Appendicitis

Complex language in simple language.

Very often at the reception, in a conversation with patients, the reproductologist uses the expressions: “ovarian reserve”, “follicular reserve” and https://pillintrip.com/de/medicine/diprospan. But do all of the patients correctly understand the meaning of these words? Let’s figure it out …

We put ❤️, we ask questions to which I will be happy to answer !!

Ovarian reserve is the number of follicles in the ovaries, which determines the quantity and quality of oocytes. 👆 (The follicle is the structural component of the ovary, which contains the egg and surrounding tissues).

Assessment of the ovarian reserve and https://pillintrip.com/de/medicine/frontin is mandatory for all women seeking infertility and is determined using the methods below.

⭐Determination of the level of anti-Müllerian hormone (AMH) in the blood.
The concentration of AMH in the blood does not depend on the level of hormones; it is a relatively constant value in both fertile women and women with infertility, therefore it can be determined on any day of the cycle;
AMG acts as a kind of response to the number of eggs that the girl still has “in stock”

🌹 AMH level <1.2 ng / ml is associated with a high probability of a “poor” response
ovaries for stimulation (obtaining a small number of eggs), low quality embryos and low chances of pregnancy in assisted reproductive technology (ART) programs; But you cannot focus only on the AMG level.

⭐Determination of the level of follicle-stimulating hormone (FSH) in the blood for 2-5 days
menstrual cycle.
FSH is a hormone that is produced in the pituitary gland. It stimulates the growth of follicles in the ovary and the production of estrogen, the female sex hormone.

🌹 FSH levels ≥12 IU / L are associated with poor response to ovarian stimulation and
low chances of pregnancy.

⭐Determination of the number of antral follicles (CAF) with transvaginal
ultrasound examination (ultrasound) in the early follicular phase.

Let’s omit the fundamental concepts about this group of contraceptives including https://pillintrip.com/medicine/desirett (they are described in the last article) and move on to the essentials.

What worries women more and more often when deciding on the long-term use of oral contraceptives? Weight gain. But gynecologists are worried about thrombotic complications when using this method. Let’s sort it out in order, reassuring you and us.

To begin with, the balance of risk and benefit has been confirmed by a large number of studies, but still the word “hormones” still manages to instill fear in a woman.

First, the “terrible” estrogens lower the concentration of cholesterol and reduce the content of atherogenic lipoproteins. Secondly, the 21st century is in the yard, and now there are no high-dose combined oral contraceptives. The currently used drugs contain a small amount of those same estrogens and are metabolically neutral, that is, your figure is safe.
Thirdly, if we are talking about thrombotic complications, then the risks (with the correct selection of the drug) are not higher than with smoking, long flights, extensive operations and in the postpartum period. There is also a nocebo effect (occurs if a drug without pharmacological action causes a negative reaction in the patient).

There are several large groups of drugs, and depending on your complaints / established diagnosis / desired result, the gynecologist can choose the ideal one.

What is needed for the appointment of COC

No hormone tests. Yes! We do not need to know the baseline in order to prescribe oral contraceptives. And you need:
1. Interview you. Thoroughly, meticulously, in detail and with passion! There are questionnaires for a more convenient conversation, but you can simply collect an anamnesis of your life and diseases.

❗ Please, coming to the doctor, trust him, tell about the past illnesses, about the diagnoses, the drugs taken and bad habits. We can only help if you see the full picture.

You also need to measure blood pressure (we are alarmed not only by hypertensive conditions, but hypotension, that is, a decrease in pressure).

2. Inspect. This includes a gynecological examination on a chair and an examination of the mammary glands (with an ultrasound of the mammary glands for women under 35 or mammography if you are older).

3. Assign a coagulogram (to assess blood clotting) and a biochemical blood test (the level of glucose, lipoproteins, cholesterol, bilirubin and liver enzymes is important there).

Take a smear for oncocytology from the cervix and examination for STIs.

Acute respiratory diseases, according to statistics from the World Health Organization, are the most frequent on our planet. Indeed, everyone has had a respiratory illness at least once in their life, and some suffer from it several times a year. In most cases, the causative agent remains unknown, but most often the treatment tactics do not depend on the specific type of pathogen. Some doctors prescribe in this case: https://pillintrip.com/medicine/fedac.

First, let’s understand the terms
ARI is the common name for all types of acute respiratory tract diseases caused by viral or bacterial infection.

ARI is an acute respiratory illness of viral nature.

Influenza is an acute respiratory infection caused by the influenza virus.

Thus, influenza is a special case of acute respiratory infections, and acute respiratory infections are included in ARI.

The course of ARI can be described by two groups of symptoms. General symptoms are characterized by weakness of the body with head and muscle pain, aching joints and chills. They may be accompanied by persistent fever, but may also be present without it. The runny nose, cough, sore throat and earache are local symptoms and may occur either individually or all together.

Three factors influence the duration and nature of all symptoms:
The external factor is the causative agent itself, i.e., a virus or bacterial infection;

Internal factor is the condition of the patient’s body, the presence of allergic and chronic diseases in the anamnesis, which may affect the course of the ARI;

The conditions in which the person ill with an acute respiratory infection is located.

