תוצאות חיפוש עבור ניתוח על שם מיילס

שלום מתן, אחלק את תשובתי לשניים: 1. לפי הסקירה המדעית המעודכנת ביותר, החל משנת 2015, לפי סקירה שיטתית בתחום אורך הממוצע של פין אנושי זקוף הוא בערך 13.12 ס"מ (11.46 ס"מ - 14.78 ס"מ). לפני שאתה נכנס לסרטים על כך שאורך הפין שלך קטן מהממוצע, שים לב לטווח, המצביע על כך שאורך הפין שלך הוא במסגרת הטווח הנורמלית (מעל הגבול התחתון).‏ זה מה שיש ועם זה צריך לנצח (אני מקווה שאין לך מחשבות על ניתוחים להארכת הפין). בדרך כלל, אורכו של הפין הרפוי אינו מעיד על אורכו של הפין הזקוף: Veale, D.; Miles, S.; Bramley, S.; Muir, G.; Hodsoll, J. (2015). "Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15 521 men". BJU International 115 (6): 978–986. 2. ברמה הפסיכולוגית, עיסוק-היתר שלך בגודל איבר המין, על אף תגובות הסביבה, הוא בסדר גודל של מחשבה טורדנית (אובססיה), שמחשידה בקיומה של הפרעה כפייתית (OCD). בהפרעה זו מרכז האדם את כל חרדותיו לנושא אחד מסוים במקום להתמודד עם המגוון הרחב של החרדות שאדם רגיל או חרדתי נאלץ להתמודד איתן. האובססיה מטרידה מאוד, מצד אחד, כפי שאתה יודע מעיסוק היתר שלך בגודל הפין שלך, אך גם פוטרת אותך מהתייחסות לחרדות בתחומים אחרים, מצד שני. אינני יודע עד כמה הדבר פוגע באיכות החיים ובתפקוד שלך. אם מדובר בפגיעה משמעותית בתחומים אלה, הייתי ממליץ על פנייה לטיפול פסיכולוגי. בהצלחה, פרופ' גידי רובינשטיין https://www.Shrink-Friendly.co.il

לצערי הרופא לא מעודכן ויצא מאמר גדול ועדכני שהפריח את החשש.

אני בספק אם הטיפול מחזיק מעמד כי הלחץ בתוך הדיסק עולה עם ההזרקה הדבר יכול להביא לזליגה מחודשת של הדיסק.

המנגנון של השמנה על ידי תרופות אנטיפסיכוטיות הוא בעיקר דרך עליה בתיאבון ומעט על ידי טרנסמיטורים במערכת העצבים. Eur Psychiatry. 2009 Apr;24(3):164-70. doi: 10.1016/j.eurpsy.2009.01.001. Epub 2009 Mar 14. How can antipsychotics cause Diabetes Mellitus? Insights based on receptor-binding profiles, humoral factors and transporter proteins. Starrenburg FC1, Bogers JP. Author information Abstract The prevalence of Diabetes Mellitus (DM) is becoming a serious public health problem. The use of atypical antipsychotics has been associated with disruption of the glucose metabolism and therefore with causing DM. The underlying mechanisms are unknown, but knowledge of the differences between the pharmacological features of various antipsychotics combined with their diabetogenic profile might help us to understand those mechanisms. This article describes how the binding of various essential receptors or transporters in essential body tissues, adipose tissue, pancreatic tissue and liver and skeletal muscle tissue can cause disruption of the glucose metabolism. With such knowledge in mind one can try to explain the differences between the diabetogenic propensities of various antipsychotics. It is well known that clozapine and olanzapine cause weight gain and DM, whereas aripiprazole and ziprasidone have much less disruptive clinical profiles. The most significant risk factor for adiposity seems to be strong blocking of histaminergic receptors. An agonistic activity on serotonergic-1a receptors, with a very low affinity for muscarinergic-3 receptors, might protect against the development of DM. More data will become available which may help to solve the puzzle.

