text:
Principal Proposed Uses
Maca is a Peruvian root vegetable used both as food and medicine. It is sometimes called "Peruvian ginseng," not because the plants have any botanical relationship, but because their traditional uses are somewhat similar. Traditionally, maca has been said to increase energy and stamina, and enhance both fertility and sex drive in men and women.
What is Maca Used for Today?
Maca is widely marketed for improving male sexual function , female sexual function , and both male fertility and female fertility . However, at present there is no reliable evidence that it actually provides any benefits at all.
Much of the evidence for maca comes from animal studies. In one study in rats, use of maca enhanced male sexual function. 1 Animal studies have had mixed results regarding male and female fertility. 2-7
There are two published human trials on maca, performed by a single research group.
In one small 12-week, double-blind , placebo-controlled study, use of maca at 1,500 mg or 3,000 mg increased male libido. 8 While this was an interesting finding, the study did not report benefits in male sexual function, just desire. Since loss of sexual function (eg, impotence) is a more common problem in men than loss of sexual desire, these results do not justify the widespread claim that maca has been shown to act like a kind of herbal Viagra.
Another small study found that 4 months of maca use increased sperm count and sperm function. 9 Unfortunately, this study failed to use a control group, and for this reason its results are essentially meaningless. (For more information on why studies must use a control group, see Why Does This Database Rely on Double-blind Studies? )
There are no human trials on maca for female fertility or female sexual function.
Contrary to widespread reporting, maca does not appear to increase testosterone levels, or, in fact, affect any male hormones. 10
Other animal studies hint that maca might offer benefits for prostate enlargement , 11,12stress , 13diabetes , 14 and high blood pressure . 15 However, this evidence is as yet too weak to justify any claims regarding maca and these conditions.
One human trial evaluated a combination of maca and cat's claw for osteoarthritis, but because it failed to include a placebo group, its results mean little. 16
Safety Issues
In the two reported human clinical trials, use of maca has not led to any serious adverse effects. However, this herb has not undergone comprehensive safety testing. Safety in young children, pregnant or nursing women, or people with severe liver or kidney disease has not been established.
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


text:
Call for a free consultation!
My name is Sarah Jones and I am a Certified Professional Midwife with the North American Registry of Midwives and a Licensed Midwife with the State of Texas. I work as a home birth midwife in the Dallas/ Fort Worth as well as at a birthing center in Tarrant county called Grapevine Birthing Center (for those of you who are desiring to deliver their babies at a birthing center). I also have an office in Fort Worth Texas in Fairmont area next to the Hospital district.
As a midwife I am very holistic in my approach to pregnancy and birth. Nutrition and healthy lifestyle are key to having healthy mom and baby. I will walk along side you and your partner to make this a fun and educational transition for both of you.
Please allow me to tell you a little bit about myself and my back round.
I grew up in China as a missionary kid, her parents run an orphanage there. I became a Certified Professional Midwife in August 2006 with the North American Registry of Midwives. Shortly after, I returned to China to practice midwifery to become one of two foreign midwives in Beijing, China.
When I was 19 she attended a friend's birth who had a midwife delivery. From that day on I knew I would spend my life growing close to my clients and their families, welcoming new life into the world and offering support to the families i works with. Becoming a midwife was at the very core of my heart.
I did a year and a half midwifery internship in the Philippines. Working just outside Manila, I received more training than I ever imagined. To support the strong need, We lived at the clinic assisting women with their personal health and delivering babies. It was here that I quickly developed her skills and strong confidence while confronting a wide range of circumstances, many of which were considered very high risk due to malnutrition and poor living conditions. Within my year and a half tenure in the Philippines, I delivered over 160 babies. This experience afforded me the skills and confidence that most programs are unable to offer midwives. I then returned to the United States to take her CPM board examinations and became officially certified with NARM, North American Registry of Midwives.
My husband Drew and I met in China. We got married in Texas in 2008 and now have three beautiful children, two boys and a girl. Our first born, a daughter, was born at home, 8 months later we brought our 15 month old son home from Ethiopia, and a year and a half after that I gave birth to our youngest son at home.
In 2014 I completed my Bachelors in Natural Health through the University of Natural Medicine with an emphasis on Nutrition to better assist my clients throughout their pregnancies and midwifery care.
With over 10 years of midwife experience and having helped over 500 babies come into the world, I have a deep passion for helping families and providing exceptional, personalized care to women. I would love the opportunity to meet you and discuss ways that I can make your pregnancy and delivery a healthy, happy and heartfelt experience.

subset: commoncrawl


text:
The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.
Your doctor may give you a test, such as the Berlin Questionnaire or the Epworth Sleepiness Scale, to gain information about your symptoms. The American Academy of Pediatrics recommends that children are screened for sleep apnea by asking about snoring.
Revision Information
- Reviewer: Marcie L. Sidman, MD
- Review Date: 12/2016 -
- Update Date: 05/20/2015 -


text: Through its imprints Routledge, CRC Press, Psychology Press, and Focal Press, Taylor and Francis are committed to publishing quality books that serve specialist communities. Whether for scholars and researchers, Higher Ed instructors, students, or professionals, our books help define fields of study, nurture curiosity, and give readers the competitive edge. Follow the navigation below to discover books within your interests or use the search field to find specific titles.


text:
Everyday Kitchen Shelves, Breakfast Nook Before and After & New Summer Do
50 comments:
Your Hair is SMOKIN' HOT! Love it! And I too still have Valentines up in my kitchen too! Glad I am not the only one!ReplyDelete
I've had five babies and swallowed waaay too many pre-natal pills to cut my hair!ReplyDelete
Your dining area looks so light and airy now...and I am seriously coveting those birdcage pics! Wonderful job!ReplyDelete
Love the new haircut too! Have a great weekend!
Love the look of your hair Fab!!!Of course I love the short hair look ;)!ReplyDelete
Wow, Shelly, I don't know what looks more amazing, you or that kitchen of yours!!! Seriously, everything looks great. What an amazing Kitchen Before an After. It's amazing what a new coat of paint and lighting can do to a room. I love it!!!ReplyDelete
Have a great weekend!!!
Gorgeous picture of your kitchen nook...but even more gorgeous of YOU...love your hair!!!ReplyDelete
I think that your new 'do is absolutely adorable! When are we going to hang out...I miss my Shelley :)ReplyDelete
Love the new light, love love LOVE your new hair! You look gorgeous!ReplyDelete
Adorable cut! Can I make a suggestion on the shelves? Take on of the pics and put it on the left corner of the top shelf in front of the frame and take the flowers on the bottom shelf and move them up, take the little pots and move them down and leave other picture on bottom but center it. I say all of this in the kindest way, I promise! xoxoReplyDelete
What ... I'm first? Sweet! Love the look of your nook and adore the short, uber blonde! Looks amazing.ReplyDelete
Love your chandy and everyday shelves and your hair (and you!) are too cute!ReplyDelete
Both great changesReplyDelete
I love your hair. The blonder the better. The shelves look good to. I love Tai Pan and Gardner Village. Whenever I'm in Utah visiting family we make it a point to get there.ReplyDelete
Love the decor and that hair cut is fabulous!ReplyDelete
Love the nook but I think I love your new 'do even more! Fabulous!ReplyDelete
SUPER CUTE HAIR!! Ok Shelley I think you need to do a post about the eye shadows and lip stick you wear...You always look soooo Glam!ReplyDelete
Your kitchen nook looks great & your new do is very cute!! LOVE!ReplyDelete
Your hair looks fabulous, as do your shelves!ReplyDelete
I love the shelf and your new "DO" is fantastic!! Happy Summer.ReplyDelete
How's it going with the eyelashes????.. the fact that I even remember this givne all that goes on in my life is a sad sad thing.. but what can I say...ReplyDelete
I love the yellow blossoms! I may have to get some of those. Also, your hair is fabulous!ReplyDelete
that before and after really shows the power of paint...beatiful!! Love the new do too!ReplyDelete
Your hair looks too cute, awesome cut and color! Love your shelves in your kitchen. I forget, did you make them or did you buy them? I have the perfect wall to do the same thing. Love how simple you've decorated them. Simple is good sometimes :)ReplyDelete
Have a great weekend
Lovely work! Your hair is beautiful!ReplyDelete
You look gorgeous! Love your hair!ReplyDelete
Love the hair!!!!ReplyDelete
Oh, you're lookin' like one hot mama! :)ReplyDelete
Everything looks great! Love how light, bright and airy it feels. Your hair looks adorable, too!ReplyDelete
Girl, you look gorgeous. LOVE the new do. And the kitchen. As always. :)ReplyDelete
I LOVE the white pitchers, nice deal and super cute! Man I love that store! As for the hair...I'm SO hatin' you right now! You ALWAYS have the cutest hair. Happy Friday to you too:)ReplyDelete
Jennie {Cinnaberry Suite}
please tell me where you got the shelves??! I have been looking everywhere for some like that. KristenReplyDelete
LOVIN' your new do! And your new shelf decor!ReplyDelete
You're a hot mama Shelly!! and your decor is fabulous, as always:) Happy Summer!!ReplyDelete
Your haircut is gorgeous! I love it a bunch!!ReplyDelete
Your hair looks great! I love the cut. If I go short I'll gonna have to take your picture to the hair stylist with me! The dining room looks so fresh and clean!ReplyDelete
Okay, so I didn't think the before pictures were too bad, but the after pictures are so calming and clean and beautiful. I love the colors!ReplyDelete
PS the hair looks great!
WOW! What a before and after!! I LOVE the pitchers too! AND your hair cut!!! FABULOUS!!! You look GORGEOUS MAMMA! :)ReplyDelete
Love your blog, just found you via Pinterest. I was wondering which of the colours on your paint chart is the kitchen/dining area painted in the blue or the upward grey shade?ReplyDelete
so did you just get those pitchers? I've been looking for some exactly like that and i live RIGHT NEXT to Tai Pan!ReplyDelete
Perfect do for summer! You have such a pretty face and great smile, I think you could rock anything!ReplyDelete
First of all, LOVe the light I saw that this weekend at Lowes and loved it. It looks AMAZING in your space. I love the before and after. You are so talented. Lastly, the new 'do' is adorable...just like you! :)ReplyDelete
I love the simplicity of the area, it looks clean and fresh.ReplyDelete
Please oh please...could Miss Mindy send me step-by-step instructions for a getting such a fabulous shade of blonde? I need to take those instructions to the salon!ReplyDelete
You look fabulous!
*sigh of relief* Thanks for admitting that I'm not the only one who leaves holiday decorations up way too long! lol! Your hair looks AMAZING! You are gorgeous!ReplyDelete
Love the new hair - you're so gorgeous!! And I love the new nook! I did a similar take using a white pitcher and yellow flowers too. And I'm not sure if you remember me asking about that font you use a lot... but that is what I wanted it for... my "bloom"! See my post here http://racksandmooby.blogspot.com/2011/04/another-take-2.html :)ReplyDelete
Hey there!! I know I'm a little late to the party, but if you see this, can you let me know about the moss wreath? I'm thinking you probably made it and I'd love to know how!!ReplyDelete
Love your house and love the blog!!
I love your dinning room. What is the name of the blue paint? I am having a hard time picking a blue that I like.ReplyDelete
L♥VE ...... where did you get your rug under your kitchen table?ReplyDelete
THANKS a bunch
Just came across this post via Pinterest. Where are the dining room chairs from? ThanksReplyDelete
Man, what a great improvement! I love the bright, fresh feel of the new wall color.ReplyDelete
Thank you for taking the time to leave your thoughts and comments. We truly love and appreciate each one!


