Cream shades may be shear or full coverage with titanium dioxide as the chief pigment purchase 75 mcg synthroid otc. Pearlescent nail polish usually contains bismuth oxychloride and/or titanium dioxide coated micas and may even contain guanine-natural fish scales generic synthroid 25mcg otc. The manufacturing of nail lacquer is usually carried out by specialty manufacturing firms that are familiar with the hazards of working with nitrocellulose and solvents purchase 125 mcg synthroid with mastercard. The manufacture consists of two separate operations: (1) manufacture and compounding of the lacquer base; and (2) the coloring and color matching of shades. Top coats that are used to enhance gloss, extend wear, and reduce dry time are usually made with high solids and low boiling point solvents. Base coats function to create a nail surface to which nail lacquer will have better adhesion. Different auxiliary resins, such as polyvinyl butyral have been used in nitrocellulose systems. Fibers, polyamide resins, and other treatment items have been added in order to provide advertising claims and some may actually alter the effectiveness of the film. In the evaluation of nail enamels the following criteria are used: color, application, wear, dry-time, gloss, and hardness. Liquid Compact Foundation A hot-pour solid creme` foundation that seems to ‘‘liquefy’’ when touched. After (C) has been added slowly and heated with (A), emulsify by adding (D) at 90°C to (A), (B) and (C) mixture. The ingredients of Part 2 are melted and homogenized at 78–82°C, then maintained by a thermostatic bath regulated to 58–62°C. The ingredients of Part 3 are dispersed in Part 1; the mixture is placed in a thermostatic bath at 58–62°C. After homogenization, the whole is cooled in a silicone-treated mold (with Dimethicone). The mechanisms that underlie the resilience of skin to the harsh outside world, and the extraordinary ability of the skin to also protect underlying tissues, are just beginning to be understood. Skin retains a large amount of water, and much of the external trauma to which it is constantly sub- jected, in addition to the normal process of aging, causes loss of this moisture. In the past several decades, the constituents of skin have also become better characterized. The earliest work on skin was devoted predominantly to the cells that make up the layers of skin: epidermis, dermis, and underlying subcutis. Now it is beginning to be appreciated that the materials that lie between cells, the matrix components, have major instructive roles for cellular activities. It is a mis- translation of the German ‘‘Grundsubstanz’’ which would be better translated as ‘‘basic,’’ ‘‘fundamental,’’ or ‘‘primordial’’ substance. By 1855, sufficient infor- mation had accumulated for its inclusion in a textbook of human histology by Kollicker¨ (2). The study of ground substance began in earnest in 1928, with the discovery of a ‘‘spreading factor’’ by Duran-Reynals (3–7). A testicular extract was shown to stimulate the rapid spreading of materials injected subcutaneously, and func- tioned by causing a dissolution of ground substance. The observed dissolution of ‘‘ground substance’’ simulated Duran-Reynals to write the following, which is just as applicable today: If the importance of a defensive entity is to be judged by the magnitude of the measures taken against it, nature is certainly pointing its finger to the ground substance, as if to invite us to learn more about it (10). The ‘‘Mucopolysaccharide’’ Period ‘‘Ground substance’’ was subsequently renamed ‘‘mucopolysaccharides,’’ a term first proposed by Karl Meyer (11) to designate the hexosamine-containing poly- saccharides that occur in animal tissues, referring to the sugar polymers alone, as well as when bound to proteins. However, the term ‘‘ground substance’’ per- sisted for many years afterward, and could be found in textbooks of biochemistry, dermatology, and pathology as late as the 1970s. The name hyaluronic acid was proposed from the Greek hyalos (glassy, vitreous) and uronic acid. It was later found to be a polymer present throughout the body, identified in virtually every vertebrate tissue, the highest concentrations occurring in the vitreous of the eye, in the syno- vial fluid