על פי רוב תופעה שפירה וחולפת בברכה דר דדשב

בראש ובראשונה העובדה שהרית היא המבורכת,יחד עם זאת הריונות שמקורם ב-TESE עם ICSI כרוכים בשיעור גבוה יותר של הפרעות גנטיות ,לכן יהיה צורך במעקב קפדני ויתכן גם ביצוע של בדיקת מי שפיר עם צ'יפ גנטי,מלבד המעקב המקובל להערכת ההתפתחות והגדילה של העובר-להלן המאמר משנה זו: Int J Fertil Steril. 2014 Apr;8(1):35-42. Epub 2014 Mar 9. Chromosomal abnormality in men with impaired spermatogenesis. Mierla D1, Jardan D2, Stoian V3. Author information 1Life Memorial Hospital, Bucharest, Romania ; Department of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania. 2Life Memorial Hospital, Bucharest, Romania. 3Department of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania. Abstract BACKGROUND: Chromosomal abnormalities and Y chromosome microdeletions are regarded as two most frequent genetic causes associated with failure of spermatogenesis in the Caucasian population. MATERIALS AND METHODS: To investigate the distribution of genetic defects in the Romanian population with azoospermia or severe oligozoospermia, karyotype analysis by G-banding was carried out in 850 idiopathic infertile men and in 49 fertile men with one or more children. Screening for microdeletions in the azoospermia factor (AZF) region of Y chromosome was performed by multiplex polymerase chain reaction (PCR) on a group of 67 patients with no detectable chromosomal abnormality. The results of the two groups were compared by a two-tailed Fisher's exact test. RESULTS: In our study chromosomal abnormalities were observed in 12.70% and 8.16% of infertile and fertile individuals respectively. CONCLUSION: Our data suggests that infertile men with severe azoospermia have higher incidences of genetic defects than fertile men and also patients from any other group. Infertile men with normal sperm present a higher rate of polymorphic variants. It is important to know whether there is a genetic cause of male infertility before patients are subjected to intracytoplasmic sperm injection (ICSI) or testicular sperm extraction (TESE)/ICSI treatment. KEYWORDS: Azoospermia; Chromosomal Abnormality; Chromosome Microdeletion; Male Infertility; Oligozoospermia

פגי שלום אכן לשזיפים יש תכונות שונות המגדירות אותם כ - functional foodsהמידע האחרון על החומר שציינת הוא משנת 1951 ואין לצערי פירוט על פעילותו The occurrence of a diphenyl isatin in California prunes. BAUM HM, SANDERS RG, STRAUB GJ. J Am Pharm Assoc Am Pharm Assoc. 1951 Jul;40(7):348-9. No abstract available קיים חומר חדש יותר על הפעילות המשלשלת של שזיפים אבל כאן תולים זאת בנוכחות סורביטול ופנולים Chemical composition and potential health effects of prunes: a functional food? Stacewicz-Sapuntzakis M, Bowen PE, Hussain EA, Damayanti-Wood BI, Farnsworth NR. Crit Rev Food Sci Nutr. 2001 May;41(4):251-86. Review מכיוון שקיימת אי בהירות ומעט מאד אינפורמציה מדעית לא ניתן להגדיר שזיפים חומר משלשל אמיתי. יש עבודה אחת מלפני שנתיים שהשוותה שזיפים לפסיליום בעצירות ונתגלה שהם יעילים יותר אך אין מידע ברור לגבי המנגנון Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation. Attaluri A, Donahoe R, Valestin J, Brown K, Rao SS. Aliment Pharmacol Ther. 2011 Apr;33(7):822-8.

שלום. בבלוגים שונים אפשר לקבל דיווחים דומים לשלך. אבל אין היום שימוש מוסכם לטרמדול בטיפול של דיכאון. קיים סיכוי, לא גדול, להתמכרות לכן ההיסוס. צירפתי לך תקציר של מאמר Exp Clin Psychopharmacol. 2011 Apr;19(2):123-30. doi: 10.1037/a0022721. Examining the use of tramadol hydrochloride as an antidepressant. Barber J. Source Department of Social Sciences, University of South Carolina Beaufort, One University Boulevard, Bluffton, SC 29909, USA. [email protected] Abstract Tramadol (Ultram, Ultracet) is a centrally acting synthetic opioid with analgesic efficacy comparable to codeine. Antinociception is attributed to low but effective affinity for the mu-opioid receptor (μ), as well as reuptake inhibition of the monoamines norepinephrine (NE) and serotonin (5HT). Dual action antidepressants mirtazapine (Remeron), duloxetine (Cymbalta), and most notably venlafaxine (Effexor), which tramadol is closely related to in structure, also inhibit NE and 5HT reuptake. These medications are proven effective antidepressants and this shared monoaminergic action resulted in the research of tramadol as a potential treatment for depression. The present article intends to substantiate the use of tramadol in this manner by analyzing several decades of research which is presented as an illustration of neuronal theories, as well as lab work and case studies of both the supporting ideas and potential hazards. Finally, the article promotes the benefits of acute action in comparison to modern antidepressants and the documentation of low abuse rates while maintaining an object view of the risks, most notably, the risk for addiction from agonist action on μ-receptors פרופ לאון גרינהאוס מיינד קליניק 036962733 036962745