text:
Raise your hand if you span haven't made no-knead bread yet. Yep, that's what I thought—I'm the only one in the world who spanhasn't/span baked this miracle of yeast, flour and water. Heck, my mom, the person who taught me how to knead at a very young age, even span style="font-style: italic;"she/span now bakes it. That's my loss, I suppose, because having had the pleasure of eating it I do find it quite delicious. But Sunday I wanted a loaf of fresh-from-the-oven bread and just couldn't wait overnight for the dough to work its magic: this meant I'd have to bake bread the old-fashioned way—by kneading.
I grew up with homemade bread and mom always had a jar filled with sourdough starter living the in the fridge. Though she didn't just make sourdough bread—she also made cinnamon-raisin bread, dark whole-wheat bread, dinner rolls, saffron rolls, hot-cross buns, and a multitude of other baked goods that involved yeast, kneading and patience. When I was young I hated being the only kid with a sandwich on homemade bread, but over time I grew to love that toasty, yeasty smell that filled the house as a loaf baked, and the way butter just tasted better on a soft slice of bread straight out of the oven.
When I graduated from college and realized I'd have to cook for myself otherwise I'd go broke, bread baking became one of my passions. The first loaf I ever baked was a French baguette from span style="font-style: italic;"The Joy of Cooking/span. It wasn't very crispy and the crumb was a bit dense but it didn't matter, I was hooked. I started spending my weekends experimenting with all sorts of different breads—one in particular that was a big hit with my friends was an olive-rosemary recipe I found in span The New Basics Cookbook.
Now that I'm older, I don't bake bread as often as I'd like—but last Sunday was a lazy day perfect for reading and waiting as my bread dough rose. Laurie Colwin has an amusing chapter about bread baking called "Bread Baking Without Agony" in her book span style="font-style: italic;"Home Cooking/span. As she recounts the first time she baked bread with a friend, she expresses frustration with all the time involved for just one loaf. She writes: "The result was a perfectly nice loaf of bread, but after spending an entire day in its service, I expected something a little more heroic." She has a point—there is a lot of downtime when baking bread, but on certain days I don't mind being abiding as the yeast does it work. I find it peaceful that so much is happening without my exerting too much energy—save for the mixing and the kneading.
I guess that's been my reluctance toward no-knead bread: I like to knead. Bread baking can be so non-eventful that if I didn't knead, I probably wouldn't feel like I'd contributed much to the process. Not to mention the excellent upper-body workout kneading gives you.
Jalapenos are at their peak right now and after picking up a whole mess of them at the farmers' market, I was searching for ways to use them beyond salsa. I then remembered a delectable bread that can be found at Goode Co. Barbecue in Houston, Texas. Most barbecue places in the state will serve you a standard couple of slices of Mrs. Baird's white bread with your pile of smoked meat. This malleable bread is excellent for wrapping around a hot link or two to form an impromptu sandwich. But Goode Co. takes its bread to a whole new level—they make theirs in-house and it's laced with jalapenos and cheese. Barbecue purists may sniff at Goode Co.'s offering; they might say it's just too fancy-pants for real barbecue. Perhaps. But it sure is tasty.
After looking through the Houston Chronicle archives, I found a recipe for this bread that had been written by none other than Sheila Lukins, author of The New Basics Cookbook, home of that olive-rosemary loaf that made me so popular at dinner parties back in the day. I read through her recipe and while it looked good enough, I made some adjustments.
Where she called for a quarter cup of sliced jalapenos, I used a whole cup. Where she recommended white cheddar cheese, I used Longhorn. And I did some other fiddling, such as using buttermilk instead of regular milk, adjusting the flour quantities and skipping some of her overly detailed directions. I was a little worried that the recipe might not turn out OK, but it actually exceeded my expectations—this was a moist, spicy and cheesy loaf—the only things missing were some hot links and brisket.
Now that I can turn on my oven without stripping down to my skivvies, I'll be baking bread more often. And since I'm back in bread-making mode, I reckon I'll finally try no-knead bread as well. But for now, I'm happy with this jalapeno-cheese loaf, my first bread of the season.
Jalapeño cheese bread
- 1 packet yeast (2 1/4 teaspoons)
- 1/4 cup warm water
- 4 tablespoons unsalted butter, melted
- 1 large egg
- 2 1/2 cups bread or all-purpose flour, plus more if needed
- 1 cup semolina flour
- 5 jalapenos, seeded and diced
- 2 cups (8 ounces) sharp cheddar cheese, grated
- 1 cup buttermilk
- 1 teaspoon sugar
- 1 teaspoon kosher salt
- Mix together the yeast and water. Mix together the melted butter, egg and buttermilk and add to yeast and water. Add the salt, sugar and bread flour to the liquids and mix well. Then add the semolina flour to the dough and mix well. If the dough is too wet, gradually add more bread flour 1/4 cup at a time.
- Place dough on a floured surface and knead for five to ten minutes until dough is smooth. Form dough into a ball and place into a bowl greased with butter. Cover the bowl, and let rise in a warm place until doubled in size—about an hour.
- Turn out dough on a floured surface, and slowly knead into the dough the jalapenos and cheese, a little bit at a time. When cheese and jalapenos are incorporated into the dough, place dough into a greased bread loaf pan. You can also sprinkle semolina in the bread pan for additional friction.
- Cover the pan and let dough rise until doubled in size (it should be at the top or a bit over the top of the pan)—about an hour. Preheat oven to 350 °F. Bake the bread for 40-45 minutes on a center rack (when you thump the top and it sounds hollow, the bread is done).
- Let cool for 10 minutes, and then slide it out of the pan, slice and enjoy!
Recipe Notes
If you can't find semolina flour, you can substitute bread or all-purpose flour and the recipe will be fine.


