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These negative effects usually subside within 3 days of initiating regular topical treatment and are lessened by applying no more than 3-4 times daily (Bernstein et al menstrual relief hormone balance discount generic alendronate canada. Contact dermatitis from direct handling of chili peppers has been reported (Williams et al women's health center of oregon buy 35 mg alendronate amex. This study concluded that chili is relatively non-toxic at the doses tested (Jang et al women's health clinic tweed heads cheapest generic alendronate uk. No information on the safety of the fruit or the leaves in children or during pregnancy or lactation has been identified in the available literature zyprexa menstrual cycle purchase alendronate cheap online. Anticoagulants, antiplatelet agents, thrombolytic agents and low molecular weight heparins: concurrent use may increase risk of bleeding; barbiturates: until clinical significance of interaction is determined, discourage concomitant use of capsaicin. Major chemical constituents of the fruit include: capsaicin (trans-8-methyl-N-vanillyl-6-nonenamide; Bernstein et al. The fruit (red bell pepper variety, raw) is a significant source of folate, iron, potassium and vitamins A, B6, C and K (U. Caution: Hands should be washed immediately after handling (unless treating the hands) to avoid accidental contact with the eyes or mucous membranes which can be highly irritating. Ingestion of chili pepper (Capsicum annuum) reduces salicylate bioavailability after oral aspirin administration in the rat. Chemopreventive effects of capsaicin and diallyl sulfide against mutagenesis or tumorgenesis by vinyl carbamate and N-nitrosodimethylamine. A randomized vehicle-controlled trial of topical capsaicin in the treatment of postherpetic neuralgia. This mixture is kept in the refrigerator and is administered by the spoonful as needed, approximately 2-3 tablespoons per day (Yukes et al. Traditional Uses: For high blood pressure, raw garlic can be eaten, prepared as a tea or combined with orange juice and taken as a drink. Fresh cloves of garlic are used to treat upper or lower respiratory tract infections such as cold, flu, sore throat and cough. This plant is also used for arthritis, diabetes and high cholesterol as a tea prepared by infusion or decoction. Distribution: this plant is native to the Northern Hemisphere, most likely originating in Central or South Asia and is cultivated widely for culinary purposes (Bailey Hortorium Staff 1976). When used externally, there have been numerous reports (particularly in young children) of irritation, necrosis and burning of the skin; however, these cases mostly involve extremely prolonged exposure (several hours or even days; cases with children: Parish et al. Garlic may also inhibit the efficacy of drugs that are metabolized through cytochrome P450 2E1 (Gurley et al. Evidence suggests that eating fresh garlic may be the most therapeutic way to use this herb because one of its most active constituents, allicin, loses its potency when heated (Gruenwald et al. Indications and Usage: Allium sativum is approved by the German Commission E for use as a supportive therapy or preventive agent for arteriosclerosis, hypertension and high cholesterol, administered as minced fresh bulb, dried and powdered bulb, oil or other preparations made from the fresh bulb. Clinical Data: Allium sativum Activity/Effect Antianginal Preparation Intravenous garlicin (60 mg/day) Design & Model Randomized, controlled clinical trial (n=34): duration: 10 days; patients with peripheral artery occlusion disease; control: nitroglycerine (n=21) Randomized, doubleblinded, placebocontrolled clinical trial: 152 participants; duration: 48 mo Randomized, singleblinded, placebocontrolled clinical trial (n=100): during 3rd trimester of pregnancy Randomized, doubleblind, placebocontrolled crossover study (n=34; duration: 44 wks) Results Significant improvement in electrocardiogram (62%) & symptoms; lowered blood sugar & plasma endothelin levels Significant reduction in plaque volume; results suggest possible curative role in plaque regression Reduced incidence of hypertension but not preeclampsia in nulliparous pregnant women Showed selective inhibition of platelet aggregation & adhesion Reference Li et al. In vivo: rats; Raw garlic extract measured serum levels demonstrated of thromboxane B2 significant antithrombotic effect while boiled garlic extract had very little effect; no adverse effects reported due to taking garlic frequently in low doses In vitro study of P450 Showed inhibition of isoenzymes and Pcytochrome P450 2C, glycoprotein 2D & 3A mediatedmetabolism of isoforms In vivo: diabetic mice Extract lowered serum glucose levels, nociceptive response In vivo: psychological Extract inhibited stress-exposed mice stress-induced immune suppression as evidenced by its prevention of the anticipated decrease in spleen weight & cell quantity Reference Fallon et al. The molecular basis of the antiplatelet action of ajoene: direct interaction with the fibrinogen receptor. Effects of garlic on 7,12Dimethylbenz[a]anthracene-induced hamster buccal pouch carcinogenesis. Garlic consumption and cancer prevention: meta-analyses of colorectal and stomach cancers. The effect of a Garlic preparation on plasma lipid levels in moderately hypercholesterolemic adults. Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey. Koscielny J, Klussendorf D, Latza R, Schmitt R, Radtke H, Siegel G, Kiesewetter H.

