Como os filhos

Continuei para baixo e notou que, passo a passo a gama de minha lanterna estava diminuindo. Agora eu podia ver apenas sete passos à frente ... seis ... cinco ... quatro.

De repente, a escuridão impenetrável tinha apenas dois pés na minha frente, uma massa negra que parecia pulsar na expectativa do meu avanço final em seu abraço. Parecia vivo.

Eu ainda não tinha chegado ao pé da escada, pois ouvi os sussurros de novo, muito abaixo, eo som, oleosa oozing que trouxe para meus braços arrepiados.
Cheguei a cialis preço frente com uma mão trêmula. Ele desapareceu na escuridão, que foi muito frio.
Meu coração martelava e minha boca estava seca e de repente azedo. Deixei escapar um grito de criança, e eu fugi para a cozinha e da luz.

Naquela noite no restaurante, eu recebeu os convidados e sentou-los. Mesmo após todos esses anos, eu gasto quase todas as noites na porta da frente, conhecer pessoas, jogar o anfitrião. Geralmente, eu gosto. Muitos clientes viagra generico portugal têm vindo a nós por uma década, são membros honorários da família, velhos amigos. Mas naquela noite, meu coração não estava nele, e várias pessoas me perguntaram se eu estava me sentindo bem.

Tom Gatlin, meu contador, parou para jantar com sua esposa. Ele disse, Jess, você está cinza, pelo amor de Deus. Você está três anos atrasada para um período de férias, meu amigo. O que é o ponto de acumular o dinheiro se você nunca ter tempo para apreciá-la?

Felizmente, o pessoal do restaurante nos reunimos é de primeira qualidade. Além de Carmen e eu e nossos filhos-Stacy, Heather, eo jovem Joe existem 22 funcionários, e cada um deles conhece o seu trabalho e executa-lo bem. Embora eu não estava no meu melhor, havia outros a tomar as providências.

Stacy, Heather, e Joe. Nomes muito americano. Engraçado. Minha mãe e pai, sendo imigrantes, agarrou-se ao mundo que eles deixaram, dando todos os seus filhos nomes tradicionais do México. Carmen pessoas eram da mesma maneira: Seus dois irmãos são Juan e José, eo nome de sua irmã é Evalina. Meu nome realmente foi Jesus Gonzalez. Jesus é um nome comum no México, mas eu tinha que mudou com os anos Jess atrás, embora, ao fazer isso eu te machuquei meus pais. (A pronúncia espanhola é Hay seuss, embora a comprar viagra na net maioria dos norte-americanos pronunciá-lo como se referindo ao salvador cristão. Há apenas nenhuma maneira que você pode ser considerado como qualquer um dos caras ou um empresário sério quando sobrecarregados com tal apelido exótico.) É interessante como os filhos de imigrantes de segunda geração americanos como Carmen e eu, costumam dar seus próprios filhos o mais popular atual nomes americanos, como se estivesse tentando esconder o quão recentemente os nossos antepassados ​​saíram do barco ou em caso disso, cruzaram o Rio Grande. Stacy, Heather, e Joe.

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Even so doctors sometimes recommend antibiotics during TEENbirth if there's a risk of an infection that could affect the mitral valve. Mayo Foundation for Medical Education and Research (MFMER). Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. CONDITIONS AND TERMS OF USE APPLICABLE TO ALL USERS OF THIS SITE. IE 5 does not use the standard box model so the column widths are overidden to render the page correctly. The proprietary zoom property gives IE the hasLayout property which addresses several bugs. Vitamin K (in micrograms) of almost a thousand common foods! Vitamin K in the food this downloadable list (not available in printed book format) will help you know exactly how much Vitamin K you're eating. Gourmet feature is restricted to questions regarding food and nutrition. For more specific questions about your individual health please contact your doctor. My husband just turned 50 and was surprised with a heart attack.