במאמר שהובא מסכמים מספר מחקרים שבהם ב 5 לא ראו יתרון לתוספי המזון ובשניים הראו שהם יעילים. זה הרבה יותר טוב מהתוצאות של חלק מהתרופות הכימותרפיות והביולוגיות הנמצאות בשימוש במחלות הסרטן השונות. קיימים תוספי מזון רבים בהם יש לנו אינדיקציה על השפעתם על תאי סרטן הערמונית. עצמי חליתי בסרטן זה ואני מייחס לשימוש בתוספי מזון חלק מהסיבות שאני עדיין כותב בפורום זה. ד"ר יוסף ברנר

שלוםן סיון עבודה חשובה שבוצעה במודל של נשים העוברות תרומת ביציות עם שרירן או שרירנים שלא עיוותו את חלל הרחם-(מודל המייחד קבוצת נשים אלו המקבלות את אותו טיפול הכנה לצורך השתלת העוברים מול קבוצת ביקורת ללא שרירנים)ולמרבה ההפתעה התברר שללא קשר לגודל השרירן ומיקומו ומספר השרירנים לא הייתה לשרירנים כל השפעה על שיעורי ההריונות שהושגו בייחס לקבוצת הביקורת בתנאי שלא היה עיוות של חלל הרחם.להלן המאמר Hum Reprod. 2007 Feb;22(2):521-6. Epub 2006 Sep 22. The effect of fibroids without cavity involvement on ART outcomes independent of ovarian age. Klatsky PC, Lane DE, Ryan IP, Fujimoto VY. Source Department of Obstetrics/Gynecology, University of California, San Francisco, CA 94143, USA. [email protected] Erratum in • Hum Reprod. 2007 Apr;22(4):1195. Abstract BACKGROUND: The effect of fibroids that do not distort the endometrial cavity on pregnancy rate (PR) and implantation rate (IR) is controversial. Use of oocyte donor-derived embryos offers an ideal patient population to study the effect of fibroids in patients utilizing assisted reproductive technologies (ARTs). METHODS: We conducted a retrospective cohort study of patients undergoing oocyte donor recipient (ODR) IVF cycles at two tertiary care fertility centres. We examined medical records for the presence of non-cavity-distorting fibroids and evaluated subsequent PR and IR. RESULTS: Three hundred and sixty-nine patients, 94 with fibroids, underwent oocyte donor recipient transfer cycles with fresh embryos. There was no statistical difference in IR (36 versus 38%) or clinical PR (47 versus 54%) between patients with or without fibroids. Neither the location (subserosal versus intramural) and the presence of multiple myomas nor the size of the myomas affected outcomes. Fibroids were more likely to be present in patients with increasing recipient age. CONCLUSIONS: Clinical PR and IR are not affected by the presence of non-cavity-distorting leiomyomata. This evidence does not support myomectomy before ART in patients with asymptomatic fibroids that do not significantly distort the endometrial cavity or cause abnormal uterine bleeding. לעומת זאת במטאנליזה יחסית חדשה שסיכמה מספר רב של עבודות מחקר מבוקרות נמצא שיעור נמוך יותר של הריונות בקרב קבוצת נשים עם שרירנים ללא עיוות של חלל הרחם .להלן המאמר: Hum Reprod. 2010 Feb;25(2):418-29. doi: 10.1093/humrep/dep396. Epub 2009 Nov 12. The effect of intramural fibroids without uterine cavity involvement on the outcome of IVF treatment: a systematic review and meta-analysis. Sunkara SK, Khairy M, El-Toukhy T, Khalaf Y, Coomarasamy A. Source Assisted Conception Unit, Guy's and St Thomas' Hospitals NHS Foundation Trust, 11th Floor, Tower Wing, Guy's Hospital Great Maze Pond, London SE1 9RT, UK. [email protected] Abstract BACKGROUND: The influence of fibroids on fertility is poorly understood. Submucosal and intramural fibroids that distort the endometrial cavity have been associated with decreased pregnancy rates (PRs) following IVF treatment. However, there is uncertainty about the effect of intramural fibroids that do not distort the endometrial cavity on IVF outcomes. METHODS: We conducted a systematic review and meta-analysis of studies to evaluate the association between non-cavity-distorting intramural fibroids and IVF outcome. Searches were conducted on MEDLINE, EMBASE, Cochrane Library and Web of Science. Study selection and data extraction were conducted independently by two reviewers. The Newcastle-Ottawa Quality Assessment Scales were used for quality assessment. Meta-analysis was performed if appropriate. RESULTS: We identified 19 observational studies comprising 6087 IVF cycles. Meta-analysis of these studies showed a significant decrease in the live birth (RR = 0.79, 95% CI: 0.70-0.88, P < 0.0001) and clinical PRs (RR = 0.85, 95% CI: 0.77-0.94, P = 0.002) in women with non-cavity-distorting intramural fibroids compared with those without fibroids, following IVF treatment. CONCLUSION: The presence of non-cavity-distorting intramural fibroids is associated with adverse pregnancy outcomes in women undergoing IVF treatment. כך שלטעמי יש מקום למחקרים נוספים מבוקרים על מנת לקבוע מסר ברור בנושא,לכן עמדתי היא שצריך בשלב ראשון במצבים אלו לנסות להרות ולבצע מספר נסיונות כולל IVF ורק במקרה של כשלון חוזר או במצב של הפלות חוזרות יש לשקול את ביצוע הניתוח השמרני להוצאת השרירן גם אם מדובר בשרירן אינטרמורלי

