Dr. Trent received the honor of becoming a Distinguished Life Fellow of the American Psychiatric Association as well as being awarded for his substantial service to the New Jersey Psychiatric Association, including serving as its president. He is a member of the American Academy of Psychiatry and Law, and a Diplomate in Psychiatry of the American Board of Psychiatry in Neurology (in Psychiatry).
Practice Area and Services
During his many years of experience his practice has focused on psychiatric care of patients and as an expert in forensic psychiatry cases. Dr. Trent confers with the referring attorney and/or others as permitted by law, reviews documents furnished by the case’s attorney and others. With appropriate legal permission of the litigant (person requesting the forensic review) and at the request of the case’s attorney, Dr. Trent may additionally conduct a forensic psychiatric evaluation of the complainant who alleges emotional damages in the case.
Common Case Types
In the sub-specialty area of forensic psychiatry, Dr. Trent has examined, reported and/or testified in hundreds of forensic matters. He has testified in State Courts in the majority of counties of New Jersey. He has also testified in State Courts in North Carolina, and Federal Courts in New Jersey and Washington, DC. His cases and/or testimony have included, in part:
•major criminal matters with allegations of homicide, kidnapping or other serious crimes. He has been retained and/or testified both for the defense or for the prosecution •serious personal injury litigation involving psychiatric conditions rising to post-traumatic stress disorder, brain injury and/or other mental conditions •psychiatric fitness for ability to work in various occupations due to psychiatric conditions, i.e., mental illness, substance usage or abuse •mental ability to make a valid will (during life) and evaluation of testaments (wills) in cases where the ability of the decedent was in dispute by heirs after the will-maker’s demise •cases with allegations of professional liability (malpractice) including allegations of suicide caused by improper care or mental injuries from improper psychiatric care •cases in which reportedly disturbed individuals require evaluation to determine if they in fact need involuntary psychiatric hospitalization for being dangerous to themselves or to others requiring protection for themselves or others •cases involving allegations of sexual crime.
Other Psychiatric Experience and Training
Dr. Trent earned a Bachelor of Arts degree from the University of Kansas in 1952 and a Doctor of Medicine degree from the University of Kansas in 1956. He completed a general rotating internship at the United States Government Hospital, Gorgas Hospital, in Ancon, Canal Zone, in 1957. He began formal psychiatric residency training at the Psychiatric Institute of the University of Maryland in Baltimore in 1957.
After two years at that institution Dr. Trent transferred to the combined facility of the University of California in San Francisco and Langley Porter Neuropsychiatric Institute, completing almost two additional years of training prior to responding to a call for service in the U.S. Army.
On active duty with the U.S. Army Reserves in 1961 he was assigned to Patterson Army Hospital at Fort Monmouth, New Jersey, as Chief of the Mental Hygiene Consultation Service examining and treating both active military personnel and their families. On fulfilling his military service in 1963, he immediately opened his psychiatric practice office in Asbury Park, New Jersey.
In private practice, Dr. Trent served as an outpatient psychiatrist as well as consulting and/or treating psychiatrist for patients in community hospitals. He has been on the staffs of several hospitals: the Jersey Shore Medical Center, the Point Pleasant Hospital and the Monmouth Medical Center where he had served as Director of Psychiatry. He also served as chairperson of the Mortality Committee at the State of New Jersey’s Marlboro Psychiatric Hospital.
After working in North Carolina in 1992-1993 as a psychiatrist for the Albemarle Mental Health Center, he resumed psychiatric practice in New Jersey as the medical director of the Psychiatric Screening Service at Monmouth Medical Center in Long Branch, New Jersey. Persons referred to the screening service on an emergency basis were evaluated for their need for psychiatric care including the possibility of commitment to a mental health hospital facility. More recently, Dr. Trent served on the staff of New Jersey’s Special Treatment Unit for sexual offenders at Avenel, New Jersey.
Besides these private practice and public sector activities Dr. Trent has been active (including as president) for the majority of his career in the New Jersey Psychiatric Association, the principal organization for psychiatrists in the state.
In addition to activity in state-level positions, Dr. Trent has also been appointed to various positions in the American Psychiatric Association, the major professional association of psychiatrists in the United States. This role included forensic-relevant work in the area of Professional Liability, where he participated in reviewing complaints of improper psychiatric treatment.
If interested in the availability of his services or additional relevant background information for his suitability for being an expert for your legal case, please contact Dr. Trent at his Eatontown, New Jersey office.
Chester L. Trent, M.D.
Suite 200, Main Suites
Eatontown, NJ 07724


BAKERSFIELD, Calif. - After a fourth grader at Columbia Elementary school died from influenza last Friday, parents and children crowded the waiting room at Memorial Urgent Care Monday. The severe case of the flue have many parents wondering how long they should wait to take their children to the doctor when they are sick.
Dr. Keith Campbell at Memorial Urgent Care in Bakersfield said there are specific symptoms to look for when deciding if your child needs medical attention.
"If your child is having a hard time breathing, if they are not acting right or have changes in their level of consciousness or the way they are acting toward you."
Another red flag to look out for is a high fever.
"It's common to have a fever with a viral illness and it's important to realize that those who have a low fever, a runny nose and a cough can maybe be treated at home," Dr. Campbell said.
Doctors said if your child has a high fever that lasts more than two or three days, you should seek medical attention immediately and stay home from school for 24 hours after the fever is gone.


Hutchison's Clinical Methods: An Integrated Approach to Clinical Practice (Paperback)
Book id: 181374
Author: Michael Glynn, William M. Drake
Type of book: Clinical Sciences
Edition: 24th Edition, 2018
Note: Product delivery duration may vary due to product availability in stock.
Disclaimer: The actual color of the physical product may slightly vary due to the deviation of lighting sources, photography or your device display settings.


Freedom to Operate Search
Medical device companies generally opt for product clearance studies for one or more markets wherein freedom to operate patent search is required to ensure the medical devices do not infringe upon the existing patents in such markets. To conduct freedom to operate patent search, or a FTO search, patent attorneys give equal consideration to granted patents and published patent applications, which may be granted at later date. Such FTO studies can help medical device companies in evaluating possible patent infringement scenarios by performing patent claim mapping.
Medical Devices in India
Medical devices regulations in India are about to undergo a radical transformation with effect from January 1, 2018. This is the date on which Medical Devices Rules 2017 will be notified, wherein various crucial provisions are stated, including definition of medical devices. This is a major change as compared to earlier regulations, wherein medical devices were covered under the pharmaceutical regulations, i.e. Drugs and Cosmetics Act. With the proposed notification of the new Medical Devices Rules 2017, the government has attempted to distinguish medical devices from pharmaceuticals.
As per the proposed medical devices regulations in India, the definition of medical devices includes any instrument, apparatus, appliance, implant, material or other article, whether used alone or in combination, including the software, intended by its manufacturer to be used specially for human beings or animals for one or more of the specific purposes of, –
(i) diagnosis, prevention, monitoring, treatment or alleviation of any disease or disorder;
(ii) diagnosis, monitoring, treatment, alleviation or assistance for, any injury or disability;
(iii) investigation, replacement or modification or support of the anatomy or of a physiological process;
(iv) supporting or sustaining life;
(v) disinfection of medical devices;
(vi) control of conception;
which does not achieve the primary intended action in or on the human body or animals by any pharmacological or immunological or metabolic means, but which may be assisted in its intended function by such means, and covered under the Drugs and Cosmetics Act, 1940 (“D&C Act”).
Medical Devices Approval in India
In accordance with the proposed medical devices rules, the government of India has proposed single window clearance for approval of medical devices in India, including, medical device applications for import, manufacture, sale or distribution and clinical investigation, whether to be assessed by the DCGI or State licensing authority. It has been proposed that all such regulatory applications for medical devices will have to be made through a single online portal of the central government, wherein the details of the portal are yet to be notified.
Medical Device Patents
Medical devices and processes can be covered under medical device IP (intellectual property) law, whereby inventors, medical device companies, medical device startups, medical device incubators and venture capitalists protect the innovations by way of patents. Such innovations cover medical devices and corresponding processes across a diverse range of categories, including, cardiovascular, dental, diabetes, neurovascular, ENT, gastrointestinal, imaging, ophthalmic, prosthetics, orthopedics, diagnostics, dermatology, infusion pumps, embolic protection, dialysis, nephrology, robotics, oncology, ventilators, surgical equipment and medical technology applications capable of being executed via smartphone and handheld devices.
Medical Device Patent Services
Patent attorneys in the field of medical devices assist clients with multiple services, including patent prior art searches, patent landscape reports, state of art patent search, patent due diligence, patent licensing agreements, FTO (freedom to operate) patent search, patent assignment agreements, patent drafting, patent prosecution, PCT patent filings (national phase and international phase), patent audit and technology licensing (in-licensing and out-licensing).
Medical Device Patents – Drafting Patent Claims and Writing Patent Applications
Patent attorneys with expertise in writing medical device patents tend to draft patent claims covering both the medical devices and methods of medical treatment. However, such patent drafting practice varies for each jurisdiction as in US and Australia, medical treatment methods can be patented whereas in China, Europe and Japan, such medical treatment patent claims are not allowed.
Medical Device Patent Attorney
Law office of Rahul Dev is a niche technology and research based law firm focusing on next generation business and legal issues faced in India and outside India during international business and cross-border technology transactions.
We assist our clients in close collaboration with our associates and counsels within India and outside by providing custom engagement models to address our client’s needs.
- How are software patents granted in India?
- Does Indian patent law allow software patents?
- How to apply for software patent in India?
- How to patent a software in India?
- How to patent a mobile application in India?
- What are the examples of software patents in India?
- What is a Provisional Patent Application?
- What are advantages of Filing a Provisional Patent Application?
- How can Patent Search help in determining Patentability of Invention?
- What is the meaning of Patent Pending Status?
Rahul Dev is a Patent Attorney & International Business Lawyer practicing Technology, Intellectual Property & Corporate Laws. He is reachable at rd (at) patentbusinesslawyer (dot) com & @rdpatentlawyer on Twitter
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Film-coated tablets of Proscar contain 5 mg of finasteride. Proscar is indicated for the treatment of benign prostatic hyperplasia symptoms. It helps prevent urologic symptoms which are associated with risks of urinary retention.
Proscar is effective in the facilitating of the symptoms, reduces the risks of acute urinary retention, risks of surgery such as prostate resection, prostatectomy.
The medicine causes regression of the growing prostate, improves urinary flow and the symptoms which enlarged prostate causes.
The recommended dosage of Proscar for all men with prostate enlargement is one 5 mg tablet once a day. The consumption of food is possible. Sometimes Proscar is used together with other medicines.
The effects of the treatment are usually seen after the 4-6 weeks of treatment. The response of a patient can be individual and should be evaluated by a caring doctor. Sometimes, special tests are needed to estimate the results.
Contraindications for Proscar are:
Use in women and children;
Use in men who are hypersensitive to finasteride;
Use in men who have allergies to finasteride and similar drugs;
Use in men who have acute or severe problems with bladder, kidneys, liver.
No clinically important drug interactions have been identified with finasteride. This means that the medicine can be mixed with other commonly used medicine. Still, before the treatment and during the treatment with finasteride, it is necessary to inform a doctor about any other medicine use.
The medicine has no potential to affect ability to perform tasks which demand alertness such as driving or operating machinery.
It is recommended to avoid drinking alcohol and smoking cigarettes during the treatment with finasteride.
Side effects are usually not observed by most men. The dose of the medicine is very low to produce any unpleasant side effects. Still some men can suffer from deterioration of existing sexual health issues like impotence or premature ejaculation. Some men complain about decreased libido which they associated with the course of finasteride.
To the other effects of finasteride the growth of the hair can be added. It is known that finasteride is used as a treatment of male pattern baldness. So, with its main purpose the medicine can produce the growth of hair which can be seen after several months of the treatment.
Symptoms of enlarged prostate are not always related directly to the size of the gland itself. The actual process of enlargement of prostate can produce no symptoms.
In some men, however, the symptoms can develop and worsen slowly and gradually until they really have great troubles with urination. Others never develop serious problems.
The treatment for prostate symptoms should be discussed with a doctor and started under control of a caring doctor. Self-treatment can lead to serious health consequences and problems. Do not self-treat or wait until the symptoms get really worse. Visit your doctor as soon as you start observing any difficulty with urination or sudden need to urinate or any other problems.


