Advice

Pain in elderly people – Pamelor

Complaints of pain observed in 25% – 50% of elderly people living at home and from 45% to 80% living in institutions in which they are given a long uhod.1-6 untreated pain has serious consequences, which include depression, decreased socialization, sleep disturbance , violation of legal capacity, slowing recovery and rising health care costs. / 3,7,8 /.

Recommendations for survey

Although patients aged 60-70 years are able to report and assess signs of pain, but evaluation of pain in patients most venerable age may be complicated by their complex conditions and situations. Complicated circumstances include loss of vision and hearing, cognitive disturbances associated with delirium, dementia and other neurological diseases, cultural barriers and false belief, such as the fact that pain is an inevitable part of aging. / 2,7,9-12 /

In the past ten years there have been several studies that have been devoted to assessing the best ways to assess pain in elderly lyudey/.10-14 / / Many of the elderly did not accurately respond to questions about pain. However, the elderly with impaired cognitive abilities and skills, disorganized speech, have difficulty in describing their discomfort and may be unable to comprehend the agonizing pain, which prevents obsledovaniyu.7, 9,11,13 In one study of elderly patients with hip fracture who were violated the cognitive and verbal skills, have difficulties with the localization of pain and said that they “hurt everywhere.” “15 In other cases, the patients experienced pain and discomfort, but a negative answer to a question regarding boli.15 However, compared with controls, they are equally likely to report the presence of pain,” yes “or” no. “

The key to optimal treatment is the identification of pain. Health workers and staff should use the pain assessment tools that are simple, easily accessible, printed big and bold letters and in a language that patients understand / 12,14,16 /. We recommend using a verbal descriptive scale (The Verbal Descriptor Scale – VDS) because it uses the familiar words (slight pain, mild pain, moderate pain, severe pain, extreme pain and the pain is so strong as it can be) / .14 /. In two studies, the scale was considered the preferred and most easily understood by the elderly in communities / 15 /. In addition, she was seen approximately 73% of hospitalized older people with cognitive disabilities vozmozhnostyami/.15.

Recommendations of the American Geriatric Society (American Geriatric Society – AGS) also recommend the use of synonyms pain: pain, pressure, burning, lumbagos, compression, inflammation, neudobstvo.16 Studies have shown that, despite the fact that the visual analogue scale (Visual Analog Scales – VAS) and categorical scale (such as VDS) is closely correlated with each other, there is wide variation in VAS responses for each category and the overlap between the categories of indicators / 14 /.

Were developed some new methods of examination have not spoken to and severely damaged starikov/11 ,13,17-21. These methods include general observation which drew attention to the following behavior: movement of persons (faces, nahmurivanie, inflating the cheeks), specific of the body (grinding, fixing, obereganie, dotragivanie) and voice (cries, screams, cries) / 11,13,17-21 /. The researchers encourage the documentation of other forms of pain: poor appetite, depressive symptoms, sleep disturbances, functional disability, agitated behavior, resisting care, rejecting behavior and crying. / 9,11,13,17 /

Since the elderly with cognitive impairment can forget about the pain, if they are sitting quietly, a good strategy is to check during the movement and palpirovanie suspicious oblasti/21, 22. Consult with your family on the patient’s previous history of pain and use of analgesics / 15,21 / /

Older people with impaired cognition, aggressive or agitated behavior and resistance to care may be associated with untreated pain / 21-24 /. Preliminary study of aggressive elderly with cognitive impairment document the level of aggression are greatly increased in subjects diagnosed with arthritis or those who have two or more of diagnosis, which can cause boli/21. New behavioral changes in patients with dementia may signal that many medical problems, including urinary tract infections, constipation, changes in the heart and discomfort as a result of falls or injuries. Pilot studies empirical application of pain medication to reduce the aggressiveness yielded some success. These studies showed that treatment of pain can reduce the use of tranquilizers prescribed for the treatment of aggressive behavior / 23,24 /.

Recommendations for treatment

American Gerontological Society has published practical recommendations for the treatment of chronic pain in older people 1998 / 16 /. Some psychological changes with aging affect the treatment of chronic pain in the elderly, frail patients. These features include slow absorption of medications, metabolic disorders and processes of elimination. These features create problems associated with excessive sedation, disorientation, constipation and urinary retention / 16,25,26 /.

American Medical Directors Association (American Medical Directors Association-AMDA) in 1999 published guidelines for the treatment of chronic pain in older / 25 /. These recommendations promote the following principles of treatment of pain:

To the extent possible, use the least invasive (oral) route destination analgesics.

Identifying the causes of pain is necessary to select the best.

Cautious approach would help avoid having excessive sedation / 26 /.

The principles of the recommendations of the AGS and AMDA introduced by discussing the following circumstances.

Short-acting Analgesics are good for acute illness or sudden acute exacerbation of chronic illness. Atsetoaminofen drug of choice to alleviate the acute and moderate pain. Regularly appointed atsetoaminofen more effective than if he is appointed as needed. Often the elderly come to the nurse practitioner, complaining of pain, but they have not tried the application atsetoaminofena in a dose of 325 mg. Patients who say atsetoaminofen “not working” should be encouraged to use the dose from 650 mg to 1,000 mg three – four times a day, if they do not have a history of alcoholism or liver disease.

The daily prescription medications can be “ahead of” the emergence of problems with pain and maintain functional activity. Keep in mind the empirical purpose of pain therapy for deeply affected, being home patients who are experiencing pain and asking for help / 23,24 /. If we take comfort main objective empirical therapy will help achieve this goal. In one study testing atsetoaminofena at a dose of 650 mg three times daily for 10 home residents with difficulties in behavior led to a 63% reduction of behavioral symptoms / 24 /.

