I had a c section with my first child. No risks just stalled dilation. They told me they were concerned about his heart rate dropping and they needed to do a c section so I said yes then. After the procedure however the nurses hinted that it was so the dr could go home sooner by sending all her patients to c section. This was in CA. It has made me hesitant about trusting doctors in a sense as I only wanted intervention if necessary.
I’m pregnant again and I’m in WV now and I expressed that I wanted a natural birth this time. I am aware of the risks of uterine rupture during labor. My OB assured me that I’d be able to do it naturally after my records were sent from CA. They initially told me that we could schedule a c section just in case and if I wanted then we could push it back to allow for more time to go into labor naturally. I expressed that I wanted to go to full term. But I didn’t want to go past 41 weeks.
They scheduled it at 39 weeks and when I asked to push it I was told that the OB will be on vacation that week and that it’ll be tough to get one scheduled because it’s Fourth of July week. I can’t change my due date that is just the week she’s due. I don’t want her to be born on a holiday but she should come when she’s ready to come.
It just feels like they’re now pressuring me to give birth to my child on their schedule instead of when my child is actually ready. It feels like they’re changing up what was said before.
I’m tempted to not show up for the scheduled c section. A part of me feels like I have no other choice and the other is that I deserve to have the option of letting my daughter come when she’s ready vs when it’s convenient. I only wanted intervention when necessary. I’m 4 weeks away I don’t think I’ll be able to find another OB within that time appointment wise.

the title of each is truncated from the online file name and the study's earliest date added for indexing purposes -- I've each study copied into my PC, links to the studies if that's challenging [DuckDuckGo works better than Google] available on request. In most instances, I've found free versions of the full studies and reports (I'd never ever pay for a copy), but maybe 10% relate to 'abstracts' that were detailed enough to be insightful. For Part 2, I've added the full title of each study/report.
200000 Long-term Exercise Using Weighted Vests in pm women M489

Long-term Exercise Using Weighted Vests Prevents Hip Bone Loss in Postmenopausal Women

We studied the effect of long-term weighted vest plus jumping exercise on hip BMD in postmenopausal women as a strategy for reducing hip fracture risk 80% of women would rather die than be institutionalized as a result of hip fracture. In an earlier study (4), we reported that 9 months of weighted vest exercise reduced fall risk in post menopausal women by improving neuromuscular measures of muscle strength and power and dynamic balance.
Eighteen postmenopausal women (age 64.1 1.6 years at baseline, 69.9 1.6 years at post-testing) who had participated in a 9-month exercise intervention volunteered for the long-term trial. Nine of the original group engaged in weighted vest plus jumping exercise three times per week for 32 weeks of the year over a period of 5 years. Nine of the original controls were active but not enrolled in the exercise program. BMD of the proximal femur was assessed by dual energy x-ray absorptiometry at baseline and after 5 years.
At follow-up, differences in BMD at all regions of the hip were higher in exercisers than controls. For exercisers, changes in BMD were 11.54% 2.37%, 20.24% 1.02%, and 20.82% 1.04% (means 1 SE) at the femoral neck, trochanter, and total hip, respectively; controls decreased at all sites (24.43% 0.93%, 23.43% 1.09%, and 3.80% 1.03%, respectively). When plotted individually for femoral neck, only three of the exercisers lost BMD, whereas all nine of the control women had decreased BMD at this site. Our data support participation in long-term exercise using weighted vests as a strategy for reducing hip fracture risk, a finding that should be confirmed in additional long-term prospective trials. Furthermore, this program is safe and practical and promotes both adherence and compliance in older women.
200000 Daidzein osteoporosis Picheritetal.2000

Daidzein Is More Efficient than Genistein in Preventing Ovariectomy-Induced Bone Loss in Rats

We investigated the ability of genistein and daidzein, two soybean isoflavones, compared with that of 17a-ethinylestradiol, in rats, to prevent bone loss in ovariectomized rats, a model for postmenopausal osteoporosis. daidzein was more efficient than genistein in preventing ovariectomy induced bone loss in rats.
200008 bone-loading-response-varies-with-strain-magnitude-and-cycle-number

Bone-loading response varies with strain magnitude and cycle number

As applied load or strain magnitude decreased, the number of cyc required for activation of formation increased. When load and number of Cycles/day (cyc) are constant, bone formation increases as frequency increases from 0 to 2 Hz (30), and, when frequency increases from 1 to 30 Hz, the strain threshold for bone maintenance decreases from 1,200 to 100 (18). Strain rate, which reflect me strain magnitude and cycle frequency, has been suggested to be one of the most important variables that determines bone response (16, 30).
When cycle number is extremely high and intense loads are applied several hundred times a day for several weeks, as occurs in military training, an almost pathological response has been measured with up to 11% bone gain in 14 wk (14). More traditional responses to exercise have been reported as a 2.2% increase in tibial BMD after 15 wk of basic training (7) or, in gymnasts, as a 2.8% increase in BMD at the spine and a 1.6% increase at the femoral neck after 8 mo of training (26) or, in men, as a 2% increase in BMD at the spine (not significant) and a 3.8% increase at the femoral neck after 16 wk of strength training (15).
Most adults are not willing or able to commit to repetitive high-intensity exercise, and forceful activities may not be safe for individuals at risk of osteoporotic fracture.
This study has shown that bone adaptation to loading is dependent on strain magnitude (rate) and the number of cyc at low frequency.
200100 Effects of Tower Climbing Exercise on Bone Mass Strength and Turnover in

Effects of Tower Climbing Exercise on Bone Mass, Strength, and Turnover in Growing Rats

Rats voluntarily climbed the 200-cm tower to drink water from the bottle set at the top of it. In 4 weeks, the trabecular bone formation rate (BFbone surface [BS]), bone volume (BV/TV), and trabecular thickness (Tb.Th) of both the lumbar vertebra and tibia and the bone mineral density (BMD) of the tibia increased, while the osteoclast surface (Oc.S) decreased. The parameter values in the midfemur, such as the total cross-sectional area, the moment of inertia, the periosteal mineralizing surface (MS/BS), mineral apposition rate (MAR), BFBS, and bending load increased, while the endosteal MAR decreased. In 8 weeks, the increases in the bone mineral content (BMC), BMD of the femur and tibia, and the bending load values of the femur were significant, but the climbing exercise did not increase BMC, BMD, or the compression load of the lumbar vertebra.
The cortical bone formation induced by the climbing exercise seemed to strengthen the structure of the midfemur. The increase in trabecular bone mass of the lumbar vertebrae and tibia was caused by both increased bone formation and reduced bone resorption.
200100 Resistance training and BMD in women

Resistance training and bone mineral density in women: a metaanalysis of controlled trials

The length of the intervention ranged from 18 to 208 weeks and the frequency ranged from twice per week to daily Lumbar spine (23 studies). Small but statistically-significant ES changes in BMD were found at the lumbar spine. These changes were equivalent to a 0.19% decrease in the exercise groups and a 1.45% decrease in the control groups. Radius (10 studies). Small but statistically-significant changes in BMD were observed at the radius. These were equivalent to a 1.22% increase in BMD for the exercise groups and a 0.95% decrease in the control groups.
a change in the percentage of body fat was a significant predictor for ES changes in BMD at the femur. In addition, the initial lean-body mass was a significant predictor for ES changes in BMD at the radius. There was a statistically-significant decrease observed in the percentage of body fat (-2% plus or minus 2; 95% BCI: -3, -1), whereas there was a statistically-significant increase in lean-body mass (2 plus or minus 1 kg; 95% BCI: 1, 2).
Kelley G A, Kelley K S, Tran Z V. Resistance training and bone mineral density in women: a meta-analysis of controlled trials. American Journal of Physical Medicine and Rehabilitation 2001; 80(1): 65-77.
200101 Jumping improves hip and lumbar spine bone mass in prepubescent children

Jumping improves hip and lumbar spine bone mass in prepubescent children: a randomized controlled trial

prepubescent children between the ages of 5.9 and 9.8 years Peak ground reaction forces were calculated across 100, two-footed jumps from a 61-cm (about 24") box. jumpers had significantly greater 7-month changes at the femoral neck and lumbar spine than controls (4.5% and 3.1%, respectively). In repeated measures ANCOVA of secondary outcomes (BMD and BA), BMD at the lumbar spine was significantly greater in jumpers than in controls (2.0%) and approached statistical significance at the femoral neck (1.4%; p = 0.085). For BA, jumpers had significantly greater increases at the femoral neck area than controls (2.9%) but were not different at the spine. Our data indicate that jumping at ground reaction forces of eight times body weight is a safe, effective, and simple method of improving bone mass at the hip and spine in children
200103 home exercise programme to prevent falls 701

Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 2: Controlled trial in multiple centres

Falls were reduced by 30% in the exercise centres there was no difference in the number who had serious injuries and no difference in hospital costs resulting from falls in exercise centres compared with control centres.
200107 Recovery periods restore mechanosensitivity to dynamically loaded bone 3389

Recovery periods restore mechanosensitivity to dynamically loaded bone

more than 100 % higher relative bone formation rates in the 8 h recovery group than in the 0 and 0.5 h recovery groups. Approximately 8 h of recovery was sufficient to restore full mechanosensitivity to the cells. In the rats allowed time to recover between load cycles, 14 s of recovery resulted in significantly higher (66–190 %) relative bone formation rates compared to any of the three shorter recovery periods. Those experiments highlight two key points about bone mechanosensitivity: (i) that mechanical loading sessions need not be long to maximize bone formation, and (ii) that extending the loading session beyond a few minutes does not contribute any additional osteogenic effect.
rest periods lasting 10 s, introduced between individual loading cycles, enhanced the amount of surface actively forming new bone compared to bones that had been loaded for the same number of cycles but lacked a recovery period between cycles (back to- back cycles). Longer recovery periods resulted in higher relative bone formation rates. In tibias allowed 8 h of recovery between each of the four daily loading bouts, relative bone formation rates were 125 % greater than the rates found in animals that had received the four bouts with no recovery time between bouts (0 h group) and 102 % greater than the rates found in animals that had received the four bouts with a 0.5 h recovery time between bouts. a recovery period of approximately 8 h between bouts is sufficient to restore full mechanosensitivity to the cells.
relative mineralizing surface and relative bone formation rate were significantly (66–190 %) higher in the 14 s group than in any of the three remaining bending groups (Fig. 6A,C). No significant differences were found among the 0.5, 3.5 and 7 s groups. Thus, the results suggest the existence of a short-term recovery threshold somewhere between 7 and 14 s, beyond which bone formation is enhanced over more closely spaced cycles. we show that only 8 h of recovery is necessary to restore mechanosensitivity to adapted bone cells. load cycles spaced 14 s apart result in a greater amount of bone formed per cycle than occurs when cycles are spaced by 7 s or less.
200200 Low-Magnitude Mechanical Loading Becomes Osteogenic When Rest Is Inserted

Low-Magnitude Mechanical Loading Becomes Osteogenic When Rest Is Inserted Between Each Load Cycle

we found that insertion of a 10-s rest interval between each load cycle transformed a locomotion-like loading regime that minimally influenced osteoblast activity into a potent anabolic stimulus. 10 s of rest between each load cycle of a low-magnitude loading protocol greatly enhances the osteogenic potential of the regimen. suggesting that load induced fluid flows near osteocytes were reduced substantially (45%) beyond the first few load cycles of repetitive ( loading.( locomotion-like mechanical insertion of a 10-s rest interval between each load cycle transformed a low-magnitude minimally osteogenic loading regimen into a potent osteogenic stimulus in two distinct in vivo models of bone adaptation
200211 Walking and leisure-time activity and risk of hip fracture in postmenopausal women

Walking and leisure-time activity and risk of hip fracture in postmenopausal women

Walking is the most common activity among older adults, and evidence suggests that it can increase femoral bone density and reduce fracture risk. risk of hip fracture was lowered by % (% condence interval [CI], %-%; P<.) for each increase of metabolic equivalent (MET)-hours per week of activity (equivalent to h/wk of walking at an average pace). Active women with at least MET-h/wk had a % lower risk of hip fracture (relative risk [RR], .; % CI, .-.) compared with sedentary women with less than MET-h/wk. Even women with a lower risk of hip fracture due to higher body weight experienced a further reduction in risk with higher levels of activity.
200300 designing_exercise_regimens_to_increase_bone.9

Designing Exercise Regimens to Increase Bone Strength

bone mass (or areal BMD (aBMD)) is merely a surrogate measure for bone strength The load induced increase in aBMD and BMC were modest, reaching 5.4% and 6.9%, respectively. Despite these small gains in bone mineral, mechanical testing revealed a 64% increase in ultimate force (the maximum amount of force the bone could support before failing) and a 94% increase in energy to failure (the amount of energy absorbed by the bone before failure). The reason that a small amount of new bone resulted in such dramatic changes in bone strength is because the new bone formation was localized to the medial and lateral periosteal surfaces where mechanical strains (stresses) were greatest. only modest increases in total new bone formation produced a large increase in bone strength by placing bone where the biomechanical demands were greatest. assessment should include some measure of bone shape and size.
High impact exercises that produce large rates of deformation of the bone matrix best drive fluid through the lacunar canalicular network system. In addition, loading applied at higher frequency (cycles per second) more effectively stimulates osteogenesis. The required mechanical load necessary to initiate new bone formation decreases as the loading frequency increases. exercise is most effective if delivered in short bouts separated by several hours. ASSESSING EXERCISE: THE OSTEOGENIC INDEX
the weekly OI generated by 20 min of walking 5 1 d·w k is 36.8. This is calculated under the assumption that a 20-min walk generates approximately 800 loading cycles to each leg and that the peak load is 1.1 times body weight, or OI (week) 1.1 times body weight) * ln[800 cycles 1 * 5dwk1) 36.8 [3] 1 d . The OI for multiple bouts of loading depends upon the recovery time allowed between sessions. Therefore, three parameters are required to assess OI: intensity, N, and time between sessions. For mild-impact exercise, such as jumping, 1, 5 times·w k the OI varies from 50 when jumping 150 1 1. times·w k to 70 for 600 jumps·wk
The osteogenic potential of exercise can be increased further when the daily exercise is divided into two shorter sessions separated by 8 h. 1 For example, consider 120 jumps· d done in one session or broken into either two sessions of 60 jumps separated by 8 h or three sessions of 40 jumps separated by 4 h: OI (1 sessiond1) 3 (times body weight) * ln[120 cycles 1] 14.4 , [4] OI (2 sessionsd1) 3 * ln[60 1] 3 * ln[60 1] 1 e 8h /6h) 21.4 , [5] 1 OI (3 sessionsd1) 3 * ln[40 1] 3 * ln[40 1] * (1e 4h /6h) 3 * ln[40 1] 1 e 4h /6h) * (1 4h/ 6h) 19.2 [6] e 1
Consequently, breaking 120 jumps into two sessions improves the OI by almost 50%, the osteogenic 1 effectiveness of 600 jumps·wk is more than doubled if the exercise is delivered in 5 daily sessions, rather than 2 1. times·w k
Jump training improved BMC in the hip and spine when performed 3 times·wk (1). However, when the number of sessions was reduced to 2 times·wk jumping did not significantly affect BMC (2). engaging in exercise during skeletal growth is unequivocally more osteogenic than exercise during skeletal maturity those who started playing at an early age (several years before menarche) had more than two times as much differential (playing arm vs nonplaying arm) in mineral accrual than those who started playing during their adult years.
200300 Walking and Reduction of Hip Fracture Risk in Older Women AAFP

