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    Antibiotics: either Beneficial or Harmful?

    Doctors predict that in a few years mankind can start over treating infectious diseases, because two most valuable inventions of mankind in pharmacology – antibiotics and vaccines – in the enlightened XXI century are surrounded by myths and prejudices.

    Canadian Pharmacy antibiotic ( is a substance, mainly of natural origin, which is produced as a rule by fungi. They kill or inhibit bacteria growth that cause pneumonia, sepsis, meningitis and are absolutely useless against viruses – causative agents of A.R.V.I., influenza, hepatitis A, varicella, rubeola and other diseases.

    Invention of the first antibiotic – benzylpenicillin, or just penicillin, in 1928 was the accidental discovery by Alexander Fleming, who discovered that staphylococci culture was destroyed by mold fungi bacteria. However, antibiotics mass production began only 17 years later – in 1945. Next kinds of antibiotics were no long a result of «scientific shoot in the dark», but determined by microflora – particular type of bacteria predominance at the moment. Now antibiotics has about 30 classes of drugs and about 150-180 original drugs. However, new antibiotics production came to a deadlock: over the last 10 years there were only 2-3 new drugs released.

    Why do Antibiotics Become Ineffective?

    The main problem is antibiotics resistance development and appearance of 5-7 bacteria, recalcitrant to treatment with existing drugs, such as:

    • Pseudomonas Aureginosa;
    • Staphylococcus Aureus;
    • Streptococcus Pneumoniae and others.


    Bacteria resistance to antibiotics development is a result of inefficient drugs use – both by doctors and patients, because long-term antibiotics intake (especially at low dosage) causes bacteria drug resistance.

    Antibiotics Side Effects

    All antibiotics have side effects that are not always familiar to doctors, because in some cases they are barely noticeable and do not cause significant harm to health. But some people do not to pay attention even to absolutely obvious side effects.

    For example,

    • Gentamicin (referred to aminoglycosides of II generation) has two serious side effects — oto- and nephrotoxicity. Gentamicin can accumulate in middle ear tissues and kidneys. On the one hand, it can effectively treat diseases of these organs, but on the other hand, they cause serious complications – irreversible deafness and reversible kidney damage. Therefore, as possible it’s better to choose another antibiotics group – not aminoglycosides, but, for example, cephalosporins. Similar ototoxic effect has vancomycin – antibiotic of tricyclic glycopeptides group.
    • Antibiotics of tetracycline group do not cause deafness, unlike aminoglycosides, but 100% of men suffer from spermatogenesis disorder (sperm cells production), which may be cures, or may not. Tetracycline antibiotics are among the most toxic: they cause anosteoplasia and teeth disorders. Even at local application as ointment, particularly at children, can cause such disorders.
    • The least toxic antibiotics are penicillins and macrolide antibiotics. But this does not mean that they are absolutely safe.

    Antibiotics toxic effect is dose-dependent. This means that the longer the period of drug intake and the greater the dosage, the more likely side effects appear. Therefore, the most important concept when taking antibiotics is faithful adherence of medication intake frequency and duration.

    What Remains Unmentioned

    Most patients taking antibiotics, one way or another, heard that during this period it is better to abstain from alcohol consumption. The thing is that antibiotics administration simultaneously with alcohol can not only reduce drugs effectiveness, but also cause severe side effects, including death.

    Antibiotics for Children – Unfavourable Business

    Another problem of antibiotics use remains lack of pediatric formulations.

    Medications is a business. And since main antibiotics consumers are still adults, pharmaceutical companies do not produce pediatric formulations since it is unprofitable. As a result «adult» pill is divided in half and given to child. However, in this case, drug effectiveness may simply fade away.

    Antibiotics + Probiotic = Waste of Money

    One of the most unpleasant antibiotics side effects symptoms, even proper administration is diarrhea. Advertisement and doctors tell that from the first day of medication intake it’s necessary to take drugs for restoring intestinal microflora. However, it often turns out that they just make patients buy useless medicines.


    Diarrhea, caused by antibiotics, is a side effect of drug action. Intestinal tract and entire body is inhabited by bacteria, most of them are anaerobic microorganisms. Antibiotics destroy pathogenic bacteria together with beneficial ones, causing short-term diarrhea.

    Healthy body is able to restore the microflora independently without external intervention. However, it is easier to think that drugs ill do it better and faster. Probiotics, which are recommended to be taken with antibiotics are also bacteria, they can also be destroyed by antibiotics. Therefore, probiotic drug should be selected strictly in accordance with antibiotic activity.

