Back Pain Diagnostic Blocks Delay Pain Relief, Add Cost - Going directly to treatment without diagnostic blocks appears to be most cost-effective approach - ModernMedicine

http://www.modernmedicine.com/modernmedicine/Modern+Medicine+Now/Back-Pain-Diagnostic-Blocks-Delay-Pain-Relief-Add-/ArticleNewsFeed/Article/detail/680388?contextCategoryId=40137

Back Pain Diagnostic Blocks Delay Pain Relief, Add CostGoing directly to treatment without diagnostic blocks appears to be most cost-effective approach

Publish date: Jul 26, 2010

MONDAY, July 26 (HealthDay News) -- Performing one or more temporary diagnostic nerve blocks to establish arthritis as the cause of back pain before treatment with radiofrequency denervation results in unnecessary tests, delayed pain relief, and added cost, according to a study in the August issue of Anesthesiology.

Steven P. Cohen, M.D., of the Johns Hopkins School of Medicine in Baltimore, and colleagues randomized 151 patients with suspected lumbar facetogenic pain to one of three alternative treatment regimens: a group that received radiofrequency denervation directly based only on clinical findings, a group that underwent denervation after positive response to a single diagnostic block, and a group that had denervation after positive responses to two blocks with lidocaine and bupivacaine.

The researchers found that, among patients in the direct-to-denervation group, 33 percent had a successful outcome at three months compared to 16 percent in the single-block and 22 percent in the double-block groups. Rates of denervation success were 64 percent for the double-block group, 39 percent for the single-block group, and 33 percent for the direct-to-denervation group. At three months, the double-block group had lower pain and disability scores than the single-block or direct-to-denervation groups. The costs for successful treatment were $6,286, $17,142, and $15,241 in the direct-to-denervation, single-block, and double-block groups, respectively.

"Using current reimbursement scales, these findings suggest that proceeding to radiofrequency denervation without a diagnostic block is the most cost-effective treatment paradigm," the authors conclude.

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Doubt cast on common back pain management

http://us.mobile.reuters.com/mobile/m/AnyArticle/p.rdt?URL=http://www.reuters.com/article/idUSTRE66M5CY20100723

News

Doubt cast on common back pain management

Fri, Jul 23 17:25 PM EDT

By Frederik Joelving

NEW YORK (Reuters Health) - Many people with arthritis-related back pain might be prevented from getting long-lasting pain relief under the current management guidelines, US researchers said Friday.

Their findings add to an ongoing controversy about how best to manage this kind of pain, which accounts for up to 15 percent of chronic lower back pain.

Today, doctors perform one or two so-called diagnostic nerve blocks, in which they inject anesthetics into the joints of the spine. If the blocks alleviate the pain, it's likely that the joint was the culprit.

The next step is to burn the nerves that carry pain signals from the joint with radiofrequency waves, a procedure used in hundreds of thousands of Americans every year, according to Dr. Steven P. Cohen of Johns Hopkins University School of Medicine in Baltimore.

In the new study of 151 patients, published in the journal Anesthesiology, Cohen and colleagues suggest skipping the diagnostic blocks and going directly to radiofrequency treatment.

Doing so, they found, provided 50 percent pain relief for at least three months in a third of all patients; in those receiving one or two diagnostic blocks, 16 percent and 22 percent improved, respectively.

"Maybe we should consider just doing the treatment," Cohen told Reuters Health, adding that radiofrequency treatment had few side effects and wasn't any more dangerous than nerve blocks.

"A lot of people could benefit," he said.

The researchers also found that the cost per successful treatment was lower when doctors didn't do any nerve blocks, amounting to almost $6,300, or about $10,000 less than when blocks were done.

In a commentary on the study, Jan Van Zundert of Maastricht University Medical Center in The Netherlands and colleagues said the results suggested current guidelines were "withholding patients from prolonged pain relief."

Still, most patients with lower back pain wouldn't benefit from radiofrequency treatment, and so would be treated in vain.

When looking at how many patients actually benefited from the treatment, the rate was almost twice as high in those who had two blocks done compared to those who had none.

As a result, millions of patients worldwide would be candidates for treatment although they might not benefit from it, said Dr. Nikolai Bogduk, a pain expert at the Newcastle Bone & Joint Institute in New South Wales, Australia.

