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Quran, the last and final Holy Book from the God for the world. This is complete code of life. You will find here all solution of your life, your society culture and your country law. Quran is only one book which is read more time in the world. You enjoy Ayat of this book and listen to sura Fatiha by downloading and installing 'Ayat screensaver'.
Freeware download of Quran Ayat screensaver 1.08, size
1.49 Mb.
Quran with Tafseer 1.0 is used to read and learn the Holy Quran in Arabic, Urdu and English Languages with five Translations and four Tafseer, all bundled together in one easy to use and small size of application. The software is equipped with a web type user interface for ease of use and provided Tafseer text with show-hide functionality also not. Freeware download of Quran with Tafseer 1.0, size 13.55 Mb.
Listen to the Holy Quran whenever you want with the help of this free software.
Desktop Quran lets you listen to the Quran as it is interpreted by various reciters.
Also free.
Desktop Quran is a simple and free audio player that lets you easily listen to the Holy Quran.. Freeware download of Desktop Quran 4 5, size 5.19 Mb.
The Quran CD/MP3 Maker is basically a program that will help you chant and memorize the Quran. There are 114 suras in the Quran and you need to download these separately as they are not included in the main program. These are available at the same place that you download the main program from. The recitation is done by Mahmood Khaleel al-Husaree,. Freeware download of Quran CD/MP3 Maker Beta 1 1, size 0 b.
Quran Auto Reciter is used to read and listen the Quran from a vast choice of famous reciters. It can be configured to launch automatically at specific times for recitals or for giving Athan at times manually configurable by yourself. Prayer timings of local majids can be configured so that you're alerted five times a day by an Athan of your. Freeware download of Quran Auto Reciter 3.0, size 16.57 Mb.
Listen the Quran Recitation in your mobile phone. Quran Recitation by Abdul Rahman Alsudais and Su'ud As-Shuraim (Makkah). Complete Quran having 114 Suras. The recitation is in .AMR format. After downloading, please unzip the Quruan_Mobile.zip file and you will get 114 files having 114 Sura of Quran. Compatible with All mobile phones like Nokia,. Freeware download of Quran Recitation for Mobile Phones 2, size 44.71 Mb.
Quran Reference is a useful application for the users who want to read and listen to Quran verses. The application includes multiple translations in English, Urdu, Persian and Japanese.
You can use the bookmarks feature to quickly jump to your favorite verses and navigate through the recitations.
. Free download of Quran Reference 1.0.297, size 0 b.
This flash program teaches you how to recite Surah Al-Fatiha of the Quran. Each word is clickable so that users can learn the individual pronounciation of the word. Each verse can also be played individually.. Freeware download of Interactive Quran Tutor - Al Fatiha 1.0, size 1.23 Mb.
Zekr is an open source Quran study software for research on the Holy Quran. It is a Quran based project, planned to be a universal, open source, cross-platform application to perform most of the usual refers to Quran. The main idea is to build an as generic as possible platform to be capable of having different add-ons and extensions.. Freeware download of Zekr 1.0.0, size 8.07 Mb.
Quran Majeed with Search is used to read the Holy Quran in Arabic, Urdu and English Languages with different Navigation styles. It also has 114 Suras and 30 Paras hierarchal Index from there you can directly access any Sura or Aya, you can change the language font and can search in Urdu Translation (Molana Fateh Muhammad Jalandhari) and English. Freeware download of Holy Quran Software 1.0, size 6.29 Mb.
This Electronic Quran provides you with the ability of listening to the Holy Quran without downloading any files. All you have to do is download this program and enjoy listening to at least 60 reciters.
System Requirements:
- Windows Operation System
- Adobe Flash Player
- Active Internet Connection. Freeware download of Electronic Quran 1 1, size 3.62 Mb.
Juz30 will help you to learn and memorize the holy Quran at your own pace. The program's user-friendly interface features a bar that displays your personal progress and a dropdown menu that you can use to select a sura or aya. You can drag and drop the suras that you already know by heart to the left-hand side of the interface, and they will. Freeware download of Juz30 2 2, size 0 b.
Muhaddith prayer times adhan software download with pre athan quran recitation.
This islamic azan time table clock program includes thousands of cities.
Main features:
- Enable/Disable individual azhan times (zuhr, asr, etc).
- More flexibility in "Safety Times": Can add/substract up to 20. Free download of Al Muhaddith: Prayer Times 6 96, size 0 b.
The Quran, more than any other single phenomenon known to us, has fundamentally affected the religious, social and political history of the world. No other sacred scripture has ever had a similarly immediate impact upon the lives of the people who first heard its message and, through them and the generations that followed them, on the entire course. Freeware download of Asan Quran 0.81, size 83.08 Mb.
QuranTrans is a collection of 3 translations (Yusuf Ali,Pickthal and Shakir) of the Holy Quran for Windows users. At the end of each verse, there is a link to the commentary of the verse, to be shown in a popup window. Other features include quick verse finding, topical index and easy navigation between translations.
At the end of each. Freeware download of QuranTrans 2.0, size 2.84 Mb.
Noble Quran Search Software allows either Noble Verses' references or advanced text string search. You can view the results and you can export them to a text file. You can search on noble verses, text fragments, key words. This new version that includes all of the English translations. Freeware download of Noble Quran Search Software 2.0, size 12.51 Mb.
Most Quran Software are consisting of a Quran version and some translations, which users can't choose or change. For studing purpose this can't help much and the user has to use many software for getting results which has to be written else where.
OpenQuran is in this case very easy to use and can be developed the way the user like. Freeware download of Open Quran 1. 9. 2025, size 18.16 Mb.
The Quran is the sacred book of the Islam. It was written by Prophet Mohammed, who received its text directly from Allah through the Archangel Gabriel. This application contains the 114 Suras or chapters of the Quran. But it's more than a simple viewer, as it has some interesting features. For example, it presents all the intonation keys for. Freeware download of Quran7 Viewer 1 8, size 7.71 Mb.
Download the Latest Telugu mp3 Community Toolbar and receive our most important news and announcements instantly.
This toolbar is equipped with an e-mail notifier and lots of online games available with a single click.
You can add useful windows components to your toolbar and stay in touch with http://www.latesttelugump3.com/.. Freeware download of Latest Telugu mp3 Toolbar 18.104.22.168, size 2.75 Mb.
My Telugu FM Toolbar is a useful browser add-on which will provide you the latest content and links from My Telugu FM Community. The news and announcements from My Telugu FM Community also will be provides directly to your web browser.
Moreover you can search the Web and get a wide choice of useful search engines from My Telugu FM. Freeware download of My Telugu FM Toolbar 184.108.40.206, size 2.09 Mb.


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Facebook Answers Critics With Mobile-Ad Surge
Profit More Than Doubles; Social Network Adds 40 Million More Users
Facebook Inc. on Wednesday put to rest any lingering doubts about its ability to transform its business into a mobile-advertising juggernaut.
The social network reported that profit more than doubled and revenue topped estimates for the ninth straight quarter. About 62% of Facebook's ad revenue now comes from advertising on mobile devices, which this year is expected to eclipse newspapers, magazines and radio in the U.S. for the first time, according to eMarketer....