The dose of acetaminophen should not exceed 4 grams in 24 hours. This threshold can be easily exceeded if the drug is given as needed. Keep in mind the differences in dosages of acetaminophen in combined acetaminophen-opioid drugs. For example, acetaminophen with codeine (Tylenol # 3) contains 325 mg of acetaminophen, 1 tablet, oxycodone (oxycodone) acetaminophen (Percocet) and hydrocodone (hydrocodone) and acetaminophen (Vicoden) contains 500 mg and propoxyphene napsylate with acetaminophen (Darvocet N100) contains 650 mg of acetaminophen in 1 tablet.

NSAIDs (Nonsteroidal antiinflammatory drugs-NSAID) to be appointed by the elderly with care, especially with regard to patients with impaired renal function receiving anticoagulation therapy and bleeding in anamneze/16. Recommendations AGS advised to avoid long-term use of any NSAID, especially in high doses and in the form of long-acting drugs (such as naproxen sodium; Naprosyn, Aleve) due to increased risk of gastric ulcer bleeding / 16 /. Assign short-drugs (eg ibuprofen) in small doses (400 mg) for adults who require nonsteroidal anti-inflammatory preparaty/26. The medicine should be taken with meals, and course of treatment should be short-lived / 26 /.

Recommendations AGS warn against the simultaneous appointment of more than one NSAID. With extreme caution should be used NSAID in patients who take oral corticosteroids. Some observations indicate that the 14-day course of 400 mg of ibuprofen brings a more significant relief and improve function in elderly osteoarthritis knee or bedra/27. Such a short course of treatment may be useful in exacerbations of arthritis. However, prolonged treatment at high doses can lead to swelling of the lower limbs, gastric bleeding and renal dysfunction / 26 /.

The recent removal of rofecoxib from the market (rofecoxib-Vioxx) due to increased risk of cardiovascular episodes, as well as similar questions about other COX-2 inhibitors, confirms the need to avoid their use in the elderly / 28 /. This group of drugs inhibits the production of prostaglandins associated with inflammation and gives fewer gastrointestinal adverse reactions than the older pain relievers / 25,28 /. Nephrotoxicity, hypertension, and edema – the usual side effects of NSAID and they also are associated with COX-2 inhibitor. In determining the dosage of NSAID in the elderly should monitor renal function.

Opioid analgesic drugs (morphine, codeine, gidromorfan, hydrocodone, oxycodone) are useful for relief of moderate to severe pain. Unlike atsetoaminofena, opioid funds may titrate doses to achieve the effect, if they are not part of the combined drugs. However, the combination drugs that include atsetoaminofen have a limit as the limit “ceiling” dose of acetaminophen is 4 grams per day. Opioid funds available in the form of many drugs. Selecting the drug depends largely on the strength of pain, medical and cognitive status and tolerance to side effects / 16,25,26 /.

Continuing pain should be treated dlitelnodeystvuyuschimi or slow to eliminate drugs. Slow to eliminate drugs should be appointed at the initial high doses and should not be appointed opioid “naive” patients. Routine doses of drugs to titrate short-range, rising and allowing the patient to move to a long-acting drugs. Requires a good understanding of morphine equivalency. For example, a dose of 5 mg of liquid concentrate of morphine every 4 – 6 hours will be “ekvianalgetichna” one dose of oxycodone (oxycodone) and hydrocodone-atseaminofen (hydrocodone-acetaminophen) tablet over the same intervals.

The dose of morphine can concentrate stepwise increase to obtain relief.

However, side effects such as constipation, sedation, violations of recognition and instability when walking can be a contraindication to achieve the necessary dosage for pain relief / 25,26 /. Start with a low dose and gradually increase to track the side effects. Constipation can be combated with the help of laxatives. A simple approach such as the appointment of cherry flavored liquid acetaminophen (which can cause diarrhea), with oral morphine concentrate (which causes constipation) opens the way to balance the side effects of the assignment anlgetikov central and peripheral deystviya.15

Neuropathic pain is often described as “shooting” and the searing pain.

Tricyclic antidepressants (nortriptyline [Pamelor], desipramine (desipramine 0 [Norpramin]) and proivosudorozhnye drugs gabapentin – (gabapentin 0 [Neurontin]) in general are most effective for treating this type of pain than traditional pain relievers. Gabapentin (Gabapentin) may be effective for reduce neuropathic cancer pain in patients who receive treatment opioidami./29 / Gabapentin has a low profile of side effects, unlike the high-profile in anticholinergic tricyclic antidepressants (which can increase levels of anxiety and confusion in patients with mild dementia with). Recommendations AGS advised to apply carbamazepine (carbamazepine – Tegretol) in trigeminal neuralgia / 16,26 / /

By achieving comfort

Pain is a frustrating (frustrating) problem for the elderly and infirm patients. The combination of routine use of drugs, careful monitoring and additional non-pharmacological approaches recommended in order to achieve that sense of comfort for the patient.

Recommendations for survey

Recommendations for treatment

To the extent possible, use the least invasive (oral) route destination analgesics.

Identifying the causes of pain is necessary to select the best.

Cautious approach would help avoid having excessive sedation / 26 /.

The principles of the recommendations of the AGS and AMDA introduced by discussing the following circumstances.

The dose of morphine can concentrate stepwise increase to obtain relief.

Neuropathic pain is often described as “shooting” and the searing pain.

Pamelor

By achieving comfort

The whole truth about Analgin

It has long been thinking about it, but a recent post about the wonders of uncontrolled drug intake and self-encouraged me finally to formulate vopros.Kogda trees were big, but I was a little girl – a headache, and the temperature was treated analgin. In my early childhood, there was also a headache tablets, but it is almost one and the zhe.A here 20 years revealed that analginum much-g-asno harmful, and almost everywhere is prohibited. However hard I tried, no serious scientific sources, or where simpler, to find out – and what was so bad analginum, I do not yet succeeded. With the exception of leukopenia, which occurs at a course of treatment.(Tell me, from what treat analginum course??) However, one doctor recommended a whisper to my son analginum at high temperature. But – whisper not know, maybe this is our family so crazy?

