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Difference between revisions of "Mkinitcpio-btrfs"
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{{Warning|1=If you need swap support, either make a partition, or use the loop method detailed below. '''DO NOT''' simply use a swap file! [http://git.kernel.org/?p=linux/kernel/git/torvalds/linux-2.6.git;a=commit;h=35054394c4b3cecd52577c2662c84da1f3e73525 Doing so will corrupt your btrfs filesystem].}}
{{Warning|1=If you need swap support, either make a partition, or use the loop method detailed below. '''DO NOT''' simply use a swap file! [http://git.kernel.org/?p=linux/kernel/git/torvalds/linux-2.6.git;a=commit;h=35054394c4b3cecd52577c2662c84da1f3e73525 Doing so will corrupt your btrfs filesystem].}}
{{Note|It is possible to allow btrfs to use the entire hard drive without using a partitioning scheme, but that is not recommended. [[GRUB2#Install_to_Partition_or_Partitionless_Disk].
{{Note|It is possible to allow btrfs to use the entire hard drive without using a partitioning scheme, but that is not recommended. [[GRUB2#Install_to_Partition_or_Partitionless_Disk].The method used for the syslinux directions in this article does not use a partitioning system. This portion of the article will be updated in the future, but until then you can study the [[GUID Partition Table]] + [[syslinux]] installation method [http://tincman.wordpress.com/2011/01/20/installing-arch-linux-onto-a-gpt-partitioned-btrfs-root-ssd-on-a-legacy-bios-system/ here].}}
{{Note|[[syslinux]] and [[GRUB2]] allow booting from a drive without a separate boot partition. However, syslinux does not currently support boot directories within a btrfs subvolume. Both syslinux and GRUB2 allow the use of modern GPT partitioning.}}
{{Note|[[syslinux]] and [[GRUB2]] allow booting from a drive without a separate boot partition. However, syslinux does not currently support boot directories within a btrfs subvolume. Both syslinux and GRUB2 allow the use of modern GPT partitioning.}}
Revision as of 16:59, 5 December 2012
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btrfs provides a number of features (such as checksumming, snapshots, and subvolumes) that make it an excellent candidate for using it as the root partition in an Arch Linux installation. For a tour of btrfs features see A tour of btrfs. As is common with FLOSS, there are a number of ways to configure btrfs as the root filesystem.
This article assumes your are doing a fresh install from the Arch Linux installation media. It is also possible to create a backup of an existing Arch Linux installation and restore it to a fresh btrfs configuration. This technique is also shown in this article.
- 1 btrfs-progs
- 2 mkinitcpio-btrfs
- 3 Back up an existing Arch Linux installation
- 4 Boot into a live image
- 5 Preparing the root drive
- 6 Installing the base system
- 7 Installing the bootloader
- 8 Final configuration
- 9 Known issues
To create a btrfs filesystem you will need to install the btrfs-progs from Official Repositories. If using Archboot, it's already available.
To get rollback features on your btrfs root device, you will need to install the mkinitcpio-btrfsAUR package from the Arch User Repository.
For reference, here are the internal variables used by mkinitcpio-btrfsAUR:
${BTRFS_HAS_ROLLBACK:=true} ${BTRFS_BOOT_SUBVOL:="__active"} ${BTRFS_DIR_WORK:="/new_root"} ${BTRFS_DIR_SNAP:="/__snapshot"} ${BTRFS_DIR_ACTIVE:="/__active"} ${BTRFS_DIR_ROLLBACK:="/__rollback"} ${BTRFS_ROLLBACK_CHOICE:="default"} ${BTRFS_ROLLBACK_LIST:="default"} ${BTRFS_ROLLBACK_LIST_COUNT:=0}
Back up an existing Arch Linux installation
Having a complete backup strategy before messing with the partitioning of storage drives is vitally important. So before doing anything you must back up, and you must also know how to recover from a backup. There are of course a number of ways to do this. But the easiest by far is to mount a spare backup drive and use rsync:
# rsync -aAXv --exclude={dev,sys,proc,mnt,tmp,media} / <dest>/`date +%Y-%m-%d-%T`/
To restore from an rsync backup, just reverse the paths. It is also possible to use tar:
# tar -cvpPJf $BACKUPDIR/$FILENAME --exclude="/proc/*" --exclude="/sys/*" \ --exclude="/mnt/*" --exclude="/media/*" --exclude="/dev/*" --exclude="/tmp/*" /
and to restore from a tar backup:
# tar -xvpJf <backup_file> -C <root>
Boot into a live image
It is recommended that you boot and install from the latest Archlinux Netinstall Image, or and up-to-date Archlinux installation, or Archboot. The latter is capable of installing to a btrfs partition natively but does not support the unified setup detailed here; it is however a good option for this procedure because it includes recent builds of all the necessary packages.
Preparing the root drive
Now it is time to actually install the btrfs filesystem. Please make sure that btrfs-progs is installed and functioning correctly:
# btrfs --help
GPT partitioning for GRUB2
To get started partitioning, we must install the gptfdisk package from the Official Repositories:
# pacman -S gptfdisk
GRUB2 requires a +2M boot partition at the front of the drive GRUB2#GPT_specific_instructions. You can create that with gdisk:
# gdisk /dev/sda
Once gdisk has loaded, you can begin entering commands into the command prompt. Type
? to see the available commands. Press
o to create a new partition table. Just use the help command and create two partitions and
then use
p to verify the output:
GPT fdisk (gdisk) version 0.8.2 Partition table scan: MBR: protective BSD: not present APM: not present GPT: present Found valid GPT with protective MBR; using GPT. Command (? for help): p Disk /dev/sda: 234441648 sectors, 111.8 GiB Logical sector size: 512 bytes Disk identifier (GUID): C75A01F9-D34E-4895-9AAB-2C8118118211 Partition table holds up to 128 entries First usable sector is 34, last usable sector is 234441614 Partitions will be aligned on 2048-sector boundaries Total free space is 2014 sectors (1007.0 KiB) Number Start (sector) End (sector) Size Code Name 1 2048 6143 2.0 MiB EF02 BIOS boot partition 2 6144 234441614 111.8 GiB 8300 Linux filesystem Command (? for help):
EF02 hex code for the partition type for the 2Mb GRUB2 boot partition. This is needed to allow GRUB2 to install the
core.img file into that partition for booting
Once you have created the partitions, we will need to set the boot flag on the btrfs partition. Press
x for advanced options and then press
a to set attributes. Press the number for the partition you want to alter, in this
example it is
2. Now press
2 to set the legacy boot flag:
Command (? for help): x Expert command (? for help): a Partition number (1-2): 2 Known attributes are: 0: system partition 1: hide from EFI 2: legacy BIOS bootable 60: read-only 62: hidden 63: do not automount Attribute value is 0000000000000000. Set fields are: No fields set Toggle which attribute field (0-63, 64 or <Enter> to exit): 2 Have enabled the 'legacy BIOS bootable' attribute. Attribute value is 0000000000000004. Set fields are: 2 (legacy BIOS bootable) Toggle which attribute field (0-63, 64 or <Enter> to exit):
Finally, press
w to write the data to the disk.
GPT partitioning for Syslinux
This section hasn't been written yet. For a quick tutorial go here;
Configure the btrfs filesystem
With the drive partitioned and ready for a filesystem, make sure btrfs-progs is installed and create the filesystem on the root partition:
# mkfs.btrfs -L btrfs-root /dev/sda2
Now it is time to mount the new filesystem. First create the mount directory:
# mkdir /mnt/btrfs-root
and mount the partition:
# mount -o defaults,noatime,discard,ssd /dev/sda2 /mnt/btrfs-root && cd /mnt/btrfs-root
discard,ssd from the mount options.
Now you should be in the newly mounted btrfs filesystem! If you plan on using the rollback features of btrfs, create a
__snapshot directory for containing snapshots:
# mkdir __snapshot
__snapshot is chosen for integration with current mkinitcpio-btrfsAUR. See the variable reference above, or the source mkinitcpio-btrfs package.
If you plan on using Syslinux as your boot loader, you will need to create a boot directory:
# mkdir boot
Next we will create the subvolumes. To see all the commands available to manage subvolumes with btrfs:
# btrfs subvolume --help
To allow us to easily snapshot the root of our Arch Linux installation, it is recommended it be contained in a subvolume named
__active is chosen for integration with current mkinitcpio-btrfsAUR. See the variable reference above, or the source mkinitcpio-btrfs package.
# btrfs subvolume create __active && cd __active
Now we will create separate subvolumes for important FHS directories. This would allow us to monitor and adjust the size allocations for each subvolume:
# btrfs subvolume create home # btrfs subvolume create var # btrfs subvolume create usr
To see your handy work:
# btrfs subvolume list -p .
ID 256 parent 5 top level 5 path __active ID 258 parent 256 top level 5 path __active/home ID 259 parent 256 top level 5 path __active/usr ID 260 parent 256 top level 5 path __active/var
Fix the permissions:
chmod 755 ../\__active var usr home
Now that the subvolumes are created and we have a layout, lets mount the root subvolume directly:
# mkdir /mnt/btrfs-active # mount -o defaults,discard,noatime,ssd,subvol=__active /dev/sda2 /mnt/btrfs-active && cd /mnt/btrfs-active
discard,ssd from the mount options.
And that's it! You should be ready to install a fresh copy of Arch Linux or restore from a backup. For example, if you made a tar backup with the techniques described above, simply:
# tar -xvpJf <backup_file> -C .
or if using rsync:
# rsync -avhHPS --exclude={dev,sys,proc,mnt,tmp,media} <backup_dir> .
btrfs and syslinux
In order to continue the installation (or restoration), boot in the root of the btrfs filesystem must be bound to the boot directory contained in the
__active subvolume. First we should create a boot directory within the subvolume:
# mkdir /mnt/btrfs-active/boot
and then bind the two directories using mount:
# mount --bind /mnt/btrfs-root/boot /mnt/btrfs-active/boot
Installing the base system
We will not be relying on AIF to do the install automatically and instead perform it manually.
/mnt/btrfs-active/etc/pacman.d/mirrorlist, and/or make other adjustments to
Lets begin by creating the necessary directories:
# mkdir -p dev proc sys var/lib/pacman
Now we bind the system directories to our installation directory:
# mount -o bind /dev dev/ # mount -t proc /proc proc/ # mount -t sysfs /sys sys/
Install base, btrfs-progs, and a bootloader (grub-bios, grub-efi, syslinux, etc). Switch
<boot_loader> to your preferred boot loader.
Also install base-devel to build mkinitcpio-btrfs from the AUR.
# pacman -r . -Sy base btrfs-progs mkinitcpio-btrfs <boot_loader> --ignore grub
Once the you have successfully configured btrfs and installed (or recovered) your Arch Linux, it is important that we tweak some settings to get everything working together so when you reboot everything will work correctly.
This section has two different configurations depending on the bootloader you selected. We can begin by editing
# nano /mnt/btrfs-active/etc/fstab
Add the following line, supplement
<uuid> for the UUID of the btrfs root partition:
UUID=<uuid> / btrfs defaults,noatime,discard,ssd,subvol=__active 0 0
discard,ssd from the mount options.
Add everything to
/mnt/btrfs-active/etc/fstab ...
(btrfs-root)/boot will be --bind mounted so kernel upgrades work:
/dev/disk/by-label/btrfs-root / btrfs defaults,noatime,subvolid=0 0 0 /dev/disk/by-label/btrfs-root /var/lib/btrfs-root btrfs defaults,noatime 0 0 /var/lib/btrfs-root/boot /boot none bind 0 0 /var/lib/btrfs-root/empty/ /var/lib/btrfs-root/__active none bind 0 0
It is not necessary to add a
subvol=XX option for /, as it must be handled by either the initramfs [btrfs_advanced] or via the kernel boot line [extlinux], and it may not be accurate anyways (e.g. rollback mode).
subvolid=0 corresponds to the btrfs root, and guarantees it will always be mounted correctly, even if the default is changed.
Optional bind an empty folder over the
/var/lib/btrfs-root/__active folder to prevent apps such as 'find' from complaining of any loops.
Download the mkinitcpio-btrfs tarball:
# wget -O /mnt/btrfs-active/root/mkinitcpio-btrfs.tar.gz https://aur.archlinux.org/packages/mk/mkinitcpio-btrfs/mkinitcpio-btrfs.tar.gz
btrfs_advanced to the
HOOKS section of
# nano /mnt/btrfs-active/etc/mkinitcpio.conf
... HOOKS="[...] btrfs_advanced" ...
Once you've chroot'ed into the btrfs installation, first install mkinitcpio-btrfs:
# cd /root # tar -xvzf mkinitcpio-btrfs.tar.gz # cd mkinitcpio-btrfs # makepkg # pacman -U mkinitcpio-btrfs-${version}.pkg.tar.xz
Then rebuild the initramfs:
# mkinitcpio -p linux
Installing the bootloader
If everything went smoothly (when does it ever?), you should have the great pleasure of installing your bootloader into the mbr of your root drive.
See GRUB for advanced instructions. Once you have GRUB configured, and you chrooted into your install directory, install the boot loader.
If you decided that you liked your current Arch Linux and are restoring from a backup, you will need to chroot into your installation after doing all the necessary steps:
# cp /etc/resolv.conf etc/ # mount -o bind /dev dev/ # mount -t proc /proc proc/ # mount -t sysfs /sys sys/ # chroot . /bin/bash
And now:
# grub-install --directory=/usr/lib/grub/i386-pc --target=i386-pc --boot-directory=/boot --recheck /dev/sda
Don't forget to update
# grub-mkconfig -o /boot/grub/grub.cfg
You should now be able to reboot into GRUB, provided there were no problems encountered doing the steps above.
Syslinux now has an automatic installer that creates the necessary folders, sets bootflags, installs MBR etc. See Syslinux#Automatic_Install for more info. Make sure you have /mnt bind mounted then run:
# syslinux-install_update -iam
Then edit the
Sample config:
PROMPT 0 TIMEOUT 0 DEFAULT arch LABEL arch LINUX ../vmlinuz-linux APPEND root=/dev/disk/by-label/btrfs-root rootflags=subvol=__active ro INITRD ../initramfs-linux.img
If you ARE using the mkinitcpio hook, remove
rootflags=subvol=__active from the APPEND line.
Final configuration
Almost done... be sure to edit
/mnt/etc/rc.conf, set the root password, and similar. Good luck on reboot!
# reboot
Known issues
Rollback support
Rollback support, while fully functional, currently has one important caveat... it cannot handle kernel rollbacks because the kernel is not a part of the snapshot. This is due to the limitations of the bootloader described above. Until bootloaders support subvolumes, you must remember to manually back up your kernel + initramfs before a snapshot. Upcoming releases of mkinitcpio-btrfsAUR will attempt to address this shortcoming.
- Syslinux operates successfully through times, but sometimes fails.
- Installing syslinux with compression enabled, or editing the configuration file after enabling compression, causes boot to fail because syslinux cannot read compressed files. This probably also affects installing a new kernel with btrfs enabled but I haven't tested this.
Slow meta-data after installation
Do a defragmentation of / after the installation is done to fix the slow metadata issue. (a simple
ls may take seconds)
# btrfs filesystem defrag /


