By T. Potros. Brenau University. 2019.
It is very important that all confirmed or suspected exposures be carefully documented in written form buy 60mg dapoxetine with amex erectile dysfunction after 70. These records are very useful during the annual medical review and can also be used as claims evidence in applicable worker compensation cases buy generic dapoxetine online impotence nasal spray. These evaluations are designed to assist in the early identification of illness or injury that may be related to the adverse effect of a work site exposure or the working environment buy dapoxetine 90 mg fast delivery erectile dysfunction doctor mumbai. In addition discount dapoxetine 90mg with mastercard impotence emedicine, any employer having workers subject to infectious disease occupational exposures is required to establish a written exposure control plan designed to eliminate or minimize exposures, and to handle them properly when they occur. A-10 January 2007 Infectious Diseases International Association Appendices of Fire Fighters Exit Physical Examinations This examination is performed when you leave your department or transfer to work that does not involve continued exposure to hazardous materials. The purpose of an exit exam is to establish the state of a responders health at the conclusion of a specific job assignment. Diagnostic tests may include: Blood tests Urinalysis Lung function testing Electrocardiogram Stress tests Biological Monitoring Biological monitoring measures the level or effects of a specific agent. It is usually done only if you are exposed to an agent which tests are available for, such as: Pesticides Lead exposure Acute Medical Care There is always a chance that emergency responders will require medical attention as a result of operations at the scene of an emergency. Because of the nature of the work, Advanced Life Support should be available to treat and transport responders requiring attention. As part of your pre-planning process, identify hospitals in your area that are equipped to handle chemical and toxicological emergencies. These facilities may have specially trained providers and equipment that could make the difference in an emergency. January 2007 A-11 International Association Infectious Diseases of Fire Fighters Appendices Annual Program Review Just like any other program, the medical surveillance component should undergo review for effectiveness. This review, which should occur annually at a minimum, can also help identify injury trends and special health effects. Annual program review elements should include: Assessments of injuries and illnesses to determine the cause. This process allows you to modify health and safety procedures when necessary A review of medical testing for exposures and environmental monitoring to ensure that they are useful An examination of emergency response capabilities and treatment procedures and an updated list of emergency contacts and facilities A careful analysis of group data to detect trends that may not be apparent through individual results so that deficiencies in such areas as training or personal protective equipment can be corrected A review of hazardous materials responses, medical records and exposure reports to ensure that responders are receiving proper follow-up care A review of confidentiality procedures and safeguards to ensure that member privacy is protected and only information on work status and restrictions is communicated to management A-12 January 2007 Infectious Diseases International Association Appendices of Fire Fighters Appendix 4 Medical Exam Items (Fire Service Joint Labor Management Wellness-Fitness Initiative) The Fire Service Joint Labor Management Wellness-Fitness Initiative recognizes the importance of consultation and/or referral to outside health care providers and/or specialists. Aspects of the follow-up and referral program include: Abnormal findings on the annual physical must be addressed by follow-up or referral Revaccination or intervention following exposures must be managed by follow-up or referral Managed care or other provider referrals are appropriate for non-service connected problems Return to work determinations require clearance by the fire department physician or other provider following a consult with an outside physician or after extended leave Follow-up on findings from annual examinations must be reviewed by the fire department physician The health care provider (organization or individual) shall provide written documentation regarding follow-up/referral program or procedures. Individualized Health Risk Appraisal Written feedback to uniformed personnel concerning health risks and health status is required following the annual examination. Reporting findings and risks and suggesting plans for modifying risks improves the physician-patient relationship and helps uniformed personnel claim ownership of their health status. Individualized health risk appraisals also must include questions that attempt to accurately measure the uniformed personnels perception of their health. January 2007 A-13 International Association Infectious Diseases of Fire Fighters Appendices Medical History Questionnaire An initial