Walking and Reduction of Hip Fracture Risk in Older Women

Walking was subdivided according to pace: easy (less than 2 miles per hour [mph]), average, brisk, and very brisk (4 mph or faster); “unable to walk” was also a category. Each activity was assigned a metabolic equivalent (MET) score, with 1 MET being the energy expended during quiet sitting. The median total activity for the study participants was seven MET-hours per week, which is equivalent to the energy expended while walking at an average pace for 2.3 hours per week. Activity and body mass index (BMI) inversely and independently correlated with hip fracture risk. Women with 24 MET-hours per week had a 55 percent lower occurrence of hip fracture than those reporting three MET-hours per week. The risk of hip fracture declined by 6 percent for each MET-hour per week (dose-dependent reduction). Heavier women had a lower fracture risk in every activity category. Hormone replacement therapy conferred the greatest risk reduction in women with the lowest level of activity (less than three MET-hours per week).Very active women (24 MET-hours per week or more) received no added benefit from hormone therapy. Walking for four hours a week or more was associated with a risk reduction of 41 percent. Furthermore, the brisker the pace, the greater the risk reduction.
standing for 10 hours a week or more also was associated with a signicantly lower risk of hip fracture.
200400 physical_activity_and_bone_health.24

Physical Activity and Bone Health

Mode: weight-bearing endurance activities (tennis; stair climbing; jogging, at least intermittently during walking), activities that involve jumping (volleyball, basketball), and resistance exercise (weight lifting) Intensity: moderate to high, in terms of bone-loading forces Frequency: weight-bearing endurance activities 3–5 times per week; resistance exercise 2–3 times per week 1 Duration: 30–60 min d of a combination of weight-bearing endurance activities, activities that involve jumping, and resistance exercise that targets all major muscle groups
Because it takes 3–4 months for one remodeling cycle to complete the sequence of bone resorption, formation, and mineralization (85), a minimum of 6–8 months is required to achieve a new steady-state bone mass that is measurable. Activities that simulate resistance training in humans, including jumping up to a platform, voluntary tower climbing, and simulated “squat” exercises, have been found to have positive effects on both cortical and trabecular bone regions of the tibia and femur Peak bone mineral accrual rate has been reported to occur at puberty (2), with 26% of adult total body bone mineral accrued within a 2-yr period of this time bone appears to be most responsive to mechanical stress during Tanner stages II through IV In a 5-yr study of a small group of postmenopausal women, exercisers who wore weighted vests averaging 5 kg during jumping activity preserved hip BMD to a greater extent than control subjects (110). men who reported participation in vigorous physical activity had a 62% lower relative risk of hip fracture than men who indicated they did not participate in vigorous physical activity
200401 Risk of Mortality kwh274

The “Weekend Warrior” and Risk of Mortality

The multivariate relative risks for mortality among the sedentary, insufficiently active, weekend warriors, and regularly active men were 1.00 (referent), 0.75 (95% confidence interval CI): 0.62, 0.91), 0.85 (95% CI: 0.65, 1.11), and 0.64 (95% CI: 0.55, 0.73), respectively.
200505 impact exercise on bone mineral density in elderly women with low BMD 30-month intervention

Effect of impact exercise on bone mineral density in elderly women with low BMD: a population-based randomized controlled 30-month intervention.

Participants (n=160) were randomly assigned to 30 months either of supervised and home-based impact exercise training or of no intervention. Outcomes were assessed at baseline, 12 months and 30 months using blinded operators. The analyses were performed on an intention-to-treat analysis. Mean femoral neck and trochanter BMD decreased in the control group [-1.1%, 95% confidence interval (CI) -0.1% to -2.1% and -1.6%, 95% CI -0.4% to -2.7%], while no change occurred in the exercise group. Mean trochanter BMC decreased more in the control group (-7.7%, 95% CI -9.7% to -5.6% vs. -2.9%, 95% CI -5.3 to -0.9). There were six falls that resulted in fractures in the exercise group and 16 in the control group during the 30-month intervention (P=0.019). A significant bone loss occurred in both groups at the radius and calcaneum. In multivariate analysis, weight gain was associated with increased BMD and BMC at all femur sites both in the exercise group and in the pooled groups. In conclusion, impact exercise had no effect on BMD, while there was a positive effect on BMC at the trochanter. Exercise may prevent fall-related fractures in elderly women with low bone mass.
200506 low-repetition-jump-training-on-bone-mineral-density-in-young-women

Effect of low-repetition jump training on bone mineral density in young women

—The hypothesis of the present study was that low-repetition and high-impact training of 10 maximum vertical jumps/day, 3 times/wk would be effective for improving bone mineral density (BMD) in ordinary young women. low-repetition and high-impact jumps enhanced BMD at the specific bone sites in young women who had almost reached the age of peak bone mass Jo hannsen and coworkers (11) have found greater increases in total and leg bone mineral content (BMC) by relatively fewer jumps from a 45-cm-high box, 25 jumps/day, 5 times/wk, total of 125 jumps/wk in a randomized, controlled trial conducted with children (3–18 yr). Also, Snow et al. (24) reported, after 5 yr of resistance training with weighted vest and an average 51.7 jumps/day, 3 times/wk, for a total of 155 jumps/wk from a 20.3-cm-high step, improved femoral neck BMD compared with a control group in postmenopausal woman (64.1– 69.9 yr).
to bring intakes over 650 mg/day of elemental calcium, which exceeds the requirements for the recommended calcium allowances in Japanese adult women of this age At both visits for measuring jump height, subjects jumped vertically at least twice with maximum voluntary effort, and the best performance was recorded. The subjects stood at the center of the circular thin rubber mat (38 cm in diameter). The jumper attached the height measuring device to her waist. The jump height measuring device and the circular mat were attached by a rope so that the traveling distance from the standing position to the maximum height reached at waist level could be measured.
Heinonen et al. (7) reported that high-impact jump training from a height of 10–25 cm, at which the estimated GRF is 2.1–5.6 times BW, produced significant improvement in femoral neck and lumbar spine BMD in premenopausal women aged 35–45 yr. In conclusion, the results of the present study indicate that 10 maximum vertical jumps/day, 3 days/wk enhanced BMD at the femoral neck in young women who had almost reached the age of peak bone mass. For practical applications, low-repetition high-impact jumps are suggested to be one of the ideal training methods for enhancing and maintaining peak bone mass in young adult women.
200509 Bounceat_the_Bell_A_novel_program_of_short_bouts

"Bounce at the Bell": A novel program of short bouts of exercise improves proximal femur bone mass in early pubertal children

,3 10 counter-movement jumps 36 per day (total min/day). bone mineral content (BMC) Intervention children gained significantly more BMC at the total proximal femur (2%) and the intertrochanteric region (27%). took only a few minutes each day and enhanced bone mass at the weight bearing proximal femur in early pubertal children.
Upwards of 90% of adult bone mass is acquired by the end of adolescence,
Teachers instructed the children to perform 10 counter movement jumps (two foot take off, clutch knees, two foot landing), three times each school day (once at morning bell, once at noon bell, and once at home time bell). Ground reaction forces for a counter movement jump were five times body weight (BW) and maximum rate of force was .400 BW/s
200606 Leisure Physical Activity and the Risk of Fracture in Men pmed.0040199

Leisure Physical Activity and the Risk of Fracture in Men

Men with a sedentarylifestyle (HR 2.56, 95% confidence interval 1.55–4.24) or men who walked or bicycled only for pleasure (HR 1.61, 95% confidence interval 1.10–2.36) had an increased adjusted risk of hip fracture compared with men who participated in regular sports activities for at least 3 h/wk. At the end of follow-up, 8.4% of the men with a high physical activity, 13.3% of the men with a medium physical activity, and 20.5% of the men with a low physical activity had suffered a hip fracture.
200608 Exercise maintains bone density at spine and hip. early postmenopausal women

Exercise maintains bone density at spine and hip EFOPS: A 3-year longitudinal study in early postmenopausal women

The exercise strategy emphasized low-volume high resistance strength training and high-impact aerobics. After 38 months, the following within-group changes were measured: DXA lumbar spine, EG: 0.8% n.s.; CG: )3.3% P <0.001; QCT trabecular ROI, EG: 1.1% n.s; ) CG: 7.7% P <0.001; QCT cortical ROI, EG: 5.3% P ) <0.001; CG: 2.6% P <0.001; DXA total hip: EG: )0.2% n.s; CG )1.9%, P <0.001; DXA distal forearm, ) EG: 2.8% P <0.001; CG: )3.8% P <0.001; BUA, ) EG: 0.3% n.s; CG )5.4% P <0.001; SOS, EG: 0.3% n.s; CG )1.0% P <0.001. At year 3 between-group differences relative to the exercise group were: DXA lumbar spine: 4.1% P <0.001; QCT trabecular ROI: 8.8% P <0.001; QCT cortical ROI: 7.9% P <0.001; DXA total hip: 2.1%, P <0.001; DXA distal forearm: 1.0% n.s.; BUA: 5.8% P <0.05; SOS: 1.3% P <0.001.
a long-term exercise study with low to moderate training volume, but high-resistance intensity along with high-impact aerobics and endurance for early postmen opausal women with osteopenia. Group training session supplemented with calcium and cholecalciferol to ensure a total daily intake of 1,500 mg calcium and 500 IE vitamin D. There was a long (6– 7 months) phasing-in period to adapt the participants to the more strenuous exercises.
The exercise regimen should affect bone along multiple pathways. During the initial warm-up sequence (running and games), exercise intensity was moderate [39, 40], but cycle number (>1,000 cycles) and strain frequency (2–4 Hz) were high. According to Cullen et al. [41], high cycle numbers compensate for strain magnitudes that are slightly below the adaptive threshold of bone. Furthermore, within the range of deliberate motion (<4 Hz.), Turner et al. [42] demonstrated significantly higher bone formation rates after higher strain frequencies (2 Hz) compared with lower frequencies (<0.5 Hz).
In a 12-month study. Jones et al. [30] demonstrated significant BUA increases relative to sedentary controls in their brisk walking group. Turner et al. [47] reported higher increments
of bone strength exercising 2·5 weeks with an intermittent 5-week rest period than with 15 weeks of continuous exercise.
200702 osteoporosis risk factors 1471-2474-9-28

The assessment of osteoporosis risk factors in Iranian women compared with Indian women

Pure vegetarianism: (2.2) and Red meat consumption more than 4 times per week (1.4) was shown as a risk factor in Indian and Iranian subjects respectively. Regular consumption of Soya (0.3), almond (0.5), fish (0.5), fruits (0.4) and milk tea 4 cups per day and more (0.4) appeared to be significant protective factors in India. Regular consumption of cheese (0.5), milk (0.5), chicken (0.4), egg (0.6), fruit (0.4), tea 7 cups per day and more (0.3) were found to be significant protective factors in Iran. Exercises were shown as protective factor in Iran (0.4) and India (0.4). Mean of weight and BMI were significantly lower in osteoporotic group in both countries BMI less than 26 have been shown as risk factors of osteoporosis in both countries. Regular consumption of Soya, almond fish, fruits and milk tea 4 cups per day and more appeared to be significant protective factors in India. Regular consumption of cheese, milk, chicken, egg, fruit, tea 7 cups per day and more were found to be significant protective factors in Iran. The percentage of women who were directly in sunshine exposure at least for 15 minutes per day was significantly higher among controls compared to osteoporotic groups in Iranian subjects (P < 0.01). and sunshine exposure was shown as a protective factor in Iran Odds ratio and 95% confidence interval include 0.45 (0.28–0.72) and it remained significant after age, weight and height adjustment. the consumption of almond, Soya products, were shown as protective factors in India The isoflavones in soybeans, which function both as phytoestrogens and antioxidants, may result in the inhibition of bone resorption Also important is total protein in the diet.
Low levels of serum albumin negatively affect transport of serum calcium. In this study black tea consumption more than 6 cups per day in Iran and Milk tea consumption 4 cups per day or more in India have been shown as protective factors for osteoporosis. Nutrients found in tea, such as flavonoids, may influence BMD
200706 Activity Reduces Risk of Fragility Fracture

Physical Activity Reduces the Risk of Fragility Fracture

A 2002 study of postmenopausal women by Feskanich et al. [13] found a dose response relationship: the risk of hip fracture was lowered by 6% for each increase of three metabolic equivalent hours of activity per week (equivalent to one hour per week of walking at an average speed). At the end of the follow-up, 8.4% of the men in the high physical activity group, 13.3% of the men in the medium physical activity group, and 20.5% of the men in the low physical activity group had suffered a hip fracture. the effective “dose” of exercise for reducing the risk of hip fracture was readily attained by recreational sports, heavy gardening, or other activities with similar intensity performed for at least three hours per week.
200803 exercise-induced increases in bone density FNR-52-1872

Sustainability of exercise-induced increases in bone density and skeletal structure