text:
the-millshop-online Pure New Wool Throw
150cm x 200cm Mist
4 units in stock
You can buy this pure new wool throw online or in store from our fabric warehouse in Northamptonshire.
Orders under 2 kilo UK will be sent by Royal Mail (recorded). Airmail to international customers.
All orders over 2 kilos UK & international will be sent by courier.
Please click here to view the shipping costs
If you would like a fabric sample please use the sample service available on this site.
Be sure to use this service if you are not familiar with the fabric or if the exact shade is important to you as colour representation on screen can vary.
Click here to learn more about our fabric samples.
Got a question? Visit Our FAQs Page

subset: commoncrawl


text:
Supplement Forms / Alternate Names
- Aortic GAGs
- Aortic Glycosaminoglycans
- Chondroitin Polysulphate
- Chondroitin Sulfate A
- GAGs
- Glycosaminoglycans
- Mucopolysaccharide
Principal Proposed Uses
Other Proposed Uses
Mesoglycan is a type of substance found in many tissues in the body, including the joints, intestines, and the lining of blood vessels. Chemically, mesoglycan is related to the blood-thinning drug heparin and the supplement chondroitin . Unlike chondroitin, mesoglycan is primarily used to treat diseases of blood vessels. Preliminary evidence suggests that mesoglycan may be helpful for atherosclerosis, varicose veins, phlebitis, and hemorrhoids.
Mesoglycan is not an essential nutrient because the body usually manufactures it from scratch. For supplement purposes, mesoglycan is commercially extracted from the intestines of pigs. Very similar substances can be produced from cartilage, bone, and the lining of large blood vessels, and are often used interchangeably.
Therapeutic Uses
Most proposed uses of mesoglycan involve diseases of blood vessels. For example, evidence suggests that mesoglycan may slow the development of hardening of the arteries , perhaps by lowering cholesterol levels , "thinning" the blood, or through other effects. 1–3
People with severe hardening of the arteries sometimes develop blockage in the arteries of the legs, a condition called intermittent claudication . This condition limits the ability to walk by causing intense, crampy pain after walking a relatively short distance. There is some evidence that mesoglycan may help. 20
The conditions just discussed involve arteries. Mesoglycan may also be useful for various diseases of the veins, including varicose veins/venous insufficiency , hemorrhoids , and phlebitis . 4–8,19
One study suggests that a substance related to mesoglycan, hyaluronic acid, might be helpful for asthma when taken by inhalation. 22
Warning: Do not self-treat phlebitis. It is a potentially deadly disease.
Preliminary evidence suggests mesoglycan may additionally be useful in treating kidney stones . 9
The substance chondroitin is used for the treatment of osteoarthritis . Based on the chemical similarities between chondroitin and mesoglycan, researchers conducted a large (almost 400 participant) 5-year, double-blind, placebo-controlled study of injected mesoglycan for slowing the progression of osteoarthritis. 21 Unfortunately, no benefits were seen.
What Is the Scientific Evidence for Mesoglycan?
Intermittent Claudication
A 20-week, double-blind, placebo-controlled trial that enrolled 242 people evaluated the effects of mesoglycan (100 mg a day orally, after a short course of injected treatment) for treating intermittent claudication . 20 Significantly more participants in the mesoglycan group responded to treatment (defined as a greater than 50% improvement in walking distance) than in the placebo group.
Atherosclerosis in General
In a double-blind, comparative study, men with atherosclerosis in the arteries of the heart (coronary artery disease) were given either 200 mg daily of mesoglycan or no extra treatment. 10 After 18 months, the layering of the vessel lining was 7.5 times greater in the untreated group than in the mesoglycan group, a significant difference. However, because this was not a double-blind placebo-controlled trial, the results can't be taken as truly reliable. (For information on why double blind studies are essential for proving a treatment effective, see Why Does This Database Depend on Double-blind Studies? )
Additional preliminary evidence that mesoglycan might help atherosclerosis comes from other studies in animals and people. 11,12
We don' t know for certain how mesoglycan might help atherosclerosis. There is some evidence that it can reduce cholesterol levels and also "thin" the blood. 13
Vein Diseases
Several studies suggest that mesoglycan may be helpful in the treatment of vein problems, such as varicose veins/venous insufficiency , phlebitis , and hemorrhoids . 14–19 For example, in a double-blind, placebo-controlled trial, 183 individuals with leg ulcers caused by poor vein function were treated with either placebo or mesoglycan (first by injection and then orally) for 24 weeks. 19 The results of this double-blind study suggest that mesoglycan significantly improved the rate at which the leg ulcers healed.
Safety Issues
Mesoglycan is essentially ground-up pig intestines and is believed to be safe, even if taken in large quantities. However, because mesoglycan appears to decrease blood clotting, it should not be combined with prescription blood thinners such as warfarin (Coumadin), clopidogrel (Plavix), ticlopidine (Ticlid), pentoxifylline (Trental), or heparin, or drugs in the aspirin family. Maximum safe dosages for young children, pregnant or nursing women, or those with severe liver or kidney disease have not been determined.
Interactions You Should Know About
If you are taking drugs that decrease blood clotting, such as warfarin (Coumadin) , heparin , clopidogrel (Plavix), ticlopidine (Ticlid), pentoxifylline (Trental) , or aspirin , do not use mesoglycan except under physician supervision.
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