Bogduk, a strong proponent of using nerve blocks, said a true analysis of cost would need to take this into account.

According to Cohen, the cost of radiofrequency treatment is about $650 for the first joint, and $350 per additional joint. A nerve block costs about half, he said.

SOURCE: http://link.reuters.com/nen39m Anesthesiology, July 23, 2010.

News

Doubt cast on common back pain management

Fri, Jul 23 17:25 PM EDT

By Frederik Joelving

NEW YORK (Reuters Health) - Many people with arthritis-related back pain might be prevented from getting long-lasting pain relief under the current management guidelines, US researchers said Friday.

Their findings add to an ongoing controversy about how best to manage this kind of pain, which accounts for up to 15 percent of chronic lower back pain.

Today, doctors perform one or two so-called diagnostic nerve blocks, in which they inject anesthetics into the joints of the spine. If the blocks alleviate the pain, it's likely that the joint was the culprit.

The next step is to burn the nerves that carry pain signals from the joint with radiofrequency waves, a procedure used in hundreds of thousands of Americans every year, according to Dr. Steven P. Cohen of Johns Hopkins University School of Medicine in Baltimore.

In the new study of 151 patients, published in the journal Anesthesiology, Cohen and colleagues suggest skipping the diagnostic blocks and going directly to radiofrequency treatment.

Doing so, they found, provided 50 percent pain relief for at least three months in a third of all patients; in those receiving one or two diagnostic blocks, 16 percent and 22 percent improved, respectively.

"Maybe we should consider just doing the treatment," Cohen told Reuters Health, adding that radiofrequency treatment had few side effects and wasn't any more dangerous than nerve blocks.

"A lot of people could benefit," he said.

The researchers also found that the cost per successful treatment was lower when doctors didn't do any nerve blocks, amounting to almost $6,300, or about $10,000 less than when blocks were done.

In a commentary on the study, Jan Van Zundert of Maastricht University Medical Center in The Netherlands and colleagues said the results suggested current guidelines were "withholding patients from prolonged pain relief."

Still, most patients with lower back pain wouldn't benefit from radiofrequency treatment, and so would be treated in vain.

When looking at how many patients actually benefited from the treatment, the rate was almost twice as high in those who had two blocks done compared to those who had none.

As a result, millions of patients worldwide would be candidates for treatment although they might not benefit from it, said Dr. Nikolai Bogduk, a pain expert at the Newcastle Bone & Joint Institute in New South Wales, Australia.

Bogduk, a strong proponent of using nerve blocks, said a true analysis of cost would need to take this into account.

According to Cohen, the cost of radiofrequency treatment is about $650 for the first joint, and $350 per additional joint. A nerve block costs about half, he said.

SOURCE: http://link.reuters.com/nen39m Anesthesiology, July 23, 2010.

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Best Language Study Website

www.smart.fm

Based in Japan

日本人和在日本的美国人搞的。最好的语言学习网站了。

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死亡人数今天上升至21。

图片报发新照片，距事件发生前半小时，距死亡台阶15米的地方，似乎很空旷。

为何到现在还没有现场完整的录像呢？

北威州长公布：Alle Opfer starben an Brust-Questschungen! 所有遇难者死因是胸部积压伤

FOCUS Online: Diabetes steckt im Knochen

Aus der FOCUS-Online-iPhone-App:

Stoffwechsel - Diabetes steckt im Knochen

http://tinyurl.com/3xlhgj6/?mobile=no

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LOVEPARADE-DRAMA Das Todes-Protokoll,德国Duisburg的Massenpanik我的记录

7月24日

18点30，msnbc把消息push给我，说10个死了，看bild.de有11个死者，而后瑞士的20 minutes也推了。电视只有ntv实况报道。后来CNN也推了。

19点ntv说死了15个。

7月25日 

10点30说死了19个。
        
到外面特意买了星期天版的

11点新闻发布会说19死，342伤。包括一个中国人。

下午RTL最先做了事件回放记录。

Chronologie der Tragödie - So kam es zur Massenpanik


7月26日

中午吃饭时，又买了图片报。尽管有iphone和网络，纸质还是有必要的

14具尸体躺在这个应急梯附近。感觉大部分德国人还是很discipline的，不然会在隧道里成百的死亡。

bild的回放

LOVEPARADE-DRAMA
Das Todes-Protokoll

Spiegel的一个视频专题很好。

接下来，就是确定责任......

