold-and-a-misdiagnosis-that-could-leave-you-breathless/

#black mold #hospital #seattle childrens hospital #mold death

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coolluminaryland-blog1 · 5 years

Text

Sepsis Diagnostics Market to Witness Exponential Growth by 2024

Sepsis can be defined as the body’s reaction to the fungal, bacterial, viral, or parasitic infection, which may further lead to systemic inflammatory reaction and organ dysfunction or organ failure. Depending on severity of infection, sepsis is classified into three types: sepsis, severe sepsis, and septic shock. Severe sepsis is associated with organ dysfunction and acute alteration in mental status, while septic shock is defined as severe sepsis with signs of abnormalities in cellular metabolism and dangerously low blood pressure and organ dysfunction, which is considered to be medical emergency.

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Sepsis is one of the most common causes of death in hospitalized patients. According to data revealed by the Centers for Disease Control and Prevention, sepsis affects around 800,000 people in the U.S. each year and it is the ninth leading cause of disease-related deaths in North America. Death can be as a result of hypotension, organ failure, high heart rate, and extreme body temperatures or due to a combination of these. Sepsis affects different populations in different manner according to race, age, severity of infection, ethnicity, etc. It is more common in the elderly and infants. According to UNICEF and WHO report (2012), severe cord sepsis was one of the top three causes of newborn death worldwide, causing 13% neonatal deaths.

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Major factors driving the growth of the global sepsis diagnostics market are rising prevalence of different antibiotic resistant bacterial strains, aging population, increasing health care awareness and health care expenditure. Furthermore, rising number of surgical procedures and increase in the number of product approvals for diagnosis of sepsis are expected to support the growth of the global sepsis diagnostics market in the near future. High incidence of hospital acquired infection is the major factor accelerating the growth of the global sepsis diagnostics market. According to the Centers for Disease Control and Prevention (CDC) (2011), approximately 1.7 million HAIs from all types of bacteria combined are reported in the U.S. each year. In addition, according to the ECDC estimates, around 4.1 million patients were diagnosed with HAI in Europe (including 30 nations) in 2013. However, lack of standard protocols and shortage of skilled staff in developing countries is hampering growth of the sepsis diagnostics market.

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The global sepsis diagnostics market has been segmented based on technology, product, pathogen type, end-user, and region. In terms of technology, the global sepsis diagnostics market has been segmented into molecular diagnostics, microbiology, immunoassay, and flow cytometry. The molecular diagnostics segment is expected to hold the largest share of the market. Increasing need of quick and accurate results and technological advances in molecular diagnostics field are expected to fuel the growth of the segment during the forecast period.

Based on product, the global sepsis diagnostics market has been divided into instruments, assay and reagents, software, and others. The assays and reagents segment is expected to dominate the global sepsis diagnostics market in terms of revenue in the near future. High share of the segment is attributed to increasing usage of assays, along with rising number of product approvals for marketing and commercialization globally.

In terms of pathogen type, the global sepsis diagnostics market has been segmented into bacterial sepsis, viral sepsis, fungal sepsis, and others. The bacterial sepsis segment dominated the global sepsis diagnostics market and this trend is expected to continue during the forecast period. Rise in cases of bacteria caused hospital-acquired pneumonia, bloodstream infections, and urinary tract infection is attributed to the highest share of the segment. Based on end-user, the global sepsis diagnostics market has been segmented into hospitals, specialized clinics, outpatient surgical centers, diagnostic centers, and pathology laboratory.

In terms of region, the global sepsis diagnostics market has been segmented into five key regions: North America, Europe, Latin America, Asia Pacific, and Middle East & Africa. North America dominated the global sepsis diagnostics market in terms of revenue, while Asia Pacific dominated the market in terms of volume. Increasing cases of neonatal umbilical cord sepsis in India, Pakistan, and China are creating significant opportunities in the sepsis diagnostics market in APAC. According to a study by Mullany et al., Nepal revealed 16% prevalence of cord infection, also around six percent, 0.521 million deaths occurred in five countries of India, Nigeria, Democratic Republic of Congo, Pakistan and China in the year of 2008.

Key players in the global sepsis diagnostics market are Thermo Fisher Scientific, Inc., Luminex Corporation, Becton, Dickinson and Company, Abbott, Cepheid, T2 Biosystems, Inc., Roche Diagnostics Limited, and Bruker.

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timclymer · 5 years

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The Truth About Tobacco and Marijuana

WHAT ARE THEY?

Substances

Are non food, mood-altering substances that are not deemed medically necessary but that are used in an effort to escape from the problems of life, to get a dreamy feeling, or a sense of well-being or of elation.

Tobacco-An addictive substance containing toxic substances with temporary harmful effects when ingested into the body. Tobacco contains thirty different substances such as nicotine, arsenic, alcohol and ammonia. Nicotine is one of the oldest, the most widely used, and, in the same amounts, stronger and more addictive than cocaine. The euphoric effect of nicotine is the same as morphine and cocaine.