When we in the U.S. along with her son became ill severe flu … short, aspirin was contraindicated for both of us: I have it on past experience evoked (now no longer a problem), uterine bleeding. And my son, and so at high temperatures were red eyes (weak blood vessels) – and after aspirin, he becomes like a rabbit, a vampire from some uzhastika.V fashion entered paracetamol and all its derivatives (Panadol, Tylenol etc.) This is the only what was available in the States. Neither me, nor for a child this medication does not work in any versions. Is that a lethal dose. The temperature is not reduced either to one-tenth. However, one of “our” American said to me – why do you, who’s going to eat one pill? And in my eyes, falling asleep in his mouth a handful of Tylenol …

But I did not go this way: the temperature got into the train and pilila 2 hours before the New York City, where one woman (also from our fellow countrymen) has shared with me analgin. Home I came to have a normal temperature, and one day cured rebenka.Ta same doctor, who prescribed secretly analginum – used the term “panadolovye children. This is when a child a spoonful of syrup in your mouth – no effect. Another one – no effect. And the advertising claims that, for now he will recover! As a result of exorbitant dose – Poisoning – drip – a complication of the kidney (nephrotoxic in large doses, small inefficient).

Several ortofen-ibupofen-nurofen-diclofenac well helps with pain. Especially in the joints. But the temperature – does not help. Moreover, having heard about the passions analginum, I’m on the advice of a dentist with complications “in the teeth” decided anesthetized ibuprofen. Numb. At the same time receiving ever-allergic glossitis, tongue in your mouth did not fit and three days without tossing and turning. (I did not suck, I swallow it. As it should be). No more budu.Poetomu forced to swell the ranks of a number of idiots that are contrary to natural selection are treated analginum not only themselves, but also the child.

Not yet posledstviy.Gospoda killers explain underdeveloped pharmacologist, who understands chemistry of drugs and medicine is not very: Why after many years of widespread use analginum became terribly harmful? What are the real pobochki and contraindications he suddenly discovered, and who suffered from it? What is the index of selectivity in analginum compared with the same paracetamol? Why not the second harmful effect on the kidneys though? Or the answer is simple – panadolovaya ate analginovuyu mafia mafia? I personally lean toward the latter inference …

How to cope with back pain

Back pain is familiar to many of us, and its cause can serve a variety of factors: from shifting to hypothermia muscles. Since the causes and specific methods of treatment will help to cope orthopedic surgeon, which necessarily have to apply if the back pain has become your constant sputnikom.A we will consider what should be done to ensure that our back as long as possible bolela.Pervoe, thing to consider – this is the work of the muscle corset that supports the lower back. Not for nothing had strict teachers would come up and pat on the back of the baby to school straightened. And rightly so. Muscular corset “remembers” the state as a slouch, and straightened his back. And the more you force yourself to sit up straight, the easier it will be your pozvonochniku.

Na posture also affects the state of the abdominals. If they are strong, the easier the spine. In addition, if you sit hunched over and compressed by the stomach and intestines, you hereby prepyatstvuete their normal funktsionirovaniyu.Vtoroe. Follow the bearing and on the street, reflected in the window tells the whole truth and tell us that delat.Trete.Periodically remove the studs. Clearly, this is the most feminine shoes, but she is the one we are often grateful for emerging in the evening back pain. Therefore try to wear comfortable shoes on a small and steady heel, at least in those days when you have a lot hodit.Chetvertoe. Do not carry weight in one hand (very much want to write: Do not carry weight in general, but for many – is a mirage), distributes the load in the two bags of roughly equal weight, and see posture.Properly lift heavy things: bend to them as closely as possible, bend your knees, keeping your back straight. Slowly, straining his abdominal muscles and legs, lift noshu.Pyatoe. To support the back during a long working day, sit on a hard chair with podlokotnikami.Shestoe.

Of course, orthopedic mattress – quite expensive, but it is a necessary thing that just need to afford. Back on the mat then takes the correct position and during the night time to otdohnut.Sedmoe. Take calcium. It should include sufficient quantities of the vitamin and mineral complex, and present in your daily consumption products: cottage cheese and other dairy products, fruits, ovoschah.Vosmoe. Do special exercises. Of course, the complex should pick orthopedic surgeon. Because, in certain diseases in this area, some exercises are contraindicated. For example, when problems with the cervical vertebrae in any case can not make sudden movements neck, if it is stiff and you need to move, all inclinations to perform slowly, capturing the extreme positions for a few seconds. By the way, problems with the cervical vertebrae can cause pain not only in the spine and neck, but also to serious headaches and obmorokam.Devyatoe. Help in correcting posture may have a special girdle (it is invisible under clothes), and for the cervical vertebrae – a special orthopedic collar (can be worn only at home).

But they should be used only for purposes vracha.Desyatoe. Many of the problems with the spine can solve massage. But a professional massage performed by a qualified physician, specially trained and have a great experience. Masseurs who have completed courses only and do not have enough experience, may not be aware of certain restrictions during a massage. As an example, the same cervical vertebrae – with their biases, and distortions is only recommended for vibratory massage and no strong pressure and sharp ryvkov.Samy useful method by which you can solve problems not only with a backbone – to do swimming. Of course, this is not about setting world records. On the spine works well, taking off his load, even when you’re just lying on vode.Krome addition, check to see that the spin does not supercool, do not stand in the draft and do not go in cold weather with open poyasnitsey.Otnesites to his spine seriously and it will save you from many problems in the future.