שלום שירן מירווח הזמן הרצוי הוא 3 חודשים,להלן מאמר מדעי המסביר את ההיבטים של מירווח הזמן בין פרוצדורה אחת לשניה Arch Androl. 2001 Mar-Apr;46(2):141-4. Pregnancy rates in relation to time intervals between repeat sperm-retrieval procedures. Fedder J, Gabrielsen A, Petersen K. SourceThe Fertility Clinic Ciconia, H&oslash;jbjerg, Denmark. Abstract A total of 76 repeat sperm retrievals were carried out in 47 azoospermic men. The outcome of the procedures was evaluated regarding to the interval between two successive procedures. Sperm motility and pregnancy rate were not increased by increasing the interval between two successive sperm retrievals from less than 90 days to more than 180 days. The pregnancy rate declined from 50% with a less than 90-day interval to 25% with a more than 180-day interval. The trend did not quite reach the significance level. Pregnancy was obtained in only 27% of the couples where TESE was done the last time against 48 and 57% where PESA and TESA, respectively, were performed the last time (p < .05). This study suggests that sperm retrieval procedures in men with obstructive azoospermia can be carried out with time intervals of only 3 months to obtain an optimal pregnancy rate, and it might suggest that an epididymal aspiration procedure should be preferred for a TESE

מעולם לא ניסיתי את קונווטק, אז ממש אין לי שמץ.. אולי כדאי לעבור שוב חברה. בהוליסטר ובקולופלסט מעולם לא הייתה לי בעייה כזאת.

תוספת ויטמין D לטיפול במלנומה יכולה להיות בעלת ערך. ראה מאמר: Mol Oncol. 2011 Apr;5(2):197-214. Epub 2011 Feb 3 ד"ר יוסף ברנר

שלום מירי, טיטניום דיאוקסיד הוא פיגמנט לבן והוא נותן את הגוון בתוספי התזונה, משתמשים בו בכמויות מזעריות המותרות לשימוש במינונים אלה.

אומגה 3 זה אחד החומרים החשובים לחולים עם סרטן הערמונית. להלן מאמר עם תוצאות הפוכות לחלוטין מאלה המובאות במחקר שהובא כאן ד"ר יוסף ברנר Display Settings:AbstractFormatSummarySummary (text)AbstractAbstract (text)MEDLINEXMLPMID ListApply Send to:Choose DestinationFileClipboardCollectionsE-mailOrderMy Bibliography FormatSummary (text)Abstract (text)MEDLINEXMLPMID ListCSVCreate File 1 selected item: 19318492FormatSummarySummary (text)AbstractAbstract (text)MEDLINEXMLPMID ListMeSH and Other DataE-mailAdditional textE-mail"SPAM" filtering software notice Add to Clipboard Add to CollectionsOrder articles Add to My Bibliography Clin Cancer Res. 2009 Apr 1;15(7):2559-66. Epub 2009 Mar 24. Dietary omega-3 fatty acids, cyclooxygenase-2 genetic variation, and aggressive prostate cancer risk. Fradet V, Cheng I, Casey G, Witte JS. SourceDepartments of Urology, Institute for Human Genetics, University of California at San Francisco, San Francisco, California 94143-0794, USA. Abstract PURPOSE: Dietary intake of long-chain omega-3 (LC n-3) polyunsaturated fatty acids may reduce inflammation and in turn decrease risk of prostate cancer development and progression. This potential effect may be modified by genetic variation in cyclooxygenase-2 (COX-2), a key enzyme in fatty acid metabolism and inflammation. EXPERIMENTAL DESIGN: We used a case-control study of 466 men diagnosed with aggressive prostate cancer and 478 age- and ethnicity-matched controls. Diet was assessed with a semiquantitative food frequency questionnaire, and nine COX-2 tag single nucleotide polymorphisms (SNP) were genotyped. We used logistic regression models to estimate odds ratios (OR) for association and interaction. RESULTS: Increasing intake of LC n-3 was strongly associated with a decreased risk of aggressive prostate cancer (P(trend) <or= 0.0001). The OR (95% confidence interval) for prostate cancer comparing the highest with the lowest quartile of n-3 intake was of 0.37 (0.25-0.54). The LC n-3 association was modified by SNP rs4648310 (+8897 A/G), flanking the 3' region of COX-2 (P(interaction) = 0.02). In particular, the inverse association was even stronger among men with this variant SNP. This reflected the observation that men with low LC n-3 intake and the variant rs4648310 SNP had an increased risk of disease (OR, 5.49; 95% confidence interval, 1.80-16.7), which was reversed by increasing intake of LC n-3. CONCLUSIONS: Dietary LC n-3 polyunsaturated fatty acids appear protective for aggressive prostate cancer, and this effect is modified by the COX-2 SNP rs4648310. Our findings support the hypothesis that LC n-3 may impact prostate inflammation and carcinogenesis through the COX-2 enzymatic pathway.

