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Am J Manag Care. 1997 Nov;3(11):1721-3.
Healthcare utilization among women with eating disordered behavior.

Sansone RA, Wiederman MW, Sansone LA.

This study was designed to explore relationship between self-reported eating disordered behavior (without formally established eating disorder diagnoses) and healthcare utilization among women in a primary care setting. Through a self-report questionnaire, 150 participants between the ages of 17 and 49 were asked if they had ever vomited, starved themselves, or abused laxatives in a manner that was intentional and self-harming (i.e., eating disordered behavior identified as pathologic by the participant). Participants who reported a history of disordered eating (n = 17) exhibited higher scores on two of five measures of healthcare utilization (mean number of telephone contacts and mean number of specialist referrals) compared with participants without eating disorders (n = 133). These data suggest that eating disordered behavior may be a predictor of increased healthcare utilization among women in primary care settings.


online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10178470&dopt=Abstract



sp2.power.uni-essen.de

The charts of 273 cancer patients were retrospectively analyzed in order (1) to evaluate the frequency of opioid change (OCH) when adjuvants (antiemetics/laxatives) were administered on a regular basis and co-analgesic medication as indicated by the specific type of pain, (2) to define risk factors for the request of OCH, and (3) to reveal settings in which OCH may not be recommended as a first-line therapeutic intervention. Opioids used included morphine, fentanyl, 1-methadone, and buprenorphine. Out of 273 patients, 103 changed opioids at least once, with a success rate of 65%. The indications for the OCH were insufficient analgesia in 43%, intolerable side effects in 20%, both in 15%, and other reasons in 22% of patients. The frequency of OCH was not influenced by the routine use of adjuvants or co-analgesics except corticosteroids, which raises queries about the concept of an opioid-sparing effect of co-analgesics. The occurrence of intolerable side effects is thought not to be dose dependent so much as to reflect differences in the individual tolerability of a distinct opioid for whatever reason (genetically fixed or individually acquired pharmacodynamic or kinetic properties). Moreover, there was strong evidence for the existence of an unpredictable and incomplete cross-tolerance between opioids, which meant careful titration of the new opioid was required after OCH. The overall frequency of OCH was similar to that observed in previous studies in spite of the documented addition of adjuvants and co-analgesics. This retrospective study supports the notion that opioid rotation must be retained as an essential therapeutic option even with optimized adjuvant and co-analgesic regimens.


online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11094993&dopt=Abstract



Curr Treat Options Gastroenterol. 1999 Dec;2(6):517-523.
Megacolon: Acute, Toxic, and Chronic.

Bharucha AE, Phillips SF.

Division of Gastroenterology and Hepatology, Mayo Clinic, 2-424 Alfred Building SMH, 200 First St. SW, Rochester, MN 55905, USA.

Megacolon refers to cecal dilatation above the dimension of 12 cm and above 6.5 cm of the sigmoid colon, measured at the pelvic brim. Dilatation of the colon can be broadly categorized into three clinical entities: In acute megacolon (Ogilvie's syndrome), colonic dilatation is attributed to a sympathetically mediated reflex response to a number of serious medical or surgical conditions in elderly patients. The initial tasks are to exclude mechanical obstruction (with a hypaque enema), to discontinue enabling medications, and to correct metabolic disturbances. Dilatation of the cecum to greater than 12 cm diameter is a cause for grave concern. The rectum should be decompressed with an indwelling tube and tap water enemas. Intravenous neostigmine is generally effective and safe for patients with colonic distention unresponsive to such conservative therapies. Endoscopic decompression is necessary for patients who do not respond to, or relapse after neostigmine, or in whom neostigmine is contraindicated. Signs of peritonitis may imply colonic perforation, and surgery will be needed, often on an emergent basis. Toxic megacolon is secondary to an identifiable inflammation of the colon. Therapy is directed toward specific treatment for the underlying disorder, inflammatory bowel disease, or infectious colitis. Bowel rest and close monitoring of the clinical status is vital. Colectomy may be needed under emergency circumstances. Chronic megacolon may be congenital (due to Hirschsprung's disease) or may represent the end-stage of any form of refractory constipation (slow transit constipation or pelvic floor dysfunction). The initial treatment for Hirschsprung's disease is surgery, while pelvic floor dysfunction and encopresis respond to biofeedback therapy. In chronic idiopathic megacolon, medical measures, such as colonic evacuation with enemas, fiber supplementation, and laxatives may suffice. If severe motor dysfunction is confined to the colon, a subtotal colectomy with an ileorectal anastomosis, or an ileostomy may occasionally be necessary.


online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11097735&dopt=Abstract [PubMed - as supplied by publisher]








The most ostensive feature that distinguishes us human from chimps and other primates is the lack of bodily hair. During evolutionary process, we have lost the majority of hair. Hair is no longer an essential part of our body, just like appendix. What little hair we still have on our scalp and a few other bodily parts is still regarded as significant for reasons other than biological necessity. Hair loss is naturally accompanied by aging process, although the extent of hair loss and the timing of onset vary widely among individuals. Thus, loss of hair and baldness is considered as a symbol of maturity or old age. Like winkles and other signs of aging, hair loss is not welcome by most people, because we don't welcome aging, and being perceived as an aging person. However, it is alopecia, or premature hair loss that especially concerns certain people.

Hair Million is a blend of Asian herbs that wards off hair loss and promotes hair growth. Of various approaches to hair restoration, Hair Million offers advantages including low cost compared with other methods or drugs, and safety, because it is made of safe and healthy herbs.














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