If you need to get a new pair of eyeglasses or contact lenses, then we urge you to visit us at Vision World of Ridgewood. At our Bushwick optical store, patients are able to get contact lens exams and fittings or comprehensive eye exams, and then purchase a great new pair of eyeglasses or contact lenses all under the same roof.
When you want to find a great new pair of designer eyeglasses, we know that you will be very excited about the selection and prices we offer eyeglasses at, at our Bushwick optical store. We carry eyeglasses for all members of the family, and for customers with all different tastes and budgets. If you need to purchase contact lenses, they can also be purchased at our optical store. We can provide our customers with both soft lenses, and hard lenses. If you need to have a new eyeglass lens prescription, or a prescription for contact lenses, you should make an appointment to be seen by our top-notch optometrist. It is very important to have yearly eye exams, not only to make sure that your lens prescription is up-to-date, but also to make sure that your eyes are free of any eye diseases. There are many eye diseases which, when caught in the early stages, can be treated; permanent vision damage from the disease will be avoided. Among the many eye problems that your eyes will be screened for during our eye exams are: glaucoma; macular degeneration; cataracts; dry eyes; diabetic retinopathy; retinal tears; and other problems of the cornea, macula, and retina. During our eye exams your eyes will also be screened to determine whether or not you have any refractive vision errors, including astigmatism, nearsightedness, or farsightedness. Today even patients with astigmatism are able to have their vision safely and comfortably corrected with contact lenses.
Whether you need a vision exam, or want to find a great new pair of designer eyeglasses, or purchase other optical goods, come visit us at our Bushwick optical store. For an appointment to see our optometrist, please call in advance.


Directions for use:
Insert/remove slowly and carefully. Dispose of sponge after each use. Only use sponge if there are excess fluids in vagina. Store package in a cool, dry place at room temperature and avoid exposure to direct sunlight. Always pee after sex to avoid UTIs!
WARNINGS: This product has not been evaluated by the FDA and is not intended to prevent any infection, disease, or pregnancy. Do not leave sponge in body.
MATERIALS: 100% sterile, medical grade polyurethane sponge and polypropylene handle.
Additional questions? See our FAQs or contact us.


“Eine Grenze ist da, wo die Vorstellungskraft endet.”
- Christoph Strasser (mehrmaliger Gewinner des RAAM) 2012 -
An dieser Stelle möchte ich Ihnen gerne einen kurzen Einblick in meine Masterthesis der klin. Psychoneuroimmunologie mit dem Thema “Exercise and Immunosuppression” ermöglichen.
Effects of additional supplementation on immune parameters in a 6 h – long term ergometer stress test. Master Thesis in Clinical Psychoneuroimmunology 2012
Prolonged, exhaustive exercise is often related to immunosuppression associated with upper respiratory tract infections influencing exercise performance.
An understanding in pathophysiology and treatment strategies remains elusive.
Additional supplementation support is commonly used among athletes and coaches are furthermore confronted with the symptoms of upper respiratory tract infections.
The purpose of this study was to assess the effectiveness of additional supplementation as complementary support to keep high performance athletes in peak physical condition while maintaining their immune health.
One endurance trained cyclist born in 1982 was recruited to participate in this single case study. The subject was a competitor in “The Race Across America” (RAAM) and in peak physical condition and he has also been experienced immunosuppression related to URTI.
A single case study was used. The experimental design was constructed as a 6 hour long-term ergometer stress test on the threshold of LTP 1. The first test was carried out without any supplementation except for carbohydrates. The intervention consisted of an additional supplementation strategy adapted to, perhaps, the individual need of the athlete.
A significant decrease of the primary outcome measure CRP-value could be reported by the end of the second treatment phase compared to the baseline phase (50%). The results of the secondary outcome measure showed changes in the T cell lines and their subpopulations insofar that the cell subsets (T8 cell counts, CD4+TL cell counts, CD4+CD8 ratio, T cell counts and NK CD8 57+ cell counts) remained roughly stable in the bloodstream.
The present study shows a significant change in the common inflammation marker, CRP, and in domains of T cell subsets indicating that additional substrate use can be an acceptable tool in the support of athletes experiencing exercise-induced immunosuppression. Nevertheless, more research is needed to understand the intricate connection between exercise, immunosuppression and energy regulation strategies.
prolonged exercise, immunosuppression, URTI, supplementation, additional supplementation support


In our technology-driven world, stress has become a constant companion. Our bodies, drowned in a sea of electromagnetic radiation from the devices we are inseparable from, are increasingly falling out of sync with nature’s rhythms. This disruption can lead to fatigue, insomnia, and overall poor health. Enter Soundcube, a revolutionary vibrational speaker designed not just to play music, but to enhance your well-being.
Understanding the Problem:
Every day, our bodies endure a barrage of invisible waves produced by our mobile phones, laptops, Wi-Fi, and other wireless technologies. This constant exposure to electromagnetic radiation throws our bodies’ natural frequencies out of balance, leading to a host of health issues including sleep disturbances, chronic stress, and more.
While this modern dilemma may seem inescapable, the solution lies in aligning ourselves once again with the earth’s natural frequencies, a concept known as brain wave entrainment or frequency following response.
The Science of Sound and Vibration Therapy:
Sound and vibration therapy is a scientifically proven method to harmonize our bodies with the earth’s frequencies, thereby promoting optimal health and wellness. The therapy works on the principle of entrainment, the synchronization of our body’s internal rhythms with the frequencies of external sound and vibration.
Pulsed Electromagnetic Field (PEMF) therapy and Binaural brain wave entrainment are key components of sound and vibration therapy. By using low-frequency sound waves, they stimulate the body’s natural healing capabilities, reducing cortisol (the stress hormone) levels and boosting endorphins, our body’s natural painkillers and mood elevators.
Introducing Soundcube – Your Solution to Enhanced Well-being:
At the intersection of science and wellness technology, we introduce Soundcube, a state-of-the-art vibrational speaker designed to promote deep relaxation, better sleep, and improved overall well-being. By combining the principles of sound and vibration therapy with cutting-edge technology, Soundcube provides a therapeutic experience that balances your body’s bio-rhythms, helping you rest, restore, and regenerate.
Experience the magic of low-frequency vibrations and sound waves with Soundcube, as it leads your body into a state of deep relaxation and healing. With every use, you’ll find yourself feeling more revitalised and in harmony with the world around you.
How Does Soundcube Work?
Soundcube uses PEMF and Binaural brain wave entrainment technologies to deliver a relaxing and immersive experience. The low-frequency vibrations from the speaker sync with your body’s natural rhythms, entraining your brain waves and heart rate to align with the soothing rhythm of the Soundcube.
In this age of chronic stress and relentless exposure to electromagnetic radiation, Soundcube offers an effective, science-backed solution to restore balance and promote well-being. Experience the restorative power of sound and vibration therapy and take the first step towards a healthier, happier life with Soundcube. Realign your bio-rhythms, restore your vitality, and regain your peace of mind.