Recreational exercise seems to at least partially maintain exercise-induced skeletal benefits achieved during growth. Exercise during growth may be followed by long-term beneficial skeletal effects, which could possibly reduce the incidence of fractures. The duration of exercise is of less importance, as a short duration of load or a small number of repetitions are enough to achieve the maximal anabolic effect. Exercise-induced skeletal benefits in BMD achieved during growth seem to be lost with cessation of exercise, whereas exercise-induced structural benefits in the skeleton may be retained even with reduced activity level.
200803 Jumping increases bone mass during growth FNR-52-1871

Physical activity increases bone mass during growth

Conclusion: Exercise during growth seems to enhance the building of a stronger skeleton through a higher peak bone mass and a larger bone size. Table 1. The skeletal response to exercise seen in randomized and non-randomized prospective controlled exercise intervention studies in pre and peri-pubertal children and in post-pubertal girls Based on current scientific knowledge, we should recommend a physically active lifestyle and an adequate nutritional intake for growing children, as one prevention strategy to reduce the current high incidence of fractures.
200805 mobility tests for predicting falls Tiedemannetal2008

The Comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people

measurements—the sit-to-stand test with one and five repetitions, the pick-up-weight test, the half-turn test, the alternate-step test (AST), the six-metre-walk test (SMWT) and stair ascent and descent tasks. Poor performances in two mobility tests, = however, increased the risk of multiple falls more than poor performance in one test alone (ORs 3.66,
Functional mobility tests Alternate-step test The alternate-step test (AST) is a modified version of the Berg stool-stepping task [17]. It involves weight shifting and provides ameasure of lateral stability. This test involved alternatively placing the entire left and right feet (shoes removed) as fast as possible onto a step that was 18 cm high and 40 cm deep. The time taken to complete eight steps, alternating between the left and right feet comprised the test measure.
An AST cut-off point of 10 s was associated with a 130% increased risk,
200810 fitness of older adults in senior activity centres after 24-week silver yoga exercises

Physical fitness of older adults in senior activity centres after 24-week silver yoga exercises

The physical fitness of older adults in both the 70-minute complete silver yoga group and the 55-minute shortened silver yoga group had significantly improved after the interventions.
200900 impact exercise on postmenopausal bone loss

A meta-analysis of impact exercise on postmenopausal bone loss: the case for mixed loading exercise programmes

There was a statistically significant improvement in bone mineral density in g per cm at the lumbar spine (WMD 0.015, 95% CI 0.005 to 0.025; 11 trials; 16 comparisons) and femoral neck (WMD 0.008, 95% CI 0.004 to 0.013; 13 trials; 19 comparisons) using impact exercise interventions compared with control. There was evidence of statistical heterogeneity for both outcomes (I =84% for lumbar spine and I =61% for femoral neck). There was also a significant improvement in hip bone mineral density using impact exercise compared with controls (WMD 0.013, 95% CI 0.001 to 0.024; four trials), but again with statistical heterogeneity (I =91%). Subgroup analyses showed that combined-impact interventions significantly improved bone mineral density at the lumbar spine (WMD 0.016, 95% CI 0.005 to 0.027; three comparisons) and femoral neck (WMD 0.005, 95% CI 0.001 to 0.010; five comparisons).
There was evidence of statistical heterogeneity for lumbar spine (I =73%), but not for femoral neck (I =0%). Low-impact interventions, which included jogging, walking, and/or stair climbing, also showed significant improvements in bone mineral density at the femoral neck (WMD 0.022, 95% CI 0.014 to 0.030, six comparisons) and lumbar spine (WMD 0.025, 95% CI 0.004 to 0.046; six comparisons). High-impact and odd-impact interventions showed no significant improvements in bone density at either site.
200906 Fall Risk Assessment Tool Tiedemannetal2010

The Development and Validation of a Brief Performance-Based Fall Risk Assessment Tool for Use in Primary Care

Each of the performance items; low contrast visual acuity, tactile sensitivity, sit to stand, alternate step, and near tandem stand ability; and measures of previous falls and medications could discriminate between prospectively categorized multiple fallers and non–multiple fallers with relative risk values ranging from 1.4 to 2.4 in the development study. The probability of future multiple falls increased from 7% with the identification of zero or one risk factor up to a probability of 49% with the identification of six or more risk factors. Clinicians who have used the assessment report that it is a practical assessment, which can be incorporated into clinical practice.
200912 Maintenance of High-Impact Activity-Induced Bone Gain by Voluntary, Unsupervised Exercises

Good Maintenance of High-Impact Activity-Induced Bone Gain by Voluntary, Unsupervised Exercises: An 8-Month Follow-up of a Randomized Controlled Trial

the signicant BMD increases that were obtained by supervised 18-month high-impact training were eectively maintained with subsequent unsupervised regular aerobic and step classes (twice per week). The nding emphasizes the effectiveness and feasibility of self-controlled aerobic and step exercises in the primary prevention of osteoporosis among healthy premenopausal women
200912 Effect of Aging on Human Skeletal Muscle

The Effect of Aging on Human Skeletal Muscle Mitochondrial and Intramyocellular Lipid Ultrastructure

intramyocellular lipid (IMCL) older adults have larger IMCL droplets, fewer mitochondria, and a lower proportion of IMCL in contact with mitochondria. These factors likely contribute to age-related reductions in mitochondrial function and lipid metabolism. Aerobic exercise training produces the opposite effect, whereby mitochondria and IMCL become closely associated and are therefore more optimally situated for oxidation ( 18 ).
201000 Exercise and Bone Macro-architecture GoingFarr2010IJBCR

Exercise and Bone Macro-architecture: Is Childhood a Window of Opportunity for Osteoporosis Prevention?

Reliance on dual energy x-ray absorptiometry (DXA) and aBMD has been a problem. DXA estimates of aBMD are confounded by changes in bone size with growth and only partially reflect bone strength. Structural adaptations, such as increases in bone width, may confer lasting increases in bone strength. exercise might significantly enhance the fracture resistance of bone, but the effects may go undetected because a single slice measurement may not coincide with regions where bone is localized (the most mechanically appropriate sites). Furthermore, the dif-ficulties in interpreting metaphyseal pQCT BMD from a single slice [90] and the potential poor long-term reproducibility of pQCT measurements as a result of the inability to find the same exact location along the length of the bone over time [80] may limit the ability of pQCT to detect exercise-induced bone adaptations.
201007 The driving force in osteoporosis query lencel2011

Inflammaging: The driving force in osteoporosis?

with regard to emerging epidemiologic studies, the hypothesis is suggesting that age-related changes such as inflammatory modifications importantly account for age-related bone loss is gaining increasing interest. circulating levels of TNF -a may be the best predictor of mortality in frail, elderly populations with a high mortality rate, whereas IL-6 may be the strongest risk marker in healthy, elderly populations It is today acknowledged that adipose tissue behaves as an endocrine tissue that secretes several inflammatory mediators. In the Geelong Osteoporosis study, the fracture risk was increased 24–32% for each SD increase in CRP levels in elderly women [34]. Finally, in healthy individuals over age 70, Cauley and collaborators have shown that in addition to CRP levels, high serum levels of inflammatory markers IL-6, TNF- a, and TNF receptors, also predict a higher incidence of non-traumatic fractures [35].

I know this is a loaded question and there are many different variables that make a good candidate for CRNA school, but I’m just wanting to gauge if my plan is realistic.
I’ve been a nurse for nearly 10 years with a grand majority of that experience being in Interventional Radiology, providing moderate sedation and intra-procedural care for patients of all acuity levels. I did well in undergrad, graduating with a 3.9 gpa and my lowest grade in a core science was a B. I’ve recently transferred to a Cardiothoracic ICU and am getting the ICU/ critical care experience that’s required. However, I’m at the point in my life that I’d like to move through this process as quickly as possible. So, I’m trying to see if it’s realistic to start applying to schools after the one year minimum requirement for critical care experience. I’m open to moving for school and I am trying to avoid programs that require specific undergraduate courses within the five-year timeframe, since I am more than 10 years out of school at this point. I would like to avoid having to retake courses.
Am I being naïve that I would be considered a good candidate or that I could get into school? I think my experience in IR has benefit in that I’ve worked in the procedural world, have worked closely with anesthesiologists and CRNAs and know what the profession entails. But I’m not sure if the minimum 1 year ICU would be good enough. Any thoughts or insights are appreciated.

I guess this is just a venting post. My mother is early stages; doesn’t realize how much she’s declining and gets extremely defensive if anyone points out she might be mistaken about something.
She receives weekly palliative chemotherapy at an outpatient clinic. I think her way of coping with the stress she feels about having cancer is to externalize her feelings on to the staff? She started getting paranoid and making up stories about how they were all out to get her, how random inconveniences that we all deal with in the American medical institution were actually a plot against her… I’ve tried to redirect her, to think of ways she can feel more comfortable at treatment, bought her new gadgets and taken her out for treats and gotten her supportive/complementary therapies — but she doesn’t want to “feel better.” She wants to be the heroic, put-upon victim of a vast conspiracy. So whatever, I let her rant.
She’s hyperverbal and can rant for hours and hours at a time. It is literally impossible for her to answer a question yes or no — she has to say a thousand words about EVERYTHING. She has to tell you about her past, her speculations, the hidden meanings she ascribes to every ordinary gesture… it’s exhausting, but I’m used to it.
And now, she’s making up stories that the nurses are stealing her meds. Her Benadryl and her steroid 😑 you know, those party drugs that someone definitely has an incentive to steal? She doesn’t understand that you can’t just casually accuse a medical professional of a crime and not expect there to be an investigation. I caught sight of one of the nurses crying in the hallway as we were leaving — I’m 100% she was stressed the fuck out that this crazy person talking nonsense is going to make her the subject of disciplinary action at work. I get it. When I worked in the medical field, this was the kind of shit I Did Not Need. I feel so sorry for her.
Now, there’s going to be a care planning meeting next week. I’m fairly certain they’re just going to say this clinic isn’t a good fit for my mother, and suggest we find someplace else to take her. So that’s great. Cannot wait for the hours and hours of ranting and screaming that will follow. 🙃
if you’ve made it this far, thanks for reading. Sometimes just telling the story helps a little.

