Guo JingJing is a gifted diver.
Wednesday, December 30, 2009
Sunday, December 27, 2009
Tigers roar to greet year of their own
Tigers roar during a photo opportunity for the upcoming New Year event at the Everland amusement park in Yongin, about 50 km (31 miles) south of Seoul December 28, 2009, three days ahead of the year of the tiger, according to the Chinese lunar calendar. The park operates a tiger safari with 32 tigers, of which 10 of them are white tigers.
from:http://news.xinhuanet.com
Guidelines Issued for Cardiovascular Risk Management in Patients With Inflammatory Arthritis
The European League Against Rheumatism (EULAR) has issued 10 recommendations for cardiovascular risk management in patients with rheumatoid arthritis (RA), ankylosing spondylitis, and psoriatic arthritis. The new guidelines are published in the September 22 Online First issue of the Annals of the Rheumatic Diseases. The statement primarily targets rheumatologists but also a broad spectrum of other healthcare providers, reflecting "best practice" for patients with inflammatory arthritis.
"Obviously, management of inflammatory arthritis patients focuses not on cardiovascular (CV) morbidity and mortality," write M.J.L. Peters, MD, from VU University Medical Center in Amsterdam, the Netherlands, and colleagues. "However, standardised mortality ratios (SMRs) are elevated and the majority of premature deaths are attributable to CV disease. CV morbidity is also enhanced and there is an increased prevalence of all stages of atherogenesis from endothelial dysfunction, to increased thickness and plaque in carotid arteries, to fatal and non-fatal myocardial infarction and stroke."
The goal of this statement was to develop evidence-based EULAR recommendations for cardiovascular risk management in patients with RA, ankylosing spondylitis, and psoriatic arthritis. The EULAR Standing Committee for Clinical Affairs convened a multidisciplinary task force of 18 experts from 9 European countries, including rheumatologists, cardiologists, internists, and epidemiologists. The task force identified problem areas and related keywords for systematic literature research, which was conducted with use of MedLine, Embase, and the Cochrane library through May 2008.
In accordance with the EULAR's "standardized operating procedures," the multidisciplinary steering committee developed recommendations for cardiovascular risk screening and management in patients with inflammatory arthritis, based on evidence from this literature review and on expert opinion.
For all patients with RA, annual cardiovascular risk assessment with use of national guidelines is recommended. This should also be considered for all patients with ankylosing spondylitis and psoriatic arthritis. When cardiovascular risk factors are identified, these should be managed according to local guidelines, or according to the Systematic Coronary Risk Evaluation function if no local guidelines are available. To further reduce cardiovascular risk, aggressive suppression of the inflammatory process is recommended.
"Although the increased CV risk is increasingly acknowledged, limited attention is paid to detecting and managing CV comorbid conditions such as hypertension and dyslipidemia," the guidelines authors write. "Early identification, adequate CV risk management, and ongoing monitoring of risk factors are mandatory to reduce the (excess) CV risk. The first principle of management is to assess and control all components of total CV risk, [including] appropriate evidenced-based advice with regard to smoking, physical activity, nutrition, weight and blood pressure."
The task force made 10 recommendations for cardiovascular risk management in patients with inflammatory arthritis. Because evidence for increased cardiovascular risk is most compelling for RA, the strength of the recommendations was greater for patients with RA vs patients with ankylosing spondylitis or psoriatic arthritis.
The 10 recommendations, and their accompanying level of evidence rating and strength of recommendation, are as follows:
1. RA should be considered as a disease in which cardiovascular risk is elevated, because of both an increased prevalence of traditional cardiovascular risk factors and the inflammatory burden. Although the evidence base is less, this may also apply to ankylosing spondylitis and psoriatic arthritis (level of evidence and strength of recommendation, 2b-3 B).
2. To lower cardiovascular risk, adequate control of arthritis disease activity is necessary (level of evidence and strength of recommendation, 2b-3 B).
3. All patients with RA should undergo annual cardiovascular risk evaluation with use of national guidelines. This should also be considered for all patients with ankylosing spondylitis and psoriatic arthritis. When antirheumatic treatment has been changed, risk assessments should be repeated (level of evidence and strength of recommendation, 3-4 C).
4. For patients with RA, risk score models should be adapted by introducing a 1.5 multiplication factor when the patient meets 2 of the following 3 criteria: disease duration of more than 10 years, rheumatoid factor or anti-cyclic citrullinated peptide positivity, and the presence of certain extra-articular manifestations (level of evidence and strength of recommendation, 3-4 C).
5. When using the Systematic Coronary Risk Evaluation model for determination of cardiovascular risk, triglyceride/high-density lipoprotein cholesterol ratio should be used (level of evidence and strength of recommendation, 3 C).