According to one researcher, “tobacco contains as nice a collection of poisons as you will find anywhere. The tobacco used in pipes and cigars contains more nicotine, more cancerous tars, and produces more dangerous carbon monoxide gas than that used in cigarettes.

Marijuana (also known as pot, reefer, grass, ganja, or weed) has been the focus of much controversy among experts.

Marijuana is a drug prepared by drying the leaves, flowering tops, stems and seeds of the hemp plant known as Cannabis sativa. Here, the name sometimes used for it- ‘Cannabis’ Its common name is "pot.” In India it is called bhang. Hashish is another form of cannabis, made from the resin of the plant and usually pressed into the form of blocks or chunks of varying potency. Hashish and an oil made from it are greater strength than marijuana.

For one thing, marijuana is extremely complex; a marijuana cigarette contains over 400 chemical compounds in its smoke. It took doctors over 60 years to realize cigarette smoke causes cancer. It may likewise take decades before anyone knows for sure just what marijuana’s 400 compounds do to the human body.

Marijuana smoke, like the smoke from tobacco, consist of a number of toxic substances, such as tars which are only soluble in fat and stored in body tissues, including brain, for weeks and months, like DDT. The storage capacity of tissues for these substances is awesome-which explains their slow deleterious effects in habitual smokers.

WHY TAKE IT?

-Some take these substances to escape from their problems: Failure to develop the skills needed for coping with problems may indeed force an individual to smoking. -To satisfy curiosity -To ease depression or boredom -Peer pressure -For the pleasure of it- -To be with the crowd-to feel, cool, grown-up, sophisticated. -By smoking, teenagers feel independent, whereas they are capitulating to peer pressure.

CONTRIBUTING FACTORS

-The quality of family life or rather the lack of it may affect whether young people take it or not -Family breakdown (divorce and separation); Eighty percent of drug addicts have serious family problems. They come from a very repressive or a very permissive family or from a home without a father. “ -Emotional conflicts: awareness is an emotionally turbulent period; hence young ones take drugs to escape the turbulence -Substance abusers are also being manipulated by the tobacco companies. The companies know that their future is with the youth. If youths can make addicts in their teens, they will likely be good customers for life.

WHAT EFFECTS?

Vascular- Researcher have further linked smoking with the hardening and general deterioration of small arms. The doctor concluded. Smoking damages these particular sections and makes their walls stiff. So when a pulse of blood comes down, the vessel can not expand (to ease its passage). That would happen in old age anyway, but it happens twice as fast in smokers. ”

Blood – Cigarette smoking causes immediate and worsening changes in teens’ blood, the kind of changes that lead to early artery problems and heart disease.

Hearing – Smoking poses a “special risk of hearing loss” for “people who work or live in high-noise-level environments.” normal “than that of non smokers.

Skin – Smoker’s Face- Many doctors believe that smoking may make a person’s facial skin look older. The faces of smokers and non-smokers are not very different at age 30. But by 40 and 50 the differences are obvious.

Tooth and bone loss- Smoking is one of the largest factors in teeth loss. Smokers sufferers a greater incidence of tooth and bone loss. They also had a great build-up of plaque and tartar, which collect on the teeth and contribute to gum disease and decay. Smoking causes constriction of the blood vessels in the gum tissue, thus reducing the circulation and speeding up the disease process. ”

Heart- Cigarette smoking as the cause of a rare but lethal heart disease named cardio-myopathy. This disease weakens the whole heart muscle, thereby inhibiting proper blood circulation. The result is ever heart failure.

Respiratory-Smokers have a much higher risk of pulmonary complications than surgery than do non-smokers. These include lung collapse and infections leading to such diseases as pneumonia. Some suffer sore throats from smoking cannabis while others suffer from bronchitis. Marijuana users were also found to have bronchial lesions characteristic of the early stages of cancer.

Nervous- Marijuana is damaging to the brain, damaging mental functions, even when a person is not under its immediate influence. It can be said with confidence that marijuana produces acute effects on the brain, including chemical and electrophysiological changes. “Although at present, there is no comprehensive proof that marijuana permanently damages the brain. to "the golden bowl” should not be dismissed lightly.

Marijuana is known “to cause birth defects when administrated in large doses to experimental animals.” Whether it has the same effects on humans is that far unproved. It should be remembered, though, that birth defects (such as the one caused by the hormone DES) often take years to manifest themselves. So, what the future holds for the children-and grandchildren-of marijuana smokers remains to be seen.

Cancer- Tobacco causes cancer in the cheeks, gums, and throat. These finds do not surprise experts. One study notes: “Snuff has the highest level of cancer-causing agents of any product taken into the body.” No wonder that “long-term snuff users have a 50% greater risk of developing oral cancer than nonusers.

For example, those who regularly chew or dip can get cracked lips, stained teeth, bad breath, and sore gums-nothing to smile about. In addition, their ability to taste and smell decreases while their heartbeat and blood pressure increase.

Whether one chew or suck on moist snuff held between cheek and gum (called dipping), oral cancer, gum disease, and nicotine addiction are inevitable consequences. Cancer develops where the tobacco touches cheek and gum, and the malignancy often spreads to other parts of the body. Smokeless tobacco contains 20 or more cancer-causing nitrosamines and polycyclic aromatic hydrocarbons.