text:
Cisplatin is a chemotherapy drug used to treat cancer of the testicles, bladder, lung, stomach, esophagus, and ovaries, as well as other forms of cancer. Cisplatin can cause numerous side effects, including:
- Nausea and vomiting
- Kidney or liver damage
- Peripheral neuropathy (numbness or tingling of the extremities)
- Hearing loss
- Ringing in the ear
- Loss of appetite
- Abnormal taste sensations
- Hair loss
Some of the treatments mentioned below have been advocated for preventing or treating cisplatin side effects. For information on the use of natural treatments as a support to cancer chemotherapy in general, see the Cancer Treatment article.
Some of the treatments mentioned below have been advocated for preventing or treating cisplatin side effects. For information on the use of natural treatments as a support to cancer chemotherapy in general, see the Cancer Treatment article.
The herb black cohosh is often used for menopausal symptoms. Because women receiving cancer chemotherapy may experience menopausal symptoms, black cohosh may appear a promising option. However, one test-tube study found that use of black cohosh may decrease the effectiveness of cisplatin. 1
There is some evidence that use of cisplatin may cause the body to develop potentially dangerous deficiencies of potassium and magnesium. 2-5 Taking supplements of these nutrients may be advisable.
Weak preliminary evidence hints that use of melatonin may reduce side effects and increase efficacy of chemotherapy regimens that include cisplatin. 6
It has been suggested that many of the undesired effects of cisplatin are due to creation of free radicals, dangerous, naturally occurring substances that can damage many cells. For this reason, treatment with antioxidants has been proposed for preventing toxic side effects. However, as yet there is no more than minimal evidence for benefit.
One animal study tested a combination of substances with strong antioxidant properties ( vitamin E , Crocus sativus , and Nigella sativa ) and found evidence that this mixture reduced the kidney toxicity of cisplatin.
A small human trial found evidence that use of vitamin E might help prevent nerve injury (peripheral neuropathy) caused by cisplatin, but because this was an open study , its results are not very reliable. 7
Another open study found possible benefits with selenium . 8
Unfortunately, in open studies, the placebo effect and other confounding factors can play a significant role. (For more information on why this is the case, see Why Does This Database Rely on Double-blind Studies?)
In a better-designed, double-blind , placebo-controlled study of 48 people undergoing cancer treatment with cisplatin, participants were given either placebo or a combination of vitamin E , vitamin C , and selenium in hopes of reducing toxicity to the ears and kidneys. 9 No significant benefits were seen.
Note that there are concerns that use of antioxidants could potential decrease the effectiveness of some forms of chemotherapy. For this reason, we strongly suggest that people on cancer chemotherapy do not use antioxidants, or any herbs or supplements, except in consultation with their physician.
Animal and test-tube studies hint that the herb milk thistle might decrease the kidney toxicity of cisplatin 10 and also possibly increase cisplatin efficacy. 11
However, no studies in humans have been reported.
One study found evidence that the supplement acetyl-L-carnitine might reduce symptoms of peripheral neuropathy caused by cisplatin. 13
The herb ginger is widely used for treatment of nausea . However, one study failed to find ginger helpful for nausea caused by cisplatin. 12
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


text:
Finding Food
Humans can go for two weeks or more without food. Although the need for food is not that urgent, you'll be more comfortable and clear-headed if you eat. Anywhere there is game, there is food, but probably not what you're accustomed to eating.
Before you head into a remote area, it's a good idea to learn what's edible in that particular region. Hopefully, you'll be able to use your hunting equipment to harvest the bulk of your food.


text:
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Because we use natural and unique materials in our rings, variation must be expected. No two rings will look the same, making your ring truly unique! Each piece of natural material will have unique patterns, grains, colors, etc. so you may receive your ring with materials that are much darker or lighter than what is pictured.
Our rings are true to international sizing standards, within a tenth of a millimeter. Before ordering, we recommend getting sized by two or three reputable jewelers following our sizing guidelines. You will need to be sized using rings that are in the same width as the ring(s) you will be ordering. Because our finger sizes can fluctuate a bit during the day depending on how hot or cold we are, it's also not a bad idea to get sized at different times of the day.
For Wider Rings (6mm-10mm wide): We recommend being sized using STANDARD FIT rings (not comfort fit) that are WIDE (at least 6mm) as the ring you would like to order from us. Most of our men's rings default to 6mm or 8mm wide. Please do not use the thin sizing rings that jewelers have as these are not accurate for wider rings and an actual ring will be tighter (because of added width) than the sizing rings that are used. If possible, get the millimeter measurement of the inside diameter of the ring that fits with a digital caliper. This will always be the most accurate way for us to size rings, however if this is not possible the ring size provided will be accurate if sized correctly.
For Narrow Rings (1mm-5mm wide): We recommend being sized using rings that are the same width as the ring you will be ordering in, if at all possible. If a matching width is not available at the jewelers we have also found that measurements given from the thin key ring sizers are generally accurate for rings made in a 1mm-5mm width.
Lastly, do not allow a jeweler to give you a size according to a "ring-sizing dowel", as in our experience this measuring method and reading is very inconsistent. Silver and gold rings can be resized, usually up or down about 2 sizes max, however most of our other rings must be rebuilt from scratch. *If a ring is ordered in the wrong size we do not offer free resizing or remakes, so be sure you are sized correctly! We are confident that if you take the time to try on rings following our guidelines that the ring we craft you will fit perfectly. Please visit our sizing guidelines page HERE for further information.
While we do everything we can to make each ring as durable as possible, they are made using natural materials which are more susceptible to damage from water exposure, impact, chemicals, scratching, and other outside forces than solid metal rings would be. We are always working to improve the quality and durability of our products and have recently developed a more overall durable sealant. As long as the sealant on your ring stays in tact the natural materials will be safe. It should also provide a more secure barrier for the natural materials in your ring from impacts and scratching but cannot be expected to be as strong as a solid metal ring.
The sealant does not provide a guarantee or warranty against water damage or breakage due to impact and other forms of abuse. If the design you chose features wood or antler with exposed edges (meaning the outside edges of the ring do not have protective metal edges) we would still advise that you remove your ring when coming in contact with water and any harsh chemicals, such as hand sanitizer. We do offer a lifetime-limited warranty which can be purchased to cover repairs, reseals, and more, throughout the life of your ring. These can be purchased within the listing of any qualifying ring that you select, or you can add the warranty to your cart by clicking HERE.
WOMEN'S RINGS which do not contain natural materials (such as crushed turquoise, antler, wood, etc.):
Most can be cleaned using warm, soapy water and lightly brushing it to remove any substances on the surface. If you're unsure how to clean your ring, please feel free to reach out for guidance. If your ring has prongs securing stone(s) we recommend having a local jeweler check the prongs at least annually to ensure they're tight and securing the stones!
To learn more about Care Guidelines and how to best care for your ring, please click HERE.
To view our FAQs, please click HERE.
Because our rings are commissioned and made-to-order we do not accept refunds. We do however stand by our work! If there is an issue with your ring when you receive it we are happy to take a look and help find a solution! Email us at email@example.com and put "Attention Repairs" in the subject line.
We take pride in our craftsmanship and quality and do everything we can to make our rings as durable as possible. However, the materials we use are natural and thus can be vulnerable to water, chemicals and breakage from impact. For this reason we are offering a lifetime limited warranty, which will give you peace of mind and keep your handcrafted ring protected and looking great for years to come!
**Warranty must be purchased along with your ring or prior to receiving your ring in the mail.
**What Is Covered & Included?
2 Free Repairs (coverage available for the following issues):
Water or Chemical Damage: Your warranty will cover any remakes or repairs of damage to the natural materials caused by water or chemicals.
Impact, Scratching or Accidental Damage: Your warranty covers all remakes and repairs to natural materials caused by impact, scratching or other accident related abuse.
*We do not offer free coverage or replacement for structural damage to the metal base of your ring, so please try not to drop a transmission on it. Keep your fingers safe.
*We do not offer coverage for lost or damaged precious stones.
2 Free Reseals and Re-Polishes: We understand you love your ring and want to wear it everyday. If it gets worn and scuffed, send it back for a reseal and polish and we will send it back fresh and clean!
20% OFF Remakes Due to Structural Damage:Due to the natural material used in your handcrafted ring, resizing your ring actually means rebuilding the ring from scratch. With the purchase of our lifetime-limited warranty, you will receive a 60% discount on your new, resized ring in exchange for your original ring.
20% OFF Remakes Due to Structural Damage: Although we cannot cover against structural damage to the base metal of your ring, we understand accidents happen and will offer 20% off the remake of a new ring.
SOLID METAL RINGS (with no wood, antler, etc.)
4 Polishes: Using certain tools, we can buff and polish the ring to remove light scratching from the surface of the ring. For black zirconium rings, please be aware it will most likely be completely remade as the scratches will remove the top layer of black, which comes from the fire-treating of the metal. The ring cannot be fire-treated again, so we reserve the right to remake the ring completely.
60% OFF Resizing Remakes: Due to the natural material used in your handcrafted ring, resizing your ring actually means rebuilding the ring from scratch. With the purchase of our lifetime-limited warranty, you will receive a 60% discount on your new, resized ring in exchange for your original ring.
20% OFF Remakes Due to Structural Damage: Although we cannot cover against structural damage to the base metal of your ring, we understand accidents happen and will offer 20% off the remake of a new ring.
*We do not offer free coverage or replacement for structural damage to the metal base of your ring, so please try not to drop a transmission on it. Keep your fingers safe.
*We do not offer coverage for lost or damaged precious stones.
If you would like to purchase the warranty with your ring you will be provided the option to do so from the Material & Warranty drop down menu below.
OTHER GIFTS: We also offer custom, matching cufflinks for any ring as well as groomsmen's gifts like hatchets and wood tie bars! Be sure to check out the Gifts page for additional products.
We would be honored to craft a unique ring for you so you can WEAR AND BE WILD!
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Customer Reviews
Came earlier than anticipated, made tracking easy, great communication, and the ring was exactly what I wanted 😍
The ring came out beautiful and fit my fiance perfectly but it did take quite a few weeks for it to make it to us. It was well worth the wait but I do wish I had ordered it a week or two earlier then I did just so I didn't get so nervous with how close the wedding was to the delivery date.