6. Intervention for cardiovascular risk factor management should be performed according to national guidelines (level of evidence and strength of recommendation, 3 C).
7. Preferred treatment options are statins, angiotensin-converting enzyme inhibitors, and/or angiotensin-II blockers (level of evidence and strength of recommendation, 2a-3 C-D).
8. The effect of cyclooxygenase-2 inhibitors and most nonsteroidal anti-inflammatory drugs (NSAIDs) on cardiovascular risk is not completely determined and should be studied further. Clinicians should therefore be very cautious in prescribing these drugs, especially to patients with cardiovascular risk factors or with documented cardiovascular disease (level of evidence and strength of recommendation, 2a-3 C).
9. When corticosteroids are prescribed, this should be at the lowest possible dose (level of evidence and strength of recommendation, 3 C).
10. Patients should be actively encouraged to stop smoking (level of evidence and strength of recommendation, 3 C).
"Cardioprotective treatment should be initiated when the estimated 10 year CV risk is above the risk threshold for each country, whether 10 or 20%," the guidelines authors conclude. "Finally, the clear relationship between disease activity and CV disease underscores the important role of tight disease control."
from:http://www.healthyoucan.com
"Obviously, management of inflammatory arthritis patients focuses not on cardiovascular (CV) morbidity and mortality," write M.J.L. Peters, MD, from VU University Medical Center in Amsterdam, the Netherlands, and colleagues. "However, standardised mortality ratios (SMRs) are elevated and the majority of premature deaths are attributable to CV disease. CV morbidity is also enhanced and there is an increased prevalence of all stages of atherogenesis from endothelial dysfunction, to increased thickness and plaque in carotid arteries, to fatal and non-fatal myocardial infarction and stroke."
The goal of this statement was to develop evidence-based EULAR recommendations for cardiovascular risk management in patients with RA, ankylosing spondylitis, and psoriatic arthritis. The EULAR Standing Committee for Clinical Affairs convened a multidisciplinary task force of 18 experts from 9 European countries, including rheumatologists, cardiologists, internists, and epidemiologists. The task force identified problem areas and related keywords for systematic literature research, which was conducted with use of MedLine, Embase, and the Cochrane library through May 2008.
In accordance with the EULAR's "standardized operating procedures," the multidisciplinary steering committee developed recommendations for cardiovascular risk screening and management in patients with inflammatory arthritis, based on evidence from this literature review and on expert opinion.
For all patients with RA, annual cardiovascular risk assessment with use of national guidelines is recommended. This should also be considered for all patients with ankylosing spondylitis and psoriatic arthritis. When cardiovascular risk factors are identified, these should be managed according to local guidelines, or according to the Systematic Coronary Risk Evaluation function if no local guidelines are available. To further reduce cardiovascular risk, aggressive suppression of the inflammatory process is recommended.
"Although the increased CV risk is increasingly acknowledged, limited attention is paid to detecting and managing CV comorbid conditions such as hypertension and dyslipidemia," the guidelines authors write. "Early identification, adequate CV risk management, and ongoing monitoring of risk factors are mandatory to reduce the (excess) CV risk. The first principle of management is to assess and control all components of total CV risk, [including] appropriate evidenced-based advice with regard to smoking, physical activity, nutrition, weight and blood pressure."
The task force made 10 recommendations for cardiovascular risk management in patients with inflammatory arthritis. Because evidence for increased cardiovascular risk is most compelling for RA, the strength of the recommendations was greater for patients with RA vs patients with ankylosing spondylitis or psoriatic arthritis.
The 10 recommendations, and their accompanying level of evidence rating and strength of recommendation, are as follows:
1. RA should be considered as a disease in which cardiovascular risk is elevated, because of both an increased prevalence of traditional cardiovascular risk factors and the inflammatory burden. Although the evidence base is less, this may also apply to ankylosing spondylitis and psoriatic arthritis (level of evidence and strength of recommendation, 2b-3 B).
2. To lower cardiovascular risk, adequate control of arthritis disease activity is necessary (level of evidence and strength of recommendation, 2b-3 B).
3. All patients with RA should undergo annual cardiovascular risk evaluation with use of national guidelines. This should also be considered for all patients with ankylosing spondylitis and psoriatic arthritis. When antirheumatic treatment has been changed, risk assessments should be repeated (level of evidence and strength of recommendation, 3-4 C).
4. For patients with RA, risk score models should be adapted by introducing a 1.5 multiplication factor when the patient meets 2 of the following 3 criteria: disease duration of more than 10 years, rheumatoid factor or anti-cyclic citrullinated peptide positivity, and the presence of certain extra-articular manifestations (level of evidence and strength of recommendation, 3-4 C).