Nutritional-Smoking destroys the vitamin C that a person takes in from food and drink. Nicotine decreased the ascorbic acid (vitamin C) content of the blood by 24 to 31 percent. Thus smokers are in much greater need of this essential vitamin. This explains why those who smoke generally are more prone to infections than those who do not. For example, smokers are more likely to catch the flu during an epidemic and they usually have it worse than non-smokers. Marijuana produces lower resistance to disease, as well as damage to chromosomes and genes.

Reproductive-Marijuana use has been addressed in lower levels of male sex hormones, which has produced problems related to the male reproductive system

Fetal damage- Smoking during pregnancy damages fetal arteries. This damage is evident with the high incidence of congenital malformations, low birth weights and premature separations among infants of women who smoke.

Even father’s smoking may harm fetus. Studies show that when a non-smoking pregnant woman is exposed to the cigarette smoke of other people [such as the father], the fetal blood contains significant amounts of tobacco smoke by-products.

Infants- because the brain’s barrier to drugs and the liver, which detoxifies nicotine, are less well developed in infants than in adults, passive smoking is particularly harmful to them. Damages could range from aversion to certain foods, due to nausea caused by tobacco smoke, to sudden infant death syndrome.

Tobacco Hinders Sleep and Memory- Smokers generally find it harder to sleep than non-smokers do, and sleep habits of smokers who suddenly quit dramatically according to researchers.

Life expectancy-Smoking-related diseases are important causes of disability and premature deaths. And as regards cigarette-related fires, not a few of the deaths and injuries in residential fires is started by smoldering cigarettes.

Social effects

Accidents- Driving a car under the influence of marijuana can be every bit as dangerous as driving under the influence of alcohol. Not surprisingly, drug users are also three or four times more likely to be involved in accidents at work.

Home- Parents who are distracted by their craving for drugs rarely provide their children with a stable home life. Infant-parent bonding-so vital during the first weeks of a child’s life-can even be inhibited. Many children who grow up in this environment take to the streets or even get involved in drugs themselves.

Employment- Addicted individuals frequently get into debt or may end up losing their jobs either due to absenteeism, truancy or negligence.

Physical Abuse- Drug abuse can also lead to physical abuse-of the minor or of the children. Cannabis especially when combined with alcohol can provoke violent behavior in a person who may otherwise be quite gentle.

Effect on Others – More than ten studies last year showed that passive smoking-inhaling the smoke from the cigarettes of others-caused lung cancer in the non-smoking spouses of smokers. Research indicates that "spouses of smokers are two or three times more likely to get lung cancer than those of non-smokers.” One study “estimated that passive smoking in the United States causes more cancer deaths than all regulated industrial air pollutants combined.

Children with parents who smoke have more colds, influenza, bronchitis, asthma, and pneumonia. Learning ability is damaged in children of mothers who smoke. In India, 39 percent of the women chew tobacco. Underweight babies are the result.

Society- A far greater cost, however, is the social damage drugs do to the community. No price could be put on the disintegration of so many families, the abuse of so many children, the corruption of so many officials, and the premature death of so many people.

Source by Okesola Josiah

from Home Solutions Forev https://homesolutionsforev.com/the-truth-about-tobacco-and-marijuana-2/ via Home Solutions on WordPress from Home Solutions FOREV https://homesolutionsforev.tumblr.com/post/184857396160 via Tim Clymer on Wordpress

#Home Solutions FOREV

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pratikwadekar2 · 4 years

Text

Oxygen Therapy Equipment Market Shows Strong Growth with Leading Players | Chart Industries Inc. (U.S.),Becton, Dickinson and Company (U.S.),Teleflex Incorporated (U.S.).

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Competitive Analysis: Global Oxygen Therapy Equipment Market

Key Pointers Covered in the Global Oxygen Therapy Equipment Market Trends and Forecast to 2026

Global Oxygen Therapy Equipment Market New Sales Volumes

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Global Oxygen Therapy Equipment Market Procedure Volumes

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Global Oxygen Therapy Equipment Market Shares in Different Regions

Recent Developments for Global Oxygen Therapy Equipment Market Competitors

Global Oxygen Therapy Equipment Market Upcoming Applications

Global Oxygen Therapy Equipment Market Innovators Study

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Segmentation: Oxygen Therapy Equipment Market

On the basis of application,global oxygen therapy equipment market is segmented into chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis and pneumonia.

On the basis of end user,global oxygen therapy equipment market is segmented into hospital and home care.

Major Market Drivers and Restraints:

Increasing prevalence of respiratory disorders,

Rise in geriatric population

Growth in technological advancement

Increase prevalence of tobacco smoking

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homesolutionsforev · 5 years

Text

The Truth About Tobacco and Marijuana

WHAT ARE THEY?

Substances

According to one researcher, "tobacco contains as nice a collection of poisons as you will find anywhere. The tobacco used in pipes and cigars contains more nicotine, more cancerous tars, and produces more dangerous carbon monoxide gas than that used in cigarettes.