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Muscle atrophy

The main method of treatment of hernia is a musculo-aponeurotic plastic. With this method, the strengthening of the abdominal wall defect is not only the aponeurosis. and muscles. This principle of treatment is the basis of a huge number of operational methods. Most popular in the inguinal hernias were ways Girard, Spasokukotsky, Bassin, Postemskogo, Kirchner, with the umbilical - a way to Mayo, with postoperative abdominal and white line - way Sapezhko and its numerous modifications.

Also widely used plastic, with additional biological and synthetic materials.

Grafts, depending on their origin are divided into:

1. autologous (taken within the same organism);
2. allogeneic (taken in the body of the same form as the body of the recipient);
3. xenogeneic (taken in the body of another species);
4. explants (non-biological tissue);
5. combined transplants (a combination of biological, most autologous and non-biological tissue).

Indications for the use of plastic materials for ventral hernia are:

1. recurrent, especially multiple recurrent hernias;
2. primary hernias of large size at a flabby abdominal wall due to the atrophy of muscles, fascia and aponeurosis;
3. postoperative hernia with multiple hernial when herniorrhaphy with local tissues does not give complete confidence in their solvency;
4. huge hernia the size of the defect of the abdominal wall more than 10x10 cm;
5. "Difficult" inguinal hernia - long lines, oblique to the direct channel, sliding and combined with pronounced muscle atrophy, razvolokneniem aponeurosis, ligaments hypoplasia.

From biological tissues most widely used in hernia surgery were: autologous transplants of skin, allogeneic transplants of dura mater and xenogeneic grafts of peritoneum.

Numerous experimental studies suggest that any biological graft during implantation undergoes a pronounced inflammatory and destructive changes, the extent of which varies from mild degeneration to necrosis, is directly dependent on the nature of the plastic material, its antigenicity and mode of treatment.

Most favorable to replace the defect of the abdominal wall are undoubtedly autologous tissue. Biological relationship with this kind of transplant brand viagra can achieve the most reliable engraftment of plastic cloth. However, in this case, marked structural changes in the graft, which are caused by denervation and blood circulation disorders: a histologically in the early period after transplantation, there are marked inflammatory changes, and the remote - the phenomenon of partial atrophy and fibrosis.

Allogeneic transplantation and, moreover, xenogeneic tissue really is always accompanied by the reaction of transplantation immunity, which leads to the death of foreign tissues. However, in cases where the plastic fabric is not highly antigenic strength, the process of destruction of the graft occurs very slowly and slightly, and simultaneously with the destruction of developing regenerative processes, replacing lost parts of the graft. Ultimately, the graft is completely replaced by recipient tissues. This is the most favorable way of morphological transformation alien plastic tissue in the body of the recipient, ensuring the success of transplantation. In those cases where the plastic fabric has a high antigenic activity, the destruction of the graft is much faster than it is replaced by tissue of the recipient. As a rule, change ends divergence of postoperative wound and exclusion of necrotic remnants of the plastic fabric.

All plastic materials used in reconstructive surgery of the anterior abdominal wall, have these or other advantages and disadvantages. The study of long-term results indicate that with the help of transplants can dramatically reduce the number of relapses. And if now it is possible to deny the usefulness of a plastic material, to reject the method at all - it means not to notice those positive qualities that lie at its core. This is primarily a decrease traumatic operations and increase its reliability.
The clinical picture of hernia strangulation is very characteristic and is generally typical.

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Mesh tape

Development and implementation of new polymeric materials and medical products largely determine the progress of modern surgery.

In this context, the relevance of the polymer implant, in particular, suture material, the use of which the most rational in any surgical situation.

We have developed a body nonabsorbable brand viagra online monofilament surgical conditioned rooms on USP 5 / 0 to 1 (metric size to EP 1 to 4) based on polypropylene (PP), polyvinylidene fluoride (PVDF) and poly (PKA). Suture materials in the form of filaments, owing to solidity and smoothness of the surface except the penetration of infection threads inside, allow them with little effort and minimal damage to even the most delicate fabrics as well as provide a good cosmetic effect and reduce the discomfort when removing sutures.

