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You get them from red meat, processed meats, high-fat dairy products, and commercially deep-fat fried foods. So avoid these: I Organ meat including liver, kidney, brains, heart, stomach, etc. I Skin of poultry I Fried foods, including deep-fat fried fish I Fatty red meat I Processed meat of any type, including those made from turkey or chicken (surprisingly, these are often higher in fat than those made from beef) I High fat dairy products, including milk, butter, cheese, ice cream, and yogurt Healthier fats come in the form of whole foods such as avocados. Others safer fats are: I Cultured dairy products, sour cream, plain yogurt, cottage cheese, fetta cheese, blue cheese, and other fermented cheeses. Omega-3 fatty acids have recently been shown to be more effective than statin drugs according to 83 a published meta-analysis Swiss researchers reviewed 97 random controlled clinical trials, including more than 275,000 participants, and discovered that statin drugs decreased mortality by 22 percent, but omega-3 fatty acids decreased mortality by 32 percent. Even death from any cause was reduced by only 13 percent with statins but by 23 percent with omega-3 fatty acids! Why not make fish (like ocean-raised salmon, herring and mackerel), cod liver oil, olive oil, borage oil, primrose oil, and flaxseed oil a part of every meal? Keeping Blood Thin Naturally Nattokinase is a potent fibrin inhibitor, reducing blood thickness and atherosclerosis of heart disease and stroke. I have a patient that does better on nattokinase and vitamin E than he did on Coumadin and Lovenox shots for recurrent pulmonary embolisms (clots to the lungs). Alternative and Natural Interventions for Cardiovascular Disease G 39 Serrepeptase digests blood clots and possibly arterial plaque. Serrapeptase, however, has no inhibitory effects on prostaglandins so stomach acid level remains unchanged. Perfusion of blood where it was formerly insufficient is the recognized method of reversing angina pectoris and lower extremity claudication. It is also the way to keep vessels working, blood pressure down, and slow or stop the progression towards atherosclerosis. Fortunately, there are a few who know how to expose misleading study design or those studies in which researchers report negative interpretations of what are actually positive results. It reminds me of our government buying into the false report that Iraq was concealing weapons of mass destruction to be used on us—reason enough to engage in what now has become a five-year war with more than 4,000 U. In addition, we have the highest levels of military intelligence now admitting that they really did not have any evidence of weapons of mass destruction—the declared basis for going to war in the first place. In fact, you will find that most of the peer-reviewed literature available on the National Library of Medicine’s public access website ( Also, its toxic effects can cause other problems which may lead to a fatal outcome. Proper investigation and treatment may sometimes be delayed by 85 a patient’s faith in such therapy. For example, these authors, also published in peer-reviewed scientific journals, state direct opposition to R.

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Some medical students make informal arrangements to volunteer in com munity health clinics or shadow physicians (while also earning money through part-time jobs like waiting tables). For motivated students who do not mind an other round of applications, there are formal programs that provide more struc tured clinical experience. The National Health Service Corps, a federal agency, offers a month-long rotation (funded with a stipend) to expose students to the practice of rural medicine and primary care in underserved areas. You might be placed in Alaska, Nevada, North Dakota, West Virginia, or other exotic locales. For instance, the Illinois Academy of Family Practitioners has a program for ris ing second-year students in which they are paired with a family practitioner for a month-long one-on-one preceptorship. For in stance, Thomas Jefferson University Hospital in Philadelphia sponsors a 6-week experience in radiation oncology (The Simon Kramer Society Ex ternship) for interested medical students. Through classroom and prac tical clinical work, you learn about another country’s health care needs and become proficient in another language. Although not every specialty has its own organized clinical summer program, many do exist and more are established every year. Above all, make every effort to use this summer to gain early exposure to different specialties without having to commit yourself to any of them. It will help you to begin prioritizing some of the many factors that go into deciding on a specialty (and on what you want out of your medical career in general). Even if your heart has always been set on orthopedic surgery, use this last summer to check out primary care or family practice. You never know what kind of meaningful clinical experience may end up changing your mind. The public no longer thought of physicians as wise, gentle men who made house calls. Instead, they began to have female doctors of their own— women who treated hypertension, performed cardiac bypass surgery, interpreted chest radiographs, and delivered babies. For many of these women physicians, their gender had an important role in their final choice of medical specialty. Across the medical specialties, the distribution of women is somewhat unbal anced. In 2001, for example, women made up only 9% of orthopedic surgery resi dents, compared to 71. Af ter all, many medical students think of these specialties as having lower status, 59 Copyright © 2004 by the McGraw-Hill Companies, Inc. Typ ically more women seem to be drawn to the primary care specialties because they are compatible with their practice styles.

