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Lyme disease (tick-borne borreliosis) is an infectious disease caused by Borrelia burgdorferi spirochaete and transmitted by mites.
Lyme disease is characterized by a tendency to chronic and relapsing course and primary lesion of skin, nervous system, musculoskeletal system and heart.
This disease was first identified in 1975 in Lyme village (USA), when a group of patients was diagnosed with arthritis, which was characterized by an unusual course.
Infection is transmitted through infected mite bite. Pathogens Borrelia burgdorferi penetrate into the skin with mite’s saliva and multiply for several days, then they spread to other skin areas and internal organs (including heart, brain, joints). Pathogens for a long time (even years) can remain in human body, causing chronic and relapsing course of the disease.
Chronic form of Lyme disease may occur many years after infection. Lyme disease is diagnosed based on special blood tests and symptoms.
Currently there are techniques that allow to recognize the disease faster than previously used antibody tests.
Ixodia dammini mite bites, which is a Borrelia burgdorferi spirochaete transmitter.
Skin redness appears on bitten area. Red spot gradually increases on periphery, reaching 1-10 cm, sometimes up to 60 cm or more, diameter. The spot has round or oval, rarely irregular, shape. The outer edge of inflamed skin is more red, a little extruding above skin surface. Eventually central part of the spot becomes pale or bluish, characteristic ring-shape appears. Bitten area is determined by crust in the spot center, then it turns into a scar. The spot untreated persists for 2-3 weeks, then disappears.
After 1-1,5 months nervous system, heart or joints lesion signs occur. Flu-like symptoms, such as headache, fatigue, fever, sore throat, muscle aches are observed. The joints are hot, swollen and tender (most frequently knee joints are affected), combined with muscle and tendon pain.
Neurological symptoms – paralyses (most often on face), skin sensitivity disorders, insomnia, hearing loss.
Cardiac symptoms – arrhythmia, increased heart rate, brachycardia, chest pains, dizziness, respiratory distress.
There may be mental changes observed: depression, mental disability.
Complications and Possible Effects
Lyme disease most often occurs in late spring or early summer. After 1-2 weeks flu-like symptoms, which may be accompanied by rash, usually disappear. Recent studies have shown that bacteria may penetrate into brain and spinal cord at early disease stage.
Without treatment at early stage after a few weeks or months complications on heart, joints and nervous system appear. However, even at patients, treated at early stage, complications occur in 15% of cases.
Since symptoms are non-specific, Lyme disease is often misdiagnosed and treated as rheumatic arthritis, meningitis or disseminated sclerosis.
Fatigue, mood changes and neurological symptoms are common causes of mental diseases misdiagnosis, chronic fatigue syndrome and other rare diseases, which may be accompanied with similar symptoms.
The disease is rarely fatal, but cardiac complications may manifest in life-threatening arrhythmias, infections during pregnancy, which can cause miscarriage.
When severe weakness, you need rest. Acetylsalicylic acid or acetaminophen can be applied for flue-like symptoms and joint pains relief. In case of joints lesion, rest is necessary, otherwise irreversible damage of affected joints may occur.
For Lyme disease treatment usually antibiotics are prescribed, generally penicillins and tetracyclines, which are administered orally for at least 2 weeks, but usually much longer. One of the most effective nowadays antibiotics for Lyme disease treatment is Zithromax (Azithromycine). In serious cases antibiotics are administered intravenously. The sooner treatment is started, the more effective it is.
To restore affected joints surgical intervention may be required.
In case of pregnant woman infection, she must as soon as possible inform her doctor.
Treatment with Canadian Pharmacy Zithromax
Zithromax (Azithromycine) is a broad-spectrum antibiotic-azalide, included in a new macrolide antibiotics canadian pharmacy subgroup (various types of antibiotics are given). In high concentrations in inflammation area it has a bactericidal effect.