晚上新闻，20死，511伤，43留医。

这次组织和管理者脑子进水了。一个50万人口的城市，招来了1百40万游客，且只通过那个该死的地下隧道入场，实际上，没有门票，不花任何钱，为何只设一个入口。

Shoulder arthritis occurs in many forms

http://healthwebsite1.webs.com/apps/blog/

Shoulder Arthritis

Posted by healthwebsite1 on March 5, 2010 at 2:33 PM

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Shoulder arthritis occurs in many forms. Osteoarthritisis the most common of shoulder arthritis types. It is also known as wear and tear arthritis as it leads to wearing off of the joint cartilage which is a protective shield for the bone. Another type of arthritis isrheumatoid arthritis. This is also quite commonly found to occur in most of the arthritis cases. In this type, the inflammation occurs in joint linings, which later on harms the cartilage and then the bone. The issue hits people who have crossed 50. People who already have had shoulder issues are more likely to develop this problem. Genetic influence also increases this likeliness. 

 

The symptoms of shoulder arthritis may show, but not in progressive way. They may appear according to weather or seasonal changes or due to some kind of activities. Not all days are the same for these symptoms to occur, which may be decrease in the range of comfortable motion, shoulder getting stiff, tenderness and swelling in the joint. The patient may feel immense pain while doing any particular physical work that may be involving a specific shoulder movement. This particular symptom when constantly felt indicates the person that something is wrong and that it should be taken into consideration.

 

Shoulder arthritis is diagnosed with the help of physical examinations and a couple of x-ray tests. These tests are performed later also, inorder to track progression of the disease. The treatment mode to be adopted for arthritis cases depend largely upon the particular case and the patient. Not all cases can be handled the same way. Initially, the treatment may be started the basic way and later on it may get to advanced versions. As the patient responds, alterations are made in the treatment plan. It takes a matter of time before the patient shows positive results.

Throat Cancer

Posted by healthwebsite1 on March 5, 2010 at 10:16 AM

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Cancer can occur at any part of the body and can be equally hazardous. Throat cancer, as the name suggests, refers to the cancer in the throat. It not only affects the throat but also impacts other nearby areas like back of the tongue, tonsils, pharynx and esophagus. Some cases are also known to be oropharyngeal cancerand hypopharyngeal cancer cases. The conditions where tonsils are affected by the cancer, are reported to be very painful for the patient. Throat cancer may not be indicated at very initial stage as its symptoms may be associated with other throat issues until the diagnosis is done.

 

Signs of throat cancer may be soreness in the throatwhich does not go for quite a long time. Cough is another major symptom that too keeps bothering for longer durations. The person may find extreme difficulty while eating and swallowing food. He may feel pain even while drinking. You may also find noticeable loss of weight though you may wonder about the cause. This loss of weight may lead to weakness. Mostly people tend to consider these cases as simple issue unless they encountered real serious ones. Along with these simple issues, the person may also have pain in the ear and areas close by. In some cases, the person may find lumps in back portion of the mouth or the throat.

 

In advanced cases of throat cancer where the cancer reaches voice box, breathing becomes very difficult and throat may start from the throat. As you spit, you may find blood-strains in the sputum. The case where blood is found in the sputum should be taken as a emergency case as it occurs mostly in advanced cases when treatment becomes difficult and chances of recovery become relatively low. The cancer is diagnosable on time and therefore should be presented to the doctor as early as possible.

Deficiency of Choline

Posted by healthwebsite1 on March 5, 2010 at 6:29 AM

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A lot of study has been done on choline to know what exactly it is. In late 1930s, scientists found that it is a pancreatic substance which prevents the fat build-up in the liver. It is not only associated with pancreas or liver but is also found in every cell of the human body. Today, it is considered to be a part of vitamin B family. Choline performs many functions in the body. It maintains the integrity of cell membranes, supports the metabolism of methyl group and activities of the nervous system. Not only this, it also lessens down the severity of any kind of inflammation. Deficiency of choline increases risks of many types.

