Preventing and Getting Rid of Roaches now and post SHTFHow to get rid of roaches – The definitive guide. We all work at making sure we have plenty of protection against the two- legged pests, and have given a lot of thought to the four- legged variety. I have only seen the creepy- crawly ones mentioned a few times so I figured I would bring up my experience with the lowest of the lows, the roach. Growing up, I had the pleasure of never seeing a roach, except on T. V. I grew up with the assumption that only dirty people had roaches. ![]() When I moved to Texas, I found out how wrong that assumption was. Even the cleanest of homes can get infested with roaches and it doesn’t take much. My first apartment in Texas appeared to be clean. Nice neighborhood, clean grounds, the apartment itself looked and “smelled” clean, all the stuff you look for when moving into an apartment. I didn’t know the signs to look for, or even that I needed to look, for a roach infestation. Within a week I seen my first roach. It was huge and it flew right into my hair. I found out later it was a wood roach or a palmetto bug. Did I mention it flies? After an hour long shower, and scrubbing my hair a dozen times, I was fine. After all, the bug was outside and I was inside, so I was safe- right? Wrong! My first midnight foray into the kitchen proved just how wrong I was. ![]() ![]() ![]() Getting rid of ear mites (Otodectes cynotis) is often as simple as applying mineral oil to your cat or dog’s ears. Apply mineral oil with an eye dropper or an ear. By far the most common question we get on our website is how to get rid of tonsil stones naturally for good instead of resorting to expensive and risky surgery like. ![]() There were roaches everywhere on the floors and counters. Of course, I didn’t have any kind of bug spray, I didn’t even have a flyswatter. I went around with a flip flop smacking all them I could catch while doing the “ewwwe dance.” The next morning I stormed the managers office complaining. I was practically laughed out of the office with the advice to go and buy some roach spray. I keep a clean house, and this is probably some kind of a fluke, some roach spray should get rid of them, so I believed. That started my two year battle with them. You can name any brand of roach spray, gel, trap, bait, and fogger, and I will guarantee that I have tried it. ![]() I moved into a different apartment that sprayed on a weekly basis. I cleaned, and cleaned, and cleaned some more. All food was kept in an airtight container or in the fridge. Nothing seemed to help. When I sprayed, it was like they spread. When when I used the baits, they seemed to multiply. When I fogged, they would disappear for a day or two, and then would be back in full force. It got so bad I was seeing them not only at night but during the day. My breaking point happened over two events. I went to make a pot of coffee and there were roaches crawling all over and in my coffee pot (to this day I still drink instant coffee) and my daughter got up from the table during breakfast, came back and there were roaches all over her food. I freaked out. I had tried everything I could think of to get rid of them and nothing was working. How do people live like this? How do people get away from them? I tried moving and they just packed themselves into my stuff and moved with me. I keep my house clean as can be, I even tried pouring straight bleach on the counters and they seemed to enjoy playing in it. After having my little breakdown, I had a thought pop into my head. So what do I know about roaches? They are creepy and nasty. They carry disease, and would probably survive a nuclear holocaust. Time to do some research. I learned so much about them, things I never wanted to know. It confirmed that I NEEDED to get rid of them, but that the approach I was taking would NOT work. Here are three things that told me I needed to find a different way: 1) Roaches can eat and survive off of pretty much anything. From that microscopic crumb that got left behind, to the glue on book bindings, stamps, and envelopes. They will also eat body parts that they shed and other dead roaches. So in essence, they can feed each other, and don’t need the food you have in your home. Just like we build immunities to antibiotics and other medications, roaches can become immune to the chemicals we spray on/feed them. They can hold their breath for an obnoxious length of time, 4. That means when you start spraying, unless you are hitting them directly they hold their breath and scurry off to a safe location, usually in another room. It works the same for the foggers, they hold their breath until they can find a pocket of fresh air the chemicals cant reach. So in spraying all the roach sprays, I effectively spread them throughout the apartment. With those being some of my biggest problems, how do I work around it. An internet search on getting rid of roaches brought up so many sites selling pesticides, and all the exterminators, that I would never find what I needed that way. I did a search on “alternative ways to kill roaches” and it came up with mixed results. Where I struck pay dirt was when I looked up “natural ways to kill roaches.” On site after site, three things kept popping up. Diatomaceous Earth (DE), boric acid, and baking soda. Here are my results for each: Diatomaceous Earth: I found that it does kill roaches if you can actually get it on them. The problems were that you do not want to breathe this stuff in so it really limited where all you could place it, and the roaches avoided it. Where it really helped was that I was able to put it in the dog and rabbit food. It was safe for my pets to eat, and yet kept the roaches out.*****NOTE: if you buy DE make sure you buy the FOOD GRADE as the stuff they sell for pool filters is very toxic to people and pets. Boric acid: I first tried Borax as I had some in the house. The problem with the borax is it caked really easy and would not work. I then bought the both the powder and tablet form of boric acid. I believe this to be the reason I am now roach free. The powder form I found at the dollar store for $3 a bottle and the tablets I found at a grocery store for around the same price. I put the tablets under all appliances, in the back and corners of my cabinets, and anywhere I didn’t want loose powder. I put the powder in a very thin line around all baseboards, on my book cases, and anywhere else I needed a large area covered. I would sprinkle it all over my floors and counters at night before going to bed, cleaning it up in the morning. It was not a quick success by any means. It took a couple of weeks for me to notice a difference and a couple of months before I completely stopped seeing them. The trick with boric acid is to put it in very thin lines other wise the roaches will go around or jump over it. Note: be very careful using boric acid on and around areas that you prepare food. It is toxic. Baking soda: here is where I started and had my least amount of success. The roaches were not interested in the baking soda by itself. When mixed with sugar (which is the most recommended) it became a hard sticky mess, at least in my high humidity area. It did work if you changed it out everyday so the mixture would be fresh, but you couldn’t spread it out like with the boric acid. It took about six months of trying all the different techniques, and finding the one that worked in my home. In the end, although I believe it to mainly be because of the boric acid, I used a mixture of the three things. I used the DE in the pet food, the boric acid pretty much everywhere else, and I would fill bottle caps with the baking soda/sugar mix and put them up as bait stations through out the house in problem areas, making sure they walked through the boric acid to get to them. I have now been roach free for 4 years. Even now, and after moving into a house, I keep lines of boric acid down behind the baseboards, and the tablets in my cabinets and under appliances. I still buy DE to mix with the animal food. The boric acid, as long as it is kept dry, will last for years. Some easy measures to take so that if/when SHTF and sanitation becomes an issue, it is one less thing for us to worry about. Please Spread The Word - Share This Post. ALSO ON THESURVIVALISTBLOG.