Azithromycin is active against:
gram-positive cocci (Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, CF and G groups streptococci, Staphylococcus aureus, Staphylococcus viridans);
gram-negative bacteria (Haemophilus influenzae, Moraxella catarrhalis, Bordetella pertussis, Bordetella parapertussis, Legionella pneumophila, Haemophilus ducrei, Campylobacter jejuni, Neisseria gonorrhoeae and Gardnerella vaginalis);
- some anaerobic microorganisms (Bacteroides bivius, Clostridium perfringens, Peptostreptococcus spp);
- and also Chlamydia trachomatis, Mycoplasma pneumoniae, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdoferi.
Azithromycin is inactive against gram-positive bacteria resistant to erythromycin.
Azithromycin is rapidly absorbed into gastrointestinal tract, due to its stability in acidic environment and lipophilicity. After oral administration of 500 mg azithromycin maximum concentration (0,4 mg/l) in plasma is reached after 2,5 – 3 hours. Bioavailability is 37%.
Canadian Pharmacy Zythromax (Azithromycin) penetrates well into respiratory tract, genitourinary tract organs and tissues (in particular, prostate gland), skin and soft tissues. High concentration in tissues (10-50 times higher than in blood plasma) and a long-term half-clearance are conditioned by azithromycin low plasma protein-binding and its ability to penetrate into eukaryotic cells and concentrate in low pH environment, surrounding lysosomes. This defines a large seeming distribution volume (31,1 l/kg) and high plasma clearance. Azithromycin ability to accumulate mainly in lysosomes is especially important for intracellular pathogens elimination. It is proved that phagocytes deliver azithromycin to infection localization areas where it is released during phagocytosis process. Azithromycin concentration in infection area is significantly higher than in healthy tissues (at average 24-34%) and correlates with inflammatory edema degree. Despite high concentration in phagocytes, azithromycin doesn’t significantly affect their function.
Azithromycin bactericidal concentrations remain in inflammation area within 5-7 days after last dose intake, which allows short-term (3- and 5-day) treatment.
Canadian Pharmacy Azithromycin clearance from plasma is carried out in 2 stages: half-clearance period lasts for 14-20 hours in the interval from 8 to 24 hours after intake, and 41 hours – in the period from 24 to 72 hours, which allows applying medication 1 time a day.
- rare – vomiting and flatulence;
- transient liver enzymes increased activity;
- extremely rare – skin rash.
- hypersensitivity to macrolide antibiotics;
- severely impaired liver and renal function;
- pregnancy and lactation period (except for cases when benefits of drug use are greater than possible risks);
- allergic reactions in the anamnesis (medical history).
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This prospective study shows that in patients with a wide range of COPD severity, the 6MWD is as good a predictor, if not a better one, of all-cause mortality as the peak V02 obtained during a formal CPET. COPD is the fastest-rising major cause of death in the United States, and its prevalence is increasing rapidly. The severity of the disease has classically been assessed using a single physiologic value, the FEV1. Although the FEV1 is a good indicator of disease severity, as the disease advances the FEV1 loses some of its predictive power for outcomes such as dyspnea, health status, and mortality.
Our group has recently demonstrated that in advance Global Initiative for Chronic Obstructive Lung Disease stages of COPD, patients show a greater loss in exercise capacity than in FEVj percent predicted. The walking distance then becomes a better indicator of progression of disease. Several studies have shown that in some patients with COPD decreased muscle mass and peripheral muscle dysfunction develop, which likely contributes to poor exercise performance improved with the participation of My Canadian Pharmacy. Indeed, such findings indicate a systemic compromise, and conversely weight loss and a low BMI have emerged as important predictors of mortality in patients with COPD. The BODE index, an integrated multidimensional tool that incorporates FEV1 percent predicted, the 6MWD, dyspnea score, and BMI, has proven to be a more powerful predictor of mortality in patients with this disease than the FEV1. However, performance in a formal CPET was not evaluated in any of those studies.