Want to apologize in advance for the novel but I hope it may help others, also helps to pass the time for me since I’m back at my second home for the next 3+ days 🤦🏻‍♂️😩🤬
TLDR: Historically had an iron stomach suffered thru 6+months of sporadic flair ups I shrugged it off unaware I could have DV and after about a month of severe flair ups I went to the ER 5/12/24. Ct scan showed diverticulitis micro perforation and 3.7 cm abscess on sigmoid colon. Had the abscess drained, it was a rather painful procedure, in the hospital for 3 days once discharged began to get better. Back eating solids before and after discharge which were well tolerated for the most part. Drain was taken out 5/24 continued to improve afterwards but that weekend I started getting similar symptoms I had originally that brought me to ER so I went to the hospital around 3pm for a check up and bloodwork had to ask for another Ct scan to confirm. I was feeling pretty good at this point and tempted to schedule for another time. They weren’t able to accommodate me at the first hospital so I was sent to another hospital to get Ct scan 30min away. Got results around 8:30pm and immediately admitted to ER was told another abscess had formed close to were the first abscess was that needed drainage but I had to be sent back to the first hospital to do the procedure. Back on IV antibiotics, ambulance ride back to first hospital at 1:00am haven’t been able to get any sleep with all the vital checks and blood draws. 6:30am 6/4 just got news that the abscess is in a very difficult to reach area may be blocked by my intestines and may not be able to be drained abdominally but can possibly go thru the glute. The other more permanent option would be to remove my entire colon and a bag for approx 3months.
Waiting to speak with the surgeon and specialist as the attending can only answer some questions but ultimately defers to surgeon/specialist
Had my kidney taken out back in 2010 which was a cake walk compared to this ordeal
The long story: So the past 36 years of my life I had an iron stomach no issues eating just about anything No gluten intolerance, food allergies, or any other food issues at worst maybe I’d get some gas/bloating after say a burger & fries or pizza or binge eating snacks/ sweets but nothing some kombucha couldn’t take care of. I didn’t have a bad diet I eat pretty clean for nearly two decades: no soda, no fast food organic non gmo try to avoid lousy processed foods and seed oils. Admittedly I have never been a huge fan of veggies but would get a few servings in for dinner. My exercise levels are mild mostly walking an gardening.
About a year ago I would get these bad cramps around my bowel movements. Thought it was just something I ate or a stomach bug didn’t pay much attention to it because it didn’t last very long and would alleviate after a bowel movement. A bit prior to this time I was suffering from a bad case of hemorrhoids which was my main focus at the time. Didn’t have constipation but sometimes had to strain rather hard to get the last bits out once in awhile also when home I had a bad habit of sittin on the toilet too long scrolling on the internet. Got to the point where I was bleeding after each BM. Was a slow process of healing but got better as I learned more about the affliction.
I added more fiber to my diet and some psyllium husk at night before bed which really helped the BM come right out with next to no straining. Epsom salt bath, getting more sleep, changing jobs to a less stressful one and a product called H-Hemorrhoid oil also helped tremendously. I still have hemorrhoids but thankfully they aren’t too much of a bother lately knock on wood.
Anyways back to these random cramps I would get. They would sporadically come and go where the painful cramping would happen for two/ three days max and it would be a quick acute cramping pain usually when I would drink coffee which virtually always stimulates a bowel movement for me. This lasted about 6+ months on and off before the cramping and then bloating became more chronic and severe so I would take a little Tylenol and Advil which kept the cramping at bay for awhile. Did this for another two months or so before it started to become very severe where I couldn’t leave the bed I was keeled over in pain for hours before it subsided to a tolerable level.
At this point I scheduled an appointment with a Gastroenterologist but couldn’t get an appointment for nearly two months. A few days later and I am still having bouts of crippling pain. I had no idea of diverticulitis as a potential cause as I could historically eaten just about anything and be ok. Looking back I should have switched to a liquid diet but continued to eat my normal diet if and when I had an appetite.
Finally it got so severe I tapped out and to be honest I probably would have not gone to the Er if not for my wife holding my feet to the fire even though it felt like an alien was hatching out my stomach. I fucking hate the hospital, I hate the smell, I hate the incompetence built into the system, the compartmentalization, I could keep going and I don’t mean to throw the baby out with the bath water so to speak as there are a lot of great people all across the professions that staff the hospitals who genuinely care and want to help but our healthcare system is so broken on so many levels. Pardon my ramble🤦🏻‍♂️
So I waved the white flag and headed to the ER was admitted 5/12/24 they did some blood work, blood cultures, urine analysis fecal sample, vitals and a CT scan with oral contrast.
Had high white blood count and the CT scan showed signs of diverticulitis microperferation that highly likely caused a 3.7mm abscess on my sigmoid colon. Immediately put on fluids and IV antibiotics. My head was spinning as this totally wasn’t on my radar but the procedure seemed minimally invasive so I didn’t think much of it. Was told I would be in the hospital for a minimum of three days. Wasn’t allowed to eat or drink until the day after the abscess was drained.
Ended up needing another CT scan the following morning this time with IV contrast to confirm the size and location and to confirm my appendix wasn’t also inflamed/ infected. After the results came back I was told appendix was unaffected so I was slated in the afternoon to have the drain procedure guided by CT scan which was on5/13/24. They gave me fentanyl for the procedure and local anesthesia so I graciously didn’t feel much just some pressure. It was very quick seemed like maybe all of 15-20min and I was conscious the entire time.
Shortly after I got back to my room the fentanyl must have worn off and I was writhing in agony until they gave me some morphine. Drain bag was in and I was in a lot of pain and mental anguish. Was given morphine every few hours which kept the pain at bay and helped me get some sleep. The first day I didn’t move much got up and waked around a couple times during the day and was still in significant pain but not quite as bad. Still couldn’t eat or drink
Second day was better; pain not as severe, started me on clear liquid but I only had the broth. Made it a point to get up and walk around more and probably walked for cumulatively over an hour in total. At this point they cut me off the morphine and gave me a small dose of Percocet and Tylenol. Literally going mental trying to wrap my head around everything. Managed to get some decent naps in between vital checks.
Third day I was feeling much better and was given the green light to eat bland low fiber solids again which was well tolerated. The doctors said if I can tolerate having two meals of solid food and have a BM that I could go home so needless to say I was motivated to eat so I could get home and actually rest and heal. It was amazing to taste food again as I had not eaten for many days at that point I simply had no appetite and my mind was now afraid of food. Even hospital food tasted exquisite. Non the less, I had solids for breakfast and lunch and even had a solid BM! I was ecstatic I was cleared to go home, a day before my birthday! There happened to be a passing shower that came through which gave way to a remarkable rainbow in view of my room’s window. I was immediately overwhelmed with tears of joy thinking I made it through the storm.
I got better little by little each day I was out of the hospital just taking 500mg Tylenol and 100mg Aspirin 2-3xday for the pain. Also was taking oral antibiotics(metronidazole, cefpodoxamine and doxycycline( I got bit by a tick a week before this all went down which is why I was on doxycycline) During this time I was instructed to eat a low fiber solid diet, avoid fatty meats no seeds, no uncooked veggies only certain fruit which I adhered to. I did get a little adventurous and ate some things I prob shouldn’t have but other than some minor cramping I was feeling way better, I was so happy to be eating again🥲
Did the whole drain bag maintenance the whole time, the bag became a light/moderate source of pain at times since you have to navigate life while having a tube inserted into the remnants of an abscess in your stomach; I’d describe it feels more like nerve pain that would shoot from the colon where the abscess was down to the tip of my penis. Come to find out through researching here there is a nerve that is wrapped around the colon that extends to the genitals likely responsible for this lovely feeling. Needless to say I was very eager to get the drain catheter taken out.
I was eating pizza again with no issues and having regular bowel movements. I was even able to tolerate iced coffee! I felt so relieved so 8 days later it was time for my drain study. By this time the fluid became clearer and lessened in volume. I believe they used Flouremetry imaging to guide the surgeon on the removal of the catheter. So he gets the image of where the drain was placed and says to himself “looks like there’s a small fistula underneath the drain.” The doctor proceeds to ask me if I want to take the catheter out which perplexed me a bit and I ask him about the fistula and he says, We’ll it’s very small and it doesn’t looks like it going anywhere. “Ok well if you think it’s ok I’d like to take it out.” “Well,” he says, “if you were my younger brothefamily member I’d say to take it out.” “Thank you for thinking of me in this in that light, really appreciate it, let’s do it!” I replied.
Procedure was quick and virtually painless. I felt very relieved like a weight had been lifted off me but knowing what I know about anal fistulas left me with a bit of a pit in my stomach knowing there was a fistula festering in a vulnerable area but I was happy to be free of the catheter and drain bag.
I am still off work at this point so I am gradually getting back into the routine. I have two young boys 2&5 who are really good but it was a challenge to care for them. I have to give a huge amount of credit and respect to my wife for going above and beyond stepping up to not only take care of the kids but for me as well on top of having to work full time❤️
I believe a day after the catheter was removed I finished up with the oral antibiotics. It felt so good to have them out of my system. I am observing the low fiber diet at this point and not eating any of the restricted foods except I would have a coconut smoothie from Trader Joe’s. I found it to be incredibly soothing however coconut is on the restricted list, also I could tolerate peeled apples which is also a no-no so it’s a minefield navigating what your body can tolerate.
So I go back to work and everything is on a positive trend. Still taking Tylenol (500mg) with a small dose of Ibuprofen (100mg) 3x/day and towards the end of the week I had begun to taper down and only have 2 doses of each per day as I was feeling much better and I had been taking it for nearly a month at this point. Also started taking time released oil of oregano a day before I came off the antibiotics and continued to take it.
On Thursday I began to have some slight cramping and bloating similar to my initial symptoms but chalked it up to eating too large of volume. On Friday I was still feeling a bit off and only ate a Banana for lunch. Shortly after I left work I was feeling lethargic. By Saturday the cramping/bloating intensified and I was out of commission, my symptoms began to come back although not as severe. I was back and forth between lying in bed and taking Epsom salt baths which helped tremendously. Also made it a point to go outside get some sun and walk around. I am very worried at this point and decided to call the hospital and we arrange for me to come in on Monday to get vitals, check up and blood work. BMs slowed down and all I could I poop out was a puss like substances(thick, beige, slight yellow) which didn’t have a foul odor. Felt a lot better after clearing that out and the trapped gas around it.
Sunday comes and I and I am feeling a lot better, I resume light walking and continue with broth and some juice. Relax for most of the day.
Monday comes (6/3/4)luckily I have this day off from work so I can mow the lawn and get to the Dr appointment. I feel nearly back to where I was prior to this flare up. Dr appointment comes I get blood work first then off to see the doctor. She asks some questions and I give her the rundown of everything that has happened. Then she does a visual check of my stomachs then tactile test pressing on my stomach. Very tendepainful when she presses in the area where the abscess was drained. Says she is concerned about the tenderness but everything else looks good but will need another Ct scan to confirm. I say let’s do it. Well of course no one again thought I would need to do the one test that can confirm what’s going on. I ask to do it today since I have the day off, so she says I will have to call the hospital and see if they can fit me in. Turns out they can’t (shocker) but can do it at the other affiliated hospital in the next town over 30 min away. So reluctantly I agree just want to get it over with.
Drive there get seen by nurse, gives me the contrast water, wait over an hour my wife flags downs nurse and shortly after I get called for the scan. Tells me they are also doing a IV contrast as well. Scan was quick then I wait for the results. Less than an hour later the nurse says the radiologist wants to admit you to the ER and I am completely stunned. I ask why and tells me they didn’t tell her.
Admitted to the ER on 6/3 @ 8:00pm I am told that I have another new abscess in close proximity to the initial abscess and it’s nearly double the size as the first on(1st one3.7cm, 2nd 7.3cm)I am immediately put on IV antibiotics(Metronidazole&Cipro)
However the hospital I was sent to don’t have the doctors that can perform this procedure so back to the first hospital I go. A bumpy ambulance ride and I was back where I started around 1:00 am. Luckily a bed is waiting for me was hoping to get sleep in between vital checks but every time I would be about to fall asleep I would hear a knock on my door😵‍💫
Spoke with the residences who told me that due to the location of the abscess they may not be able to drain it abdominally. Can either go through my glute to drain it or just remove colon completely and wear a bag for ~3months and reverse once healed. Said former abscess looks completely healed
Waiting to hear from specialist and colorectal surgeon on how to proceed. Apparently everyone is returning back from a gastro convention 🙄
I’m ready to get this lousy colon outta me but I’m scared of the recovery/having a bag.
The one question I have is how the hell does this slip under the radar? This new abscess in nearly close the old one shouldn’t a diverticula have been seen on previous Ct scans?
Can abscesses really grow that fast when I have been taking antibiotics for a large portion of the time, not to mention the first one took nearly a year to reach half of the size w/no antibiotics or dietary intervention?
Not adding up to me, could use insight from others who have gone through this before. Again sorry for the long read and thank you everyone who made it to the end.

Hi all,
I'm interested in finding out your thoughts on nursing interventions that improve motivation to quit smoking. Is there anything that can be done to bring the e-cigarettes into the forefront of research so that we could prescribe them as cessation tools? What methods would you use to increase adherence to smoking cessation clinics?
Also in my research the idea that women have a harder time quitting smoking than men has come up and I'm wondering if any of you have any thoughts that might compensate for this and increase female cessation rates?

This is just a concept; not a completed thing.
UnderIllness.
A new disease has been discovered. It doesn't affect humans, but it does affect monsters. It does not spread. However, it is a birth condition that happens randomly, although there are risk factors. It is not detected until a new monster baby is born. There is no known cure to the disease itself, there are only treatments to palliate its devastating side effects.
The disease was named "Fatal Magic Failure". With FMF, The monster's SOUL doesn't generate nor process enough magic so the organism can sustain. Monsters are made of magic. Without enough magic, the monster's organs will eventually fail and shut down. Monsters born with such a disease.... Are not compatible with life. Without assistance, babies born with the disease only last a couple of days at most. If they even manage to survive birth itself.
In skeleton monsters, the disease is even more agressive, since there are no organs that can work with the bare minimum amount of magic in case the soul fails. They rely on their soul completely.
Newborns with the disease are put under medical assistance as soon as they are born, and they'll require medical intervention for the rest of their life. They are put under life support and extremely invasive medicines that overall make them live an extremely low quality life. But making them live artificially and extending their death date as much as possible is the only way scientists can keep studying the disease. And even with assistance, few reach adulthood.
(Note: Here, Papyrus is the older sibling)
One of the most extreme cases of FMF is Little Sans. Doctors were surprised he was born with the disease, since his brother Papyrus was born healthy, and there was no family history of FMF.
It was a miracle he even survived birth, since the chances of a live birth were exceptionally low. As soon as he was born, he was put under life support, and doctors decided the best for him was to keep him in the hospital for the rest of his life... Or at least until they found a cure. After his birth, he had a pacemaker installed in his soul, so it would shock it in case it failed.
FMF affected Sans everywhere; since his body was so weak, he couldn't go outside without supervision, and only for an hour per day. Due to his frail health, he couldn't move much, since the smallest injury could dust him. As a result, his legs stunted, forcing him to always stay in bed or in a wheel chair. He has multiple needles and tubes connected to his soul, they provide painkillers, support magic, and they do drenate the residual magic. The few magic he has (thanks to the tubes and needles) is used to move the wheelchair and to help nurses assisting him. He is so frail that if you just gently touch him, while you won't hurt him, you'll have some dust in your hands. He can't eat on his own either. Both his physical and mental growth stopped both thanks to the disease and the devastating side effects of the medicines. So, despite being an adult, he is trapped in the body and mind of a 9 year old. Which was basically the age his body and mind stopped growing up. He also sounds like a 9 year old boy too.
He is alone most of the time in his hospital room. The only time of the day he has someone around him is when his brother comes in to visit him, or when nurses and doctors come in to help him or run tests on him. Naturally, he is touch starved and needs warmth and attention.
Surprisingly enough, his intelligence didn't seem to suffer that much. Sure, it's limited to the intelligence of a child, but his creativity is still there. When he is not being tested, he spends his time drawing different mechanisms that he hopes they could help him making his life easier. He also writes different methods to (hopefully) cure his fatal condition. He always shows the documents to the doctors, but they rarely say anything about them. They just smile at him. He also likes to read and telling jokes. It's his coping mechanism.
He both resents and appreciates life. He doesn't like not living a normal life, with no doctors, no hospitals and no stress. But at the same time... He loves life. He thinks that despite knowing he could die any day... Life gave him a second chance. That most monsters like him don't make it to adulthood, and he did. And that if they still keep him like that, is because they are working very hard to save him and others, and by letting them use him as a "guinea pig", he is helping them, others and himself. He considers himself a fighter.
His favourite persons are his brother, Nurse Toriel, and her adopted child who has been visiting him frequently as of late: Frisk.
Papyrus wanted to be a security guard like his best friend, Undyne. But after learning his brother was sick.. He made up his mind and decided his dream could wait. He decided to study to become a scientist and he wouldn't rest nor give up until he finally could cure his brother.
There are two possible outcomes:
Good ending: Sans miraculously survives and gets oficially cured. The disease is erradicated, and while he'll have both physical and mental sequels, Sans will life a long, healthy life for the rest of his days.
Bittersweet ending: A cure is found, but it's already too late to help Sans. His condition is at its worst and it is at the point of no return. Sans' soul shuts down and he turns into dust not long after that.

Smartg4control is a leading automation company providing hotel room and hotel guest room automation services. Out patient Clinic Management System, Nurse Call system, Outpatient clinic system, Hotel MUR DND GRMS, Intelliggent Building Lighting Control, Lighting and Dimming Panel, Mood Lighting and Dimming system, Smart Hospital SystemsSmartg4control is a leading automation company providing hotel room and hotel guest room automation services. Out patient Clinic Management System, Nurse Call system, Outpatient clinic system, Hotel MUR DND GRMS, Intelliggent Building Lighting Control, Lighting and Dimming Panel, Mood Lighting and Dimming system, Smart Hospital Systems, control systems, Building Managment System BMS. https://www.smartg4control.com/

Definition and Purpose

BMS is a centralized control system that integrates with various building subsystems to provide real-time monitoring, automated control, and data analysis. Its primary purpose is to create a comfortable, safe, and energy-efficient environment for patients, staff, and visitors while minimizing operational costs and environmental impact.