Residing Will As Well As Tough Power Of Attorney For Medical Services. What Is The Huge difference?When there is no hope of ultimate recovery, a Living Will is a legal file attending to only deathbed factors to consider; a client unilaterally declares his/her desire that life-prolonging measures be terminated.
On the other hand, individuals utilize a Durable Power of Attorney for Health Care to appoint somebody to make all health care decisions, limited by particular elections relating to deathbed concerns.
The client should be at least 18 years old and psychologically skilled at the time he or she carries out either file but unskilled to take part in the decision-making process when either is executed. It is essential to bear in mind that both files are just applicable if the customer mishandles.
Under the a Living Will, a customer states that if he or she is licensed to have an incurable, terminal injury/illness and/or to be permanently unconscious by 2 analyzing physicians (including the client's attending doctor), that artificial life-support systems be withheld or disconnected. The customer may also choose to cease artificial nutrition and hydration (intravenous feeding) by so designating on the type. (Find more info at: legalhelper.net/living-will.aspx).
Under the Health Care Power of Attorney, the client makes three different and independent elections authorizing the agent:.
1. To direct disconnection of synthetic life-support systems in case of terminal health problem;.
2. To direct disconnection of synthetic life-support systems in the occasion of permanent coma; and.
3. To direct discontinuation of synthetic nutrition and hydration.
In addition, the Health Care Power of Attorney type offers a space for the customer to set forth any specific medical, religious or other desires concerning his/her health care. The client may also use this section as a backup source for organ donation. (Find more details at: legalhelper.net/power-of-attorney.aspx).
Both documents are signed in front of 2 witnesses and a notary public or a justice of the peace who acknowledges the client's signature. The witnesses to a Living Will are sworn by the notary public/justice of the peace and suggest that the client is at least 18 years of age and signed the instrument as a complimentary and voluntary act.
The Living Will witnesses may not be the client's spouse, participating in doctor, heirs-at-law or individual with claims versus the customer's estate.
The Health Care Power of Attorney witnesses might not be the designated representative, the partner, beneficiary or client or person entitled to any part of the client's estate upon death under Will, Trust or operation of law.
my site Individuals are often confused as to why both a Living Will and Health Care Power of Attorney are required or proper . The Living Will is useful as a backup document: In the event that the customer goes into an irreversible coma and the healthcare agents designated in the Health Care Power of Attorney are departed or unloadable , the Living Will state the desires of the client worrying his/her death-bed treatment which may be followed by participating in doctors. The law supplies that to the degree that a Durable Power of Attorney disputes with a Living Will, the Health Care Power of Attorney controls. Copies of both the Durable Power of Attorney for Health Care and the Living Will are forwarded to the client's medical care doctor for addition in medical records.
Both documents are revocable through typical cancellation treatments.
Keep in mind that LegalHelper.net supplies an user friendly, quick, and affordable online method for developing finished legal documents for any events.
Under the a Living Will, a customer declares that if he/she is certified to have an incurable, terminal injury/illness and/or to be completely unconscious by 2 examining physicians ( consisting of the client's participating in doctor), that artificial life-support systems be kept or disconnected. The customer may likewise choose to cease synthetic nutrition and hydration (intravenous feeding) by so designating on the type. In addition, the Health Care Power of Attorney kind provides a area for the customer to set forth any specific medical, religious or other desires concerning his/her health care. The Living Will is helpful as a backup document: In the event that the client goes into an irreparable coma and the health care representatives designated in the Health Care Power of Attorney are unloadable or deceased , the Living Will sets forth the desires of the customer worrying his/her death-bed treatment which might be followed by participating in physicians. Copies of both the Durable Power of Attorney for Health Care and the Living Will are forwarded to the client's main care physician for addition in medical records.


Hay House Radio Episode Recap
- Episode Name: “Vaccine-Chronic Illness Controversy”
- Live Broadcast: June 27th, 2016 at 3:00 pm Pacific Time
Episode Replays: Mondays at 11:00 pm Pacific Time / 2:00 am Eastern Time and Sundays at 2:00 pm Pacific Time / 5:00 pm Eastern Time
Episode Summary Re-cap
Find out what to know about whether or not to vaccinate and how to heal if you’ve been vaccine injured.
Dr. Judy Mikovits, a 30-year veteran biochemist and molecular biologist found evidence of murine-related gammaretroviruses (XMRV) in 6% of the US population associated with diseases including cancer, autism, ME/CFs, Epstein-Barr Virus, chronic Lyme disease, Lou Gehrig’s disease Parkinson’s disease, and Alzheimer’s Disease. She also found the blood supply to be contaminated. Others suggested these retroviruses were most likely introduced into humans via vaccines.
Special Guests: Judy Mikovits, PhD and Annie Dru Allshouse
Judy A. Mikovits, PhD has spent her life training to be a research scientist to honor her grandfather who died of cancer when she was a teenager. Dr. Mikovits earned her BA from University of Virginia and PhD in Biochemistry and Molecular Biology from George Washington University. In her 35-year quest to understand and treat chronic diseases, she has studied immunology, natural products chemistry, epigenetics, virology and drug development.
In just over twenty years she rose from an entry-level lab technician to become director of the lab of Antiviral Drug Mechanisms at the National Cancer Institute before leaving to direct the Cancer Biology program at EpiGenX Pharmaceuticals in Santa Barbara, California where she had met and married David Nolde in 2000.
There in 2006, she became attracted to the plight of patients with Chronic Fatigue Syndrome and Autism. In only five years she developed the first neuroimmune institute from a concept to a reality and is primarily responsible for demonstrating the relationship between immune based inflammation and these diseases. She has published over 50 scientific papers.
Dr. Judy A. Mikovits recently founded MAR Consulting Inc. with her collaborator Dr. Frank Ruscetti.
Marconsultinginc.com | Plaguethebook.com | Facebook
Annie Dru Allshouse is a Price-Pottenger Nutrition Foundation advisory board member, a board member of the Hunt, Gather, Grow Foundation, and an ancestral cuisine educator. As a real-food educator, Annie is grounded in the six principles of ancestral cuisine as outlined by Dr. Weston A. Price in his seminal work, Nutrition and Physical Degeneration. Annie has had nearly a decade’s worth of experience facilitating groups seeking personal health restoration with these time-honored principles.
Important Facts About Vaccines, Your Immune System & Your Brain
How Your Immune System Works – the primary job of the immune system is to distinguish the difference between self and non-self (or pathogen).
What You Need to Know About Vaccines
Vaccines – the idea is that vaccines are supposed to train the immune system see a pathogen (in the vaccine) and respond to that pathogen with an appropriate immune response, so that there’s a memory for how to deal with that pathogen again, before the pathogen kills the host. The concept is a good one, however, vaccines have ingredients that can set the stage for autoimmunity and inflammation.
- Antigens – a foreign molecule or stimulus that trains the immune system.
- Adjuvants – amplifiers that makes things as robust as possible. Aluminum is an example. Adjuvants boost everything into overdrive, including the pathogen in the vaccine. These can be very dangerous and could set the stage for autoimmunity.
- Excipients – inactive ingredient used as a carrier, like eggs, milk, antibiotics and Vero monkey kidney cells. While these are “inactive” ingredients, they can still cause challenges for the body.
- Ingredients in Vaccines – Centers for Disease Control (CDC) List of Vaccine Ingredients.
- Vitamin Shots – keep in mind that the vitamin K shot is vitamin K1 and has added ingredients (not recommended). Some B vitamin shots may have additives as well. Ask to see the ingredients or consider a compounding pharmacy that does not add preservatives or other ingredients.
Schedule of Vaccines
- CDC Schedule of Vaccines from Birth to Adulthood
- 49 doses of 14 vaccinations before the age of 6
- 74 doses of vaccinations by the age of 18 (this includes the HPV vaccine, which is often given during puberty
- Changes in vaccine schedules over the years – The Healthy Home Economist features an at-a-glance visual of how vaccine dosages have changed over the years.
Key Ages to Avoid Vaccines – It was only in the last decade that science discovered that the immune system influences the brain and vice versa.
- Before the age of 3 years old – the immune system is not fully developed. If you inject a vaccine before the immune system is developed (where it would then understand the difference between self and other), two things happen: (1) the body starts working on fighting infection at a time when it needs to be focusing on development, such as developing a healthy brain; and (2) the body can get confused because you’ve injected a pathogen when it still doesn’t know the difference between self and other. This can set the stage for autoimmunity.
- Puberty – between 10 and 21 years old, the brain is being fine-tuned, particularly the amygdala, hypothalamus and pineal gland. All of these are involved in empathy and reasoning. When you vaccinate, it creates an inflammatory response, which can stop this important development in order to fight the invader.
- Pregnancy – Since the immune system of the mother has been trained to tell the difference between self and other, the fetus is not “self.” We do not want mom to reject the fetus. Vaccinating during pregnancy can create challenges for the fetus. Two examples are: (1) the pathogen can go to the fetus; and (2) the mother’s microbiome becomes the baby’s microbiome. Today, we know the microbiome is critical for health and wellbeing.
- Menopause – time of hormonal change, as we age, the immune system is the most vulnerable.
- Elderly – the immune system is weaker and the brain is more vulnerable. Beware of the high-dose flu vaccine because it has more adjuvants, which cause inflammation in the HPA (hypothalamus-pituitary-adrenal) axis in the brain.
Family Health Conditions & the Vaccine Decision – Consider not vaccinating if any of these conditions run in your family.
Tips for Healing If you Feel You’ve Been Vaccine-Injured or Have an Autoimmune Condition
Nutrition – First and foremost, focus on what you have control over. Good sources of food and water are a great place to start. One way to think about nutrition is to go back to the way our ancestors or grandparents did things.
- Ancestral Nutrition – follow these guidelines for a traditional diet that supports a healthy immune system, healthy brain function and a healthy microbiome.
- Avoid – processed foods, sugar and GMO foods (genetically modified). All of these foods contain toxins that adversely impact health and wellness. It’s also helpful to avoid toxins in the environment as much as possible. Some easier ones to avoid are household cleaners (switch to non-toxic brands or home-made options, like 1:1 water and white vinegar with about 10 drops of peppermint essential oil) and personal care products.
- Seek out clean drinking water sources – spring water, natural artesian water and filtered water.
- Support Your Body’s Natural Detoxification System – When you sign up for my newsletter, you receive a free one-hour podcast with tips for natural detoxification with food, supplements and personal care product changes.
Resources: Create A Community of Support
Since vaccinations are mainstream, as are GMO foods and processed foods, making changes to support your health can often feel isolating. The good news is that a growing number of people are making big changes and looking for a community of support. Meetup.com, Facebook (e.g., the Stop Mandatory Vaccination Facebook Group) and others are here to help!
Dr. Judy, Annie and I are all here for you, so please contact us if you need guidance or support. We will even set up classes and support if you are interested, just let me know by contacting me.
List of Supportive Doctors – these doctors can help with evidence to support you in opting out of vaccines based on health conditions or genetics.
How to Claim Medical Exemption in California – The Weston A. Price Foundation has put together these tips to claim medical exemption for vaccines.
Dr. Judy recommends having a lawyer write a letter to your public school saying that they cannot deny your child’s right to a free education.
Hay House Wisdom Community Members can listen to this show again anytime, and you can download and podcast this and over 10,000 archived audios from your favorite authors.
Tune in Next Week
Tune in July 11th to Loving Yourself to Great Health, Dr. Darren Weissman, chiropractic holistic physician, best-selling author, and international speaker in the field of consciousness, joins me to answer the question: Why do we keep falling into patterns that limit our health and well-being?
JOIN ME EVERY TUESDAY AT 12PM PACIFIC
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- Love Intuition: Follow the Energy to True Love - April 10, 2019