subset: commoncrawl


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Pertinent Roundtable Insights On Indications For Orthotic Management
Choosing the most effective type of orthotic device for a given condition can be tricky as one must consider factors that include materials, potential modifications and cost.
Accordingly, the panelists discuss possible indications for OTC orthoses, conditions that are particularly challenging to treat with orthotics and the role of functional foot orthoses in managing bunion deformities.
Q: Are all prefabricated, over-the-counter (OTC) foot support systems essentially the same? Are there unique characteristics of any of the devices which makes them better suited for certain foot problems?
A: All three panelists note the variety of OTC orthoses available. Kevin Kirby, DPM, notes that OTC orthoses are made from a variety of materials, have a large range of medial arch height and heel cup contours, and have considerable variation in cushioning, shape and shoe fit.
Dr. Kirby notes that OTC orthoses with increased medial arch height would be more appropriate for patients who have symptoms such as posterior tibial tendonitis/dysfunction related to increased subtalar joint pronation moments. He says OTC orthoses with increased heel cushioning may provide some relief from symptoms for patients who have plantar heel pain due to plantar fat pad atrophy.
One should base the recommendation for an OTC orthosis on the shape of the patient's foot, the biomechanical etiology of the symptoms, the activities and the shoes in which the patient intends to wear the orthoses, suggests Dr. Kirby.
Michael Burns, DPM, says most prefab orthoses are made of soft material and some are composed of a material that maintains its shape independent of the shape of the shoe. He notes that most OTC orthoses are designed to cushion the foot but not stabilize it. If cushioning is the main goal, Dr. Burns notes a soft device may be adequate but he tends to use firmer (shank independent devices) orthoses to increase stability.
"Unlike custom-molded foot orthoses, OTC orthoses are not specifically designed for each foot's unique three-dimensional plantar contours and they are not specifically designed to reduce the pathological internal and external forces that are causing a patient's pain," cautions Dr. Kirby.
In addition, Dr. Kirby says OTC orthoses are made of softer, less durable materials than most custom-molded foot orthoses. Accordingly, Dr. Kirby points out that OTC orthoses must be replaced and remodified every six months on average whereas more durable custom-molded foot orthoses will last an average of over 10 years. The ability to modify an OTC for a specific condition is important, according to Richard Blake, DPM. He prefers the YourSole device. Dr. Blake cites the device's stability, deep heel cups, stable medial and lateral arches, and the fact that the orthosis is heat moldable and full length. Furthermore, he notes that the arch area is deep enough for necessary reinforcements and one can easily grind the material for accommodations.
Q: When should one utilize a prefabricated device?
A: Dr. Burns and Dr. Kirby say cost concerns can be a factor. Dr. Kirby uses prefab orthoses for patients who cannot afford the higher price of custom molded foot orthoses. He adjusts OTC orthoses in the office for these patients until the devices function as much like a custom foot orthosis as possible.
"Interestingly, when I have modified the OTC orthoses of those patients who 'cannot afford custom foot orthoses' so their symptoms resolve, many of them are soon able to afford custom foot orthoses so they can have a more long-lasting solution to their foot and lower extremity pain," points out Dr. Kirby.
When orthotic control is indicated, Dr. Burns says patients frequently ask if there is an alternative to custom functional orthoses. He acknowledges the argument, often made by insurance companies, that one should try OTC supports before custom functional orthoses. For the common complaint of plantar fasciitis, Dr. Burns says it is initially reasonable to combine OTC orthoses with calf and plantar fascia stretching as well as a heel lift if indicated.
In regard to plantar fasciitis, Dr. Burns initially will use low Dye strapping with stretching. If most of the pain resolves, he suggests another week or two of taping along with continued stretching. If the patient does not respond well at first, he uses anti-inflammatory therapy. For persistent symptoms, Dr. Burns encourages patients to use custom functional orthoses. He says such devices are definitive and are an adjunct to continued treatment. Dr. Burns also says prefab devices can be effective for metatarsalgia if patients need cushioning.
Dr. Blake says one can use a prefabricated orthotic initially on all patients with biomechanical issues. He notes that DPMs can learn the right amount of canting if foot stability is a factor and if the patient has any unique sensitivities.
"OTC products are so much less durable in general than custom made plastics so they will never replace them," explains Dr. Blake. "(Prefabs) can give reliable support for two to six months but then nosedive in stability."
Dr. Kirby uses OTC orthoses for patients who need immediate pain relief and cannot wait for the fabrication of custom devices. However, as soon as possible, he will schedule patients for orthotic modification to facilitate better fit and reduce the abnormal external and internal forces in the foot and lower extremity that are causing symptoms.
Q: What foot problem do you personally find is the most challenging to treat with a functional foot orthosis and why is it so difficult? What specific orthotic modifications do you utilize to improve your outcome in these cases?
A: For Dr. Burns, posterior tibial tendon dysfunction (PTTD) is the most challenging condition to treat as it is a loss of the primary decelerator of pronation that typically occurs in a badly pronated foot. He says the condition almost always requires foot and leg support. Dr. Burns adds that acute cases require immobilization. In some instances of PTTD, he says a lace ankle brace over a custom orthosis may be helpful during rehabilitation. Then the patient can use the laced ankle brace for increased demand as recovery continues, according to Dr. Burns. He notes that a Richie Brace can be helpful for these patients.
Tarsal tunnel syndrome is the most challenging condition to treat with orthotic devices, according to Dr. Blake, who says the plantar nerve sensitivity makes arch support very painful. In these cases, he notes the foot that needs good support to prevent heel valgus cannot tolerate that support. Dr. Blake cites tape as a good option for many of these patients since even soft orthotics can be intolerable.
Dr. Kirby says dorsiflexion stress injuries to the lateral midfoot are challenging. He calls these injuries lateral dorsal midfoot interosseous compression syndrome (lateral DMICS) wherein the dorsal aspects of the lateral midfoot joints, such as the fourth and fifth metatarsal-cuboid joints, are painful with ambulation. The cause of these injuries is an excessive dorsiflexion moment on the lateral column joints. Dr. Kirby says this is caused by either an over-supinated foot or a foot that is at the end range of pronation of the subtalar joint. Yet there is still increased ground reaction force on the lateral metatarsals, according to Dr. Kirby.
He says these injuries are much harder to treat with orthoses since most orthosis designs tend to supinate and not pronate the foot. Dr. Kirby notes that orthotic modifications for lateral DMICS include a lateral heel skive, an everted balancing position, increased medial expansion plaster and valgus forefoot extensions. With these modifications, Dr. Kirby says one can try and evert the rearfoot, and reduce the dorsiflexion moments on the lateral column during weightbearing activities.
Another challenging case for Dr. Burns is central metatarsal overload without specific plantar plate insufficiency. In these cases, it may be difficult to pinpoint the etiology of the pain so the treatment may be less targeted. He notes the importance of exactly fitting the orthotic shell to the plantar aspect of the forefoot.
Dr. Burns adds that he often has the shell molded directly to the positive cast with only some expansion for the heel cup. Then he uses extrinsic forefoot posts, if necessary, for balancing.
An accommodating forefoot extension like Plastizote can permit dynamic molding of the extension to the forefoot, according to Dr. Burns. He says this provides some cresting and support of the toes, and helps to further reduce pressure under the metatarsophalangeal joints (MPJs). In such situations, Dr. Burns prefers using Spenco type topcovers to reduce the shear forces. He notes that a heel raise may help accommodate for equinus, either in the ankle or forefoot.
Q: What is the role of the functional foot orthosis in the management of bunion deformities?
A: Dr. Blake calls functional orthotics a "double-edged sword" when it comes to bunions. On the positive side, he notes they can shift weight laterally and proximally, unloading the first metatarsal head. On the negative side, he says functional orthoses can crowd shoes and place a dorsiflexory force on the first metatarsal, limiting propulsion and further jamming the first ray.
Sometimes, functional devices act solely as an attachment for a reverse Morton's extension. If the foot continues to pronate on a plastic orthotic, Dr. Blake says the first ray gets jammed. In cases like these, he says full pronation support is better than 70 or 80 percent support.
When it comes to reducing joint pain associated with either hallux abducto valgus (HAV) or functional hallux limitus, Dr. Burns cites the efficacy of functional orthotic control. When the first ray is flexible, he feels it is helpful to plantarflex the ray a bit when taking the impression. As he notes, OTC supports are often not adequate and if the symptoms persist, he wants the patient to try custom functional control before deciding that orthotic control will not be adequate treatment.
"This is always a bit of a dilemma when suggesting a patient try an OTC support," says Dr. Burns. "If the response is not adequate, I always wonder if a custom device would relieve the patient's symptoms and I am hesitant to recommend surgical intervention until the patient has given it a try."
As Dr. Kirby notes, functional foot orthoses may help slow down the progression of bunion deformities if the first intermetatarsal angle is not already too large. However, he says when the first intermetatarsal angle is too large, even a well designed foot orthosis will have little effect in slowing down the progression of a bunion deformity.
"I have never seen a functional foot orthosis reduce the severity of a bunion deformity," maintains Dr. Kirby.
Q: Are functional foot orthoses more beneficial before or after corrective surgery for bunion deformities?
A: Preoperatively, Dr. Kirby says orthoses can slow the progression of the deformity and decrease pain to the first MPJ. Dr. Blake says orthoses may be crucial in helping some patients avoid bunion surgery. He emphasizes the importance of obtaining a stable pre-op orthotic as there are many pitfalls with fit and shoegear.
For example, Dr. Blake says one may discover preoperatively that the patient has nerve hypersensitivity secondary to Morton's neuroma and cannot wear the orthotic. He points out that this finding could change the post-op choices if one notes these pre-op problems and completely addresses them.
In Dr. Burns' experience, HAV is influenced, if not caused, by abnormal function. However, he acknowledges there is mixed literature on the subject. Therefore, if Dr. Burns repairs a bunion deformity without surgically addressing the cause of the midfoot instability, he emphasizes the importance of continuing orthotic control to reduce the deforming force from acting again on the first MPJ.
In practice, he discusses this with the patient before starting treatment and establishes orthotic control. If the midstance instability is well controlled, Dr. Burns encourages the patient to continue orthotic control after surgery. If there are remaining symptoms or significant deformity, Dr. Burns then offers surgical repair.
In regard to the common HAV repair with distal metatarsal osteotomy, Dr. Burns says the orthotic device will still fit well after surgery. Usually, he says the only adjustment necessary is shortening the device a bit to permit the slight first ray shortening that accompanies such procedures.
Dr. Burns describes the common scenario of a patient who presents with first MPJ pain that resolves with functional orthotic control. He notes that these patients may return years later with pain in the second MPJ with digital contracture and perhaps some increase in HAV deformity. As Dr. Burns maintains, this is often the precipitating event that spurs him to recommend HAV repair and continued orthotic control.
Postoperatively, Dr. Kirby says orthoses protect the first MPJ from abnormal mechanical forces and moments that may have caused the bunion deformity. He says post-op orthotics can also prevent other problems from occurring.
Dr. Blake emphasizes that post-op orthoses are "utterly mandatory" after bunion surgery. After surgery, he notes the first MPJ is very weak and good orthotic devices are normally mandated for a minimum of two years postoperatively.
Dr. Blake is the Past President of the American Academy of Podiatric Sports Medicine. He practices in San Francisco.
Dr. Burns is the CEO of Burns Lab. He is a Fellow of the American Academy of Podiatric Sports Medicine.
Dr. Kirby is an Adjunct Associate Professor in the Department of Biomechanics at the California School of Podiatric Medicine at Samuel Merritt College. He is the Director of Clinical Biomechanics at Precision Intricast Inc.
Dr. Valmassy is a Past Professor and Past Chairman of the Department of Podiatric Biomechanics at the California College of Podiatric Medicine. He is a staff podiatrist at the Center for Sports Medicine at St. Francis Memorial Hospital in San Francisco.
For further reading, see "Exploring Orthotic Indications For Various Conditions" in the June 2006 issue of Podiatry Today or "How To Overcome Obstacles With Custom Orthoses" in the June 2007 issue. Also check out the archives at www.podiatrytoday.com.