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For the other living species, see Somali ostrich. The ostrich or common ostrich (Struthio camelus) is either one or two species of large flightless birds native to Africa, the only living member(s) of the genus. Struthio, which is in the ratite family. In 2. 01. 4, the Somali ostrich (Struthio molybdophanes) was recognized as a distinct species. However, phylogenetic studies have shown that it is the sister group to all other members of Palaeognathae and thus the flighted tinamous are the sister group to the extinct moa. It lives in nomadic groups of 5 to 5. When threatened, the ostrich will either hide itself by lying flat against the ground, or run away. If cornered, it can attack with a kick of its powerful legs. Mating patterns differ by geographical region, but territorial males fight for a harem of two to seven females. The common ostrich is farmed around the world, particularly for its feathers, which are decorative and are also used as feather dusters. Its skin is used for leather products and its meat is marketed commercially, with its leanness a common marketing point. Exceptional male ostriches (in the nominate subspecies) can weigh up to 1. Get up to the minute entertainment news, celebrity interviews, celeb videos, photos, movies, TV, music news and pop culture on ABCNews.com. What is Trending? Women: You'll Get Bigger Before You Get Smaller How to do a Healthy Food Prep Under $50 The Reason Many of You are Getting Bigger and Not Smaller. Aboriginal Australians are legally defined as people who are members "of the Aboriginal race of Australia" (indigenous to mainland Australia or to the island of Tasmania. 7 11 Australia Dancers Diet Book
At sexual maturity (two to four years), male common ostriches can be from 2. At one year of age, common ostriches weigh approximately 4. Their lifespan is up to 4. The feathers of adult males are mostly black, with white primaries and a white tail. However, the tail of one subspecies is buff. Females and young males are greyish- brown and white. The head and neck of both male and female ostriches is nearly bare, with a thin layer of down. The eyes are shaded from sunlight from above. The strong legs of the common ostrich are unfeathered and show bare skin, with the tarsus (the lowest upright part of the leg) being covered in scales: red in the male, black in the female. The tarsus of the common ostrich is the largest of any living bird, measuring 3. The outer toe has no nail. Common ostriches can run at a speed over 7. Common ostriches can tolerate a wide range of temperatures. In much of their habitat, temperatures vary as much as 4. Their temperature control relies in part on behavioural thermoregulation. For example, they use their wings to cover the naked skin of the upper legs and flanks to conserve heat, or leave these areas bare to release heat. The wings also function as stabilizers to give better maneuverability when running. Tests have shown that the wings are actively involved in rapid braking, turning and zigzag maneuvers. Unlike all other living birds, the common ostrich secretes urine separately from faeces. Unlike most birds, the males have a copulatory organ, which is retractable and 2. Their palate differs from other ratites in that the sphenoid and palatal bones are unconnected. Other members include rheas, emus, cassowaries, moa, kiwi and the largest known bird ever, the now- extinct elephant bird (Aepyornis). However, the classification of the ratites as a single order has always been questioned, with the alternative classification restricting the Struthioniformes to the ostrich lineage and elevating the other groups. Subspecies. Four living subspecies are recognised: Common ostrich (S. Historically it was the most widespread subspecies, ranging from Ethiopia and Sudan in the east throughout the Sahel. It has now disappeared from large parts of this range. It is farmed for its meat, leather and feathers in the Little Karoo area of Cape Province. During the mating season, the male's neck and thighs become brighter. Its range is essentially limited to southern Kenya and eastern Tanzania. The females are more brown than those of other subspecies. Its range overlaps with S. The Tree of Life Project, The Clements Checklist of Birds of the World and IOC recognize it as a different species, but Howard and Moore Complete Checklist of the Birds of the World does not. Bird. Life International has reviewed the proposed split and accepted it. Hybridization with the subspecies that evolved southwestwards of its range, S. However, as there is considerable variation of this character and there were no other differences between these birds and adjacent populations of S. There were 1. 9th- century reports of the existence of small ostriches in North Africa; these are referred to as Levaillant's ostrich (Struthio bidactylus) but remain a hypothetical form not supported by material evidence. However, their exact status as such is controversial, and they have alternatively been considered more basal (or more derived) ratites. Other unspecified ratite remains are known from the Eocene and Oligocene of Europe and Africa; their status as early ostriches too is questionable, and may in fact represent multiple lineages of flightless paleognaths. While the relationship of the African species is comparatively straightforward, a large number of Asian species of ostrich have been described from fragmentary remains, and their interrelationships and how they relate to the African ostriches are confusing. In China, ostriches are known to have become extinct only around or even after the end of the last ice age; images of ostriches have been found there on prehistoric pottery and petroglyphs. Though Olson 1. 98. Competition from ostriches has been suggested to have caused the extinction of the eogruids. Africa: Struthio linxiaensis (Liushu Late Miocene of Yangwapuzijifang, China)Struthio orlovi (Late Miocene of Moldavia)Struthio karatheodoris (Late Miocene of Greece and Bulgaria)Struthio wimani (Early Pliocene of China and Mongolia)Struthio brachydactylus (Pliocene of Ukraine)Struthio chersonensis (Pliocene of SE Europe to WC Asia) – oospecies. Asian Ostrich, Struthio asiaticus (Early Pliocene – Late Pleistocene of Central Asia to China ? Morocco)Giant Ostrich, Struthio dmanisensis (Late Pliocene/Early Pleistocene of Dmanisi, Georgia)Struthio anderssoni (Pleistocene to Holocene in N China- Mongolia, to 8. BP. Farmed common ostriches in Australia have established feral populations. Attempts to reintroduce the common ostrich into Israel have failed. DNA tests on fossilized eggshells recovered from eight archaeological sites in the states of Rajasthan, Gujarat and Madhya Pradesh found 9. North African ostrich. This suggests that ostriches traveled between India and Africa before the two landmasses drifted apart. Only 1. 6 percent of common ostrich sightings were of more than two birds. They are most active early and late in the day. When being pursued by a predator, they have been known to reach speeds in excess of 7. Lacking teeth, they swallow pebbles that act as gastroliths to grind food in the gizzard. When eating, they will fill their gullet with food, which is in turn passed down their esophagus in the form of a ball called a bolus. The bolus may be as much as 2. US fl oz). After passing through the neck (there is no crop) the food enters the gizzard and is worked on by the aforementioned pebbles. The gizzard can hold as much as 1,3. As with other birds, an individual may reproduce several times over its lifetime. The mating season begins in March or April and ends sometime before September. The mating process differs in different geographical regions. Territorial males typically boom in defence of their territory and harem of two to seven hens. They will go to the mating area and he will maintain privacy by driving away all intruders. They graze until their behaviour is synchronized, then the feeding becomes secondary and the process takes on a ritualistic appearance. The cock will then excitedly flap alternate wings again, and start poking on the ground with his bill. He will then violently flap his wings to symbolically clear out a nest in the soil. Then, while the hen runs a circle around him with lowered wings, he will wind his head in a spiral motion. She will drop to the ground and he will mount for copulation. The dominant female lays her eggs first, and when it is time to cover them for incubation she discards extra eggs from the weaker females, leaving about 2. This uses the colouration of the two sexes to escape detection of the nest, as the drab female blends in with the sand, while the black male is nearly undetectable in the night. This is believed to be the case due to the high rate of predation. Fewer than 1. 