COPD Letter & Questionnaire
Spirometry is a common breathing test used to determine how much and how fast you can get the air out of your lungs. You are asked to take a big breath in and blow it out as hard and long as you can into a machine. You will be asked to do this at least 3 times to make sure that we get the best test possible. You are then given a medication to breathe in, and then the test is done again to see if the medicine makes your breathing better. Spirometry is the only way to truly tell if you have COPD.


Mild or severe hearing loss is a common condition in the United States, affecting more than 35 million Americans, according to National Health and Nutritional Examination Surveys. That accounts for more than 15% of the entire adult population, which makes hearing loss one of the most widespread medical issues after arthritis and heart disease. Unfortunately, it is not always seen with the seriousness it deserves, which causes a great deal of medical and social complications to those affected by it. But why exactly does this happen and why do people overlook hearing issues so much? What do they risk by doing so?
Risks of leaving hearing loss untreated
Hearing is one of humans’ five senses and we all need it to function in society and interact with the world around us. From the moment a person’s hearing starts to deteriorate, that quality of that person’s life will decrease. Medical research shows that the damage goes much further than the ears and it can impact people in many ways:
- If hearing loss is caused by an infection or is a symptom of an underlying disease, neglecting to see a specialist can lead to serious medical complications.
- Reduced awareness of one’s surroundings. Hearing impairment increases the risk of accidents and personal injury, especially when driving or when operating machinery at the workplace. Pedestrians are also at risk, because they might not be able to hear vehicles.
- Reduced performance at the workplace because instructions are not understood.
- Poor communication with friends, family and co-workers. People who have trouble hearing often feel ashamed to ask interlocutors to repeat themselves and the miss out on important details.
- Irritability and anger because one cannot connect with society
- In the long run, hearing loss can be even more harmful can cause emotional scarring. People who live with this condition and refuse to seek medical attention for years start to distance themselves from others and refuse to connect to colleagues and family. They can experience depression, anxiety and a constant feeling that they are unable to communicate. For children and teenagers this condition can become even more harmful, because it can interfere with cognitive development and social skills development.
Why do so many hearing loss cases go undiagnosed?
From the facts above, it’s clear that hearing loss is not harmful and it should be addressed immediately. But why do so many people neglect it? The most common reason is that they simply are not aware of it. Hearing loss almost always occurs gradually, so people don’t realize something is wrong. They imagine that their conversation partners don’t speak loud enough or that the TV volume is too low.
Another reason why people don’t seek medical attention is that they believe in myths and don’t know what a hearing test consists of or what it means to live with a hearing aid:
Biggest hearing loss myths
- Hearing loss is temporary and it will come back on its own in no time. That is not true. Having a “bad ear” isn’t something that heals on its own and more often than not it needs treatment.
- People can easily live with a hearing impairment. They can live, but the quality of their lives is drastically affected, especially relationships with friends and family.
- GPs can diagnose hearing loss and they should have told you. Because conversations with a GP take place in a quiet room, the doctor might not realize there is a problem with your hearing.
- Hearing loss only happens to elderly people. Although being over 65 is a risk factor and most cases of hearing impairment occur in this age category, you can have hearing loss earlier in life, even in your 20s.
- Taking a hearing test is complicated and painful. In fact, going to a hearing test Colorado Springs is quick and painless. The test takes as little as five minutes and does not hurt at all: you will only wear a pair of headphones in a soundproof room and a specialist will play sounds at different frequencies for you. All you have to do is raise your hand when you hear a noise and this will be enough to diagnose a problem.
- Wearing a hearing aid is uncomfortable. Things are actually the other way around. Modern hearing aids are light and discrete. They work as amplifiers, helping you hear normally, and thus helping you function in society. The aid will be fitted according to your needs, so it will not hurt your ear after prolonged use. After a while, putting it on becomes second nature, as normal as putting on a watch in the morning.


The Health Advocacy Clinic (HAC) is a medical-legal partnership with Aunt Martha’s Health and Outreach Center as well as Hesed House, the second largest homeless shelter in Illinois. Most of our clients are homeless. The ones who are not consist of low-income members of the community who struggle with poverty. Whether our clients stay in public housing or at Hesed House, they share one thing in common: their lives are stressful in a way that many of us cannot begin to comprehend.
HAC clients frequently experience stress trying to secure basic needs such as shelter, food, and safety. The effects of such stress can have long-term effects on their bodies and overall health. “The longer the stress lasts, the worse it is for both your mind and body.”1 Many of our clients are considered chronically homeless, which requires that they have been homeless for at least a year or have been homeless at least four times within the last three years and have a disability, and have therefore been subjected to the harmful effects of chronic stress.2 Although Hesed House provides its guests with a safe place to spend the night and three meals a day, guests are on their own during the day. Walking the streets of Aurora, they may become victims of crimes that threaten their safety simply because of their status as a homeless person. If they are disabled, physically or mentally, they may be perceived to be less likely to fight back during a physical attack, robbery, or sexual assault. Additionally, guests may be unable to find stable employment, which will prevent them from earning the funds necessary to escape homelessness.
The HAC works to secure Social Security Disability benefits for our disabled clients. Our work is necessary because of the strong link between homelessness and disabling conditions. According to the Department of Housing and Urban Development, “people living in shelters are more than twice as likely to have a disability, compared to the general population.”3 Even if a client’s disabling condition did not cause their homelessness, the condition certainly was not improved due to the chronic stress the homeless face. For example, a client of the HAC came to Hesed House with back pain problems. After having to spend every night sleeping on a mat on the floor, his back pain has become so severe that he walks with a cane and is being referred for spinal surgery. The disabling condition does not have to be physical; mental illness can be worsened by the stress of homelessness as well. A former client of the HAC struggled daily with managing several mental health diagnoses while staying at Hesed House. Now that she has been granted Social Security Disability benefits and was able to move into her own apartment, she is able to function in society much easier.
At the HAC, a student will learn the relationship between chronic stress and medical conditions. They will see how a controllable disease such as asthma or high blood pressure can be worsened to the point of disability by the chronic stress associated with homelessness. For HAC clients pursuing Social Security Disability, the condition must be disabling enough that the client will be unable to work for 12 months or more. A law student can attest to the fact that stress can have a negative impact on the human body, but it is the HAC clients who can show you how devastating chronic stress can be on every aspect of the human life: physical, psychological, and emotional.