What vegetables protect against wrinkles? Stay always young!

What vegetables protect against wrinkles? Always be young! “Many people dream of an elastic skin, shiny hair and beautiful nails. In order to improve their appearance, there is little use of creams and lotions. Many products contain ingredients that make us krasivee.Estestvennoy protection against wrinkles is cocoa, rich in copper and theobromine. Cucumbers, radishes, or kartofelNaprimer, vegetables such as cucumbers, radishes, or potatoes – a perfect sinks acids which inhibit premature aging of the skin. In addition, according to food expert from Germany, some vitamins for the skin as a balm. Vitamins C and E contain, for example, especially a lot of antioxidants, with the help of which reduce the so-called free radicals. These parts of the molecule occur in the body due to heat exposure, smoking or stress and result in too high a concentration to the appearance of morschin.

Chechevitsa or olive masleVitamin C is found in many varieties of fruit, vitamin E – in the lentils and olive oil. Very useful, originally a Slavic dish of our ancestors. Lentils are rich in essential amino acids, vitamins and minerals; normalizes blood sugar levels, so good fit patients with obesity and diabetes. Lentil helps to normalize the metabolism, reduce blood cholesterol levels, so those who have a hereditary predisposition to cardiovascular disease (for example, in the family met strokes and heart attacks) are very suitable for this dish every day. Lentils are rich in magnesium, potassium, B vitamins, folic acid, which is also useful for serdtsa.Predlagayu recipe side dish of lentils to: Lentils 200 g (cup) sweet red pepper 50 g Onion 1 piece (small) 50 g Celery 30 g of crushed black Pepper Salt, kitchen Thyme RozmarinChto do:

1. Preliminary before cooking soak the lentils should be at 3.4 hours. (This will significantly reduce the cooking time). 2. Chop finely pepper luk.

3. Peel the celery – to do this carefully cut the top layer along the entire length of the stem. After purified celery cut into small pieces and add to the rest of ovoscham.

4. Finely chop chesnok.

5. Fry all the vegetables in olive oil until golden brown. When roasting constantly stirring, add spices and sol.

6. When the vegetables, fry, add the soaked lentils. Pour all the water (if you want the dish would be hypocritical) or broth .

7. Add the bay leaf and cook until done. Bon appetit! Carrots and broccoli sufficient supply of the organism with vitamin A is important for the elastic and elastic skin.

Therefore, carrots and broccoli, too, must constantly be in menyu.Salaty Lollo Ross, Arugula, Romaine, radicchio, endive – judging by the resounding names all these noble signori come to us from Italy. Indeed, the Mediterranean sun – not only the cradle of civilization, but also the birthplace of most salad ovoschey.Dlya slim figure from nature, too, has something to offer. The bitter substances contained in certain types of lettuce and endive salad, reduce appetite. In laurel leaves, chicory, or cabbage contains elements that are useful for rapid and smooth pischevareniyaSalat romenSalat Romain often called Roman lettuce or Roma, as well as indirect salad for its origin (birthplace – the Greek island of Kos). Its crisp leaves have a dark green color and tart, slightly spicy flavor. Usually this sort of use in sandwiches or Caesar salad. Often Romain is part of mixed salads. Very tasty it with yogurt dressing. Romaine Lettuce contains a large amount of sodium that has been successfully used in special diets.(synonyms: romaine lettuce, Roman salad, salad Braid): forming a head of loose elongated shape with a crisp juicy, slightly fibrous leaves are green. Leaves within a cabbage-head vary in color: external – saturated green, the closer to the middle – light green. Taste salad tart, slightly spicy, especially good with a sauce of yogurt, spicy greens, are often added to mixed salads to bring richness and flavor. Included in the classic recipe Caesar salad.

“Juice Romaine lettuce is used in the treatment of certain diseases (eg,” bronze disease “), as in admixture with a powder of seaweed it helps to intensify the adrenal cortex (helps produce epinephrine). In addition, a salad of sodium contained 60% more than potassium, which is important under certain diet.Rodina salad – Kos (Greek archipelago), in connection with which there is yet another name – “Koc salad.” Broad-leaved (synonyms : batavia, batavia):-leaved form with poorly cut leaf surface is known as the Batavian. Taste and properties similar to tsikornym salatom.Predpolagayut that the homeland-leaved – North China. Tsikornye salads were known in ancient Rome, where IIL used as a vegetable in salads. About them were mentioned by Horace, Virgil, Ovid and Pliny. In Europe, cultivated as a vegetable salad plant and for roots that are cultivated plants are not as stringent as thick and fleshy, and after roasting and grinding are added to the kofe.Terpkie taste leaves combine well with apples, bacon, mustard sauce.Usually leaves blanch to remove the bitterness.

Since it is also preparing an autumn salad of apples, sweet red pepper, green peas and cabbage. Shoots also served stewed with eggs, fried potatoes, cheese, baked in teste.Salatny chicory (synonyms: endive, tsikorny Vitluf salad, salad “white head”): a young plant chicory as small kochanchikov of juicy crispy leaves pale-yellow coloring. Variety Vitluf known since 1870. The cultivation of chicory salad consists of two stages: in the summer growing roots, and in winter from the obtained roots are banished to the darkness kochanchiki.Vkus tender lettuce bitter, due to the presence in the chemical composition of inulin and intibin. In addition to these substances chicory salad leaves are rich in vitamins and minerals: they contain ascorbic acid, carotene, protein, sugar, nitrate, sulfuric and hydrochloric acid salts of potassium, which improve the activity of the kidneys. Inulin, which gives the bitter taste, has a regulating effect on the metabolism and is used as a sweetener in diabetes. Intibin improves the digestive system, the activity of the liver, gallbladder, pancreas, cardiovascular system, has a positive effect on hemopoietic organy.Dlya lettuce leaves of chicory along the cut, but you can prepare dishes from whole kochanchikov.