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Promotional Products & Gifts
Notepads & Portfolios
Choose the size that is right for you. Our promotional notepads and personalized journals have a large, highly visible space for your company name, logo, or message. These personalized note pads have many functional styles including corporate desk notepads, executive notepads, small pocket notepads, and even executive porfolios. Check out our Regatta 3-in-1 Notepad- one of our most popular custom imprinted notepads. It features a two-tone leather like cover with detailed stitching and a metal ballpoint pen. Along with the refillable 75-page notepad it has a 2-year reversible promotional calendar. We also offer a personalized executive planner that is well designed and concisely organized. These easy to use desktop calendar planners have a convenient week view within the monthly formatted calendars. Browse through our line of promotional pocket pal pocket calendars to see which style best reflects your brand.


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The Smart Sell
A version of this article appears in the January/February 2008 issue of Home Energy Magazine.
January 04, 2008
Using the right approach to energy efficiency upgrades can mean the difference between success and failure for a home performance contractor.
Peruse any magazine rack and it's a trend that can't be missed: Going green has never been more hip. Cover after cover declares inside expertise on how to be more environmentally friendly. And the focus of these stories is often the home. Many building and renovation industry professionals see this trend as a new arena for sales and a fresh way to market their products and services. It seems admirable, but it's more complex than one might realize.
To read complete online articles, you need to sign up for an Online Subscription.
Once an order has been placed there is an automatic $10 processing fee that will be deducted with any cancellation.
The Home Energy Online articles are for personal use only and may not be printed for distribution. For permission to reprint, please send an e-mail to email@example.com.


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Virtual Combustion Testing
A version of this article appears in the March/April 2013 issue of Home Energy Magazine.
February 25, 2013
As any BPI Building Analyst will tell you, it's hard to become adept at combustion testing. It takes lots of practice, in real houses, with real mechanical equipment. No amount of classroom training is a good substitute. Unfortunately, many training programs don't provide much hands-on time.
To read complete online articles, you need to sign up for an Online Subscription.
Once an order has been placed there is an automatic $10 processing fee that will be deducted with any cancellation.
The Home Energy Online articles are for personal use only and may not be printed for distribution. For permission to reprint, please send an e-mail to email@example.com.


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Graz Trip Planner
Plan a trip to Graz and know your trip budget
Planning a trip to Graz in Austria is no simple job. With so many attractions to see, one is bound to get baffled. Drafting a Graz itinerary is one way to have a well-organized trip. If you are reading this, then you have landed at the right place, since Triphobo will not only present you an off-the-shelf itinerary, but will also let you customize it.
While planning your trip to Graz, Austria, Triphobo lets you know the estimated budget. This includes your transportation cost, accommodation cost, and other expenses. As you plan your trip to Graz, Austria, you can select the mode of transport and book it. In case you have already booked your transport, just add it to the itinerary. The estimated budget will be adjusted according to the changes you make to your Graz, Austria itinerary.
As you plan the itinerary, you can book accommodation in Graz, Austria using TripHobo. This booking is possible through booking.com, airbnb, agoda, HotelsCombined, priceline.com, and cleartrip. You are provided the best deals that are near to the attractions in Graz, Austria. If you have prebooked your accommodation, you only have to add it to the Graz, Austria trip plan.
Graz, Austria has a plethora of attractions like Uhrturm, Grazer Schlossberg, Schloss Eggenberg. Through 'Add Activities', you are presented the best tours, places, and restaurants to visit in Graz, Austria. Here, you will see the operational timings of the attraction as well as their admission cost. As you add these attractions to the days, Triphobo also provides the default time required to travel from one place to another by driving. If you are commuting by any other mode like trains, subways, or buses, you can make the change. You can even block some time where you won't be able to add any activity. After all, one is entitled to some personal time during an exhaustive trip.
Through group planning, Triphobo allows you to share your itinerary with your travelling companions. Invite them to view the Graz, Austria itinerary and boast to them about your trip planning skills. Use our app, and you will be able to chat with your co-travellers about making any changes to the plan.
After completing your plan, you can view it to get a comprehensive look of your Graz, Austria trip.
Plan your trip to Graz with an estimated budget for your travel. The average daily cost of food in Graz is USD 57 per person. For a family of four, the cost of eating out is USD 228. For accommodation, be ready to spend around USD 55 for a budget accommodation and USD 134 for a luxury hotel, per day, per person. For getting around Graz, you will need a rough figure of USD 44 per day. For detailed Graz trip cost calculator, use Graz Trip Planner.
Average Daily Cost* USD323 Per Person
Cost for One Week USD2261 Per Person
Cost for Two Weeks USD4522 Per Person
Cost for One Month USD9690 Per Person
Average Daily Cost* USD 146 Per Person
Cost for One Week USD 1022 Per Person
Cost for Two Weeks USD 2044 Per Person
Cost for One Month USD 4380 Per Person
Average Daily Cost* USD 99 Per Person
Cost for One Week USD 693 Per Person
Cost for Two Weeks USD 1386 Per Person
Cost for One Month USD 2970 Per Person
*Based on Food, Accommodation & Transportation
- Budget Accommodation USD 55
- Luxury Accommodation USD 134


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20 July 2010 - China. An oil firefighter worker, Han Xiaoxiong, is rescued after been submerged underneath a thick oil slick. Another firefighter, Zhang Liang, died during this incident. The workers ran into trouble as they were attempting to fix an underwater pump during oil spill cleanup operations. The spill was caused by a pipeline blast at the Dalian Port.
© Lu Guang / Greenpeace
1 - 12 of 5649 results.


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You have a unique medical history. Therefore, it is essential to talk with your doctor about your personal risk factors and/or experience with lung cancer. By talking openly and regularly with your doctor, you can take an active role in your care.
General Tips for Gathering Information
Here are some tips that will make it easier for you to talk to your doctor:
- Bring someone else with you. It helps to have another person hear what is said and think of questions to ask.
- Write out your questions ahead of time, so you don't forget them.
- Write down the answers you get, and make sure you understand what you are hearing. Ask for clarification, if necessary.
- Don't be afraid to ask your questions or ask where you can find more information about what you are discussing. You have a right to know.
Specific Questions to Ask Your Doctor
Do I need a second opnion?
- What is the stage of my lung cancer?
- Was it caught early or has it spread?
- Based on my medical history, lifestyle, and family background, am I at risk for lung cancer?
- What is the possibility that my cancer is related to environmental toxins that might cause lung cancer in other family members?
What are my treatment options?
- Am I a candidate for genotyping and targeted therapy?
- What are the risks and benefits associated with my treatment options?
- What other treatments are available?
- How long will the treatments last?
- What side effects can I expect?
- Will I need to change my daily routine?
- How will I feel during treatment?
- What will I need to do to take care of myself during the treatment period?
- What will we do if the treatment does not succeed?
- How can I find help to quit smoking?
- Are there other lifestyle changes I can make to help my prognosis?
- How likely is it that my treatments will kill all the cancer cells?
- How do I know that my treatment program is effective?
- Should I consider participating in a clinical trial?
- Do you know of any support groups or other patients I can talk with?
Revision Information
- Reviewer: EBSCO Medical Review Board Michael Woods, MD, FAAP
- Review Date: 09/2018 -
- Update Date: 07/11/2016 -