Marijuana (also known as pot, reefer, grass, ganja, or weed) has been the focus of much controversy among experts.

Marijuana is a drug prepared by drying the leaves, flowering tops, stems and seeds of the hemp plant known as Cannabis sativa. Here, the name sometimes used for it- 'Cannabis' Its common name is "pot." In India it is called bhang. Hashish is another form of cannabis, made from the resin of the plant and usually pressed into the form of blocks or chunks of varying potency. Hashish and an oil made from it are greater strength than marijuana.

WHY TAKE IT?

CONTRIBUTING FACTORS

-The quality of family life or rather the lack of it may affect whether young people take it or not -Family breakdown (divorce and separation); Eighty percent of drug addicts have serious family problems. They come from a very repressive or a very permissive family or from a home without a father. " -Emotional conflicts: awareness is an emotionally turbulent period; hence young ones take drugs to escape the turbulence -Substance abusers are also being manipulated by the tobacco companies. The companies know that their future is with the youth. If youths can make addicts in their teens, they will likely be good customers for life.

WHAT EFFECTS?

Blood – Cigarette smoking causes immediate and worsening changes in teens' blood, the kind of changes that lead to early artery problems and heart disease.

Hearing – Smoking poses a "special risk of hearing loss" for "people who work or live in high-noise-level environments." normal "than that of non smokers.

Skin – Smoker's Face- Many doctors believe that smoking may make a person's facial skin look older. The faces of smokers and non-smokers are not very different at age 30. But by 40 and 50 the differences are obvious.

Nervous- Marijuana is damaging to the brain, damaging mental functions, even when a person is not under its immediate influence. It can be said with confidence that marijuana produces acute effects on the brain, including chemical and electrophysiological changes. "Although at present, there is no comprehensive proof that marijuana permanently damages the brain. to "the golden bowl" should not be dismissed lightly.

Marijuana is known "to cause birth defects when administrated in large doses to experimental animals." Whether it has the same effects on humans is that far unproved. It should be remembered, though, that birth defects (such as the one caused by the hormone DES) often take years to manifest themselves. So, what the future holds for the children-and grandchildren-of marijuana smokers remains to be seen.

Cancer- Tobacco causes cancer in the cheeks, gums, and throat. These finds do not surprise experts. One study notes: "Snuff has the highest level of cancer-causing agents of any product taken into the body." No wonder that "long-term snuff users have a 50% greater risk of developing oral cancer than nonusers.

Reproductive-Marijuana use has been addressed in lower levels of male sex hormones, which has produced problems related to the male reproductive system

Even father's smoking may harm fetus. Studies show that when a non-smoking pregnant woman is exposed to the cigarette smoke of other people [such as the father], the fetal blood contains significant amounts of tobacco smoke by-products.

Infants- because the brain's barrier to drugs and the liver, which detoxifies nicotine, are less well developed in infants than in adults, passive smoking is particularly harmful to them. Damages could range from aversion to certain foods, due to nausea caused by tobacco smoke, to sudden infant death syndrome.

Tobacco Hinders Sleep and Memory- Smokers generally find it harder to sleep than non-smokers do, and sleep habits of smokers who suddenly quit dramatically according to researchers.

Social effects

Home- Parents who are distracted by their craving for drugs rarely provide their children with a stable home life. Infant-parent bonding-so vital during the first weeks of a child's life-can even be inhibited. Many children who grow up in this environment take to the streets or even get involved in drugs themselves.

Employment- Addicted individuals frequently get into debt or may end up losing their jobs either due to absenteeism, truancy or negligence.

Effect on Others – More than ten studies last year showed that passive smoking-inhaling the smoke from the cigarettes of others-caused lung cancer in the non-smoking spouses of smokers. Research indicates that "spouses of smokers are two or three times more likely to get lung cancer than those of non-smokers." One study "estimated that passive smoking in the United States causes more cancer deaths than all regulated industrial air pollutants combined.

Source by Okesola Josiah

from Home Solutions Forev https://homesolutionsforev.com/the-truth-about-tobacco-and-marijuana-2/ via Home Solutions on WordPress

#Home Solutions Forev

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lopezdorothy70-blog · 5 years

Text

Is Arthritis in Childhood Becoming the “New Normal?”

For people who think of arthritis as a disease of the elderly, learning that children also suffer from arthritic conditions may come as a shock. Across age groups, various forms of arthritis are a growing public health problem in the United States. New cases of juvenile rheumatoid arthritis and other types of autoimmune arthritis in young Americans are two to three times higher than in Canada, with cases occurring within the wider context of proliferating pediatric autoimmune disorders. Over one four-year period (2001-2004), the number of ambulatory care visits for pediatric arthritis and other rheumatologic conditions increased by 50%.

Currently, one child in 1,000 develops some form of chronic arthritis – about twice the estimated prevalence of the early 1980s.

The medical community lumps childhood arthritic disorders under the broader umbrella of “juvenile rheumatoid arthritis” or “juvenile idiopathic arthritis” (JIA). “Idiopathic” means “no identifiable cause.” There has been a predictable rush to pinpoint predisposing genetic factors, even though most of the genetic variations identified in JIA “are shared across other autoimmune disorders.” Of more practical relevance, an emerging consensus points to environmental factorsas major contributors to JIA, with childhood infections attracting particular attention.

