kbordson

This is such a cute thread!!

There is no "excuse" for that, but I would like to hear the full story behind it. I'm not saying to give the hospital the benefit of the doubt... but I am wondering what the triage nurse thought or how the woman actually presented (did she look more stable than she truly was, did they get initial vitals and she was "normal" when just then a gsw or mva came in? or were they just dismissive just because "no hable" and that attitude killed this poor woman)

pubmed: (edit to add this one too!!!) Eur J Pharm Sci. 2006 May;28(1-2):59-66. Epub 2006 Feb 17. Effect of a mixture of caffeine and nicotinamide on the solubility of vitamin (B2) in aqueous solution. Evstigneev MP, Evstigneev VP, Santiago AA, Davies DB. Department of Physics, Sevastopol National Technical University, Studgorodok, Sevastopol, 99053 Crimea, Ukraine. max_evstigneev@mail.ru The effect of caffeine (CAF) and nicotinamide (NMD) on the solubility of a vitamin B2 derivative (FMN) has been evaluated for mixtures containing either a single hydrotrope (CAF or NMD) or the two hydrotropes simultaneously. A model for analysis of ternary systems, which takes into account all possible complexes between the molecules, has been developed and tested with experimental NMR data on the three-component mixture FMN-CAF-NMD. The results indicate that special attention should be given to the concentration of a hydrotropic agent used to enhance the solubility of a particular drug. A decrease in the efficacy of solubility of the vitamin on addition of large amounts of hydrotropic agent is expected in the two-component systems due to the increased proportion of self-association of the hydrotrope. It is found that a mixture of two hydrotropic agents leads to an increase in the solubility of the vitamin in three-component compared to the two-component system. Rather than using just one hydrotropic agent, it is proposed that a strategy for optimising the solubility of aromatic drugs is to use a mixture of hydrotropic agents. J Steroid Biochem Mol Biol. 2007 Mar;103(3-5):368-71. Epub 2007 Jan 12. Caffeine decreases vitamin D receptor protein expression and 1,25(OH)2D3 stimulated alkaline phosphatase activity in human osteoblast cells. Rapuri PB, Gallagher JC, Nawaz Z. Bone Metabolism Unit, Creighton University, School of Medicine, 601 North 30th Street, Omaha, NE 68131, USA. thiyyari@creighton.edu Of the various risk factors contributing to osteoporosis, dietary/lifestyle factors are important. In a clinical study we reported that women with caffeine intakes >300 mg/day had higher bone loss and women with vitamin D receptor (VDR) variant, tt were at a greater risk for this deleterious effect of caffeine. However, the mechanism of how caffeine effects bone metabolism is not clear. 1,25-Dihydroxy vitamin D(3) (1,25(OH)(2)D(3)) plays a critical role in regulating bone metabolism. The receptor for 1,25(OH)(2)D(3), VDR has been demonstrated in osteoblast cells and it belongs to the superfamily of nuclear hormone receptors. To understand the molecular mechanism of the role of caffeine in relation to bone, we tested the effect of caffeine on VDR expression and 1,25(OH)(2)D(3) mediated actions in bone. We therefore examined the effect of different doses of caffeine (0.2, 0.5, 1.0 and 10mM) on 1,25(OH)(2)D(3) induced VDR protein expression in human osteoblast cells. We also tested the effect of different doses of caffeine on 1,25(OH)(2)D(3) induced alkaline phosphatase (ALP) activity, a widely used marker of osteoblastic activity. Caffeine dose dependently decreased the 1,25(OH)(2)D(3) induced VDR expression and at concentrations of 1 and 10mM, VDR expression was decreased by about 50-70%, respectively. In addition, the 1,25(OH)(2)D(3) induced alkaline phosphatase activity was also reduced at similar doses thus affecting the osteoblastic function. The basal ALP activity was not affected with increasing doses of caffeine. Overall, our results suggest that caffeine affects 1,25(OH)(2)D(3) stimulated VDR protein expression and 1,25(OH)(2)D(3) mediated actions in human osteoblast cells. PMID: 17223552 [PubMed - indexed for MEDLINE] Eur J Pharm Sci. 2000 Mar;10(1):17-28. Caffeine and nicotinamide enhances the aqueous solubility of the antimalarial agent halofantrine. Lim LY, Go ML. Department of Pharmacy, National University of Singapore, 10 Kent Ridge Crescent, Singapore, Singapore. The aqueous solubility of the antimalarial agent halofantrine in phosphate buffers pH 5.9 and 7.0 (ionic strength 0.08) is increased by the addition of caffeine and nicotinamide. Solubility is increased to a greater extent in the presence of caffeine (12.5-125 mM) than nicotinamide (125 mM -2.0 M). The greatest increase in solubility was observed at pH 5.9 where the basal solubility of halofantrine rose from 0.91 to 435 microM when 125 mM caffeine was added. Phase solubility studies support the formation of a 1:1 complex between caffeine and halofantrine which is characterised by a K(1:1) constant of 2.75x10(3) M(-1) (pH 5.9). A less stable 1:1 complex is formed at pH 7.0 (K(1:1)=6.37x10(3) M(-1)). Differential scanning calorimetry of solid mixtures of caffeine and halofantrine showed the absence of the endotherms of the two drugs and the appearance of a distinct endotherm (with a smaller enthalpy) characteristic of the complex. An analysis of the 1H-NMR spectra of mixtures of caffeine and halofantrine revealed perturbations in the chemical shifts of the methyl group and proton at positions 4 and 8 of caffeine, and a change in splitting pattern of the H(9) proton of the phenanthrene ring in halofantrine. PMID: 10699380 [PubMed - indexed for MEDLINE]