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Bronchoscopy is the visual examination of the air passages leading into the lungs. The exam is done with a bronchoscope, a long, thin tube with a camera on the tip. The tube may be flexible or rigid, depending on why it is being done.
Reasons for Procedure
Bronchoscopy is most often done for the following reasons:
- Diagnose cancer, a lung disease, or an infection
- Examine for obstructions and abnormal secretions
- Obtain a tissue sample for examination under a microscope— biopsy
- Obtain a secretion sample for culture or cancer testing
- Investigate the source of a persistent cough or blood that is being coughed up
- Check for a foreign object that may have accidentally been inhaled rather than swallowed
Bronchoscopy may also be done for treatment such as
- Foreign body removal
- Widening of a narrow airway
- Controlling bleeding
- Open abscess or remove diseased tissue
- Remove or treat tumors
- Placement of stents
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Sore and swollen throat
- Reaction to anesthesia
- Irritation of the airways or vocal cords
- Bleeding
- Hole in the airway or collapsed lung
- Irregular heart rate
- Infection
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
What to Expect
Prior to Procedure
Your doctor may do some or all of the following:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
Leading up to your procedure:
- Arrange for a ride to and from the procedure.
- The night before, eat a light meal. Do not eat or drink anything after midnight unless otherwise instructed.
Local anesthetic will be given to numb the throat and you will have sedation. These will also help to prevent coughing and gagging. Sometimes, a bronchoscopy is done under general anesthesia. In this case, you will be asleep.
Description of the Procedure
The bronchoscope is a long, thin tube. It will be inserted through the nose or mouth. The scope will be passed down the throat and into the lungs.
The scope sends an image of the lung tissue to a monitor. The images and the scope may be used to remove a small tissue sample. If a foreign body is present, it may be removed through the scope. If a lavage is planned, a water solution may be used to wash an area. The solution is then removed and sent to a lab for examination.
Immediately After Procedure
The removed tissue or secretions will be sent to a lab for examination or culture.
How Long Will It Take?
Less than 1 hour
How Much Will It Hurt?
Anesthesia prevents pain during the procedure. You may feel a tugging sensation when the doctor removes a tissue sample. You may also have some breathing difficulty or shortness of breath during the procedure.
Expect some soreness in your throat and hoarseness for a few days after the procedure. Any discomfort after the procedure can be managed with medications.
Post-procedure Care
Right after the procedure, the staff may:
- Take an x-ray of your lungs.
- Encourage you to sip water. You will gradually progress to solid foods.
When you return home, be sure to follow your doctor's instructions. If you had to stop medications before the procedure, ask your doctor when you can start again.
You may be given a report after the sedative wears off and you are alert. It may take a few days to receive results from a biopsy. It may take up to 6 weeks for findings from a tuberculosis test. Ask your doctor when to expect your results.
Call Your Doctor
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Cough, shortness of breath, or chest pain
- Coughing up more than a teaspoon of blood
- Severe nausea or vomiting
- Increased or unusual stridor, which is a noisy sound that is heard when breathing
- Pain that you cannot control with the medications you have been given
If you think you have an emergency, call for emergency medical services right away.
Revision Information
- Reviewer: EBSCO Medical Review Board Michael Woods, MD, FAAP
- Review Date: 09/2018 -
- Update Date: 09/09/2014 -


text: Tuesday, October 02, 2012 Foundation Gears Up for 2013 Pittsburgh-Marquette Challenge The Marquette Challenge is an annual student-led grassroots fundraising effort that supports physical therapy research. Over the past 24 years, students participating in the Marquette Challenge have raised more than $2.3 million in support of the Foundation and its mission. To learn how your school can help advance physical therapy research and gain national recognition check out the interactive Challenge kit.


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Flourless mini chocolate cupcakes with "Polly fluff"Tuesday, February 7th, 2012
These adorable and moist mini cupcakes only contain 3 ingredients: eggs, chocolate and butter. The chocolate cake recipe came to my attention being one of the monthly challenges in "Daring Bakers" and thus popping up all over the internet. Regretfully I'm not a Daring Baker anymore due to lack of time, but never the less I do recommend this recipe. It's very versatile and you can bake cupcakes, mini cupcakes, cakes or what ever with this lovely recipe. I chose to do mini cupcakes as I was making dessert for a New Year's party at Lena's with many guests. I made two batches and I ended up with more than 50 mini cupcakes. On a side note they they were quite easy to transport and not too fragile despite traveling by bus, metro and finally train.
For topping I made a "fluff", which is widely known in Sweden lately, you basically melt 180 grams of candy or chocolate into 300 ml heavy cream. It's important not to let it boil. Leave in the fridge overnight and then whip it up with an electric beater until fluffy and light. For this variant I used Polly which is a Swedish chocolate candy with array flavour. After whipping the "fluff" I piped the cupcakes and as a finishing touch I decorated each cupcake with a raspberry.
Flourless mini chocolate cupcakes
Makes around 25 depending on size.
(Source: Daring Bakers Challenge January 2009, for example here and here)
450 gram of semisweet chocolate, roughly chopped
150 gram unsalted butter
5 large eggs, separated
Put chocolate and butter in a heatproof bowl and set over a pan of simmering water (the bottom of the bowl should not touch the water) and melt, stirring often.
Separate the egg yolks from the egg whites and put into two medium/large bowls.
Whip the egg whites in a medium/large grease free bowl until stiff peaks are formed (do not over-whip or the cupcakes will be dry).
With the same beater beat the egg yolks together.
Add the egg yolks to the cooled chocolate.
Fold in 1/3 of the egg whites into the chocolate mixture and follow with remaining 2/3rds. Fold until no white remains without deflating the batter.
Pour batter into mini cupcake molds, the ones I use are called "småbrödsformar". The batter should fill only 3/4 way up. Bake at 175 degrees C for 10 minutes.


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A risk factor is something that increases your likelihood of getting a disease or condition.
It is possible to develop inflammatory bowel disease with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing inflammatory bowel disease. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.
While scientists continue to search for the cause of inflammatory bowel disease, they have determined that certain genetic and environmental factors may increase the likelihood of developing the condition. Exactly why these factors add to the risk is not known at this time.
Risk factors include the following:
Genetic Factors
Having a family member with inflammatory bowel disease increases your chances of getting the disease.
Ethnic Background
Caucasians are more likely to develop both types of inflammatory bowel disease. People of Jewish heritage are at greater risk of Crohn's disease.
Smoking adds to the risk for Crohn's disease, but seems to lower the risk of ulcerative colitis. In addition, former smokers are at greater risk than nonsmokers.
Socioeconomic Factors
Inflammatory bowel disease seems to occur more often among people in higher socioeconomic classes and people with white-collar jobs.
Having a diet that is high in fat, sugar, and meat may increase your risk of Crohn's disease and ulcerative colitis.
Revision Information
- Reviewer: EBSCO Medical Review BoardDaus Mahnke, MD
- Review Date: 09/2018 -
- Update Date: 09/17/2014 -


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The Cottage Iron Crib in Choice of Finish is available in many colors to suit your unique design. These cribs are made in the USA out of pure metal and completed with premium finishes creating a piece that is truly built to last generations.
This crib has a traditional charm and will showcase almost any bedding.
Would you like us to help you find a similar item? Talk with our Design Consultants toll-free at1-800-927-5164.
*Shipping transit time varies based on destination. Free shipping offers are limited to the 48 contiguous states of the USA.
International Customers (including Alaska and Hawaii) please contact a Customer Service Representative if you have any questions about placing an order with PoshTots.
Some assembly required. Assembly service available upon request.
This item is custom made especially for you upon order.Click here for our policy on custom made items.
Promotion codes cannot be used for sale item purchases.
*Free shipping offers are limited to the 48 contiguous states of the USA.


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Biographical Timeline
"Ildebrando D'Arcangelo is a complete knock-out as Leporello – charming, funny, sexy, but pointedly in touch with his emotions in ways that his master can never be. What a difference a native Italian speaker makes in the role."
The Independent
"Ildebrando D'Arcangelo's dark baritone is an ideal Figaro voice and he looks the part"
The Guardian
Hailed by critics for his magnificent voice and stage presence, Italian bass-baritone Ildebrando D'Arcangelo has established himself as one of the most exciting singers of his generation. Ildebrando D'Arcangelo is well-known to audiences throughout Europe as well as North America. In his extensive work, both in opera and concert, he has collaborated with Claudio Abbado, Riccardo Chailly, Myung-Whun Chung, Sir John Eliot Gardiner, Daniele Gatti, Valery Gergiev, Bernard Haitink, Nikolaus Harnoncourt, Christopher Hogwood, René Jacobs, Riccardo Muti, Seiji Ozawa, Antonio Pappano, and the late Sir Georg Solti.