גיל שלום, נדיר מאוד. 1: Noshita N, Mashiyama S, Fukawa O, Asano S, Watanabe M, Tominaga T. Extracranial metastasis of anaplastic oligodendroglioma with 1p19q loss of heterozygosity--case report. Neurol Med Chir (Tokyo). 2010;50(2):161-4. PubMed PMID: 20185886. 2: Zhen L, Yufeng C, Zhenyu S, Lei X. Multiple extracranial metastases from secondary glioblastoma multiforme: a case report and review of the literature. J Neurooncol. 2010 May;97(3):451-7. Epub 2009 Nov 7. Review. PubMed PMID: 19898745. 3: Frank S, Kuhn SA, Brodhun M, Mueller U, Romeike B, Kosmehl H, Regenbrecht CR, Ewald C, Reichart R, Kalff R. Metastatic glioblastoma cells use common pathways via blood and lymphatic vessels. Neurol Neurochir Pol. 2009 Mar-Apr;43(2):183-90. PubMed PMID: 19484696. 4: Miliaras G, Tsitsopoulos PP, Markoula S, Kyritsis A, Polyzoidis KS, Malamou-Mitsi V. Multifocal glioblastoma with remote cutaneous metastasis: a case report and review of the literature. Cen Eur Neurosurg. 2009 Feb;70(1):39-42. Epub 2009 Feb 3. PubMed PMID: 19191206. 5: Mentrikoski M, Johnson MD, Korones DN, Scott GA. Glioblastoma multiforme in skin: a report of 2 cases and review of the literature. Am J Dermatopathol. 2008 Aug;30(4):381-4. PubMed PMID: 18645311. 6: Zustovich F, Della Puppa A, Scienza R, Anselmi P, Furlan C, Cartei G. Metastatic oligodendrogliomas: a review of the literature and case report. Acta Neurochir (Wien). 2008 Jul;150(7):699-702; discussion 702-3. Epub 2008 Jun 12. Review. PubMed PMID: 18548193.

בוקר טוב, כשעבדתי בביה"ח שיבא, תיארנו קשר כזה ולהלן תקציר של מאמר שלנו משנת 1997. לא ברור האם מדובר בתחלואה משותפת של מספר מחלות או על גרימה של ה- SSRI למשהו אימופלסיבי... בברכה, ד"ר יאנקו Display Settings:AbstractFormat SummarySummary (text)AbstractAbstract (text)MEDLINEXMLPMID ListApplySend to:Choose DestinationFileClipboardCollectionsE-mailOrder Format Summary (text)Abstract (text)MEDLINEXMLPMID List Create File 1 selected item: 9099464 Format SummarySummary (text)AbstractAbstract (text)MEDLINEXMLPMID List E-mail Additional text E-mail "SPAM" filtering software notice Add to Clipboard Add to Collections Order articles Clin Neuropharmacol. 1997 Apr;20(2):126-9. Emergence of kleptomania during treatment for depression with serotonin selective reuptake inhibitors. Kindler S, Dannon PN, Iancu I, Sasson Y, Zohar J. Psychiatry A Department, Chaim Sheba Medical Center, Tel Hashomer, Israel. Kleptomania, one of the rare impulse-control disorders, is characterized by an irresistible impulse to steal objects not needed for personal use or monetary value. There is a comorbidity between mood disorders, eating disorders, anxiety disorders, personality disorders, and kleptomania. Several recent case reports have suggested that serotonin reuptake inhibitors could be effective in the treatment of obsessive-compulsive spectrum disorders and specifically in kleptomania. We describe three depressed patients who paradoxically experienced kleptomanic behavior during treatment with serotonin selective reuptake inhibitors.