 

Deficiency of choline increases the probability of coronary heart disease (CHD) and other related issues. Though, CHD is caused due to increase in the blood level of homocystiene. But since, choline also contributed to the conversion of homocysteine, its deficiency may lead to such problems. Choline's deficiency cases may be mild as well as severe. In mild cases, the person may experience tiredness, sleeplessness, memory-related issues and some kidney problems. The severe cases may cause liver malfunction, heart diseases, growth obstruction, shortage of red blood cells, diminishing fertility, anemia and blood pressure problems. Other serious problems like kidney failure and respiratory problems have also been seen among people who are choline deficient.

 

The deficiency of choline may also lead to vitamin B deficiency. The worst impact of this deficient is that the messenger molecule of nervous system known as acetylcholine, no longer remains in the body. Acetylcholine does not form in the absence of choline. The deficiency is caused majorly due to poor diet, the diet that is lacking in essential nutrients like various vitamins including vitamin B and folic acid. The deficiency of other nutrients causes choline deficiency. So to avoid these many problems, have a healthy and rich diet.

Broken Nose

Posted by healthwebsite1 on March 4, 2010 at 6:40 AM

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Broken nose refers to a nose fracture or crack in the bone of the nose. It may happen due to any injury during sports activity or fights or may be due to road accidents or major fall. The crack may also happen due to injury caused by a very sharp knife. Any injury to the nose can be very painful but one should get confirmed of any fracture has occurred or not. Many symptoms indicate this. Swelling of the nose after the injury, deformity seen in the nose, due to which the nose is termed as crooked nose and, tenderness felt in the touch are the two major symptoms that clearly indicate about the condition. Other symptoms can be bruised nose and bleeding through it. Slight crack sound while touching the nose also proves, the nose has got a crack.

 

Due to broken nose, the person may hardly be able to breathe due to sheer pain. Though some of these symptoms when found as one, might not seem to you too complicated. But if you find that the swelling persists even after 3 days or breathing still seems to be difficult even after the swelling is gone, or you get fever, all these post-symptoms should be considered as serious issues and doctor should be contacted. Also if you find your nose is bleeding quite often after the injury, you may consider as alarming.

 

The condition of broken nose should be considered as an emergency case if, transparent fluid is discharged from the injured nose or the person faints immediately after the violent blow to his face or nose. Even if after the accident, he feels severe headaches that are difficult to bear with, he should be considered as emergency patient. Any injury to the nose may also lead to recurring vomits and pain in the neck. He may also feel numbness in the nose area or other facial areas. All these symptoms call for immediate medical attention and action.

Myasthenia Gravis

Posted by healthwebsite1 on March 2, 2010 at 6:11 AM

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Myasthenia gravis is a muscle disease which is associated with neurological disorders. Therefore it is considered as neuromuscular disease. It is also known to be an autoimmune disorder since it is caused by antibodies that prohibit acetylcholine receptors. Therefore, this objects their stimulative effects. The problem is sorted out with the help of immunosuppresants. The most common symptom of gravis is weakness in muscles or fatiguing of musclesof any particular area for some time and then their getting back to normal after some time. To get normal, the person may require to take some rest for a while. The muscles of eyes control their movement. Facial muscles control facial expressions, aid in doing facial activities like chewing, swallowing and talking. When these muscles get this disorder, they stop functioning for a while. As a result, all these activities are hampered for some time. After that, they get normal and the person starts performing these activities normally.

 

Myasthenia gravis may happen to other muscles also that aid in performing many other important functions like breathing. It may also impact neck muscles and limb muscles making situations difficult for movements. This can happen at nay point of time. The symptoms may also be not very regular. Therefore the diagnosis gets delayed as people don't find it necessary. When any person's speech gets impacted for sometime then he may realize the problem and seek diagnosis. The disease is characterized by the body's antibodies being directed against its own receptors.

 

Myasthenia gravis indicates weakening of muscles so their strengthening may only help in its treatment. It is diagnosed through a thorough physical examination in which the patient has to undergo certain activity tests. This helps in knowing what is wrong and at what point, thereby concluding about the disease. Other tests include blood tests, edrophonium test, neurophysiology, pulmonary function test and some pathology tests.

