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By: C. Bengerd, M.A., M.D., M.P.H.

Professor, Tufts University School of Medicine

The word'Tao" is derivedfroma Mandarinwordmeaning"way";it standsfor ultimatereality medications bipolar buy chitosan without a prescription,universalenergy nature medicine 500 mg chitosan,and livingin harmonywith the universe treatment plan for anxiety cheap chitosan 500mg on line. In Chinesetradition chi royal treatment discount chitosan 500 mg on line,thesky(thegenerator all phenomena) of exemplifies yangyin-the passive,dark, the active,bright,maleprinciple; earth exemplifies the female principle. Citing yin-yang theory, macrobioticscan categorize any phenomenonor concept as either yin or yang. However,while the Chinese theory (which includesacupuncture) distinguishes function,macrobiotics by VitalisticGurus and Their Legacies 229 distinguishes accordingto structure. Forexample,macrobiotics categorizesthe earth as yang becauseit is denserthan the sky (that is, the rest of the universe); Chinesecosmologytakesthe oppositeview. Kotzschnotesthat 'while Ohsawa purportsto presentan ancientOrientalwayof thinking,in practicehis [system] does not correspondto the classicalChinesesystem. As your body and mind become healthier and clearer,you willjoyfully realize the boundlessenergy that lies within us all. Furthennore,the "yin/yang-ness" any food is affectedby how it is prepared of and eaten. But he further advised consuming foods within his seven classes that are at or "reasonablynear" the midpoint of yin and yang-'unless there is a specific reasonfor anotherchoice. Yin-yangtheory, religiousunderpinnings, a Japaneseculinary bias and complicate macrobiotics. But its diet is reducible to the consumption of unprocessedor minimallyprocessedfoods, primarilywhole grains and vegetables,which,ideally,shouldbe grown"organically"in the region where the consumer lives and eaten in season. Kushi adviseschewing food slowly and quietly at least fifty times per mouthful or until it liquefies. His "Standard MacrobioticDiet"-designed primarilyfor residentsof temperate regionsencompasses: · Cooked,"organicallygrown,"wholegrains-an averageof 50 percent of the volume of each meal · Soup made with vegetables,seaweed,grains, or beans, usually seasoned with miso or soy sauce-about 5 to 10 percent of daily food intake · "Organic" vegetables, preferably grown locally, mostly cookedabout 20 to 30 percentof daily food intake 230 the HealthRobbers · Cooked beans, soybean-based products,and seaweed-about S to 10 percent of daily food intake · Be~erages: "traditional," nonstimulating, non-aromatic teas (such as roasted brown rice tea); and water-preferably spring water or "quality" well water-not iced, and in moderation · Fresh, white-meatfish-5 to 15percentoffood intakeon one to three days each week, "if neededor desired" · Fresh, dried, and cooked fruit, preferably grown locally and "organically"-two or three servingsper week · Occasionalsnacks: lightlyroastednuts, peanuts,and seeds · Condiments: unrefined sesame oil, unrefined com oil from stoneground corn, sea salt, soy sauce, miso, gomashio (a mixture of dryroasted and crushed sesame seeds and sea salt), seaweed powder, pickles such as umeboshi (a Japanese plum), tekka (a mixture of mincedlotusroot,burdock root,carrot,ginger, miso),andsauerlcraut and "Food to avoid for better health" includemeat, poultry, dairy products, refined sugars, molasses,honey, vanilla,tropical and semitropicalfruits and fruit juices, coffee, mint teas, potatoes, sweet potatoes, yams, tomatoes, eggplant,peppers,asparagus,spinach,avocado,hot spices,refinedgrains, and all canned, frozen,or irradiatedfoods. But, as a Kushi Foundationpamphletstates,"macrobioticsis more than a hill of beans. A Seminar Professionals for Throughoutthe year,the KushiInstituteconductsresidentialseminarsranging from weekendworkshopsto its LeadershipStudiesProgram. In June 1989,I attendedthe five-dayMichioKushiSeminarfor MedicalProfessionals, held in Becket. However,upon registering,I waschargedan additional$30 for membershipin One PeacefulWorld-required for participationin all instituteprograms. Eighteenpeopleotherthan myselfattendedthe seminar:twelvemedical doctors, two registered nurses (one a nurse practitioner),an osteopath, an endodontist,a chiropractor,and a nutritionresearcherwith a doctorate. He claimed that "chakras" were responsiblefor this movement-but close observation revealedthat the circlingwas causedby motionsof his arm. Although hypothetically there are only five to seven major "body chakras," there is no consensuson the total number of chakras; hundreds of minor ones are said to exist. The methods espoused by Kushi are part of what he calls natural medicine, "the medicine of energy and vibrations. Voice diagnosis supposedly identifies disorders of "certain systems, organsor glands. It is used to "characterizethe basic constitutionaltendenciesof the body and the mind as well as the potentialdestinyof the currentand future life of the subject. He illustratedthis behaviorby sitting in a chair and moving his knees repeatedlyapart and together. Lawrence Lindner, executive editor of the Tufts UniversityDiet and NutritionLetter,had a privateconsultationwith a certifiedsenior macrobiotics counselorat the Kushi Instituteas part of an assignmentfor AmericanHealth magazine. In the May 1988issue,Lindnerreportedthat