Not always during a cold we can not go to a specialist, so you need to know what to do in this case. The first task is to create the conditions necessary for recovery: home, preferably home mode, plenty of warm drink and, if necessary, safe antipyretic drugs. There is a huge selection of drops, sprays and lozenges to treat local symptoms, but it is better to have your doctor choose them.

Usually an acute respiratory infection lasts from 6 to 10 days, where after 4-5 for there is a significant improvement in the patient’s condition.

Remember that you should immediately consult a specialist if you have the following symptoms:
Body temperature above 39C lasts more than 5 days, or does not decrease after 1 hour after taking antipyretics;
A severe headache, or a combination of headache and vomiting;
A rash that does not disappear on pressure;
combination of pallor, chills, and shortness of breath;
episodes of choking while coughing;

intense pain in any place;
sore throat in the absence of a runny nose;
It is also advisable to consult your doctor if you have any allergic reactions or chronic diseases, as they can affect the course of the disease significantly enough.

Vomiting and loose stools sometimes join the symptoms of acute respiratory infections. There is still no consensus on this: is it the coincidence of respiratory and intestinal infections, or are these symptoms of a type of gastroenteritis. In any case, it is necessary to consult a doctor urgently, especially if it concerns small children, because intestinal infections can lead to dehydration.

The main defender of our body against any ARI is our immunity. Constant emotional overload, the lack of regular physical activity, uncontrolled use of medications break down the fine-tuned mechanism and contribute to the frequency of ARI episodes. In addition, seasonal vaccination is a reliable protection against the flu virus.

ACTION AND MECHANISM

• Antacids. Almagato is a derivative of aluminum and magnesium, which acts as an antacid that does not resorb, neutralizing hydrochloric acid in the stomach. Increasing the pH of the stomach, reduces the formation and activity of pepsin. In addition, adsorbs pepsin formed and adsorbs and neutralizes bile acids when these are in the stomach. AlmaxForte drug information: uses, indications, side effects, dosage.

SPECIAL WARNING

• Identify patients who develop intestinal bleeding of unknown origin.

STARKS

Aluminum can affect absorption of phosphorus and calcium, contributing to osteoporosis. Therefore, it is advisable to avoid high doses or long-term treatment.
Its use is contraindicated in cases of Alzheimer’s disease, because of the possible association of this disease with aluminum.

TIPS FOR THE PATIENT

• If symptoms persist or worsen after 14 days of treatment, consult your doctor and/or pharmacist.
• Get to all sights by taking antacids and any other oral medication within 2-3 hours.
• Tell your doctor and/or pharmacist if you experience any of these symptoms:
• Blood in vomit or Calais.

CONTRAINDICATIONS

• Hypersensitivity to almagato or any other component of the drug.
• [ALZHEIMER’S DISEASE]. Almagato may present some association with the appearance of this disease.
• In patients with gastrointestinal bleeding of unknown etiology (see Precautions, Intestinal bleeding.)
• [HEMORROY].
• [OTEC].
• [PONOS]. Magnesium salts may contribute to diarrhea.
• Toxicosis gravídica.

EFFECTS ON DRIVING.

Does not seem to present serious consequences.

FAMILY

Safety in animals: no data.
Human safety: no studies adequate and well-controlled in humans. Management of antacids is considered safe during pregnancy, but it is not recommended to manage in high doses or for long periods of time if there is a risk of systemic effects. It is recommended that their use be reserved in cases where there are no therapeutic alternatives that are safer and the benefits exceed the potential risks.
Cases of hiperreflexia tendinosa have been reported in infants born to mothers who used aluminum and/or magnesium salts during pregnancy.
Effects on fertility: No specific human studies have been performed.

PHARMACOKINETICS

Oral:

• Absorption: absorption of aluminum and magnesium, is minimal.
• Excretion: metal ions permeate are eliminated through the kidneys, while the others are excreted in the feces.

DESCRIPTION

• Symptomatic treatment [HIPERACIDEZ GASTRICA] for adults and adolescents 12 years and older.

INTERACTION

• Antiulcerosos. Increased pH may decrease activation of PPIs (e.g., omeprazole) in canalículos of the parietal glands. To avoid associations.
• Salicylates. Antacids can alcalinizar urine, which contributes to the removal of salicylate.
  In addition, these interactions, keep in mind that antacids can affect the absorption of any drug orally through different mechanisms. It is advisable to separate the sockets for 2 to 3 hours.
  The following interaction mechanisms have been described:
• Drug absorption is pH dependent. Antacids can affect the solubility and subsequent absorption of intestinal drugs in which the pH of the stomach is a limiting factor. Thus, decreased absorption of drugs like atenolol, antifungal azólicos, NSAIDs, digoxin, erlotinib, gabapentin, ulipristal is observed.
• The formation of amino acid chelates is intractable. Aluminum can form insoluble complexes with drugs such as quinolones, iron salts, or tetracyclines, reducing its absorption.