text:
A hemangioma is a type of birthmark. It develops shortly after birth, usually on the head or neck. It may be close to the surface of the skin or deeper below the skin.
For most, a hemangioma will grow quickly and then slowly disappear over time. It is often gone before puberty. If your child develops a birthmark that grows, talk to a doctor.
A hemangioma is a cluster of blood vessels that do not form properly. It is not known what cause hemangiomas. It is also unclear what makes them grow or disappear.
Risk Factors
Hemangiomas are more common in Caucasian baby girls. Other factors that may increase a baby's chances of a hemangioma:
- Premature birth
- PHACE syndrome
Symptoms will depend on the location of the hemangioma:
A hemangioma that is close to the surface of the skin:
- Appears as red strawberry-like or purple bump on the skin
- May continue to grow and spread
- A hemangioma that is deeper under the skin will appear as bluish swelling under the skin
Most hemangiomas have no further symptoms. However, some large hemangiomas may lead to:
- Ulceration—deep sores in the skin
- Scarring
- Disfigurement
- Problems with growth and function of structures nearby, such as the eyes or airway
- Abnormalities of the blood vessels of the eye or brain (associated with some hemangiomas of the face)
- Hemangiomas in other locations can be associated with heart, kidney, gastrointestinal, brain, or spinal abnormalities
You will be asked about your child's symptoms and medical history. A physical exam will be done. Some hemangiomas are obvious with physical exam. If there is any question, your doctor may recommend testing. Tests may also be done to determine the size and effect on nearby organs.
Imaging tests can evaluate the hemangioma and surrounding structures. These may include:
Most hemangiomas will resolve on their own and do not require any treatment. The mark will significantly fade by age 5 and nearly disappear by puberty. Your doctor may only recommend monitoring during the growth period.
If the hemangioma is causing problems, one or more of the following treatments may be advised:
- Dressings to help prevent infections in ulcerated areas of the skin and to control oozing
Medications may include:
- Acetaminophen for pain relief
- Beta-blockers, steroids, or vincristine (rarely) to help shrink the hemangioma
- Topical ointments to help with wound healing and pain relief
- Antibiotics may speed healing with or without the presence of a bacterial infection
- Surgery—particularly for hemangiomas that are causing pain, or problems with sight or breathing
- Lasers—most effective on superficial hemangiomas
If ulcers have developed, more aggressive treatment may be needed. It may require a combination of treatments above.
Revision Information
- Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
- Review Date: 11/2018 -
- Update Date: 12/20/2014 -


text:
Compare prices for hostels in Blarney with one click. Add your travel dates and see all prices on all hostel booking sites like Hostelworld, Hostelsclub and Booking.com.
Now, that is a bummer. At the moment we do not have any super cool information on things to do in Blarney. We guess this means we have to travel once again to [city]. We are working on it!
So far no one of the community left a comment and travel tips for Blarney. How about you kick off that list here? Just leave your best backpacking recommendations for Blarney below:


text:
Making a commitment to increase your activity level is a great start, but it's not always enough. Lots of things can stand in our way. We have work, family and community obligations.
"Well, you know, that's a lot of reasons a lot of people use -- that they don't have time. I owe myself one hour a day. I can give my body one hour a day, I'm happy."
Gym memberships cost money. So does home exercise equipment, and exercise clothing. Some people shy away from physical activity because they've had an injury, or they're afraid they might get hurt.
"My knees. I've had knee surgery on both knees when I was bigger. And they get to hurting once in awhile."
Your emotions may be an obstacle. It can be hard to start a program, or hit the treadmill after a hard days work.
"You know, some people might stop their exercise program because they think there is only one way to do it -- in the gym, running on the track -- and they hate that."
Once you've figured out what your obstacles are, you can work on ways to get around them.
"There's a lot of way to get physical activity nowadays without going into the gym. There are tracks at a lot of the local schools. There are public parks with great trails and bicycle trails everywhere."
"You know, I joined a health club, there just wasn't time to get there. I decided to try personal training. And I said, 'Well, this is someone who is going to work on my time schedule when it's best for me.'"
Support doesn't have to be a physical trainer. It could be a family member, friend, or co-worker.
"Yeah, I have a very good support family system. My sister and I make ourselves wake up early in the morning and we walk at least one hour or more, three times a week."
And when you run into setbacks, don't beat yourself up. Everyone gets off track sometimes.
"Everyday is not going to be a good day. It's okay to miss a day. It's okay to be tired. Maybe Friday's not going to work out this time, and it's okay to make it up on Saturday, maybe on Monday, and start fresh."
"Well, in the past it was really easy to have a setback and just say, 'Forget it. I'm not doing it.' But I think as you get older, mortality starts to really matter. And I realize that without my health, I have nothing."
Animation Copyright © Milner-Fenwick


text:
A sentinel lymph node biopsy is the removal and testing of specific lymph node tissue called sentinel nodes. The sentinel nodes are the lymph nodes to which cancer would spread first.
Reasons for Procedure
This biopsy is done to determine if cancer cells have spread from the tumor to nearby lymph nodes. Cancer often spreads from the tumor to the nearest lymph node or nodes. These lymph nodes are called the sentinel nodes. It is important to understand that the sentinel node will probably be the first one to get cancer if the cancer has spread. For example, the sentinel nodes in breast cancer are often found in the armpit.
This biopsy is often done during cancer-removal surgery or prior to surgery. Sentinel node biopsy is part of the staging process. Staging is an attempt to determine how much the cancer has spread away from the original tumor. The cancerous tissue may have been biopsied already.
Possible Complications
Complications are rare. But no procedure is completely free of risk. If you are planning to have this biopsy, your doctor will review a list of possible complications. These may include:
- Infection
- Bleeding or bruising
- Scarring
- Nerve damage and chronic pain
- Allergy to dye
If the lymph nodes are removed, there is an increased risk of the following:
- Delayed wound healing
- Additional pain
- Lymphedema —a condition in which fluids collect under the skin causing swelling
Some factors that may increase the risk of complications include:
- Obesity
- Recent or long-term illness
- Smoking
- Poor nutrition
- Use of certain medications
- Bleeding disorders
What to Expect
Prior to Procedure
Your doctor will do a physical exam. Tests may include the following:
- Blood tests
- Urine tests
- Imaging studies may be done to look for cancer spread or the location of the sentinel nodes and may include:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
Prior to the procedure, you should also:
- Eat a light meal the night before. Do not eat or drink anything after midnight.
- Arrange for a ride to and from the hospital.
Depending on the location of the lymph node, you may be given one of the following:
- General anesthesia —You will be asleep during the procedure.
- Local anesthesia—The area will be numb.
- Regional anesthesia—An area of your body will be numb.
Description of the Procedure
A blue dye, and often a radioactive tracer, will be injected into an area near the tumor. It may be done several hours before surgery. The dye and tracer will travel from the tumor area to the sentinel nodes. This will also help identify which nodes are the sentinel lymph nodes. A small incision will be made. The sentinel node(s) will be removed. The removed node will be checked for cancer cells. If cancer is found, the rest of the lymph nodes in that area will be removed.
If cancer is not seen in the sentinel node, it is unlikely that the cancer has spread to the other remaining lymph nodes. The other lymph nodes are not removed.
How Long Will It Take?
The biopsy takes about 30-60 minutes. Surgery to remove the entire cancer takes longer.
Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Post-procedure Care
The result of the sentinel lymph node biopsy determines if additional lymph nodes need to be removed. It can also help determine the severity of your cancer.
Call Your Doctor
Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Redness, warmth, swelling, stiffness, or hardness in the extremity
- Dark or swollen fingers and toes
- Persistent nausea and/or vomiting
- Pain that you cannot control with the medications you were given
- Cough, shortness of breath, or chest pain
- New or unexpected symptoms
If you think you have an emergency, call for emergency medical services right away.
Revision Information
- Reviewer: EBSCO Medical Review Board James Cornell, MD
- Review Date: 11/2018 -
- Update Date: 12/20/2014 -


text:
Event Information
Date and Time
Refund Policy
Refunds up to 7 days before event
Eventbrite's fee is nonrefundable.
Whether you are persuading colleagues, selling a client or energizing a team, the power of your presentation skills makes the difference between success and failure.
The experience in this presentation skills training seminar is as close as you can get to having a personal, public speaking training coach. You present at least seven times over the course of two days. Your presentations are videotaped and evaluated. And you get expert one-on-one coaching at the end of each presentation. The presentation skills workshop are kept small and are in a supportive environment to allow for maximum engagement and learning. After taking this presentation skills course, you will be able to notice gains in effectively communicating your ideas, enhance personal and corporate image, and ultimately increase sales for your business.
Join Dale Carnegie Training for this interactive presentation skills training workshop today!
Date and Time
Dale Carnegie Training Northern New Jersey
1140 Bloomfield Avenue
West Caldwell, NJ 07006
Refund Policy
Refunds up to 7 days before event
Eventbrite's fee is nonrefundable.