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Pulse Necklace 15July2009
Pulse Choker Hack Notes for July 15th, 2009[edit]
Silk Screening Conductive Paint[edit]
We tried silk screening silver conductive paint (MGchemicals 842-20G) onto two different types of fabric, a water resistant one and a water proof "leather like" one. Both showed very high resistance (higher than the meter can read) even for very short thick traces. It looks really cool though - hopefully we can figure out what we're doing wrong, and make this work. We also tried measuring the resistance of a huge dollop of paint on the spoon: silver = infinite resistance (!), copper = 200kOhms. It didn't matter if the paint was dried or wet. Note that we shook the bottle prior to use to ensure that the silver particles were dispersed evenly.
Our new Axial LEDs look great (small, short wires), but they are dim, perhaps 1/4 the brightness of our other surface mount LEDs for the same current. We tried putting more power through it, but it remained dim. This product was the 5mcd LED P419-ND from digikey.
We wired up our favorite LED/transistor sensor (CNB2301-ND) with 3K on the resistor and 4.7K on the transistor. With room lights on we are able to observe considerable signal from the transistor when we darkened it (by placing something in front of it), however with room lights off the device doesn't work. This is because there is no current flow through the LED (as measured by 0V across the LED resistor). So we swapped in a 500 ohm resistor for the LED instead, but still no current flowed. Did we damage the LED somehow?
We decided after measuring the LED that the stat sheet is wrong, and the LED needs to be wired the other way. So we switched power and ground for it, and now the device seems to work even in the dark. For skin, the transistor seems to be (a) open for no object in front of it, (b) totally closed even with the finger pressed in tight, indicating that we are saturating the available current flow through the transistor. Inspecting the stat sheet further, its Rload should be much smaller. We swap in a 750ohm resistor. This indeed fixed it so that the transistor isn't totally open with finger pressed to it. With the o-scope on AC triggering, 5mV per division and my finger through the window, we were able to observe a 2mV "heart beat" at ~1Hz over top of the 50mV 60Hz noise. Clearly we need some filtering. Equally clear is the fact that the o-scope is going to be hard for prototyping this stuff without an amplifier.
So Eric's homework: figure out a suitable circuit for use with this sensor and an arduino. Chung-Hay's homework: figure out why the silver conductive paint isn't conductive.


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DAKAR (Thomson Reuters Foundation) - The Red Cross in Guinea said on Wednesday it had been forced to suspend operations tackling Ebola in the country's southeast after staff there were threatened by a group of men armed with knives.
The incident on Tuesday in Gueckedou, about 650 kms (403 miles) southeast of the capital Conakry, is the latest in a series against health workers, undermining efforts to help the region's weak health systems fight one of the world's deadliest diseases.
A Medicins Sans Frontieres centre in nearby Macenta was attacked by youths two months ago after staff there were accused of bringing the disease to Guinea.
"Locals wielding knives surrounded a marked Red Cross vehicle. We've suspended operations for safety reasons," a Red Cross official in West Africa said, asking not to be named.
"I imagine this won't be the last time this happens," he added.
The outbreak of the disease in Guinea, Liberia and Sierra Leone is the largest and deadliest ever, according to the World Health Organization (WHO). The organisation has recorded 467 deaths from 759 known cases since February.
Local and foreign doctors are battling a deep-rooted fear and lack of understanding of the disease, which has driven dozens of victims to evade treatment and made it harder to track patients.
Health ministers from 11 West African states are meeting in Accra, Ghana, on Wednesday and Thursday to try to coordinate the regional response to the epidemic.
WHO has flagged three main factors driving the spread of Ebola - the burial of victims in accordance with cultural practices and traditional beliefs in rural communities, the dense population around the capital cities of Guinea and Liberia and the bustling cross-border trade across the region.
<For a map of the region affected by Ebola, please click - link.reuters.com/fyj32w>
Ebola causes fever, vomiting, bleeding and diarrhoea and can kill up to 90 percent of those it infects. Highly contagious, it is transmitted through contact with the blood or other fluids of infected people or animals.
Liberia's President Ellen Johnson Sirleaf has called the crisis a national public health emergency.
Addressing his nation for the first time about the issue late on Tuesday, Sierra Leone's President Ernest Bai Koroma called for leaders on all sides of the political divide to work together to tackle the crisis.
"This is a national fight. And all must be involved," he said. Koroma said that the government and the U.N. World Food Programme had started providing food aid to 30,000 people in the two districts affected by Ebola.


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Use the form on the right to contact us.
You can edit the text in this area, and change where the contact form on the right submits to, by entering edit mode using the modes on the bottom right.
4104 65th Street
Holland, MI 49423
United States
Entirely hand-crafted artisan jewelry; a path of movement in twisted wire - a journey inspired and influenced by literature, music, and dance. Enter the portal of the ethereal feminine adventure.


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18625 Centennial
Marshall, Michigan 49068
Listing Office: Berkshire Hathaway HomeServices Michigan Real Estate
Disclaimer: The data relating to real estate for sale on this website comes in part from the Broker Reciprocity Program of SWMRIC, LLC. Real estate listings held by brokerage firms other than @properties are marked with the Broker Reciprocity thumbnail logo and detailed information about them includes the name of the listing brokers.
Marshall is a city in Southern Michigan. It is located in Calhoun County and has a population of just over 7,000 residents. The area houses one of the largest National Historic Landmark Districts in the U.S. Here, there are numerous…Learn More
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BOSTON ( TheStreet) -- Over at Motley Fool, Michael Meyer says hedge funds are interested in Arena Pharmaceuticals ( ARNA - Get Report). True, but not in the way he means. Meyer: Arena has seen hedge funds acquire roughly 29 million shares during the most recent quarter. The largest holder of Arena shares is Wellington Capital. Since the company has roughly 215 million outstanding shares, institutions acquired roughly 13% of the company's float. This is a pretty strong indicator that the company may have a promising 2013. Meyer's reasoning is off track. Hedge funds aren't interested in Arena, at least not on the long side, according to third-quarter ownership data. Wellington Capital is a long-only mutual fund investment adviser, not a hedge fund. There were 136 institutional investors who filed 13Fs listing Arena among their stock holdings at the end of the third quarter, according to Whalewisdom.com. The aggregate number of Arena shares in these 13Fs totaled 95.6 million shares at Sept. 30, 2012, an increase of 29 million shares, or 42%, over the June 30, 2012 filings. Twenty-seven institutional investors opened new positions in Arena in the third quarter, and another 69 funds added to existing positions. But remember, when an investors buys a share of Arena, another investor is selling. So, in the third quarter, 51 funds closed out their Arena positions with another 48 funds reducing their positions, according to Whalewisdom.com. Hedge funds are under-represented among Arena shareholders, owning just 6% of the company -- defined as owning less than 5% stakes in the company. No hedge fund owned more than 5% of Arena. Traditional investment managers (think mutual funds) own 37% of Arena, according to CapitalIQ. Arena's overall institutional investor ownership is 47%, which includes mutual funds (37%) and hedge funds owning stakes smaller than 5% (6%). Public ownership of the company (think retail investors) stands at 52%, according to CapitalIQ. Arena is often referred to a retail investor-driven stock, so now you know why. Institutional investor ownership in the company is increasing but "Wall Street" still owns less than half of the outstanding shares.
Fourth-quarter ownership data won't be available until the middle of February. How does Arena stack up against its weight-loss competitor Vivus ( VVUS - Get Report)? Total institutional investor ownership of Vivus was 62% of Vivus at the end of the third quarter, which included 42% ownership by mutual funds and 12% from hedge funds with less than a 5% stake, according to CapitalIQ. Hedge funds with more than a 5% stake in the company represented 17% of Vivus' outstanding shares, according to CapitalIQ. Meyer is right about hedge funds being interested in Arena, but I'm pretty sure it's on the short side. Arena's short interest stood at 52 million shares at the end of 2012 -- or approximately 22% of the company's 234 million fully diluted outstanding shares. Exact figures aren't available but assume safely that the lion's share of those 52 million short shares held by hedge funds. -- Reported by Adam Feuerstein in Boston. Follow @AdamFeuerstein


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What does Joe Biden think of a 2016 run for President?
"I can die a happy man never having been president of the United States of America," Biden said in GQ's newly released profile. "But it doesn't mean I won't run."
"The judgment I'll make is, first of all, am I still as full of as much energy as I have now -- do I feel this number two, do I think I'm the best person in the position to move the ball? And, you know, we'll see where the hell I am."
Speculation has it that if Hillary Clinton runs in 2016, Biden won't, and the article describes him as "a Hillary Clinton away from the White House."
Senator John McCain, who ran against Obama in the 2008 presidential election, said Biden is "unique."
"He's had some role in every major national-security crisis that his nation has faced in the last thirty-five years," McCain said.
"I don't know anyone like him in the U.S. Senate. Look at the number of times he's been able to conclude agreements. I would say he's been the most impactful vice president that I've known -- certainly in modern times."
As Biden took the interviewer to locations from his childhood, including his old high school, about twenty giggling girls held up their phones, and the Vice President paused for pictures.
Biden told the students he owed it to Archmere Academy for helping him overcome his stutter. "I used to stutter really badly. Everybody thinks it's funny. And it's not funny. It's not," he said.
"He was, you know, made fun of," said his sister, Valerie Biden Owens. "One guy called him 'Dash,' signed the football to 'dash dash dash Biden,' because it was 'J-J-J-Joe Biden.'"
Now, if Joe Biden becomes President, "the State of the Union speech would be the longest in history," McCain joked.


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A man tried on a pricey watch at a Midtown luxury store — then ran out the door with it, police said.
The suspect, captured on surveillance camera, entered the Tourneau Watch Store on 57th Street near Madison Avenue about 2:50 p.m. yesterday, cops said.
He asked to see Cartier's Ballon Bleu model, which is valued at $8,100, and tried it on, according to authorities. The watch has a sapphire crystal, and its strap is made of pink gold and steel.
The sticky-fingered shopper then took off — running east on 56th Street towards Park Avenue.
Police are asking anyone with information about the heist to call Crime Stoppers' hotline at 1.800.577.TIPS, or to send tips via the Crime Stoppers' Web site.