Georg Ivanovas From Autism to Humanism - systems theory in medicine
Closely connected to nutrition is the gut flora which came into the centre of scientific interest lately. The gut flora contributes to the host’s nutrition by providing carbohydrates, amino acids and vitamins (Gilmore/Ferretti 2003). By that it regulates fat storage and even might be connected to obesity (Bäckhed et al 2004). Every kind of nutrition has its own flora with its own characteristics. The intestinal flora consists of about 1,2 kg bacteria and is so complex that not two people have the same complement of bacteria (Abott 2004). These micro-organisms adapt to each other and to the host even by exchanging genetical material (Xu et al 2007).
To really judge the importance of the gut flora, its organizational purpose has to be understood. The intestines are the most pervious part of the body. In the guts the distinction between me and other is problematic. Food has to be reduced to a size that the autopoietic unit ‘human’ (chap. 4.8) is able to absorb it and to maintain simultaneously its autonomy.
This happens in cooperation and in a symbiotic exchange relation with many bacteria. That is, the human is here in a very close contact with a multitude of bacteria that are potentially harmful. The mechanisms how this shifting balance between helpful and harmful bacteria is performed are slowly investigated (Xavier/Podolsky 2000; Neish et al 2000; Podolsky 2002; Ganz 2003; Coye et al 2005).
Immune regulation and inflammation processes are closely involved in this process. Thus, the gut flora plays an important role for the immunological balance (Podolsky 2000), might influence allergic disposition (Noverr et al 2005), is the first line of defence against pathogenic bacteria (LeBlanc et al 2008) and even might prevent kidney stones (Kaufman et al 2008). It is an ecological system with all characteristics of complexity.
When Helicobacter pylori infection was found to be related to stomach ulcer, this lead to a shift of paradigm in the treatment of the disease. Till then stomach ulcer was a typical ‘psychosomatic’ disease. Today Helicobacter is seen as the leading cause even of gastric malignancies (Kawakubo et al 2004), although it is inadequate as a monocausal explanation. Only a fraction of the ‘infected’ patients develop peptic ulcer, gastric cancer, or malignant lymphoma (Kawakubo et al 2004). The lifetime risk for persons with Helicobacter pylori to suffer peptic ulcer ranges from 3 percent in the US to 25 percent in Japan. Life style factors are still as good to predict peptic ulcer and the best results are attained, if the two (life-style and bacterium) are combined (Levenstein 1998). Nevertheless, Helicobacter is present in most cases of peptic ulcer (Suerbaum/Michetti 2002) and the typical linear strategy of medicine is the eradication of the bacterium understood as ‘causing’ the disease.
Such an intervention into an ecological context changes its balance. Therefore, some scientists expected an altered immune response with unpredictable consequences after Helicobacter eradication (Whitfield 2003). There is, indeed, some evidence that the eradication of Helicobacter contributes to cancers of the upper stomach (cardia) (Kamangar et al 2006), to asthma (Chen/Blaser 2007), to oesophageal disease and infant diarrhoea (Whitfield 2003).
Applying a linear logic to such relations is somehow confusing. When Helicobacter is defined as the ‘cause’ of stomach ulcer, then the eradication of Helicobacter is the ‘cause’ of oesophagitis, diarrhoea, cardia cancer and asthma. But such statements do not really make sense as systems like the gut are necessarily nonlinear. For example, in mice the prognosis in the case of a re-infection with Helicobacter is worse than in the infected and untreated animals (Mueller et al 2005). This finding makes only sense, when principles of adaptation are introduced.
In any case, it would be more appropriate to talk about the ‘presence’ of Helicobacter facilitating gastric ulcer and not of ‘causes’ or of H. pylori ‘infection’. This becomes even more obvious when different contexts are taken into account.
The stomach is normally protected against bacterial damage through gastric mucin (Kawakubo et al 2004). The reduced defence mechanism could be seen as cause of the disease on a different level. This is, indeed, the old paradigm of stress theory. But also nutrition plays a role. It not only influences the gut population, in general. Exogenous cholesterol enhances the growth of H. pylori populations directly (Kawakubo et al 2004). That is, a nutrition rich in cholesterol (the minor part) or inducing the own production of cholesterol (the major part) contributes to the increase of Helicobacter.
A ‘causal chain’ (chap 2.1.d) wisely knowing that such a chain has no other meaning than to exhibit the theory and interest of the observer would be
nutrition ► cholesterol ► Helicobacter ► stomach ulcer
Every intervention, every drug changes the gut flora contributing to many diseases (Stockert 2001). The effects of iron, antibiotics and systemic cortisone can be judged in middle and long term only, when their effects on the gut are considered. For example, the higher incidence of breast cancer through antibiotics has been attributed to the damage they do to the gut flora (Velicer et al 2003).
Another disease attributed to the damage of the gut flora through antibiotics and bad diet is eosinophilic oesophagitis which showed a sharp rise in the last years (Noel et al 2004). Its eosinophilic character is of special interest. Eosinophilic reaction is normally seen in helminth infection or in allergic disease. The two are somehow interconnected as the reduction of helminth infections leads to a rise of allergic disease (Wickelgren 2004). One proposed explanation for this finding is that worm infections occupy certain receptors which might provoke allergic disease when not used. This theory, as such, is surely too simplistic as receptors change according to a certain situation and IgE is part of a wider network (Gould/Sutton 2008). However, it provides a first rough model of how the body can be triggered by different germs, or, if these are lacking, by other substances.
The theory says, more generally spoken and probably much nearer to the truth, that the immune system has to be occupied with a certain amount of germs, otherwise it occupies itself with substances normally not acting as an antigen. This is also the core of the so-called hygiene hypothesis (Watts 2004). It says that the reduced contact with bugs leads to allergic disease. The theory is based on the observation that a reduced exposition to bacterial and helminth diseases is related to atopic disease. For example, children with many brothers and sister and/or with animals, and/or children living on farms have an impressingly lower incidence of allergic disease (Braun-Fahrländer et al 2002).
The hypothesis is supported by animal studies (King et al 2004). “Autoimmune diseases in susceptible strains of mice or rats develop earlier and at a higher rate among animals bred in a specific pathogen-free environment than among animals bred in a conventional environment.” (Bach 2002). Even lymphoma (Becker et al 2004) and multiple sclerosis (Ponsonby et al 2005) are connected to the lack of exposition to bugs. Some attribute the protective effect of bacterial infection to T cell differentiation and to the level of cytokines (Weiss 2002).
The ‘hygiene’ problem starts already with birth. The gut flora develops within the first 2-3 days. The first colonisation is extremely important. Colosturm, the first milk in breast feeding, plays a major role. But the bacteria of the environment as well. It has been shown that infants born in a modern hospital are exposed to fewer bacteria and develop a less rich flora than children under ‘normal’ hygienic conditions (Stockert 2001). As in hospitals patients acquire multiple antibiotic-resistant enterococcal strains within days of admission (Gilmore/Ferretti 2003) hospital birth might contribute to allergic disease in two ways. It leads to a reduced flora and it provides highly selected, often pathogen bacteria.
Therefore, the hygiene hypothesis has to be seen in a wider sense. It is not only the confrontation of the immune system with certain bacteria that matters. It is also the question which bacteria persist in the human under which circumstances. This wider concept explains why infectious diseases during the first 6 months of life are associated with an increased risk of atopic dermatitis (Benn et al 2004). The more inadequate the gut flora is, the more probable are infections and the more probable is the persistence of pathogenic germs.
Antibiotics play a role. “By altering the balance of gut microbes, antibiotics can disrupt the immune system's ability to distinguish between innocuous substances and harmful microbes. This finding, from experiments on mice, adds weight to the notion that antibiotics could be at least partly responsible for the rise in allergies and asthma in children” (Randerson 2004). This connection between the use of antibiotics and allergic disease has been maintained by many researchers (Bach 2002; Randerson 2004, Noverr et al 2005). But it is no surprise that other studies do not confirm these findings (Benn et al 2004).
As the gut is a nonlinear system, interventions into its ecology through nutrition or in eradicating certain bacteria will not reveal predictable results. Nothing might happen, consequences might occur only very slow, or other co-factors are needed to produce symptoms.
Therefore it is also doubtful whether the administer of worms in patients with bowel inflammation or allergic disease is really as useful as first results suggest (Coghlan 1999, Kolfs 2004, Summers 2005). Although the eradication of the helminths gives rise to allergic reactions, this does not mean that the administration of helminths will have the opposite effect. This linear exchange value is not true in polyvalent situations (chap 3.5). This does not mean that the application of worms is generally useless. It only means that the whole concept has to be considered cautiously, especially all generalizing statements.
The administration of living organisms, so-called probiotics, has a long tradition, but was seen as “folk medicine” (Tamboli et al 2003) used only by different methods of complementary and alternative medicine (CAM) in the treatment of atopic diseases, in all kind of bowel disturbances and in people with a tendency for infections. Only lately its positive effects became accepted by orthodox medicine (Bach 2002; Shanahan 2003) and had been proved to be effective in respected trials (Tubelius et al 2005). Thus the positive effect of germ administration became more widely accepted.
B. thetaiotaomicron is helpful to prevent bowel inflammation (Gilmore/Ferretti 2003) and E coli nissle 1917 is as effective in the treatment of colitis ulcerosa as mesalazine (Rembacken et al 1999). The protective effect of the E. coli nissle 1917 was detected (by observation) in WW I, when the bacterium was isolated in a soldier who was spared of a severe gastroenteritis. The bacterium became the main substance of a probiotic remedy (Mutaflor®), and was used since for many purposes.
In the now flowering research on probiotics it has been found that already the DNA of probiotic bacteria has an immunstimulatory effect (Rachmilewitz et al 2004). But even this has been known by CAM for decades. Refined parts of bacteria (for example Prosymbioflor®) is used at the beginning of a probiotic therapy, in small children and/or in sensible persons.
The orthodox proposition to add the immunstimulating DNA to nutrition in order to avoid allergic diseases (Rachmilewitz et al 2004) springs from the linear thinking that so often leads into trouble. The therapy with refined bacterial parts has sometimes no effect, but not so rarely it leads to an overstimulation with all kind of inflammatory reactions. Therefore it is no surprise that a trial showed that the general administration of certain probiotics is correlated with an increased mortality in acute pancreatitis (Besselink et al 2008). Probiotics have to be dosed carefully and the regimen has to be altered according to the observed effects. There is no simple dose-effect relation.
But the gut flora is only one part of human symbiosis, although the most prominent one. The flora of the mouth, the ears, the vagina, the skin, they all play a role in the adaptation of humans to their environment and in the competence of the immune system. Actually, the human organism consists of 90% non-human cells (Nicholoson et al 2004).
Thus, all kinds of diseases might be influenced with probiotics. It is a quite common strategy in vaginosis. Also HIV-infections seem to be to some extend preventable through lactobacillus (Tao 2005). As this germ is often present, especially in the milk and the mouth, this might explain why the transmission of HIV through breastfeeding is rarely observed. It was also proposed to use probiotics in recurrent otitis media (All-Sttodley et al 2006).
The understanding of the bacterial biotope ‘human’ is essential for any concept of chronic diseases.
For example, it is futile to ask which germ is causing bacterial vaginosis. Until now 35 bacteria have been found (Fredericks et al 2005) and may be Helicobacter will have soon some companions as the cause of peptic ulcer. However, these germs might often be more an indicator of an imbalance and less a causal agent.
Although the bacterial flora is quite complex it is not such a great methodological challenge. With some concepts of adaptation, symbiosis, cooperation and competition it should not be too difficult to model clinical observations.