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Apple is taking a lot of heat over the release of the iPhone 5 and its corresponding operating system, iOS 6. The screen is too small. The sales, too few. It lacks NFC. The complaints go on and on.
Outcry is strongest over the new Apple Maps application, which replaces Google Maps. While it has its flaws, the outsized reaction to Apple Maps comes more from media hype and unrealistically high expectations than any severe problem. Like the uproar over "Antenna Gate" in 2010, we'll soon forget all about it.
Why we're reacting
I am not saying that a reaction wasn't warranted. As a longtime iPhone user, maps always has been one of my most-used and most-enjoyed features. Whether looking for a coffee shop downtown or planning a trip cross country, ubiquitous mapping has fundamentally improved my life. It's like having an extra sense, and I would be lost — literally — without it. I'm sure many iPhone users agree.
The redesign of an app so important to so many would have drawn attention even if it brought improvements to the experience. The widespread use of Maps is one reason there have been so many complaints about the application. We are never so vocal as when we are dissatisfied, and many, many people are dissatisfied right now.
We're used to seeing high-quality experiences from Apple. There is dramatic tension in the idea that Apple may have made a miscue.
That dramatic tension is also the reason that news coverage of the Maps app has been so thorough. As Donald Murray wrote in Writing For Your Readers: Notes on the Writers Craft from The Boston Globe:
The experienced writer sees the world through the lens of language, and that lens captures the tension between forces in the world that will produce a story.
This tension may make for a good story, but it's precisely the reason that we are all overreacting.
Why we're overreacting
Described in these pages as "mediocre to bad" and by The Guardian as Apple's "first significant failure in years," Apple must be feeling the heat from this wrong turn. A spokesperson's recent claim that Apple is "just getting started" and Tim Cook's recent apology indicate that Apple is sensitive to these complaints.
With some of the most skilled design and engineering talent in the world, Apple has the capacity to fix Maps. Critically, Apple should also have the motivation to fix Maps — something it lacked with the Podcasts app, which remains garbage nearly two months after I first complained about it.
Reactions to Maps have been so severe that Apple must turn more of its attention to fixing Maps, and spokespeople claim it is. Reports that Apple is recruiting Google Maps contractors also support this view. If Apple is motivated to fix Maps, improvements should occur more rapidly than we've seen for Podcasts.
The core feature set for map applications is fairly consistent. All Apple must do is ape its competitors offerings and add in Apple's traditional fit and finish – complaints will cease. This will require Apple to make large improvements in the geographic data that Maps is based on, but there are indications that this is already happening. It will be no small feat to develop a mapping database on par with Google's, but Apple is one of the most valuable companies in history (at least when it comes to market cap). I wouldn't put anything beyond its reach.
The long game
Reactions to Apple's Maps remind me of responses to Microsoft's Surface and Twitter's tighter API restrictions earlier this year. There is an important similarity in all of these stories: They are all aggressive plays by companies in long-term markets.
We are only now in year three of tablet computer use, and it's clear already that tablets will be a (or even the) dominant computing form factor of the next five to ten years. Microsoft saw the writing on the wall, and is now working to bring its own tablets to market. Microsoft makes enough money with Windows and Office to invest hundreds of millions of dollars into Surface and improve it iteratively over the next several years. These initial tablets are the first step on that path. With the first Surface tablets, it's less important that they be good, and more important that they simply be, so that they can be better after further development.
Twitter is also in it for the long haul, and wants to be a dominant media company for years to come. Though they took a lot of flack from developers and pundits over tighter API rules announced in August, these changes ultimately give Twitter more control over the end user experience for their product. Further, as Molly McHugh wrote for Digital Trends:
There are lots of pundits saying that only the geekiest of Twitter users will be upset by these changes; the tech scene watchers for who Twitter has become a pulse. But I think those analysts are underestimating the social impact Twitter has started to have.
This is the fifth year of popular use of Twitter. Though this seems to be a bad short-term move, if Twitter is still popular in five or ten years, this will only have been a minor bump in the road.
Maps is also an important long-term play for Apple. Apple does not want to be dependent on any other technology company — least of all Google, with which Cupertino has an ever-warming cold war. Though Apple Maps is bad right now, it frees Apple from dependence on Google maps. This is painful for iPhone users, but it's necessary pain. It could also be temporary pain. If Apple Maps is significantly improved six months from now, this glitchy release will only be a humorous memory.
Remember Antenna-Gate?
Pundits and tech media railed against Apple in similar style during the "Antenna Gate" fiasco following the launch of the iPhone 4. But how much does the famous "iPhone 4 Death Grip" matter today? Hardly. It doesn't even matter to me, and I actually own an iPhone 4 that will drop calls if I hold it wrong without a case. You know what? I love my iPhone 4.
Maps seems to be the new Antenna Gate, all the way down to drawing a reaction from Apple's CEO. The most recent development in this story, occurring just before my deadline, was Cook's release of a statement that Apple is "extremely sorry for the frustration" that Maps has caused. This is the clearest indicator so far that Apple is aware of the Maps problem and moving to deal with it. Cook closed his note with the following:
Everything we do at Apple is aimed at making our products the best in the world. We know that you expect that from us, and we will keep working non-stop until Maps lives up to the same incredibly high standard.
Now that Cook is on the case, I am even more confident Maps will be addressed quickly.
However, if Maps isn't updated, and is instead neglected like Apple's awful Podcasts app? Well, then I'll really be worried.
Editors' Recommendations
- The best iPhone apps (April 2020)
- Can switching to an old, outdated smartphone cure your addiction?
- How to mirror your smartphone or tablet on your TV
- Apple Music vs. Spotify
- The best smartwatches for 2020


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"This is a superbly conceived and wonderfully performed collection about war and its emotional impact . . . Anna Prohaska's glittering soprano is hard-hitting in four Hanns Eisler songs, and while she finds an unearthly purity in Schubert's "Ellens Gesang I", she is as pungent in Kurt Weill's settings of Whitman as she is cool in Michael Cavendish's ancient lute song "Wandring in This Place". The imagination and care that has gone into this compilation is exceptional, and the results are totally compelling."
The Guardian [CD review Behind the Lines], 6 July 2014
Born into a distinguished musical family in Vienna (her great-grandfather was the composer Carl Prohaska, her grandfather the conductor and teacher Felix Prohaska), Anna Prohaska studied in Berlin at the Hanns Eisler Academy of Music. In 2002, at the age of 17, she made her debut at the Komische Oper in Harry Kupfer's production of Britten's Turn of the Screw and then in Willy Decker's production of Albert Herring. When she was 23, she took on the role of Frasquita at short notice in a production of Carmen conducted by Daniel Barenboim at the Berlin Staatsoper Unter den Linden, and was promptly engaged as a member of its permanent ensemble. In December 2010 at the Staatsoper, she sang Anne Trulove in a new production of The Rake's Progress under Ingo Metzmacher. She made her Salzburg Festival debut in Rusalka under Franz Welser-Möst in 2008; in 2009 she returned for Luigi Nono's Al gran sole carico d'amore, in 2010 she sang her first Zerlina thereand in 2011 she appeared there as Mozart's Despina in Cosě fan tutte.
In addition to concerts with the Deutsches Symphonie-Orchester, Anna Prohaska has worked closely since 2007 with the Berliner Philharmoniker, including the world premiere of Wolfgang Rihm's Mnemosyne under Matthias Pintscher in a ceremony for Claudio Abbado in 2009. In 2010 she was the soloist in Berg's Lulu Suite with the Simón Bolívar Symphony Orchestra conducted by Abbado in Venezuela and Lucerne.
Besides contemporary music and the standard repertoire, Anna Prohaska also devotes herself to early music and has worked with Moderntimes_1800 of Innsbruck, the Akademie für Alte Musik of Berlin, the Academy of Ancient Music, Concentus Musicus Wien with Nikolaus Harnoncourt and Concerto Köln. She has given recitals at the Berlin Staatsoper, Hamburg's Laeiszhalle, London's Wigmore Hall, Salzburg Mozarteum, Schubertiade and Vienna Musikverein, as well as with Maurizio Pollini in Paris and Lucerne. In 2008 she was awarded the Daphne Prize and in 2010 the Schneider-Schott Music Prize. Anna is currently a "Junge Wilde" artist at the Konzerthaus in Dortmund.
Recent appearances include the Brahms Requiem with Dohnányi and the Boston Symphony; Jens Joneleit's new opera Metanoia and Elliott Carter's new song cycle What Are Years with Barenboim and the Berlin Staatskapelle; Wolfgang Rihm's new work for high soprano and orchestra Samothrake with Ulf Schirmer and the Gewandhausorchester and Jörg Widmann's Babel under Nagano at the Bavarian State Opera; as well as a European tour of Baroque arias with Arcangelo and Jonathan Cohen. At the Theater an der Wien she sang Marzelline in Fidelio with Harnoncourt and Anne Trulove. For the Staatsoper in Berlin she sang Mozart's Zerlina, Susanna and Pamina, Isolde in a new production of Martin's Le Vin herbé and her first Sophie in Der Rosenkavalier with Sir Simon Rattle.
Further engagements in 2014 include Poulenc's Dialogues de Carmélites under Simon Rattle at Covent Garden as well as Mozart's Blonde in Baden-Baden under Yannick Nézet-Seguin and in Paris under Philippe Jordan. She will also make a recital tour with pianist Eric Schneider featuring their programme of war-themed songs, with appearances including London's Wigmore Hall, the Vienna, Berlin and Dortmund Konzerthaus, Paris's Palais-Royal and the festivals of Salzburg, Edinburgh and Bad Kissingen.
In January 2011, Anna Prohaska signed an exclusive recording agreement with Deutsche Grammophon. A wide-ranging song recital entitled Sirčne was released later that year in the German-speaking markets. It received an Echo Klassik Award in 2012. The Enchanted Forest, Anna Prohaska's Baroque programme with Arcangelo conducted by Jonathan Cohen, was released on Archiv Produktion in March 2013. That month also saw the release of her performance of Berg's Lulu Suite, with the Vienna Philharmonic conducted by Pierre Boulez. Her latest recording, scheduled for June 2014 to mark the centenary of the outbreak of World War I, is Behind the Lines with pianist Eric Schneider, their programme of songs on the subject of war.