In light of the interest in infections, how do we explain the deafening silence about the possible role of vaccines as an autoimmune trigger for JIA, when the stock-in-trade of vaccination is the “mimicking [of] a natural infection”? One study out of Brazil alludes to case reports linking autoimmune rheumatic diseases such as JIA to vaccination-but quickly dismisses the vaccine hypothesis as “controversial.” However, American children suffering from JIA and other debilitating autoimmune disorders deserve to know whether the dozens of vaccines they receive through age 18 are at least partially responsible for their misfortune.

A study published in 2001 found a temporal association between the infant hepatitis B vaccine and chronic arthritis (as well as other adverse health outcomes) in the general population of US children.

Diminished quality of life

Childhood arthritis-a disorder that results in permanent joint damage-is characterized by joint pain, swelling, stiffness and other symptoms that interfere with activities of daily living such as dressing and walking. The National Institutes of Health (NIH) understatedly describes the quality-of-life impact of JIA on all spheres of a child's life as follows: “Juvenile arthritis can make it hard to take part in social and after-school activities, and it can make schoolwork more difficult.”

Currently, one child in 1,000 develops some form of chronic arthritis-about twice the estimated prevalence of the early 1980s. A diagnosis typically is conferred when a child under age 16 has experienced joint swelling for at least six weeks.

One intriguing historical study found that prenatal or neonatal presensitization to influenza triggered the subsequent onset of JIA upon reexposure to influenza virus. Does influenza vaccination, which targets pregnant women as well as children beginning at six months of age, represent a form of prenatal and neonatal

Assembling vaccine-related clues

Although JIA onset can be as young as six months of age, studies looking at childhood patterns of arthritis report dual peaks of onset in toddlers (1-2 years of age) and just prior to adolescence (8-12 years of age). The childhood vaccine schedule administers multiple vaccines during both of those windows, including hepatitis B vaccination in infancy and the first dose of the human papillomavirus (HPV) and meningococcal vaccines at ages 11-12 (or earlier). A study published in 2001 found a temporal association between the infant hepatitis B vaccine and chronic arthritis (as well as other adverse health outcomes) “in the general population of US children.”

Among the possible infectious candidates for JIA, researchers have pointed to several specific viruses-including influenza, rubella and Mycoplasma pneumoniae-that may “initiate or augment this chronic disorder.” One intriguing historical study found that prenatal or neonatal presensitization to influenza triggered the subsequent onset of JIA upon reexposure to influenza virus. Does influenza vaccination, which targets pregnant women as well as children beginning at six months of age, represent a form of prenatal and neonatal “presensitization” to influenza capable of laying the groundwork for JIA?

The Flulaval Quadrivalent influenza vaccine package insert shows that 13% of children (aged 5 through 17 years) reported arthralgia, described as a systemic adverse event.

This is a reasonable question to ask, particularly because of the seasonal pattern of JIA onset, with the winter months (just after influenza vaccination) representing “the peak time of year for new cases of JIA to present.” Moreover, a look at the package inserts of common childhood flu shots shows that arthralgia and arthritis (terms often used interchangeably to describe joint pain) are documented adverse reactions of the vaccines, both in clinical trials and postmarketing reports. Consider the two GlaxoSmithKline influenza vaccine formulations approved for children six months of age and older:

The package insert for the Fluarix Quadrivalent influenza vaccine describes arthralgia as one of the “most common systemic adverse reactions” in children aged 6 through 17 years-documented in one in ten children in that age group.

The Flulaval Quadrivalent influenza vaccine package insert shows that 13% of children (aged 5 through 17 years) reported arthralgia, described as a “systemic adverse event.”

It is somewhat more challenging to consider the association of rubella vaccination with joint pain because children typically are vaccinated for rubella in the context of one of two combination vaccines: measles-mumps-rubella (MMR) or measles-mumps-rubella-varicella (MMRV). However, Merck manufactures a live virus rubella vaccine (Meruvax II). In the package insert, the company cautions that “postpubertal females should be informed of the frequent occurrence of generally self-limited arthralgia and/or arthritis beginning 2 to 4 weeks after vaccination.” Citing incidence rates for arthritis and arthralgia of 0% to 3% in children and 12% to 26% in adult women, the Meruvax II insert states that reactions in adolescent girls “appear to be intermediate in incidence between those seen in children and in adult women.”

There is no human vaccine for Mycoplasma pneumoniae (or M. pneumoniae), a species of bacteria typically associated with mild respiratory infections in humans (sometimes called “walking pneumonia”). (Efforts to develop a human vaccine have failed because they have, “ironically,…often led to exacerbation of disease.” However, six companies manufacture related pig vaccines in the U.S.) Disturbingly, mycoplasma are “commonly found as including in viral vaccine production, and “are too small to be seen under a standard lab microscope.” Although “the detection of mycoplasma contamination is of utmost concern in…vaccine manufacturing”-not least because contamination has the potential to “disrupt patterns of human gene expression”-studies have found that “half of all lab scientists fail to check for the presence of Mycoplasma in their cell cultures.”