Key Features of BMS

• Real-time Monitoring: BMS continuously monitors the performance of building systems and equipment, providing insights into energy consumption, temperature levels, and equipment status.
• Automated Control: BMS automates routine tasks such as adjusting thermostat settings, turning lights on/off, and regulating airflow based on predefined parameters and occupancy patterns.
• Data Analytics: BMS collects and analyzes data from sensors and devices to identify trends, detect anomalies, and optimize system performance through predictive maintenance and proactive interventions.
• Integration Capabilities: BMS integrates seamlessly with other Smart hospital systems, such as EHR and security systems, to enable data sharing, interoperability, and centralized management.

Lighting and Dimming PanelMood Lighting and Dimming systemSmart Hospital Systemscontrol systemsBuilding Managment System BMS

Benefits of Implementing BMS in Hospitals

The implementation of BMS offers a wide range of benefits to hospitals, stakeholders, and patients alike.

Efficiency and Cost Savings

By optimizing energy usage, automating routine tasks, and identifying opportunities for improvement, BMS helps hospitals reduce operational costs, lower utility bills, and minimize waste.

Enhanced Patient Experience

A comfortable, well-maintained environment is essential for patient satisfaction and healing. BMS ensures optimal conditions by regulating temperature, humidity, and lighting levels, thereby enhancing the overall patient experience.

Improved Facility Management

BMS provides facilities managers with valuable insights and tools to proactively manage building systems, prioritize maintenance tasks, and respond promptly to issues, minimizing downtime and disruptions.

Challenges in Implementing BMS

While the benefits of BMS are clear, implementing such a system in a hospital setting comes with its own set of challenges.

Initial Costs and Investments

The upfront costs associated with installing and configuring a BMS can be significant, requiring hospitals to allocate resources and budget accordingly. However, the long-term savings and benefits often outweigh the initial investment.

Data Security Concerns

With the increasing connectivity of building systems and devices, ensuring the security and integrity of data becomes a top priority. Hospitals must implement robust cybersecurity measures to protect sensitive information and prevent unauthorized access.

Training and Adoption Issues

Successfully implementing BMS requires buy-in from all stakeholders and effective training programs to ensure staff members understand how to use the system effectively. Resistance to change and lack of training can hinder adoption and limit the system's effectiveness.

Case Studies of Hospitals Using BMS

To illustrate the real-world impact of BMS, let's explore some case studies of hospitals that have successfully implemented and benefited from this technology.

Real-world Examples

• Hospital A: By implementing a BMS, Hospital A was able to reduce energy consumption by 20%, resulting in significant cost savings and environmental benefits.
• Hospital B: BMS helped Hospital B improve patient comfort and safety by monitoring air quality, controlling temperature, and detecting equipment failures in real-time.

Success Stories and Lessons Learned

Through these case studies, hospitals have learned valuable lessons about the importance of strategic planning, stakeholder engagement, and ongoing maintenance in maximizing the benefits of BMS.

Future Trends in Smart Hospital Systems

As technology continues to evolve, so too will smart hospital systems and the role of BMS within them.

Advancements in Technology

Emerging technologies such as artificial intelligence, machine learning, and advanced sensors will further enhance the capabilities of BMS, enabling predictive analytics, autonomous operations, and personalized experiences for patients.

Predictions for the Future of BMS

In the future, BMS will become even more integral to hospital operations, acting as the central nervous system that orchestrates and optimizes all aspects of the healthcare environment, from patient care to facility management.

Conclusion

In conclusion, smart hospital systems, powered by technologies such as the Building Management System (BMS), are revolutionizing the healthcare industry by improving efficiency, enhancing patient experiences, and optimizing resource utilization. While challenges exist, the benefits of implementing BMS far outweigh the costs, making it a valuable investment for hospitals seeking to thrive in the digital age., control systems, Building Managment System BMS. https://www.smartg4control.com/

Definition and Purpose

BMS is a centralized control system that integrates with various building subsystems to provide real-time monitoring, automated control, and data analysis. Its primary purpose is to create a comfortable, safe, and energy-efficient environment for patients, staff, and visitors while minimizing operational costs and environmental impact.

Key Features of BMS

• Real-time Monitoring: BMS continuously monitors the performance of building systems and equipment, providing insights into energy consumption, temperature levels, and equipment status.
• Automated Control: BMS automates routine tasks such as adjusting thermostat settings, turning lights on/off, and regulating airflow based on predefined parameters and occupancy patterns.
• Data Analytics: BMS collects and analyzes data from sensors and devices to identify trends, detect anomalies, and optimize system performance through predictive maintenance and proactive interventions.
• Integration Capabilities: BMS integrates seamlessly with other Smart hospital systems, such as EHR and security systems, to enable data sharing, interoperability, and centralized management.

Lighting and Dimming Panel

Hi all,
I’m half Malaysian Chinese and half Nigerian. Born in the UK, moved to Malaysia few weeks later but left for the UK when I was 6. I’m a UK doctor and just struggling to get my head around the healthcare system, I’d be so grateful if anyone could fill me in.
Specifically, my relative has metastatic cancer. He was seen in a private hospital, which went badly, and he has since been given much better care in his local government hospital. Are chemotherapy and immunotherapy fully subsidised, and if so, for how long? Have asked relatives there but they’re not very savvy and I’m being told different things. I don’t want to get directly involved just yet as I don’t want to undermine anyone. Relative will likely need treatment for as long as he lives (i.e. several courses) which may be 6 months to 2 years. Wondering if he will be able to have this until the end, as a subsidised treatment rather than us running out of money?
Also, what is palliative care like? Are there nurses that visit patients at home, what about medications for end of life?
Coming from a UK perspective where everything is 100% free and there is a large emphasis on palliative care here to ensure a dignified death.

DAY: June 3 2024
6-3-2024

AIRPLANE NOISE EXPOSURE MAY INCREASE RISK OF CHRONIC DISEASE

Locations of 90 study airports in the United States symbolized by quartiles of participants pooled from the Nurses’ Health Study (NHS) and NHSII living around each airport. Increasing point sizes are proportional to the increasing quartiles of study participants from the pooled sample of NHS and NHSII living within 22.2 miles (35.7 km) of each study airport at baseline. States are outlined and colors indicate each of four U.S. Census regions. The 100th meridian west of the Prime Meridian denotes the boundary between arid and humid areas.
6-3-2024

NEW MACHINE LEARNING METHOD CAN BETTER PREDICT SPINE SURGERY OUTCOMES

Researchers who had been using Fitbit data to help predict surgical outcomes have a new method to more accurately gauge how patients may recover from spine surgery. Using machine learning techniques developed at the AI for Health Institute at Washington University in St. Louis, Chenyang Lu, the Fullgraf Professor in the university’s McKelvey School of Engineering, collaborated with Jacob Greenberg, MD, assistant professor of neurosurgery at the School of Medicine, to develop a way to predict recovery more accurately from lumbar spine surgery. The results published in the journal Proceedings
6-3-2024

PEDIATRICIAN SUGGESTS FIVE QUESTIONS TO ASK BEFORE A PLAYDATE

Playdates are a fun way for children to develop friendships and learn important social skills. Visiting another family’s home will also expose your child to a new environment. Before the playdate, it’s a good idea to talk with the other parent about household habits, rules and expectations. It’s also a great opportunity to share any important details about your child? like a food allergy, pet allergy or other health issues. Here are a few important questions to ask: 1. Who will be watching the children? Will a parent be home,
6-3-2024

UNDERSTANDING HOW THE BRAIN CONTROLS SOCIAL GAZE

For animals such as primates, the act of gazing plays a key role in social interaction, used to both send and gather information. In a new study, Yale scientists uncover two brain regions that contribute to this type of social attention. The findings yield important insight into how this dynamic behavior arises and might be used to boost social behavior in disorders like autism in which engaging in social attention can be challenging, researchers say. The findings were published May 31 in the journal Neuron.
6-3-2024

WHY YOU MAY NOT BE GETTING THE BENEFITS YOU EXPECTED FROM MINDFULNESS

You’ve probably seen the word mindfulness everywhere these days, from the news, to magazines, to social media. Mindfulness is sometimes packaged as a mental health cure-all, and studies do suggest that mindfulness-based therapies support mental health. Your friends or family may even have told you that mindfulness has changed their lives. But if you have tried mindfulness and feel like it isn’t working for you, our developmental psychology research might explain why. In our recent study, we have found that being highly mindful may not be beneficial for all. Instead,
6-3-2024

MOST SLEEP TIPS SHARED ON TIKTOK ARE SUPPORTED BY SCIENTIFIC EVIDENCE

A new study found that most sleep tips shared on TikTok are supported by empirical evidence. The research findings show that of 35 unique sleep tips shared in popular videos, there was empirical support for 29. Only six sleep tips were unsupported by scientific evidence. “These results suggest that the sleep research and sleep medicine communities have done a good job of promoting appropriate tips for sleep hygiene,” said lead
6-3-2024

DOES SLEEP CLEAR MORE TOXINS FROM THE BRAIN THAN WHEN WE’RE AWAKE? LATEST RESEARCH CASTS DOUBT ON THEORY

There’s no doubt sleep is good for the brain. It allows different parts to regenerate and helps memories stabilize. When we don’t get enough sleep, this can increase stress levels and exacerbate mental health issues. Evidence also supports the notion that the brain gets rid of more toxic waste when we’re asleep than when we’re awake. This process is believed to be crucial in getting rid of potentially harmful things such as amyloid, a protein whose build-up in the brain is linked to Alzheimer’s disease. However, a recent study in
6-3-2024

‘PLACEBO’ OR ‘SHAM’ SURGERY IS NOT A CRUEL TRICK—IT CAN BE VERY EFFECTIVE

Ten years ago, a scan showed that I had torn the meniscus in my knee. The pain was bad and I was limping a lot of the time. My doctor recommended arthroscopic knee surgery to fix it. Being scared of scalpels, I asked whether there were other options. He said I could try physiotherapy, but that it was unlikely to work. I tried the physio and did the recommended exercises diligently, and my knee pain and function returned to almost normal. I even ran my first (and only) marathon a
6-3-2024

WHY, FOR SOME, PSYCHOTHERAPY MIGHT BE A BETTER TREATMENT FOR DEPRESSION THAN DRUGS

During a psychotherapy session, one of my patients reported to me that the antidepressants he’d been prescribed by his GP had “killed his desire.” He felt “dead inside,” he told me. Unfortunately, this wasn’t an isolated case. I’ve heard similar descriptions of the effects of antidepressants from many patients. Many say they feel like “zombies.” However, some patients report that these drugs are helpful—even essential—in the management of their mental health. Antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), and popular anti-anxiety medication benzodiazepines can offer
6-3-2024

INTOXICATION WITHOUT ALCOHOL: AUTO-BREWERY SYNDROME

How can someone have alcohol intoxication without consuming alcohol? Auto-brewery syndrome, a rare condition in which gut fungi create alcohol through fermentation, is described in a case study in the Canadian Medical Association Journal. “Auto-brewery syndrome carries substantial social, legal, and medical consequences for patients and their loved ones,” writes Dr. Rahel Zewude, University of Toronto, with co-authors. “Our patient had several [emergency department] visits, was assessed by internists and psychiatrists, and was certified under the Mental Health Act before receiving a diagnosis of auto-brewery syndrome, reinforcing how awareness of
6-3-2024

WHAT ARE MINDFULNESS POTENTIAL HEALTH BENEFITS?

Can mindfulness meditation be good medicine for both mental and physical ills? Yes, says one expert who explains the practice and what conditions it might help. A particular form of mindfulness that focuses on pleasure has been shown to work as well as a starting dose of a narcotic for pain and better than traditional psychotherapy for substance abuse, said Eric Garland, director of the University of Utah’s Center on Mindfulness and Integrative Health Intervention Development. But the meditation style may work for more than just chronic pain and addiction.
6-3-2024

CRACKING THE AGING CODE: INSIGHTS INTO LIPID CHANGES

Researchers at the RIKEN Center for Integrative Medical Sciences (IMS) have discovered numerous age-related changes in the lipid metabolism of mice, across both organs and sexes. Among these changes was the selective accumulation, throughout the body, of certain lipids produced by gut bacteria as the mice aged. They also discovered a sex difference in the kidneys and a gene responsible for it. Published in Nature Aging, this study could lead to better understanding of
6-3-2024

THE FDA WILL SOON WEIGH IN PSYCHOACTIVE DRUGS

Lori Tipton is among the growing number of people who say that MDMA, also known as ecstasy, saved their lives. Raised in New Orleans by a mother with untreated bipolar disorder who later killed herself and two others, Tipton said she endured layers of trauma that eventually forced her to seek treatment for crippling anxiety and hypervigilance. For 10 years nothing helped, and she began to wonder if she was “unfixable.” Then she answered an ad for a clinical trial for MDMA-assisted therapy to treat post-traumatic stress disorder. Tipton said
6-3-2024

ZYN IS FOLLOWING BIG TOBACCO’S PLAYBOOK FOR TEENS

Zyn’s synthetic nicotine offers the kick of a cigarette or dip without the cancer-causing smoke and chemicals of tobacco, packaged in a pouch that can be discreetly tucked into the upper lip. But that doesn’t mean they’re risk-free. Very little is known about how nicotine pouches could affect health or addiction trends in the U.S. Moreover, tobacco companies are selling the products in dosages and flavors that seem very clearly designed to appeal to younger users, even though buyers are supposed to be at least 21. Even without a ton
6-3-2024

EARLY MENOPAUSE LINKED TO GREATER RISK FOR BREAST, AND POSSIBLY OVARIAN CANCER

Some women who experience menopause early—before age 40—have an increased risk of developing breast and ovarian cancer, according to research being presented at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass. “There is also higher risk of breast, prostate and colon cancer in relatives of these women,” said Corrine Welt, M.D., chief of the Division of Endocrinology, Metabolism and Diabetes at the University of Utah Health in Salt Lake City, Utah. Welt and colleagues began the study with the hypothesis that some women with primary ovarian insufficiency and
6-3-2024

BE READY FOR STORM SEASON

by Tia R. Ford, Mayo Clinic News Network Each hurricane season, it is critical to take proactive steps to protect yourself, your family and your property. Hurricanes and other severe storm events can be devastating, but with proper preparation, you can minimize risks and stay safe. This year, the National Oceanic and Atmospheric Administration National Weather Service forecasters predict an 85% chance for above-normal hurricane activity in the Atlantic throughout the season beginning June 1 and ending Nov. 30. Taking time to prepare in advance of severe weather can help
6-3-2024