מני שלום, הנני תזונאית בחברת סולגאר, אנו לא מייצרים תוספי תזונה המכילים את צמח המורינגה ועל כן זה כל המידע שיש לי על צמח זה. בריאות שלמה והמשך יום מקסים, הדר

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שלום רב אני מבינה שאתה עסוק כעת בהתנגחות קצת איתי, ובנסיון לחזק את נושא הדיקור והטיניטוס. אני גם יודעת שלא תמיד אדם רואה את התמונה המלאה, אבל בשביל זה יש מחקרים וספרות מקצועית ועיתונות רפואית. ואני רופאה, ומאמינה ברפואה ומחקר ולא עובדת בשיטה של נדמה לי. אז אולי אתה 15 שנים בנושאי רפואה סינית, אבל אני 30 שנה באודיולוגיה ו 20 שנה רופאה, אז בבקשה לא לספור לי שנים. התמונה המלאה של הדיקור מבחינתי היא שבמקרים מסוימים יש בו תועלת ואני ששה לשלוח חולים עם מחלות ספציפיות לטיפולים משלימים, ובמקרים אחרים - כמו למשל בנושא הטיניטוס, מדובר באפקט פלצבו. לא שאני מזלזלת בפלצבו אבל לפחות בוא נאמר את האמת לאנשים. אז ככה. אספתי כמה דוגמיות על קצה המזלג ככה מהצד שיהיה מעניין. כל מה שצריך הוא לפתוח ספרות רפואית. ביקשת שאפנה את החולים לעבודות = אז יאללה לעבודה, כל אחד יכול לקרוא ומי שיודע ומבין אנגלית ידע להבין את המשמעות של אין הבדל בהשוואה לפלצבו (כלומר אין הבדל בין כלום לבין דיקור בנושא הטיניטוס). בכנסים הכי רציניים שיש בעולם בנושא טיניטוס והטיפול בו מציינים במפורש את העדר ההשפעה של דיקור (ואפילו את האופציה שהוא עשוי לגרום להחמרה, אגב, ובכנסים אלה יושבים גדולי האנשים שדנים בטיניטוס בעולם הרפואה), אגב גם מוזכרים העדר ההשפעה של גינקו, הומיאופתיה, ועוד שונות ומשונות . ואני חותמת בזאת את הויכוח כי נמאס לי ויש עוד דברים נחמדים בחיים חוץ מאשר להתווכח מי יותר גיבור. 1. J Laryngol Otol. 1984 Nov;98(11):1103-9.Links A controlled trial of acupuncture in tinnitus.Marks NJ, Emery P, Onisiphorou C. The relationship of tinnitus to pain is examined and a theoretical case made out for the possible use of acupuncture in the treatment of tinnitus. A double-blind cross-over controlled trial is described. The use of Visual Analogue Scales (V.A.S.) is discussed in this context. 35 per cent of patients described some benefit from the active treatment only, although we were unable to demonstrate this objectively. Statistical analysis of the group as a whole revealed no significant differences between placebo and active acupuncture treatment. 2. 1: Ugeskr Laeger. 1999 Jan 25;161(4):424-9.Links [The effect of traditional Chinese acupuncture on severe tinnitus. A double-blind, placebo-controlled clinical study with an open therapeutic surveillance][Article in Danish] Nielsen OJ, M&oslash;ller K, J&oslash;rgensen KE. H&oslash;reklinikken, Vejle Sygehus. The aim of the present study was to determine the effect of intensive acupuncture on severe tinnitus. The structure of the study was a randomized, double-blind, clinical investigation with open therapeutic surveillance and included 54 patients. All were subjected to 25 treatment sessions over a period of two months, each treatment lasting 30 minutes. Fifty-two patients completed the study. The variables used for self-registration were based on the Visual Analogue Scale, where annoyance, loudness and awareness of the tinnitus were assessed. These were recorded twice daily over a four month period starting one month before the first treatment and ending one month after the last treatment. Questionnaires, interviews and audiometry were carried out repeatedly. No statistically significant differences were found between the acupuncture group and the placebo group. 3. Audiology. 1994 Nov-Dec;33(6):351-60.Links Acupuncture in the management of tinnitus: a placebo-controlled study.Axelsson A, Andersson S, Gu LD. Department of Audiology, Sahlgrenska University Hospital, Gothenburg, Sweden. The present study was performed on 20 patients randomly selected from a large group with noise-induced tinnitus in order to investigate the effect of acupuncture on their tinnitus. The patients were divided into two groups. One group first received classical Chinese needle acupuncture for 5 weeks, and the other was given a placebo procedure; after a 2-week interval, the procedures were reversed. A single-blind cross-over design was used. Acupuncture was given by a Chinese otolaryngologist around the ear as well as at distal points on the extremities. Placebo consisted of mock electrical stimulation via surface electrodes connected to a Chinese electro-acupuncture stimulator which delivered a weak sound and a light flash at a frequency of 2 Hz but no current to the surface electrodes. The effect was evaluated by the use of visual analogue scales. No significant difference between acupuncture and placebo was found in annoyance, awareness or loudness of the tinnitus. Many patients indicated a preference for acupuncture due to unspecific effects such as improved sleep, decreased muscle tension and improved blood circulation. It is concluded that acupuncture has no specific alleviating effect on noise-induced tinnitus. 4. Br J Audiol. 