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Supplement Forms/Alternate Names
- Bonemeal
- Calcium Aspartate
- Calcium Carbonate
- Calcium Chelate
- Calcium Citrate
- Calcium Citrate Malate
- Calcium Gluconate
- Calcium Lactate
- Calcium Orotate
- Dolomite
- Oyster Shell Calcium
- Tricalcium Phosphate
Principal Proposed Uses
Calcium is the most abundant mineral in the body, making up nearly 2% of total body weight. More than 99% of the calcium in your body is found in your bones, but the other 1% is perhaps just as important for good health. Many enzymes depend on calcium in order to work properly, as do your nerves, heart, and blood-clotting mechanisms.
To build bone, you need to have enough calcium in your diet. But in spite of calcium-fortified orange juice and the best efforts of the dairy industry, most Americans are calcium deficient. 1 Calcium supplements are a simple way to make sure you are getting enough of this important mineral.
One of the most important uses of calcium is to help prevent and treat osteoporosis, the progressive loss of bone mass to which menopausal women are especially vulnerable. Calcium works best when combined with vitamin D.
Other meaningful evidence suggests that calcium may have an additional important use: reducing PMS symptoms.
Here are the recommendations from the Institute of Medicine: 198
- 0-6 months: 200 mg
- 7-12 months: 260 mg
- 1-3 years: 700 mg
- 4-8 years: 1,000 mg
- 9-18 years: 1,300 mg
- 19-50 years: 1,000 mg
51-70 years
- Males: 1,000 mg
- Females: 1,200 mg
- 71 and older: 1,200 mg
The recommendations for women who are pregnant or nursing are:
- Under 19 years: 1,300 mg
- 19 years and older: 1,000 mg
Food Sources
The National Institutes of Health's Office of Dietary Supplements offers this list of foods that are high in calcium: 201
In addition to food sources, many forms of calcium supplements are available on the market, each with its own advantages and disadvantages.
Calcium Absorption
To absorb calcium, your body also needs an adequate level of vitamin D (for more information, see the article on Vitamin D ).
Various medications may impair calcium absorption or metabolism, either directly or through effects on vitamin D. People who use these may benefit by taking extra calcium and vitamin D. Implicated medications include corticosteroids , 30-32heparin , 33-35isoniazid , 36-38 and anticonvulsants . 39-45Note: Calcium carbonate might interfere with the effects of anticonvulsant drugs, and for that reason should not be taken at the same time of day. 46,47
Naturally Derived Forms of Calcium
These forms of calcium come from bone, shells, or the earth: bonemeal, oyster shell, and dolomite. Animals concentrate calcium in their shells, and calcium is found in minerals in the earth. These forms of calcium are economical, and you can get as much as 500 mg to 600 mg in one tablet. However, there are concerns that the natural forms of calcium supplements may contain significant amounts of lead. 2 The level of contamination has decreased in recent years, but still may present a health risk. 3,4 Calcium supplements rarely list the lead content of their source, although they should. The lead concentration should always be less than 2 parts per million.
Refined Calcium Carbonate
This is the most common commercial calcium supplement, and it is also used as a common antacid. Calcium carbonate is one of the least expensive forms of calcium, but it can cause constipation and bloating, and it may not be well absorbed by people with reduced levels of stomach acid. Taking it with meals improves absorption because stomach acid is released to digest the food. 121 (See the section, Chelated Calcium, below.)
Chelated Calcium
Chelated calcium is calcium bound to an organic acid (citrate, citrate malate, lactate, gluconate, aspartate, or orotate). The chelated forms of calcium offer some significant advantages and disadvantages compared with calcium carbonate.
Certain forms of chelated calcium (calcium citrate and calcium citrate malate) are widely thought to be significantly better absorbed and more effective for osteoporosis treatment than calcium carbonate. However, while some studies support this belief, 6,7,9,10 others do not. 8,122,123 The discrepancy may be due to the particular calcium carbonate products used; some calcium carbonate formulations may dissolve better than others.
One study found that calcium citrate malate in orange juice is markedly better absorbed than tricalcium phosphate/calcium lactate in orange juice. 148
A form of calcium called active absorbable algal calcium (AAACa) has also been promoted as superior to calcium carbonate, but the study upon which claims of benefit are founded actually used quite questionable statistical methods (technically, post-hoc subgroup analysis). 133
Chelated calcium is much more expensive and bulkier than calcium carbonate. In other words, you have to take larger pills, and more of them, to get enough calcium. It is not at all uncommon to need to take five or six large capsules daily to supply the necessary amount, a quantity some people may find troublesome.
Therapeutic Dosages
Unlike some supplements, calcium is not taken at extra high doses for special therapeutic benefit. Rather, for all its uses, it should be taken in the amounts listed under Requirements/Sources, along with the recommended level of vitamin D. (See the article on vitamin D for proper dosage amounts.)
Calcium absorption studies have found evidence that your body cannot absorb more than 500 mg of calcium at one time. 11 Therefore, it is most efficient to take your total daily calcium in two or more doses.
Use of prebiotics known as "inulin fructans" may improve calcium absorption. 149
It is not possible to put all the calcium you need in a single multivitamin/mineral tablet, so this is one supplement that should be taken on its own. Furthermore, if taken at the same time, calcium may interfere with the absorption of chromium and manganese . 12,13,14 This means that it is best to take your multivitamin and mineral pill at a separate time from your calcium supplement.
Although the calcium present in some antacids or supplements may alter the absorption of magnesium , this effect apparently has no significant influence on overall magnesium status. 15,16 Calcium may also interfere with iron absorption, 17-22,150 but the effect may be too slight to cause a problem. Some studies show that calcium may decrease zinc absorption when the two are taken together as supplements; however, studies have found that, in the presence of meals, zinc levels may be unaffected by increases of either dietary or supplemental calcium. 23-29
Therapeutic Uses
According to most, though not all studies, use of calcium (especially in the form of calcium citrate) combined with vitamin D may modestly slow the bone loss that leads to osteoporosis . 48-55,151-153 Calcium and vitamin D may help prevent falls that lead to osteoporotic fractures. In a review of 26 randomized trials, researchers found that the two supplements lowered the risk of falls in high-risk elderly people. 200
A rather surprising potential use of calcium came to light when a large, well-designed study found that calcium is an effective treatment for premenstrual syndrome (PMS). 56 Calcium supplementation reduced all major symptoms, including headache, food cravings, moodiness, and fluid retention. It is at least remotely possible that there may be a connection between these two uses of calcium: weak evidence hints that PMS might be an early sign of future osteoporosis. 57,58
One small but carefully conducted study suggests that getting enough calcium may help control symptoms of menstrual pain . 89
Some, but not all, observational and intervention studies have found evidence that calcium supplementation may reduce the risk of colon cancer . 59,134-135,154-156 Risk reduction might continue for years after calcium supplements are stopped. 182 However, calcium supplements might increase risk of prostate cancer in men, as discussed in the Safety Issues section. For menopausal women, calcium supplementation, especially with vitamin D added, may reduce cancer risk in general. 187
Individuals who are deficient in calcium may be at greater risk of developing high blood pressure . 60,61,126 Among individuals who already have hypertension, increased intake of calcium might slightly decrease blood pressure, according to some, but not all, studies. 62,127 Weak evidence hints that use of calcium by pregnant mothers might reduce risk of hypertension in their children. 185
Calcium supplements might slightly improve the cholesterol profile. 63,64,124
Calcium supplementation has also been tried as a treatment to prevent preeclampsia in pregnant women. While the evidence from studies is conflicting, 66-68,157-15 calcium supplementation might offer at least a minimal benefit.
The drug metformin , used for diabetes, interferes with the absorption of vitamin B 12 . Interestingly, calcium supplements may reverse this, allowing the B 12 to be absorbed normally. 70
Rapid weight loss in overweight postmenopausal women appears to slightly accelerate bone loss. 71,136 For this reason, it may make sense to take calcium and vitamin D supplements when deliberately losing weight. It has been additionally suggested that calcium supplements, or high-calcium diets, may directly enhance weight loss, but current evidence is more negative than positive. 72,130,137,159-165,186,188,189,191
Finally, calcium is also sometimes recommended for attention deficit disorder , migraine headaches , and periodontal disease , but there is as yet no meaningful evidence that it is effective for these conditions.
It is important to note that despite the benefits of calcium supplementation for certain conditions, a large, placebo-controlled trial involving over 36,000 post-menopausal women found that daily supplements of 1,000 mg of calcium carbonate combined with 400 IU of vitamin D3 for an average of 7 years did not significantly reduce death rates from all causes. 196
What Is the Scientific Evidence for Calcium?
A number of double-blind, placebo-controlled studies indicate that calcium supplements (especially as calcium citrate, and taken with vitamin D) are slightly helpful in preventing and slowing down bone loss in postmenopausal women. 73-76,138,165-169,180 Contrary to some reports, milk does appear to be a useful source of calcium for this purpose. 183-184
However, the effect of calcium supplementation in any form is relatively mild and may not be strong enough to reduce the rate of osteoporotic fractures. Note that the use of calcium and vitamin D must be continual. Any improvements in bone density rapidly disappear once the supplements are stopped. 77 A large randomized trail of over 3,000 postmenopausal women aged 65-71 years old found that 3 years of daily supplementation with calcium and vitamin D was not associated with a significant reduction in the incidence of fractures. 197
In a much larger observational study (not a randomized trial) involving 61,433 women aged 39-73, researchers investigated the effects of dietary calcium (as opposed to supplements) on the risk of osteoporosis and fracture over a 19-year period. 199 They found that women who consumed less than 750 mg/day of calcium had a higher rate of osteoporotic fractures in any location. Unexpectedly, however, the study also found that those who consumed the highest amounts of calcium (over 1,137 mg/day) did not have a comparatively reduced rate of fractures or osteoporosis. Indeed, this high dietary intake was associated with an increase in the number of hip fractures for reasons the authors could not completely explain.
Other studies have found that calcium carbonate may not be effective. 170-171
One study found benefits for male seniors using a calcium and vitamin D-fortified milk product. 172 (See, however, possible increased risk of prostate cancer discussed in Safety Issues .)
Calcium and vitamin D supplementation may help bones heal that have become fractured due to bone thinning. 139
Calcium supplements may do a better job of strengthening bones when people have relatively high protein intake. 125
Heavy exercise causes increased calcium loss through sweat, and the the body does not compensate for this by reducing calcium loss in the urine. 190 The result can be a net calcium loss great enough so that it presents health concerns for menopausal women, already at risk for osteoporosis. One study found that use of an inexpensive calcium supplement (calcium carbonate), taken at a dose of 400 mg twice daily, is sufficient to offset this loss. 190
Calcium supplementation could, in theory, be useful for young girls as a way to "put calcium in the bank"—building up a supply for the future in order to prevent later osteoporosis. However, surprisingly, the benefits seen in studies have been modest to nonexistent, and this approach may only produce results when exercise is also increased. 79-81,140-143,173-175,181
One study found that in calcium-deficient pregnant women, calcium supplements can improve the bones of their unborn children. 82
Evidence suggests that the use of calcium combined with vitamin D can help protect against the bone loss caused by corticosteroid drugs, such as prednisone. A review of five studies covering a total of 274 participants reported that calcium and vitamin D supplementation significantly prevented bone loss in corticosteroid-treated individuals. 83 For example, in a 2-year, double-blind, placebo-controlled study that followed 65 individuals with rheumatoid arthritis taking low-dose corticosteroids, daily supplementation with 1,000 mg of calcium and 500 IU of vitamin D reversed steroid-induced bone loss, causing a net bone gain. 84
There is some evidence that essential fatty acids may enhance the effectiveness of calcium. In one study, 65 postmenopausal women were given calcium along with either placebo or a combination of omega-6 fatty acids (from evening primrose oil ) and omega-3 fatty acids (from fish oil ) for a period of 18 months. At the end of the study period, the group receiving essential fatty acids had higher bone density and fewer fractures than the placebo group. 85 However, a 12-month, double-blind trial of 42 postmenopausal women found no benefit. 86 The explanation for the discrepancy may lie in the differences between the women studied. The first study involved women living in nursing homes, while the second studied healthier women living on their own. The latter group of women may have been better nourished and already received enough essential fatty acids in their diet.
Premenstrual Syndrome (PMS)
According to a large and well-designed study published in a 1998 issue of American Journal of Obstetrics and Gynecology, calcium supplements are a simple and effective treatment for a wide variety of PMS symptoms. 87 In a double-blind, placebo-controlled study of 497 women, 1,200 mg daily of calcium as calcium carbonate reduced PMS symptoms by half over a period of three menstrual cycles. These symptoms included mood swings, headaches, food cravings, and bloating. These results corroborate earlier, smaller studies. 88,89
High Cholesterol
In a 12-month study of 223 postmenopausal women, use of calcium citrate at a dose of 1 g daily improved the ratio of HDL ("good") cholesterol levels to LDL ("bad") cholesterol levels. 124 The extent of this improvement was statistically significant (as compared to the placebo group), but not very large in practical terms. Similarly modest benefits were seen in a previous, smaller double-blind, placebo-controlled study. 63 A third double-blind, placebo-controlled study failed to find any statistically significant effects. 64
Colon Cancer
Evidence from observational studies showed that a high calcium intake is associated with a reduced incidence of colon cancer , 91 but not all studies have found this association. 92
Some but not all evidence from intervention trials supports these findings. 90,176-178
A 4-year, double-blind, placebo-controlled study followed 832 individuals with a history of colon polyps. 90 Participants received either 3 g daily of calcium carbonate or placebo. The calcium group experienced 24% fewer polyps overall than the placebo group. Since colon polyps are the precursor of most colon cancer, this finding strongly suggests benefit. Combing the results for two trials, involving a total of 1,346 subjects also with a history of polyps, researchers found that 1,200 mg or 2,000 mg of daily elemental calcium led to a significant reduction in polyp recurrence compared to placebo over a 3-4 year period. 193 Another, large-sized study found that calcium carbonate at a dose of 1,200 mg daily may have a more pronounced effect on dangerous polyps than on benign ones. 144
However, a gigantic (36,282 participant), very long-term (average 7 years) study of postmenopausal women failed to find that calcium carbonate supplements at a dose of 1,000 mg daily had any effect on the incidence of colon cancer. 178 Given these conflicting results, if calcium supplementation does have an effect on colon cancer risk, it is probably small.
A very large randomized, placebo-controlled trial of over 36,000 postmenopausal women found daily supplementation with 1,000 mg of calcium plus 400 IU of vitamin D did not reduce or prevent hypertension during 7 years of follow-up. These results are possibly limited by non-study calcium use. 195
Safety Issues
In general, it is safe to take up to 2,500 mg of calcium daily (1,000 mg/day in infants 12 months old or younger), although this is more than you need. 93,119,198 Greatly excessive intake of calcium can cause numerous side effects, including dangerous or painful deposits of calcium within the body.
Note: If you have cancer, hyperparathyroidism, or sarcoidosis, you should take calcium only under a physician's supervision.
Some evidence hints that use of calcium supplements might slightly increase kidney stone risk. 96,132,178 However, increased intake of calcium from food does not seem to have this effect and could even help prevent stones. 94,95,97,132 One study found that if calcium supplements are taken with food, there is no increased risk. 146 Calcium citrate supplements may be particularly safe regarding kidney stones because the citrate portion of this supplement is used to treat kidney stones. 147
There is preliminary evidence that calcium supplementation in healthy, post-menopausal women may slightly increase the risk of cardiovascular events, such as myocardial infarction. However, it remains far from clear whether this possible risk outweighs the benefits of calcium supplementation in this population. 192,194
Large observational studies have found that, in men, higher intakes of calcium are associated with an increased risk of prostate cancer. 98,99,100,179 This seems to be the case whether the calcium comes from milk or from calcium supplements.
Calcium supplements combined with high doses of vitamin D might interfere with some of the effects of drugs in the calcium channel blocker family. 101 It is very important that you consult your physician before trying this combination.
Concerns have been raised that the aluminum in some antacids may not be good for you. 102 There is some evidence that calcium citrate supplements might increase the absorption of aluminum; 103-107 for this reason, it might not be a good idea to take calcium citrate at the same time of day as aluminum-containing antacids. Another option is to use different forms of calcium, or to avoid antacids containing aluminum.
When taken over the long term, thiazide diuretics tend to increase levels of calcium in the body by decreasing the amount excreted by the body. 108-111 It is not likely that this will cause a problem. Nonetheless, if you are using thiazide diuretics, you should consult with your physician on the proper doses of calcium and vitamin D for you.
Finally, calcium may interfere with the absorption of antibiotics in the tetracycline and fluoroquinolone families as well as thyroid hormone. 112-118 If you are taking any of these drugs, you should take your calcium supplements at least 2 hours before or after your medication dose.
Interactions You Should Know About
- You may need more calcium if you are taking:
- If you are taking aluminum hydroxide , you should take calcium citrate at least 2 hours apart to avoid increasing aluminum absorption.
You may need more calcium if you are taking the following anticonvulsants:
- Phenytoin (Dilantin)
- Carbamazepine
- Phenobarbital
- Primidone
- Note: It may be advisable to take your dose of anticonvulsant and your calcium supplement at least 2 hours apart because each interferes with the other's absorption.
If you are taking the following medications, you should take your calcium supplement at least 2 hours before or after your dose of medication because calcium interferes with the absorption (and vice versa):
- Antibiotics in the tetracycline or fluoroquinolone ( Cipro , Floxin , Noroxin ) families
- Thyroid hormone
- Do not take extra calcium except on the advice of a physician if you are taking Thiazide diuretics .
- Do not take calcium together with high-dose vitamin D except on the advice of a physician if you are taking calcium channel blockers .
- You may need extra calcium if you are taking:
- It may be advisable to wait 2 hours after taking calcium supplements to eat soy (or vice versa). A constituent of soy called phytic acid can interfere with the absorption of calcium.
- Taking supplemental calcium may be helpful if you are taking metformin .
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