Most biological inertness of them have PVDF monofilament. However, in order to improve the hemocompatibility and thromboresistance suture material used, such as cardiovascular surgery, we developed a method for forming on the surface of the nanocoating linear-chain carbon-carbyne (RF Patent 2287623).

Since the braided or twisted sutures along with good manipulative properties are characterized by high wick that creates the danger postoperative infection seams, and also "sawing" effect during a tissue, we developed a technology application to Mylar and nylon filament hydrophobic fluoropolymer coating. Received "psevdomononiti" have zero wick, reliability, assembly and good flexibility.

Clinical trials have shown that such filaments are convenient to manipulate, reliable tally surgical sites, atraumatic not absorb wound discharge and did not become infected.

For the prevention or treatment of surgical sepsis can bring substantial benefits to antimicrobial sutures.

We obtained the nylon filament containing immobilized ionic chemical bond gentamicin (RF patent 1241553 and 1241554).

The results of microbiological and preclinical generic viagra studies received sutures showed that for effective and prolonged antimicrobial action is necessary to introduce a string of at least (5-7)% antibiotic.

Clinical trials of antimicrobial suture materials have shown high efficiency in the prevention of septic complications after surgery in this complex patient population, as patients with cancer of the gastrointestinal tract.

For the first time in Russia we have developed and put into mass production of plastic mesh implants for hernia and other soft tissue defects in the support of PVDF and PP-filaments, Mylar complex yarns with fluoropolymer coating. To cialis without prescription improve the biocompatibility in PVDF-coated grids formed carbyne (RF Patent 2288304).

Properties of yarns and knitted weave features provide endoprostheses high biocompatibility, mechanical strength, dimensional stability in all directions, resistance to blooming and shedding edges, resistance to infection, resistance to biodegradation, gentleness, minimum material consumption.

Based on the same mesh cloths are designed mesh tape (slings) for use as a urethral lonno-loop in the surgical treatment of stress incontinence treatment (RF Patent 2297808), and implants for reconstructive surgery of the pelvic floor.

For the prevention of adhesions after operations on organs and tissues with serous layer (the abdominal cavity, tendon sheath, joint, pleural cavity, pericardial, spinal cord membranes, middle ear cavity), designed and produced protivospaechny gel.

The gel acts as a temporary artificial "barrier" between the damaged serous surfaces, ensuring their effective separation in the healing time, and then dissipates. Reduction of adhesion surfaces of organs and tissues contributes to the preservation of their mobility and prevents the formation of adhesions.

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Thrombosis hemorrhoids complicated by inflammation of their indication for anticoagulation of local action in the form of suppositories and combined preparations containing analgesics, thrombolytic and anti-inflammatory components. This group includes Proctosedyl and gepatrombin G. Pharmacodynamics gepatrombina F lies in the fact that heparin binds the plasma coagulation factors and prevents blood clots, reduces inflammation and swelling, and polidokanol has analgesic and local sclerosing effect. Prednisolone has anti-inflammatory effect, reduces the itching and burning. Preferable to use gepatrombina T is that he has a strong antithrombotic and anti-inflammatory effect.

When hemorrhoidal thrombosis also demonstrates the use of anticoagulants local action. This group of drugs brand viagra include heparin and troksevazinovaya ointment. In 70-80% of cases, thrombosis of hemorrhoids complicated by inflammation of the transition to subcutaneous tissue and the perianal region. In this case, the above-mentioned drugs are used in combination with water-based ointments, possessing potent anti-inflammatory action. These include levosin, levomekol, mafinid.

Ongoing bleeding for one hour is a sign of an acute process and to eliminate it you can use candles containing epinephrine. In addition, use these local hemostatic materials, such as adrokson, beriplast, tahikomb, spongostan consisting of fibrinogen and thrombin. When introduced into the anal canal, they dissolve, forming a fibrin film.