0% of nests survive the 9 week period of laying and incubation, and of the surviving chicks, only 1. Common ostriches in captivity have lived to 6. Animals that prey on ostriches of all ages may include cheetahs, lions, leopards, African hunting dogs, and spotted hyenas. While the caudal end of the mesobronchus branches into several dorsobronchi. Together, the ventrobronchi and dorsobronchi are connected by intra- pulmonary airways, the parabronchi, which form an arcade structure within the lung called the paleopulmo. It is the only structure found in primitive birds such as ratites. Due to this the lack of connective tissue surrounding the parabronchi and adjacent parabronchial lumen, they exchange blood capillaries or avascular epithelial plates. The use of air sacs forms the basis for the three main avian respiratory characteristics: Air is able to flow continuously in one direction through the lung, making it more efficient than the mammalian lung. It provides birds with a large residual volume, allowing them to breathe much more slowly and deeply than a mammal of the same body mass. It provides a large source of air that is used not only for gaseous exchange, but also for the transfer of heat by evaporation. The air then flows through the anatomical dead space of a highly vascular trachea (c. Inspired air moves into the respiratory system as a result of the expansion of thoraco abdominal cavity; controlled by inspiratory muscles. During expiration, oxygen poor air flows to the anterior air sacs. Racist Star Trek Fans Decry Discovery's Diversity, Revealing They Know Nothing About Star Trek. When original Star Trek: Discovery showrunner Bryan Fuller and executive producer Heather Kadin were developing the series, they were both adamant about making sure that the show stayed true to Star Trek creator Gene Roddenberry’s vision of social progressiveness and inclusion. But for a vocal contingent of racist “fans,” Discovery’s emphasis on diversity is tantamount to “white genocide.”There’s nothing particularly new about fandoms hating any sort of deviation from classic franchises, which were historically dominated by white, cisgender heterosexual men. Racist fans take it a step further, by claiming any attempt to rectify unequal representation attacks white men like themselves—e. Star Trek is quite literally about an organization of interstellar explorers who could not do what they do, were it not for the fact that their society is based on interplanetary cooperation and acceptance of one another. From the very beginning, Star Trek has tried to champion onscreen diversity in ways that other shows like it haven’t. The original series that ran from 1. Japanese man, both of whom played substantial roles that didn’t play up to racial stereotypes of the time. Later series like The Next Generation and Deep Space 9 carried on in this tradition by featuring black and female ship captains leading ethnically diverse crews. On the whole, Star Trek hasn’t always succeeded as much as it could have, with regards to representation, but over the decades the series has steadily improved. When Discovery was first announced, Fuller promised the show would feature a diverse crew composed of people with different ethnic backgrounds, sexualities, and genders, all reflective of the myriad cultures that contribute to Starfleet. The show seems to be fulfilling that promise: of the seven main leads, four of them are men and women of color. It’s also great that the show’s first trailer features First Officer Michael Burnham (Sonequa Martin- Green) and Philippa Georgiou (Michelle Yeoh) so prominently. When you look back at original Star Trek episodes about the crew’s encounters with hostile aliens from another planet, the day was almost invariably saved by Kirk and company figuring out how to see things from their enemy’s perspective, and ultimately trying to work with them . Where fists and phasers failed to solve a problem, understanding and diplomacy prevailed. Star Trek has always argued that being able to see past one’s differences from another is the single greatest ability that a person—one that could lead to the creation of a truly fantastic society. Star Trek hasn’t always lived up to that message itself (see: preponderance of white guy captains in the franchise’s history), but Discovery is attempting to make sure that it does. There will always be those people who tell you that they miss the good old days when women, people of color, and queer people simply weren’t a part of scifi fandoms. Those good old days are a myth. We’ve always been here. The only thing that’s changed is that shows like Star Trek: Discovery aren’t trying to ignore that truth anymore. And those people who hate Discovery for its inclusivity are too small- minded to realize what they hate is what Star Trek stands for. One of the main reasons the franchise has been so beloved and so successful is because it’s ignored these sorts of cries for intolerance all these years. FDA prescribing information, side effects and uses. Chantix is indicated for use as an aid to smoking cessation treatment. Chantix Dosage and Administration. Usual Dosage for Adults. Smoking cessation therapies are more likely to succeed for patients who are motivated to stop smoking and who are provided additional advice and support. Provide patients with appropriate educational materials and counseling to support the quit attempt. The patient should set a date to stop smoking. Begin Chantix dosing one week before this date. Alternatively, the patient can begin Chantix dosing and then quit smoking between days 8 and 3. Chantix should be taken orally after eating and with a full glass of water. The recommended dose of Chantix is 1 mg twice daily following a 1- week titration as follows: Days 1 – 3: 0. Days 4 – 7: 0. 5 mg twice daily. Day 8 – end of treatment: 1 mg twice daily.
Patients should be treated with Chantix for 1. For patients who have successfully stopped smoking at the end of 1. Chantix is recommended to further increase the likelihood of long- term abstinence. Patients should begin Chantix dosing and reduce smoking by 5. Continue Chantix treatment for an additional 1. ![]() Does Chantix Cause Weight Loss Or Gain On ZoloftEncourage patients to attempt quitting sooner if they feel ready . For patients with severe renal impairment (estimated creatinine clearance less than 3. L per min), the recommended starting dose of Chantix is 0. The dose may then be titrated as needed to a maximum dose of 0. For patients with end- stage renal disease undergoing hemodialysis, a maximum dose of 0. CHANTIX® (CHANT-iks) (varenicline) Tablets. What is the most important information I should know about CHANTIX? Some people have had serious side effects while using. One of the most overlooked aspects of how smoking influences weight is that smoking is a sedentary activity. If you work at a desk and. It is not uncommon for smokers to suffer weight gain after quitting smoking. The cause is straight forward and there are ways to better manage weight gain. Chantix is indicated for use as an aid to smoking cessation treatment. Chantix Dosage and Administration Usual Dosage for Adults. Smoking cessation therapies are more. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function . These postmarketing reports have included changes in mood (including depression and mania), psychosis, hallucinations, paranoia, delusions, homicidal ideation, aggression, hostility, agitation, anxiety, and panic, as well as suicidal ideation, suicide attempt, and completed suicide. Some patients who stopped smoking may have been experiencing symptoms of nicotine withdrawal, including depressed mood. Depression, rarely including suicidal ideation, has been reported in smokers undergoing a smoking cessation attempt without medication. However, some of these adverse events occurred in patients taking Chantix who continued to smoke. Some neuropsychiatric adverse events, including unusual and sometimes aggressive behavior directed to oneself or others, may have been worsened by concomitant use of alcohol . ![]() ![]() Observe patients for the occurrence of neuropsychiatric adverse events. Advise patients and caregivers that the patient should stop taking Chantix and contact a healthcare provider immediately if agitation, depressed mood, or changes in behavior or thinking that are not typical for the patient are observed, or if the patient develops suicidal ideation or suicidal behavior. The healthcare provider should evaluate the severity of the symptoms and the extent to which the patient is benefiting from treatment, and consider options including dose reduction, continued treatment under closer monitoring, or discontinuing treatment. In many postmarketing cases, resolution of symptoms after discontinuation of Chantix was reported. However, the symptoms persisted in some cases; therefore, ongoing monitoring and supportive care should be provided until symptoms resolve. In the non- psychiatric cohort, Chantix was not associated with an increased incidence of clinically significant neuropsychiatric adverse events in a composite endpoint comprising anxiety, depression, feeling abnormal, hostility, agitation, aggression, delusions, hallucinations, homicidal ideation, mania, panic, and irritability. In the psychiatric cohort, there were more events reported in each treatment group compared to the non- psychiatric cohort, and the incidence of events in the composite endpoint was higher for each of the active treatments compared to placebo: Risk Differences (RDs) (9. CI) vs. In the non- psychiatric cohort, neuropsychiatric adverse events of a serious nature were reported in 0. Chantix- treated patients and 