TYPE OF WEIGHT LOSS SURGERY WOMEN UNDERGO BEFORE PREGNANCY MAY INFLUENCE CHILDREN’S WEIGHT GAIN

The type of weight loss surgery women undergo before becoming pregnant may affect how much weight their children gain in the first three years of life, suggests a study presented at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass. Researchers found children born to women who underwent the bariatric procedure known as sleeve gastrectomy before they became pregnant gain more weight per month on average in the first three years of life compared with children born to women who had the less common Roux-en-Y gastric bypass weight loss
6-3-2024

WHAT IS BLADED BEEF? MECHANICALLY TENDERIZED STEAKS SHOULDN’T BE EATEN RARE, FOOD POLICY EXPERT EXPLAINS

For many steak lovers, nothing says summer like a tender slice of beef seared to a dark gloss on the outside while remaining juicy red on the inside. But when it comes to steaks and roasts labeled “blade tenderized” or “mechanically tenderized,” rare is not the best option, says Northeastern food policy expert Darin Detwiler. People who consume mechanically tenderized steaks rare are more susceptible to developing food-borne illness from E. coli or salmonella contamination, he says. Consumers can’t tell by looking at beef products whether they are blade or
6-3-2024

STUDY FINDS TIMING OF BRAIN WAVES SHAPES THE WORDS WE HEAR

The timing of our brain waves shapes how we perceive our environment. We are more likely to perceive events when their timing coincides with the timing of relevant brain waves. Lead scientist Sanne ten Oever and her co-authors set out to determine whether neural timing also shapes speech perception. Is the probability of speech sounds or words encoded in our brain waves and is this information used to recognize words? The team first created
6-3-2024

BENEFITS OF AN ACTIVE WORKSTATION

For the millions of people who sit at a desk for long hours at a time, day after day, you may want to stand up for this. Mayo Clinic research shows that using an active workstation can help you move more and think better at work — without affecting your job. Sitting too much at work or home can increase your risk of certain diseases, says Dr. Francisco Lopez-Jimenez, a Mayo Clinic cardiologist and senior author of a study on the topic. “Sitting for eight hours or more a day
6-3-2024

NICOTINE MARKETING STILL TARGETS ADOLESCENTS JUST AS IT DID DECADES AGO, SAYS RESEARCHER

About 37 million children ages 13 to 15 around the world use tobacco, according to a 2024 report from the World Health Organization. In 2023, e-cigarettes were the most commonly used tobacco product in the U.S., with 7.7% of middle school and high school students reporting e-cigarette use. Cigarettes were the next most common, with 1.6% of middle- and high school students saying they had consumed them in the past month. Research shows that most people who use tobacco start in childhood. I am a public health researcher who studies
6-3-2024

LOW-DOSE ASPIRIN REDUCES INFLAMMATION CAUSED BY SLEEP LOSS

A new study to be presented at the SLEEP 2024 annual meeting, held in Houston, Texas, June 1–5, found that low-dose acetylsalicylic acid, also known as aspirin, can reduce inflammatory responses to sleep restriction. Results show that compared with placebo, preemptive administration of low-dose aspirin during sleep restriction reduced pro-inflammatory responses. Specifically, aspirin reduced interleukin-6 expression and COX-1/COX-2 double positive cells in lipopolysaccharide-stimulated monocytes, as well as C-reactive protein serum levels. “The novelty of this study is that it investigated whether we can pharmacologically reduce the inflammatory consequences of sleep
6-3-2024

NEW STUDY SHEDS LIGHT ON THE EFFECTS OF HUMOR IN MEDICAL PRACTICES

A humorous remark at just the right time can go a long way. Benevolent humor helps medical assistants (MAs) cope positively with their stressful working day, according to a new study published in BMC Primary Care by the Martin Luther University Halle-Wittenberg (MLU) and the Federal Institute for Vocational Education and Training (BIBB). The researchers surveyed more than 600 MAs to find out how they experience their work and what
6-3-2024

FDA WARNS OF BACTERIAL AND OTHER DANGERS FROM RECALLED INFANT FORMULA

The U.S. Food and Drug Administration is warning parents about a goat milk infant formula potentially tainted with a bacterium that’s very dangerous to babies. Crecelac brand formula, already under recall since May 24, could contain Cronobacter, which “can cause bloodstream and central nervous system infections, such as sepsis and meningitis” in infants, the FDA warned in a statement issued Friday. Two other Farmalac brands are also being recalled because they failed to meet FDA safety regulations. The three recalled brands are: CRECELAC INFANT Powdered Goat Milk Infant Formula with
6-3-2024

SCIENTISTS DEVELOP AI TOOL TO PREDICT HOW CANCER PATIENTS WILL RESPOND TO IMMUNOTHERAPY

In a proof-of-concept study, researchers at the National Institutes of Health (NIH) have developed an artificial intelligence (AI) tool that uses routine clinical data, such as that from a simple blood test, to predict whether someone’s cancer will respond to immune checkpoint inhibitors, a type of immunotherapy drug that helps immune cells kill cancer cells. The machine-learning model may help doctors determine if immunotherapy drugs are effective for treating a patient’s cancer. The study, published June 3, 2024, in Nature
6-3-2024

A DARK SIDE TO DARK CHOCOLATE? NEW STUDY FINDS VERY MINIMAL RISK FOR KIDS FROM METALS IN CHOCOLATES

Chocolate lovers may have been alarmed by a 2023 Consumer Reports finding that some dark chocolate brands could contain harmful levels of lead and cadmium. However, a new study by Tulane University published in Food Research International has found that dark chocolate poses no adverse risk for adults and contains nutritionally beneficial levels of essential minerals. The study sampled 155 dark and milk chocolates from various global brands sold in the United States and tested for the presence of 16 heavy metals ranging from the toxic (lead and cadmium) to
6-3-2024

LACK OF INSURANCE KEEPS MANY AMERICANS FROM BEST CANCER MEDS

A cutting-edge class of drugs is saving and extending the lives of cancer patients. But the drugs, called immune checkpoint inhibitors (ICIs), are so expensive that some uninsured Americans can’t access them, a new report finds. New policies are needed “to improve health insurance coverage options and to make new treatments more affordable,” the American Cancer Society (ACS) said in a news release outlining the findings. The study was led by ACS researcher Dr. Jingxuan Zhao. Her team presented the findings at the annual meeting of the American Society of
6-3-2024

UNDERSTANDING RISKS AND NEED FOR URGENT TREATMENT

It’s always important to prioritize health by participating in stroke risk screenings. These assessments offer invaluable insights into personal health profiles, enabling you to address potential risk factors head-on. Through simple measures such as monitoring blood pressure, measuring cholesterol levels, and adopting healthier lifestyle choices, you have the opportunity to dramatically reduce your susceptibility to stroke. Whether accessed online, in public programs, or through primary care providers, these screenings can provide proactive steps towards a healthier future. As we delve deeper into stroke awareness, it’s imperative to familiarize yourself with
6-3-2024

STUDY FINDS THAT OLDER ADULTS WITH SLEEP APNEA HAVE HIGHER ODDS OF HOSPITALIZATION

A new study found that sleep apnea is associated with increased odds of future utilization of health care services including hospitalization among older adults. Results show that participants aged 50 years and older with sleep apnea had a 21% higher odds of reporting future use of any health service compared with those without sleep apnea. Specifically, individuals with sleep apnea had 21% higher odds
6-3-2024

STUDY FINDS MORE WOMEN IN OIL-RICH GULF COUNTRIES BATTLE WITH BREAST CANCER

Breast cancer incidence has surged in the oil-rich Gulf (GCC) states, with the disease developing its own localized clinical and pathological features, setting them apart from those found in women with breast cancer in western countries, a study published in the journal Frontiers in Oncology finds. The study attributes the hike to the nature of menstrual cycle of women in these countries, hereditary factors, weaning children earlier than expected, prevalence of hormonal treatment, obesity, and use of contraceptives. The research is authored by a panel of nine oncologists from four
6-3-2024

HEALTH CARE PROVIDERS WANT THIS INFORMATION BEFORE PRESCRIBING THE HIV PREVENTION, PREP, TO ADOLESCENTS, STUDY FINDS

HIV infections among adolescents and young adults continue to be at high levels, with Americans between the ages of 13 and 24 accounting for approximately 20% of all new HIV infections in 2019. However, uptake of a preventive regimen known as pre-exposure prophylaxis (PrEP) in this group remains low. Approved by the U.S. Food and Drug Administration (FDA) since 2012, PrEP is highly effective for preventing HIV when taken as directed and reduces the risk of HIV from sex by 99% and from injection drug use by 74%. A new
6-3-2024

EXPENSIVE, DANGEROUS AND VERY ‘EN VOGUE’

When Los Angeles County medical examiners worked last year to determine how Matthew Perry died, they discovered something startling. The amount of ketamine in Perry’s bloodstream was about the same as what would be used during general anesthesia, his autopsy showed. Perry’s death—now the subject of an investigation by the Los Angeles Police Department and the Drug Enforcement Administration—is putting a spotlight on the growing use of ketamine. There are more prescriptions, dedicated clinics and a burgeoning black market that
6-3-2024

HOW TO FIND THE RIGHT BALANCE BETWEEN TELEMEDICINE AND IN-PERSON CARE

A patient sits in the living room of her apartment in the Brooklyn borough of New York during a telemedicine video conference with a physician on Jan. 14, 2019. Patients can now see an array of doctors without leaving their recliner thanks to telemedicine. But that doesn’t mean trips to the office should end. Finding the right balance between virtual and in-person visits can be a key to getting good care.
6-3-2024

MANY PFAS FOREVER CHEMICALS ARE TOXIC—HERE’S HOW TO AVOID THEM

From non-stick frying pans to stain-resistant sofas, some of the most innovative everyday products are made using chemicals known as per- and polyfluoroalkyl substances (PFAS). These “forever chemicals”—so-called because they don’t degrade—have been used in a variety of consumer and commercial applications since the 1950s. They can repel water and oil, resist high temperatures and act as “surfactants” by helping different types of liquids mix. There are around 15,000 different PFAS chemicals. Each one has a slightly different chemical composition, but they all have at least two carbon-fluorine bonds.

• 6-3-2024POLLUTANTS AND CLIMATE CHANGE CONTRIBUTE TO MILLIONS OF DEATHS FROM CARDIOVASCULAR DISEASE EACH YEAR, WARN SCIENTISTS
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• 6-3-2024WHITE BLOOD CELL ‘NETS’ COULD BE EARLY WARNING SIGN OF MAJOR IMMUNOTHERAPY COMPLICATION
• 6-3-2024MENTAL HEALTH, LACK OF WORKPLACE SUPPORT ARE LEADING FACTORS DRIVING NURSES FROM JOBS: STUDY
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• 6-3-2024THE FUTURE OF DRUG TESTING: VASCULARIZED ORGAN-ON-A-CHIP TECHNOLOGIES
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Intermittent (but increasingly active) commenter, maybe first time poster—(as you’ll see below, I’m a little fried to remember now).
I’m going to admit upfront. I. Fucked. Up. I guess some might consider me the bad apple that ruins it for everyone else. I have peripheral neuropathy that, best as doctors can tell, began as chemo induced during ABVD treatment, and despite not chemo in around 15+ years, it’s progressively gotten worse. But neurology, rheum, a world class neurology place—nobody can find any underlying exacerbating factor. So my neuropathy is bullshit (in the sense this is not the usual course).
But frankly, it doesn’t even know the meaning of the word bullshit compared to what I call “the medical establishment.”
So anyways, I had a great pain clinic. Great, really, much of a unicorn as I know that is. But I have continuing problems with “unauthorized escalation.” We aren’t talking anything nuts here—I don’t inject, crush, snort, boot or any of that crazy stuff. We’re talking like an extra pill a day with my 60 mg MS Contin or my 10 mg Oxy IR—and not every day. And here’s the thing—so with this known escalation issue, my wife controls my meds. Unfortunately—I’m something of an expert hide and seek player. It’s kinda sad really. I never wanted this for her. But I just CANNOT be trusted to manage my own doses. But the thing is? When she noticed it (always)? We just rationed and made it to the next appointment with some withdrawal in some cases.
But late April? Yeah I was running on fumes to make it to my appointment, got snippy with my daughter, and my wife kicked me out of the house for the evening, possibly longer. I accidentally took my MS Contin intended for Sunday on Saturday and so on Monday pissed clean. I explained but was obviously on nails, but the pain was still not managed……so I failed a pill count. And like that scene in Goodfellas—“Now I gotta turn my back on you.”
I get it. I violated the contract—which also said if they suspected addiction they’d help me, but no matter. I was in panic mode. I was able to get an appointment with Bicycle Health, thinking at LEAST Bupe could help me through.
…..the clinician told me since I was in pain, visibly so, and would prefer to go back to pain management, they couldn’t help me.
So I got an appointment at a local chain, Savida health. By this point I was 24 hours out from my last MS Contin. I was basically laying on the desk and hanging out of the chair during our appointment—but as much from the pain as pending withdrawal. She interviewed me about my past, and given that I’d never bought off the streets, altered my drugs and whatnot…..
She actually had to withhold laughter when I told her about the first time my “addiction” was noticed…..when my mom was coming home from her job, noticed the light were on at my house at 3 am and confronted me and counted my pills. The therapist asked how she “found me”—was I snorting, using the foil thing, shooting up?
……I was playing guitar. My meds were confiscated, I got really angry because I was in pain from fracturing my L1, had a forced intervention with my psych, and wound up in a psych ward and forced into 12 step. I figured I’d never get opioids again and went through a decade of just about EVERY drug reccomended for neuropathy, two different SCS units, eventually got desperate enough to try to Kratom which ate up my bowels and made me dizzy at the dose I wound up on, and even visited capsacian town.
But no, Savida doesn’t really see that as OUD. She was pretty clear I’d be doing therapy and whatnot for a disorder I didn’t seem to have.
In a first for the on-site nurse, the therapist told me to go the ER, pronto. But here’s the kicker—two critical things happened.
1) my wife has LIfe360 on our phones—she had me on GPS at the smoke shop right in front of there (genius marketing on their part), and despite photos of the office (she thought Savida was a specific doctor and my mother thought it was a clinic that catered to our Latino population), I was harrangued that I had “bought and taken something” well into the ER and over a week.
2) at some point I “panic took” too much Baclofen and Clonidine, maybe Lyrica? I had been carrying some extra Clonidine in anticipation of WD—but I was just poppin and freaking. Plus I somehow had two pill containers and admit I took advantage of that—but what I didn’t realize was some were 10mg and some were 20mg. So what happened?
I hobble into the ER, get the riot act from the Dr about how they can’t do PM, and that I need a ride to get a single shot. They call my wife…..
……and I pass out and piss myself, to the point where the Doc and my wife can’t arouse me. So about meds for me! At some point my mom takes over so my wife can handle the girls. At some point I get a CT I have no recollection of, get hit with Narcan through an IV (the bruise from which is JUST going away)……..and promptly fall back asleep.
…..does that EVER happen, except with like the elephant fentanyl? Regardless I come around in a serious way eventually and mom takes me home.
I had been in contact with my GP and Psych, reminding them they should now have the power to prescribe Bupe. Or hell, you know, the GP could just help with my pain, because I don’t even want ER meds and frankly just want my tapentadol back, which my insurance will finally cover again after forced off it about a year ago due to losing my job and having to go on my wife’s coverage.
Their reccomendation? Inpatient detox, because the psych had a colleague who said they had helped “other patients in similar situations.
I look it up…..yeah, it’s an hour away and all about “recovery” and 12 step. I rode that shot out at home with Clonidine.
Look, I screwed up….first by violating the contract theb not finding another pain clinic. Maybe you guys will tell me that I really am an addict and need high powered help. But I’m two weeks out from MS Contin now…..and I’m in the worst pain ever. Constant 7 or 8–the meds at least kept me around 4 or 5, except at night—which is what led to the escalations.
I’m probably two weeks, maybe a month from getting into a clinic. In the evenings I’ve started to have a tendency to rage at my family. My wife wants to leave me. I’m very likely burned at the ER. I screwed up—but then the system failed me, or it sure as hell feels like anyways.
Is there any emergency response to an untreated flare? Note: mention the streets and the claws come out
EDIT: the dark web or any sort of web transaction counts as the streets, yo