General treatment

The basis is a common treatment is the use of flebotropnyh drugs that affect the increase in venous tone, improve micro-circulation in cavernous cells and normalization in their blood. This group includes many products, but in our opinion, the most effective is diosmin. Study of the effectiveness of the drug conducted in a prospective randomized study carried out on 120 patients with acute hemorrhoids. Compared with patients receiving placebo, in patients of the group are almost in 2 times reduced the need for non-narcotic analgesics. In 98% of treated diosmin is stihaniya inflammation and the rate of annual exacerbations decreased by 2,2 times.

It should be noted that in spite of the use of modern effective drugs, medical treatment, carried out mainly in the acute phase of illness, is only a palliative measure, and provides short-term positive effect. Resumption of constipation, errors in diet, increasing physical activity, usually lead to another escalation that requires re-conservative treatment. Therefore, the ineffectiveness of this type of treatment, especially in the later stages of the disease, there should be a combined treatment, including conservative and minimally invasive techniques or conservative and traditional surgical methods.

Minimally invasive treatments

In recent years, due to the development of new technologies in the medical industry, creating new sclerosing agent, becoming more common so-called minimally invasive treatments for hemorrhoids, it is suitable for use in an outpatient setting. These include infrared photocoagulation of hemorrhoids sclerotherapy, ligation, latex rings, ligation of the hemorrhoidal vessels under the control of Doppler, etc. In most countries, America and Europe, typical hemorrhoidectomy currently operates in only 17-21% of patients, and the rest is used minimally invasive treatments .

In patients with initial stages of hemorrhoids with a predominance of symptoms of bleeding should be infrared photocoagulation and sclerotherapy. To speed up the regenerative processes of these treatments is desirable to supplement the therapeutic laser. Ligation of hemorrhoids latex rings can be carried out in the third stage of hemorrhoids, for which the main symptom is Viagra what is the cause of impotence loss of hemorrhoids. Contraindication for minimally invasive treatments for hemorrhoids is thrombosis, acute and chronic paraproctitis, anal fissure, and other inflammatory diseases of the anal canal and perineum.

Infrared photocoagulation for domestic use photocoagulator Svet1 or Redfield (USA). Focused reflector light output from the halogen lamp is directed into the fiber. Through anoscope tip of the fiber is fed to hemorrhoidal node to contact. Thermal energy flow passing through the optical fiber coagulates the surface of the haemorrhoid. Such coagulation is carried out in 26 locations closer to his leg. Manual switch allows dosing duration of the procedure from 0,5 to 3 seconds and provide the depth of coagulation of 34 mm. At the initial stages of the cessation of bleeding was achieved in 67-72% of patients. At later stages of this procedure is only effective to stop the bleeding as a temporary measure, with the subsequent application of another, more radical treatment.

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Activate oncogenes

Who saw the cancerous liver cells in the lung, or kidney, or vice versa?? NOBODY! So why and on what basis we declare that the cells travel? The cell of any organ has only the cancer cells that is identical to a healthy cell of the body and healthy cells of the body, it has degenerated. Of course, this casts doubt on the theory of metastasis. Medicine does not know any secrets of cancer, nor the secrets of such structures, which we used to call metastases. And the author does not reveal the essence of metastasis. Assumptions are many, but the real evidence as yet and no, not in the experiment, neither under a microscope. Absolutely can not use such findings and explanations, as we try to do in medicine.

- M. Jolondz: - "Thus, the cancer eventually, begins with one of the many simultaneously and systematically regenerate normal cells. But cancer never starts immediately with the rebirth of one normal cells. Meanwhile, such an incorrect claim is common in the literature.

This conclusion the author is really closer reality than the conventional. But even here ignorance of the mysteries of cancer are not given to the author to see a more realistic picture. And conventional wisdom is also correct, it should not be considered incorrect. Cancer can really start as a single cell (apparently very rare), and from many cells simultaneously and systematically reborn.

The most important thing is that cancer may arise and starts in the tissue (tissue), where the accumulation of carcinogens. Elsewhere, the cancer will never be?