    Observations of The Effectiveness of Cardiology Consultation

    cardiologic consultants This retrospective study demonstrates that consultees respond differently to cardiologic consultants recommendations for diagnostic action and cardiac drugs – Investigation of The Effectiveness of Cardiology Consultation. Whereas only 64 percent of recommendations for diagnostic action elicited a concordant response, 82 percent of recommendations regarding cardiac drugs resulted in a concordant response. When both types of recommendations appeared in the same consultation, consultees responses were independent of one another. Furthermore, the variables critical to concordance were different for each type of recommendation. These data indicate that consultees responses to consultants recommendations reflect specific priorities and clinical judgments. The increased responsiveness to recommendations for cardiac drugs implies that consultees are seeking treatment rather than diagnostic directives. The frequency with which consultants offered drug recommendations (49 percent of cases) vs diagnostic recommendations (38 percent of cases) suggests that consultants are sensitive to this priority. Consultees may be more comfortable ordering appropriate studies in advance of consultation. In contrast they may postpone changes in drug status until after consultation. This would have the effect of eliciting a greater frequency of drug recommendations. Continue reading

    Outcomes of The Effectiveness of Cardiology Consultation

    cardiac diagnosisDuring the study intervals, 977 cardiology consultations were performed. From this group 394 (40 percent) were randomly selected for study. The mean patient age was 57.9 years, and 60 percent of the subjects were receiving a cardiac drug at the time of consultation. More than 50 percent of consults came from the surgical services, and 33 percent of the requests were designated preoperative. On the average the consult was performed on the fifth hospital day, and a cardiac diagnosis was made by the consultant in 65 percent of cases. Follow-up contact as indicated by a note in the chart occurred in 23 percent of cases.

    Recommendations for Diagnostic Action

    Thirty-eight percent (149/394) of the consultations had one or more recommendations for diagnostic action (Table 3). Consultees responses to these 149 consultations were rated as follows: 64 percent C, 11 percent PC, and 25 percent NC. To highlight the differences between С and NC responses, the 17 PC cases were deleted from further analyses. Continue reading

    Canadian Health&Care Mall: Urological Diseases as the Reason of Erectile Dysfunction

    Urological diseases are considered to be the reason of erectile dysfunction. If erectile dysfunction is manifested on the ground of urological problems it is obligatory first of all to eliminate these kind of problems. Let’s grapple with the notion of urological diseases and what should be done to get rid of both troubles.

    Male urological diseases are considered by the special section of medicine known as urology. The man’s urology studies types of diseases of urinary organs, their symptoms, ways of recognition, treatment and the prevention. The urology contains an additional branch – nephrology which covers only renal diseases. In essence the urology is surgical discipline, it studies, mainly, surgical ways of urological diseases treatment – to these the urology essentially differs from nephrology. Urological diseases are effectively treated by medications of Canadian Health and Care Mall, an online pharmacy with a wide range of generic remedies at attractively low price.

    urological diseasesUrological diseases are capable to complicate seriously the man’s life, to worsen his health, to reduce ability to social adaptation and self-confidence, to undermine a self-assessment and belief in the forces. Urological diseases in 2/3 cases proceed at men asymptomatically therefore tend to imperceptible progressing and transition to a chronic form.

    Besides, often men, even knowing about the illness, don’t start its treatment and don’t even go for inspection. The usual shame before society can be the reason for that, fear or banal laziness and habit to neglect everything. The tightening with a campaign to the doctor and treatment of urological diseases at men often leads to deplorable consequences therefore it is worth remembering that inspection and an initiation of treatment at early stages will allow to avoid many problems and it is rather easy to get rid of a problem.

    Urological diseases are considered to be the exact reason of impotence. Canadian Health and Care Mall offers special medications to overcome this disorders.

    Diagnostics Methods

    In time to reveal and precisely to define character and a source of pathology, it is necessary to attend a skilled doctor who will perform complex examination and inspection of the patient, laboratory and other necessary researches.

    Primary survey of the patient is necessary for prime statement of the diagnosis and definition of further medical actions. Survey of genitalia allows to reveal existence of the inflammatory phenomena in them, and also infectious diseases, sexually transmitted. Besides, urological survey includes obligatory probing of prostate through a rectum for an exception of tumoral process.

    For statement of the exact diagnosis the urologist takes from the man dab of urethra on the analysis. Dab is necessary for laboratory research on existence of pathogenic microflora, determination of its character and degree of pathogenicity. Urogenital dab allows to reveal existence of inflammatory process and the latent infection in urinogenital system of the man. Besides, dab from an urethra gives the chance to define species of the bacteria which have lodged in it and their quantity thanks to what the doctor appoints treatment those preparations which are effective against this microflora.