Kurchavy endiviySalat Frisse unique. Frize was known in Roman times, where the very valued for its taste and medicinal properties. At first bite Frisse seems bitter. Bitterness give very useful intibin and inulin that promote the work of the digestive tract and blood circulation, normalizes metabolism, improves the level of hemoglobin in the blood, reduces the deposition of salts, helps regulate water metabolism and stimulates the excretion of cholesterol from the body, helps with obesity and diabete.

Gorech accentuates the taste of others products – not just fish, shrimp or cheese, which Frisse often used, but, for example, citrus. And as with other salads – sweet. (Synonyms: Frieze, Fries): salad with bright green, curly leaves, with a particular bitter taste, which is due to the presence of substances intibina having medicinal properties and beneficial affects on the organs of digestion and circulation. Leaved leaves contain ascorbic acid, carotene, vitamins B1, B2, PP, valuable for the body of sugar, inulin, salt, K, Ca, Fe, Mg and P. leaved leaves are used in mixed salads, in addition, they can otvarivat.Redichchio (synonyms : radichchio, Italian chicory, radicchio): very beautiful salad, referring to tsikornym. As the name implies, the birthplace of plants – Italy. Lettuce, green at first, but after a frost, they turn red, acquiring the various shades of pink to purple, while the veins remain white. Kochanchiki usually small, more or less dense, round or elongated formy.Pri purchase must choose a dense kochanchiki with healthy leaves. It is noteworthy that redichchio one of the few salads that can be stored in the refrigerator (in a plastic bag) for a week without losing their taste for lettuce kachestv.

Vkus rich, bitter. Blends well with various sauces and fillings. You can eat fresh, but also tushenym.Korallovy salad and roasted red and green (synonyms: Lollo Rosso, Lollo rossa, Lollo Biondi, Lollo bionda): soft, curly, light green color with a broad reddish-pink edge of the leaves collected in a loose outlet. One of the world’s most popular salads. Leaves from reddish-pink edges look very effective. Salad ranked first on the content of calcium and the second after the spinach – the content of mineral soley.Vkus nutty, slightly bitter, better to serve with the sauce for grilled meats. In coral lettuce green leaves with thick curls gathered in a fairly dense rosette.Properties and taste the same as that of the coral red lettuce. Serve with sauce for grilled myasu.Dubovy salad and red zelenyyListovoy salad in the form of loose kochanchikov. Leaves form (brokenness) resembles an oak leaf. The color varies from green to maroon-korichnevogo.Orehovy flavor salad goes well with sauces and filling neperebivayuschimi its delicate fragrance, as well as mushrooms, to the chopped almonds, smoked salmon, grenkam.Kochanny oily salad (synonyms: salad oil, Buttercrunch, Butterhead ): light green salad with a fairly tight head packing.

The leaves are very tender, slightly oily, rounded, slightly compressed. Oily surface of these kinds of results, as a rule, a high content of vitamin E (tocopherol). Buying oil salad, choose a head of heavy for its size, no darkening of the leaves (they taste worse). Watercress watercress homeland – Africa and Asia Minor; * was known in ancient Egypt, from the Egyptians came to the Greeks and Romans; * From the XVIII century and is still widely cultivated in many countries, in Russia is more popular in the south, is found on private land, the non-chernozem zone; * fresh leaves because of the content of mustard oil glucoside have slightly sharp taste, a taste reminiscent of horseradish they contain significant amounts of protein, mineral salts of potassium, calcium, iron, iodine, vitamins, * from the leaves (before bolting) prepared salads, use as a seasoning for fish, meat, used in cooking soups and green soup (synonyms: garden perechnik ): annual crucifers. Distributed in the Caucasus, especially in Georgia. Used in food, young leaves, with a tart taste, because it contains maslo.

V juice, mustard cress contains proteins, nicotinic acid, mineral salts, a large amount of ascorbic acid, carotene, routine, group B vitamins, iron salts, iodine, potassium, phosphorus.Often used in the dietary food with vitamin A deficiency, as well as a tonic, improves digestion, and beneficially influence the condition of the nervous system (improves sleep, lowers blood pressure). Cabbage Salad “Iceberg” (synonyms: salad Krisphed “salad” Ice Mountain “): the leaves are collected in a dense round loaf medium or large sizes of up to 1 kg or more. Large leaves are greenish-whitish, with serrulate margin, crispy, sweet, very juicy. The refrigerator can store up to three weeks and bolee.Blagodarya pleasant fresh taste of crisp succulent leaves, salad is usually run by just fills in the vegetative masle.Bataviya (synonym: salad minonett): hybrid of iceberg lettuce and oak. The leaves are painted in colors from red-brown to light green, margin wavy collected poluraskidistuyu rosette of large size. Salad tastes crisp, sweet, goes well with fatty meat or bacon and walnuts. Launched in France.

List of most health claims

List of the most useful health produktov.

1. Brown rice Many shy away from carbohydrates because of them, supposedly, get fat. But they are very important for maintaining energy levels.Do not forget about whole grains: brown rice, bread and cereals, which contain many volokna.Eto help lower cholesterol, reduce your risk of cardiovascular disease, colon cancer, gallstones, diabetes and obesity, it is also vitally important intestinal health, which become less aktivnym.

2. Chicken eggs chicken eggs often respond poorly, but they are a source of protein and lutein, which protects the eyes from cataracts. Studies suggest that they prevent blood clots, reducing the risk of heart attack and stroke. According to a recent study found that eating 6 eggs a week lowered the risk of breast cancer by 44%. Nutritionists now say that 1-2 eggs a day does not raise cholesterol levels, because the body itself produces cholesterol from saturated fats, but does not get it from cholesterol-which include yaytsa.