Both Flulaval and Fluzone (some of the most commonly prescribed flu vaccines for children) contain thimerosal, the mercury-based vaccine preservative. In addition, numerous other vaccines on the childhood vaccine schedule contain aluminum

Metals and arthritis

A 2018 study published in Environmental Research notes that individuals with rheumatoid arthritis and other connective tissue diseases often display sensitivity to heavy metals such as mercury and nickel. The researchers hypothesize that “metal-specific T cell reactivity can act as an etiological agent in the propagation and chronification of rheumatic inflammation” (where “chronification” refers to the progression from transient to persistent). Holistic health practitioners would not be surprised by this hypothesis, having warned for years that the symptoms of heavy metal toxicity can “mimic those of certain autoimmune diseases,” including various types of arthritis.

Although researchers have noted that the mechanism linking infection to autoimmunity “is complex and multifaceted,” the phenomenon of “molecular mimicry” (whereby the immune system attacks “self” antigens that are structurally similar to “non-self” antigens) offers one likely explanation. Some investigators have posited that the aluminum adjuvants in vaccines can induce autoimmune illness through an acceleration of molecular mimicry. Do the metals in childhood vaccines play a role in triggering JIA? This is just one of many critical unanswered questions that need to be answered concerning the potential role of vaccination in the autoimmunity epidemics affecting both children and adults.

Please visit Children's Health Defence for more information.

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jerrytackettca · 6 years

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93 Percent Breathing Polluted Air

Breathing clean air is a right that should be enjoyed by every person on Earth, but as industry, agriculture and other sources of air pollution have proliferated, clean air has become increasingly scarce.

The problem has grown to monumental levels, such that the World Health Organization (WHO), in their latest report on air pollution and child health, stated, “Exposure to air pollution is an overlooked health emergency for children around the world.”1

Worldwide, the report states, 93 percent of children live in areas with air pollution at levels above WHO guidelines. Further, more than 1 in 4 deaths among children under 5 years is related to environmental risks, including air pollution. In 2016, ambient (outside) and household air pollution contributed to respiratory tract infections that led to 543,000 deaths in children under 5.

“Polluted air is poisoning millions of children and ruining their lives,” Tedros Adhanom Ghebreyesus, WHO director-general, said in a news release. “This is inexcusable. Every child should be able to breathe clean air so they can grow and fulfil their full potential.”2

Where Are Children Most at Risk?

Children are exposed to polluted air both indoors and out. Outside, ambient air pollution comes primarily from the combustion of fossil fuel, waste incineration, industrial and agricultural practices and natural disasters such as wildfires, dust storms and volcanic eruptions.

In 2016, ambient air pollution led to 4.2 million premature deaths, nearly 300,000 of which occurred in children under the age of 5 years. Exposure to air pollution occurs in developed countries — especially in low-income communities — however, children living in low- and middle-income countries (LMICs) were most affected.

Fine particulate matter (PM 2.5) refers to dust, dirt, soot and smoke — particles smaller than 2.5 micrometers in diameter. It’s the most studied type of air pollution, and the WHO report revealed that in LMICs, 98 percent of children under 5 years are exposed to fine particulate matter at levels higher than the WHO air quality guidelines.

In some areas, like African and Eastern Mediterranean regions, 100 percent of children under 5 are affected. In contrast, 52 percent of children under 5 in HICs are exposed to potentially dangerous levels of ambient air pollution. Indoors, 41 percent of the world’s population is exposed to household air pollution, particularly from cooking with polluting fuels and technologies.

WHO: Children Particularly at Risk From Polluted Air

Children are more vulnerable to the effects of air pollution than adults, in part because their bodies (including their lungs and brains) are still developing, putting them at risk from inflammation and other health damage from pollutants. They also have a longer life expectancy, giving more time for diseases to emerge.

Overall, a combination of “behavioral, environmental and physiological factors” makes children particularly susceptible to air pollution, WHO notes, adding:3

“[Children] breathe faster than adults, taking in more air and, with it, more pollutants. Children live closer to the ground, where some pollutants reach peak concentrations. They may spend much time outside, playing and engaging in physical activity in potentially polluted air.

Newborn and infant children, meanwhile, spend most of their time indoors, where they are more susceptible to household air pollution, as they are near their mothers while the latter cook with polluting fuels and devices … In the womb, they are vulnerable to their mothers’ exposure to pollutants. Exposure before conception can also impose latent risks on the fetus.”

The WHO report analyzed studies published within the past 10 years, and used input from dozens of experts, to reveal some of the top health risks air pollution poses to children. Among them:4

Adverse birth outcomes, including low birth weight, premature birth, stillbirth and infants born small for gestational age.

Infant mortality — As pollution levels increase, so does risk of infant mortality.

Neurodevelopment — Exposure to air pollution may lead to lower cognitive test outcomes, negatively affect children’s mental and motor development and may influence the development of autism and attention deficit hyperactivity disorder.