pre-employment history questionnaire must be completed to provide baseline information with which to compare future medical concerns. A periodic medical history questionnaire must be completed to provide follow-up information. Hands-on Physical Examination An initial pre-employment history questionnaire must be completed to provide baseline information with which to compare future medical concerns. This allows a future determination to be made regarding the most accurate and consistent method for evaluating body composition of uniformed personnel. For the purposes of this initiative, the international database will not record body composition until such efforts are complete. Evaluate for common visual disorders including cataracts, macular degeneration, glaucoma and diabetic retinopathy. An occupational injury is an injury such as a cut, fracture, sprain or amputation that results from a work-related accident or from exposure involving a single incident in the work place. An occupational illness is any abnormal condition or disorder other than one resulting from an injury, caused by exposure to environmental factors associated with employment. Such acute and chronic illnesses and diseases are caused by inhalation, absorption, ingestion or direct contact with toxic substances or harmful agents. Most facilities choose to extend this program to contractors, subcontractors, visitors, regulatory agency personnel and site owners or their representatives. Bloodborne Pathogens Standard On December 2, 1991 the Occupational Safety and Health Administration promulgated a new standard for bloodborne pathogens that greatly changed how fire fighters, emergency response personnel and all other workers potentially exposed to bloodborne diseases should be trained and equipped to protect themselves from infections. Of these, 21 to 30 will suffer clinical illness and 4 to 6 will need hospitalization. Between 4 and 12 of the cases with clinical illness will become chronic carriers, and 1 to 3 of them will suffer from chronic Hepatitis. It calls for identifying workers at risk through exposure control plans; it sets requirements for limiting exposure to those workers through a combination of engineering controls, personal protective equipment and worker training; and it calls for Hepatitis vaccination to be offered to all at-risk employees at no cost to the employees. Finally, there is a provision for post-exposure evaluation and follow-up, so that workers who are exposed on the job can receive proper assessment of their risk and appropriate treatment and documentation. The standard became effective 90 days since its publication in the Federal Register (March 6, 1992). The employers Exposure Control Plans should have been completed within 60 days of the effective date (May 5, 1992). The Information and Training and Record keeping requirements were to take effect within 90 days of the effective date (June 4, 1992). Section 18 of the Occupational Safety and Health Act requires that a state must provide satisfactory assurance that it will establish and maintain an effective and comprehensive occupational safety and health program for all public employees as effective as that contained in the approved state plan covering private employees. The following is a summary of the most important parts of the standard applicable to fire fighters. This is not a word-for-word transcription of the standard, and does not contain all of the provisions of the standard. This plan describes how the employer will meet the overall goals of the standard (minimizing employee exposures) and the specific elements of the program. Safer medical devices include equipment like needleless systems, sharps with engineered sharps injury protection and plastic capillary tubes. There must be a regular maintenance and replacement schedule for engineering controls. It is not the Agencys intent to prohibit these employees from eating or drinking during such extended periods. Therefore, eating and drinking in ambulance cabs is permitted under the final standard provided the employer has implemented procedures to wash up and change contaminated clothing prior to entering the cab. In addition, employers must prohibit the consumption, handling, storage and transport of food and drink in the rear of the vehicle. Consequently, these devices have been retained under the requirements for provision of personal protective equipment. In additionthese devices are to be readily accessible to employees who can reasonably be expected to resuscitate a patient. For people with sensitivity to the gloves ordinarily provided, alternatives (hypoallergenic gloves or glove liners, for example) must be provided. The employers responsibility to ensure accessible personal protective equipment for employees at non-fixed worksites cannot be overemphasized. If penetrated with blood or other potentially infectious materials, the garment shall be removed immediately. When removed from the area of use, the containers must be closed prior to removal, placed in a secondary container if leakage is possible and may not be reopened in any way that would expose an employee to the risk of an injury. If the outside of the container