Eye Transplantation

Posted by healthwebsite1 on January 29, 2010 at 4:34 PM

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Eye transplantation is often believed to be the process in which entire eye is transplanted. But that is not so. Actually, the surgery involves transplantation of just the cornea of the eye. Therefore it is also known ascorneal transplant. Medically the procedure is termed as keratoplasty. Today, the eye transplant is practiced most of all and has gained immense success and popularity. The method is used to treat many eye problems like corneal scarring, infection and failure. The eye-related issues that occur due to genetic reasons are also given transplantation treatment.

 

Eye ailments like keratokonus in which the shape of the cornea turns thin are also corrected by this method. Any injury to the eye that has been caused accidentally can also be given eye transplants, if required. The actual organ, cornea which is transplanted cannot be manufactured or engineered. It can be have only from the donor who is willing to donate it after his death. The patient's consent is also taken. His eye area is given a local anesthesia or probably a sedative that makes him feel comfortably sleepy. The area to be operated is then, cleaned properly. The complete surgery is done using operating microscope. After theeye transplantation operation is done, the patient is required to stay in the hospital just for one or two days.

 

After the eye transplantation surgery, the patient is recommended certain medicines like eye drops containing antibiotic to prevent eye infection of any kind, steroid that aids in organ acceptance and cyclopegic eye solution drops which is meant to relax eye muscles. Along with these medicines, painkiller medicines may also be administered to keep him calm and fine. The patient requires to take complete care of the eye and should do anything to keep it safe from dust and infection. The success of the operation largely depends upon the quality of cornea given by the donor, doctor's expertise and patient's age.

Denture Problems

Posted by healthwebsite1 on January 29, 2010 at 3:19 PM

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Getting denture can be a relief for those having no teeth at all but at the same time, it can also bring some concerns. These concerns may be related to somedenture problems need to be aware about for all those who are going to start using them or are already using them. It is true that artificial teeth cannot replace natural ones completely but you can sure try to make their usage as comfortable as possible. The denture related pain and discomfort can be coped up provided you know and follow some useful tips and instructions related to its use.

The most known cause for denture problems is related to its fitting issues. Until your denture fits in your gums completely, you may be having continuous discomfort, if not pain. This discomfort may be due to constant sliding of the denture above your gums. This may even injure your gums at times, leading to gums swelling or even gum bleeding. If you keep ignoring the problem, it may become give rise to other complications, making the problems unbearable. You should therefore, know about some dental facts that can help you understand causes of the problems. Dentures may be loose fitting due to the very fact that your dental ridges keep changing in shape thereby resulting to changing the fitting of dentures on them. This can be the main cause of denture-discomfort. To ease down the situation, you can use some dental cushions and adhesives that can help in fitting.

If you find your gums are inflamed, take your dentures out and give some time to your gums to take rest. Their exposure to air may help them revive. Denture problems may also arise as a result of poor denture hygiene. Due to this, several kinds of infections can harm your entire mouth. So it is very vital to keep your dentures clean, preserve them in clean solution while you are not using them and rinsing the mouth before you fit them again.

Bad Breath

Posted by healthwebsite1 on January 29, 2010 at 10:14 AM

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Bad breath is a common issue known to be the major point of embarrassment for many. It can happen to anyone, anytime due to certain reasons. The scientific name of this condition is halitosis. Until the cause is a serious one, it can be treated with the help of simple tips and measures. If the problem takes a chronic turn, it may be associated to a complex medical issue that needs timely diagnosis and treatment by a professional dentist. Foul smell in the breath can commonly be caused due to the food you eat. There are certain foods, even the small quantities of which causes really bad smell in the mouth. Foods containing garlic, onion, spices, eggs and non-vegetables are known to be having strong odors.

 

After the digestion when these foods get absorbed in the blood and the blood gets into the lungs, the air being exhaled out from the lungs is found to be carrying the smell. Another factor responsible for bad breath is digestion of foods we eat. During the digestion process, gases are produced that in the form of burps, come out from your mouth, giving smell bad enough to make anyone feel sick.