5. When using the Systematic Coronary Risk Evaluation model for determination of cardiovascular risk, triglyceride/high-density lipoprotein cholesterol ratio should be used (level of evidence and strength of recommendation, 3 C).
6. Intervention for cardiovascular risk factor management should be performed according to national guidelines (level of evidence and strength of recommendation, 3 C).
7. Preferred treatment options are statins, angiotensin-converting enzyme inhibitors, and/or angiotensin-II blockers (level of evidence and strength of recommendation, 2a-3 C-D).
8. The effect of cyclooxygenase-2 inhibitors and most nonsteroidal anti-inflammatory drugs (NSAIDs) on cardiovascular risk is not completely determined and should be studied further. Clinicians should therefore be very cautious in prescribing these drugs, especially to patients with cardiovascular risk factors or with documented cardiovascular disease (level of evidence and strength of recommendation, 2a-3 C).
9. When corticosteroids are prescribed, this should be at the lowest possible dose (level of evidence and strength of recommendation, 3 C).
10. Patients should be actively encouraged to stop smoking (level of evidence and strength of recommendation, 3 C).
"Cardioprotective treatment should be initiated when the estimated 10 year CV risk is above the risk threshold for each country, whether 10 or 20%," the guidelines authors conclude. "Finally, the clear relationship between disease activity and CV disease underscores the important role of tight disease control."
from:http://www.healthyoucan.com
Baby's Bowels and Constipation
There are a lot of misconceptions about what constipation is and its significance in babies.
Can Infrequent Bowel Movements Still Be Normal?
Since milk is such a nutritious substance, sometimes almost all of it is absorbed and there is little left to move along, and stools become infrequent. For example, some perfectly normal breastfed infants only go once a week. Other infants just have a slower (but completely normal) gut, so they also go infrequently.
Prolonged, severe constipation can have a medical cause (for example, if the muscles in the intestine don't work or there is some sort of blockage), but that's a very rare occurrence, while infrequent, hard stools, on the other hand, are very common.
Constipation Defined
There is no medical harm in the stool staying in the body for a long time, and the frequency of your baby's bowel movements (BMs) does not really define true constipation. True constipation occurs when the baby's stools cause significant difficulty and discomfort when being passed, because they are very dense and hard. This definition excludes the baby who has soft, easy-to-pass stools once a week, even if he seems to strain a lot in the process.
Tips for Concerned Parents
Try a different brand of formula if you're bottle feeding. (Constipation should never be considered a reason to discontinue breastfeeding.)
Add a little non-absorbable sugar or dark fruit (prune or pear) juice to your baby's formula. Or just give some extra water or electrolyte solution between feedings, especially in hot weather.
Try a little help from below, like a glycerin suppository or a well greased thermometer if the addition of a little sugar does not work.
Remember that most babies with infrequent BMs are not truly "constipated" and nothing needs to be changed.
When to Worry About Baby's Constipation
Contact your pediatrician if the infrequent, hard stools seem to be causing significant discomfort to your baby. But keep in mind that infrequent but soft, easy-to-pass BMs are not constipation and rarely require intervention.
Can Infrequent Bowel Movements Still Be Normal?
Since milk is such a nutritious substance, sometimes almost all of it is absorbed and there is little left to move along, and stools become infrequent. For example, some perfectly normal breastfed infants only go once a week. Other infants just have a slower (but completely normal) gut, so they also go infrequently.
Prolonged, severe constipation can have a medical cause (for example, if the muscles in the intestine don't work or there is some sort of blockage), but that's a very rare occurrence, while infrequent, hard stools, on the other hand, are very common.
Constipation Defined
There is no medical harm in the stool staying in the body for a long time, and the frequency of your baby's bowel movements (BMs) does not really define true constipation. True constipation occurs when the baby's stools cause significant difficulty and discomfort when being passed, because they are very dense and hard. This definition excludes the baby who has soft, easy-to-pass stools once a week, even if he seems to strain a lot in the process.
Tips for Concerned Parents
Try a different brand of formula if you're bottle feeding. (Constipation should never be considered a reason to discontinue breastfeeding.)
Add a little non-absorbable sugar or dark fruit (prune or pear) juice to your baby's formula. Or just give some extra water or electrolyte solution between feedings, especially in hot weather.
Try a little help from below, like a glycerin suppository or a well greased thermometer if the addition of a little sugar does not work.
Remember that most babies with infrequent BMs are not truly "constipated" and nothing needs to be changed.
When to Worry About Baby's Constipation
Contact your pediatrician if the infrequent, hard stools seem to be causing significant discomfort to your baby. But keep in mind that infrequent but soft, easy-to-pass BMs are not constipation and rarely require intervention.
How Can I Perform Liposuction On Myself?