found of the joint capsule, in the umbilical cord as Wharton’s jelly. These receptors themselves are regulated and are the substrates for phosphokinases (32). Their relationships are becoming clarified through the ability to sequence rapidly using the new techniques of mo- lecular genetics. Physicochemical studies indicate that the polymer can take on a vast num- ber of shapes and configurations, dependent on polymer size, pH, salt concentra- tion, and associated cations. Blood vessels are unable to penetrate joint syno- Hyaluronan 323 vium, cartilage, and the vitreous of the eye. Potent hyaluronidase inhibitors are involved, a class of molecules about which little is known. The β-linkage is of more than passing interest and not merely a curios- ity relevant only to carbohydrate chemists. A high mo- lecular weight chain of β-linked N-acetylglucosamine is the structure of chitin. Chitin and cellulose are the most abundant sugar polymers on the surface of the earth. Yet such β-linked sugar polymers are rare in vertebrate tissues, and require unusual reactions for their catabolic turnover. There is strong evidence that an H2O bridge between the acetamide and carboxyl groups is involved in the secondary structure. The unusually stiff tertiary poly- meric structure is also stabilized by such hydrophobic interactions. Glycosaminoglycans and proteoglycans must be distinguished from ‘‘mu- cins,’’ the branch-chained sugars and their associated proteins. These occur more often on cell surfaces, though they also accumulate in the intercellular ‘‘ground substance,’’ particularly in association with malignancies. This problem has arisen in part because of the ill-defined or unknown nature of histochemical color reactions. The molecular domain encompasses a large volume of water, and even at low concentrations, solutions have very high viscosity. It functions as a sieve, to exclude certain molecules, to enhance the extracellular domain of cell surfaces, particularly the lumenal surface of endothelial cells, to stabilize structures by electrostatic interactions, and also acts as a lubricant. Hyaluronan increases whenever rapid tissue proliferation, regeneration, and repair occur (14). Ele- vated levels promote cell detachment, in preparation for mitosis, as cells leave tissue organization, and enter the transient autonomy required for the mitotic event to occur. The water of hydration also opens up spaces creating a per- missive environment for cell movement. Hyaluronan is generally produced in the interstitium, in the mesenchymal connective tissue of the body, and is thought to be largely a product of fibroblasts. This remaining 15% that reaches the blood stream has a rapid turnover, with a t1/2 of 2 to 5 min, being rapidly eliminated by receptors in the liver, and also, by unknown mechanisms in the kidney (15,53,54). Hyaluronan also increases in the circulation in liver disease, particularly cirrhosis, and in renal failure reflecting aberrant degradation (65– 67), in rheumatoid arthritis (68) and in some malignancies, resulting from in- creased tissue synthesis (69). This corresponds approximately to the time when a ‘‘switch’’ from the scar-free fetal wound healing to the adultlike wound healing with scarring occurs (71). There is also an abundance of inflammatory cells, a necessary component for the normal process of wound healing. Such observations are made in both the experimental fetal rabbit and sheep models, as well as clinically, in infants delivered following in utero surgery. Aspects of wound healing appear to be a strategic retreat to an embryonic situation, fol- lowed by a rapid recapitulation of ontogeny. However, overexpression of hyaluronidase also correlates with disease pro- gression, as shown recently in bladder (77,78) and in breast tumor metastases (79,80). It is the probable basis of the failure to rosette in the classic sheep red blood cell rosette test, a former laboratory procedure used to diagnose malignancy (93,94). These are referred to collectively as hya- ladherins, a term coined by Toole (38,39). Such factors are presented to cells as mechanisms for growth control and modulators of cell func- tion. They also appear to be a component of the nuclear matrix in a wide variety of cells (103,104).