 

People who don't give ample time to brushing of teeth also, face this problem. Insufficient tooth brushing for long duration causes remains of food that you had been eating. This food decays and gives a clear way to bad breath. The deposition of floss on the tongue also results due to this reason and contributes to this menace. Not only this, several oral diseases also occur that can be painful for you to cope-up with. In worst cases, people have to give up with their oral assets that had been playing such important roles in their lives. Therefore, it is important to consider sufficient cleaning of teeth and gums on regular basis or else you never know, how many times you get embarrassed and where.

Problem of Vaginal Discharge

Posted by healthwebsite1 on December 31, 2009 at 1:13 AM

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Problem of vaginal discharge is a common problem among women. Most of the minor problems remain unidentified as women think that's normal. It is very important for any woman to know to what extent is the vaginal discharge normal and to what, it's not. One should clearly know that little discharge that keeps the surface moist is normal. This discharge is little acidic in nature which cleans off the bacteria and dead cells from the area. It comes from the cervix. The normal vaginal discharge varies woman to woman, her body composition and menstrual cycle. The discharge may increase on certain conditions. For example, during any sexual activity, it increases to act as lubricant for sexual intercourse. 

As far as the discharge does not smell, or does not cause any itching or irritation in the vagina it is normal. If the discharge starts smelling, or becomes white and thick in consistency, contains stains, little or large amount of blood, it is abnormal which means there isvaginal infection. The abnormal vaginal discharge should be treated with due consultation from a suitable doctor or gynecologist. The problem of vaginal discharge can take a serious turn anytime. This can also be the indicator of possible risk associated to any sexually transmitted diseases through unprotected sexual intercourse. So it is better to get the problem diagnosed and start with the required treatment so that major risks involved, are avoided.

As soon as the problem of vaginal discharge is diagnosed, the woman should take care that she maintains proper hygiene. During periods she should change her pads frequently and should avoid the use of tampons during non-period days. It would be wise even for the partner to go for the checkup, may be he is infected. The doctor may also advice certain medicines in the form of tablets and ointments. The woman should follow exactly what the doctor tells her and should go for the checkup even after the infection is gone.

Folic Acid For Pregnancy

Posted by healthwebsite1 on December 30, 2009 at 10:50 PM

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Once the woman knows she has conceived and is having a normal pregnancy, she is recommended supplements for iron, calcium and folic acid. Folic acid, also known as folate is actually vitamin B9 which is found in green and leafy vegetables like spinach. Folic acid for pregnancy can be very beneficial. It promises healthy growth of the baby by reducing chances of many birth defects in the baby. These defects include neural and spinal defects. Folic acid is advised to be taken strictly daily basis, immediately after conception and during early pregnancy. Folic acid is a not-to-miss nutritional supplement that promises its benefits for wellbeing of the mother and her baby.

 

The commonest of neural defects in the baby is spina bifida. Other defects include enencephaly characterized by under-development of brain and encephalocele that shows protrusion of a brain tissue from the skull and skin of the baby. The vitamin in folic acid is also vital for development of DNA. So folic acid for pregnancy, is the essential-most ingredient and should be consumed religiously. Infact, it is advised even to the women who are planning to conceive. Before getting pregnant, women should check they have enough of folic acid and if they don't they should start having it as soon as possible, even before pregnancy.

 

Folic acid helps in generation of cells. Apart from supplements, the mother should also have diet rich in these nutrients. There are many food items available in the market that rich in folic acid. These foods include pastas, breads, cereals and grains like rice. To ensure you are having the required quantity, you need to have supplements in the form of pills. So, every expectant mother or women expected to conceive should stay sure they are having the needed amount of folic acid for pregnancy or else they may later, regret for not having it.