3. Milk, dairy produktyNe vain milk are the main food. It contains valuable proteins, easily digestible fat and healthy sugar lactose. Richly milk and calcium. It is necessary for the functioning of the nervous system and muscles to work properly. The doctors assure us that even one glass of milk a day dramatically reduces the risk of stomach cancer. Because dairy products benefit all, especially yogurt, indispensable for people whose body does not tolerate laktozu.S age our calcium requirements rise, so it is important to include in the daily diet of calcium-rich foods. Low-fat cow’s milk is very good for health. It is rich in calcium, essential for bones and prevention osteoporoza.Peyte daily two glasses of skim milk or include in your diet low-fat yoghurts and calcium-rich frukty.

4. ShpinatV this product more nutrients than any other. This is a source of iron, vitamins C, A and K and antioxidants help to protect against heart attack and stroke.Spinach protects against colon cancer, osteoporosis and arthritis. Like eggs, it’s packed with lutein, useful for the eyes, so try a breakfast of eggs with shpinatom.

5. BananyVsego one yellow fruit contains 467 milligrams of potassium, which is needed to make the muscles (particularly the heart) remained strong and healthy. It also helps reduce blood pressure.Bananas are a good source of fiber which help prevent heart disease, and they neutralize the acid, so they’re useful for treating izzhogi.Dobavte chopped banana in oatmeal and grind it in a blender with yogurt or milk and a small amount of fruit juice. Sources of potassium are lentils, sardines and kuraga.

6. KuryatinaEto very healthy meat. Eat breast, which has the least fat, and remove the skin. In addition, the chicken is rich in proteins and prevents bone loss. It is also a source of selenium in preventing cancer, and vitamins B, increase energy and boost your mozga.

7. LososinaOna fats rich in omega-3 to lower cholesterol, protect against some cancers and prevent trombov.Issledovaniya show that salmon can help ease depression and prevent memory loss. It contains niacin, which, according to some sources, protects against disease Altsgeymera.Postavte to eat fresh or tinned salmon at least 3 times a week. Fats in omega-3 are also contained in Walnut orehah.

8. ChernikaV this little miracle of a few calories, but bursting with nutrients. Blueberries contain antioxidants that help prevent cataracts, glaucoma, varicose veins, haemorrhoids, stomach ulcers, heart disease and rak.Chernika helps reduce brain damage after a stroke and reduce inflammation of the digestive tract, helping to cope with the illness zheludka.

9. TravyS we age, our sense of taste is dulled, and the easiest to add salt to make food more appetizing. But as salt increases blood pressure, and better meals by adding herbs and spices. The taste of fresh herbs stronger, but for the sake of convenience, you can keep in the kitchen range of dried trav.

10. ChesnokPo to popular belief, garlic repels vampires. Scientists added to the vampires bacteria and viruses that just can not stand garlic flavor due to the content in garlic essential oils and phytoncids. Garlic is good for treatment of colds. In addition, its use reduces the risk of cancer of the stomach and intestines, improves digestion and protects against the risk of vascular zabolevaniy.U this little bulb has great advantages. Garlic helps prevent cancer and cardiovascular disease, reduces the risk of stroke.It also has anti-inflammatory effect, helping to reduce pain and swelling caused by arthritis. It is useful and diabetics. If you can not stand the smell, eat garlic kapsuly.

11. YablokiBabushki in Germany often repeated his granddaughters saying “One apple a day – doctors without work.”Research scholars confirm this view. For example, those who eat an apple a day are less likely to get Alzheimer’s. Substances contained in apples, can retard the development of cancer cells, possess anti-inflammatory effect and help the work of the stomach. And in them a warehouse of vitamins and trace elements that enhance the immune system and improves cardiovascular sistemy.

12. RybaEsli you care about your heart, eat more fish instead of meat. Three “fish” meal a week or 30 grams of fish per day reduces the risk of heart attack by 50%. The Japanese and Eskimos who regularly consume fish, much less likely to suffer from cardiovascular disease. A useful fish for the brain, and nerve cells, contributing to their regeneration. Fish, as well as apples, reduces the risk of disease Altsgeymera.

13. KlubnikaOna not only very tasty, but extremely useful. In strawberries contain more vitamin C than a sour lemon. A taste are incomparable! A fine strawberry not only that – a high content of iron increases the body’s immunity. Some dyes and essential oils that are rich in this berry, can deter the formation of specific enzymes that encourage the development of cancer. And to top it all – in strawberries contain a lot of zinc, which is very beneficial effect on women seksualnost.

14. MorkovLyubimy childhood vegetable also prevents the development of cancer. In addition, as contained in carrots, beta-carotene favorably affects the skin and eyes. By the way, beta-carotene is more soluble in fats, so the salad of carrots necessarily directly charge vegetable oil or smetanoy.

15.PeretsOstry chili pepper chili improves metabolism, thus contributing to weight loss. Kapsatsin, giving the sharp taste of pepper, promotes the development of gastric juices and prevents the reproduction of harmful bacteria in the stomach and kishechnike.Sladky pepper or paprika, too, should be in your diet. In addition, it contains a lot of vitamin C in red pepper contains a dye luteolin. Even in small doses luteolin inhibits the development of cancer, protects against cardiovascular disease and age problem.

16. SoyaSoya contains a lot of lecithin and B vitamins, which increase the mental abilities and strengthen the nervous system. By the way, especially soybean sprouts polezny.