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Drivers experience dramatic first Daytona 500 practice with Gen-6 car
DAYTONA BEACH, Fla. (AP) -- It took all of 15 minutes for NASCAR's new Gen-6 race car to throw drivers a few curves of its own at the first practice for the Daytona 500.
Ryan Newman lost control of his Chevrolet right in front of Carl Edwards and Mark Martin, and all three cars sustained damage. It's the third time in a week that a wreck has collected Martin, who also suffered damaged cars in a crash started by Matt Kenseth last week and another triggered by Tony Stewart in Saturday night's exhibition race.
Newman had no idea what caused him to spin.
"My car came around, I don't know if it was the air off of Carl's car or what," he said. "Carl came over and said `Hey man.' I said, `I don't even know what to tell you yet."'
The accident happened as drivers are still adjusting to the new car, a process that has been bumpy so far. Dale Earnhardt Jr. triggered a multi-car accident in January testing, Kenseth started an accident last Friday and the wreck in the exhibition race cut the 19-car field to 12.
Edwards was just as vexed as Newman.
"I was up close to Ryan and then all of a sudden his car just got a little loose and there was no space," Edwards said. "I could have given him more space, but I don't think either one of us really understands why his car got so loose. It was just all of a sudden and he was turned sideways. It's really interesting and something I'm going to be careful of during the race."
Edwards said he believes the finicky cars could contribute to an entertaining season-opening Daytona 500 on Sunday.
"Race cars are supposed to be hard to drive, it's supposed to be on the edge, you are supposed to be sliding around," Edwards said. "We as drivers, it is our responsibility to learn how to drive them. If this (warm) weather stays like this, and we can run cars sideways down the corner and give each other a little bit of room, it's going to be an awesome 500."
Meanwhile, Earnhardt and defending Sprint Cup champion Brad Keselowski also had issues in the first practice session, which was paced by two-time Daytona 500 winner Michael Waltrip. Earnhardt blew an engine, and Keselowski had a fuel system problem that limited his track time.
"Something went wrong with the fuel system in the car," Keselowski said. "That's not what you want when you're in front of the pack because when your car slows down, they've got nowhere to go and it could cause a wreck. So we're going to spend a little extra time to make sure we've got whatever it is figured out."
Earnhardt had to wait for an engine change, which will send him to the back of the field for Thursday's qualifying race.
"I'm sure there is some logical explanation as to what happened, but, we'll just put a new one in and start at the back of the qualifier and race up through there," Earnhardt said.
Waltrip was fastest in the first practice, turning a lap at 198.347 mph. Kasey Kahne led the less-eventful second practice - only 27 of 45 drivers practiced - with a lap at 197.737 mph.
It was Danica Patrick who impressed in the second session. She was fourth on the speed chart, but her 10-lap average of 195.775 mph led all drivers. Patrick last Sunday was fastest in qualifying and became the first woman to win a pole in NASCAR's top Sprint Cup Series.