the counselortold him: (1) his heart was somewhat enlarged because he ate too much fruit, (2) his kidneys were w~ (3) he was slightlyhypoglycemic,(4) deposits of fat and mucus werestartingto buildup in his intestines,(5) colddrinkscould freezethe Vitalistic Gurusand TheirLegacies 233 deposits and cause kidney stones, and (6) he should avoid eating chicken becauseit is linkedwithpancreaticcancerandmelanoma. Moreover,macrobioticadultswerefoundto have low serumconcentrationsof B12· Several lawsuits have claimedthat cancer patientswho relied on macrobiotic methodsinsteadof proventherapymet with disaster. They are either still pendingor were settled out of court with an agreementnot to disclose settlementterms. They say that nutritional deficiencies result only from following the diet incorrectly-in an overlyrestrictivefashion. They claim they do not try to lure patientsawayfrommedicaltreatmentwithpromisesthatthediet willcure them.


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This is a variant of chronic atrophic gastritis in which numerous lymphoid follicles are present in the mucosa and submucosa of the stomach medicine 1800s purchase chitosan now. In this condition medications used for depression purchase chitosan 500 mg online, there are superficial erosions and mucosal haemorrhages symptoms 5 days before your missed period purchase chitosan 500mg without prescription, usually following severe haematemesis symptoms ibs order chitosan 500 mg with visa. Though they can occur at any level of the alimentary tract that is exposed to hydrochloric acid and pepsin, they occur most commonly (98-99%) in either the duodenum or the stomach in the ratio of 4:1. Intestinal metaplasia, focal or extensive, in atrophic gastritis is significant because its incidence is high in populations having high prevalence rate of gastric cancer like in Japan. It involves the body glands which are replaced by proliferated mucus neck cells, conforming in appearance to normal pyloric glands. In this, there is thinning of the gastric mucosa with loss of glands but no inflammation though lymphoid aggregates may be present. This is an uncommon condition characterised pathologically by enormous thickening of gastric rugal folds resembling cerebral convolutions, affecting mainly the region of fundic-body mucosa and characteristically sparing antral mucosa. The patients present with dyspepsia, haematemesis, melaena or protein-losing enteropathy. There is marked gastric atrophy with disappearance of gastric glands and appearance of goblet cells (intestinal metaplasia). In these conditions, the possible hypotheses for genesis of stress ulcers are as under: 1. Grossly, acute stress ulcers are multiple (more than three ulcers in 75% of cases). They are more common anywhere in the stomach, followed in decreasing frequency by occurrence in the first part of duodenum. Microscopically, the stress ulcers are shallow and do not invade the muscular layer. The margins and base may show some inflammatory reaction depending upon the duration of the ulcers. These ulcers commonly heal by complete re-epithelialisation without leaving any scars. Peptic ulcers are common in the present-day life of the industrialised and civilised world. Gastric and duodenal ulcers represent two distinct diseases as far as their etiology, pathogenesis and clinical features are concerned. The features of gastric and duodenal peptic ulcers are described together below while their contrasting features are presented in Table 20. The peak incidence for duodenal ulcer is 5th decade, while for gastric ulcer it is a decade later (6th decade). Duodenal ulcer is almost four times more common than gastric ulcer; the overall incidence of gastroduodenal ulcers being approximately 10% of the male population. However, in contrast to duodenal ulcers, the patients of gastric ulcer have low-to-normal gastric acid secretions, though true achlorhydria in response to stimulants never occurs in benign gastric ulcer. Besides, 10-20% patients of gastric ulcer may have coexistent duodenal ulcer as well. Thus, the etiology of peptic ulcers possibly may not be explained on the basis of a single factor but is multifactorial. Non-steroidal antiinflammatory drugs are most commonly used medications in the developed countries and are responsible for direct toxicity, endothelial damage and epithelial injury to both gastric as well as duodenal mucosa. There is conclusive evidence that some level of acid-pepsin secretion is essential for the development of duodenal as well as gastric ulcer. Peptic ulcers never occur in association with pernicious anaemia in which there are no acid and pepsin-secreting parietal and chief cells respectively. Some degree of gastritis is always present in the region of gastric ulcer, though it is not clear whether it is the cause or the effect of ulcer. Besides, the population distribution pattern of gastric ulcer is similar to that of chronic gastritis. Pyloric antrum and lesser curvature of the stomach are the sites most exposed for longer periods to local irritants and thus are the common sites for occurrence of gastric ulcers. Some of the local irritating substances implicated in the etiology of peptic ulcers are heavily spiced foods, alcohol, cigarette smoking, unbuffered aspirin. Nutritional deficiencies have been regarded as etiologic factors in peptic ulcers.

