By Centers for Disease Control and Prevention (U.S.)
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A research-based advisor to controlling the harmful urge to gamble
From Howard Shaffer, PhD, a famous professional on playing habit, and Harvard well-being guides comes switch Your playing, switch your existence, a landmark new publication and is the reason how playing difficulties are regarding different underlying matters: resembling nervousness, temper fluctuation, trouble with impulse keep watch over, and substance abuse difficulties. Dr. Shaffer bargains a sequence of self-tests to assist assessment the measure of playing challenge and research the mental and social context of the habit, with particular options and methods for finishing the issues with easy instruments that any one can do.
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Additional info for Extreme heat : a prevention guide to promote your personal health and safety
Chemical and Pharmacologic Cardioprotectors Several compounds have been studied that may be able to mitigate the cardiotoxic properties of anthracyclines. Chemical cardioprotection, as with other strategies to reduce these agents’ cardiotoxicity, is based on the premise that the mechanisms that further cardiac damage differ from those of oncologic efficacy. Were this not the case, cardioprotection would come at the cost of reduced effectiveness. Initial attempts at cardioprotection were based on mechanistic similarities and the similarities in pathologic changes with α-tocopherol (vitamin E) deficiency and doxorubicin cardiotoxicity; this agent is an important lipid-soluble antioxidant.
Such a sliding scale for positivity, while intriguing, would require a complex program that includes variations in cycle dose, cycle timing, and risk factor corrections; what would be significant for a given patient might not be so for another. To a great extent, this is not entirely at variance with what we, as effective clinicians, already undertake; we integrate all available clinical data to arrive at an individualized pretest probability of disease that we use to guide our interpretation of test results.
By selecting patients in whom a cardiac problem is suspected on the basis of clinical assessment, the predictive value of ejection fraction testing rises and approaches useful levels even at intermediate TABLE 2-6 C ARDIAC M ONITORING CUMULATIVE DOSE (STANDARD DOXORUBICIN EQUIVALENT) OR TIME AFTER COMPLETION OF DOXORUBICIN OF cumulative dosages. For patients with cardiac signs, symptoms, or risk factors, and ejection fraction decreases of >10 percentage points, confirmation is appropriate, as are less cardiotoxic regimens.