Childhood obesity

Lung function — Prenatal exposure to air pollution is associated with impaired lung development and lung function in childhood.

Acute lower respiratory infection, including pneumonia

Asthma — Exposure to ambient air pollution increases the risk of asthma and exacerbates symptoms of childhood asthma.

Ear infection

Childhood cancers, including retinoblastomas and leukemia

Health problems in adulthood — evidence suggests that prenatal exposure to air pollution may increase the risk of chronic lung disease and cardiovascular disease later in life.

Surprising Sources of Air Pollution

Pollution is only worsening in many parts of the world, and without aggressive intervention, deaths due to ambient air pollution could increase by more than 50 percent by 2050.5

The majority of global airborne particulate pollution — 85 percent — comes from fuel combustion, with coal being the “world’s most polluting fossil fuel.”6 Even in the U.S., an estimated 200,000 premature deaths are caused by combustion emissions, including that from vehicles and power generation.7

In a study of electric power generation in the U.S., which is coal-intensive, a study published in the journal Energy revealed that switching to natural gas for electricity generation could lead to significant benefits, including reducing sulfur dioxide emissions by more than 90 percent and nitrogen oxide emissions by more than 60 percent.8

In a Lancet study, authors took it a step further, noting that an even better solution would be shifting to low-polluting renewable energy sources such as wind, tidal, geothermal and solar options.9

The WHO authors also called for urgent changes to reduce air pollution, including switching to clean cooking and heating fuels and technologies and promoting the use of cleaner transport, energy-efficient housing and urban planning. They also advocate for improving waste management and locating schools away from busy roadways and factories.10

Industrial Agriculture’s Contribution to Air Pollution

WHO’s guidelines, as well as their estimates of how many people are breathing polluted air, do not account for ozone or nitrogen oxides, which are also known air pollutants.

Emissions of nitrogen oxides combine with oxygen and sunlight to break down into ozone. Levels of this air pollutant have tripled since 1990,11 possibly due to synthetic nitrogen-based fertilizers, which release nitrogen oxides into the atmosphere.

Researchers have long known soil microbes convert nitrogen-based fertilizers to nitrogen oxides and release them into the air. However, it was estimated that only 1 kilogram of gas was produced per 100 kilograms of fertilizer, or roughly 1 percent. Researchers thought the amount of gas would increase linearly, or stay at 1 percent of the amount of fertilizer used.

However, further experimentation found the increase was exponential and not linear, as the original research didn't account for conversion when excess nitrogen fertilizer was applied to the fields. In California, agricultural lands may be responsible for as much as 51 percent of nitrogen oxides off-gassing across the state, especially in areas that use synthetic nitrogen-based fertilizers.12

Research published in the journal Geophysical Research Letters has also demonstrated that in certain densely populated areas, emissions from farming far outweigh other sources of particulate matter air pollution.13 As nitrogen fertilizers break down into their component parts, ammonia is released into the air.

Ammonia is one of the byproducts of fertilizer and animal waste. When the ammonia in the atmosphere reaches industrial areas, it combines with pollution from diesel and petroleum combustion, creating microparticles. Concentrated animal feeding operation (CAFO) workers and neighboring residents alike report higher incidence of asthma, headaches, eye irritation and nausea.14

Air Pollution Is Becoming More Dangerous Than Ever

Pollution is the “largest environmental cause of disease and premature death in the world today,” according to research published in The Lancet.15 The study revealed that 9 million premature deaths were caused by pollution in 2015, which is 16 percent of deaths worldwide. What’s more, among the pollution-related deaths, the majority — 6.5 million — were caused by airborne contaminants.

Fine particulate matter can enter your system and cause chronic inflammation, which in turn increases your risk of a number of health problems, from cancer to heart and lung disease. In the case of heart disease, fine particulate air pollution may increase your risk by inducing atherosclerosis, increasing oxidative stress and increasing insulin resistance, the researchers noted, adding:16

“The strongest causal associations are seen between PM 2.5 pollution and cardiovascular and pulmonary disease. Specific causal associations have been established between PM 2.5 pollution and myocardial infarction, hypertension, congestive heart failure, arrhythmias and cardiovascular mortality.

Causal associations have also been established between PM 2.5 pollution and chronic obstructive pulmonary disease and lung cancer. The International Agency for Research on Cancer has reported that airborne particulate matter and ambient air pollution are proven group 1 human carcinogens.”