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3 Essential Smoothies for Triathletes in Training
You spoke, we listened. This trio of triathlete-specific smoothie recipes will help fuel your best results.
We recently teamed up with the IRONMAN Fitness Blender by Oster and asked our social media community for its favorite smoothie ingredients. We received a few expected answers (and a few surprises!) and asked nutritionist and pro triathlete Pip Taylor to craft a few recipes just for you.
by Pip Taylor
Smoothies are perfect for IRONMAN athletes finding it challenging to consume enough calories. If you're having difficulty maintaining weight, these liquid meals can be a great way to keep your body on track with something less filling than solid food.
Smoothies are ideal after a workout, when recovery is paramount but a full meal seems too heavy. Invest in a thermos or chilled flask so your concoction can ready immediately after a training session.
There are no rules when it comes to what you put into a smoothie, so be adventurous about trying out different fruits, vegetables, herbs, nut butters and protein powders. For those wishing to avoid cow milk, there are plenty of other options: try coconut, almond or rice milk, or use yogurt for added probiotics. (Be mindful, however, of drinking too many smoothies if you're watching your weight: It's easy to over consume liquid calories.)
The Pre-Workout Smoothie
Why: Early morning workouts mean even earlier breakfasts—or for many, no breakfast at all. But if you're aiming to nail those interval times, having some fuel on board is critical. A smoothie provides fuel and fluids in a convenient and easy to digest form. You can drink it in the car on your way to morning Masters swim, or sip on it as you stretch and get ready to run or roll out the door.
When: Digestible liquid meals like smoothies mean that the time between eating/drinking and working out can be shortened. Aim for at least 30 minutes lag time for greater gastrointestinal comfort.
What: For a pre-workout smoothie when training in the heat, try blending with ice cubes to make a cold slushie (cold drinks have been shown to boost performance in the heat). To make a thick, spoonable ice-cold smoothie, freeze in an ice tray then simply blend the frozen smoothie cubes with an extra dash of milk or juice.
Blueberry Honey Pre-Workout Smoothie
The fruit and honey provide energy and the blueberries pack in antioxidants. Yogurt adds probiotics and may be easier to digest than milk, but you can use whatever milk or milk alternative you prefer.
Ingredients¾ cup blueberries (fresh or frozen)
¾ cup natural plain yogurt
2 tsp honey
3 ice cubes (optional)
1) Throw all ingredients into the blender and blitz until combined. Serves 1.
The Recovery Smoothie
Why: We need recovery fuel soon after exercise, but higher post-workout body temperatures mean that blood has been diverted away from the stomach. This makes digestion more difficult, and food borderline unappetizing. Liquid meals may be better tolerated after a high-intensity workout—they help quench thirst and are easier to get down.
When: 30 to 45 minutes after a workout. This becomes even more important when you are doing double or even triple workouts in a day.
What: The ideal recovery meal or snack contains protein for muscle repair, carbohydrates for glycogen replenishment, and essential fats. Whey protein is an ideal protein to add as it is quickly absorbed.
Banana-Almond Protein Smoothie
The ingredients in this smoothie pack in the protein and will have a cooling effect on your body after a workout.
Ingredients1 scoop whey protein
1 banana
1 Tbsp almond butter
¾ cup milk or milk alternative
3 ice cubes (optional)
1) Throw all ingredients into a blender and blitz for 30 seconds.
The Nutrient-Dense Smoothie
Why: Too many triathletes rely heavily on packaged sports foods. These might be great for race day and for key workouts, but getting a substantial proportion of your daily calories from sports drinks, gels and chews is less than ideal and will leave you lacking in the nutrient department. Try to incorporate more real fool and include a couple of nutrient-dense smoothies throughout the week. Green vegetables (with a little fruit to sweeten) are a convenient way to boost your nutrient intake.
When: Any time, especially for those in hard training and in need of extra calories. Substitute as a snack or use as a nutrient-dense breakfast.
What: Experiment with green vegetables such as kale or spinach as the base. Vegetables are more nutritious than most fruits, which are also higher in (natural) sugars. Other vegetables like beets, carrots, celery, cucumber and herbs are also great. Sweeten with a little fruit to make it more appealing.
Minty-Chia Green
Chia seeds are rich in protein and contain valuable Omega-3 essential fatty acids. When you soak the chia seeds in water, they expand and become gelatinous, adding thickness and substance to a drink.
Ingredients1 tsp chia seeds
4 tsp water
1 green apple
10 fresh mint leaves
large handful of baby spinach or kale
½ cup fresh apple juice
1) Combine chia seeds with the water and soak for a few hours or overnight in the fridge (do this in a bigger batch and use 1 tbsp of the gelatinized mix).
2) Add rest of ingredients plus the chia seed mix to a blender and blitz until combined.
Pip Taylor is a nutritionist and professional triathlete.


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An overbearing and at times ridiculously aggressive Massachusetts Senator Scott Brown came across as a desperate man Thursday night, as he attempted to gain the upper hand in the first debate of this year's most closely-watched U.S. Senate race and, by extension, in a reelection contest that seems to be slipping away from him.
Brown literally attacked Elizabeth Warren, his Democratic challenger, from start to finish.
Warren, unruffled and showing the confidence of a woman who has moved ahead of Brown in most recent polls, sometimes rolled her eyes or shook her head in disappointment. She made her points about economic injustice and Wall Street wrongdoing, about holding corporations to account and establishing far tax policies, about relieving the crushing burden of student-loan debt and about making sure that Mitt Romney and a Republican Senate do not fill the next vacancies on the U.S. Supreme Court. Brown could attack all he wanted, but the senator who joined fellow Republicans in trying to block President Obama's nomination of Elena Kagen to the high court could not change the reality that Warren was right when she said: "This really may be the race for the control of the Senate and the Supreme Court may hang in the balance."
Warren was smooth and effective, "explaining things" with the same confidence that Bill Clinton displayed in Charlotte. It wasn't always easy; as Brown interrupted at every opportunity -- to accrue Warren of lying about her heritage, of attacking asbestos victims, of starting Occupy Wall Street.
But Warren never sweated it. She knew she had the winning hand.
And she played it. Again and again.
In a very Democratic state that very much does not want Republicans to take control of the U.S. Senate, Warren kept emphasizing that -- for all Brown's talk of bipartisanship and moderation on abortion rights -- "It's not about Senator Brown's vote. It's about the votes of all the Republican senators."
Noting again and again that Brown had told Republican donors across the country that then needed to help him win so that Republicans would take charge of the chamber, Warren kept returning to a basic theme: "This is about control of a Senate."
That was a powerful message, and a correct one.
But the even more powerful message came when Warren declared mid-way through the debate: "This really is about who you want as commander in chief."
In a state that once elected Mitt Romney governor but that will never vote for him again, Warren drew the line of distinction that her opponent feared most -- and that Republican candidates in other states are coming to fear as the Romney campaign stumbles from candidate-created crisis to candidate-created "crisis."
"I support President Obama," she said.
Brown just gulped.
He knows he's got a problem. And that problem is named Mitt Romney.
On the eve of first debate by 2012 election season's most intense contest, a Massachusetts group made a simple request of Scott Brown.
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Progress Massachusetts asked the senator to level with the voters about where exactly he stands with regard to Mitt Romney and Paul Ryan. Does supposedly-moderate Brown think the country would be better served with the most extreme Republican ticket in the party's history assuming executive authority over the United States? And, if that is the case, how exactly will he help them to exercise that authority?
Basic questions. Easily answered.
Except by Scott Brown, whose debate performance Thursday night offered a striking example of how a career politician can talk out of both sides of his mouth without saying anything of consequence.
Brown kept trying to suggest that a handful of reasonably moderate votes made him a paragon of bipartisan virtue who should not be seen as a Republican.
In contrast, Warren, the Wall Street reformer and consumer champion who entered the Senate race with a real determination to change Washington -- even if it means standing up to her own party -- was clear and unequivocal.
"I want (President Obama) to stay on as commander in chief," she declared.
The contrast between Brown and Warren could not have been more stark.
But the real debate was and is between Brown and Brown.
The senator has objected to the Republican platform of Mitt Romney and Paul Ryan, decrying the document's extreme and inflexible language on social issues "a mistake." The senator has distanced himself from his party's vice presidential nominee, noting that he voted twice to block Senate consideration of Ryan's signature proposal, the "Roadmap for America's Future." And the senator has noisily rejected Romney's dismissal of 47 percent of Americans as a "dependent" class that Republicans should not bother with, saying "That's not the way I view the world."
Yet, Brown still wants to have it both ways. He wants conservative backers of the Romney-Ryan ticket to think he's with them. He wants moderate and liberal independents, and even some Democrats, to see him as a renegade Republican who has not taste for the ticker.
That's political gimmickry, and Progress Massachusetts executive director Michael Fogelberg -- a veteran Massachusetts activist with decades of experience as a tenant organizer and consumer and environmental campaigner -- called him on it.
In a letter delivered to Brown, Fogelberg wrote: "The Republican nominee for President - your endorsed candidate - has said in no uncertain terms that he believes that nearly half of America believes that they are "victims" who do not "care for their lives." Mr. Romney cannot credibly serve as the Commander in Chief of our nation when he so clearly has such contempt for half of our nation's population."
"As such," Fogelberg continued, "Senator Brown, I urge you to immediately, and in no uncertain terms, rescind your endorsement of Mitt Romney for President. Failure to do so is tantamount to an endorsement of Mr. Romney's reprehensible and divisive remarks. Any half-measure, such as a mere Tweet criticizing the comments, would be seen as a cynical political ploy."
But Brown's entire career has been a cynical political ploy. He's got to keep the conservative money flowing. So it is hard to imagine that he will renounce Romney, and he certainly is not going to oppose his Republican caucus when it comes to organizing the Senate
Elizabeth Warren would have won the debate on points.


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Yes to both questions.
Student or Learner
By a strange turn of fate, John met his wife and married her years later.
By a strange turn of fate, John realized the true meaning of life and started helping people in need.
Do I use the phrase "by a strange turn of fate" right? Does it mean "Because of/Owing to a strange change of fate?" Thanks.
Yes to both questions.
Thanks, Anglika.
Those simple sentences are my style.


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Our step-by-step methodology will walk you through the process of making improvements
Our guide tackles the most common problems with existing documentation systems
RE-ORG offers tools for those entrusted with the protection of museum collections for the benefit of future generations. Join the community and make a difference! It's easy... and it's entirely free!


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Warren Buffett told more than 30,000 shareholders gathered for Berkshire Hathaway's annual meeting that the company will not change much when he's no longer in charge.
Buffett noted that newspapers often write stories saying Berkshire won't be the same without him, but he assured the crowd "it will be the same."
He said that Berkshire has created a strong "culture" over the years that would reject any attempt by an outsider to make changes that don't reflect his way of doing business.