17. Green chayEgo miraculous properties are based on the content of catechin. This bioactive compounds prevents the development of atherosclerosis, and protects against prostate cancer. Also, green tea is very good for weight loss, only for the appearance of the result should drink at least four cups a day. But in the black tea catechin is not contained, as is destroyed in the process of izgotovleniya.Takim way, we see that to maintain health is actually not so difficult. All listed products are available to everyone, regardless of his income.The main thing – to cultivate one’s willpower. And do not be tempted to burgers, cheesecakes, crisps and so on. Eat with pleasure and benefit for themselves! And you will save health for many, many years. On materials of the British газеті The Daily Mirror and the German magazine “Focus”

List of drugs from swine flu and recommendations on prevention

To prevent A/H1N1 must use the same steps as that for normal seasonal influenza (World Health Organization recommendations)

Cover nose and mouth with a tissue when you cough or sneeze. After using a towel throw in the trash.
Wash your hands often with soap and water, especially after you’ve sneezed or coughed.
Will be effective as the use of alcohol hand washing.
Avoid close contact with sick people.
Avoid touching your eyes, nose and mouth.
Avoid hugs, kisses and handshakes.
If you are sick, stay home and limit contact with other people, so as not to infect them, keep a minimum distance of 1 meter from the surrounding
When flu symptoms seek immediate medical help.

“Scheme of treatment and prevention of influenza caused by virus type A/H1N1,

adult

1. Nonspecific prevention of influenza in adults.

Kagotsel – scheme 2 days on 2 tables. per day, 5 days break and another 2 days to 2 tables. per day (daily dose 24 mg) .*

Arbidol – direct contact with sick flu or SARS – 200 mg per day for 10-14 days *

during epidemics of influenza and other acute respiratory viral infection, to prevent

exacerbations of chronic bronchitis, recurrent herpes infection –

200 mg twice a week for 3 weeks .*

Interferon alpha-2b in combination with interferon gamma – 1 times per day, respectively, ME 50000 and 100000ME a day for 10 days *

* Note – except for pregnant women

1.2. For pregnant women (from the 14th week of pregnancy) can be used with interferon alfa-2b in suppozitorijah 150000ME 2 times a day (daily dose 300000ME) within 5 days.

2. Treatment of adult patients with milder forms of influenza caused by virus type A/H1N1.

2.1. Arbidol – 4 times a day, 200 mg every 6 hours (daily dose 800 mg) for 7-10 days *.

Interferon alpha-2b (50,000 IU per vial) in combination with interferon gamma (100000 IU in vial) – 2-6 times per day (daily dose 50 000 IU and 100 000 IU, respectively) every other day for 10 days, after a break one week repeated the same pattern *

* Note – except for pregnant women

2.2. For the treatment of pregnant women (from the 14th week of pregnancy) can be used with interferon alfa-2b in suppozitorijah – by 500000 IU 2 times a day (daily dose 1000000ME) within 5 days.

2.3. Symptomatic treatment (analgesics, the means used to treat allergic reactions, vitamins) – on the testimony

3. Treatment of adult patients with moderate forms of influenza caused by virus type A/H1N1

3.1. Kagotsel in combination with Arbidol *:

kagotsel – on the first day on the 2 tables. 3 times a day (daily dose 72 mg),

next 3 days to 1 table. 3 times a day (daily dose 36 mg);

arbidol – 4 times a day, 200 mg every 6 hours (daily dose 800 mg) in

7-10 days.

Interferon alpha-2b (50,000 IU per vial) in combination with interferon gamma (50000 IU per vial) – 2-6 times per day (daily dose 50 000ME and 100-000ME, respectively) every other day for 10 days, after a break of one week repeats the same pattern *

Ingavirin – daily dose of 90 mg 1 time a day for 5 days (including the appointment of the drug in the first 2 days of onset) *

Oseltamivir – 75 mg twice a day (daily dose 150 mg) for 5 days (including the appointment of the drug in the first 2-3 days of onset) *

* Note – except for pregnant women

3.2. For the treatment of pregnant women (from the 14th week of pregnancy) can be used with interferon alfa-2b in suppozitorijah 500000ME 2 times a day (daily dose-1000000ME) within 5 days. Then, maintenance therapy for 150000ME 2 times a day (daily dose of 300000ME) to 2 times a week for 3 weeks.

3.3. Symptomatic treatment (antibacterial and antifungal, analgesics, nonsteroidal anti-inflammatory drugs, the means used to treat allergic reactions, hormones, and tools that affect the endocrine system, means of affecting the respiratory, solutions, electrolytes, acid balance correction tools, power tools, vitamins and other means) – on the testimony

4. Treatment of adult patients with severe forms of influenza caused by virus type AH1N1.

4.1. Kagotsel in combination with Arbidol *:

kagotsel – on the first day on the 2 tables. 3 times a day (daily dose 72 mg),

next 3 days to 1 table. 3 times a day (daily dose 36 mg);

arbidol – 4 times a day, 200 mg every 6 hours (daily dose 800 mg) in

7-10 days.

Interferon alpha-2b (50,000 IU per vial) in combination with interferon gamma (100000 IU in vial) – 2-6 times per day (daily dose 50 000ME and 100-000ME, respectively) every other day for 10 days, after a break of one week repeats the same pattern *

Interferon gamma – 2-6 times per day (daily dose of 100,000 IU) within 15 days *

Ingavirin – daily dose of 90 mg 1 time a day for 5 days (including the appointment of the drug in the first 2 days of onset) *

Oseltamivir – 75 mg twice a day daily dose of 150 mg () within 5 days (taking into account the effectiveness of the drug in the first 3 days of onset) *

* Note – except for pregnant women

4.2. For the treatment of pregnant women (from the 14th week of pregnancy) can be used with interferon alfa-2b in suppozitorijah 500000ME 2 times a day (daily dose-1000000ME) within 10 days. Then, maintenance therapy for 150000ME 2 times a day (daily dose 300000ME) to 2 times a week for 3 weeks.