0. In the psychiatric cohort, neuropsychiatric events of a serious nature were reported in 0. Chantix- treated patients, with 0. In placebo- treated patients, serious neuropsychiatric events occurred in 0. Some patients had no history of seizures, whereas others had a history of seizure disorder that was remote or well- controlled. In most cases, the seizure occurred within the first month of therapy. Weigh this potential risk against the potential benefits before prescribing Chantix in patients with a history of seizures or other factors that can lower the seizure threshold. Advise patients to discontinue Chantix and contact a healthcare provider immediately if they experience a seizure while on treatment . Some cases described unusual and sometimes aggressive behavior, and were often accompanied by amnesia for the events. Advise patients to reduce the amount of alcohol they consume while taking Chantix until they know whether Chantix affects their tolerance for alcohol . In some cases, the patients reported somnolence, dizziness, loss of consciousness or difficulty concentrating that resulted in impairment, or concern about potential impairment, in driving or operating machinery. Advise patients to use caution driving or operating machinery or engaging in other potentially hazardous activities until they know how Chantix may affect them. Cardiovascular Events. In a placebo- controlled clinical trial of Chantix administered to patients with stable cardiovascular disease, with approximately 3. Chantix, but certain nonfatal cardiovascular events occurred more frequently in patients treated with Chantix than in patients treated with placebo . Table 1 below shows the incidence of deaths and of selected nonfatal serious cardiovascular events occurring more frequently in the Chantix arm compared to the placebo arm. These events were adjudicated by an independent blinded committee. Nonfatal serious cardiovascular events not listed occurred at the same incidence or more commonly in the placebo arm. Patients with more than one cardiovascular event of the same type are counted only once per row. Some of the patients requiring coronary revascularization underwent the procedure as part of management of nonfatal MI and hospitalization for angina. Table 1. Mortality and Adjudicated Nonfatal Serious Cardiovascular Events in the Placebo- Controlled Chantix Trial in Patients with Stable Cardiovascular Disease. Mortality and Cardiovascular Events. Chantix(N=3. 53)n (%)Placebo(N=3. Mortality (Cardiovascular & All- cause up to 5. Cardiovascular death. All- cause mortality. Nonfatal Cardiovascular Events (rate on Chantix > Placebo) Up to 3. Nonfatal myocardial infarction. Nonfatal Stroke. 2 (0. Beyond 3. 0 days after treatment & up to 5. Nonfatal myocardial infarction. Need for coronary revascularization. Hospitalization for angina pectoris. Transient ischemia attack. New diagnosis of peripheral vascular disease (PVD) or admission for a PVD procedure. A meta- analysis of 1. The study in patients with stable cardiovascular disease described above was included in the meta- analysis. There were lower rates of all- cause mortality (Chantix 6 . These events included in the endpoint were adjudicated by a blinded, independent committee. Overall, a small number of MACE occurred in the trials included in the meta- analysis, as described in Table 2. These events occurred primarily in patients with known cardiovascular disease. Table 2. Number of MACE cases, Hazard Ratio and Rate Difference in a Meta- Analysis of 1. Clinical Trials Comparing Chantix to Placebo*Chantix. N=4. 19. 0Placebo. N=2. 81. 2MACE cases, n (%)1. Patient- years of exposure. Hazard Ratio (9. 5% CI)1. Rate Difference per 1,0. CI)6. 3. 0 (- 2. 4. The meta- analysis showed that exposure to Chantix resulted in a hazard ratio for MACE of 1. MACE events per 1,0. The meta- analysis showed higher rates of CV endpoints in patients on Chantix relative to placebo across different time frames and pre- specified sensitivity analyses, including various study groupings and CV outcomes. Although these findings were not statistically significant they were consistent. Because the number of events was small overall, the power for finding a statistically significant difference in a signal of this magnitude is low. Chantix was not studied in patients with unstable cardiovascular disease or cardiovascular events occurring within two months before screening. Patients should be advised to notify a healthcare provider of new or worsening symptoms of cardiovascular disease. The risks of Chantix should be weighed against the benefits of its use in smokers with cardiovascular disease. Smoking is an independent and major risk factor for cardiovascular disease. Chantix has been demonstrated to increase the likelihood of abstinence from smoking for as long as one year compared to treatment with placebo. Somnambulism. Some cases described harmful behavior to self, others, or property. Instruct patients to discontinue Chantix and notify their healthcare provider if they experience somnambulism . Clinical signs included swelling of the face, mouth (tongue, lips, and gums), extremities, and neck (throat and larynx). There were infrequent reports of life- threatening angioedema requiring emergent medical attention due to respiratory compromise. Instruct patients to discontinue Chantix and immediately seek medical care if they experience these symptoms. Serious Skin Reactions. There have been postmarketing reports of rare but serious skin reactions, including Stevens- Johnson Syndrome and erythema multiforme, in patients using Chantix . As these skin reactions can be life- threatening, instruct patients to stop taking Chantix and contact a healthcare provider immediately at the first appearance of a skin rash with mucosal lesions or any other signs of hypersensitivity. Patient with Hypokalemia and Metabolic Acidosis. A 3. 9- year- old woman who had been in excellent health presented with a chief complaint of weakness in her lower extremities. Two weeks before admission. Helicobacter pylori antigen and was treated with amoxicillin, clarithromycin, and lansoperazole. One day before admission she was seen in the. The serum lipase was mildly elevated, and she was diagnosed with mild. The serum potassium concentration was 3. Eq/L. She was treated with intravenous fluids and prochlorperazine. On the day of admission, she noted onset of bilateral lower extremity weakness, inability to walk without a. She also stated that she had been having intermittent leg cramps and that she recalled having. She took no medicines on a regular. She also reported no unusual dietary intake. She was married with. She had no occupational exposures. Her mother died in her 7. SLE, her father died at 8. A review of systems was unremarkable except for the symptoms described above. Her vital signs were as follows: temperature. The conjunctiva were pink, and the oral mucosa was dry. Lungs were clear, and heart sounds were. The abdomen was mildly obese with normal bowel sounds and mild right upper quadrant and epigastric tenderness without. The neurologic exam was normal except for motor strength that was graded as 4/5 in the distal upper extremities. There. was hyper- reflexia and gross tremor with extended effort. Electrocardiogram showed sinus rhythm, rate 9. QTc 4. 82 ms, with infero- lateral. ST depression. No U- waves were seen. Chest x- ray was unremarkable. Additional tests included the following: arterial blood gas p. H 7. 2. 6, Pco. 2 1. Hg, Po. 2 1. 47 mm. ![]() Case Discussion. In summary, this patient was admitted with the inability to walk. Physical examination indicated that this was primarily due to. Catabolism of protein is not a practical source of quick energy because of all of the following, EXCEPT that A) proteins are more difficult to break apart than lipids. Topiramate (brand name Topamax) is an anticonvulsant (antiepilepsy) drug. In late 2012, topiramate was approved by the United States Food and Drug Administration (FDA. ![]()