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The greater occipital nerve pierces the fascia just below the superior nuchal ridge along with the occipital artery womens health for life generic 70 mg alendronate free shipping. It supplies the medial portion of the posterior scalp as far anterior as the vertex menstruation tracker purchase discount alendronate line. The lesser occipital nerve arises from the ventral primary rami of the second and third cervical nerves menstruation twice a month buy 35mg alendronate with mastercard. The lesser occipital nerve passes superiorly along the posterior border of the sternocleidomastoid muscle women's health big book of exercises pdf purchase alendronate amex, dividing into cutaneous branches that innervate the lateral portion of the posterior scalp and the cranial surface of the pinna of the ear. Selective blockade of greater and lesser occipital nerves can provide the pain management specialist with useful information when trying to determine the cause of cervicogenic headache. Cervical facet block the cervical facet joints are formed by the articulations of the superior and inferior articular facets of adjacent vertebrae [6]. Except for the atlanto-occipital and atlantoaxial joints, the remaining cervical facet joints are true joints in that they are lined with synovium and possess a true joint capsule. This capsule is richly innervated and supports the notion of the facet joint as a pain generator. The cervical facet joint is susceptible to arthritic changes and trauma caused by acceleration-deceleration injuries. Such damage to the joint results in pain secondary to synovial joint inflammation and adhesions. Each joint receives fibers from the dorsal ramus at the same level as the vertebra as well as fibers from the dorsal ramus of the vertebra above. This fact has clinical importance in that it provides an explanation for the ill-defined nature of facet-mediated pain and explains why the branch of the dorsal ramus arising above the offending level must often also be blocked to provide complete pain relief. At each level, the dorsal ramus provides a medial branch that wraps around the convexity of the articular pillar of its respective vertebra and provides innervation to the facet joint. Selective blockade of cervical facet joints can provide the pain management specialist with useful information when Stellate ganglion block the stellate ganglion is located on the anterior surface of the longus colli muscle. This muscle lies just anterior to the transverse processes of the seventh cervical and first thoracic vertebrae. The stellate ganglion is made Diagnostic and Prognostic Nerve Blocks trying to determine the cause of cervicogenic headache and/or neck pain. The greater, lesser, and least splanchnic nerves provide the major preganglionic contribution to the celiac plexus. The nerve travels along the thoracic paravertebral border through the crus of the diaphragm into the abdominal cavity, ending on the celiac ganglion of its respective side. Interpatient anatomical variability of the celiac ganglia is significant, but the following generalizations can be drawn from anatomical studies of the celiac ganglia. The ganglia located on the left are uniformly more inferior than their rightsided counterparts by as much as a vertebral level, but both groups of ganglia lie below the level of the celiac artery. Postganglionic fibers radiate from the celiac ganglia to follow the course of the blood vessels to innervate the abdominal viscera. These organs include much of the distal esophagus, stomach, duodenum, small intestine, ascending and proximal transverse colon, adrenal glands, pancreas, spleen, liver, and biliary system. It is these postganglionic fibers, the fibers arising from the preganglionic splanchnic nerves, and the celiac ganglion that make up the celiac plexus. The diaphragm separates the thorax from the abdominal cavity while still permitting the passage of the thoracoabdominal structures, including the aorta, vena cava, and splanchnic nerves. The diaphragmatic crura are bilateral structures that arise from the anterolateral surfaces of the upper two or three lumbar vertebrae and disks. The crura of the diaphragm serve as a barrier to effectively separate the splanchnic nerves from the celiac ganglia and plexus below.