is itself contaminated, it must be placed in a secondary container that is similarly constructed. The vaccine shall be made available "after the employee has received the training required" (see below) and "within 10 working days of initial assignment to all employees who have occupational exposure unless the employee has previously received the complete Hepatitis B vaccination series, antibody testing has revealed that the employee is immune, or the vaccine is contraindicated for medical reasons. Participation in a prescreening program (a program to screen people for previous exposure to Hepatitis B) cannot be made a prerequisite for receiving Hepatitis B vaccination. If an employee initially declines vaccination but decides later to get vaccinated, the employer shall make the vaccine available at no cost. If an employee declines to receive the vaccination, he/she must sign a waiver as described in the standard. Public Health Service recommends that people who have had the vaccination series should receive routine booster doses, they shall be made available to all employees at no cost. After the exposure incident is reported, the employer shall make available to the employee a confidential medical evaluation and follow-up, which includes at least: o Documentation of the route of exposure and circumstances under which it occurred. The label must include the biohazard legend: A training program must be provided at no cost during working hours to all employees with occupational exposures. Training must be provided at the time an employee is initially assigned to a job where occupational exposure may take place, within 90 days after the effective date of the standard (March 3, 1992) and at least annually thereafter. Employees who have already had some training in bloodborne pathogens in the year prior to the standard only need training on subjects which their previous training did not cover. There must also be training updates when the tasks or procedures done by the employee change or create a new exposure. Medical records are confidential and may not be disclosed or reported without the employees written consent. Medical records are to be available to employees and to anyone having written consent of the employees upon request. Training records are available to the employee or employee representative upon request. The standard is the only standard, both from within and outside the fire service that includes performance tests to ensure that each type of clothing resists penetration to bloodborne pathogens. Garments also are required to meet stringent requirements for liquid tight integrity in those areas of the garment that are designed to provide protection, material strength and physical hazard resistance, seam strength and closure strength. Gloves are tested for tensile strength and elongation both before and after heat aging and isopropyl alcohol immersion. Additionally, gloves must meet requirements for dexterity, puncture resistance, liquid tight integrity and minimum sizing. Like the garments, facewear must meet requirements for liquid tight integrity in those areas of the facewear that are designed to provide biological protection.
Does the tumor attract it the way a rapidly divid- ing tissue attracts metal or carcinogens? Or does the metal al- ready piled up in the tumor cells attract the malonate because of its chelating nature? Perhaps malonate accumulates in tumor cells simply because it cannot be detoxified there purchase 90mg dapoxetine fast delivery impotence of organic organ. I believe there is a normal route for your body to metabolize malonic acid order generic dapoxetine online impotence 10, because when malonic acid-containing foods are eaten purchase dapoxetine in india erectile dysfunction drugs walmart, I observe the immediate appearance of malonyl- Coenzyme A (malonyl CoA) buy dapoxetine erectile dysfunction genetic. Malonyl CoA has been well studied by scientists and found to be the beginning of fat formation. So this alternate fat-making mechanism that uses up malonic acid seems to me like a favor evolution is trying to do for us. Its normal ability to metabolize malonic acid is lost, so it must try the next route, detoxification. Detoxifying Malonate A popular detoxification method used by the body is to pin a methyl group onto the offending molecule. That uses up the or- gans supply of vitamin B12 and folic acid, but at least the malo- nic acid is gone. Of course we must still get rid of the methyl malonate, which is toxic, but thats another story. Another drawback of pinning a methyl group is that it uses up your methyl supply, which means methionine, choline and betaine. The organ under siege is becoming vitamin deficient and malnourished, and so is the rest of your body that is trying to support it by sending more supplies to it. If it has a tough, thick wall around it, these supplements cannot enter, so we must wait for the second week of the 21 Day Program. There are three more steps: malonic acid methyl malonate maleic acid D-malic acid maleic anhydride Fig. Tumor cells have lost the ability to do the detoxifying chemistry on their own, but if you supply the ingredients, they can still carry