And one of the important features of cancer, long before the rebirth of healthy cells into abnormal (cancerous) in a particular tissue first appears Oncology process. It was only later, as one of the outcomes of this process - in his area of flow can be reborn (or may not be reborn in low onkoprotsesse) healthy cell into a cancer or a portion of healthy cells into cancer cells.

- M. Jolondz notes: - "Incorrect mix of ideas about cancer and cancer cells and tumors brand name viagra characteristic of modern oncology, and serves as a source of other serious errors."

- Well noticed. But the author himself did not escape this fate of serious errors. Why is it, as shown above, uses a classic, but here - suddenly not. Maybe he knows the secret of cancer, but none of his works, he was so her and did not disclose. Everywhere the author is talking only about the effects of cancer.

You can not divide these abnormal cells to cancerous or malignant. This variety of pathological cells, which is the result of the cancer process, cancer. Ie We in cancer cells, we have only one type: the cancer, or anyone - the tumor, or cancer. By the way, why is the conversion of benign into malignant tumors.

And the so-called "cancer" and the so-called "malignant" cells from the healthy differ only in that in both there is uncontrolled growth and uncontrolled division. Therefore, it was assumed that such abnormal cells are cancer. It should be noted that neither the author nor the classical science does not show the fundamental difference between healthy cells and abnormal. And this difference is that (personal conclusion) that, within certain limits (in homeostasis) in healthy cells, all changes are reversible, and in pathological cells - these changes become irreversible. But this requires a separate discussion.

And "cancerous" and "malignant" cell - this is only the outcome (outcome) of cancer of the process, which by virtue of circumstances arose and developed in the body. As long as the medicine will be tentative and unproven, questionable, and other acts, regulations, hypotheses and definitions until you can not find effective means of combating the disease.

M. Jolondz: - "All the hormones can only be regarded as promoters (activators, stimulators) of carcinogenesis, ie, themselves do not cause cancer transformation.

It must be noted that the surprising finding that the author did! It was the closest to reality. Only it is not clear, on the one hand, the author remains a supporter of the view that direct carcinogens cause cancer transformation, and on the other hand - has denied that hormones, which are often carcinogenic properties (it has repeatedly proved by experiments), suddenly it does not cause ...?? Here the apparent contradiction.

Secondly, the promoters - are substances which add to the catalysts increases their activity and selectivity, and sometimes resistance. If hormones are the author's opinion - it's promoters, then who is the catalyst? So, the author was right that the hormones themselves do not cause cancer transformation, and if he had gone farther in this direction, he would see that and carcinogens by themselves do not cause cancer transformation, and are only catalysts.

And most importantly, the generally accepted theory of cancer in all operate on the theory of carcinogenesis, but still no one showed - as well as carcinogens affect healthy cells? There just is not confirmed by experiment and conclusions. And it is easy to show and prove.

- M. Jolondz notes: - "In recent years, found that chemical carcinogens first penetrate the cell, and then subjected to in her transformations and metabolized by the cell. Carcinogenic agents have not the chemical carcinogens, and the products of their metabolism (metabolism) in a cage. "

- It's generally a paradoxical conclusion. Why did the author does not explain what he meant by "metabolic products of chemical carcinogens? This is generally something new. Secondly, no one has yet been able to find or see (there is only speculation) in the simulation of cancer to chemical carcinogens interact with the cell at least in some way.

Is the author does not know that any interaction should leave a trace, ie residues in something else? Is the author does not know that until now scientists could not explain the apparent fact, as observed in experiments - where and how they disappear carcinogens in the event of a cancer cell (tumor)? This fact was among the unresolved and it simply forgot.

Is the author does not know that at the first stages of the transformation of healthy cells into cancer cells are no remnants of carcinogens in the DNA of cells not?! This was confirmed experimentally! This means that carcinogens can not possibly hit the DNA!