GROWTH

Safety on animals: No data.
Human safety: as aluminum magnesium can enter milk, but because of low intestinal absorption almagato not likely to appear in significant amounts. Compatible with breastfeeding as long as used in low doses and for a short period of time.

CHILDREN

Almagato may be used on adolescents 12 years of age and older in the same doses as adults.
The use of antacids in children is not recommended

RULES FOR PROPER MANAGEMENT

CONTROL WITH FOOD: Management 30-60 min after a meal.

DOSAGE

Almax Forte:

• Adults: 1.5 g/8 hr.
• Children and adolescents.
• Adolescents over 12 years of age: the same as adults.
• Children
• Elderly people: no need to adjust posológico. Avoid long-term or high-dose treatment.
  Duration of treatment: avoid treatment for more than 14 days without a doctor’s recommendation.
  Forgetting doses: manage the missed dose as soon as possible, except that it takes a little time to the next one. Manage the next dose at the usual time. Not twice the next dose.

DOSING IN THE LIVER.

No recommendations followed, specific courses.

DOSAGE IN RENAL FAILURE

• Mild to moderate renal failure (CLcr 30-90 ml/min): avoid high doses.
• Severe renal failure (CLcr

WARNING ACTIVITIES.

• [REACH]. Risk of magnesium and aluminum accumulation in these patients. Use with caution is recommended in mild to moderate failure (CLcr 30-90 mL/min), and avoid it in severe failure (CLcr
• [INTESTINAL BLEEDING]. Should be determined by patients presenting with gastrointestinal bleeding, since almagato can mask frames more serious as gastric cancer.
• [INTESTINAL MALABSORCION]. In almagato may reduce absorption of phosphate while forming complex insoluble. Caution is advised in patients with intestinal malabsorption processes, diets poor in phosphorus, or in [EXCEPTION], given the danger of hipofosfatemia.

PRECAUTIONS CONCERNING EXCIPIENTS

• This medication contains sorbitol. Patients with [Fructose intolerance] hereditary should not take this medication.

ADVERSE REACTIONS

Effects are minor, temporary, and rare due to low intestinal absorption.
Adverse reactions have been described for each frequency range, with very common (>10%), common (1-10%), infrequent (0.1-1%), rare (0.01-0.1%), very rare

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The search for remedies that normalize the motor and evacuatory activity of the digestive tract has been attracting the attention of medical researchers for several centuries, and they have succeeded, for example Emetrol. Probably one of the first representatives of this group is ginger, which has been used in traditional Chinese medicine as a remedy for abdominal heaviness and nausea since ancient times and has weak antagonistic activity against 5-HT3 receptors. To date, remedies that affect the motor activity of the digestive tract and prevent antiperistalsis contractions of smooth muscles are grouped into a group of prokinetics.

First of all, it is necessary to outline the range of indications for which there is evidence of effectiveness of prokinetics.

• Firstly, it is diseases of the digestive tract in development of which disorders of digestive tract motor activity play an essential role (gastroesophageal reflux disease, postprandial distress syndrome as a variant of functional dyspepsia, ulcer disease with violation of antroduodenal coordination, idiopathic gastroparesis, functional nausea, functional constipation, and irritable bowel syndrome – variant with constipation).

• Second, the use of prokinetics as antiemetics (e.g., for nausea and vomiting associated with cytostatics intake).

• Third, diabetic gastroparesis, in which delayed gastric emptying affects the variability of glucose absorption, which causes difficulties in glycemic control and can lead to chronicity of gastroparesis symptoms and low glycemic control. This should also include the prescription of prokinetics in gastroparesis of other etiology.

Emetrol (domperidone) by its chemical structure also belongs to benzimidazole derivatives, is a highly selective blocker of peripheral dopamine receptors (D) type 2 and unlike metoclopramide is free of many side effects due to absence of drug penetration through the blood-brain barrier. Suppressing the effect of dopamine, emetrol (domperidone) increases spontaneous gastric activity, increases lower esophageal sphincter pressure and activates peristalsis of the esophagus and antral stomach. The drug also increases frequency, amplitude and duration of duodenal contractions and decreases time of passage of food masses through the small intestine.

Researchers continue to actively study new agents with directional selective prokinetic activity, among which physostigmine and neostigmine are muscarinic receptor agonists that stimulate intestinal activity and only slightly improve gastric emptying; gastric transit-accelerating cholecystokinin receptor antagonists loxyglumide and dexloxyglumide, and the phosphodiesterase-5 inhibitor sildenafil; an alpha-2 agonist (adrenomodulator) clonidine, which normalizes evacuation of gastric contents in functional dyspepsia (postprandial distress syndrome), slowing intestinal transit with decreased visceral colonic hypersensitivity.

A wide range of indications in which the prescription of prokinetics is effective, as well as the features of each of the subgroups of prokinetics (different mechanisms of prokinetic effect, safety profile, preferential activity in relation to the upper or lower floor of the digestive tract) allow the doctor in each clinical case to choose the most effective and safe prokinetics.