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INTERNATIONAL BROADCASTING CONVENTION, AMSTERDAM, September. 11, 2014 – SanDisk Corporation (NASDAQ: SNDK), a global leader in flash storage solutions, today unveiled significant upgrades to its SanDisk Extreme PRO CFast 2.0 memory card and announced that the SanDisk Extreme PRO SSD has been qualified for 4K capture. These two products expand SanDisk's extensive portfolio of high-performance products designed for the professional broadcast, cinematography and photography industries.
"The performance demands for media and broadcast professionals continue to rise and SanDisk is committed to delivering leading-edge capture and storage technologies," said Dinesh Bahal, vice president, product marketing, SanDisk. "The new SanDisk Extreme PRO CFast 2.0 card and SanDisk Extreme PRO SSD will help produce the highest quality content possible, and significantly improve workflow efficiency."
As a follow-up to the world's first CFast 2.0 card in 2013, the upgraded SanDisk Extreme PRO CFast 2.0 card will power the next generation of high-performance cameras and camcorders. The 128GB card delivers shot speed of up to 440MB/s* and data transfer speeds of up to 515MB/s* for extreme workflow efficiency. Additionally, the SanDisk Extreme PRO CFast 2.0 card combines the speed, capacity and performance needed to record cinema-quality 4K video (4096x2160p)1 in storage capacities of up to 128GB**, making it the right choice for demanding professionals.
Recognizing the industry-leading performance and reliability of SanDisk's CFast 2.0 products, leading motion picture equipment manufacturer ARRI has named the SanDisk Extreme PRO CFast 2.0 card as its card of choice for its ALEXA and AMIRA cameras.
"We are happy to work with SanDisk to move the CFast 2.0 standard forward, as it aligns with our commitment to offer the most efficient workflows possible to our customers," said Stephan Schenk, managing director at ARRI. "Our ALEXA and AMIRA cameras were the first to implement CFast 2.0 recording, which brings a range of production benefits. CFast 2.0 opens up creative opportunities through longer recording times and higher frame rates with top-quality codecs, all at an impressive price/performance ratio."
Industry leaders ARRI, Canon, Hasselblad, PhaseOne and Leica, and video technology pioneers, Atomos and Blackmagic Design, are strong supporters of the CFast 2.0 standard.
"The performance of the SanDisk Extreme PRO cards is amazing, and we are incredibly excited by what they will allow our customers to do," said Grant Petty, CEO, Blackmagic Design. "URSA is the world's first digital camera designed around a user-upgradable sensor and lens mount, and a critical part of its design is the use of a dual CFast 2.0 recorder for nonstop recording. With these new SanDisk cards, our customers can dual-record and capture at incredible speeds."
SanDisk understands that pro-level performance is required for heavy workloads and effective multi-tasking. For professionals looking to store and edit 4K video, SanDisk Extreme PRO SSDs deliver up to 550 MB/s* sequential read speeds that give professionals the 24/7 consistent performance they need for the most demanding and graphic-intensive applications. The SanDisk Extreme PRO SSD is ideal for working with large files, such as 4K Ultra HD1, because it delivers the necessary speeds and data safety. The SSD's performance and value have been recognized by Atomos and Blackmagic Design, and it is now qualified by both companies for 4K RAW and 4K ProRes capture in each company's top products.
"Reliability in the field is a cornerstone of Atomos products and a reason why SanDisk is one of our closest partners for capturing ProRes and DNxHD to an affordable SSD," said Jeromy Young, CEO Atomos. "With the emergence of our 4K Shogun recorder, we are excited to extend certification for the SanDisk Extreme PRO SSD."
The new SanDisk Extreme PRO CFast 2.0 memory cards will be available at select photo specialty stores in October. The SanDisk Extreme PRO SSDs are currently available online and purchasable through SanDisk's worldwide network of authorized distributors and resellers. For more detailed product information, visit www.sandisk.com.
SanDisk will be showcasing its newest offerings at IBC, Stand C11.65, Hall 11.
SanDisk Corporation (NASDAQ: SNDK), a Fortune 500 and S&P 500 company, is a global leader in flash storage solutions. For more than 25 years, SanDisk has expanded the possibilities of storage, providing trusted and innovative products that have transformed the electronics industry. Today, SanDisk's quality, state-of-the-art solutions are at the heart of many of the world's largest data centers, and embedded in advanced smart phones, tablets and PCs. SanDisk's consumer products are available at hundreds of thousands of retail stores worldwide. For more information, visit www.sandisk.com.
© 2014 SanDisk Corporation. All rights reserved. SanDisk and SanDisk Extreme PRO are trademarks of SanDisk Corporation, registered in the United States and other countries. CFast is a trademark licensed by the CompactFlash Association. Other brand names mentioned herein are for identification purposes only and may be the trademarks of their respective holder(s).
* 128GB SanDisk Extreme PRO CFast 2.0 card: Based on internal testing; performance may be lower depending upon host device. 240GB SanDisk Extreme PRO SSD: Based on internal testing; performance may vary depending upon drive capacity, host device, OS and application. 1MB=1,000,000 bytes.
** 1GB=1,000,000,000 bytes. Actual user storage less.
1 14K (4096x2160) and 4K Ultra HD (3840x2160) video support may vary based upon host device, file attributes and other factors. See www.sandisk.com/HD
This news release contains certain forward-looking statements, including expectations for markets, products, industry trends and customers that are based on our current expectations and involve numerous risks and uncertainties that may cause these forward-looking statements to be inaccurate. Risks that may cause these forward-looking statements to be inaccurate include among others: the market demand for our products may grow more slowly than our expectations or our products may not be available in the capacities that we expect or perform as expected, or the other risks detailed from time-to-time in our Securities and Exchange Commission filings and reports, including, but not limited to, our most recent quarterly report on Form 10-Q and our annual report on Form 10-K. We do not intend to update the information contained in this news release.


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Generations of experience, serving generations to come.
National Lutheran Communities & Services. For retirement living. For health and senior care. For a rewarding way of life.
National Lutheran Communities & Services (NLCS) has been blessed with a long tradition of service to people of all faiths. Since 1890, we've helped people find wonderful choices for retirement living, new options for financial security and expert services for health care and wellness. While staying rooted in our heritage, we have continued to plan for the needs of future generations we will serve.
NLCS is a faith-based, not-for-profit ministry of the Evangelical Lutheran Church in America's (ELCA) Delaware-Maryland, Metropolitan Washington, D.C. and Virginia Synods serving people of all beliefs. NLCS provides seniors with a variety of lifestyle, residential and health care options through retirement communities in Maryland and Virginia.
Explore life at The Village at Rockville,(formerly the National Lutheran Home) in Rockville, Md., The Legacy at North Augusta in Staunton, Va., and our newest communities: The Village at Orchard Ridge, a CCRC in Winchester, Va., and The Village at Providence Point, coming soon to Annapolis, Md. Learn about our home care services with myPotential at Home.
Check Out Our Latest News!
October 8, 2019
The Village at Orchard Ridge–A National Lutheran Community is unveiling the nominations for the inaugural... Read More
September 3, 2019
Great Place to Work and FORTUNE have honored myPotential at Home, through its parent organization,... Read More


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No matter your story, you are invited to come unto Christ. We can all experience more joy in our individual lives when we turn to Him — who loves us most.
Jesus saved the world so each of us could live more fully, without losing our unique individuality. As we turn to Him, we can grow into the people we were truly meant to be and better serve and love those around us. We invite you to learn more about His mission, His teachings, and His role as Savior of the world.
The truths taught by Jesus have a direct impact on how we live our lives. He can make you a better person. You can make us a better church.


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Exosomes Research Products
A range of specific tools and technologies are needed for the isolation and analysis of exosomes and their cargo. Learn about products developed to simplify the overall study of exosomes.
Episode 1 - "What is an Exosome?"
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JackV necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 89 diseños de 22 diseñadores freelance.
We are looking to create a simple yet creative web 2.0 logo for a Cellphone Repair website - Based of our brand colors.
Winner will get more projects
Have a look at our website ( http://www.unlimitedcellular.us/outofwarrantyv2/ ) It's still in development but you can get a pretty good idea of what we do and how we do it.
- I'm trying to target the 18-35 crowd mostly but not limited to them.
- Our color compositions and combinations are unique - at least in out industry.
- We plan to use this logo for marketing materials and promotional products so i will need vector files with and without gradients.
- I would like to see a few versions of a wrench & cellphone concept
- OOW is the acronym
- http://www.outofwarranty.com is the website address (When launched)
- Out Of Warranty is the company name
- we dont have a slogan yet - feel free to throw one in
- We plan to trademark the logo, so please use royalty free vectors only - no freebie/creative commons stuff.
- feel free to use a "green" element (we are eco friendly) - Not important.
- we will be repairing cameras, mp3 players and other electronics further down the line.....but cellphones are our priority
- color scheme from website
- web 2.0
- simple - no more then 3 colors (2 colors is preferable)
- young & fresh but not to much.
- completely original
- rainbows?
- cheap clipart
- Reflections wont really work with our site..
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