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Hematuria means blood in the urine. Normally, urine does not contain any blood. There are 2 kinds of hematuria:
- Microscopic hematuria—Urine contains a very small amount of blood. It cannot be seen with the naked eye.
- Gross hematuria—Urine appears red or tea-colored.
Hematuria can be caused by many conditions, such as:
- Vigorous exercise
- Injury to the abdomen, pelvis, or internal organs of the urinary tract
- Conditions that affect the urinary tract, such as infection, vesicoureteral reflux, blockage or abnormalities, or tumors
- Cancer of the kidney or bladder
- Kidney disease
- Kidney stones
- Bleeding disorders, such as hemophilia
- Certain congenital diseases, such as polycystic kidneys
- Certain medications
Sometimes the exact cause is not found.
Risk Factors
Factors that may increase your child's chance of hematuria include:
- Urinary tract infection
- Recent upper respiratory tract infection
- Family history of kidney problems
- Injury or abuse
- Medications, such as certain antibiotics or pain relievers
- Pelvic radiation therapy for cancer treatment
In some cases, there may be other symptoms with hematuria. These other symptoms will depend on the underlying condition that is causing the hematuria. For example, if a urinary tract infection is the cause, your child may have to urinate often. There may also be a burning feeling during urination.
Call your child's doctor if you see blood in the urine.
You will be asked about your child's symptoms and medical history. A physical exam will be done.
Tests to look for infections and signs of kidney trouble may include:
- Urine tests—to confirm the presence of blood and look for protein, bacteria, or cancer cells in the urine
- Blood tests—to check how well the kidneys are functioning and to look for conditions that cause hematuria
Your child's doctor may also need to look at the kidneys and urinary tract. Imaging tests may include:
Other tests that may be done include:
- Cystoscopy—to look at the lining of the bladder
- Kidney biopsy (done in rare cases)—to remove a small sample of kidney tissue for testing
Treatment will depend on the cause. Some causes do not require treatment. Other causes can be treated with medication. For example, a urinary tract infection is treated with antibiotics.
Surgery may be needed if the urinary tract is blocked.
By treating the underlying condition, the doctor may be able to prevent your child from developing hematuria.
Revision Information
- Reviewer: EBSCO Medical Review BoardKari Kassir, MD
- Review Date: 03/2018 -
- Update Date: 05/05/2014 -