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Other Proposed Natural Treatments
Herbs and Supplements to Use Only With Caution
Hepatitis is an infection of the liver caused by one of several viruses, the most common of which are named hepatitis A, B, and C. Hepatitis A is spread mainly through contaminated food and water, whereas hepatitis B is transmitted by sexual contact and use of contaminated needles. The route of transmission of hepatitis C is not completely clear but is believed to be similar to that of hepatitis B.
When you first develop hepatitis, it is called acute hepatitis. Hepatitis can also become a long-term disease known as chronic hepatitis. All forms of hepatitis cause jaundice, liver tenderness, and severe fatigue. Hepatitis A is the mildest form and seldom causes symptoms continuing longer than a couple of months. Hepatitis B and C produce more severe symptoms, which last two or three times longer, and can go on to become chronic.
Chronic hepatitis consists of persistent liver infection and inflammation that lingers long after the primary symptoms of the disease have disappeared. It can produce subtle symptoms of liver tenderness and continued fatigue and over time can gradually destroy the liver. Chronic hepatitis also appears to increase the risk of liver cancer.
The best treatment for hepatitis is prevention. You can avoid hepatitis A by practicing good hygiene and using the conventional preventive treatment, known as immune globulins, while traveling in areas where the disease is common. Hepatitis B can be prevented by immunization and the same precautions taken against HIV infection. HIV precautions almost certainly decrease the transmission of hepatitis C as well.
Conventional medicine has little in the way of treatment for the initial hepatitis infection once it has started. Treatment for chronic hepatitis is developing but is still quite imperfect. The most effective methods involve varieties of interferon.
Proposed Natural Treatments for Viral Hepatitis
Traditional Chinese Herbal Medicine
Viral hepatitis has long been a serious problem in China and other parts of Asia, and for this reason many herbal formulas to treat it have been devised. The traditional Chinese herbal combination Shosaiko-to (Minor Bupleurum) has been approved as a treatment for chronic hepatitis by the Japanese Health Ministry. 37 However, a search of the literature uncovered only one large-scale, double-blind, placebo-controlled study supporting its effectiveness. 38 In this 24-week trial, the efficacy of Shosaiko-to was tested in 222 people with chronic active hepatitis using a double-blind, placebo-controlled, crossover design. Results showed that use of Shosaiko-to significantly improved liver function measurements compared to placebo. Although these results are promising, an absence of long-term evaluation limits their meaningfulness. (Researchers only followed participants for 3 months.)
Other combination Chinese herbal therapies have also shown a bit of promise for the treatment of chronic hepatitis, including those named Bing Gan Tang, Yi Zhu decoction, Fuzheng Jiedu Tang, and Jianpi Wenshen recipe. 40-42 However, the quality of most of these studies was again quite poor. In a review of 10 randomized trials involving 517 people with chronic hepatitis C, researchers found that some herbs, like milk thistle , Bing Gan Tang, Yi Zhu decoction, and Yi Er Gan Tang, were associated with an improvement in lab results suggesting improved liver functioning. 71 However, they ultimately concluded that there is not enough evidence to support the use of herbal medicine as a treatment for hepatitis C.
A well-designed, double-blind, placebo-controlled study evaluated a mixture of traditional Chinese herbs for people with hepatitis C and symptoms of fatigue. 55 The tested mixture contained: Radix astragali (6%), Radix acanthopanax (8%), Radix bupleuir (8%), Radix et tuber curcumae (10%), Rhizoma polygonum (10%), Radix glycyrrhiza (4%), Radix isatis (14%), Radix paeoniae rubra (14%), Radix salviae (14%), and Herba taraxaci (12%). However, it failed to prove more effective than placebo regarding symptoms or objective signs. Another complex Chinese herbal combination has also failed to prove effective. 60
One Chinese herb widely advocated for chronic hepatitis B, Sophorae flavescentis , has not yet been shown effective, according to a comprehensive review of studies. 56
In support of Chinese herbal therapy, researchers reviewing 26 randomized controlled trials concluded that the combination of Chinese herbs with interferon (a standard medication used to treat chronic viral hepatitis) resulted in better treatment response, fewer cases of relapse, fewer adverse events, and improved lab results compared to interferon alone. 72
Note : There are many incidents in which use of Chinese herbs for treatment of hepatitis appears to have caused serious liver injury. 43,64 For this reason, we do not recommend using Chinese herbs for hepatitis, except under the supervision of a physician.
For more information, see the article on Traditional Chinese Herbal Medicine .
Ayurvedic Medicine
Ayurvedic medicine, the ancient medical system of India, has many traditional treatments for hepatitis. Some of these have undergone scientific evaluation. One such is a combination treatment called Kamalahar, which contains Tecoma undulata, Phyllanthus urinaria , Embelia ribes, Taraxacum officinale , Nyctanthes arbortristis, and Terminalia arjuna . In a double-blind, placebo-controlled study, 52 people with acute hepatitis were randomly assigned to receive placebo or this combination herbal therapy at a dose of 500 mg, 3 times daily for 15 days. The results indicate that the herbal combination improved liver function to a significantly greater extent than placebo. 44
Another combination therapy contains Capparis spinosa, Cichorium intybus, Solanum nigrum, Terminalia arjuna, Cassia occidentalis, Achillea millefolium , and Tamarix gallica . In a poorly reported, 5-week, double-blind, placebo-controlled study of 30 children with hepatitis A, use of this combination formula apparently improved the rate of recovery as compared to placebo. 45 Benefits were also seen in a 6-week study of 34 people with acute hepatitis. 46 A third double-blind, placebo-controlled study evaluated the effectiveness of this combination in the treatment of a variety of liver conditions, including chronic and acute hepatitis, and found some evidence of benefit. 47
Single herbs have been tried as well. In a double-blind trial of 33 people with acute viral hepatitis, use of the herb Picrorhiza kurroa at a dose of 375 mg three times daily significantly speeded recovery time as compared to placebo. 48
The herb Phyllanthus amarus has also been extensively studied as a treatment for chronic viral hepatitis, but it does not appear to be effective. 27-36 Its close relative Phyllanthus urinaris has also failed to prove effective. 57 Indeed, a review of 16 randomized trials including 1,326 patients concluded that there is not enough evidence to support the use of the Phyllanthus species for treating hepatitis B. 74
Note that at the present, the quality of the reported studies remains poor, and Ayurvedic herbs cannot be regarded as a proven treatment for viral hepatitis. For more information, see the Ayurveda article.
Other Herbs and Supplements
The herb milk thistle has been proposed as a supportive treatment for viral hepatitis. However, study results are mixed, regarding both chronic 1-3,59,63,70 and acute 4,5 viral hepatitis. A 2007 review of all published and unpublished studies on milk thistle as a treatment for liver disease concluded that benefits were seen only in low-quality trials, and, even in those, milk thistle did not show more than a slight benefit. 66 A subsequent 2008 review of 19 randomized trials failed to find any evidence of a favorable effect on viral hepatitis. 67 Since then, however, a randomized trial involving 105 people with acute hepatitis found that those who received milk thistle (140 mg, 3 times daily) for 4 weeks experienced an improvement in symptoms (eg, jaundice, dark urine, discomfort) compared to the placebo group. 70 Researchers did not find any changes in the lab findings, though.
Chronic hepatitis can cause cholestasis (backup of bile in the liver). In a 2-week, double-blind study of 220 individuals with cholestasis, use of the supplement SAMe at a dose of 1,600 mg daily significantly improved liver-related symptoms as compared to placebo. 49 Most participants in this study had chronic viral hepatitis.
The supplement phosphatidylcholine has shown some promise for hepatitis. In one double-blind study, it enhanced the effect of interferon in people with chronic hepatitis C, but not in those with chronic hepatitis B. 50 However, in an open study phosphatidylcholine failed to produce improvements in individuals with acute hepatitis. 51
One small, double-blind study found the herb picrorhiza more effective than placebo for reducing signs of liver damage in people with acute viral hepatitis . 65 However, this study was highly preliminary and suffered from numerous flaws.
One study failed to find N-acetylcysteine at a dose of 600 mg daily helpful for acute viral hepatitis. 58
In Japan, an injectable combination of licorice (the herb, not the candy) and certain amino acids is used for chronic hepatitis. 20 However, it is not clear whether the treatment actually works. 62 Even if this were established, the results would not imply that oral licorice would have a similar effect; furthermore, the high dosages used for treatment of chronic hepatitis may cause an elevation of blood pressure and other serious medical problems. Warning: Do not inject preparations of licorice designed for oral use.
Thymus extract has been tried as a treatment for hepatitis B and C. However, the results of small double-blind trials have not been positive. 23-26
Antioxidant supplements have also failed to produce benefit. 61,69 A review of 20 randomized trials involving 1,225 people with liver disease (including viral hepatitis) found that antioxidants ( beta-carotene , vitamins A , C , E , and selenium ) were not linked to a reduced risk of death. 69
Vitamin E has also been studied on its own as a possible treatment for chronic hepatitis B. Two small randomized trials found that vitamin E at a dose of 300 mg twice daily improved lab results, indicating that the liver was functioning better. 68
Other common natural medicine recommendations for hepatitis include astragalus , cordyceps , reishi , schisandra , taurine , vitamin C , and whey protein . However, there is as yet no meaningful scientific evidence that these approaches really work.
Herbs and Supplements to Use Only With Caution
Many natural products have the capacity to harm the liver. Furthermore, due to the generally inadequate regulation of dietary supplements that exists at the time of this writing, there are real risks that herbal products, at least, may contain liver-toxic contaminants even if the actual herbs listed on the label are safe. For this reason, we recommend that people with liver disease do not use any medicinal herbs except under the supervision of a physician. Here, we list some specific information to aid in your decision-making process.
All forms of vitamin B 3 may damage the liver when taken in high doses, including niacin, niacinamide (nicotinamide), and inositol hexaniacinate. (Nutritional supplementation at the standard daily requirement level should not cause a problem.)
A great many herbs and supplements have known or suspected liver-toxic properties, including but not limited to: barberry , borage, chaparral , coltsfoot , comfrey , germander , germanium (a mineral), greater celandine , kava , kombucha , mistletoe , pennyroyal , pokeroot , sassafras , and various herbs and minerals used in traditional Chinese herbal medicine .
In addition, herbs that are not liver-toxic in themselves are sometimes adulterated with other herbs of similar appearance that are accidentally harvested in a misapprehension of their identity (for example, germander found in skullcap products). Furthermore, blue-green algae species such as spirulina may at times be contaminated with liver-toxic substances called microcystins, for which no highest safe level is known.
Some articles claim that the herb echinacea is potentially liver-toxic, but this concern appears to have been based on a misunderstanding of its constituents. Echinacea contains substances in the pyrrolizidine alkaloid family. However, while many pyrrolizidine alkaloids are liver-toxic, those found in echinacea are not believed to have that property.
Whole valerian contains liver-toxic substances called valepotriates; however, valepotriates are thought to be absent from most commercial valerian products, 52 and case reports suggest that even very high doses of valerian do not harm the liver. 53-54
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


text: Great protection and smart features! 4 I received this case as a gift for Christmas, in blue, and I've really grown to like it. At first it seemed a little bulky and thick, but after using it for a couple of weeks, I find that the small bit of added width does a great job providing protection and functionality, without really being all that bulky or heavy. Pros: 1. The multiple stand angles (four, although only three really feel solid) are great. I haven't found any situation where one of the three cover "groove angles" didn't provide an excellent viewing angle or work surface. 2. The case material is surprisingly pleasant. It has a plastic-y, fake leather kind of texture that makes it really easy to hold, without any slipping. Because it seems to be plastic, it's really easy to clean. 3. The case provides full protection of the iPad with just small portions of the top and bottom open, for port and microphone and headphone access. The iPad mounts in the case with a hard plastic bracket that fits the iPad extremely well and holds it perfectly. (Minor) Cons: 1. The magnets in the cover are very strong, to the point that shifting or moving the cover when its rolled around to the back of the tablet can turn off your iPad while it's in use. This doesn't happen very often and is easy to avoid just by being careful, but it can be startling to have your iPad just turn off while you're typing an email or browsing for something. 2. The design of the case uses a large strap to pivot the cover around the iPad, for either using it with the cover's built-in grooves or for folding it behind the iPad. It can be a little "floppy" if you're not used to it. 3. I really wish the cover would sit flat on the iPad. There is a seam about 1/3rd of the way "into" the cover that allows for an extra stand angle that has a very slight buckle when it's put over the iPad screen. It's very minor and doesn't seem to cause any issues with the smart power functions of the iPad, but it's one of those minor annoyances that I keep seeing when I'm not using the iPad. The bottom line is that I really like this case. The cons I've listed are all very minor and don't affect my overall satisfaction with it. If you're looking for something that provides good protection and thoughtful features, The Case Logic Folio is a great option, well worth checking out. Robb N. Denver, CO 2013-01-07