Antibiotics Upper respiratory infections should be treated aggressively in the pregnant asthmatic patient synthroid 125 mcg low price, as in the nonpregnant patient (see Chapter 2) buy synthroid 125mcg online. Erythromycin is probably a safe alternative in the patient who is allergic to penicillin order synthroid 200 mcg with amex. However, hepatotoxicity has been observed in pregnant patients treated with the estolate salt of erythromycin (McCormack et al. Briefly, diphenhydramine, chlorpheniramine, pheniramine, and tripelen- namine are generally considered safe for use during pregnancy. A few studies have shown that expectorants and mucolytics are efficacious in the treatment of asthma. It is of utmost importance that these agents, as well as theophylline mixtures containing iodides, not be used during pregnancy, because the iodine blocks the synthesis of thy- roxine in the fetus, resulting in hypothyroidism or congenital goiter (Carswell et al. Other drugs used to treat asthma are also contraindicated for use during pregnancy (Table 5. The beta- adrenergic agonists are a critical element of first-line pharmacological therapy (Cunningham, 1994). Supplemental oxygen should be administered, as needed, to maintain a pO2 greater than 60 mmHg. Intravenous hydration is also important, along with respiratory care to remove the tenacious secretions. If initial spirometry indicates severe obstruction, an intra- venous bolus of 125 mg methylprednisolone should be considered. It has been recommended that corticosteroids should be part of the initial therapy for women with severe, acute asthma (Cunningham, 1994; National Heart, Lung and Blood Institute, 1991). After two or three doses of epinephrine or inhaled beta-agonists, if the wheezing is not corrected, then intravenous aminophylline may be indicated. Dosing should be based on theophylline levels, if the patient has been receiving oral theophylline (it should be noted that theophylline requirements decrease as pregnancy advances; see Table 5. The patient should be admitted to the hospital if she demonstrates a poor spirometric response to therapy, has no symptom improvement, or has pneumonia or pneumothorax. Endotracheal intubation and mechanical ventilation should be considered when signs of respiratory failure present. Patients who respond quickly to such therapy should be discharged on an intensified reg- imen. A tapering schedule of oral corticosteroids should be given if intravenous steroids were used. Close follow-up should be arranged to reassess their clinical condition and possible adjustments in medication. Opiates, sedatives, and tranquilizers are contraindicated in asthmatics because they cause alveolar ventilatory depression, and are associated with respiratory arrest imme- diately after use (Table 5. Beta-adrenergic blockers and parasympathetic agents should also be avoided in asthmatics because they can cause bronchospasm. Chronic asthma Chronic asthma patients need additional steroid therapy for coverage during the stress of labor if they have received oral steroid therapy for more than 2 weeks within the pre- vious year to prevent adrenal crisis. Corticosteroids should be given in cases of severe or mild asthma with wheezing that is unresponsive to bronchodilators. Beclomethasone dipropionate is effective and safe when prolonged steroid use is necessary. Beta-agonist by inhalation every 3–4 h as needed is used for outpatient management of chronic asthma, along with inhalation steroids such as beclomethasone (Cunningham, 1994). Cromolyn sodium can be given chronically by inhalation, and is fairly effective in improving the symptoms of an asthmatic. An added benefit with cromolyn use is a decreased requirement for other antiasthma agents. Cromolyn therapy is best begun during remissions because it requires several days to reach an effective dosing regimen. Medications that cause bronchospasm or depress alveolar ventilation should be avoided in the pregnant woman with asthma (Table 5. Effect of bronchial asthma on the course of pregnancy, labour and perinatal outcome. Many surgeons are reluctant to perform operative procedures on women known to be pregnant, although emergency procedures are sometimes necessary. In addition, elective or indicated procedures may be carried out on women with an unrecognized pregnancy. General principles that