Hg, and bicarbonate 8 m. Eq/L, urinalysis p. H 7. 0, specific gravity 1. The urine K+ was 1. L. Later that night the patient complained of worsening weakness, and she was unable to hold a cup or lift. A repeat serum K+ was 1. Eq/L. Forced vital capacity was 3. She was subsequently given 4. Eq of oral and intravenous KCl. Physical examination indicated that this was primarily due. Laboratory studies showed severe hypokalemia (K+ 1. Eq/L). Although the family history of connective tissue disease raised the possibility of a myopathy, the normal creatine. In this patient, the severity of hypokalemia is such that it alone could. The patient's history indicates that hypokalemia, although milder, had been present for. Interestingly her serum potassium concentration 3 days before admission. Eq/L and then declined rapidly along with worsening of generalized weakness. Our initial differential diagnosis therefore. Hypokalemia can be caused by an intracellular shift of potassium, a decrease in potassium. The serum potassium concentration does not decline significantly until there. Although there is no accurate method to calculate the absolute amount of potassium deficit in a patient. Eq based on the severity of her hypokalemia (1). This is also supported by the amount of potassium (5. Eq) given orally and intravenously in the first 2. Eq/L. Hypokalemia due to intracellular shift is most often seen in association. H, an increase in serum catecholamines or insulin, rapid cell proliferation, or genetic or. The effect of acidemia on the serum potassium. In our patient, if the metabolic acidosis was acute, causing potassium to be shifted out of cells, her total body potassium. An intracellular shift of potassium. Although obligate urinary sodium losses can approach zero, there is. Eq/d. This loss over time could lead to profound. Our patient did not consume alcohol and was on a regular diet. Her oral intake had decreased. We. therefore should initially focus on increased urinary potassium output as the major underlying cause of her chronic hypokalemia. The source of potassium loss can be ascertained by evaluating renal. Normally potassium is freely filtered and extensively reabsorbed in the proximal. Henle, so that only about 1. In. this segment and in the collecting duct potassium is passively secreted under the influence of multiple factors, most importantly. The final urinary potassium excretion is a reflection of potassium secretion in the distal nephron. As indicated above. However, a urinary potassium. Eq/d in a patient with significant hypokalemia points to abnormal renal loss of potassium. This hormonal influence is counterbalanced by a direct inhibitory effect of hypokalemia. In addition, angiotensin II enhances proximal and distal convoluted sodium reabsorption by stimulating. Na+- H+ exchanger and Na. Cl cotransporter, respectively. This decreases sodium delivery to the more distal potassium secretory sites. With vomiting, compared with diarrhea, potassium loss in the urine. Although hypovolemia and hyperkalemia stimulate aldosterone secretion, their effect on the ROMK potassium channel. Hypovolemia down regulates and hyperkalemia up regulates ROMK. This paradoxical effect is mediated through a network of kinases, named WNK . The effect of aldosterone on potassium secretion, regulated. Reference 4). This combination of hypokalemia and. HCMA can be due to loss of potassium and bicarbonate from either the gastrointestinal tract in the presence of diarrhea or. Our patient did not have a history of diarrhea. In addition, diarrhea- induced hypokalemia, as noted above. In our patient the urinary potassium was reported to. Eq/L, but one might wonder whether, given this patient's dilute urine (specific gravity 1. If urinary osmolality is available, we could assess renal. TTKG; urinary K+/plasma K+: urinary osmolality/plasma osmolality), which can be used to assess distal nephron potassium secretion while “correcting”. On a normal diet and with a normal serum. TTKG is between 7 and 9. On a high- potassium diet or with hyperkalemia the TTKG should be > 1. Proper use of the TTKG requires that the urine be more concentrated. Despite lack of a more comprehensive evaluation, the data supporting renal potassium loss in association with HCMA is strongly. RTA) in our patient. HCMA, hyperchloremic metabolic acidosis; MA, metabolic alkalosis; UK, urine potassium; UCl, urine chloride; RTA, renal tubular. RAS, renal artery stenosis; GRA, glucocorticoid responsive aldosteronism; AHA, apparent hyperaldosteronism. We filter approximately 5. Eq of bicarbonate daily and reabsorb 8. Na+- H+ cotransporter and to a lesser extent by a H+- ATPase. This process requires carbonic anhydrase, an enzyme located both in the brush border and intracellularly in renal. The remainder of filtered bicarbonate that is not reabsorbed in the proximal tubule is normally almost entirely. The kidneys also need to regenerate the bicarbonate used in neutralizing. Eq/d of acid in foodstuff. Bicarbonate regeneration results primarily from secretion of hydrogen by H+- ATPase pumps in . Secreted hydrogen is buffered by titratable acids, primarily. When faced with systemic acidosis, the kidneys are able to increase. A recently discovered. G- protein–coupled receptor that accepts hydrogen as a ligand may be a sensor that relays information about changes in systemic. H to acid- secreting cells in the kidney (6). Although ammonia entry into collecting duct has been considered to be mostly passive, there is increasing evidence that. Rhesus proteins located in the distal nephron (7). A defect in this complex and highly integrated system resulting in decreased bicarbonate reclamation or regeneration would. RTA (8). Arrows represent bicarbonate handling by the kidney. The thickness of the arrow represents the relative amount of bicarbonate. The values for PRTA and DRTA are given when serum bicarbonate is relatively normal (left. Whereas some patients. Fanconi syndrome). Isolated hereditary PRTA may be due to mutations in the basolateral. Patients with PRTA are able to reclaim filtered bicarbonate fully only if the filtered load is low but not when it is normal. In contrast, distal RTA (DRTA) is characterized by a defect in urinary acidification. Figure 2). A rare form of combined proximal and distal tubular RTA is due to mutations in carbonic anhydrase II (CAII) (1. Type IV RTA, a defect in bicarbonate regeneration due to lack of urinary buffers, specifically ammonia, associated with. First, hypokalemia is usually milder. PRTA. Patients with PRTA may present with osteomalacia and rickets, whereas patients with DRTA are more likely to present. Several laboratory studies evaluating the urine p. H and the degree of bicarbonate. RTA (Figure 2) (8). The urine p. H in DRTA is always > 5. PRTA. However. when the acidosis is corrected with sodium bicarbonate or other alkalinizing therapy, patients with PRTA excrete bicarbonate. H. This distinction is the basis for the ammonium chloride test developed more than 5. Davis and Wrong (1. In this test an acute metabolic acidosis is generated through ingestion of ammonium chloride, and urine p. H is measured. A test that combines the acidifying effects of furosemide. The sensitivity and specificity of this test needs to be established. Such testing is not required, however, if the serum. H is > 5. 3 because this establishes the diagnosis of DRTA and excludes. PRTA. Another distinguishing feature is that metabolic acidosis will improve or correct with a small amount of daily supplemental. Eq/kg per day) in DRTA but not with PRTA, which requires much larger amounts of bicarbonate replacement due. Urinary citrate excretion tends. DRTA but not other RTAs. The urinary anion gap, an indirect measure of urinary ammonium excretion, is negative. A more physiologic test is to measure fractional excretion of bicarbonate (HCO3) at a serum bicarbonate concentration of about 2. Eq/L achieved by an intravenous HCO3 infusion. This should be zero in normal subjects, > 1. PRTA, and < 5% with DRTA (Figure 2). There are other more sophisticated tests such as urine: plasma Pco. Her urine p. H was 7 on admission when her serum bicarbonate. Eq/L. This easily establishes a diagnosis of DRTA, and no further test is needed. However, the. uric acid of 1. DRTA. Both uric acid and phosphate are reabsorbed. Practice Questions . A full- term female infant failed to gain weight and showed metabolic acidosis in the neonatal period. A physical examination at 6 months showed failure to thrive, hypotonia, small muscle mass, severe head lag, and a persistent acidosis (p. H 7. 0 to 7. 