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September 24th, 2013
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- Aloe
- Astragalus
- Bacailin
- Boxwood Extract
- Curcumin
- Elderberry
- Propolis
- Reishi
- Schisandra
- Spirulina
Note : None of these treatments has been proven effective as yet for the uses cited above.
Human immunodeficiency virus (HIV) is the virus responsible for AIDS (acquired immunodeficiency syndrome). This virus progressively destroys or damages cells in the immune system, making its host vulnerable to certain cancers and infections. Opportunistic infections—caused by microorganisms that do not ordinarily cause illness in healthy people—can have serious or even fatal effects in people with AIDS.
Within a month or two of exposure, infection with HIV may cause short-term flu-like symptoms, followed by a symptom-free period lasting months to years during which the virus continues to multiply. After this stage, people with HIV may develop swollen lymph nodes, recurrent herpes sores, diarrhea, weight loss, and/or chronic yeast infections (oral or vaginal)—a state previously called AIDS-related complex (or ARC). Children may experience delayed development or fail to thrive. The infection is called AIDS when the number of immune cells known as CD4+, or helper T-cells, drops below a certain level, or when opportunistic diseases such as Pneumocystis carinii pneumonia develop. Today, both ARC and AIDS are collectively called symptomatic HIV infection. This condition is increasingly rare in the developed world due to the success of pharmaceutical treatments, and, for many people, HIV infection is a manageable, if challenging, chronic illness.
HIV is spread most commonly through unsafe sexual practices or by intravenous drug abuse. Mothers can infect their babies before or during birth, or later through breastfeeding.
The most effective treatment for HIV is called HAART, or highly active antiretroviral therapy. This approach generally involves the combined use of three or more drugs, taken from various families of antiretroviral drugs, including non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), fusion inhibitors, and protease inhibitors. Taken together, these medications can prevent the development of AIDS indefinitely. HAART, however, causes numerous side effects. Surveys have shown that people with HIV often take natural remedies in addition to conventional medications, in hopes of reducing side effects and enhancing efficacy. If you have HIV, it is particularly important to talk with your doctors about any natural substances you're taking and to be alert to possible interactions. Most importantly, people with HIV should not use St. John's wort or garlic . Even vitamin C may pose risks. (See Natural Treatments to Avoid below.)
Proposed Natural Treatments for HIV
Among the many proposed natural treatments for HIV, none has more than preliminary supporting evidence.
Inhibiting Viral Replication
No natural remedies rival the effectiveness of antiretroviral drugs for inhibiting HIV replication in the body. However, preliminary research suggests that an extract of the leaves and stems of the boxwood shrub may have at least some efficacy. 1 Many other herbs and supplements have been proposed as well, but there is little evidence as yet that they work.
In a double-blind, placebo-controlled study of 145 people with HIV, French researchers studied the effects of two doses of a preparation made from the evergreen boxwood ( Buxus sempervirens ). 2 The preparation was given in doses of 990 mg and 1,980 mg per day for periods ranging from 4 to 64 weeks.
When participants started the study, they had no symptoms of HIV and had never taken antiretroviral drugs. They were kept off anti-HIV drugs during the study. (This was before the use of anti-HIV drugs became widespread.) At the end, researchers found that among those taking the lower dose, fewer people developed AIDS, symptomatic HIV, or CD4+ counts below 200 compared with those taking the higher dose or placebo. Additionally, by the end of their treatment period, fewer people in the low-dose group had a large increase in the amount of HIV virus they carried compared to the other two groups.
The researchers had originally planned the study to continue for 18 months (78 weeks). However, as the study progressed, a review committee decided to halt the study early when the average participant had taken boxwood or placebo for only 37 weeks. The review committee felt it was unethical to continue to have some people take placebo, given the positive results among those taking the extract. Nonetheless, further research is necessary to confirm the effectiveness of boxwood extract for HIV, particularly in combination with proven antiviral drugs, which have now become the standard of care for HIV infection.
No severe side effects were reported in this study, and the people taking boxwood had the same overall rate of side effects as those taking placebo. 3
However, there are some safety concerns with this herb. A substance called cycloprotobuxine is believed to be one of the active ingredients in boxwood. 4 High doses of this substance can cause vomiting, diarrhea, muscular spasms, and paralysis. Warning : For this reason, the herb should only be taken under medical supervision! Safety in pregnant or nursing women, young children, or people with liver or kidney disease has not been established. In addition, touching fresh boxwood leaves can occasionally cause skin irritation. 5
Note : Only a special boxwood extract has been studied as a treatment for HIV infection. Do not try to use raw boxwood leaf, as it might not be safe.
One of the constituents of the herb aloe , acemannan, has shown some promise in test tube and animal studies for stimulating immunity and inhibiting the growth of viruses, including the HIV. 107-109 These findings have led to trials of acemannan (or whole aloe) for the treatment of HIV infection. However, a double-blind, placebo-controlled trial of acemannan failed to find any benefits for people with severe HIV infection. 111 (Interestingly, there is some question whether the effects seen in these studies were actually due to acemannan itself or a contaminant called aloeride. 110 )
Other substances that have been investigated for possible HIV suppression include bacailin (Chinese skullcap), curcumin , elderberry , schisandra , spirulina , and reishi . However, as with aloe, the evidence that they work is primarily limited to test tube and animal studies; whether these results translate into real improvement among people with HIV has yet to be determined.
The herb St. John's wort contains a substance called hypericin which has been investigated for possible anti-HIV effects. However, contrary to popular belief, neither hypericin nor St. John's wort are at all useful for treating HIV. 6 In addition, St. John's wort seriously impairs the activity of standard HIV medications and might lead to treatment failure. (See Natural Treatments to Avoid below.)
Enhancing the Immune System
In test tube studies, a number of substances have been found to improve measures of immunity in HIV infection, for example, by elevating CD4+ counts, changing the ratio between CD4+ cells and other immune cells, increasing amounts of other immune chemicals, or enhancing the body's ability to attack invading substances. However, there is relatively little information on whether they can actually help people with HIV infection.
One of the natural substances most widely used by people with HIV in hopes of enhancing immune system function is the antioxidant N-acetyl cysteine (NAC), but evidence that it helps is somewhat conflicting.
NAC is a specially modified form of the dietary amino acid cysteine. NAC supplements help the body make the important antioxidant enzyme glutathione . Early human trials, including a double-blind study of 45 people, suggest that NAC may increase levels of CD4+ cells in healthy people and slow CD4+ cell decline in people with HIV. 13,14 Another study of NAC combined with selenium had mixed results, affecting T-cell counts in some people but not others. 15 However, preliminary results of yet another study found that NAC had no effect on CD4+ counts or the amount of HIV virus in the blood. 16Whey protein also contains cysteine and may increase glutathione levels, but there is no evidence as yet of any meaningful benefit.
One study found evidence that the amino acid methionine taken at a dose of 2.4 g daily may mildly improve immune function in people with HIV. 124
Other natural treatments that are sometimes recommended to boost immunity in HIV include:
- Andrographis
- Trichosanthin (compound Q)
- Lipoic acid
- Coenzyme Q 10
- Maitake
- Component of licorice known as glycyrrhizin
- Momordica charantia (an herb also called bitter melon)
- Echinacea
- Ginseng
- Omega-6 fatty acids
- Carnitine
- Proteolytic enzymes
However, there is no real evidence as yet that these treatments actually work. Garlic is sometimes recommended as well; however, for safety reasons it should be avoided in HIV infection. (See Natural Treatments to Avoid below.)
Fish oil is also sometimes recommended for enhancing immunity in HIV infection. However, one 6-month, double-blind study found that a combination of the omega-3 fatty acids in fish oil plus the amino acid arginine was no more effective than placebo in improving immune function in people with HIV. 17
One study found that the hormone DHEA does not improve immunity in people with HIV. 126
Study results are mixed on whether massage therapy can improve measures of immune function in people with HIV. 112-114 A careful review of 35 randomized trials found that relaxation therapies may be generally helpful at improving the quality of life of HIV-positive patients and in reducing their anxiety , depression , stress , and fatigue . 129 These interventions, though, had no significant effect on the growth of the virus, nor did they influence immunologic or hormonal activity. Subsequently, however, a small study involving 48 HIV patients found that mindfulness meditation—a popular method for inducing the relaxation response—slowed the loss of the specific immune cells destroyed by the virus, though more research needs to be done to confirm this result. 132
Immune support for people with HIV is also discussed in the Homeopathy Database , under the HIV support chapter.
Treating Other Symptoms of HIV and Opportunistic Infections
Besides the treatments mentioned earlier, a number of natural remedies have been proposed for symptoms of HIV or common opportunistic infections.
Bovine colostrum has been suggested as a treatment for the chronic diarrhea that commonly occurs in people with HIV or AIDS, but the evidence that it works is weak at best. 18-20
Tea tree oil and cinnamon have been suggested as treatments for thrush (oral candida infection). 21,22 There is some evidence that capsaicin cream applied topically is beneficial for limb pain due to peripheral neuropathy associated with HIV. 130, 131
Dehydroepiandrosterone ( DHEA ) is a hormone that seems to decrease in people with AIDS, possibly because of malnutrition 23 and stress. 24 One small double-blind trial suggests that DHEA (50 mg per day) may improve mood and fatigue scores in people with HIV; 104 another small trial found inconclusive results. 25 A more substantial (145-participant) double-blind study found that DHEA at a dose of 100 to 400 mg daily improved symptoms of dysthymia (minor depression ) in people with HIV, without significant adverse effects. 120
Note : DHEA does not appear to provide general benefits for people with HIV, such as improving immunity, suppressing virus levels, or aiding weight maintenance. 126
Chinese herbal combinations have been investigated for the treatment of HIV, but the results have not been very promising. In a 12-week, double-blind, placebo-controlled trial, 30 HIV-infected adults with CD4+ counts of 200 to 500 were given a Chinese herbal formula containing 31 herbs. 26 The results hint that use of the herbal combination might have improved various symptoms compared to placebo, but none of the differences were statistically significant. Interestingly, people who believed they were taking the real treatment showed significant benefit regardless of whether they were in the placebo group or the real treatment group.
In another double-blind, placebo-controlled trial, 68 HIV-infected adults were given either placebo or a preparation of 35 Chinese herbs for a period of 6 months. 27 The results indicate that use of Chinese herbs did not improve symptoms or objective measurements of HIV severity. In fact, people using the herbs reported more digestive problems than those given placebo.
Fighting Weight Loss
Undesired weight loss is a frequent symptom of HIV and AIDS. Sometimes weight loss is so extreme that the person seems to "waste away"—hence the name "AIDS wasting syndrome," which is technically defined as the loss of more than 10% of body weight combined with either chronic diarrhea or weakness and fever. Many factors can contribute to this weight loss, including loss of appetite, nausea, malabsorption of nutrients, and mouth sores.
Supplemental medium-chain triglycerides (MCTs), a particular type of fat, and glutamine may be helpful for this symptom, although there is no definitive evidence as yet that they work.
Fat malabsorption is particularly common in HIV infection and can lead to both diarrhea and weight loss. MCTs medium-chain triglycerides , which are more easily absorbed than ordinary fats (long-chain triglycerides), may help decrease diarrhea and wasting. Two small, double-blind studies have found that MCTs are more easily absorbed than long-chain triglycerides in people with HIV or AIDS. 7,8 However, there is no direct evidence as yet that MCTs actually help people gain weight.
In both of the studies described above, participants consumed nothing but a special nutritional formula containing MCTs. Taking MCTs in this way requires medical supervision to determine the dose.
People with HIV or diabetes should not use MCTs (or any other supplement) without a doctor's supervision. For more information, including dosage and safety issues, see the full MCTs article.
Another promising treatment for wasting is the amino acid glutamine , a substance that plays a role in maintaining the health of the immune system, digestive tract, and muscle cells. Although research is still preliminary, one double-blind, placebo-controlled study found that a combination of glutamine and antioxidants (vitamins C and E , beta-carotene , selenium , and N-acetyl cysteine ) led to significant weight gain in people with HIV who had lost weight. 9
Another small, double-blind trial found that combination treatment with glutamine, arginine , and beta-hydroxy beta-methylbutyrate (HMB) could increase muscle mass and possibly improve immune status. 10
Whey protein is sometimes recommended for weight gain in HIV, but evidence that it works is preliminary at best. 11 One study found that while exercise improved weight gain, whey protein alone or in combination with exercise offered no benefit. 105Fish oil might be helpful for weight gain, however. 12
Treating Medication Side Effects
Several natural treatments have been proposed to treat side effects from various medications used in the treatment of HIV.
Reverse transcriptase inhibitors , such as lamivudine and zidovudine, may damage mitochondria, the energy-producing subunits of cells. The supplement CoQ 10 has been tried for minimizing side effects attributed to mitochondrial damage. In one study, use of CoQ 10 improved sense of well-being in asymptomatic people with HIV infection; however, it actually worsened pain symptoms in people with peripheral neuropathy. 115
Taking AZT can lead to zinc deficiency, which may interfere with immune function. 28 One partially-blinded study found that zinc supplements may benefit people on AZT. 29 In the zinc-treated group, body weight increased or stabilized, CD4+ count rose, and participants had significantly fewer opportunistic infections.
Carnitine has also been proposed as a treatment for AZT side effects, based on very early evidence that it may keep AZT from damaging muscle cells. 30,31 Other weak evidence hints that the acetyl form of carnitine might reduce nerve-related side effects caused by HIV drugs in general. 128
Based on highly preliminary evidence, vitamin B 12 has been suggested as a preventive for blood abnormalities caused by AZT. 32
In one well-designed, double-blind study, use of the amino acid glutamine at a dose of 30 g daily significantly reduced the diarrhea caused by the protease inhibitor nelfinavir . 116 Presumably, glutamine would be helpful for other protease inhibitors as well.
It has been suggested that the supplement NAC might help prevent side effects from the antibiotic TMP-SMX (trimethoprim-sulfamethoxazole). However, two controlled studies found that NAC did not significantly decrease adverse reactions to TMP-SMX. 33,34 Note, however, that TMP-SMX is known to decrease folate levels in the body, and folate supplements might, therefore, be useful.
The herb milk thistle is sometimes recommended for preventing liver problems related to use of HIV medications. While there is no direct evidence that it is helpful for this purpose, there is fairly good evidence, at least, that use of milk thistle does not adversely affect blood levels of indinavir.
In one study, 130 HIV patients on highly active antiretroviral therapy (HAART) were randomized to receive 1 of 4 treatments: acupuncture plus relaxation therapy , acupuncture plus health education, sham acupuncture plus relaxation therapy, or sham acupuncture plus health education. 87 After 4 weeks of treatment, the people in the acupuncture plus relaxation group experienced a greater improvement in their GI symptoms compared to the other groups.
General Nutrition Support
People infected with HIV may be particularly vulnerable to malnutrition because of decreased appetite, poor absorption, or possibly increased requirements for specific nutrients. Studies have found deficiencies of vitamins A , B 1 , B 6 , B 12 , and E , beta-carotene, choline , folate , selenium , and zinc to be common among people with HIV infection. 35-49 Many deficiencies become more common as the disease worsens. This suggests, but does not prove, that taking supplements of these nutrients may be helpful.
Note : One study evaluated whether use of a multivitamin tablet might reduce infectivity of African women with HIV. Researchers unexpectedly found the opposite: multivitamin tablets increase the levels of HIV virus present in the genital area. 117 The reason for this surprising finding is unknown. It is not clear whether the same response would occur among people living in developed countries who, presumably, have better underlying nutrition.
Vitamin A and beta-carotene are described together here because the body uses beta-carotene to produce vitamin A. Substances called carotenoids are closely related to vitamin A; this family includes lutein and lycopene .
Vitamin A deficiency may be linked to lower CD4+ counts as well as higher death rates among people infected with HIV. 50 A few preliminary studies have raised hopes that beta-carotene supplements might increase or preserve immune function or decrease symptoms among people with HIV. 51-54 One small, double-blind study suggested that taking beta-carotene might raise white blood cell count in people with HIV. 55 However, two subsequent larger controlled trials found no significant differences between those taking beta-carotene or placebo in white blood cell count, CD4+ count, or other measures of immune function. 56,57
Two observational studies lasting 6 to 8 years suggest that higher intakes of vitamin A or beta-carotene may be helpful, but they also found that caution is in order with regard to dosage. 58,59 This group of researchers generally linked higher intake of vitamin A or beta-carotene to lower risk of AIDS and lower death rates, with an important exception: people with the highest intake of either nutrient (more than 11,179 IU per day of beta-carotene, more than 20,268 IU per day of vitamin A) did worse than those who took somewhat less.
Note : Keep in mind also that excessive dosages of vitamin A can be toxic to the liver. Consult with your physician on the right dose for you. For other dosage and safety issues, see the full articles on Beta-carotene and Vitamin A .
At one point it was thought that vitamin A supplements might decrease the rate of transmission of HIV from a pregnant mother to her newborn. However, it now appears that the reverse may be true: vitamin A may increase chance of such transmission. 127
One double-blind study found statistically weak evidence that use of mixed carotenoids by AIDS patients might prolong life. 121
An observational study found that HIV-positive men with the highest intakes of vitamin B 1 , B 2 , B 6 , and niacin had significantly longer survival rates, while a similar study found that those taking the most B 1 or niacin had a significantly lower rate of developing AIDS. 62,63
Vitamin B 12 deficiencies in people infected with HIV have been linked to neurologic symptoms, including slower processing of information in studies of cognitive functioning; early research suggests that restoring B 12 levels to normal may decrease these symptoms. 64,65 B 12 deficiency has also been linked to lower CD4+ counts and more rapid development of AIDS. 66
Vitamin B 6 deficiency has been linked to impaired immune function in one study of people with HIV infection. 67
Note : Excessive intake of vitamin B 6 can cause neurologic problems. Consult with your physician on the right dose for you. For other dosage and safety issues, see the full Vitamin B 6 article.
Massive doses of vitamin C have at times been popular among people with HIV based on highly preliminary evidence. 68,69 An observational study linked high doses of vitamin C with slower progression to AIDS. 70 High intake of vitamin E was also linked to decreased risk of progression to AIDS in a different observational study. 71
However, a double-blind study of 49 people with HIV who took combined vitamins C and E or placebo for 3 months did not show any significant effects on the amount of HIV virus detected or the number of opportunistic infections. 72 It has been suggested that vitamin E may enhance the antiviral effects of AZT, but evidence for this is minimal. 73
The substance choline has been newly added to the list of essential nutrients. Evidence suggests that people with HIV who are low in choline may experience more rapid disease progression. 74
A study of 71 HIV-positive children noted a high rate of iron deficiency. 75 One observational study of 296 men with HIV infection linked high intake of iron to a decreased risk of AIDS 6 years later. 76
Note : Do not take iron supplements unless you know that you are iron-deficient.
Selenium is required for a well-functioning immune system. 77 Observational studies have linked higher levels of selenium in the blood with higher CD4+ counts 78 and reduced risk of mortality from HIV disease. 79,80 Selenium deficiency may also increase the infectiousness of women with HIV. 81
In a double-blind, placebo-controlled study of 450 people with HIV, use of selenium supplementation at a dose of 200 mcg per day appeared to reduce measures of viral load. 14 However, the statistical method used in this study is somewhat questionable. Previous smaller studies using more standard statistical methods failed to find such effects. 83-84 And, as part of a larger systematic review, researchers found that selenium (compared to placebo) did not improve outcomes in pregnant women with HIV or their infants. 134
In one double-blind, placebo-controlled study, use of selenium at a dose of 200 mcg decreased anxiety in patients undergoing HAART. 118
Selenium has also been proposed as a preventive or treatment for cardiomyopathy, a disorder of the heart muscle that can affect people with AIDS, but evidence so far is weak. 85,86
Some, but not all studies, have found that HIV-positive people tend to be deficient in zinc , with levels dropping lower in more severe disease. 87-92 But does this mean that taking zinc will help? The answer is not clear.
Higher zinc levels have been linked to better immune function and higher CD4+ cell counts, whereas zinc deficiency has been linked to increased risk of dying from HIV. 93-95 One preliminary study among people taking AZT found that 30 days of zinc supplementation led to decreased rates of opportunistic infection over the following 2 years. 96
However, other research has linked higher zinc intake to more rapid development of AIDS. 97 In another study of HIV-positive people, those with higher zinc intake or those taking zinc supplements in any dosage had a greater risk of death within the following 8 years. 98 And, as part of systematic review analyzing the use of supplementation in pregnant women with HIV, researchers did not find evidence to support the use of zinc for improving outcomes in mothers or their infants. 134
One study found that use of zinc supplements could reduce diarrhea symptoms in people with HIV. 123
Because so many nutrients are affected by HIV infection and treatments, multivitamin supplements are a logical choice.
A double-blind study of 40 people on HAART found that use of a multinutrient supplement improved CD4 counts and possibly improved neuropathy symptoms. 122
However, as noted above, one study evaluated whether use of a multivitamin tablet might reduce infectivity of African women with HIV, and unexpectedly found the opposite: multivitamin tablets increase the levels of HIV virus present in the genital area.
Natural Treatments to Avoid
People using HIV medications should not take St. John's wort . In a study of healthy volunteers, St. John's wort was found to decrease the blood concentration of indinavir, one of the most widely used protease inhibitors , by 49% to 99%. 101 This could lead to treatment failure as well as the emergence of resistant strains of the HIV virus. St. John's wort also appears to interact with non-nucleoside reverse transcriptase inhibitors (NNRTIs) such as nevirapine. 106
Garlic may also combine poorly with certain HIV medications. Two people with HIV experienced severe gastrointestinal toxicity from the protease inhibitor ritonavir after taking garlic supplements, 102 and another study found that garlic might interfere with the action of the protease inhibitor saquinavir, reducing blood levels of the medication. 103
One study found, rather surprisingly, that vitamin C at a dose of 1 g daily substantially reduced blood levels of indinavir. 119
Other possible harmful effects discussed elsewhere in this article include worsening of peripheral neuropathy symptoms by CoQ 10 and increase of infectivity attributable to use of multivitamins. If you have HIV, talk with your doctor before using any herb or supplement, no matter how harmless it may seem. Given the large numbers of drugs, herbs, and supplements taken by many people with HIV, the possibility of interactions is high.
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