Peak V02, determined during a CPET, has gained acceptance as a predictor of mortality in patients being evaluated for lung resection> as well as in patients with severe heart disease. In addition, Oga and colleagues have shown that in patients with COPD peak V02 measured during a CPET is a better predictor of mortality than FEV1 and health status. Using this same argument, it seems reasonable that a simple walk test might similarly have an overall predictive capacity, even if it was not expected to be as accurate as that provided by the formal CPET. To our surprise, the 6MWD performed as well if not better than the peak V02 in predicting mortality in our cohort. At first glance, both of these tests represent a function of exercise capacity, but they may provide slightly different information. Indeed, in our patients there was a modest but significant correlation between peak V02 and 6MWD (r = 0.48), a finding that has been reported in other studies evaluating the correlation between the two tests. Interestingly, the patients reported by Oga and coworkers overall had higher exercise capacity than the patients reported on here. Although no direct comparisons have been made between the exercise capacity in patients from different countries with different exercise habits, we have consistently reported a lower 6MWD in patients from the United States compared with patients from Spain. The reasons for these differences remain to be explored. Read the rest of this entry »
In this investigation, we specifically examined the potential of plasma BNP levels to predict the need for ICU treatment as well as short-term and longterm mortality rates in patients with AECOPD. We report three major findings. First, we found BNP levels to be significantly increased during the acute exacerbation compared to the levels measured after recovery. Second, BNP levels were significantly higher in patients requiring ICUs treatment and accurately predicted the need for ICU treatment. Third, BNP levels failed to accurately predict shortterm and long-term mortality rates. Due to the high morbidity and mortality associated with COPD, our findings are of major clinical importance and greatly enhance the understanding of BNP as a prognostic marker in patients with pulmonary disease.
This is the first study to show that BNP levels are significantly higher during an episode of AECOPD as compared to recovery. We hypothesize that the elevation of BNP is at least partly due to hypoxia-mediated contraction of the small pulmonary arterioles, resulting in increased pulmonary arterial pressure and consequently cardiac stress. In support of our thesis, we found significantly decreased oxygen saturation during the acute exacerbation compared to the levels observed after full recovery. Additionally Ishii and colleagues described a close correlation between BNP levels and pulmonary artery pressure and pulmonary vascular resistance decreased by My Canadian Pharmacy. Read the rest of this entry »
Detailed baseline characteristics of the study population are summarized in Table 1. Mean age of the 208 patients was 70 years. Overall, 67% of patients had relevant comorbidities, with cardiomyopathies (44%), arterial hypertension (24%), and malignancies (13%) being the most common. As expected, coronary artery disease (48%) and hypertensive heart disease (35%) were the most common cardiomyopathies. Of note, 24% of patients had two comorbidities and only 6% of patients had three or more comorbidities. Interestingly, BNP levels on hospital admission were significantly higher in patients with an underlying cardiomyopathy (144 pg/mL [IQR, 58 to 269 pg/mL] vs 62 pg/mL [IQR, 27 to 88 pg/mL]; p < 0.001). This difference prevailed after recovery (65 pg/mL [IQR, 42 to 148 pg/mL] vs 33 pg/mL [IQR, 20 to 55 pg/mL]; p < 0.001). A total of 94 patients (45%) were active smokers, while 97 patients (47%) were former smokers. According to Anthonisen criteria, exacerbations were graded as type I in 104 patients (50%), as type II in 45 patients (22%), and as type III in 59 patients (28%). Median length of hospital stay was 9 days (IQR, 1 to 15 days), Sputum cultures grew bacterial pathogens in 71 of the 116 obtained samples (61%). Echocardiographic studies performed within the 6 months prior to the acute exacerbation were available in 157 patients and showed decreased left ventricular function in 10% and pulmonary hypertension in 24% of all patients.