I need to get fat off of my abs/stomach but it is so hard and the results take too long to come. I think liposuction is a good option, but I dont have the money. I've been thinking about self-liposuction, but its very complicated. I need something that is sharp enough to cut through the skin without too much pressure, like an X-acto knife, or if you can think of anything else to cut with. Where can I buy that cutting object? I also need some way to numb the section I will be cutting becuse that would really hurt. How and where can I get a topical anesthetic to numb the skin and the parts under it? Plus I need to know if I will bleed to death or if blood will gush out like mad, and also if the cut will heal on its own or if I should go to the emergency room for stiches. I am serious here. I am really going to go through with this once i get the right info. Thank you for your help.
Why Do People Rely On Liposuction Instead Of Losing The Weight Naturally?
Why on earth do people get liposuction done or any other surgery to get rid of fat? Unless you have pounds of loose skin, what is the point? Why can't they just eat healthier and exercise to lose that fat?
What would you do if the average healthy weight loss when you're not losing muscle but only pure fat is 1-2 pounds a week, and you have 150+ to lose……exactly. Get the liposuction.
Unless you want to work out constantly for the next couple of years with minimal results, if any at all, like it is for most people.
And if it was just eat healthy and exercise, believe me, a lot more people would be skinny. So many other factors come into losing weight that those two factors above will never accomplish the goal alone.
Especially when the body is designed to hold onto weight with all of its will, due to prevention of starvation, and if you go below a certain amount of calories, your body goes into starvation mode and then it is almost impossible to lose weight.
Again, get the liposuction. I would do it if I could afford it. But its good ol' exercising and eating like a rabbit with minimal results for me.
How Much Would I Have To Pay For Liposuction On My Stomach?
I would also like to know of a reputable clinic in the leicestershire area. I have tried exercise and all that but I have that stubborn bit that refuses to shift so I am seriously thinking of liposuction. I would be grateful for any info. Thankyou.
You need to check the Plastic Surgery Board. Do not go on word of mouth. Also check the health board to see if the doctor has ever been sued. I am considering liposuction and I have heard the procedure is safe if done by a good doctor. Do thorough research and always ask questions. But be aware that even with liposuction you will have to diet and exercise anyways. Liposuction is supposed to give you a boost and get rid of the stubborn areas that women sometimes cannot get to. The fat on our stomachs is different than the fat anywhere else on our bodies. Oh and please dont get desperate and go to a foreign country for this. I think that would be a bad idea.
Would It Be A Waste To Get Liposuction Before Getting Pregnant?
I'm not planning on getting pregnant immediately, but I'm 19 and I plan on having kids. The only area I want to get liposuction on is my stomach. In the event that I get pregnant in the next few years, will it ruin the effect?
Has anybody had liposuction prior to pregnancy?
Has anybody had liposuction prior to pregnancy?
Hunny, don't even think about it. You're too young. Go exercise and go on a nice, healthy diet that is good for you. Do crunches and a lot of aerobics. That will help your stomach. And I suggest you wait until you are married to even begin to think about having children. Why would you want to have children in the next few years? You have so much left to do while you're young. Children will just make it hard to party, have fun, and enjoy the remainder of your youth. Wait for a bit longer until your life is steady, strong, you have a great job with lots of money and can afford to have a baby. Think about it a bit more… it's well worth it because you may end up regretting it.
Can Liposuction Be Used To Reduce Weight To Get Into The Guard Or Military?
I have a friend that is talking seriously about getting liposuction done to help him lose part of the 90 lbs he needs to lose to get into the military.
Obviously its not authorized or suggested, I think he's planning to not tell them.
Ideas? Is he right -will it work?
What are the moral implications?
Obviously its not authorized or suggested, I think he's planning to not tell them.
Ideas? Is he right -will it work?
What are the moral implications?
Who says lipo is not authorized? Just as long as he's recovered and medically cleared, And he has the paper work from the doctor to prove it. There shouldnt be a problem. Its not against the military to get lipo. But i wouldnt suggest not telling them. Theres no reason not to. Besides what happens if (knock on wood) something happens in the future thats related to the surgery medically, then he's caught. Then hes in trouble for lying to the military in the first place. I wouldnt suggest it.
Besides if he's got the money why not?
Okay- that regulation is from the army. The only way to really check is to just call the recruiter from the service that he wants to join. And double check with them. you dont have to give them any info. Its just a yes or no question.
Liposuction?
I'm average size women, however, I do have a pouch in my mid section and love handles. Does anyone know what this typically cost to have liposuction in those areas?
i do not recommend liposuction, only diet an exercise.
i had a lipo and they took like a 50% of the fat…this was 3 months ago
i´m dissapointed
Thursday, December 24, 2009
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