the clinician should be aware of when surgery is anticipated in a pregnant woman are based on physiologic differences between the pregnant and non- pregnant state (Box 6. Virtually all anesthetic agents and 98 percent of medications cross the pla- centa, exposing the fetus to medically significant levels. Even a minimal degree of hypotension and hypoxia is to be avoided because this may result in placental hypoperfusion and fetal hypoxemia. Pregnant women being prepared for surgery should be placed on their left side, adequately hydrated, and preoxygenated prior to induction of anesthesia. Pharmacokinetics of anesthetic agents have been reported for only pancuronium, and its disposition was a pregnancy-associated decreased half-life, and this was probably due to significantly increased clearance (Little, 1999). Increased blood volume is caused by a plasma volume increase of approximately 1000 cc and a 300–500 cc increase in red cells. This usually results in lower hematocrit compared to the nonpregnant woman, and is commonly known as physiologic anemia of pregnancy. Accordingly, the glomerular filtration rate increases (as measured by the endogenous creatinine clear- ance) because of increased blood volume. Serum creatinine and blood urea nitrogen decrease because of dilution by increased plasma volume. Other changes in the renal sys- tem include dilatation of the ureters and a relative stasis of urine, resulting in a ‘relative’ hydronephrosis. The relative hydronephrosis is frequently more pronounced on the right than on the left side. Other cardiopulmonary changes that occur during pregnancy include a slight increase in heart rate, and decreased systolic and diastolic blood pressures in the second trimester. Respiratory rate increases slightly during pregnancy with a decrease in physiologic ‘dead space’ as pregnancy pro- gresses. Tidal volume is increased during pregnancy, but minute ventilation and compli- ance do not change during pregnancy. Gastrointestinal system changes with pregnancy affect pregnant women that require anesthesia and/or surgery. The risk for aspiration pneumonitis in surgery on the gravid patient is increased because of pregnancy-associated decreases in intestinal motility and gastric emptying. This has implications for anesthesia dose man- agement of the pregnant patient; lower doses than in the nongravid patient may achieve the desired anesthetic effect. Serum levels as high as 400 mg percent are not unusual during the third trimester and cause increased red cell sedimentation rate in pregnant women. Hematocrit is decreased during pregnancy accompanied by a relative leukocytosis (white blood cell count greater than or equal to 10 000–12 000 or even higher during labor). Several hema- tologic measures are unchanged during pregnancy: for example, the relative percent of immature forms (i. Whole blood clotting time, prothrombin time, and partial thromboplastin time remain in normal ranges during pregnancy. Surgery should be performed without delay when it is indicated for life-threatening maternal conditions. Indicated laboratory tests and radiologic procedures should be per- formed without hesitation to properly guide life-saving surgical procedures. Anesthetic adjuncts, or other ‘nonanesthetic’ drugs and medications during the pre-, intra-, and post-operative peri- ods may also adversely affect the fetus. Regional techniques (spinal and epidural procedures, paracervical and pudendal blocks) result in physiologically important fetal exposure to clinically significant anesthetic levels. Anesthetic potency is related to protein-bound fraction, and the amount of binding determines the duration of action. Highly protein bound anesthet- ics are lipid soluble and readily cross the placenta (Morishima et al. Malformations were not increased in frequency among offspring of women who used procaine, lidocaine, benzocaine, or tetracaine during the first trimester, and there were no adverse fetal effects when these agents were utilized at any time dur- ing pregnancy (Heinonen et al. No investigations of bupivacaine, chlorprocaine or prilocaine have been published with regard to their teratogenic effects. Transient newborn neurobehavioral changes in infants whose mothers received local anesthetic agents have been reported, and vary from mod- erate for regional blocks (Rosenblatt et al.