*Apologies for length, but thanks for reading if you need a detailed account of an induction experience that was positive overall despite expecting the worst.
I stalked non-elective induction stories over the past few weeks in anticipation and fear that my birth would result in induction and a cascade of medical interventions. I was induced but my labor resulted in a fairly natural, non-augmented experience.
My baby was born healthy and perfect on Memorial Day at 41 weeks and 5 days. I am advanced gestational age but my provider never pressed induction but informed me that the hospital I was delivering at “required” induction for post due dates at 41 weeks and 3 days. I did ALL the things post due date in an attempt to naturally put myself into labor but nothing worked- my advice to others trying to get themselves into labor is to just go with the flow and don’t worry about hitting all the “worked for me!” tricks, they’re just coincidences.
I was scheduled for induction at my hospital at 41 and 3 at 9pm but was instructed to call and make sure they had a bed for me. I prayed they didn’t to buy myself more time, but given that it was a holiday weekend they were not busy and told me to come on in. When I got there they reviewed my birth plan, set me up with a saline lock and got orders for a cervix softener. They chose cervidil for me because my cervix had been dilated to a 1 and high with no effacement change for the past 9 days. They pretty much just shoved it up there and told me to go to sleep and they’d check it in 12 hours. I wish I would have been able to go home and do this part because it was totally uneventful and I could have actually slept. In hindsight, I also may have asked to hold off on the saline lock this first night too. I felt some light contractions through the night, and my water broke at hour 10. It was a drizzle not a gush and I was still totally comfortable but with noticeable contractions in mixed variation.
Doctor checked me and confirmed my cervix was soft but I was still a 1. I continued to contract on my own and asked to be switched to wireless monitoring so I could prioritize movement. It took me the next eight hours to get to a 2. Around hour nine I started to get nervous because contractions were getting more intense but they were also spreading out from 3-4 minutes to 5-7 and I adamantly did not want to augment my labor with pitocin. I knew the clock was ticking on my water breaking. Surprisingly, this was hardly brought up by staff as a concern, and was only presented as an option if labor completely stalled.
Right before shift change (21 hours since I was admitted/about 10 hours of active labor) I agreed to a dose of fentanyl for pain. I don’t regret it because I was able to zone out for an hour and I still felt pain but it mattered less. It really just allowed me a bit of time to rest. My night nurse was a literal angel sent from heaven and immediately started hyping me up for the hard stuff. I was about a 4 but really thin at 12 hours of active labor and felt so disheartened because I felt like I was in the thick of it but 4 didn’t sound like a lot.
I got clearance to take a shower and I immediately felt a change in pressure and intensity. This was great for progression but I was no longer grounded in my contractions and felt like I was dying. Over the next hour I went from a 4 to a 7 and none of the things I was doing to mentally stay in control were working anymore. I had really wanted to go sans-epidural but I caved at this point in fear that I wouldn’t be able to handle it to the end. I feel proud I got to 7, as I really underestimated labor pain and feel like I learned that I am not as tolerant to pain as I assumed I was.
Anesthesiologist got me set up in 10 minutes flat and receiving the epidural was not bad AT ALL. Seriously, piece of cake. It was perfect for the next hour (I could feel and move my legs from knees down) and then the dosage started to build to where I felt like I was made of stone. My blood pressure dipped hard and babies heart rate started to decel with it so I had to be manhandled into various positions to keep him stable. My nurse stayed with me the entire night and worked her ass of babying my baby’s heart rate. I shook hard off and on and at some points started to have slurred speech due to the epidural being so high so I wish I would have asked more questions about dosage options since the RNs were unable to modify once it was set. My option was basically that it just runs its course.
23 hours in of active labor and shift change blessed me with another wonderful nurse. I was exhausted at this point and kind of just dozed awaiting the feeling to push. I never felt it because I had zero sensation. I got checked and my body was “ready” (e.g., I shit myself unknowingly). I wish I would have had more control over my body for this part for the sake of perineal care but I felt absolutely nothing. I also got the feeling my Dr was a little rough knowing I couldn’t feel and I got a second degree tear. I pushed (or at least what felt like pushing) for 45 minutes and he was out.
My water had been broken for 26 hours so I needed quick clearance from the on-call pediatrician but thankfully my baby didn’t require anything else. Overall, I’m happy I was able to follow most of my birth plan and staff was respectful of my written decisions. I really thought I’d have to advocate for myself more because of all the trauma dumping people shared and what I’ve read. I was even allowed to eat throughout labor (but I didn’t really want to.)
To all who are afraid of what to expect from induction, there are many positive scenarios we just tend to hear the negative ones most often. You can and will do this! Love and support to all who are anxiously awaiting the unknown. ♥️

First off, the treatments are actually not uncomfortable at all, to my surprise.
To provide a little background, April 2023 I had my right kidney removed due to Urothelial carcinoma. I began chemotherapy (carboplatin / cisplatin), which ended in September of last year, and transitioned immediately into immunotherapy. Every 3 months I get a scan and they have been clear since last June '23. My last scan however revealed a tumor in my bladder. My urologist got me into the hospital and had it removed. Pathology returned High Grade Urothelial Carcinoma, non invasive.
My Oncologist and Urologist are stunned.
So, while I continue with my monthly Immunotherapy treatments, I also go to my Urologist for BCG.
Anyone have this type of occurrence while being one year into chemo / Immunotherapy treatment?
Also, one more question - My BCG nurse is very skillful and nice. Treatments aren't awkward at all as I feared they would be. I am however puzzled by this paper apron thing that is provided for my lap. While she was preparing to do the treatment last week, I asked about it. She explained that it was provided for modesty. I kinda smiled and told her that didn't make any sense at all to me. Am I not understanding something?