2). Blood lactate, pyruvate, and alanine were greatly elevated. Treatment with thiamine did not alleviate the lactic acidosis. Which of the following enzymes is most likely deficient in this patient? Alanine amino transferaseb) Phosphoenolpyruvate carboxy kinasec) Pyruvate carboxylased) Pyruvate dehydrogenasee) Pyruvate kinase The right answer is- d)The symptoms are suggestive of Pyruvate dehydrogenase complex deficiency. Pyruvate dehydrogenase complex (PDC) deficiency (PDCD) is one of the most common neurodegenerative disorders associated with abnormal mitochondrial metabolism. Pyruvate dehydrogenase, a multienzyme complex, catalyzes the conversion of pyruvate to acetyl co A. The major fate of Acetyl co A is oxidation in citric acid cycle, which is a chief metabolic cycle to derive energy from carbohydrates. Malfunction of this cycle deprives the body of energy. The impaired conversion of pyruvate to Acetyl co A leads to elevation of blood pyruvate, lactate and alanine. The persistent metabolic acidosis is due to accumulation of lactates in blood that results in nonspecific symptoms (e. Similar symptoms though mild in nature can also be observed in Thiamine deficiency, as TPP is requires as a coenzyme for PDH complex. Since in the given case the patient is resistant to supplementation with thiamine, the deficiency of thiamine is ruled out. Alanine transferase catalyzes the conversion of pyruvate to alanine (transamination). It cannot be the defect as alanine levels are also elevated. Phospho enol pyruvate carboxy kinase catalyzes the conversion of Oxaloacetate to phosphoenol pyruvate. The deficiency is rare. Pyruvate carboxylase catalyzes the conversion of pyruvate to oxaloacetate. Pyruvate kinase catalyzes the conversion of phosphoenol pyruvate to pyruvate. The clinical manifestations in the given case are only suggestive of PDH complex deficiency. A 3- year- old female child whose growth rate has been in the lower 1. She is diagnosed as having cystic fibrosis. For which of the following vitamins is this child most likely to be at risk of deficiency? Vitamin Cb) Vitamin B6c) Folic acidd) Retinol (vitamin A)e) Riboflavin (vitamin B2)The right answer is- d) – Cystic fibrosis, is an autosomal recessive disorder affecting approximately 1 in 2. It is caused due to defective chloride ion channels of exocrine glands and epithelial tissues involving pancreas, sweat glands, and mucous glands in the respiratory, digestive, and reproductive tracts. Affected patients usually have abnormal mucus secretion resulting in recurrent respiratory infections, gastrointestinal obstruction and pancreatic enzyme dysfunction. The protein cystic fibrosis transmembrane conductance regulator (CFTR) is defective, leading to abnormal chloride transport. Because cystic fibrosis leads to pancreatic damage and diminution of the ability to secrete HCO3. Retinol is a fat soluble vitamin that must be absorbed along with lipid micelles; hence the absorption of retinol is grossly affected. A 5. 4- year- old male who was diagnosed with HIV (human immuno deficiency virus) infection 2 years back, is currently in the terminal stage. He is now cachectic and having a difficult time obtaining any caloric intake yet he refuses to take a naso gastric or gastric feeding tube. Since his muscle and organs are metabolically active, which of the following amino acids will produce both glucose and ketone bodies as an energy source? Alanineb) Tyrosinec) Prolined) Glycinee) Leucine. The right answer is b) Tyrosine. Tyrosine is the only amino acid in the given options that is both glucogenic as well as ketogenic. Upon metabolism tyrosine produce one molecule of fumarate and one molecule of acetoacetate. Fumarate is converted to Oxaloacetate (through intermediate formation of malate) which can be converted to glucose. Acetoacetate is cleaved to form 2 molecules of acetyl co A under the effect of Thiolase enzyme. Glycine is converted to serine that produces pyruvate by non oxidative deamination. Leucine is purely ketogenic. Upon metabolism it produces acetoacetate and acetyl Co. A, both are ketogenic fractions. A 4. 0 - year- old man presents with chest pain that radiates to his left jaw and shoulder. He is diagnosed with a myocardial infarct (heart attack) and is prescribed a statin medication. Statins are competitive inhibitors of HMG Co. A reductase, which converts HMG Co A to which of the following? Isopentenyl pyrophosphateb) Mevalonatec) Geranyl pyrophosphated) Farnesyl pyrophosphatee) Cholesterol. The right answer is- b) Mevalonate. The reaction catalyzed by HMG Co A reductase is the principal regulatory step in the pathway of cholesterol synthesis and is the site of action of the most effective class of cholesterol- lowering drugs, the HMG- Co. A reductase inhibitors (statins). Mevalonate is phosphorylated sequentially by ATP by three kinases, and after decarboxylation the active isoprenoid unit, Isopentenyl pyrophosphate (C5), is formed. Isopentenyl diphosphate is isomerized by a shift of the double bond to form dimethylallyl pyrophosphate, then condensed with another molecule of Isopentenyl diphosphate to form the ten- carbon intermediate Geranyl pyrophosphate (C1. A further condensation of Geranyl pyrophosphate (C1. Isopentenyl pyrophosphate forms Farnesyl pyrophosphate (C1. Cholesterol is the final product of the pathway. Which of the following compounds is the direct precursor for the heme nitrogen atoms? Glucoseb) Glycinec) Succinyl co Ad) Alaninee) Methionine. The right answer is- b) Glycine. Heme is synthesized in living cells by a pathway that requires Succinyl- Co. A, derived from the citric acid cycle in mitochondria, and the amino acid glycine. The product of the condensation reaction between Succinyl- Co. A and glycine is . Through a number of further steps Heme is synthesized. Glucose does not have nitrogen in its structure to contribute towards heme formation, whereas alanine and methionine do possess amino groups but they do not contribute to Heme nitrogen. A pregnant woman is able to transfer oxygen to her fetus because fetal hemoglobin has a greater affinity for oxygen than does adult hemoglobin. Why is the affinity of fetal hemoglobin for oxygen higher? The tense form of hemoglobin is more prevalent in the circulation of the fetus. There is less 2, 3- BPG in the fetal circulation as compared to maternal circulation. Fetal hemoglobin binds 2, 3- BPG with fewer ionic bonds than the adult form. The Bohr effect is enhanced in the fetus. The oxygen- binding curve of fetal hemoglobin is shifted to the right. The right answer is - c). The enhanced uptake of maternal oxygen by fetal Hb is due to less binding of 2, 3 BPG with fetal Hb. It is not due to more prevalence of tense form of fetal hemoglobin in the circulation. It is also not due to less 2, 3 BPG in the fetal circulation, the Bohr Effect is not enhanced in the fetus and the oxygen - binding curve of fetal Hb is also not shifted to the right. In Hb A (adult Hb) when 2, 3- BPG binds to deoxyhemoglobin, it acts to stabilize the low oxygen affinity state (T state) of the oxygen carrier, exploiting the molecular symmetry and positive polarity by forming salt bridges with lysine and histidine residues in the four subunits of hemoglobin. The R state, with oxygen bound to a heme group, has a different conformation and does not allow this interaction. By selectively binding to deoxyhemoglobin, 2, 3- BPG stabilizes the T state conformation, making it harder for oxygen to bind hemoglobin and more likely to be released to adjacent tissues. Fetal hemoglobin (Hb. F) exhibits a low affinity for 2, 3- BPG, resulting in a higher binding affinity for oxygen. This increased oxygen- binding affinity relative to that of adult hemoglobin (Hb. A) is due to Hb. F’s having two . The positive histidine residues of Hb. A . That’s the way O2 flows from the mother to the fetus. A 3. 5- year- old female presents with severe dehydration and decreased urine output. Her blood urea nitrogen level is abnormally elevated because her kidneys are not able to excrete urea in the urine. In the production of urea, which of the following is an important intermediate? Serineb) Glutamatec) Prolined) Ornithinee) Leucine. The right answer is- d) Ornithine. Urea is the end product of nitrogen/amino acid metabolism. Urea formation requires the participation of 6 amino acids which are aspartic acid, ornithine, citrulline, argino succinic acid, arginine and N- Acetyl glutamate. Out of these N - Acetyl glutamate is the only amino acid that acts as an allosteric activator of Carbamoyl phosphate synthase- 1 enzyme, rest all participate in urea formation. Ornithine acts as a catalyst in the process of urea formation. Ornithine is a non standard amino acid, it is not incorporated in to tissue proteins but it participates in urea formation and polyamine synthesis. Serine does not participate in urea formation. It is glucogenic, incorporated in to tissue proteins, required for synthesis of glycine, cysteine and sphingosine. Also participates in one carbon metabolism, forming O- glycosidic linkages and is present in at the active site of many enzymes. Glutamate is a precursor of GABA, glutamine, glucogenic, a neurotransmitter and is incorporated in to tissue proteins. It does not participate in urea formation. Proline also does not participate in urea formation; it is incorporated in to tissue proteins and is present at those places where kinks or bends are needed in the folding of the proteins since it is an imino acid. Collagen is rich in hydroxy proline (its hydroxylated form). Leucine is a branched chain amino acid; it is purely ketogenic and has no role in urea formation. Which of the following is a common compound shared by the TCA cycle and the urea cycle? Lean It UP Lose Weight Fast: How to Do It Safely. Sick of crash diets and fad diets? Follow these healthy tips. If you are looking to lose weight fast and safely, you’ve come to the right place. This article features proven tips that are based on scientific research and.