Many parents seeking family dental care in Neptune, NJ, wonder whether their child will need to wear braces. If they get an answer in the affirmative, they ask at what age their child can start wearing braces. Most kids who need orthodontic treatment start it at the age of 12 or 13. Some children start earlier. In those years, the head and mouth are still in their growing stages. This process makes the shifting of teeth a bit easier.
How Long Will My Child Wear Braces?
The answer to this question depends on a lot of factors. This includes the actual placement of the braces, as well as the type of braces that the orthodontist uses and their treatment plan. Most teens will wear their braces between 18 and 30 months. During that time, their braces will get adjusted by an orthodontist every one to two months. This allows your teen’s teeth to align over time. After your teen returns to treatment at the family dental care practice, they might wear retainers anywhere for a couple of months to a couple of years.
Will Braces Actually Hurt?
When your child has an appointment with their orthodontist, they will get the connecting wires of the braces tightened. This causes pressure on the brackets, which allow the teeth to shift. After this process, your teen might feel some soreness. However, they won’t feel the pain for long.
Dr. Alkamary of Glamorous Smile Dental Spa prides herself on creating beautiful smiles and promoting the importance of family dental care in Neptune, NJ.


The Importance Of Wound Care After A Pressure Sore Or Surgery
Taking good care of a wound is always important, but for those that are medically fragile, wound care can be lifesaving. When an individual has a wound that results from consistent contact with a bed, for example, it can be very difficult for them to heal. Constant vigilance is needed to keep the wound from getting deeper. For those with a compromised immune system or trouble healing because of conditions like diabetes, wound care services make it possible to heal damaged tissue and avoid further complications. If you or your loved one is trying to manage with a wound that is not healing, it's time to meet with wound care services to get some help.
Pressure Sores That Won't Heal
Pressure sores are graded by stage. In stage one, it appears as a red spot on the skin. By stage four, the wound is open and you can visibly see muscles, tendons, and bone. They are caused when an individual is confined to a bed or wheelchair and is not able to move about. A stage one pressure sore can begin as early as two hours in the same position. Once a stage four pressure sore is present, it takes careful wound care to get the wound to heal. If it gets infected, problems with an infection can become systemic and fatal.
Wound Care After Surgery
A surgical procedure can leave you with a significant wound that needs to heal. You may have drains that need to be checked daily and bandages that have to be replaced. Wound care services take a careful look at your wound and make sure that it is healing as it should be. The wound should be cleaned and properly dressed to give you the best chance at healing. Surgical wounds can get infected without proper cleaning, so it's important to follow all the prescribed protocol after surgery.
Your Individualized Wound Care Plan
Your type of wound, your medical status, and your ability to take care of the wound on your own, all become part of your wound care plan. For those that can't take care of their own needs, a wound care plan emphasizes the care needs and what should be done, step-by-step, in order to help you heal.
It can be difficult to heal after developing a pressure sore or surgical wound. Work with your specialist and understand the role of wound care services as you heal.


Dr. Donkin's Curated Collection of Products
Dr. Scott Donkin
Scott Donkin, DC, DACBOH is an internationally published author, chiropractor, lecturer, and consultant who has been in private practice in Lincoln, Nebraska for over thirty years. He speaks nationally and internationally on numerous ergonomic, health, wellness, longevity, and quality of life topics. Dr. Donkin is considered an expert on the use of the physical environment to promote balance, human performance, health, safety, and longevity. Dr. Donkin has served as President of the American Chiropractic Association’s Council on Occupational Health, Advisory Board member of the Wellness Councils of America and Chairman of the WorkWell Board of Directors.


Dr. Minhaz Ahmed
Dr. Minhaz Ahmed is a dedicated individual who has significantly contributed to healthcare and community development. He is best known as the co-founder and board member of the OBHIZATRIK Foundation.
Besides his involvement with OBHIZATRIK, Dr. Minhaz Ahmed also works at Ad-Din Medical College Hospital, showcasing his medical expertise and dedication to patient care. His experience at the hospital has provided him with valuable insights into the healthcare system, further strengthening his commitment to improving healthcare access and delivery.
With his combined experiences in healthcare and community development, Dr. Minhaz Ahmed brings a unique perspective to OBHIZATRIK. His medical background equips him with the necessary knowledge and understanding to identify and address the specific healthcare needs of the communities the foundation serves.


Kidney stones are a widespread condition among the population, with a higher frequency during the hottest periods of the year. Excess waste substances in the urine are sometimes deposited in the renal cavities, leading to hard, crystallized formations that can grow and progress into tiny stones. It is fairly straightforward to get rid of small stones (the so-called gravel). Larger stones, on the other hand, can obstruct the urinary tract, resulting in infections and painful colic. After your first bout of colic, there is a very high risk of further outbreaks.
Why Do Kidney Stones Form?
The main conditions favoring the formation of kidney stones are:
a low volume of urine (less than two liters of urine per day);
an increase in the concentration of certain elements (calcium, sodium, oxalates, etc.) in the urine;
a reduction of the substances in the urine that can inhibit crystallization.
What Can I Do to Avoid Them?
The entire scientific community agrees that increasing your intake of liquids during the day is the easiest and most effective way to prevent the formation of kidney stones. Drinking at least two liters of oligomineral water a day causes urine volume to increase. This, in turn, causes the concentration of elements leading to the formation of stones to decrease while also promoting the spontaneous expulsion of crystals.
For Information and Orders
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AQUAURO, 1 liter


THE CANCER SURVIVORS'
Bill of Rights
Natalie Davis Spingarn
© 1999 NCCS
1. Survivors have the right to continuous lifelong medical care, as needed. The physicians and other professionals involved should make every effort to be:
- Sensitive to cancer survivors' lifestyle choices and their need for self-esteem, dignity and privacy of the information trusted to them;
- Careful, no matter how long these patients have survived, to take symptoms seriously and not to dismiss aches and pains, for fear of recurrence is a normal part of survivorship;
- Vigilant to watch for any long-term and late effects of cancer and its treatment in follow-up clinics and offices;
- Informative and open, providing survivors with as much or as little candid medical information as they wish, and encouraging informed participation but not expecting survivors to manage that care on their own;
- Knowledgeable about counseling and rehabilitation resources, and willing to refer survivors and their families as appropriate for emotional support and therapy aiming to improve the texture as well as the quantity of time that is theirs to live.
2. No matter in which setting their care is offered -- be it the fee for service or some sort of managed care system -- survivors have the right to quality care emphasizing:
- Informed choice - choice of the setting in which care is delivered, choice of primary physicians and specialists delivering that care, as well as choice of appropriate, effective and safe treatments (including ongoing clinical trials);
- Efficient yet humane management of such unfortunate byproducts of disease as fatigue and pain - pain control management, for example, which approaches survivors more as partners in identifying the proper amount of medication needed at any given time than as potential drug addicts;
- Appropriate use of hospital and other facilities, wherein cost effectiveness and patient-centered care are balanced so that no survivor is dismissed -- after a mastectomy, for example -- unable to care for her or himself or secure the care needed to avoid dangerous and painful situations;
- Constant respect for survivors' wishes as to when and how to discontinue treatment should that time arise, including the scrupulous honoring of "living wills" and similar documents.
3. In their personal lives, survivors, like other Americans, have the right to the pursuit of happiness. This means they have the right:
- To talk with their families and friends about their cancer experience if they wish, but to refuse to discuss it if that is their choice, and not to be expected to be more upbeat or less blue than anyone else;
- To be free of the stigma of cancer as a "dread disease" in all social relations, wherever they may take place -- from home to work or marketplace;
- To be free of blame for having the disease and of guilt for having survived it;
- To participate in support groups and other survivor support and/or advocacy activities as they wish, for in such settings they usually feel less isolated, more informed, and more able to express their feelings, be they feelings of hope or of despair, without fear of being regarded as "bad" or "ungrateful" or simply "uncooperative" patients.
4. In the work place, survivors have the right to equal job opportunities. This means they have the right:
- To aspire to jobs worthy of their skills, and for which they are trained and experienced, and thus not to have to accept jobs they would not have considered before their cancer experience;
- To be hired, promoted, and accepted on return to work, according to their individual abilities and qualifications, and not according to "cancer" or "disability" stereotypes with "reasonable accommodation," under federal and state law, such as changes in duties or hours, which allows them to work while receiving medical treatment without falling into a survivors' "Catch-22" -- too ill to work, but too healthy to qualify as "disabled" and so entitled to protection under the Americans with Disabilities Act;
- To privacy about their medical histories.
5. Since health insurance is an urgent survivorship concern, every effort should be made to assure all survivors decent, affordable coverage, whether public or private, or provided under managed care or fee-for-service systems. This means:
- For employers, that survivors have the right to be included in group health coverage, which is often less expensive and provides employees with more protection under the Health Insurance Portability and Accountability Act (HIPAA or Kassebaum - Kennedy Act) regardless of health history;
- For physicians, counselors, and other professionals concerned, that they keep themselves and their survivor-clients informed and up-to-date on the dangers of health insurance discrimination which can make it difficult to buy and keep coverage, as well as on available group or individual health policy options (noting, for example, what major expenses like hospital costs and medical tests outside the hospital are covered and what amount must be paid before coverage);
- For social policy makers, both in government and in the private sector, that they seek both to broaden insurance programs to include diagnostic procedures and treatments which help prevent recurrence and ease survivor anxiety and pain, as well as to lower the unfair barriers often imposed by the accidents of race, minority culture, age, or plain lack of means to pay for adequate health insurance coverage.
In sum, cancer survivors have the overriding right to access quality health care. Implicit in that right is universal access to adequate health insurance coverage. For "quality" becomes an empty word without the means to achieve such coverage.