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Ginger Immenhauser (Civilian)
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Tamie Towers said on 02/24/2012 at 03:34 pm
I'll Go (A Soldiers Oath) - I would like to share with you, a music video dedicated to all soldiers called - I'll Go (A Soldiers Oath) - by Kelly's Lot - It is a tribute to all veterans, and is well worth watching - Here's the link: (this is not a download, simply a link to a YouTube video) - http://youtu.be/c5p1Qiqggao - Or you can copy & paste (or type) the following link into your address bar: http://youtu.be/c5p1Qiqggao - To each and every veteran - Thank You - I salute you - Tamie L. Towers - Patriot - firstname.lastname@example.com - P.S. My dear friend Kelly Zirbes of Kelly's Lot wrote and performed this song and has given permission for the video to be shared and/or embedded anywhere.
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text: 2014 Ford Shelby Gt500 Battery Battery Car Dead DIY: Fix, If you hate buying new expensive batteries …I have good news! There's an easy new way to bring your old batteries back to life again …so you never have to buy new pricey batteries again! The average person spends $15,000 on batteries over their lifetime… But this fast and simple method eliminates that entire cost and lets you save thousands over your lifetime on battery costs! So if you want to learn this simple new way to bring ANY old battery back to life again…Then stop what you're doing and watch this presentation while you still can. Update : Thursday 2020-04-09 06:29:25 pm