What part of this can't be understood? She HAS an appointment. So please don't call her names. She's just looking for more. I just hope next Monday is not too late. That's actually pretty good for getting an outpatient surgical consult. If she has an attack - that's what the ER is for. (just don't go to that one in CA)

What part of this can't be understood? She HAS an appointment. So please don't call her names. She's just looking for more.

Don't get discouraged! It all happens when it's supposed to.... and even if some finish in 2.5yrs and others take 10+, what's most important is that you learn what you need to excel where you want to be. Don't compare your journey to others with a jaded eye. Your life has taken a course of adventure and change and love.... that is SO MUCH more important than any lil piece of paper!

I LOVE Epcot!! Disney is one of my favorite places! I go every 1-2 years... and love it each time. I might be "childish" or "immature" but there's just something so wonderful about "Happily Every After." It's hopeful and innocent. Life might have disappointments, but the mouse makes me smile!

I would double check your benefits - these days laparoscopy is becoming the standard of care for many, MANY noncosmetic procedures. Most appy's are done through the camera, I do most tubal ligations and many standardly "open" procedures are being done "minimaly invasive." The benefits are more than just cosmetic. Shorter incisions mean faster healing time and shorter hospital stays. If it is your gallblader, surgery is likely your best option. But ask the GI doc about this: Short-term ursodeoxycholic acid treatment improves gallbladder bile turnover in gallstone patients: a randomized trial.

Internet proof so it must be correct! (ps, I like the section on finding European guys to leave behind

Of sorts, I guess I am!

Oh, DAMN ! Can I use that as my sig line????? PLEEEEASE??? I'll pay you Royalties, for every post made with it! Of course you can use that! (and you don't have to pay royalities.... unless you really want to. Then payment in rum will be fine. I don't need any Royalty here.)

Do you go looking for pictures like THAT?! That is a serious case of blue balls

You're as wonderful as a slinkie!! NOT REALLY GOOD FOR ANYTHING BUT THEY BRING A SMILE TO YOUR FACE WHEN PUSHED DOWN THE STAIRS.

[sigh] and my sweet and innocent helpful thread is so tainted.... and yes, the OB/Gyn just said taint

You should know... vitals can be "stable" at a constant 39.5C - HOT, yes... Stable yes.... Normal, nope. (and just in case someone else reads this... I am NOT admitting that I am not "normal." Cuz I am normal. And stable. )

If you had a hoo-ha, I would be happy to doctor it! But I can think of things to do with other parts down there too

That would make the visits kind of boring. Hey... I'm stable. Just depends on the defination of "stable"

For the tactical soccer mom..... better think twice before that advance to the MILF!

This past weekend... I got a diaper bag made by Eagle with the sie pouch for the holster. Not that I need a diaper bag much less one with a pouch for a holster. But... it was Eagle! And digital camouflage! Now, I just have to figure out if I'm going to keep it (just in case) or give it to my sister.

Agreed there are definatley places for Nurse Practicioners, Midwives, Physician Assistants! And my nurse is wonderful! But, I don't expect her to do all the teaching or talking .... (but... I wouldn't mind if she would offer to do all the charting. )

No... we look for those in the patients. Doctors would [shocked voice]never[/shocked voice] do such a thing!

(only a little metal here - teenie tiny screw to hold the new ligament nicely)

I thought this was a nice summary of what you should be looking for when you go and see a new doc.

Actually... sometimes it fun to try to educate them. My stepson used to work for the TSA... and he would come home with the stupidest new regulations for the day.... And never once thought to question the logic behind why this or that is suddenly bad. A regular vogon. I like trying to pry open his tightly sealed eyes...

I think they look kinda cool, and the marketing department is doing a great job... but I think I will wait until gen 2 or 3. I will get one... just let others figure out the glitches first