1998 Jun;32(3):197-204.Links Effect of traditional Chinese acupuncture on severe tinnitus: a double-blind, placebo-controlled, clinical investigation with open therapeutic control.Vilholm OJ, M&oslash;ller K, J&oslash;rgensen K. Department of Audiology, Vejle Hospital, Denmark. This study aims to determine the effect of intensive acupuncture on severe tinnitus. The structure of the study was a randomized, double-blind, clinical investigation with open therapeutic surveillance and included 54 patients. All were subjected to 25 treatment sessions over a period of two months, each treatment lasting 30 minutes. Fifty-two patients completed the study. The variables used for self-registration were based on the visual analogue scale (VAS), where annoyance, loudness and awareness of the tinnitus were assessed. These were recorded twice daily over a four-month period starting one month before the first treatment and ending one month after the last treatment. Questionnaires, interviews and audiometry were carried out repeatedly. No statistically significant differences were found between the acupuncture group and the placebo group. 5. Arch Otolaryngol Head Neck Surg. 2000 Apr;126(4):489-92. Links Efficacy of acupuncture as a treatment for tinnitus: a systematic review.Park J, White AR, Ernst E. Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, England. [email protected] BACKGROUND: Tinnitus is a prevalent condition for which patients may seek treatment with acupuncture since no conventional treatment has been shown to be effective. OBJECTIVE: To summarize and critically review all randomized controlled trials on the efficacy of acupuncture as a treatment for tinnitus. DATA SOURCES: Four independent computerized literature searches (MEDLINE, Cochrane Controlled Trials Register, Embase, and CISCOM) were conducted in December 1998 using the key words acupuncture and tinnitus. STUDY SELECTION: All randomized controlled trials that compared any form of acupuncture with any control intervention in the treatment of tinnitus were included. DATA EXTRACTION: Data were extracted by 2 authors independently. The methodological quality of the included randomized controlled trials was assessed using the Jadad score. DATA SYNTHESIS: Six randomized controlled trials were included in the review, 4 of which used crossover design. Four studies used manual acupuncture and 2 used electroacupuncture. Five of 6 studies used inconsistent acupoints. Three studies scored 3 points or more on the Jadad scale. MAIN OUTCOME MEASURES: Outcome measurements were visual analog scale scores for loudness, annoyance, and awareness of tinnitus; subjective severity scale scores for tinnitus; or Nottingham Health Profile scores. RESULTS: Two unblinded studies showed a positive result, whereas 4 blinded studies showed no significant effect of acupuncture. CONCLUSION: Acupuncture has not been demonstrated to be efficacious as a treatment for tinnitus on the evidence of rigorous randomized controlled trials. 6. Clin Otolaryngol Allied Sci. 1982 Oct;7(5):325-9.Links Acupuncture treatment of chronic unilateral tinnitus--a double-blind cross-over trial.Hansen PE, Hansen JH, Bentzen O. In a double-blind controlled trial the effect of traditional Chinese acupuncture versus placebo acupuncture was evaluated among 17 patients (8 females and 9 males, mean age 45.7 years) with chronic (mean disease duration 5.3 years) unilateral tinnitus. None of the patients had any treatable otological disease. All patients suffered from daily tinnitus, the intensity of which was recorded by the patients themselves every day during a period of 15 weeks. Each patient was treated by traditional Chinese acupuncture as well as placebo acupuncture following randomization (Figure 1). Each period of treatment comprised 2 treatments a week for 3 weeks. Throughout the whole investigation a period effect was recorded, insignificant in the acupuncture-placebo group, but significant in the placebo-acupuncture group (Friedman analysis of variance) (Table 4). There was no significant difference between traditional Chinese acupuncture and placebo (Wilcoxon test, P greater than 0.05, one-tailed). There was no relation between the patients' subjective statements and the results of sound balance measurements as an objective standard of tinnitus (Spearman test). 