Best Weight Loss Exercises . Whether you are running outside or on a treadmill, it simply is the best exercise because you are burning calories, as well as strengthening your legs and heart. Running will get you nice and lean. For those with bad knees, the elliptical machine is a good choice. However, most important is choosing a cardiovascular modality or modalities that you enjoy. Types of cardiovascular exercises include jogging, sprinting, power walking, cycling, hiking, swimming, spinning and aerobics classes. Whatever your weight loss exercise of choice, the key to efficient weight loss is to avoid your body adapting to your weight loss program, whether it is your nutritional or exercise program: vary the mode, vary the place you train, vary the workout, vary the time of day, vary the intensity of the workout, vary the duration, vary as much as you can. The body senses stress and adapts as quickly as possible, your body starts to adapt to your exercise routine. When begins to adapt, you stop seeing results. You burn less calories and tax your muscles inefficiently. It doesn’t take long for you to start questioning little to no weight loss from your 4. However, once the training parameters change, the body must re- adapt, thereby accelerating your progress. If possible change your exercise routine every three to four weeks. Here’s a run down of the some of the best weight loss exercises. Click here to calculate how many calories you will burn based on your body weight and exercise duration. ![]() Running. Running (treadmill or outdoors) – the best weight loss exercise. Running is one of the most efficient methods of burning calories. For every mile you run, you burn approx. Highest calorie burn and cheap as chips. All you need is a pair of quality running shoes. Plus, if you stick with it, you’ll get hooked, making weight loss and weight maintenance easy. Check out a beginners running plan and how to run to get started. Elliptical Trainer. If you can’t run this is an awesome piece of machinery. The elliptical trainer combines the cardio of running with resistance and it is low impact. Another positive is that burning the equivalent amount of calories as running feels easier on the elliptical. Great weight loss exercise. Compare the elliptical trainer with the treadmill. Cross- Country Skiing Cross- country skiing (machine or outdoors) is a fantastic endurance sport, calling on every major muscle group. Again it is a combination of resistance and cardio exercise. If you’ve got snow I suggest you ski. Rowing. Cardio and resistance training in one fierce calorie- burning workout lasting between 2. Best used for interval training. Just make sure most of your power driving the stroke comes from large muscle of the thighs – not the upper body (a common mistake). Step Aerobics Step Aerobics targets legs, hips and glutes. It is an intense calorie- burning exercise. Calories burned during this weight loss exercise depends on speed and step height. Bicycling Bicycling (stationary or outdoors) targets thighs and calf muscles. Effectiveness for weight loss depends on speed and resistance/ incline. However, pear- shaped women beware of high resistance, as this will increase muscle mass in your thighs and exacerbate your problem area. Swimming Swimming – excellent full- body weight loss exercise. Water supports the body. Thus, less stress is placed on joints – low- impact. Brilliant for those with injuries. Jumping Rope Jumping rope is a seriously simple, but effective weight loss exercise. Ten minutes of jumping rope burns the rough equivalent of running an eight- minute mile. This weight loss exercise also improves cardiovascular endurance, coordination and agility. Racquetball/ Squash. The high- intensity makes racquetball a great weight loss exercise. Rock Climbing Rock climbing is a weight loss exercise that combines cardiovascular exercise with resistance training. This weight loss exercise burns A LOT of calories, esp. Push yourself – everyday. Too often, one spots people “working- out” at the gym, but who are mostly in conversation with someone (sometimes even on the phone!), concentrating on television screens more than their work out, seem completely unfocused and are not even sweating. To do it right you must focus on the exercise you are doing and constantly push yourself harder, increasing the level of difficulty as you get more fit. If you did level 7 on the elliptical cross- trainer last week and found it easier, your body is not working as hard and you are burning less calories. Weight loss stops. Thus, increase the cross- trainer to level 8 this week. Never stand still. There is nothing permanent except change. If you are not going forward, you are heading backward. ![]() Almond Paleo Hummus Dip. Recipe: Almond Hummus. One of the most frequently typed search items in my Is It Paleo? A staple dish in the Middle East, it has gained a huge popularity all over the world and is often served as a dip or a side dish at barbecues, picnics, work lunches and as a snack. So is it Paleo? The quick answer is . Legumes are avoided on the paleo diet due to their antinutrients content – phytates and lectins – which inhibit nutrient absorbption, cause inflammation and play with healthy hormonal functions. CANADIAN Gluten Free Products and Products Not Containing Gluten Ingredients. Some people suffer from an intolerance to foods containing gluten, which is a type of. Nothing says summer like a good s’more in your hand. That gooeyness that sticks to every finger, is what makes this dessert such a treat in our home. I have a serious addiction to Mozzarella Sticks but always assumed they would be difficult to make. You proved me wrong (and to be completely honest these. You Have Reached Your Personal Print Limit On These Coupons You can print each coupons a maximum of two times. Come back the first business day of each month for new. Easy Baked Mozzarella Cheese Sticks Recipe that is perfect for an after school snack or party appetizer. It's also a great game day recipe! Cranberry Butter Nov 11, 2015 Looks Delicious! Peanut Butter and Honey Trail Mix Bars Nov 04, 2015 Looks Delicious! Loaded Butternut Squash and Sweet Potato. There has been a lot written about legumes being safe for consumption if they’re prepared and cooked properly but since it’s a bit of a hassle, most of us simply go without. And given that chickpeas are the base ingredient in hummus (the word . However, as with pretty much anything non- paleo, there are alternatives and even if officially it’s no longer hummus, you can still get a similar flavour and texture using different base ingredients. This recipe is inspired by a dip from Byron Bay I tried recently. It uses almonds as a base, which work really well with the hummus flavours of tahini, garlic, lemon and olive oil. I would recommend this dip as an every now and then food as both almonds and tahini, which comes from sesame seeds, contain a large proportion of Omega- 6 fatty acids. It’s not a problem if you have a balanced diet full of Omega- 3’s, but it is something to be aware of. Anytime Quick Meal: "Shit In a Pan" This is a quick 'n easy way to make a tasty meal and clear out the fridge. The more variety in the ingredients, the better!On the upside, tahini is one of the highest sources of methionine, an essential amino acid, it’s high in vitamin E and it adds a fantastic flavour to any dish. Quick sanity check, there are worse things you could eat and if a little . Just saying. You can buy pre- blanched almonds or do it yourself, see how here. I used a Mayvers Hulled Tahini. Unhulled tahini does contain more calcium, but the hulls contain phytates and other antinutrients so go for the hulled version! Tahini should be stored in the fridge because it’s high in poly- unsaturated fats, which are sensitive to heat and light and can easily turn rancid (even if Vitamin E is resistant to rancidity). There’s been no doubt. The Hallelujah Diet Ingredients. 15. 0gm blanched almonds. Celtic salt. A pinch of pepper. Instructions. Pre- blanch the almonds if you need to. Process all ingredients in a food processor until smooth. Drizzle with olive oil and some paprika and parsley when serving. Store in the fridge with a thing layer of olive oil on top to prevent drying (almonds love moisture). I like to serve this dip with radishes, carrot and celery sticks or red peppers. It’s also yummy on salads and vegetables. Preparation time: 1. Cooking time: none. Number of servings: 4- 5. Fluffy Nutella Buttercream Frosting - Kitchen Treaty. August 3. 1, 2. 