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Bone 'turnover' link to diabetes

http://www.bbc.co.uk/news/health-10727169

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19死，342伤，死者中有一个中国人，还有一些其他外国人，包括荷兰，澳大利亚，墨西哥等

Loveparade 2010 Duisburg; kurz vor der massenpanik

事件之前



ntv


WDR


ZDF




RTL


Pressekonferenz Loveparade 2010, 25.7.2010, 12 Uhr


一个只有50万人的城市，来年了1百40万人。。。


DW World

文字

图片

事件回放，也只有RTL做了这个编辑

Massenpanik: Tote und Verletzte bei Loveparade,目前15死，数十人伤

msnbc把消息推给我，说10个死了，看bild有11个死者，而后瑞士的20 minutes也推了。电视只有ntv刚报道。现在CNN也推了，而后ntv说15死。。。

http://www.n-tv.de/panorama/15-Menschen-sterben-bei-Loveparade-article1127116.html

stern.de: Hilfe jenseits der Schulmedizin

Aus der stern.de-iPhone-App:

Alternative Heilmethoden gegen Kopfschmerzen: - Hilfe jenseits der Schulmedizin

http://www.stern.de/kopfschmerz/therapie/alternative-heilmethoden-gegen-kopfschmerzen-hilfe-jenseits-der-schulmedizin-598497.html

Link zum AppStore: http://itunes.apple.com/de/app/stern-de/id306192028?mt=8

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stern.de: Krank im Kreuz

Aus der stern.de-iPhone-App:

Rückenschmerzen - Krank im Kreuz

http://www.stern.de/ruecken/erkrankungen/rueckenschmerzen-krank-im-kreuz-659057.html

Link zum AppStore: http://itunes.apple.com/de/app/stern-de/id306192028?mt=8

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FOCUS Online: Der Kick für den Rücken

Aus der FOCUS-Online-iPhone-App:

Skechers, MBT & Co. - Der Kick für den Rücken

http://tinyurl.com/2w86gw2/?mobile=no

Von meinem iPhone gesendet

FOCUS Online: Diabetes steckt im Knochen

Aus der FOCUS-Online-iPhone-App:

Stoffwechsel - Diabetes steckt im Knochen

http://tinyurl.com/3xlhgj6/?mobile=no

Von meinem iPhone gesendet

Glucosamine doesn't ease low back pain: study

Glucosamine doesn't ease low back pain: study

By Genevra Pittman

NEW YORK (Reuters Health) - The popular anti-arthritis supplement glucosamine may not help most cases of low back pain, according to a new study. Patients were no better after treatment with glucosamine than after treatment with placebo.

While it's possible that glucosamine could be beneficial for some people with low back pain, said Dr. Philip Wilkens, the lead author on the study and a chiropractor at Oslo University Hospital in Norway, it's hard to know which ones.

Glucosamine is one of the most popular supplements used by people with osteoarthritis, and it's shown some success for that indication at other sites in the body. About a quarter of patients with lower back pain use it, but there hasn't been much evidence to show that it improves their symptoms.

Dr. Wilkens and his colleagues enrolled 250 outpatients with low back pain in a randomized trial. All of the patients had at least some degree of degenerative lumbar osteoarthritis. Half received a standard dose of glucosamine (1500 mg/day) for six months, and the other half received placebo.

At baseline, at the end of the treatment period, and again six months after that, the patients completed questionnaires about their pain and how it interfered with their lives.

Immediately after treatment ended as well as 6 months later, both groups reported fewer problems related to their back pain - but people who took the placebo improved just as much as people on glucosamine, according to the report, which was published July 6th in the Journal of the American Medical Association.

About a third of patients in each group had mild stomach or skin problems, but there were no serious side effects caused by glucosamine.

The authors believe part of the improvement in patients' pain might have been due to the fact that they were allowed to get other treatment during the study. The rest of the improvement, said Dr. Wilkens, could be a placebo effect. Also, he said, patients with chronic pain have periods of getting better and worse, and most were probably in their worse state when they agreed to start the trial.

Glucosamine is considered a dietary supplement in the United States, so the FDA does not approve it for medical use. It is, however, approved for medical use in most of Europe. Glucosamine can be bought without a prescription, often for less than 50 cents a day.

The results of the study shouldn't discourage people who take glucosamine for other types of osteoarthritis, Dr. Wilkens said. Because of differences in joints, glucosamine may act differently in other parts of the body, he noted.

"It's probably helping a lot of people with knee pain," he told Reuters Health. But in terms of using it as a treatment for people with low back pain, "our evidence suggests that (they're) not going to benefit."

http://link.reuters.com/nyz95m

JAMA 2010.



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