In the previous paragraph it was noted that carcinogens do not cause malignant transformation. Experimentally established that the carcinogenic substances and inert substances with DNA do not interact. It is unclear why proponents of the classical theories and the author continued to argue The rush of love misplaced about the mutagenic effects of carcinogens to DNA cells?

And yet, it should be noted the excellent idea of the author's conclusions, that carcinogens do not have a carcinogenic effect. It was a great line of thought. But then the author of it went away and came down on the metabolic products of carcinogens. Strongly influenced by the generally accepted theory.

- M. Jolondz: - "Here, we show that tumor cells for a long time (several years) are developed in isolation from the circulatory system."

- Going forward, we can say that the author has not demonstrated that he had promised. At least, in his writings that could not be found.

And the show will not succeed. And just because the tumor or cancer cells arise in the absence of the circulatory system, and at her, but only in the tissue (tissue), where there was accumulation of carcinogens, and only some time after that, as in this outbreak originated Oncology process .

Cancer cell and tumor - it is the same kind of abnormal cells that arise in cancer trials. Until the emergence of cancer in certain tissues (tissues) of the body, cancer (tumor) cells in the body NO!

M. Jolondz wrote: - "Thus, interferon can prevent the development of tumor process, initiated by tumor viruses, but almost not able to provide therapeutic effect with already formed tumor processes."

It is unclear, because there is now evidence that interferon can prevent the development of cancer. That is based on the author? And indeed the viral theory of the origin of cancer has not yet reveal to us the mystery of cancer. But the author is further admits: "viral oncogenes in themselves do not reveal a common mechanism for turning healthy cells into cancer." We can not, on the one hand (this is nearly always) assume that a common mechanism for turning healthy cells into cancer, but on the other - immediately recognized that while the mechanism for turning healthy cells into cancer is unknown.

Somehow, in the future a similar assumption about one or another mechanism has a leading role, and becomes the head. The fact that when something is supposed to tend to forget. Today we know a large number of alleged theories. But things are there, the mechanism of the transformation of healthy cells into cancer remains a "sealed". This is the main mystery of cancer. Until now, scientists have not answered the question - why a normal cellular gene that suddenly becomes a cancer at the initial appearance of the tumor, and thus they do not have any differences?

And if indeed interferon was capable of preventing the development of tumor process, without any exceptions to interferon cured cancer patients. This conclusion is easily provable.

- And M. Jolondz recognized further: "oncogenes is in every body of any vertebrate animal, but they are in a special form, which does not cause cancer. Say, smoking leads to the fact that the chemicals that enter the cell, activating oncogenes. And start a cancerous growth ... The inclusion of the viral oncogene is influenced by chemical or physical carcinogens ... Given the presence of many carcinogens, we can propose the following mechanism of carcinogenesis. Chemical and physical carcinogens lead to different chromatin damage.

- It is not clear above, the author states that carcinogens do not have a carcinogenic effect, as already said here that carcinogens activate oncogenes!? Where, in this case, right? And what a special form of the supernatural, which does not cause cancer ... and suddenly carcinogens activate these oncogenes. We must not forget that the tumor may occur in the body, neither the first nor the second input of carcinogens, ..., but only with repeated their input, and after some time. This means that carcinogens do not activate oncogenes. And, moreover, that in the early stages it is no different from the healthy gene oncogene. Does not exist in any healthy organism, Oncogene!

If the review is carried out experiments on the modeling of cancer processes, it becomes clearly apparent that the genes in the initial stage of the transformation of healthy cells into cancer have no effect on this conversion! And it is a fact that can be convincingly confirm the new evidential experiments. Why nobody wants to notice this?

The huge presence of carcinogens and experiments with them have not yet named suggest a mechanism of carcinogenesis associated with damage to the genome, which until now have not found a real confirmation. And even on the contrary, it is possible to see clearly and (as described in many experiments) that the carcinogens themselves can not cause damage to the chromatin, since there are no residues in their DNA is not, and they all disappear to nowhere. Ie obvious - the refutation of this conclusion. To disappear carcinogens? In response to this question lies the mystery of cancer.

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