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Browse by Medical Category
Read Dr. Jeremy Ruskin's analysis of cryoballoon ablation in Medpage Today
Thursday, May 13, 2010
Cryoballoon ablation shows promise as new treatment for arrhythmia
Michael Walsh's heart was constantly racing; and the irregular heartbeat caused by a type of arrhythmia called atrial fibrillation (AF) was leading to physical discomfort and emotional distress. "It's a panicked feeling when your heart starts to race," he said. "You don't know whether it's the arrhythmia or a heart attack. It was miserable." Walsh, 48, of Andover, New Hampshire, suffered these debilitating symptoms for five years until undergoing a new procedure at the Mass General Heart Center that freezes heart tissue to restore normal heart rhythm. Cryoballoon ablation Atrial fibrillation is the most common type of irregular heart beat — or arrhythmia — affecting more than 2.5 million Americans. AF causes the upper chambers of the heart to beat too fast, inhibiting the movement of blood in and out of the heart. AF diminishes a person's overall quality of life with symptoms like fatigue, shortness of breath and chest pain, while also significantly increasing their risk of stroke and heart failure. AF is often treated with drug therapy, but for many patients drugs alone are not sufficient to ease the suffering. "My doctors had me try several medications, but they were not working and the arrhythmias were coming back just as bad. I broke through them all at the maximum doses," he explained. "I wanted to try something that would keep the AF from coming back." Through the father of one of the students at the boarding school where he is a teacher and coach, Walsh learned about a new treatment available at Mass General — cryoballoon ablation. During this minimally invasive procedure, doctors insert a balloon catheter into a blood vessel in the upper leg and snake it through the circulatory system until it reaches the heart. Once in place, the balloon is inflated and extremely cold energy flows through the catheter, freezing the heart tissue that is causing the irregular heart beat. Walsh made an appointment with Jeremy Ruskin, MD, director of the Mass General Cardiac Arrhythmia Service, where doctors have been part of clinical trials evaluating this new procedure. "Mr. Walsh was a good candidate for the procedure because he had paroxysmal AF, and we were seeing promising results among patients with that type of arrhythmia," said Moussa Mansour, MD, a cardiologist with the Heart Center's Cardiac Arrhythmia Service and director of the Electrophysiology Laboratory. In October 2009, Walsh went in for the procedure, which was done using conscious sedation. The procedure lasted three hours, and after one night in the hospital Walsh was on his way home. Days after the procedure, he had not had any irregular heart rhythms. His doctors were cautions and told him not to worry if he had an episode, but six months later he has still not had any symptoms. "I would have done anything to be free of the AF. I wanted to be healthy again," he said. "I can't say 100 percent that this is never going to happen again, but I am feeling great now." STOP-AF Cryoballoon ablation is still being tested and is not approved by the U.S. Food and Drug Administration. However, results from the large, multicenter trial called STOP AF have been promising. Jeremy Ruskin, MD, director of the Cardiac Arrhythmia Service at Mass General, presented data from 245 highly symptomatic patients at the Heart Rhythm Society's annual Scientific Sessions in May. Results indicated that patients treated with cryoablation had a treatment success rate of 69.9 percent after 12 months, compared to 7.3 percent for those who received traditional drug therapy. Results also showed that cryoablation improved the physical and mental quality of life for patients in the study. Overall, only 20 percent of the cryoablation-treated patients reported any symptoms after 12 months. "The results from the STOP-AF trial are promising. They indicate that cryoballoon ablation is effective for treating arrhythmias in patients who are not being helped by the traditional drug therapies," said Dr. Mansour. Cryoballoon ablation may also have several additional benefits.
"In cryoablation, the balloon freezes the whole vein at once rather than burning several points of the vein, as is done during radiofrequency ablation, another common treatment for AF. Using heated energy to burn the vein can sometimes disrupt the lining of the heart or cause esophageal injury," he said. "This is one of the several small advantages of cryoablation."
Cryoballoon ablation is available as part of ongoing clinical trials at Mass General. Michael Walsh will have a final follow-up appointment one year after his procedure.
"Even though it's still being tested, I felt this was the best option for me," said Walsh. "I didn't want to control the AF, I wanted to eliminate it. So far I couldn't be happier."
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Questions and Answers - General Information
Q: In the past three days my husband's breath has smelled strongly acidic. Is this related to his diabetes?
A: If his glucose levels have been elevated, he could be breaking down fat for fuel at a rapid rate. This produces ketones, which can produce fruity or acidic breath. You can purchased ketone strips at the pharmacy to test urine for the presence of ketones. If this persists and if his glucose stays elevated in spite of any efforts on his part for correction, have him see his physician.
Q: I read that people with diabetes should not use heating pads. Why not?
A: This recommendation is more of a caution for those who have neuropathy and may not feel if the pad gets too hot and could be burned as a result.
Q: Do I need to fast before having an A1C test?
A: No, fasting is not required for an A1C because the test measures your average blood glucose levels over the past three months.
Q: What is ketoacidosis and what are the symptoms?
A: Ketoacidosis is the build-up of ketones (a by-product of rapid fat breakdown in the body) and can be life-threatening if left untreated. This would generally not occur unless glucose levels were very elevated over a longer period where the cells, needing fuel, rapidly break down fat to help keep you alive. At that point, one may be in a diabetic coma. In pregnancy, it is important for good control to prevent ketoacidosis so ketone bodies do not form, as they can cross the placenta and be toxic to the fetus. Symptoms may include fruity smelling breath, high blood sugar, excessive thirst, frequent urination, nausea and vomiting. If concerned, you can buy strips at the pharmacy to test urine for the presence of ketones.
Q: Why do I need to fast for 10 hours before a fasting glucose blood test?
A: This time frame gives your body a chance to digest all food in your system to more readily determine what your true fasting blood sugar is. Carbs, proteins and fats all digest at a different rate and a larger meal will take longer to digest. A fasting blood sugar of 126 repeated twice is a diagnosis of diabetes.
Q: Does drinking black coffee impact a fasting test?
A: Caffeine is a central nervous system stimulator, and may have a short term effect on blood sugars. Only water should be consumed prior to testing.
Q: How would I know if I am diabetic? What are the signs?
A: Frequent urination, rapid weight loss, dizziness, and excessive thirst are just some of the symptoms associated with, but not exclusive to diabetes. This is certainly truer of those on the path to type 1 diabetes. Many others will only know by getting a blood test to see if their fasting levels are elevated. 100-125 is generally considered pre-diabetes, 126 and greater with 2 tests is a diagnosis of diabetes. I suggest you request a fasting glucose test for starters.
Q: If I have some of the risk factors for diabetes, how often should I be tested to find out if I do have it or not?
A: If you are not experiencing any symptoms, an annual physical should be enough. Your glucose levels should be under 100; ideally between 80-90. If you are experiencing any symptoms such as weakness, frequent urination, increased hunger or thirst, or frequent infections, then get a fasting test now.
Q: Is it possible to stop being diabetic?
A: Once you have diabetes, you will always have it, but you can manage it to the point that it appears as if you don't have it. What this means is that you can get your blood sugars under control and within normal ranges, and maintain the healthy lifestyle required to stay within range. Learn all you can at this time on how to manage diabetes and live with it. You will find, for the most part, that an active lifestyle with healthy foods in moderate amounts will allow you a "normal" quality life.
Q: My fingertips hurt from testing. Does it matter if I get my blood sample from somewhere else on my body?
A: Fingertips (on the sides of tips) offer a more reliable capillary flow and reading because changes in glucose levels are detected here more rapidly. This is especially important when treating hypoglycemia. If you wish to use an alternative site such as your forearm or thigh where the blood flow is less, make sure you are using a meter that requires a smaller blood sample. You may want to discuss this with your physician.
Q: I am new to diabetes and am having trouble sticking myself for testing my blood sugar.
A: The first step in pricking your finger is to wash your hands with soap and water when at home. Make sure your hands are warm, and have your hand pointing down so the blood can flow to the tips. Pick any finger, using another finger to support it or lay it on its side so that you can stick the side of the tip, not directly on the tip of the finger. There are many nerve endings in your tips, and this area can be very sensitive. The good news is that the meters today require very little blood. You need to either ask your pharmacist or your physician's office to help get you started. Once you are shown, then you can practice and more assured of the readings you are getting.
Q: Does obesity cause type 2 diabetes?
A: Obesity is not the cause of type 2 diabetes, but is a strong contributor if one is genetically disposed. In my many years of counseling, I have seen very few folks with a BMI over 30 - in the obese classification - that don't have elevated or elevating glucose. Increased body fat appears to interfere at the cellular level with the uptake of glucose from the bloodstream into the cell: the job of insulin. This creates a condition called insulin resistance. Unless lifestyle changes are made towards better eating habits and activity, pre-diabetes will usually blossom into diabetes.
Q: If a 13 year old is diagnosed with diabetes, is it always type 1 and necessary to be on insulin or can it be controlled by diet?
A: No, the diagnosis of a child is not always type 1 diabetes. With childhood obesity so common now, we are seeing type 2 diabetes at much younger ages. Those who are truly type 1 require insulin to live. If your child is not requiring insulin at this time, it may be true that he/she may need it in the future if the pancreas is on a path to no longer being able to produce insulin. There are tests that can help determine this. Discuss this with your physician. Following a healthy lifestyle and eating whole foods is most important with or without medication.
Q: How can I help my young adult son with type 1 diabetes get a good night sleep? He has trouble falling and staying asleep.
A: Many people have this problem and there is no one answer. The first goal would be to maintain stable glucose levels, as fluctuating levels can certainly affect good sleep. A cup of hot herbal sleep tea 1/2 before bed may help him relax and be able to fall asleep easier. Supplementing with Melatonin, a sleep hormone produced by the body, can often help. Quieting his mind is key; some people benefit by listening to relaxation tapes at night. Exercise during the day can also make for better sleep at night. The most important factor is that he wants to take steps to sleep better and overall maintain a better quality of life.
Q: I read that with type 2 diabetes, the production of insulin goes down with age. Does it ever go down to nothing? Is it possible to test how much insulin my body still produces?
A: It is possible to have your production of insulin cease over time, but usually this is not the case for type 2 diabetes. It is even less likely if you live a healthy lifestyle for both diet and activity. You can have your insulin output measured with a C-Peptide test. If your body truly no longer makes insulin, as the case with type 1 diabetes, and you are not injecting insulin, you will die. There are those with type 2 diabetes who do require insulin to have any semblance of good levels, but can survive without insulin for some period of time, but with high levels.
Q: While being treated for pancreatitis in the ICU for the second time, I was told that my blood sugar was 422 and that I am diabetic. I have not gained any weight, I am on a pretty strict diet and yet my sugar doesn't run under 200 for more than a day even though I am taking 75 units of Lantus. My doctor has told me to hold off on increasing the units until our next visit. I have not been diagnosed with type 1 or 2! Are there any other tests that could help diagnose the type of diabetes I have?
A: If you were truly type 1, you would require insulin for survival. At the moment, you appear to be type 2, requiring insulin to help lower your numbers. Each bout of pancreatitis may be affecting the insulin producing cells a bit more, resulting in a reduced ability of your body to produce sufficient insulin to keep your levels in a better range. At this time, your physician is probably trying to see if you stabilize at 200 or less and perhaps begin to lower on your own as your cells possibly start producing more insulin again. The C peptide test can give an indication of how much insulin your cells are producing. It does appear you need further discussions of this with your physician.
Q: My boyfriend is diabetic. He is a bit of a rebel and doesn't test his levels. At least once a month he turns into what I call a "zombie". He starts to get sweaty/clammy, he tends to be forgetful, he repeats himself, and this last time he was totally out of his right mind and became violent. When I confronted him about it afterwards, he had no recollection of doing it. How do I help him?
A: Erratic glucose levels can mimic bipolar behavior and potentially be harmful to you both. He is obviously experiencing high/low glucose level swings. He does need to take this seriously, see his physician assuming he has one, and follow with a diabetes eating/lifestyle plan. He should be testing his levels. He may need medication to help get his levels under control. Being a rebel is fine about some things, but not about a condition that can be life threatening if left unmanaged. If he refuses to do anything to better control himself, you may have to take a tough love stand for your own well-being and possible protection.
Q: If a 13 year old is diagnosed with diabetes, is it always type 1 and necessary to be on insulin or can it be controlled by diet?
A: No, the diagnosis is not always type 1 diabetes at a young age, as was typically more so in past years. With childhood obesity so common now, we are seeing type 2 diabetes at much younger ages. Those who are truly type 1 require insulin to live. If your child is not requiring insulin at this time, it may be true that he/she may need it in the future if the pancreas is on a path to no longer being able to produce insulin. There are tests that can help determine this. Discuss this with your physician. Following a healthy lifestyle and eating whole foods is most important with or without medication.
Q: Does having lows blood sugar readings of 60 or 70 affect my A1C level?
A: A1C is a 1.5 to three month average of your glucose levels. It does not specify highs vs. lows. The goal of good control is not to have erratic swings in sugars, as this creates wear and tear on the neuropathic system. Being in the 70's is very normal (symptom free) for many people and better overall than levels over 100. Just continue to follow a very healthy lifestyle with attention to eating unrefined foods as much as possible, as blood sugars are always subject to change over the life cycle.
Q: Can I drink water during the two hour period before testing my blood sugar?
A: Of course! Water is a major nutrient, as we are composed of at least 60% water. It is calorie free, so it will not raise your blood sugar. It is most important that you stay well hydrated, as elevated glucose can be most dehydrating, leading to headaches and dizziness. The textbook recommendation is to drink half your body weight in ounces of water throughout the day.
Q: Can a diabetic use a hot tub?
A: This has been a controversial issue for some time, but should really be treated on an individual basis. The first consideration is that the hot tub should be very clean, which would probably rule out many commercial tubs that accommodate lots of people in a day. Don't go in with any open sores, cuts, etc. Poor circulation in hands/feet may also be cause for avoidance if one has reduced ability to sense high heat. If your physician doesn't see an obstacle, start with a few minutes, working up to a maximum of about ten. Be mindful of chlorine which may be irritating.
Q: Do people with diabetes need to use special toothpaste?
A: Generally speaking, no, because you are not ingesting toothpaste. However, you do want to pay attention to the ingredients in things like cough syrup and other medicaitons over the counter that may have sugar in them. Many products have sugar free versions. Always ask your pharmacist when you aren't clear about the best product to buy for diabetes.
Q: It has been just a few weeks since my diagnosis of type 2 Diabetes and I am a bit freaked out because I've yet to see anybody mention their A1c being anywhere in the same ball park as mine, which is 11. Am I in huge trouble or what?