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One of the new major developments phine and some other drugs mentioned in the text. Should very ill patients receive Local and regional anesthetics strong analgesics postoperatively? Tese include wound infiltrations during operations, Many patients are not well resuscitated and may be field blocks, nerve blocks, and regional blocks of the hypovolemic after major surgery. Tese are particularly useful in the first a lot of adrenergic stimulation, which tends to tempo 12 to 24 hours, when we are very worried about cardio rarily keep the blood pressure up. When pain is abolished, Opioids are the most useful in this group, but in some these patients may reveal their “true” blood pressure specific situations, general anesthetic drugs such as in and become hypotensive. Some medical staff therefore travenous ketamine in “subanesthetic” doses can be used avoid opioids in such patients. Morphine causes his “Coanalgesics” tamine release, which may cause vasodilatation, but it is Drugs such as antidepressants and anticonvulsants are usually mild and beneficial to the heart. Intravenous steroids such as dexa prefer to see a patient struggling and showing signs of methasone are becoming more popular for use as anti life rather than pain free and sleeping quietly. Some tie emetics after surgery, but they have not been proven to up such patients to their beds when they are struggling. Others resort to sedatives and hypnotics, such as diaz epam or even chlorpromazine. Many patients are rest Nonpharmacological methods less because they have pain or a full bladder. Tese methods should be Is the pain threshold higher in used more whenever possible. They may, therefore, request more drugs cated about acute pain and its management in the and will be able to tolerate them better. Consent is not normally re ever, no respecter of race or class, and every individ quired except for experimental and research pur ual must be treated as unique. Intravenous, rectal, or oral routes can be used in an upward or How to organize pain management downward stepladder manner depending on the after major surgery circumstances. Pain relief may require the barest mini an important role in any acute pain service and mum of staff drugs and equipment. Such equipment, and good monitoring are essential in guidelines help countries, especially those with the least all institutions where major surgery is done. Optimum monitoring of the patient should in ward rounds, run emergency services for com clude equipment for respiratory monitoring, in plications, carry out research, and conduct audits cluding pulse oximetry and cardiovascular moni on pain management. Simple sedation ob service with guidelines and protocols to cover servation charts and early warning charts for ad children and adults in accident and emergency verse events will help manage even the most dif wards, operating rooms, and recovery wards as ficult patients in the least well-resourced areas.

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This can be remedied by runs on a track or by walking; increased breathing disperses it. Springs and wells relate to the bladder and in these cases diuretics should be employed. An earth-tremor or the shaking of a house predicts the onset of sickness when it is observed by a healthy man; a change and the restoration of health for a sick one. In the healthy, it is wise to change the regimen because it is the existing regime which is disturbing the whole body; therefore first give an emetic so that, after this, he may be fed up again gradually. But in the case of a sick man, because the body itself is undergoing a change, the same regimen should be continued. To see land flooded with water or by the sea is a sign of illness, indicating excess fluid in the body. Nor is it good to see the earth looking black or scorched; this shows excessive dehydration of the body and there is the risk of severe or fatal illness. The patient should not bath till he has eaten; then let him lie soft and relax, avoiding cold and sun. To dream of diving into a lake, the sea or rivers is not a good sign as it too indicates an excess of moisture. In those suffering from fever, however, it is a good sign, indicating that the heat is being quenched by moisture. It is a good sign for health to see anything normal about one’s clothing, the size being neither too large nor too small but in accordance with one’s own size. Anything too large or too small for one’s limbs is not good; in the one case the regimen should aim at a decrease, and in the other, an increase. To see the dead, clean, in white clothes, is good; while to receive something clean from them denotes health both of the body and the things which enter it. This is because the dead are a source of nourishment, increase and propagation, and it is a sign of health that what enters the body should be clean. On the contrary, if the dead appear naked, or in dark garments, or unclean, or taking or carrying anything out of the house, this is an inexpedient sign indicating disease because the things entering the body are harmful. These should be purged away by circular runs and walks and, after an emetic, a soft and light diet should be given which is gradually increased. The appearance of monstrous creatures which appear during sleep and frighten the dreamer indicate a surfeit or unaccustomed food, a secretion, cholera and a dangerous illness. An emetic should be followed by an increasing diet of the lightest foods for five days; the food should neither be excessive nor pungent, nor dry nor warm. Warm baths and relaxation are also advisable, and both the sun and the cold should be avoided. The stronger the meats seem, the greater the degree of inadequacy of the diet; weaker meats indicate a smaller deficiency, as if it were good to partake of whatever were seen in the dream. If the dreamer flies in fright from anything, this means an obstruction to the blood as a result of dehydration. Fighting, being stabbed or bound by another indicates that some secretion, inimical to the flows, has taken place into the body.