The average incidence of pain in cancer is 33% in the early stage and around 70% in the late stage of disease menstruation quotes quality alendronate 70 mg. With regard to pain intensity menstrual meme purchase genuine alendronate on-line, about half of patients report moderate or major pain pregnancy tips order 70 mg alendronate with mastercard, with the incidence of major pain tending to be highest in cancer of the pancreas women's health center lansdale pa alendronate 70 mg otc, esophagus, and stomach. Typical causes of pain in gastrointestinal cancer include stenosis in the small intestines and colon, capsula distension in metastatic liver disease, and obstructions of the bile duct and ureter due to infiltration by cancer tissue. Such visceral pain is difficult to localize by the patient due to the specific innervation of the abdominal organs, and it may appear as referred pain. From the literature, we know that in more than 90% of patients, the pain may be controlled with simple pain management algorithms. Observational studies from palliative care institutions, such as the Nairobi Hospice, Kenya, report an almost 100% success rate with a simple pain algorithm. Coanalgesics and invasive therapy options are rarely indicated (see other chapters on general rules for cancer pain management and on opioids). If fluoroscopy is available, along with adequately trained clinicians, neurolysis of the celiac plexus may be used to reduce the amount of opioids and augment pain control in hepatic and pancreatic cancer. Why it is so difficult for the patient with visceral pain to identify exactly the spot that hurts? Visceral afferent fibers (pain-conducting C fibers) converge on the spinal level at the dorsal horn. Therefore, discrimination of pain and exact localization of the source of pain is impossible for the patient. A patient with pancreatic cancer would never tell the doctor that his pancreas hurts, but instead will report "pain in the upper part of the belly" radiating around to his back in a bandlike fashion. The nociceptive pain conducting afferent nerve fibers of some of the visceral organs meet sympathetic efferent fibers before reaching the spinal cord in knots called nerve plexuses. This situation allows an interesting therapeutic option: interruption of the nociceptive pathway with a neurolytic block at the site of the celiac plexus. This is one of the few remaining "neurodestructive" therapeutic options still considered useful today. Nerve destruction at other locations has been shown to cause more disadvantages than benefits to the patient, such as anesthesia dolorosa (pain in the location of nerve deafferentation). Why are some people reluctant to use morphine or other opioids in patients with gastrointestinal cancer? From early studies, we know that one of the undesired effects of morphine is the induction of spasticity at the sphincter of Oddi and bile duct. This opioid side effect is mediated through the cholinergic action of opioids as well as through direct interaction of the opioids with mu-opioid receptors. Recent studies have not confirmed these findings, and so morphine can be used without reservations. Generally, pain of the intra-abdominal organs originates from the stimulation of terminal nerve endings, and is referred to as visceral-somatic pain, as opposed to pain from nerve lesions, which is called neuropathic pain. The pain characteristic most often reported by the patient is that it is not well localized. Patients typically describe the pain as generally "dull" or "pressing," but sometimes "colicky. For colon and pelvic organ cancers, the target is the myenteric plexus, and for bladder and rectosigmoid cancers, the hypogastric plexus is the target. However, these techniques should only be used by experienced therapists-book knowledge is definitely insufficient. The indication for a neurolytic block in pancreatic cancer is well recognized because of the rapid progression of the disease and its insufficient sensitivity to radiotherapy and chemotherapy. From the literature, we know that up to 85% of patients do benefit from a neurolytic block. Although serious side effects from neurolysis of the celiac plexus are rare, the facts have to be explained to the patient, and an informed consent form should be signed. It is estimated that worldwide 1 in 8 individuals suffer, at least from time to time, from constipation.