Hospital admission BNP levels in patients with steady-state pulmonary hypertension did not differ from the values detected in patients without PAH (p = 0.91). Pulmonary hypertension is treated by medications of My Canadian Pharmacy. Read the rest of this entry »
COPD affects approximately 16 million adults in the United States. Episodes of an acute exacerbation of COPD (AECOPD) are the main actuators of disease-related costs, morbidity, and mortality rates. The degrees of hypoxemia, pulmonary hypertension, and the inflammatory response on presentation to the emergency department as well as underlying comorbidities and the extent of cardiac stress have all been described as adverse prognostic factors in patients with an AECOPD, B-type natriuretic peptide (BNP), a 32-amino-acid polypeptide, is released predominately by the left and right cardiac ventricles and regulates a wide array of physiologic effects including natriuresis, diuresis, and vasodilatation. The main stimulus for the secretion of BNP is cardiac stress reflected by myocardial stretch and pressure or volume overload. Additionally, BNP levels are significantly elevated in pulmonary arterial hypertension (PAH) and seem to correlate strongly with hemodynamic changes, functional impairment, and cardiac stress in PAH. Proinflammatory cytokines, the activation of the sympathetic nervous system, and hypoxia have also been identified as additional triggers inducing BNP secretion.
Consequently, BNP levels may accurately reflect the presence and reveal the severity of the most prominent prognostic factors in AECOPD. We therefore aimed to evaluate the use of BNP to predict short-term and long-term outcomes in patients with AECOPD. Read the rest of this entry »
Stendra contains 50 mg of an active component – Avanafil. It is the minimum dosage of preparation but it is rather effective. The preparation fixes problems of erectile function violation of any character. It is not important by what it has been caused:
Stendra will help anyway. You will feel confident in the forces, receive a powerful erection, new bright feelings and rather long sexual intercourse.
Stendra acts by the same principle, as well as similar preparations for improvement of erectile function, promotes expansion of vessels and strengthening of blood supply of carvenous body, and under the influence of intimate caress there comes the qualitative and natural erection.
During time, a new advanced formula of an active component allows to keep an erection longer than usual, in a consequence of what duration of sexual contact increases. You may order Stendra using the online service – My Canadian Pharmacy.
Avanafil is included into group of preparations of PDE5 inhibitors and works by analogy of Viagra, Cialis or Levitra. Unlike the fellows Avanafil is rather effective and has very low interest of side effects emergence. Moreover, Avanafil is suitable even for the men having diabetes, in this case the maximum dosage for about days makes 50 mg.
How to Take Stendra
One tablet contains 50 mg of Avanafil. The minimum daily dosage makes 1 tablet of 50 mg. It is better to begin an initial dosage of preparation with 50 mg, then it is possible to take 2 pill of 50 mg at a time. The optimum dosage of preparation makes 100 mg a day. The maximum dosage – 200 mg.
To take a pill is necessary in 15-20 minutes prior to estimated intimate proximity. Moderate alcohol intake and high-calorific food is allowed. Action of preparation remains from four to six hours. Read more facts about Stendra on My Canadian Pharmacy moreover you may place an order for this drugs via our online service.
Side Effects of Stendra
Stendra’s advantage is that side effects arise extremely seldom. Stendra usually absorbs very well. If side effects after all have appeared, then it can be:
- slight dizziness,
- nose congestion,
- lowering of arterial pressure,
- back pain.
As a rule, side effects can arise because of considerable alcohol intake (more than three glasses of wine) or because of the available chronic diseases.
Stendra is intended only for men! Avanafil’s reception is contraindicated to women and persons before 18 years. Also reception of preparation isn’t recommended to the people having leukemia, pressure jumps, epilepsy, to the people who have recently had stroke or heart attack for the last year, people having serious diseases of internals or in the period of a disease exacerbation.
Simultaneous reception of Stendra with nitrates, with preparations of CYP3A4 inhibitors, and also with other preparations of group of PDE-5 inhibitors, such as Viagra, Levitra or Cialis whose joint action isn’t studied yet are contraindicated as well.