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The dose is adjusted depending on the plasma fibrinogen concentration produced by the previous injection cheap 50mcg synthroid overnight delivery. Withdraw the required quantity of urokinase and mix with a further volume of NaCl 0 order synthroid 100mcg without a prescription. Inspect visually for particulate matter or discolor- ation prior to administration and discard if present generic synthroid 25mcg on line. Aspirate the cannula then instil the solution and cap for 20--60 minutes (up to 4 hours may be necessary in some cases). Cannula infusion Preparation and administration Check that you have selected the correct strength of vial(s). Withdraw the required quantity of urokinase and add to a suitable volume of NaCl 0. Inspect visually for particulate matter or discolor- ation prior to administration and discard if present. Intravenous infusion (loading dose) Preparation and administration Check that you have selected the correct strength of vial(s). Inspect visually for particulate matter or discolor- ation prior to administration and discard if present. Continuous intravenous infusion via a syringe pump Preparation and administration Check that you have selected the correct strength of vial(s). Inspect visually for particulate matter or discolor- ation prior to administration and discard if present. Technical information Incompatible with Urokinase is incompatible with Gluc solutions. Monitoring Measure Frequency Rationale Haemorrhage Continuously * Risk of bleeding. Angiograminperipheralarterial 2-hourly * Assessment of response to thromboembolism therapy. Additional information Common and serious Immediate: Allergic reactions including bronchospasm have been undesirable effects reported. Injection/infusion-related: sensations of warmth, dull ache or pain may be felt in the vessel being treated. Significant interactions * The following may "risk of haemorrhage with urokinase: anticoagulants, heparins, antiplatelet agents, e. Stop administration and give supportive therapy as appropriate including fresh frozen plasma, fresh blood and tranexamic acid if necessary. Local sensations of warmth, dull ache or pain may be felt locally in the vessel being treated. This assessment is based on the full range of preparation and administration options described in the monograph. Vancomycin | 849 Vancom ycin 500-mg, 1-g dry powder vials * Vancomycin hydrochloride is a glycopeptide antibiotic. Antibiotic-associated pseudomembranous colitis (oral): 125mg orally every 6 hours (up to 2g/day in severe cases) usually for 7--10 days. Withdraw the required dose and add to a suitable volume of compatible infusion fluid. Inspect visually for particulate matter or discolor- ation prior to administration and discard if present. To reduce the risk of ‘red man’ syndrome (see below) a 1-g dose is usually given over 2 hours. Fluid restriction: the maximum concentration is 10mg/mL, but "risk of infusion-related effects. Withdraw the total daily dose and add to a sufficiently large volume of compatible infusion fluid. Inspect visually for particulate matter or discolor- ation prior to administration and discard if present. May be mixed with common cordials immediately before administration to mask the taste. Technical information Incompatible with Aminophylline, amphotericin, ampicillin, aztreonam, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, chloramphenicol sodium succinate, dexamethasone sodium phosphate, drotrecogin alfa (activated), foscarnet, heparinsodium,omeprazole,piperacillinwithtazobactam,propofol,sodium bicarbonate, ticarcillin with clavulanate. Displacement value Nil Stability after preparation From a microbiological point of view, should be used immediately, however: * Reconstituted vials may be stored at 2--8 C for 24 hours. Auditory and Daily and for several * Ototoxicity may occur on overexposure to vestibular function days after cessation vancomycin. Signs of supra- Throughout treatment * May result in the overgrowth of non-susceptible infection or organisms -- appropriate therapy should be superinfection commenced; treatment may need to be interrupted. Pharmacokinetics Elimination half-life is 4--6 hours in normal renal function (120--216 hours in haemodialysis). Significant interactions * Vancomycin may "levels or effect of the following drugs (or "side- effects): ciclosporin ("risk of nephrotoxicity), diuretics-loop ("risk of ototoxicity), suxamethonium ("effect). Actionincaseof overdose No known antidote, stop administration and give supportive therapy as appropriate. This assessment is based on the full range of preparation and administration options described in the monograph. It also constricts peripheral blood vessels and causes contraction of the smooth muscle of the intestine, gall bladder and urinary bladder. Doses are usually expressed