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When there are external heat loads concurrent with the performed work symptoms hiatal hernia chitosan 500 mg on-line, however treatment 02 binh cheap chitosan, both the central drive for increased conductance and the rise in local skin temperature cause dilation of skin vessels medications education plans discount chitosan 500mg free shipping, thereby increasing their blood capacity and reducing their resistance symptoms 4dp5dt fet purchase chitosan 500 mg amex. In order to meet the oxygen demand of the working muscles, cardiac output can be maintained only by further constriction of splanchnic vessels and an increase in heart rate. Figure 20-8 schematically presents selected thermoregulatory responses to heat stress. Tc is maintained at a uniform level which is determined only by M and which is independent of ambient temperatures at lower levels of external heat stress. This is termed the "prescriptive zone" to indicate the range of thermal environments in which men can work without strain on homeostatic core temperature. The upper limit of the prescriptive zone in highly acclimatized men working at 300 kcal hr. The upper limits of this zone are lower T at high work rates because Tc is higher. Thermoregulatory responses to heat stress in Zone A (Full/Compensation), B (Time Limited Compensation), and C (Uncompensated Heat Storage). Responses under steady state conditions are linear with Effective Temperature in Zones A and B. This represents the highest core temperature at which a highly acclimatized man can maintain a steady state of thermal balance, and then for only two hours or less. The upward slope of Tc in Zone B indicates an attempt to maintain the core to surface gradient as reaches higher levels, although there is a thermoregulatory strain imposed on Tc. The maximum tolerable level of heat stress corresponding to the Tc limit of 39 °C (102. Men who are less fit or less well-acclimatized for work at 300 kcal/hr would reach limiting levels for thermal balance at lower core temperatures and at corresponding lower levels of external heat stress. As a practical guide, the average core temperature of men should not exceed 38°C (100. Thus, in Zone C, rate of heat loss fails to match rate of heat gain, and heat storage ensues with Tc and Ts rising continuously in proportion to the heat load. Rate of storage may be accelerated by fatigue or failure of the sweating mechanism. It is not possible to achieve a steady state during continued work, and this is indicated by broken lines in Zone C (Uncompensated Heat Storage). Metabolic processes are accelerated by the rising core temperature, further increasing the rate of body temperature rise. Without cessation of work and removal from the environment, continued exposure in Zone C inevitably leads to collapse from circulatory failure or heat stroke. Under intense radiant heat loads, skin temperature rises rapidly to the pain threshold (45°C, 113°F), and it is the pain which becomes the limiting factor in tolerance time rather than heat storage in deeper tissues. Any well-motivated young man in good physical condition who works for the first time under conditions of heat stress will exhibit signs of heat strain evidenced by increased heart rate, high body temperature, and other signs of heat intolerance. But on each succeeding day of heat exposure, his ability to work improves and signs of strain and discomfort diminish. In other words, he adapts to the thermal stress, and as a result of his working in a hot environment, he has acquired the enhanced tolerance to environmental heat stress called heat acclimatization. The acclimatization process begins with the first exposure to heat and is achieved most safely and expeditiously over a period of one to two weeks by progressive degrees of heat exposure and 20-35 U. In order to achieve maximum acclimatization, the work level should be in the 200 to 300 kcal/hr range. A factor apparently essential in inducing acclimatization is the sustained elevation of Tc and Ts above levels for the same work in a cool environment. Acclimatization ordinarily cannot occur when heat stress levels exceed a certain level, and personnel working in areas of unusual stress, such as firerooms and enginerooms, should not be expected to adapt physiologically to their environment if the parameters outlines in Table 20-4 are exceeded. Table 20-4 Bureau of Medicine and Surgery Recommended Heat Stress Design Conditions for Firerooms of Surface Vessels* Once acclimatization has occurred, there is a significant increase in sweat output which is produced at a lower Ts in comparison to both sweat rates and skin temperatures earlier in the adaptive process. Within the environmental restrictions discussed above, the increase in evaporative cooling with a steeper core to skin gradient is sufficient to compensate fully for the heat load. This is demonstrated by restoration of the core temperature to levels observed while performing the same work in a cool environment.