out the detoxification routine. Couldnt we simply stay on these supplements and not be deprived of the malonate-containing foods? Unfortunately, we would have to stay drenched in supplements, even taking them in the night. Other Malonic Acid Sources Once I identified malonic acid as a common denominator in all tumors I searched everywhere for it. Then most recently I learned that acrylic acid that we eat with heated oils gets changed into malonic acid by our metabolism. You have killed tapeworms, removed dental plastic, and are in the process of excluding it from your diet. Some Expected Benefits The most surprising benefit from the malonate-free diet and malonate-free mouth is stopping the production of effusates. Effusates are caused by seepage of body fluid into places where it does not belong. The lung is a favorite tissue for water ac- cumulation of this type, but the abdomen is another common site. The actual culprit is maleic anhydride a substance that is formed from malonic acid in your body. Maleic anhydride as a cause of tissue edema has been 67 known a very long time, but only when inhaled. It was never guessed that cancer sufferers with effusions actually had this chemical in them. And the pressure of this fluid against heart and lungs, against liver and intestine, or against lymph nodes in the groin can produce se- vere pain and breathlessness. Another surprising benefit of removing all malonate from your body is improved kidney function. Stopping use of malonic acid foods and getting every vestige of plastic out of your mouth can start your 67 The Merck Index, 10th Ed. But eating the tiniest bit of an ordinary malonate- containing dairy product (not allowed in this program) can ruin your progress in days! No amount of the detoxifiers, vitamins B12, C and folic acid could stop effusates from occurring or creatinine levels from rising when malonates were still arriving in the body from any source. We were forced to conclude that detoxifying malonic acid after consuming it did not prevent the damage done by it. The supplements needed to detoxify all the malonates in your body are included in the 21 Day Program. In a few days, with your new malonate-free diet and rein- forcing supplements, your tumor cells will no longer have to put up with Krebs cycle blockage. And a daily dose of thyroid will help your mitochondria to divide so fresh young mitochondria are born to handle the improved Krebs cycle activity. Damaging Dyes Your anti-tumor (tumor-shrinking) diet should also be free of carcinogenic dyes. Of course, we have believed that our diet is free of cancer-causing dyes, since laws were passed outlawing them decades ago. Cheese, butter, cream, which state that an- natto seed or riboflavin (natural dyes) have been added, also have traces of these dyes! Not only these, but a host of azo dyes, a finding as unbelievable as it is revealing. Azo dyes have a special chemical structure that involves two nitrogen atoms ( N=N). Is it the result of an error in identifying it to the manufacturer using other food dyes? A manufacturer using unsafe dye for some legitimate purpose and safe food dye nearby cannot keep them totally apart? One cannot expect the work force in a fac- tory to understand the issuesthe terrible seriousness of keep- ing them apartthe system must be made fool proof. With over 20,000,000 people (mostly women) dying their hair in the United States alone, should it not be made safe? Could there be simple negligence, in spite of safeguards such as required testing of each batch of synthetic dye to be used? This would proba- bly uncover the mysterious transmissible factor that pollutes nearly all (over 90%) of the processed food in the U. It was a cruel hoax to perpetrate on young war heroes and their families, but incredibly, researchers 71 are still experimenting with its use! It is not easily detoxified by your body and therefore, cannot be quickly eliminated. The left hand portion of the molecule is respon- sible for the carcinogenic action. It produces mainly tumors of the liver, gallbladder, lung, and urinary blad- der (particularly papillomas here). Most azo dyes were taken out of the food market because of their carcinogenicity but now are present everywhere in trace amounts, detected by the Syncrometer. At one time it was allowed as a butter colorant, hence its popular name Butter Yellow. It has three azo portions in the molecule, making it the most difficult of dyes to detoxify, too. While it is concentrated inside the tumor, it slowly leaks out, being taken up by the liver and other vital organs. It requires large doses of coenzyme Q10, vitamin B2 and glutathione (this is part of the 21 Day Program) to detoxify our azo dye collection. When we track carcinogenic dyes with the Syncrometer, we see them appear in the kidneys and bladder afterward. Hair dye and food dye are considered to be far apart in terms of danger to the body by our government agencies. It is assumed that the hair, being external to the body, does not transmit its dye or other chemicals to the body. Hair dye is immediately absorbed by the scalp and remains there in a large reservoir to be slowly absorbed for six weeks! For this rea- son, hair