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Additional botanical references consulted are cited in the "Botanical Description" section of each monograph breast cancer bake sale ideas purchase alendronate 70 mg with amex. Biomedical Literature Research To compile relevant biomedical literature on the safety and efficacy of medicinal plants included in this guidebook menstrual night sweats cheap 70mg alendronate overnight delivery, several databases and references have been consulted omega 7 menopause cheap 35mg alendronate with mastercard. Preclinical and laboratory studies are also included in this guidebook breast cancer 8mm purchase alendronate without a prescription, even though generally their results cannot be applied to humans. For example, if a particular plant is applied topically as an herbal remedy for dermatological conditions, in vitro or animal studies that demonstrate the antimicrobial or antiinflammatory activity of the traditional preparation of the plant could support or validate its external use as long as the plant has been shown to be nontoxic. It is important to keep in mind that considerable variation exists in the amount of published clinical and pharmacological research available for a given plant. Plants for which more research has been conducted (particularly those that are sold commercially on a large scale) will have more information available on safety, contraindications, herb-drug interactions and clinical applications. This database is a valuable resource for those interested in further study on Caribbean medicinal plants. For a brief summary of the clinically relevant information on a particular plant, consult Part 2: "A Quick Guide to Home Remedies" by searching for the common name of the plant. Information in this section is organized alphabetically by Spanish or English common name. For more detailed information about medicinal plants, including botanical descriptions, photographs or illustrations, indications and usage (if available) and references cited, see Part 3: "Medicinal Plant Profiles. If the same plant species has more than one common name, or if more than one plant species is referred to by the same common name, an explanation is provided as a "Note" below the Latin name. Other Spanish and English common names, besides the one most frequently reported for that species, are listed. Botanical synonyms (other accepted scientific names that are used widely in the literature), are listed when appropriate. Detailed explanations of each type of preparation are provided in the "Quick Guide" section of this book, listed by Spanish name (see Part 2). Sources from which each plant is typically procured in the New York City area (or other urban areas in the United States) are listed in this section based on botanical collection and ethnomedical interviews with Dominican New Yorkers. The origin and range of each plant, including preferred habitat, is included when available. The exact origin of a particular species may be difficult to determine and is often disputed within the botanical community. Any information identified in the scientific literature on the safety and potential adverse effects of each plant is provided in this section, including precautions, contraindications, drug interactions and results of toxicity studies when available (see subheadings below). This information is separated from the initial description on safety and precautions because it is difficult (if not impossible) to apply and extrapolate the results from animal toxicity studies to humans. A review of the scientific literature on the pharmacological activity and therapeutic efficacy of each plant species is summarized. If numerous relevant biomedical studies have been published on a particular plant, these are presented in table format for ease-of-use at the end of each plant entry (see "Clinical, Preclinical and Laboratory Data Tables" section below); otherwise, results are summarized in paragraph form. Major chemical constituents are listed based on relative abundance and/or biological activity when this information is available. For more information on plant identification, please see the "Methods: Botany and Plant Taxonomy" section of this introduction. Botanical nomenclature is based on the taxonomic work of Carolus Linnaeus (1707-1778), the botanist who established the binomial system of plant nomenclature. A genus (the plural of which is genera) may be composed of a single species or several hundred. This person is called the author of the species name; for example, in the case above, the complete name, which would allow for the most precise identification, is Allium sativum L. In: Traveling Cultures and Plants: the Ethnobiology and Ethnopharmacy of Human Migrations. If you do not find a particular plant listed in this section, check the index in the back of the book as it may be included under a different common name.

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