Headaches and migraines impact our quality of life and get in the way of doing the things we love.
Studies show in the United States, more than 45 million people suffer from chronic, recurring headaches. If you find yourself among this category, there is hope.
We'll Help You Get To The Bottom Of What's Causing Your Headaches or Migraines
Learn from an expert in the field
Fellowship-trained in Interventional Pain Management
Dr. Austin Harper is a board-certified Anesthesiologist and a fellowship-trained interventional pain medicine physician serving our Tyler and Longview locations. He joins the Precision Spine Team from Loma Linda University in California where he completed a fellowship in Pain Medicine. During his fellowship he was trained by multiple Pain Management specialists in different fields including Anesthesiology, Physical Medicine & Rehabilitation, and Neurology.
Dr. Harper completed his B.S. in Psychology at the University of Texas at Austin. He then went on to earn his medical degree at Texas A&M Health Science Center and completed his Anesthesiology Residency at Baylor Scott & White in Temple, Texas.
Dr. Harper’s goal is to contribute to the development of a multidisciplinary practice with the focus on person-centered pain management. He believes that one of the best ways to manage a person’s pain is through a team of healthcare providers working directly with the patient to focus on not only the patient’s pain but also the psychological, physical, social, and spiritual aspects of health and disease. The primary goal is to provide a variety of strategies and interventions for pain management with an emphasis on self-management and active patient participation. His underlying goal is to help every patient live a full life.
Find Relief from your headaches or Migraines today
- Learn the types and causes of headaches
- Hear how to differentiate between and a headache and a migraine
- Hear stories of hope
- Learn your options for relief
Precision Spine Care is a spine center of excellence that treats patients across Texas and includes spine surgeons, non-surgical spine physicians, fellowship-trained pain management physicians, as well as physical therapists, on-site diagnostic tools, and other alternative treatment providers.
Precision Spine Care has locations in Tyler, Longview, Lufkin, Texarkana, and Nacogdoches. Coming in July of 2021, we are pleased to expand additional pain care locations across Dallas, including pain management in Arlington, Addison, and Rockwall. View a complete list of our locations here.


Asthma is an inflammatory disease that affects the airways of the lungs. It can cause difficulty in breathing and make it very challenging or almost impossible to do some certain tasks. It is a chronic condition which is has no known cure yet but can be managed.
Asthma affects millions of people around the world with 25 million in America alone. In 2019 it caused 461,000 deaths across the world.
When a normal person breaths, the muscles around the airways are relaxed making air to move easily but during an asthmatic attack the muscles around the airways constrict (tighten) causing the airways to become narrow. As you know when something becomes narrow it will be difficult for things to pass through it. When the airways of the lungs become narrow, air cannot flow freely. This tightening of the airways is called Bronchospasm. As a result of this the airway will become inflamed causing mucus to fill the airways, which will reduce the amount of air that can pass through it.
When these conditions take place asthmatic attacks will begin with symptoms of cough and tightness of the chest.
TYPES OF ASTHMA
There different types of asthma and they include:
- Allergic asthma: This is the asthma triggered by allergens. It is the most type of asthma. The allergens include dust, food, pollen grains, mold, pet dander from animals like dogs and cats. Allergic asthma is seasonal because it appears when it is the season of those allergens.
- Non – allergic asthma: This is the asthma that is not caused by allergens but by irritants and pollutants in the air. The irritants includes:
- Burning wood
- Cold air
- Viral infections.
- Air fresheners and perfumes
- Polluted air
- Occupational asthma: This type of asthma is caused by triggers in the place of work. The triggers in the work place include:
- Industrial chemicals
- Fumes and gases
- Proteins from animals.
These irritants are mostly found in industries such as manufacturing, textiles, farming, and wood work industries.
- Exercise – induced bronchoconstriction (EIB): This type of asthma is usually triggered when people exercise within the first few minutes of starting and few minutes after ending. This type of asthma was formally called Exercise- induced asthma. Most people with asthma experience this type of asthma.
- Nocturnal asthma: This is the type of asthma where the symptoms worse at night. Heart burns, pet dander, dust mites are suspected to be the triggers of nocturnal asthma. The sleep cycle of a person can also trigger this type of asthma
- Aspirin –induced asthma: This type of asthma is triggered when people take aspirin or other NSAIDS such as ibuprofen.
- Cough – variant asthma (CVA): This is the type of asthma that is characterized by persistent dry cough. Common symptoms associated with asthma are usually absent in CVA. This type of asthma can become a full blown asthma if it is not treated on time.
SYMPTOMS OF ASTHMA
Asthma symptoms can include the following:
- Tightness in the chest or chest pain
- Coughing mostly at night
- Shortness of breath
- Chest pain
- Fast breathing
- Sleeping troubles
The symptoms may worsen or not improve even with the use of inhaler and may result in these severe symptoms:
- Severe difficulty in breathing
- Gasping for air
- Feeling dizzy
- Experiencing confusion
- Paleness or blueness of lips or finger nails
- Difficulty in walking or talking
Seek immediate medical attention if you experience any of these severe symptoms.
CAUSES OF ASTHMA
Researchers are yet to find the cause of asthma. But certain factors can increase the chances of developing asthma which include:
- Allergies: When a person is allergic to some things the risks of developing asthma will be high.
- Genetics: if your family has a history of asthma there is a possibility that you will asthmatic
- Environmental factors: Exposure to toxins, fumes, allergies, second – or – third hand smoke in the environment can trigger the development of asthma especially in infants and young children whose immune systems are not fully developed.
- Respiratory infections: Respiratory infections such as Respiratory syncytial virus (RSV) can cause asthma in young children.
COMMON ASTHMA ATTACKS TRIGGERS
Anybody can have asthmatic attack when they come in contact with things that can trigger. These triggers may cause instant asthmatic attacks but to some other people an attack may start hours or days later.
It is important to know that what can lead to an asthmatic attack in A may not cause it in B. But the more common triggers include:
- Air pollution: Air pollutants such as wild fire smoke, car exhaust, factory emissions and many more can trigger of asthmatic attacks.
- Exercise: Exercising can trigger off the occurrence of asthmatic attack in some people.
- Cigarette smoke: Smoking or inhaling tobacco smoke (second – hand smoking) can trigger asthmatic attacks especially in an enclosed area like car or home. The best thing to do is to quit smoking or stay away from people who smoke because both smoking and inhaling smoke from people who smoke can stir up asthmatic attacks.
- Smoke from burning wood or grass: Smoke from these places contains harmful gases or particles which when inhaled can trigger asthmatic attacks. It is advisable to avoid burning wood in your home. This might be a very difficult thing to do especially for people in places where firewood is used for cooking.
- Food and food allergies: Any food can cause an allergic reaction. Food additives and preservatives are believed to cause allergies in some people and these allergies can then lead to asthmatic.
- Respiratory infections: Respiratory diseases such as the common cold, flu, sinus infections, respiratory syncytial virus (RSV).
- Negative emotional states: Negative emotional states such as depression,stress, anxiety, fear can trigger an asthmatic attack.
- Certain medications: Medications such non steroidal anti- inflammatory drugsIbuprofen, naproxen and aspirin are the most common drugs that can trigger asthmatic attacks.
Some other triggers of asthma can include:
- Extreme environmental weather condition.
DIAGNOSIS OF ASTHMA
The diagnosis of asthma begins with studying the family history of the patient and then carrying out physical examination.
Family history: If you have family members with asthma the risks of developing this breathing condition is very high.
Physical examination: The doctor can use a stethoscope to listen to your breathing. Skin tests can also be carried out check for any sign of allergic reaction such as eczema.
Breathing tests: The doctor can conduct a pulmonary function tests (PFTs) which measures the airflow into and out of your lungs. The more common of these tests is the spirometry where you blow into a device that measures the speed of the air.
Breathing tests are not usually conducted on children less than 5 years because it will be difficult to get an accurate result. The doctor will prescribe asthma medication for your child instead. If the symptoms improve then the child has asthma.
Bronchodilator or other asthma medication may be prescribed by your doctor if test results are pointing towards asthma for adults. If condition improves with this medication the doctor will treat your condition as asthma.
TREATMENT OF ASTHMA
There is no cure yet for asthma, but you can alleviate and prevent symptoms.
The type of treatment methods that can be used to help people with asthma depends on how severe the symptoms are. The severity of asthma can be:
- Intermittent: This is when the asthma does not interfere with daily activities. The symptoms are mild and can last for few days in a week or few days in a month.
- Mild persistent: The symptoms of this disease appear more than twice a week but not every day of the week and up to 4 nights per month.
- Moderate persistent: Here the symptoms manifest daily and at least 1 night a week. Some daily activities may be limited.
- Severe persistent: This is the worst of them all. Symptoms occur several times a day and in most nights. Daily activities of the sufferer will be greatly affected.
Asthma symptoms can be alleviated through quick – relief and long term control medications.
Quick–relief asthma treatments: These are medications used to get quick relief from asthma symptoms if an attack occurs. Bronchodilators are used to provide quick relief as it relaxes the tightened muscles around the airways which will reduce symptoms quickly. Bronchodilators are most commonly taken with an inhaler or nebulizer. It can also be taken orally or injected.
Long- term asthma control medications: These medications are used to provide daily relief from asthma symptoms. They may not provide relief if you have an asthmatic attack. The long- term asthma control medications include:
- Anti –inflammatories: These medications are used to reduce swelling and mucous production in the airway which will help to make easier for you to breathe.
- Long –acting Bronchodilators: These are bronchodilators that have long lasting effects. They should be used in combination with anti –inflammatory asthma medications.
- Anticholinergics: These are used to prevent the tightening of the muscles of the airways. You should take them daily in combination with anti-inflammatories.
When asthma is so severe that it does not respond to treatment doctors use what is called Biologics. These biologics are used to target specific antibodies in the body, disrupting the pathway that leads to asthma-causing inflammation.
PREVENTION OF ASTHMA
The cause of asthma still remains unknown and so there are no specific methods to prevent the development of asthma.
However the things to do to prevent asthma attacks are much available and they include:
- Stay away from things that can trigger asthma attacks.
- Avoid exposure to allergens.
- Take your medications regularly which can help to prevent the occurrence of asthma attack.
- Stop smoking if you do and stay away from people that smoke.
- Eat balanced diet
- Minimize stress because stress can trigger off asthma attack.
- Maintain a schedule of exercising daily. Although physical activities can trigger off asthma attacks, regular exercising can actually reduce the occurrence of an attack.