dye should be non-carcinogenic and easily excreted by the body. If you have used hair dye you must begin to detoxify it and use only all-herbal dye in the future (see Sources). Even eggplants and bananas are colored, suggesting a combination of pesticide and dye was used. Fast Green brings with it the lanthanide metals (thulium, gadolinium, lanthanum, etc. Two hot water washes are needed to clean the surface enough to risk cutting the fruit. Remember, wherever the lanthanides arrive in your body, immunity is im- mediately dropped. This allows parasite eggs to survive, as well as Streptococcus bacteria, the pain causers. The lanthanides polluting this dye could be the way children initiate cancers even when they do not have tooth fillings. A mutation at these genes could result from a translocation similar to The Philadelphia Chromosome, characteristic of leukemia, a bone marrow cancer. At the bone marrow the Syncrometer detects abnormal vitamin A products like 13-cis-retinoic acid instead of the normal 9-cis.
Imple- mentation of a gluten-free diet is important in these cases to avoid malnutrition (59) order dapoxetine 30mg with visa erectile dysfunction ed natural treatment. Supplements In healthy individuals buy dapoxetine online erectile dysfunction medications otc, it is crucial to support the body with adequate nutrients in order to optimize physical exercise and increase muscle mass or muscle endurance cheap 90 mg dapoxetine overnight delivery erectile dysfunction cancer. Supplements have become an enormously profitable industry and the effect of most supplements on the market can be questioned proven dapoxetine 30 mg erectile dysfunction doctors fort worth. Through basic research, the safety of several different supplements for use in healthy people has been established (60). There is limited information available that is specific to patients with polymyositis and dermatomyositis; information that is available is presented further on in this chapter. A large number of studies have been published on the subject, describing the ergogenic outcome on muscle strength and size when using creatine in combination with resistance training . This provides the ability to work out at an enhanced level and results in a greater gain in muscle mass (65). Creatine supplements have recently been evaluated in a placebo-controlled trial in patients with myositis, in combination with stable immunosuppressive treatment and/or steroids (68). The creatine-supplemented group had a significant improvement, compared with the placebo group, in the primary outcome that reflected the ability to undertake high-intensity exercise. Side effects of creatine supplements, for example, muscle cramps and heat intol- erance, have been described. These side effects may be related to an increase in water retention during the initial days of supplementation. Water retention and an increase in muscle mass may cause weight gain while supplementing with creatine (69). The use of creatine supplements with exercise among patients with myositis was without significant side effects and was considered effective and inexpensive (68,70). In animal models with arthritis, it was suggested that creatine supplementation might have an anti-inflammatory action; similar suggestions have been made based on research using cell cultures in which creatine supplementation also had an anti- inflammatory action on endothelial cells. These effects may arise from the ability of creatine-supplemented cells to inhibit endothelial permeability and expression of adhesion molecules, decreasing the traffic of proinflammatory cells and mediators from the bloodstream into the tissue (71). Regarding creatine supplementation in general, the literature is based on adults, so there is a lack of data regarding safety of creatine use in growing adolescents. Therefore, no conclusions can be drawn for patients with juvenile dermatomyositis and creatine supplementation (72). Although creatine is a common supplement, commercially marketed creatine products might not meet the same quality control standards as pharmaceuticals, and because of possible impurities or differences in dosage, caution is urged. Patients should always discuss use of any dietary supplement with their physician. Anabolic Steroids Anabolic steroids increase muscle mass and strength, and have been used by athletes for decades. The use of anabolic steroids in sports was banned by the International Olympic Committee in 1974. Use of these hormones may generate several side effects, such as severe acne, increased body hair, and aggressive behavior that may occasionally trigger violent behavior (74). Without a prescription from a doctor, anabolic steroids are an illegal drug, and the use of hormones without a physicians surveillance could involve major risks. In recent years, anabolic steroids have been investigated in terms of possible benefits for patients with disease-related muscle wasting. Testosterone administration has had positive results in different patient populations, but because it is a natural androgen hormone, it possesses virilizing effects, which limits the population that can be treated. An alternative is oxandrolone, a