4.3. Symptomatic treatment (antibacterials, analgesics, nonsteroidal anti-inflammatory drugs, muscle relaxants, the means used to treat allergic reactions, means that affect the blood, hormones and tools that affect the endocrine system, means of influencing the cardiovascular system, solutions, electrolytes, means of correcting the acid balance, money supply, means of affecting the respiratory system, respiratory support, vitamins and other means) – if indicated.

4.4. Organization of treatment of complications – see note.

Interim guidelines

“Scheme of treatment and prevention of influenza caused by virus type A/H1N1,

children ”

1. Nonspecific prevention of influenza in children (under the threat of contracting influenza and in the foci).

Arbidol - for children aged 3-6 years 50 mg daily, 2 times for 7 days, children older than 7 years – 100 -200 mg per day, 2 times for 7 days.

Kagotsel - children from 7 to 12 years to 24 mg per day, 2 times for 7 days.

Oseltamivir (Powder for suspension for oral administration or capsules):

children from 1 to 8 years – with a weight of less than 15 kg to 30 mg, 15 to 23 kg of 45 mg, 23 to 40 kg to 60 mg over 40 kg – 75 mg 1 time a day for 5 days ;

children over 12 years – 75 mg 1 time a day for 10 days after contact with an infected person, no later than the first two days after exposure, during the influenza epidemic within 6 weeks.

Interferon gamma in combination with interferon alfa 2b (liofilizat for solution for intranasal administration, the contents of the vial or ampoule is dissolved in 5 ml of water for injections):

Interferon gamma – used in complex therapy from 0 to 18 years, 2-3 drops in each nasal passage for 30 minutes before breakfast, every other day for 10 dney.Pri necessary preventive courses povtoryayut.Pri single contact, only one burial.

Interferon alfa 2b – is used in complex therapy in contact with the patient and / or / with supercooling in accordance with the dosage of age: infants and children under 1 year (single dose of 1000 IU), 1 drop; children from 1 year to 14 years - (a single dose of 2000 IU) and 2 drops – 2 times a day for 5-7 days. If necessary preventive repeat courses. For a single contact, only one zakapyvaniya.Pri seasonal increase in incidence according to age dose in the morning after 1-2 days.

Interferon alpha-2b (suppository) (used in complex therapy) – for children under 3 years 150000ME 2 times a day every other day for 10 -14 days for children from 3 to 6 years 500000ME 2 times a day for 10 days - every other day.

2. Treatment of children with milder forms of influenza caused by virus type A H1N1.

2.1. Arbidol - children older than 7 years, the daily dose of 300 mg (100 mg 3 times daily) for 3 days

Oseltamivir (Powder for suspension for oral administration or capsules) not later than two days from the time of symptoms:

children from 1 to 8 years – with a weight of less than 15 kg to 30 mg, 15 to 23 kg of 45 mg, 23 to 40 kg to 60 mg over 40 kg, 75 mg 2 times a day for 5 days;

children over 12 years – 75 mg 2 times a day for 5 days. Increasing the dose of 150 mg per day does not lead to greater effect.

Interferon gamma in combination with interferon alfa 2b (liofilizat for solution for intranasal administration, the contents of the vial or ampoule is dissolved in 5 ml of water for injection):

Interferon gamma – used in complex therapy at the first signs of the disease to children from 0 to 18 years to 2 drops in each nasal passage, 5 times a day for 5-7 days;

Interferon alfa 2b – is used in complex therapy at the first signs of the disease:

infants and children under 1 year – 1 drop 5 times a day (single dose of 1000 IU daily dose of 5000 IU) for 5 days;

children from 1 year to 3 years – 2 drops 3-4 times a day (single dose of 2000 IU daily dose of 6000 – 8000 IU) for 5 days;

children from 3 to 14 years – to 2 drops 4-5 times a day (single dose of 2000 IU daily dose of 8000 – 10000 IU) for 5 days.

Interferon alpha-2b (rectal suppository) (used in complex therapy):

newborn babies – premature with gestational age less than 34 weeks – daily dose of 450,000 IU (150,000 IU for 3 times a day every 8 hours) for 5 days, after an interval of 5 days, repeated the same pattern (indication);

newborns, including preterm with a gestational age over 34 weeks – daily dose of 300,000 IU (150,000 IU in 2 times a day 12 hours) within 5 days after a break of 5 days, repeated the same pattern (indication);

children aged 1 month to 3 years – daily dose of 300000 (for 150000 IU 2 times a day 12 hours) for 7 days, after a break of 5 days, repeated the same pattern (indication of rates may be increased to three) ;

children aged 3 years to 7 years – a daily dose of 1,000,000 IU (at 500000 IU 2 times a day 12 hours) for 7 days, after a break of 5 days, repeated the same pattern (indication of rates may be increased up to three);

children aged 7 to 18 years – a daily dose of 1000000 (to 500000 IU 2 times a day 12 hours) during – 10 days after a break of 5 days, repeated the same pattern (indication of rates may be increased to three ).

2.2. Symptomatic treatment.

3. Treatment of children with moderate forms of influenza caused by virus type A H1N1.

3.1. Arbidol – children older than 7 years, the daily dose of 300 mg (3 times per day to 100 mg) for 3 days.

Oseltamivir (Powder for suspension for oral administration or capsules) not later than two days from the time of symptoms:

children from 1 to 8 years – with a weight of less than 15 kg to 30 mg, 15 to 23 kg of 45 mg, 23 to 40 kg to 60 mg over 40 kg – 75 mg 2 times a day for 5 days ;