in terms of pressor units: Vasopressin 100 micrograms 5 argipressin pressor units. Biochemical and other tests Baseline plasma osmolality or baseline bodyweight (to enable monitoring of fluid balance) Electrolytes: Serum Na, K Dose Diabetesinsipidus:0. Inspect visually for particulate matter or discolor- ation prior to administration and discard if present. Monitoring Measure Frequency Rationale Signs of extravasation During infusion * Extravasation may cause tissue necrosis and gangrene. Signs of During and * Anaphylaxis has been observed shortly after hypersensitivity immediately post injection. Chest pain During and post * Anginal chest pain may occur in susceptible injection individuals. Peripheral ischaemia * May cause peripheral ischaemia in patients with peripheral vascular disease. Vasopressin | Verapamil hydrochloride | 855 Additional information Common and serious Immediate: Anaphylaxis and other hypersensitivity reactions have undesirable effects been reported. Other: Tremor, sweating, vertigo, circumoral pallor, ‘pounding’ in the head, abdominal cramps, desire to defecate, passage of gas, nausea, vomiting, water intoxication. Action in case of overdose Symptoms to watch for: "Risk of water retention and/or#Na, i. This assessment is based on the full range of preparation and administration options described in the monograph. Pre-treatment checks * Do not give in cardiogenic shock, sinoatrial block, and uncompensated heart failure. Inspect visually for particulate matter or discolor- ation prior to administration. Verapamil hydrochloride | Voriconazole | 857 Additional information Common and serious Immediate: Rarely bronchospasm with urticaria and pruritus. This assessment is based on the full range of preparation and administration options described in the monograph. Voriconazole 200-mg dry powder vial * Voriconazole is a triazole antifungal and a synthetic derivative of fluconazole. Voriconazole has ahighoral bioavailability(96%) soswitchtooral administrationas soon as possible. The oral form should be used unless it is judged that the benefit outweighs the risk; Cr should be closely monitored. Dose in hepatic impairment: in patients with a Child--Pugh Class A or B use the standard loading dose but half the maintenance dose. Discard the vial if the vacuum of the vial does not pull the diluent into the vial.

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If you have homemade Lugol’s iodine (made by your pharmacist or by yourself order synthroid 50 mcg visa, see Recipes) 25 mcg synthroid overnight delivery, add a tsp synthroid 200 mcg generic. Vitamin C is acid and is our natural healing agent but it will sting on a broken skin surface. Zinc oxide is another natural healer because it competes away the iron that fungus and bacteria need for their reproduction. Never use commercially available zinc compounds though, simply purchase your own zinc oxide powder, mix it with cornstarch and keep in a large old salt shaker, dust it wherever there is moisture or fungus growth. It may be impossible to deprive the fungus of moisture, for example if your feet sweat and you must wear socks. Launder with borax only (soaps and detergents contain aluminum which pollutes the skin). They may have developed a foothold underneath the toe nail where a steady supply of moisture, iron and sugar is available to them. Nevertheless, your white blood cells will eventually gobble them up if you let them. In thrush (yeast infection of the mouth) you must again outwit its growth by doing everything possible at one time. Avoid trauma like eating abrasive foods (crusts, popcorn, nuts, lozenges) or sucking on things. Floss teeth only once a day (using monofilament fish line), followed immediately by brushing with white iodine (or Lugol’s, but this may temporarily stain). Since reinfection is constant, you must continue to do all the treatments given to permanently cure yourself of fungus disease. Clearing up fungus at one location but not another will not bring you a permanent cure, either. Although sheep, cattle, pigs and humans can be “natural” hosts to the adult stage, the other stages are meant to develop outdoors and in secondary hosts. When fluke stages other than the adult are able to develop in us, I call it fluke disease. Or, when an adult that “normally belongs” to another species is able to develop in us, I also call that fluke disease. Or even with adult flukes in their “normal” host, when they move from the organ that they “normally” colonize to other organs in the body I call this fluke disease, too. Four fluke varieties engaged in this extra territorial pursuit are the intestinal fluke, sheep liver fluke, pancreatic fluke, and human liver fluke. If an adult crosses the wall to the inside and then manages to get out through the fallopian tubes to the abdominal cavity it takes some endometrium with