Pimples and blackheads all over the face – especially teenagers know the problem. But acne can be treated. What causes acne, what types there are and what the therapy looks like. After reading this article, we hope too, you can obey any myths about acne, like Why Do I Get Pimples on My Lips After Kissing?
What is Acne?
Acne is one of the most common skin diseases. Around 85 percent of the population has been affected at some time. Acne, due to hormonal changes during puberty, occurs mainly in teenagers from the age of nine. Almost every teenager has already discovered the characteristic blackheads and pimples on his or her face. By the third decade of life, the condition usually subsides. If acne occurs in adults over the age of 25, it is referred to as acne tarda, late acne or adult acne.
Physiological or mild acne
About 60 percent of young people suffer from harmless, so-called physiological or mild acne. They usually only have to deal with a few blackheads and pimples for a short period of one to two years, which can be controlled with over-the-counter remedies from the pharmacy.
About 40 percent, however, have a more pronounced form of acne, the so-called clinical acne. It can persist until the end of the second decade of life or even beyond and requires treatment by a dermatologist (specialist in dermatology). If the medication is discontinued too early, relapse occurs and the therapy starts all over again. Therefore, the doctor will prescribe maintenance therapy when the acne is largely under control. This may take a few years or longer to reach the natural remission phase at the end of the second and beginning of the third decade of life.
Acne can become a heavy burden not only on the body but also on the soul. This is especially the case with the very severe forms of progression. Papules, pustules as well as nodules – especially on the face – can be perceived as very disturbing cosmetically and can lower personal self-esteem. In the case of severe acne, a dermatologist should definitely be consulted, also because of these psychosocial factors, who may also consult a colleague in the field of psychosomatics.
What Causes Acne?
Several factors are involved in the development of acne. These are:
- sebaceous gland hyperfunction
- cornification disorder in the sebaceous gland duct
- overgrowth of bacteria
- inflammatory reaction
Sebaceous gland hyperfunction and keratinization disorder
In adolescents, at the onset of puberty, under the influence of male sex hormones (androgens) and growth factor (GH), the sebaceous glands enlarge and produce more sebum. This results in sebaceous gland hyperfunction. Normally, the sebum passes unhindered through the sebaceous gland canal to the surface of the skin. In acne, however, the cells lining the duct, which are also stimulated by androgens, additionally form increased horny material. The excess horny material eventually clogs the excretory duct so that the sebum can no longer drain away. Initially, blackhead precursors (microcomedones) form, which we cannot see with the naked eye.
These give rise to all other skin manifestations typical of acne, including open and closed blackheads. By applying gentle pressure, the thread-like emptying whitish content – the sebaceous-horny mixture – of the blackhead can be seen. Open comedones can be recognized by their black dot in the center. This blackish discolored spot consists of melanin, which comes from the pigment-forming cells (melanocytes) of the mouth of the duct. Therefore, it is not dirt. From open blackheads, the horny sebum material can be more easily dissolved by exfoliating substances, acne cleansers or medications such as vitamin A acid preparations. In the case of closed blackheads, there is a risk of inflammation, deterioration, discoloration and scarring, especially when they are squeezed out. Here, the so-called acne toilet by experienced medical cosmeticians can additionally help.
Because fat and horny cell production in the sebaceous glands is stimulated even more strongly by male sex hormones, acne is usually more pronounced in men and boys than in girls and women.
Overgrowth of bacteria and inflammation
Due to the overactivity of the gland, a certain bacterium, Cutibacterium acnes, finds improved growth conditions in the sebaceous gland excretory duct and multiplies. However, acne is not an infectious disease. In itself, we all have these bacteria on our skin. They have many enzymes that, among other things, break down sebum and keep inflammation going in the area surrounding the sebaceous gland apparatus. Special immune cells migrate into the region, loosening the wall of the duct and facilitating and increasing the back-and-forth of messengers of inflammation. As a result, pustules, papules and nodules form on the skin. If the bacteria encapsulate in the follicular duct, antibiotic resistance can develop, which is closely associated with the inflammation and poorer response to certain acne medications for topical application. External factors that promote blockage of the sebaceous gland excretory ducts should also be avoided. These include fats or oils in skin care and cosmetic products, certain medications, hot-humid climates, or mechanical irritants, for example, caused by too tight or occupational clothing (chin straps, helmets, face shields).
Some people may ask, Why Do I Get Pimples on My Lips After Kissing? Does kissing cause pimples on lips? Or, does lip kissing cause pimples? But it all just a myth that kissing can make you get pimples.
Symptoms and Forms of Acne
Acne mainly develops where there are many sebaceous glands:
- on the face,
- on the neck and side of the neck
- on the front triangle of the chest (décolleté),
- on the back up to the buttocks
- on the outer upper arms and especially shoulders
However, acne can also appear under the armpits and in the genital, buttock and groin regions. However, this is not a disease of the sebaceous glands but of the hair follicles (terminal hair follicles), i.e. a completely different disease (acne inversa or hidradenitis suppurativa). This has a different treatment concept and those affected should be cared for by specialized skin centers.
In the clinical picture of acne proper (acne vulgaris), a distinction is made between several forms characterized by different skin changes, but fluid transitions are always present:
- Acne comedonica: It is characterized by the appearance of open and closed blackheads, which are not or hardly inflamed. The number of closed blackheads significantly exceeds the number of open blackheads, especially in women. In acne comedonica, the blackheads are mainly located on the face, especially in the lateral nose, chin and forehead areas.
- Acne papulo-pustulosa: In this form of acne, in addition to blackheads, there are inflammatory pustules (pus-filled protrusions of the excretory duct) and, when touched, painful papules (up to five millimeters in size) and small nodules (five to ten millimeters in size). In addition to the face, the chest, back and upper arms may also be affected. Different types of scars can develop quickly or later from the inflammations.
- Acne conglobata or cystic acne: Mainly men are affected by this severe form of acne. One to two centimeter large, highly inflammatory and painful nodules form, which in the course of time merge with each other to form ducts or encapsulate as deep abscesses. After the inflammations have healed, characteristic acne scars remain.
In addition, there are various other forms of acne, of which some examples are given here:
- Acne fulminans occurs as a complication of acne conglobata. It can lead to fever and death of affected skin areas (skin necrosis), kidney inflammation and joint inflammation.
- Acne neonatorum occurs in newborns, but heals quickly after delivery. The cause is thought to be male sex hormones that are transferred from the mother to the embryo.
- Acne infantum means that acne persists in infancy. Possible causes are congenital hormonal enzyme deficiencies or locally over-oily skin.
- Acne medicamentosa: pimples and pustules caused by medications, for example, cortisone preparations,vitamin B complex, iodine compounds, antidepressants or modern anti-tumor preparations.
- Acne venenata (occupational acne/contact acne) affects people who work with oils or tar, for example, or who work in hot and humid environments (smelting furnaces, hot mangles), or it is caused by ingredients in cosmetics that cause blackheads.
Especially if pimples appear on the face, shoulders and chest during puberty, acne should be considered. In order to rule out other skin diseases such as purulent hair follicle inflammations and fungal diseases, as well as rosacea in patients from the middle of the third decade of life, and to initiate treatment, a visit to a dermatologist is advisable.
The diagnosis “acne” can already be made on the basis of the typical appearance. In addition, information on the time of onset, whether there is a rapid progression, other existing (skin) diseases and a family history of acne are very important. The doctor will also ask about cosmetics, the use of medication and dietary habits, as well as whether there is a tendency to scarring.
In order to confirm the diagnosis of acne and to draw up a suitable treatment plan, the doctor may take purulent wound secretions from the pustules or nasal secretions or even blood in severe cases or if an additional infection is suspected.


Earlier this month, US DOT updated its drug testing regulations. These changes take effect January 1, 2018 and apply to all transportation workers –aviation, transit, rail – who are already subject to federal DOT drug tests.
With this update, DOT has expanded the types of drugs it tests for. Beginning January 1st, you will be tested for four additional drugs, specifically semi-synthetic opioids: hydrocodone, oxycodone, hydromorphone, oxymorphone. These semi-synthetic opioids are sold under brand names such as OxyContin, Percodan, Percocet, Vicodin, Lortab, Norco, Dilaudid, and Exalgo, etc. When the changes take effect, DOT drug tests will screen for the use of these drugs:
Marijuana; Hydromorphone; Amphetamine; Cocaine; Oxycodone; Methamphetamine; Codeine; Oxymorphone ; MDMA/MDA; Morphine; 6-Acetylmorphine; Hydrocodone; and Phencyclidine
Under the existing DOT drug testing process, Medical Review Officers (MROs) determine whether there is a legitimate medical explanation for a positive test result, such as taking a legally prescribed drug. With this update, if you test positive for a semi-synthetic opioid, your MRO will downgrade your positive result to negative if you have a legally valid prescription for the drug found in your system.
There are other important things you should know about how this rule impacts you:
There is no time limit on the use of a legally valid prescription. DOT recognizes that there could be an unintended hardship on you if a MRO was able to deny a prescription from being a legitimate medical explanation simply because it took you a longer time to finish taking the drug than expected. As a result, there’s no cutoff date after which the prescription for a drug you’re taking can’t serve as an explanation for a positive result.
MROs cannot deny your prescription from acting as a legitimate medical explanation for a positive test result simply because they believe your doctor should not have prescribed you that medication. But, MROs must review and take all reasonable steps to verify the authenticity of the records you provide, and may contact your doctor for further information to verify your prescription.
Before this rule, MROs were required to report to DOT and employers drug tests results and worker medication information if the MRO believed the information would cause the worker to be medically disqualified or pose a safety risk. Under this rule, before the MRO reports information about your prescription drugs to DOT or employer, the MRO must give you five business days to ask your doctor to call the MRO and determine if the medication can be changed to one that does not pose a significant safety risk. If the MRO determines a medical qualification or safety risk still remains, the MRO will report information about the drugs you’re taking.
Remember that while some state laws allow marijuana use, it is still prohibited by US DOT. If you test positive for marijuana, no prescription can downgrade your positive result to negative.
- You can view the US DOT update here: https://www.gpo.gov/fdsys/pkg/FR-2017-11-13/pdf/2017-24397.pdf