01. Dessert is beautiful in many, many ways, but in our house, we especially appreciate its ability to bridge the divide between my vegetarianism and his carnivorous diet. Because unless we’re putting lard in our pie crusts or sprinkling bacon on our ice cream (and even my bacon- loving guy isn’t really on board with the bacon- in- desserts thing), dessert is naturally vegetarian. No need for our usual fork- in- the- road recipes, which really isn’t such a bad way to live, but there’s something fun about being able to nosedive simultaneously into, for instance, the same Fluffy Nutella Buttercream frosted cupcakes. Nutella in buttercream form. Pure heaven. After all, if dessert is beautiful, Nutella is pure divinity. People write poems about it. And there’s even a holiday to celebrate it! This fluffy, light buttercream combines your traditional buttercream ingredients, butter and powdered sugar, with a nice dose of Nutella. A little vanilla adds a perfect note, and a good pinch of kosher salt rounds out the sweetness while also highlighting that delicious chocolate- hazelnut flavor that’s uniquely Nutella. And lastly, it’s got heavy whipping cream, which I love, love, love adding to my buttercream recipes. It gives an otherwise heavy frosting such a wonderfully airy texture. Free Easy Weeknight Dinners e. Book. Subscribe to the Kitchen Treaty email list and receive new recipes or my weekly newsletter for free! Plus, as a welcome gift, you’ll receive my Top 1. Easy Weeknight Dinners e. Book! So that’s kinda fun. In this case, I topped basic vanilla cupcakes (from the same vanilla sponge cake recipe I used for my Strawberry Shortcake Cupcakes) with the stuff. Pure, simple perfection. It’d also be magical atop banana cupcakes, or maybe even sandwiched between two peanut butter cookies. Dessert – especially this one – is a beautiful thing indeed. Yield: Enough to frost 1. Prep: 5 minutes. Total: 5 minutes. This fluffy – and super easy – buttercream frosting recipe features everyone’s favorite chocolate- hazelnut spread, Nutella. Pure perfection. One batch of this buttercream should be plenty to frost one standard- sized layer cake or generously top a dozen cupcakes. Ingredients: 1 cup (2 sticks) unsalted butter, room temperature. Nutella or other chocolate- hazelnut spread. Pinch kosher salt (up to 1/4 teaspoon, to taste)2 tablespoons heavy whipping cream. Directions: In a stand mixer afixed with the paddle attachment, beat together the butter and powdered sugar on low until well- blended. Add the Nutella and increase the speed to medium. Beat for two minutes. Add the vanilla extract and salt and whip for an additional 3. Add the whipping cream and beat for about one minute, until the frosting lightens slightly in both color and texture. She loves creating irresistible and flexible recipes that help multi- vore families like hers keep the peace - deliciously. ![]()
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If you're questioning what is wrong with your cat, here’s a look at some of the ways cats hide their pain, common conditions they suffer from, and how to get your cat the care he needs. How Cats Hide Discomfort“Whether or not cats hide their pain all depends on the problem,” says Susan O’Bell, DVM at the Angell Animal Medical Center in Boston, Mass. One common problem that brings cats to the veterinarian or emergency room is signs of a lower urinary tract infection that have gone undiagnosed.“Cats with this affliction can be impacted in a variety of ways, from mild discomfort to a life threatening inability to pass urine,” Dr. O’Bell says. It is possible, however, to see no outward signs of pain or illness in cats until they’ve begun losing weight or have a decreased appetite — something that’s difficult to monitor if you have multiple cats or if your cat doesn’t eat voraciously when healthy.“I suspect the will to hide weakness originates from their . O’Bell says. O’Bell says. Whether one, all or a combination of these behaviors is prevalent, your veterinarian will need a thorough history of your cat’s personality and normal behavior, medical records and additional diagnostics like lab work to get a better idea of the problem. Common Cat Ailments. According to Dr. O’Bell, changes in weight and signs of periodontal disease are the top two health concerns to recognize and look out for when it comes to cats. Brushing your cat’s teeth or even taking a peek in their mouth on a weekly basis will help you spot signs of infection or areas of concern before they become life- threatening. O’Bell says. Obesity poses a risk for diabetes in your cat, and puts strain on their joints, liver and kidneys. Conversely, drastic weight loss is something to lookout for and will prompt your veterinarian to screen your cat for health concerns with blood work, a biochemistry panel and a urine test. Additional under- recognized health concerns include arthritis and hyperthyroidism. While it’s easier to recognize arthritis or orthopedic abnormalities in dogs, cats may hide signs of discomfort. If your cat hesitates before making a jump or their coat has lost some of its luster, it may be because they are having difficulty moving or grooming themselves. Cats with arthritis may also eliminate outside of the litter box because they’re unable to jump inside of it.“Hyperthyroidism is often diagnosed in advanced stages because early symptoms may seem like signs of good health like a good appetite, high energy and slight weight loss,” Dr, O’Bell says. O’Bell adds. Diagnosing kidney disease in cats early and making the appropriate changes in their diet with specialized food can help manage their condition and lead to a longer survival rate. Understanding your cat’s kidney disease will also help you to recognize signs of dehydration, a common complication, earlier on that if the disease was left undiagnosed. By either hiding their symptoms completely or refusing medicine, cats are particularly difficult patients to treat. O’Bell, “there are a variety of diagnostic aids and advanced treatments available to cats that can help their owners keep them healthy.”Ask your veterinarian about the different forms of medication available to you (liquid, tablet, gel, injection) and find the best fit for your cat. You’ll also want to ask about the different types of food available to help your cat manage their condition, and experiment with different brands until you find one that they like. Changes in helping your cat cope may be quick and easy or take a bit more time, but with patience, you’ll be able to find something that works.“For some cats, simply the addition of a second litter box is enough to please them,” Dr. O’Bell says. Here's How Pet Food Can Help. How Long Do Cats Live? And How to Make Your Cat Live Longer. Ways to Help Your Cat Stay Disease Free. Tips for Creating a Stress- Free Enviornment for Your Cat. Diet for Gallbladder Sludge . This sludge, which accumulates in the bottom of your gallbladder, can cause more serious gallbladder problems. It's possible that a low- fat diet, which physicians recommend for gallstones, may help with gallbladder sludge as well. Your gallbladder helps in digestion by storing and excreting bile that's formed in the liver, according to the National Institutes of Health. Bile helps in digestion, especially in the digestion of fats. Many people are familiar with gallstones, most of which form from cholesterol in the gallbladder. But your gallbladder also can accumulate sludge, which forms from cholesterol and calcium bilirubinate, according to the University of Maryland Medical Center, or UMMC. Gallbladder sludge usually forms before gallstones, according to the UMMC. If too much cholesterol accumulates in the gallbladder, sludge forms first. If the problem worsens, then cholesterol crystals can form, eventually leading to gallstones. Sludge in your gallbladder also can cause inflammation and painful symptoms that could lead to the need to remove the gallbladder itself, according to Massachusetts General Hospital. Physicians generally recommend a diet low in fat and cholesterol to help treat gallbladder sludge and prevent it from occurring in people at high risk, according to Massachusetts General Hospital. To follow this low- fat diet, you should focus on cutting back on saturated fats, which are found primarily in animal- based foods such as meat and high- fat dairy products, reports the UMMC. Switch to lean cuts of beef, pork and chicken, and make certain you choose skim milk and low- fat versions of ice cream and cheese. You also might want to switch from butter to a vegetable- oil- based margarine. There's some evidence that certain fats may help improve gallbladder health, which could help you avoid sludge buildup in your gallbladder, according to the UMMC. For example, omega- 3 fatty acids, which are found in fish oil and walnuts, seem to help your gallbladder empty itself of bile, which can prevent sludge buildup. In addition, monosaturated fats such as those found in canola oil and olive oil may help. You're at high risk for developing gallbladder sludge if you lose a lot of weight very rapidly, according to Massachusetts General Hospital. Therefore, to prevent gallbladder sludge from forming, you should avoid fad or crash diets that cause you to lose more than 1 or 2 lbs. In addition, fiber may be helpful in encouraging your gallbladder to empty and avoid sludge buildup, according to the UMMC, so make sure to add high- fiber foods to your diet. |