7. From the 1Department of Special Needs Education, Faculty of Education, University of Oslo, Norway, 2North Trent Department of Medical Audiology, The Royal Hallamshire Hospital, Sheffield, UK, 3Briskeby School and Resource Centre for the Hearing Impaired, Lier, Norway Falkenberg E-S, Tungland OP, Skollerud S. Habituation therapy of chronic distressing tinnitus: a presentation of a treatment programme and an evaluation study of its effects. Audiological Medicine 2003; 2: 132–137 During the last 15 years, tinnitus suffering has been an increasing reason for patients to seek medical and audiological advice in Norway. In 1998–1999 we introduced Tinnitus Habituation Therapy (THT) to nearly 200 tinnitus sufferers. This paper presents the programme and the evaluation of the effects it had on the patients. Two treatment groups were presented and pre- and post-treatment analysis was used. Immediately after the treatment, 59% reported less annoyance and 72% reported increased ability to cope with tinnitus. A follow-up assessment 12 months after the end of treatment, involving 164 patients who completed the survey, indicates that these effects are maintained, and a considerable number even continued to improve. Key words: habituation, multidisciplinary team, neurophysiological based management, tinnitus, tinnitus-related activity in the nervous system (TRA), white noise generator. ___________ Tinnitus, also denoted “the perception of sound within the head in the absence of external auditory stimulation” (Hazell and Jastreboff, 1990), is an annoying condition that during the last two decades has been an increasing reason for patients to seek audiological and medical advice. A prevalence study of tinnitus as part of the National Study of Hearing in England, (Coles, 1984) dealt with different aspects of hearing and disorders associated with tinnitus. He found that the prevalence of tinnitus perception, lasting more than 5 minutes, in the adult population, was 17%. Fabijanska et al. (1999) suggested in the introduction to their paper “Epidemiology of tinnitus and hyperacusis in Poland” that tinnitus affects about 17% of the general population around the world. An epidemiological study performed by the Norwegian National Institute for Public Health in 1996 showed that 15% of the population are affected by tinnitus (Birkeland, 1998), and this corresponds with a study from Sweden, with a prevalence of 14% (Axelsson and Ringdahl, 1989). These authors also found tinnitus to be disabling in 2.4% of the people surveyed. In Coles’ study (1984), 1% reported a definite impairment in quality of life and about 8% complained of sleep disturbance in varying degrees. The occurrence of tinnitus seems to increase with age (Chung et al., 1984; Brown, 1990; Siwiec, 1999; Fabijanska et al., 1999), but there is no clear evidence that tinnitus becomes more of a health problem (Lindberg et al., 1984; Scott et al., 1990). Clinical data from first presentation at specialist tinnitus clinics consistently show that the majority of patients are 50–70 years of age (Sanchez et al., 1999). The effect of gender on the prevalence of tinnitus is inconstant. Many studies have shown females to be slightly more affected by tinnitus, but the results have not reached statistically significant values (Davis and Rafaie, 2000). Evidence referring to unpublished data from Sheffield has shown that approximately 60% of tinnitus sufferers relate their first awareness of tinnitus to changes in their life, small or substantial (Tungland, 2002, personal communication). These could include events such as being made redundant, retiring, sickness in the family, problems at work, accidents, surgery, or even having had their ears syringed. Such events can produce a change in the arousal of the brain or its homeostasis, resulting in a state of heightened brain arousal during which the tinnitus signal is registered cortically (Jastreboff, 2000). It is also likely that such events can weaken the normal mechanisms of defence against anxiety and other emotional reactions. A considerable number of treatments have been suggested and tested. Many of these, however, have been reported as having little or no long-term effect on tinnitus, e.g. Tan et al. (1999) who reported no effects from hyperbaric oxygenation treatment; Simpson et al. (1998) none from homeopathy; Nebeska et al. (1999) and Wilholm et al. (1998) none from acupuncture. A large study by Drew and Davies (2001) showed that 12 weeks treatment with Gingko biloba, was no more effective than placebo. 8. אז נגעתי בקצה התמונה. וברור שיש בינינו חילוקי דעות וטוב שכך כי החיים מעניינים יותר בדרך הזו. ושיהיה לך יום טוב, ד"ר טלי מרק

אסף שלום, קיימים מחקרים המראים ששום מסייע להורדת כולסטרול. אשמח לשלוח לך את המחקרים אך על מנת שאוכל לעשות זאת אבקש ממך להשאיר לי את כתובת המייל שלך. בריאות שלמה, הדר

מחקר מרוסיה שפורסם ב 1995 מראה ששימוש ברודיולה מפחית הישנויות של סרטן שטחי של שלפוחית השתן ב 50% Urol Nefrol (Mosk). 1995 Mar-Apr;(2):46-7. ד"ר יוסף ברנר

אסף שלום, אני מודה לך שאתה דואג לעדכן אותנו ולהפנות אותנו למאמרים ומחקרים. שבוע מקסים, הדר

עופר שלום, אפשר לשמור במקרר שבועיים ובמקפיא חודשיים ויותר. רצוי לשמור בצנצנת זכוכית. כדאי להשקיע מאה שקלים במטחנת קפה ולטחון בבית. בהצלחה צביקה קורן