A: That is very high and needs to come down somewhat gradually so as not to experience feelings of low blood sugars. Taking charge of your food and lifestyle is the path to stay on. Insulin at this time may help to detoxify your beta cells, giving your pancreas a rest while you move into a more normal range. Be patient with yourself, but diligent. You didn't develop diabetes over night; you may have been pre-diabetic for some time. The closer you get to more normal weight, the better your chances for better control with less medication.
Q: Why are people with diabetes supposed to be so careful about treating cuts and other injuries?
A: A person who has poorly controlled diabetes may find it takes longer to stop the bleeding or to heal the cut. This the same caution for any wound, especially on the feet, which is why people with diabetes are encouraged to check feet daily for even a small splinter. If you maintain good levels that have been established with your physician, then healing times should be similar to anyone else who is basically healthy.
Q: Can diabetes cause a person's feet to have a bad odor?
A: Diabetes left unchecked may be involved in a foot infection, which can certainly cause an odor. Any build up of bacteria or fungus can do the same. Be sure your feet are thoroughly washed with soap before bed, inspect your feet for any cuts, splinters, etc, and when wearing socks, they should be cotton. A yearly visit to a podiatrist is recommended for persons with diabetes. I suggest you at least pose this question to your physician.
Q: Can the low blood sugar that I experience from time to time be a sign that I could be heading down the road to diabetes?
A: Right now, it is most important that you learn to eat correctly for hypoglycemia (i.e. low blood sugar). This would mean to eat a small meal or snack every few hours. Food should be unrefined: no sugary starchy white stuff. Instead, eat lots of veggies, legumes and fish if you eat it. A handful of dry roasted nuts can curb a low blood sugar episode. What's needed are small doses of protein. Left unchecked over time, it is possible for hypoglycemia to advance into hyperglycemia, and then on to diabetes.
Q: Why do I get extremely tired and fall asleep after eating a meal? This is true when I eat any food with greater simple sugars, desserts especially. I am sleepy within an hour of eating.
A: You are most likely "carb sensitive", which means that those refined carbohydrates will quickly turn into sugar in your body, and release a good dose of serotonin to the brain. This is a hormone that has a very calming effect and, for someone like yourself, will help to put you to sleep! I would suggest you now experiment with eating only complex carbs and shifting more into veggies, fish, and legumes for awhile to see if that helps you become more alert. This will also help your blood sugar numbers come down.
Q: What is "Brittle Diabetes"?
A: "Brittle" is a term used when one has had diabetes for a long time, and in spite of a solid focus on maintaining a healthy lifestyle and good medication management, it becomes harder to control blood sugars. This is more often the case with insulin dependent diabetes. Some folks do better with an insulin pump in such cases.
Q: Can very low blood sugars cause depression and cause someone to act like a different person, ex. extreme anger and hostility?
A: Erratic blood sugars can cause mood swings, such as one would expect with untreated bipolar disorder. If you have ever gone for long periods without food and experienced a feeling of irritability as a result, magnify that many times for blood sugars dropping suddenly too low, or blood sugars that roller coaster day to day. I hope that this person is willing to do what is suggested to get glucoses into a more normal range.
Q: I was recently diagnosed with type 2 diabetes and now I have my first bought of cold/ bronchitis since my diagnosis. How do I know when I should see my doctor vs. let the illness run its course?
A: When you have diabetes and are ill enough to where your blood sugars go too high and/or your illness doesn't come under control in a normal course, you should certainly seek medical attention. Stay well hydrated. With diabetes, you may find you now respond to illness differently so do not hesitate to talk to your health care team if you have any questions.
Q: How can I prevent diabetes? I am 14 and overweight and diabetes runs in my family.
A: Be very active, and learn as much as you can about healthy eating. Learn to love anything from the veggie world, and make fruits your choice when you crave something sweet. Drink plenty of water and cut out sodas, chips and other snack "junk" foods. Just because there is diabetes in your family, it doesn't mean you have to get it if you start now with lifestyle changes. Learn as much as you can.
Q: Can eating before a gestational diabetes glucose test cause the results to be inaccurate? Before the one hour glucose test, I ate a whole bagel with cream cheese, and whole banana and about 12 oz. of apple juice before I drank the liquid for the test. No one told me not to eat or drink before the test. My reading came back as 157 and now after being on the diet for 3 days, my blood sugar levels have not gone over 80 and have gone as low as 52. My question is could the test have been wrong and should I ask to be retested?
A: Oh my! I do hope you informed them of that high carb breakfast for what should have been a fasting test. However, you are still higher than you should be; 110-120 one hour post meal is what is followed by some of the more "tight control" oriented practitioners. You would do well to watch your carbohydrate intake, especially in the morning, but you should not have blood sugars this low during the day. A fasting reading of 80-90 is good; under 120 two hours post meal is acceptable by some standards. Testing for ketones is also important if you truly have gestational diabetes. Revisit this with your health care team and ask them what their blood sugar criteria is.
Q: How does smoking affect diabetes?
A: Diabetes is considered a cardiovascular disease and smoking negatively affects the cardiovascular system. Smoking also depletes the body of ascorbic acid (vitamin C), a major antioxidant - a cell protector - and can deposit lead and other unwanted chemicals into the fatty tissues of the body. This can definitely interfere with metabolism and good blood sugar control.
Q: What impact would my husband's diabetes have on our future child if we decide to have a baby?
A: It is not a given that you would give birth to a child with diabetes though the genes may be present. The most important focus would be for him to first get blood sugars under control and be in good health. (Yes, this is important for the father as well as the mother). Then, follow a healthy lifestyle as the child grows, to avoid some of the triggers that might manifest later in life. This applies to both type 1 and type 2 diabetes.
Q: Does fasting make diabetes symptoms worse? My doctor also told me that if I lose all the weight I need to, the condition would disappear. Is this true?
A: In general blood sugars are far better managed with a controlled, regular eating pattern. Erratic eating, such as fasting and then eating large amounts, is perceived by the body as "binge" eating. Your doctor is right in that diabetes is very well managed when one is living a healthy lifestyle. Weight loss is secondary to consistently good habits.
Q: Do I use the first or the second drop of blood when testing my blood sugar?
A: With most strips now, you can touch them with the first drop. It takes far less blood than it used to in order to get a good sample. One drop is all that is needed.
Q: Is it OK for my 14 year old daughter with type 1 diabetes to get her belly button pierced or a small tattoo?
A: This is touchy. As a general rule, we say piercings/tattoos are not good ideas because they can be an invitation to infection. I suggest you consult with the nurse in her physician's practice. The conditions would have to be most sterile for any piercings - or pedicures for that matter. If your daughter's blood sugars are in exquisite control, and your medical team knows of a place that has met some standard, then something small may work, particularly if your daughter is rebellious, and would go out and do this on her own, but in poor conditions. Weigh and balance your decision after some detective work.
Q: What is the best way to test for type 1 diabetes? Is there a chance that a blood test is wrong?
A: Type 1 diabetes means that without taking insulin, you cannot live. There are those who still produce some insulin, but not at sufficient amounts so to control their blood sugars without taking insulin. This is referred to as type 1.5 diabetes. Your physician can order a C-Peptide test which can give you some idea of how much insulin your pancreas is producing. Type 1 diabetes often comes on fast and strong, with rapid weight loss, thirst, frequent urination, then stabilizes for a period until the cells stop insulin production. Type 2 diabetes is much more common than type 1.
Q: Is it normal for someone to go from healthy to insulin diabetic very quickly? I have been overweight for years and have been having my blood sugar checked at bi-annual doctor's appointments, always to be told it was "fine". All of a sudden my A1c is 10.1 with a fasting blood sugar of 329 and I was diagnosed as type 2 diabetic and placed on insulin immediately.
A: With blood sugars over 300, it is now the thought of many endocrinologists to start a person on insulin to detoxify the beta cells of the pancreas. This may only be for a short period if lifestyle changes are diligently made. Sometimes, it is a shift to oral medication, or none at all. Over the years, one may need a return to insulin and/or other medications. Take charge of your lifestyle habits and get all the education you can on managing this disease.
Q: How does diabetes affect your mood and thinking process?
A: With or without diabetes, when blood sugars are not in balance, fatigue, dizziness, "fuzzy" thinking, mood swings, and other symptoms may result. With insulin-requiring diabetes, this can be an even greater challenge to maintain stable blood sugars, but is very achievable with the right monitoring and support. Having a disease like diabetes does provide greater challenges for stable health and moods, but does not negate the ability to attain and maintain them.
Q: Is it possible that weight gain and morphine use caused me to develop type 2 diabetes? I had a morphine pump that leaked into my bloodstream and all through my body when it wasn't supposed to for about a month and, as a result, I gained in excess of 50 pounds.
A: The stress that caused you to be placed on the pump in the first place, plus the probability that you have a genetic disposition to diabetes, triggered further by weight gain, is now surfacing as diabetes. If you are now returning to your normal weight and following a healthy lifestyle, you may very well get back under 100 fasting and hopefully not much over 90. Many people have had blood sugars over 100 but under 126 for years - known as pre-diabetes. Pre-diabetes is just now being more aggressively focused upon for diabetes prevention. A good plan right now is to align yourself with someone who understands healthy eating for diabetes, and become as active as you can.
Q: Will losing a large amount of weight help me to avoid the diabetes that runs in my family? I am 19 years old and very overweight. I recently took my blood sugar a few times and the results scared me: 170 when I woke up.
A: Changing your lifestyle which will ultimately result in body composition changes and weight reduction can certainly keep diabetes in check. You surely have a wake-up call, and now is the time to get guidance in eating and begin a regular exercise program. Be most dedicated to yourself now, as 170 fasting would indicate diabetes. With perseverance, you can stay in control.
Q: Can diabetes prevent someone from losing weight? I know I am at high risk of getting diabetes but when I diet, it doesn't make a difference and I can't lose weight. I play lots of sports and am not lazy.
A: Diabetes in and of itself does not generally cause you to retain weight. Sometimes the medications a person is taking will often interfere, contributing to levels of fluid retention. Be as active as you can, striving to become a "lean machine", even if the numbers on the scale don't immediately change. Be very honest with yourself about your food intake/portions vs. activity levels. If you can locate a nutritionist in your area who also will suggest appropriate vitamin/mineral compounds and carbohydrate vs. protein amounts, that may be the boost you need.
Q: Can a type 2 diabetic become a type 1 diabetic after several years and how can I find out? My recent blood test showed that my pancreas is 1.5 and I understand this is very low.
A: Yes, you can become type 1 after years of being type 2. What this would mean is that you cannot live without taking insulin. It sounds as though you had a C-Peptide test, and discovered that your insulin reserves are low. If you have a practitioner in your area who understands nutritional therapies, this may help preserve and improve what insulin production you have. Eat whole, unrefined, organic foods as much as possible. Stay active, and work on the "tough" one: stress reduction.
Q: Since I have been a "bad" diabetic by not eating what I'm supposed to, can I reverse the damage I assume I have already done to my body? I have been type 2 for about eight years and am taking Avandia, Glucophage, Lipitor, Lizinopril.
A: I don't have a crystal ball, but getting a handle on things now can certainly slow down and possibly arrest further damage. It sounds like you may need to start from square one with nutrition and overall management. Appropriate vitamin/mineral supplementation can also be helpful. It is better late than never; it's time to find out!
Q: I have type 1 diabetes. What are the chances that my child will develop type 1 as well?
A: While there is a genetic component to type 1 diabetes, environmental factors play a role as well. Research suggests that genes account for less than halfthe risk for developing type 1 diabetes. 90% of children who develop type 1 diabetes do not have a relative with this disease and it is reported that only 15% of people with type 1 diabetes have a first-degree relative, such as a parent, with diabetes. There are certain genes called HLA markers associated with diabetes risk which can be identified at birth. Research is ongoing and very active in the field of diabetes and genetic markers soupdated information could be available in the near future.
Q: I am not diabetic according to medical tests. However, I can have a normal blood sugar reading of about 90 before breakfast and then after a moderate cereal-toast breakfast, my blood sugar will go over 200. Why does this happen?
A: Have you had an Oral Glucose Tolerance Test? Newer research is placing more emphasis on the after meal glucose elevations as opposed to just monitoring fasting glucose. You are experiencing hyperglycemia, which as an initial diagnosis, generally manifests as slowly elevating fasting glucose. Ideally, your fasting glucose should be closer to 80. 100 is pre-diabetes.
I would suggest that your breakfasts now consist of more protein and less carbs. Good choices include egg, yogurt, nut butter, cheese, meat, oatmeal, etc. Target for 20-30 grams of protein at each meal. Any carbs you eat should have fiber: whole grain toast toast, fresh fruit, etc. Breakfast cereals generally don't fit these criteria unless you search for a type with higher fiber. I suggest an overabundance of plant foods now, to clean out your system a bit, giving your liver a work break. This should help to fine tune your metabolism. Make sure you have essential fatty acids in your intake: fish/plant foods are main sources.
Q: What is normal glucose levels with the finger prick method (meter) on both one and two hour tests for non-diabetics? I only have seen fasting and two hour levels. I began testing one and two hours after beginning a meal. I have had the following elevations on one hour (174,139,155,161 and 196.) On the two hour test I have had (79,157,190,109,101,152 and 128.) My fasting levels are between 89 and 94, and the control shows the meter works fine. So it seems my fast is always ok; my one hour is always pretty high, and my 2 hour is a mix of high and normal. I have had really severe neuropathy for several years, and no other test results (like MRI's) show any problems.
A: Your readings are high and I would consult an endocrinologist, especially if you already have undefined neuropathy. In fact, more emphasis is now being placed on 2 hour levels than on fasting levels. 94 for a fasting also reflects an upward trend.
Severe neuropathy would reflects years of hyperglycemia, and would generally manifest first as peripheral neuropathy. "Severe" implies that you already have loss of sensation, compromised sight, etc. If this describes you, and you have not been referred to specialists before now, referral is long overdue. Have you been taking any nutritional supplements, or working a practitioner who understands this application? B vitamins and magnesium are compromised with neuropathy, and should be taken together with a nutrient dense diet. All diabetic diets are not equal in terms of balance and nutrient quality. Choose your practitioners now carefully; seek second opinions as necessary.
Information on the "Question and Answer" pages should not be relied on for medical or technical advice. Always consult your healthcare team. Diabetes Action and Jane DeVane cannot be responsible for errors or wrongful use of the information available on this website. The information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician/medical team.