the title of each is truncated from the online file name and the study's earliest date added for indexing purposes -- I've each study copied into my PC, links to the studies if that's challenging [DuckDuckGo works better than Google] available on request
198400 static vs dynamic loads and bone strength 1984-J-Biomech-static intermittent (dynamic) loads more effective than static loads for triggering bone growth
198909 Effect of resistance training on lumbar extension strength - PubMed
These data indicate that when the lumbar area is isolated through pelvic stabilization, the isolated lumbar extensor muscles show an abnormally large potential for strength increase.
199100 measurement of back strength in osteoporotic and elderly patients
Improvement of back extensor strength (BES) can be used as a therapeutic method for patients with chronic back pain and osteoporosis. The method of evaluation must be reliable and accurate without compromising the condition of the patient. We report the development of a back isometric dynamometer (BID-2000)
199108 Influence of brisk walking in previously sedentary women aged 30-61 years
broadband ultrasonic attenuation (BUA) values for the calcaneous (? ultrasound) in formerly sedentary women, a modest program of a widely acceptable form of exercise, brisk walking (~ 6.2 km/hr or 4 mph), can provoke an increase in this sensitive index of bone condition.
199110 nutritional requirements of rare elements 2661.full
Boron deprivation apparently affects the function or composition of several body systems including the skeleton, ///// with a boron supplement of 3 mg/day for 48 days. Seven of the women were fed a diet low in magnesium (116 mg/2000 kcal); the other five women had their diet supplemented with 200 mg Mg/day. The boron supplementation reduced the total plasma concentration of calcium and the urinary excretions of calcium and magnesium, and elevated the serum concentrations of 17/3-estradiol and testosterone.
of silicon deficiency have been described for chickens Signs and rats. Most of the signs initially reported indicated aberrant metabolism of connective tissue and bone ///// It has been postulated that humans require silicon in the range of 5-20 mg/day.
199300 arthritis of the hip and hip fractures annrheumd00485-0015
we found that subjects with symptoms of arthritis of the hip had a markedly reduced risk of hip fracture. This suggests that OA of the hip should be included in the list of factors that protect against hip fracture.
199301 Muscle strength in osteoporotic versus normal women
back extensor strength (BES) osteoporotic women had significantly lower BES than the normal women.
199305 ipriflavone on bone mass ovariectomized women
These results demonstrate that ipriflavone administration prevents the rapid bone loss that follows ovariectomy. Thus, ipriflavone can represent an attractive alternative for the prevention of osteoporosis in postmenopausal women who present contraindications to the estrogen replacement therapy.
199306 effects of walking on vertebral bone loss in postmenopausal women
anaerobic threshold (AT). The exercise regimen consisted mainly of walking at a speed that kept the exercise heart rate above the AT We conclude that short-term (7months) exercise with intensity above the AT is safe and effective in preventing postmenopausal bone loss.
199306 bone density trial of peroral magnesium in osteoporosis
magnesium regulates calcium transport, and magnesium replacement in magnesium-deficient ostmenopausal patients resulted in unexpected improvement in documented osteoporosis, we investigated the effect of magnesium treatment on trabecular bone density in postmenopausal osteoporosis. Twenty-two patients (71 per cent) responded by a 1-8 per cent rise of bone density. in untreated controls, the mean bone density decreased significantly (P < 0.001).
199402 Mechanotransduction in bone 875.full
We hypothesize that interstitial fluid flow affects bone formation, and we tested this hypothesis indirectly by measuring the effect of different loading frequencies on bone formation rate in vivo.
199405 treatment with ipriflavone on bone in postmenopausal women
Ipriflavone (IP) After 12 months, a reduction of BMD was evidenced in the (placebo)PL-treated group, at both the spine (-2.2%, P < 0.01 vs baseline) and the forearm (-1.2%). In the IP-treated group, an increase of BMD was obtained (+1.2%, P < 0.01 vs placebo, at the spine; +3%, not significant, at the forearm).
199412 Effects_of_high-intensity_strength_training_on_mul
Interventions.-High-intensity strength training exercises 2 days per week using five different exercises (n=20) vs untreated controls (n=19). Results.-Femoral neck bone mineral density and lumbar spine bone mineral density increased by 0.005:t0.039 g/cm2 (0.9%:t4.5%) (mean:tSD) and O.009:tO.033 g/cm2 (1.0%:t3.6%), respectively, in the strength-trained women and decreased by -0.022:t0.035 g/cm2 (-2.5%:t3.8%) and - 0.019:t0.035 g/cm2 (-1.8%:t3.5%), respectively, in the controls (P=.02 and .04). Total body bone mineral content was preserved in the strength-trained women (+2.0:t68 g; 0.0%:t3.0%) and tended to decrease in the controls (-33+77 g; -1.2%:t3.4%, P=.12). Muscle mass, muscle strength, and dynamic balance increased in the strength-trained women and decreased in the controls (P=.03 to <.001 ).
Conclusions.-High-intensity strength training exercises are an effective and feasible means to preserve bone density while improving muscle mass, strength, and balance in postmenopausal women.
The following exercises were used for training: hip extension, knee extension, lateral pull-down, back extension, and abdominal flexion using pneumatic resistance machines (Keiser Sports Health Equipment, Fresno, Calif). These exercises were chosen because they trained the major muscle groups attached to the bones of interest. The intensity of the training stimulus was set at 80% of the most recently determined one repetition maximum (lRM) for each muscle group for hip extension, knee extension, and lateral pull-down exercises and 16 on the Borg scale17fo r back extension and abdominal flexion. The lRM is the maximum mass of a free weight or other resistance that can be moved by a muscle group through the full range of motion using good form one time only
199505 Lifetime Leisure Exercise and Osteoporosis Epidemiology
A positive association between current exercise and BMD was found at the total hip (p = 0 001) and at each hip component—greater trochanterp = 0.02), intertrochanter (p = 0.001), and femoral neck (p = 0.02). Mean hip bone densities of strenuous (p = 0.004) and moderate (p = 0.004) current exercisers were higher than those of mild or less than mild exercisers. Lifetime exercise was also positively associated with BMD of the total hip (p = 0.008) and hip components, and demonstrated a borderline signicant association (p = 0.06) with spine BMD. These data suggest a protective effect of current and lifelong exercise on hip BMD, but not on osteoporotic fracture, in older men and women.
199507 resistance training on regional and total BMD in premenopausal women
This study was designed to assess the effects of 18 months of resistance exercise on regional and total bone mineral density (BMD) soft tissue lean mass (STL) premenopausal women aged 28–39 All subjects consumed a 500 mg/day elemental calcium supplement throughout the study. Initial Ca intake without supplement averaged 1,023 mg/day in total sample. BMD increased signicantly above baseline at the lumbar spine for the exercise group at 5 months (2.8%), 12 months (2.3%), and 18 months (1.9%) as compared with controls. Femur trochanter BMD increased signicantly (p < 0.05) in the exercise group at 12 months (1.8%) and 18 months (2.0%) but not at 5 months (0.7%) as compared with controls. No changes in total BMD, arm BMD, or leg BMD were found.
199600 functional loading to influence bone mass and architecture -- mechanically adaptive process
Unusual strain distributions, high strains, and high strain rates seem to be particularly osteogenic. The osteogenic response which follows exposure to such strains appears to saturate after only a few loading cycles Each exercise session need not be prolonged but should include as many novel strain distributions as possible, preferably involving high peak strains and strain rates estrogen amplifies the osteogenic response to a single period of loading.
199602 Exercise effects on bone mass in postmenopausal women
Exercise effects on bone mass in postmenopausal women are site-specif... https://academic.oup.com/jbmarticle-abstract/11/2/218/7500793?redir... The bone mass increase with the strength regimen was signicantly greater at the trochanteric hip site (control -0.6 + 2.2%, exercise 1.7 + 4.1%,p < 0.01), at the intertrochanteric hip site (control -0.1 + 2.1%, exercise 1.5 + 3.0%,p < 0.05), Ward's triangle (control 0.8 + 5.2%, exercise 23 + 4.0%,p < 0.05), and at the ultradistal radial site (control -1.4 + 2.3%, exercise 2.4 + 4.3%. p < 0.01). There was no signicant increase in BMD with the endurance regimen except at the radius midsite (control -1.0 + 23%, exercise 0.1 + 1.4%, Postmenopausal bone mass can be signicantly increased by a strength regimen that uses high-load low repetitions but not by an endurance regimen that uses low-load high repetitions. We conclude that the peak load is more important than the number of loading cycles in increasing bone mass in early postmenopausal women.
199607 female athletes High-Impact Exercise taaffe1997
the percent change in lumbar spine BMD after 8 months was significantly greater ( p 0.0001) in the gymnasts (2.8 2.4%) than in the runners (20.2 2.0%) or controls (0.7 1.3%). An increase in femoral neck BMD of 1.6 3.6% in gymnasts was also greater ( p < 0.05) than runners (21.2 3.0%) and approached significance compared with controls (20.9 2.2%, p 0.06). For cohort II, gymnasts gained 2.3 1.6% at the lumbar spine which differed significantly ( p < 0.01) from changes in swimmers (20.31.5%) and controls (20.4 1.7%). Similarly, the change at the femoral neck was greater ( p < 0.001) in gymnasts(5.0 3.4%) than swimmers (20.6 2.8%) or controls (2.0 2.3%). bone mineral at clinically relevant sites, the lumbar spine and femoral neck, can respond dramatically to mechanical loading characteristic of gymnastics training in college-aged women. We conclude that activities resulting in high skeletal impacts may be particularly osteotropic for young women.
During the period of observation, gymnasts and swimmers trained for approximately 20 h/week. These athletes trained year-round, and underwent approximately 3 h/week of weight training and 2.5 h/week of aerobic activity (running, cycling). Runners averaged 43.1 15.6 mi/week and included a similar amount of weight training in their exercise regimen as the gymnasts and swimmers.
199700 brisk walking and postmenopausal women 26-4-253
the promotion of exercise through brisk-walking advice given by nursing staff may have a small, but clinically important, impact on bone mineral density but is associated with an increased risk of falls. encouraged them to gradually work up to walking for 40 min three times a week. 'Brisk' was defined as walking at a pace that was faster than usual walking for the subject but not so fast as to be uncomfortable or to cause shortness of breath. a simple regimen of self-paced brisk walking may reduce loss of bone mineral density at the femoral neck and is associated with a mean 2% net difference (95% CI -0.3 to +5%) in bone mineral density at this site over 2 years. At the lumbar spine no difference between the brisk-walking and placebo groups was observed, The women in our placebo group experienced a 2.8% fall in femoral bone mineral density compared with a fall of 0.25% among the brisk-walking group over 2 years.
199700 Dietary vitamin C and bone mineral density jepicomh00179-0011
mean intake was 407 mg/day. Longer duration of vitamin C supplement use was associated with higher BMD in women Frequent intake of foods rich in vitamin C was not associated with BMD. Conclusion-There was no evidence that vitamin C from the diet was associated with BMD, although long term use of vitamin C supplements was associated with a higher BMD in the early postmenopausal years and among never users of oestrogen.
199700 Ipriflavone Inhibits Bone Resorption 212376212
While clearly demonstrating that ipriflavone can inhibit bone resorption in the rat, the present study also suggests that confounding factors such as diet formulation and/or feeding habit should be taken into consideration when investigating the protective effect against bone loss of new compounds in experimental animals.
199700 Long-Term_Effect_of_Testosterone_Therapy_on_Bone_M
Serum levels of testosterone increased to the normal range in all androgen-treated hypogonadal men. The most significant increase in BMD was seen during the first year of testosterone treatment in previously untreated patients, ONE OF THE prominent clinical symptoms of testoster E OF THE prominent clinical symptoms of testosterone deficiency in men is a significant decrease in bone ONE OF THE prominent clinical symptoms of testosterone deficiency in men is a significant decrease in bone mineral density (BMD)
199706 Nutritional influences on BMD postmenopausal women - PubMed
lumbar spine (LS), femoral neck (FN), femoral trochanter (FT), With higher intakes of zinc, magnesium, potassium, and fiber, LS BMD was significantly higher a significant difference in LS BMD was also found between the lowest and highest quartiles for these nutrients and vitamin C LS BMD and FT BMD were lower in women reporting a low intake of milk and fruit in early adulthood than in women with a medium or high intake
199709 Five jumps per day increase bone mass and breaking force in rats
Five-week-old rats were divided into control or five jump trained groups comprised of 5-, 10-, 20-, 40-, and 100-jump groups, representing the number of jumps per day. The rats were jump-trained 5 days/week for 8 weeks, and the height of jump was increased to 40 cm progressively The present results indicate that a large number of strains per day is not necessary for bone hypertrophy to develop in rats.
199800 Biphasic effects of genistein on bone tissue rat model
In summary, lower doses of genistein from soy foods would be expected to act similarly to estrogens with a beneficial effect on bone tissue, but at high doses that are unlikely to be consumed in human diets, this soy derivative may have potentially adverse effects on bone cell functions and thereby on bone tissue
199800 foods and BMD 1-s2.0-S0002916522043477-main
199900 Tucker1999AJCN-PotassiummagnesiumfruitvegandBMD
Results: Greater potassium intake was significantly associated with greater BMD at all 4 sites for men and at 3 sites for women (P < 0.05). Magnesium intake was associated with greater BMD at one hip site for both men and women and in the forearm for men. Fruit and vegetable intake was associated with BMD at 3 sites for men and 2 for women. Greater intakes of potassium and magnesium were also each associated with less decline in BMD at 2 hip sites, and greater fruit and vegetable intake was associated with less decline at 1 hip site, in men. To our knowledge, this is the first study to relate usual intake of these nutrients and foods to BMD and to change in BMD over time in older men
Only 8.7% of men used calcium supplements, compared with 23% of women. More men and women used vitamin D supplements than calcium supplements. Average magnesium intakes just exceeded the 1989 recommended dietary allowance (RDA) (42), but fell below the recently released RDA of 320 mg/d (43) for women and were far below the new RDA of 420 mg/d for men. Average reported fruit and vegetable intakes were 4.7 fruit or vegetables or both/d for men and 5.3/d for women, which is somewhat higher than the 3.1–3.4 servings/d reported in national surveys (45). In men (Table 2), the association between potassium and BMD was significant for all 4 bone sites, with slopes ranging from 0.022 to 0.04 g/cm2, or 5.8% of average BMD for every 1000 mg K. For magnesium intake, results were significant for the radius and the trochanter and approached significance for the remaining 2 hip sites. Differences in BMD associated with each 100-mg difference in magnesium intake ranged from 0.023 to 0.027 g/cm2. These represent differences of 3.8% of average BMD. For the femoral neck, the slope of 0.0086 represents a 1% greater BMD for each fruit or vegetable consumed per day. Two studies reported cross-sectional associations between potassium intake and BMD in free-living adult populations (20, 21).
TABLE 6 Top 20 food sources of potassium and magnesium in the study population Our results for fruit and vegetable intakes were also interesting, with significant protective cross-sectional associations in both men and women and suggestive protective longitudinal effects in men. Fruit and vegetables are important sources of potassium and magnesium and this finding supports their potential role in the prevention of osteoporosis.
199800 Physical Activity and Osteoporotic Fracture jathtrain00011-0017
Race, BMI, and inactivity significant risk factors age, were predicting the occurrence of osteoporotic fracture.Pollock and Brechue28 recommended approximately 2 sessions per week of strength-training exercises. They suggest a minimum of 15 minutes of muscle conditioning session, per preceded by and followed by cool-down a warm-up a program. Resistance exercise equipment that is designed to protect the lower back and prevent loss of balance should be used. A program that involves starting with light weights and gradually increasing resistance in small increments is suggested.
Physical activity predictor for fracture status was greater than heredity, smoking alcohol use and dairy product intake.
199800 Weighted Vest Exercise 53A-1-M53 (full study)
199801 Weighted vest exercise reduces fall risk in older women (abstract)
Our intent was to determine if weight-bearing exercises with added resistance from weighted vests would improve dynamic balance, muscle strength and power, and bone mass in postmenopausal women, thereby reducing risk for falls and hip fracture. Results: Significant improvements were observed for indices of lateral stability, lower-body muscular strength (16-33% increase), muscular power (13% increase), and leg lean mass (3.5% increase) in exercisers vs controls (p < .05). No significant changes (p > .05) were detected for femoral neck bone mass in exercisers or controls at the conclusion of the trial. Conclusions: Lower body exercise, using a weighted vest for resistance, provides an effective means of improving key indices of falls in postmenopausal women.
199805 leisure-time physical activity and mortality
Those who reported exercising at least 6 times per month with an intensity corresponding to at least vigorous walking for a mean duration of 30 minutes were classified as conditioning exercisers, those who reported no leisure physical activity were classified as sedentary, and other subjects were classified as occasional exercisers.
The hazard ratio for death adjusted for age and sex was 0.71 (95% confidence interval [CI], 0.62-0.81) in occasional exercisers and 0.57 (95% CI, 0.45-0.74) in conditioning exercisers, Leisure-time physical activity is associated with reduced mortality, even after genetic and other familial factors are taken into account.
199806 menopausal symptoms canfamphys00052-0109
Some scientific evidence of the safety and efficacy of alternative treatments during menopause was uncovered, with the strongest evidence emerging in favour of phytoestrogens, which occur in high concentrations as isoflavones in soy products. Genistein, one of the important isoflavones, was recently reported to have identical effects to conjugated equine estrogens in maintaining bone mass in ovariectomized rats.28 total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels can be significantly reduced by three servings of soy products daily, with phytoestrogens accounting for 60% to 70% effects. of the phytoestrogen consumption through legumes is assumed to be safe as part of a balanced diet, grapefruit juice (containing three bioflavonoids) might increase bioavailability of administered 17f-estradiol and estrone."
One study of the effects of exercise on the frequency of postmenopausal hot flashes found that moderate to severe hot flashes occurred in 21.5% of a group of postmenopausal women belonging to an athletic club compared with 43.8% of women in a large control group who did not exercise in a structured manner. Numerous anecdotes report the effectiveness of exercise in alleviating menopausal symptoms.
199910 24-Week Aerobic Exercise Program and women 2000Efficacyofa24-weekaerobic67-443-448
The purpose of this study was to investigate whether a 24-week program of aerobic high-impact loading exercise was beneficial for enhancing physical fitness and bone mineral density (BMD) in osteopenic postmenopausal women. Exercise programs included treadmill walking at an intensity above 70% of maximal oxygen consumption (VO2max) for 30 minutes, followed by 10 minutes of stepping exercise using a 20-cm-high bench. The results showed that the quadriceps strength, muscular endurance, and VO2max in the exercise group had significant improvements, The BMD of the L2–L4 and the femoral neck in the exercise group increased 2.0% (P > 0.05) and 6.8% (P < 0.05) and those in the control group decreased 2.3% (P < 0.05) and 1.5% (P > 0.05), respectively.
The assignment of subjects into exercise or control group was not randomized, but based on subjects’ anticipated compliance with the 6-month exercise training program. Grip strength of the dominant hand was measured using a hand held dynamometer (Jamar, Jackson, MI, USA). The second part of the exercise program was 10 minutes of stepping exercise at a speed of 96 beats per minute using a 20-cm-high bench, with rest after the first 5 minutes.
A slight increase in spinal BMD (2.0%) was noted in the exercise group (P > 0.05) whereas a decrement of 2.3% was observed in the control group (P < 0.05). The BMD value of the femoral neck was significantly increased in the exercise group (6.8%, P < 0.05) whereas a 1.5% decrease in BMD was noted in the control group. Further analyses of the effect of HRT on BMD showed that subjects who were taking HRT exhibited greater improvements (10.1%) in BMD of the femoral neck than their non-HRT counterparts (6.7%) in the exercise group. Non-HRT subjects, however, showed a greater increase in BMDof the spine (1.9%) than HRT subjects (1.5%). In the control group, subjects who were taking HRT exhibited greater decrease in BMD of the spine and femoral neck (3.0% and 3.7%) than their non-HRT counterparts (2.2% and 1.1%). the stepping exercises employed in this study were regarded as high-impact exercise with specified strain on the femoral neck [42]. Hatori et al. [44] reported that walking above the anaerobic threshold (AT) was effective in increasing BMD, whereas exercise below the AT was not.
Aerobic exercise combined with high-impact exercise was also found to improve physical fitness, including muscle strength, muscular endurance, and VO2max in this study. Persons with problems in these parameters of physical fitness were suggested to have a propensity to fall our study demonstrated that a 24-week program of aerobic high-impact exercise resulted in significant improvements in BMD of the femoral neck in Chinese post menopausal women. Other benefits included improvements in muscle strength, muscular endurance and VO2max, which may have beneficial effects on physical fitness and reducing the risk of cardiovascular diseases and falling.