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Machine Support On-site machining services
SKF Marine has extensive experience with machining on new installations as well as performing challenging repairs around the globe.
- Milling and grinding: SKF Marine performs on-site milling and grinding of any foundation, for new build and repair jobs, separately or in combination with alignment solutions.
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Solar Empowerment
A version of this article appears in the Solar & Efficiency Special issue of Home Energy Magazine.
March 20, 2007
Gary Gerber, CEO and founder of Sun Light and Power in Berkeley, California, has been working in the renewable energy field for 30 years. He successfully steered his solar design and installation company through the lean years when the country all but abandoned solar energy to the more recent second solar boom times. His company is thriving well enough to have been named one of the top 100 fastest-growing companies in the Bay Area by the San Francisco Times in 2004, 2005, and 2006, and he expects it to be on the list again in 2007. With over 40 employees, Sun Light and Power (SLP) is at once a pioneer and an expert in the field of solar design and installation. "I am a general contractor involved in sustainability, and I've been traveling down the road of green construction for over ten years, with a keen interest in the bigger picture of energy," says Gerber.
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Wilmington, NC Elijah's Restaurant review…from Doug & Margi
Elijah's located in Chandler's Wharf, Water St., 343-1448. www.elijahs.com. A casual American grill and oyster bar on the Cape Fear River. Oyster bar, deck seating and more formal enclosed dining room. Seafood, steaks, poultry and pasta. Open late. Lunch and … Continue reading


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You, me, & the TRC
A version of this article appears in the May/June 2013 issue of Home Energy Magazine.
April 30, 2013
How Do Utilities Define Cost, and How Does That Affect Your Business?
Three small letters in the form of an equally petite acronym, TRC, have an enormous impact on your business if you are involved in any way with residential energy efficiency. But do you know what the TRC is and how it affects you? If you don't, you should. Let's see what it is, and then we'll move on to why it matters.
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