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Romney, Ryan not alone in home-state shutouts
Trivial pursuit time: How many presidential tickets have lost their home states?
We'll provide the answer shortly, but the point of this is to note that Republicans Mitt Romney and Paul Ryan are the first ticket since 1972 that failed to carry their home states.
It was widely expected that Romney would lose reliably blue Massachusetts, which has only voted four times since 1928 for a GOP presidential nominee. That was twice for Dwight Eisenhower and twice for Ronald Reagan.
Wisconsin, of course, is a different story. Ryan's home state was a hotly contested battleground, made even more so by Republican gains in statewide offices and Congress. Plus, there was the matter of GOP Gov. Scott Walker's ability to beat back a recall effort this year.
Obama won Wisconsin last week by about 7 percentage points. Ryan told WISC-TV this week he was disappointed he and Romney didn't win the Badger State.
"We had hoped to win Wisconsin, fought hard for Wisconsin," Ryan said in the TV interview. "We cut the president's lead in half, but nevertheless it wasn't enough."
So what's the answer to our trivia question? Smart Politics, the blog at the University of Minnesota's Humphrey School of Public Affairs, says there have been 20 instances in which the presidential and VP candidates on a ticket failed to carry their home states.
In 1972, the last time it happened, George McGovern came close but didn't carry South Dakota in his blow-out loss to Richard Nixon. McGovern lost running mate Sargent Shriver's home state of Maryland by nearly 24 points.


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VANCOUVER — Philanthropist Michael Audain has struck again through his Audain Foundation, donating $2.5 million to the UBC Museum of Anthropology.
A new 5,800 sq. ft. Audain Gallery will be created, which will be used to "host and attract major international shows that have not been able to travel to Vancouver due to a lack of appropriate space." It will also allow the Museum to develop more of its own shows.
The Audain Gallery is part of Museum of Anthropology's current "major capital renewal project," A Partnership of Peoples. The $55.5 million, multi-year project is slated to open in January, and will include a 44,000 sq. ft. new wing called the Centre for Cultural Research. Fifty-five thousand sq, ft. of the existing museum has also been renovated.
A Museum press release said the renos are designed to "help transform the Museum of Anthropology into one of the most advanced anthropological research facilities in the world."
Audain is the chairman of Polygon Homes, and one of Canada'a most prominent art collectors. He is a past president of the Vancouver Art Gallery and a trustee of the National Gallery of Canada in Ottawa. He has given millions of dollars to local arts organizations over the last few years.


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