synthetic testosterone analog, that also can be used in treating women and children with chronic muscle-wasting conditions (76). Under the controlled conditions of the trial, the adverse effects were minimal and the drug was considered safe and classified as a treatment of possible benefit (77). No controlled studies have been performed in patients with polymyositis or dermato- myositis, so whether oxandrolone has any effect in these disorders is not known. Glutamine Glutamine is a conditionally essential amino acid, meaning that it is essential during conditions of trauma, sepsis, or cancer. Glutamine provides the body with new precursors for energy substrates, antioxidants (mostly glutathione), and acute-phase proteins found in the blood shortly after onset of an infection (80). This mobilization leads to an intramuscular glutamine depletion, resulting in a decrease in lean muscle mass (81). Patients in intensive care may develop severe myopathies and muscle biopsies from these patients show low levels of muscle glutamine (82). Patients with myositis are treated primarily with glucocorticoids, which induce the release of glutamine into the blood at the expense of muscle protein degra- dation. Fatty Acids Fat is the most calorically dense food component and is known as the most efficient way for the body to store excess energy. Fat is more than just energy storage, however, because every cell within the body has a membrane around the surface and surrounding the nucleus. These membranes are built of fatty acids, called phospholipids, which can be released from the membrane by different enzymes and used for multiple tasks, depending on the fatty acid type. Both linoleic and -linolenic acid are essential fatty acids, which means that the body cannot synthesize them. In a modern Western diet the ratio between n-6 and n-3 fatty acids is about 20 to 1, and this may have an effect on eicosanoid synthesis. Prior to consuming any dietary supplements, patients should consult with their physician and with their nations dietary guidelines (86,8991). Vitamin D Osteoporosis and fractures are common consequences of glucocorticoid therapy and of physical inactivity. Thus, patients with polymyositis and dermatomyositis are at high risk for developing this complication. Prevention of bone loss should be considered as part of the therapy for these patients. Prevention of steroid-induced bone loss is based on calcium and vitamin D supple- mentation, adequate protein intake, and regular physical exercise (92). The classic function of vitamin D is to regulate bone formation and resorption through regulating calcium homeostasis. For children and adolescents, glucocorticoid treatment may cause failure to reach a normal peak bone mass with an increased risk for hip and spine fractures later in life, which makes supplementation of calcium and vitamin D even more important in this population (93,94). The vitamin D receptor is present on various immune cells, producing and releasing the active hormone. Major dietary sources of vitamin D are fortified dairy products, fatty fish, and fish liver oils. The sunlight exposure is significantly less in northern climates and especially low during winter months (93,99). The serum level of vitamin D is the best indicator for defining any deficiency, insufficiency, or toxicity. Concentrations below 40 to 50 nmol/L reflect vitamin D insufficiency and intoxication levels are clearly above 200 nmol/L. There have been no reports of intoxication from sunlight exposure; all of the observed cases are owing to excessive oral intake (96). Most dietary guidelines for vitamin D are based on maintaining bone health, and differ throughout a lifetime. Important variables are season, latitude, and the food fortification of the country per se (100). This is another strong indication for vitamin D supplementation in patients with dermatomyositis. Vitamin E Aggressive distribution of vitamin E was used for treatment of polymyositis and dermatomyositis during the early 20th century for several decades. An explanation for this could probably be that one of the primary manifestations of vitamin E deficiency is myopathy (101,102). Reversible human myopathy caused by vitamin E deficiency has been described in a couple of cases (103,104). Vitamin E is a soluble lipid that acts primarily as an antioxidant and as a scavenger of products from lipid peroxidation preventing cell damage, but in recent years, non-antioxidant functions such as signaling and gene regulation have been discovered (105). Vitamin E covers eight structurally related isomers, the most active of which is -tocopherol. Nuts are also a good source of vitamin E, whereas fruits, vegetables, and meat contain lesser amounts. Another aspect to consider in determining the need for vitamin E supplementation is the antioxidant needs during exercise. Reactive oxygen species are generated in contracting muscles and mediate muscle damage and inflammatory responses after a demanding exercise bout. Dietary supplementation with vitamin E in order to negate this contraction-induced muscle damage has been controversial because of dissimilar test parameters including age and fitness of