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Ripening involves the modification of proteins and fats by microbial and milk proteases and lipases that remain in the young cheese treatment solutions buy discount chitosan 500mg line. Some countries allow acceleration of flavour development through the addition of commercial enzyme preparations medications metabolized by cyp2d6 purchase chitosan 500 mg otc. Lysozyme may also be added in the manufacture of hard-cooked Emmental medicine plus buy chitosan 500mg cheap, Gouda and Gruyиre-type cheeses to prevent growth of the spoilage organism treatment zinc deficiency purchase 500 mg chitosan, Clostridium tyrobutyricum, which otherwise would be troublesome in the later stages of ripening. In addition, the curd may have been inoculated with a bacterial or fungal culture before ripening. As these bacteria grow they modify the flavour and generate gas bubbles that result in holes or eyes within the cheese. Internally mould-ripened blue-veined cheeses, including Danish Blue, Gorgonzola, Roquefort and Stilton, primarily use Penicillium roqueforti. Traditional manufacture relies on the natural development of the mould that originates from spore populations that become established in the local cheese-making environment. Large-scale production now uses spore inocula, which are mixed into the curd before the cheeses are pressed and formed. Young cheeses are usually punctured with stainless steel rods to promote fungal growth by increasing oxygen levels within the cheese and then stored under controlled humidity at around 9°C. Cheeses are ripened for up to a year during which they develop the characteristic blue veins, and the aroma and flavour that is due to methyl ketones such as 2heptanone. Bacteriophage infections of starter cultures have been a major problem in cheese and other dairy fermentations. The use of phage inhibitory media, defined strains, the rotation of strains and phage-insensitive bacterial strains has improved the situation. Attempts are being made to harness the natural defences of the bacteria, such as inhibition of bacteriophage adsorption to the bacterium and blocking of phage nucleic acid penetration. The genes for these phage resistance factors appear to be plasmid encoded and resistance plasmids may be exploited to improve the ability of industrial strains to resist phage attack. In lactic acid bacteria, the genes for many of the key enzymes involved in lactose and casein metabolism are not chromosomal, but plasmid-borne and prone to being lost. The mapping of the plasmids and subsequent isolation of these genes has allowed them to be transferred to the chromosome, providing strains with greater stability. Such techniques may also lead to the introduction of genes from other lactic acid bacteria and heterologous genes. These may provide additional properties, especially the ability to produce extra organoleptic compounds, remove off-flavours, speed ripening and destroy microbial contaminants. Alternate methods of introducing additional enzymes, and antimicrobial agents to prevent spoilage include the use of encapsulation technology. The enzyme or agent can be contained within liposomes (microscopic phospholipid spheres) and added, probably most conveniently during curd processing. Probiotics Probiotics are organisms and substances that promote the development and maintenance of balanced intestinal microflora. Several fermented yoghurt-like dairy products and milk-based carriers containing these specially selected live probiotic microorganisms are now available. However, the actual mechanism underlying these activities has yet to be elucidated. Their effects appear to include the ability to stimulate the immune response, often seen as an increase in the production of immunoglobulin A (IgA). Within the gut these bacteria promote colonization, and modify both gut bacterial numbers and their metabolic activity. They may improve intestinal integrity and reduce the mutagenic effect of certain intestinal metabolites. Their ability to aid re-establishment of gut microflora could be particularly useful in animals and humans following the application of oral antibiotics. Perenterol 250) are used in the treatment of diarrhoea, particularly when associated with oral antibiotic treatment. For example, when food and water inoculated with Lactobacillus salivarius is fed to 1-dayold chickens infected with Salmonella enteritidis (a cause of salmonellosis) the salmonellae are prevented from colonizing their gastrointestinal tracts.

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