Using Your Diet to Protect Against Air Pollution

Because you can’t always control your exposure to air pollution, especially that outdoors, one of the best options is to fortify your diet with nutrients that may have a protective effect against pollutants. This includes:17

• Omega-3 fats — They’re anti-inflammatory, and in a study of 29 middle-aged people, taking an animal-based omega-3 fat supplement reduced some of the adverse effects to heart health and lipid levels, including triglycerides, that occurred with exposure to air pollution (olive oil did not have the same effect).18

• Broccoli sprouts — Broccoli-sprout extract was shown to prevent the allergic nasal response that occurs upon exposure to particles in diesel exhaust, such that the researchers suggested broccoli or broccoli sprouts could have a protective effect on air pollution’s role in allergic disease and asthma.19

A broccoli-sprout beverage even enhanced the detoxification of some airborne pollutants among residents of a highly polluted region of China.20

• Vitamins C and E — Among children with asthma, antioxidant supplementation including vitamins C and E helped to buffer the impact of ozone exposure on their small airways.21

• B vitamins — A small-scale human trial found high doses of vitamins B6, B9 and B12 in combination completely offset damage caused by very fine particulate matter in air pollution.22

Four weeks of high-dose supplementation reduced genetic damage in 10 gene locations by 28 to 76 percent, protected mitochondrial DNA from the harmful effects of pollution, and even helped repair some of the genetic damage.

Stopping Air Pollution Will Take a Global Effort

In many areas of the world, people have limited options to improve air quality both inside and outside of their homes. WHO recommends the use of clean stoves for cooking as a key way to improve household air pollution, but notes that “reducing ambient air pollution requires wider action, as individual protective measures are not only insufficient, but are neither sustainable nor equitable.”23

Solving the problem, and protecting the health of future generations of children, will instead take a global effort. According to WHO:24

“To reduce and prevent exposure to both household air pollution and ambient air pollution, public policy is essential. Air pollutants do not recognize political borders but travel wherever the wind and prevailing weather patterns take them. Therefore, regional and international cooperative approaches are necessary to achieve meaningful reductions in children’s exposure.

Approaches to preventing exposure must be complementary and mutually reinforcing, on every scale: houses, clinics, health care institutions, municipalities, national governments and the global community …

Individual efforts can add up to collective action that changes minds, changes policies and changes the quality of the air around us. Such actions would go far toward ensuring that children can breathe freely, without the terrible burdens imposed by air pollution.”

In your own home, I recommend taking steps to keep your indoor air clean, including opening windows to let fresh air in and avoiding the use of known air pollutants like chemical cleaning products, air fresheners and scented candles. Purifying your home’s air is also a wise step, but no one filter can remove all pollutants, so be sure to do your research on the different types of air filters to meet your specific needs.

from http://articles.mercola.com/sites/articles/archive/2018/11/13/children-air-pollution-health-risks.aspx

source http://niapurenaturecom.weebly.com/blog/93-percent-breathing-polluted-air

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paullassiterca · 6 years

Text

93 Percent Breathing Polluted Air

Where Are Children Most at Risk?

WHO: Children Particularly at Risk From Polluted Air

Overall, a combination of “behavioral, environmental and physiological factors” makes children particularly susceptible to air pollution, WHO notes, adding:3

The WHO report analyzed studies published within the past 10 years, and used input from dozens of experts, to reveal some of the top health risks air pollution poses to children. Among them:4

Adverse birth outcomes, including low birth weight, premature birth, stillbirth and infants born small for gestational age.

Infant mortality — As pollution levels increase, so does risk of infant mortality.

Childhood obesity

Lung function — Prenatal exposure to air pollution is associated with impaired lung development and lung function in childhood.

Acute lower respiratory infection, including pneumonia

Asthma — Exposure to ambient air pollution increases the risk of asthma and exacerbates symptoms of childhood asthma.

Ear infection

Childhood cancers, including retinoblastomas and leukemia

Health problems in adulthood — evidence suggests that prenatal exposure to air pollution may increase the risk of chronic lung disease and cardiovascular disease later in life.

Surprising Sources of Air Pollution

Pollution is only worsening in many parts of the world, and without aggressive intervention, deaths due to ambient air pollution could increase by more than 50 percent by 2050.5

In a Lancet study, authors took it a step further, noting that an even better solution would be shifting to low-polluting renewable energy sources such as wind, tidal, geothermal and solar options.9

Industrial Agriculture’s Contribution to Air Pollution

WHO’s guidelines, as well as their estimates of how many people are breathing polluted air, do not account for ozone or nitrogen oxides, which are also known air pollutants.

However, further experimentation found the increase was exponential and not linear, as the original research didn’t account for conversion when excess nitrogen fertilizer was applied to the fields. In California, agricultural lands may be responsible for as much as 51 percent of nitrogen oxides off-gassing across the state, especially in areas that use synthetic nitrogen-based fertilizers.12

Air Pollution Is Becoming More Dangerous Than Ever

Using Your Diet to Protect Against Air Pollution

A broccoli-sprout beverage even enhanced the detoxification of some airborne pollutants among residents of a highly polluted region of China.20

• Vitamins C and E — Among children with asthma, antioxidant supplementation including vitamins C and E helped to buffer the impact of ozone exposure on their small airways.21

• B vitamins — A small-scale human trial found high doses of vitamins B6, B9 and B12 in combination completely offset damage caused by very fine particulate matter in air pollution.22

Stopping Air Pollution Will Take a Global Effort

Solving the problem, and protecting the health of future generations of children, will instead take a global effort. According to WHO:24

from Articles http://articles.mercola.com/sites/articles/archive/2018/11/13/children-air-pollution-health-risks.aspx source https://niapurenaturecom.tumblr.com/post/180061014626

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