the subjects, dose and duration of the antioxidant, and type of exercise performed (106108). As myositis therapy, vitamin E is no longer used because it is not considered effective (109). Herbal Supplements Herbal supplements are widely used and among the most popular products are supplements with immune-stimulatory properties. The field of research evaluating alternative medicine and autoimmunity is limited but there have been some cases reported. Dietary polyphenols can be divided into four subgroups: flavonoids, stillbenes, lignas, and phenolic acids (110). It has been determined both epidemiologically and experimentally that polyphenols have anti-inflammatory activity. Their presumed beneficial effects are mainly antioxidative in disorders such as stroke, cancer, and inflammatory diseases (111). The researchers also noted that the muscles were more fatigue resistant and concluded that this feature was owing to an improved structure of muscle tissue. Potent immune-activating properties have been shown in algae (Spirulina platensis and Aphanizomenon flos-aquae), both in human (chemopro- tective effects) and animal studies (increased macrophage activity (114,115)). Support for an immunostimulatory property is based on reports that patients suffering from autoimmune skin disorders have experienced flares and discomfort such as blisters after taking supplements containing Spirulina or echinacea (purple cornflower), another popular immune-boosting herbal supplement (115).
But if the 16 nodules were malignant order dapoxetine uk erectile dysfunction treatment viagra, then he was in a late stage of disease order 60 mg dapoxetine with amex erectile dysfunction and diabetes medications, with very little hope and prostate surgery useless order genuine dapoxetine on-line intracorporeal injections erectile dysfunction. He started the parasite program at home cheap 30 mg dapoxetine otc erectile dysfunction medication canada, cor- rected his life style to shut out isopropyl alcohol and zapped a lot. He had successfully stopped his can- cer, but the task was now to shrink his tumors. He had a Staphylococcus infection spreading from his jaw although he wore full dentures. He was started by removing both dentures until they could be tested for malonate and the usual carcinogens. We reassured him that these liver tumors were small by comparison with the usual liver tumors we see. The nodules on the surface of liver and lungs certainly were perplexing; we would just wait and see what happened to them after getting rid of the internal liver tumors. Calcium was too low; implying a toxin in the parathyroids and alk phos was slightly high im- plying tumor activity in his lungs [dye toxicity]. He was given the usual supplements to detoxify malonic acid: B12 (4 mg), folic acid (25 mg twice daily), and vitamin C. He was still very Positive for copper at the parathyroid gland even without wearing his dentures. He simply threw Adam Lar- 8/12 8/19 away his supplements, except the sen list given which had been tested. Two radiologists could find no marbles, plaques, or tumors of any kind on the surface of his liver or rib cage. There were no small marbles inside his liver, either, although fibrous remnants were visible to me. He had tested Negative to copper, isopropyl alcohol, and staphylococcus bacteria in the prostate and had probably been free of them for ten full days in a row. He had two new dentures that tested free of ma- lonates and metals and he was eager to eat his food again, instead of drinking it. Or did luck play a role when no dental problems presented themselves that couldnt be corrected in one minutejust by removing his dentures? Of course, he had already dissolved the grade 4 malignancy in his prostate by himself before he arrived. Her doc- tor told her not to worry, but she worried more and more as new family members got the disease. Finally, her massage therapist found three lumps and she knew the inevitable was beginning to happen. She had started herself on the parasite program three months ago, so there was no ortho-phospho-tyrosine and, therefore, no malignancy any- where when she arrived. But she had not eliminated isopropyl alcohol so she was at great risk for getting cancer or getting it back if she had it earlier. By using unsterilized dairy products daily, she was picking up the fluke parasite stages. She immediately stopped drinking purchased water or beverages and taking untested supplements. The staphylococcus bacteria would be under a metal or plastic tooth or in a cavi- tation. The reasoning was that if she could shrink these tumors she could prevent getting cancer in them, and be spared the family fate. She was very interested in cause and effect relationships, so she planned to learn the technique of testing in order to protect herself from breast cancer in the future. The ultrasound showed fibrous masses throughout both breasts, the right side being more extensively involved. The early stages of cobalt and malonate toxicity are clearly present: globulin is too low and cal- cium is too low also. Total protein, which is the sum of albumin and globulin, is completely nor- mal, but the globulin is a little too low. Low