it— causing endometriosis. This is not an example of flukes straying into the wrong organs, but of having its stages reproducing where they never could before. Yet a human is big and makes a valiant effort to kill the stages, block access to tissues and otherwise battle them. The intelligent approach is to discover what enables these mighty monsters to do their reproducing in our bodies instead of the pond with its snail/minnow secondary hosts. The presence of isopropyl alcohol is associated in 100% of cancer cases (over 500 cases) with reproduction of the intestinal fluke stages in a variety of organs causing cancers in these organs. The presence of wood alcohol is associated in 100% of dia- betes cases (over 50 cases) with reproduction of pancreatic fluke stages in the pancreas. The presence of xylene and toluene is associated in 100% of Alzheimer cases (over 10 cases) with the reproduction of intes- tinal fluke stages in the brain. Much more work needs to be done to examine the relation- ship between fluke reproduction, the solvent and the chosen or- gan. Ideally, we should all pool our results, adding to the body of knowledge I have begun. In other words, the minute amounts that we inhale here and there do not accumulate to the point of serious damage. The sources of benzene and propyl alcohol that I found are given in special lists (page 354 and 335). But a pattern is emerging: foods and products that require sterilization of bottles and ma- chinery to fill these bottles are polluted with propyl alcohol or wood alcohol. Diabetes is quite old as an illness, too, and so is its associated solvent, wood alcohol. Should we conclude that benzene, xylene and toluene were used much less in the past? Fluke diseases could be eradicated with some simple ac- tions: monitoring of solvents in foods, feeds and products. It is in the interest of the consumer to have her or his own independent way of monitoring too. Chemical ways can be devised, besides the electronic way pre- sented in this book. Imagine a small test strip like a flat toothpick which turns color when in contact with propyl alcohol. An industry that not only proclaims purity for its products but provides the proof to your satisfaction. Burning And Numbness Burning sensations in the skin let you know that nerves are involved. Mercury may have started the trek of a host of other toxins as well into your nervous system: pesticide, automotive chemicals, household chemicals, fragrance and even food chemicals. Some people can get a burning sensation after a car trip, some when exposed to perfume, some when walking down the soap aisle in a grocery store. Maybe the mold toxins interfere with pan- tothenic acid used by your body, because giving pantothenate (500 mg three times a day) can sometimes relieve the condition and, of course, this is good for your body. Numbness of fingers or feet has become quite common since thallium and mercury toxicity has spread so widely. Remove all the metal in your dentalware immediately, replacing with composite (see Dental Cleanup, page 409). Hopefully, your immune system is still strong enough to clear the bacteria growing around the metal and in pockets in the jaw. Three kinds of Shigella are readily obtainable on slides: Shigella dysenteriae, Shigella flexneri, Shigella sonnei. Nana Hughes, 48, had numbness of the whole right arm, hand and right side of her head; it was particularly bad in the last four months. She started on the parasite program, stopped using nail polish, and stopped all detergents for dishes or laundry. Maria Santana, 45, had numbness in both arms; they would tingle and “go to sleep” a lot. She went off all commercial body products, did a kidney cleanse and killed parasites. She had diffi- culty getting rid of Prosthogonimus but in two months she had everything cleaned up. Her legs, arms, sleep problem, urinary tract problems were all gone and she could focus on her last problem, digestion. Candy Donaldson, 44, had numbness from her shoulder to the wrist of one arm, it started a year ago. She was advised to stop caffeine use and switch to milk (her calcium level was low: 9. She decreased the phosphate in her diet (meat, nuts, grains, soda pop) and started the kidney cleanse. When the gas leak was fixed, both her lithium and vanadium toxicity disap- peared. In six weeks she had also killed parasites and her periods became regular for the first time. After four months she had done three liver cleanses and suddenly her numbness improved. If cleaning cavitations brings you immediate improvement you know that these bacteria were part of the problem. Have them checked again if problems return; dental bacteria are noto- rious for returning. If kidney cleansing makes it worse for a day and then better, you know kidney bacteria are partly responsible.

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