levels are caused by toxins, such as malonate in the parathy- roids, one of its earliest toxic actions; perhaps it simply chelates out our valuable calcium. It could also be low due to insufficient potassium pump action by the tissues and a subsequent loss through the kidneys to keep the ratio between inside and outside of tissues correctly balanced. For the present, we must be content to supplement potas- sium, since this is known to stimulate respiratory metabolism and could help the tumor tissue to normalize. It takes 25 mg to team up with vita- min B12 to begin to detoxify all the malonic acid and its derivatives in the body. Even this amount cannot keep up with detoxifying malonic acid if it is eaten as food or constantly being sucked on in the mouth (dental plastic). Chemotherapeutic agents frequently are anti- folate compounds, intended to kill cancer cells. Our approach is not one of killing tumor cells; it is one of removing the factors that stimulate these cells to abnormal growth rates and repairing their metabolism so they begin to make their normal metabolites again (differentiation). Biotin 1 mg once a day to repair the bodys ability to utilize malonic acid in fat metabolism (this is hypothetical). Lorene did her best to get rid of cobalt from her life style, at one point even finding a trace in a blue T-shirt and blue jeans (detergent residue). She was testing Positive for more, not less, malonic acid derivatives al- though she had stopped eating any. We had become suspicious of dental work, since this seemed to be the only big event occurring. The race was on to find other toxins in the dental plastic that were trav- eling to the breast. The new plastic had malonic and maleic acids, besides copper, cobalt, and vanadium! Sep 2 Breast is softer; only one intensely white area remains An ultrasound and blood test were scheduled. Her frustration with stalled tooth filling and the frequent interruptions for testing and removal, all faded as she produced the negatives. It can be avoided by swishing with Lugols solution or 1% chlorine bleach (see Recipes) right in the dentists office before, during, and after the procedure. And calcium, too, had not risen a bit; more evidence of malonate being put in her mouth to suck on continually. In spite of taking vitamin D, the phosphorus dropped instead of risingtoxins were reaching the parathyroids. The underlying Iron 124 63 toxicity is the life threatening part of Sodium 140 136 tumor disease. Or perhaps, she can make the final changes herself; she may learn where the problem resides, what to do about it, and get it done all by herself. Her initial toxin test showed freon at the colon; cobalt at the colon; and lead, thallium, arsenic, and copper at the bone marrow. But ortho-phospho-tyrosine was already Negative, giving her a nice head start to clear these liver tumors. The tumor marker, Ca 125 was still elevated (61), representing the remaining tumors. She was in good physical health, otherwise, except for an intense tinni- tus, which was her most troublesome symptom. The high albumin and globulin were due, no doubt, to the presence of both cobalt and vanadium in the liver. And the source of these must be her dentalware [and Ascaris], since all her supplements had been tested for these metals. She could not recover without removing these metals; the liver was not able to control albumin and globulin production due to them. Besides the usual first day procedures and supplements, she was given potassium gluconate powder to raise her potassium. In spite of this and killing all tapeworm stages and removing all plastic from her teeth, she still tested Positive for malonate in the fasted state. She had been back to the dentist a number of times to remove small bits of leftover metal and plastic. Although we had carefully selected safe composite ingredients for her, the completed job would often not be safe. Only one tooth at a time was being worked on so we could iden- tify the cause of any new problem more easily. After each visit she was re- tested in the fasted state and often found Positive for malonates and metals. Sometimes unsafe plastic would be put back in, al- though we had tested the ingredients. This was not the dentists fault [nobody knew that acrylic plastic is turned into malonic acid by the body]. Her September 21 blood test probably reflects this as the total protein is again too high (8. Obviously she could make enough blood to replace the small amount she was still losing. On October 2, ten days later, she was done with all her dental work, but was she really free of all metal and malonic acid in each and every tooth? The texture of the liver was exceptionally good; this was obviously a healthy liver now. It was all her liver needed to dis- solve and digest all the tumors and function well again. He offered his much awaited turn to a new patient once, after being in line for hours, and when I inquired about his missed appointment, he guilelessly said there was a sick woman in line behind him and she needed to see the doctor before dark. Denny had been given one month to one year by his doctor at home, for a metastasizing adenocarcinoma with an unknown primary source.