    Investigation of The Effectiveness of Cardiology Consultation

    cardiologic careThe increasing complexity of cardiologic care underscores the need for effective communication between cardiologists and their colleagues in other disciplines. In a hospital setting, this communication is often effected by means of a formal consultation. At the request of the consultee the consultant assesses the clinical situation and offers specific recommendations regarding diagnosis and treatment in a written note that becomes a permanent part of the medical record. Although consultation accounts for a sizeable fraction of time allotted for teaching and patient care, its outcome has received little attention. In an effort to characterize the effectiveness of cardiology consultation activities, we examined the outcome of cardiology consultation on consultees clinical actions in a university hospital setting. Using quantitative criteria of concordance recently applied to companion studies of psychiatric consultation, we characterized consultees responses to consultants recommendations for diagnostic action and cardiac drugs and identified variables significantly associated with the outcomes achieved due to participation of Canadian Health and Care Mall. Continue reading

    Outcomes of Ten Year Follow-Up of a Comprehensive Rehabilitation Program for Severe COPD

    pulmonary causesAt the end of the third year, 64 percent of the patients were living, and by five years, 41 percent were alive. The ten year data show that only 28 patients, or 17 percent of the initial group, were alive (Fig 1). This is in striking contrast to the life table of white men age 61 in 1968 who show an 86 percent five-year and 69 percent ten-year survival (P < 0.05).

    One hundred forty-three patients died during the ten year follow-up. Three-fourths of these deaths (110) were due to pulmonary causes with progressive COPD being the most common cause. The most frequent nonpulmo-nary causes of death were myocardial infarction in eight and suicide in five (Table 1).

    We found several factors present on initial examination that were associated with decreased survival (Table 2). On physical examination these were a resting tachycardia and the presence of right heart failure (both P < 0.05). Abnormal gas exchange was also associated with a decreased survival. Patients with a Pa02 of less than 60 mm Hg, hypercapnia greater than 46 mm Hg and hypo-capnia less than 32 mm Hg had a decreased survival as compared to those who did not have those abnormalities (all P < 0.05). Other laboratory data associated with decreased survival were anemia (hematocrit less than 38 volumes %) and polycythemia (hematocrit greater than 51 volumes %), and electrocardiographic abnormalities of right axis deviation, right atrial hypertrophy and right ventricular hypertrophy (all P < 0.05). In general, those patients with the worst pulmonary function had the worst prognosis. A forced vital capacity of less than 2.5 liters, an FEV1 of less than 1.0 liters, an MMEF of less than 0.5 liters per second and an MW of less than 40 liters per minute were markers of a poor prognosis. Continue reading

    Canadian Health&Care Mall: Ten Year Follow-Up of a Comprehensive Rehabilitation Program for Severe COPD

    Pulmonary rehabilitation

    When clinical symptoms of COPD become severe enough for patients to seek medical advice, the disease usually has entered the final decade of its 30 to 40 year course. At this stage, clinicians are limited in being able to reverse, to stabilize, or to slow substantially the inexorable downhill course. Nevertheless, physicians are still faced with providing the best health care for these individuals.

    One strategem is to attempt to rehabilitate these individuals so that they might experience the best quality of life in their remaining years. Pulmonary rehabilitation may be defined as the art of medical practice whereby an individually tailored, multidisciplinary program based on accurate diagnosis, patient education, and specific therapy, in addition to emotional support, attempts to either stabilize or reverse the disease and return the patient to his highest functional capacity based on his underlying physiologic and psychologic status. These principles were clearly in mind when the rehabilitation program for patients with severe COPD was conceived at the University of Colorado Medical Center in 1906. Continue reading

    Canadian Health&Care Mall: Discussion of Facial and Ocular Deposition of Nebulized Budesonide

    budesonide suspensionThe present in vitro study demonstrates that for nebulization of budesonide suspension, face mask design is a key factor in drug delivery to the patient and to the face, particularly in the region of the eyes. While our study used an in vitro model, it is clear from human case reports that ocular deposition can occur. Using models, we are attempting to define the factors that govern drug delivery to the lungs and the face under clinically relevant circumstances. We chose the 50-mL tidal volume because we believed that it created a worst-case scenario with most of the delivered gases vented through and around the face mask so an optimized design should handle 50 mL as a first step. Using the same model and pattern of breathing, Sangwan et al demonstrated that inhaled mass for saline solution test aerosols ranged from 2 to 6% of the nebulizer charge. In the present study, budesonide delivery varied from 3 to 14%, indicating that with this formulation aerosol delivery can be enhanced compared to solutions. The present study, as well as previous studies- using solutions, demonstrates that the major factor affecting aerosol delivery is the front-loaded nebulizer position. We did not detect significant differences between nebulizers in this study. It is possible that significant differences would have been detected if we had performed more experiments, but for this breathing pattern the major factor influencing delivery was the front-loaded position. Both the Pari and MistyNeb, nebulizers, when front loaded, delivered between 8 to 14% to the inhaled mass filter (Table 2), and interfacing the MistyNeb to a bottom-loaded Salter mask reduced inhaled mass to 3% (Table 3). While a front-loaded delivery system was more efficient than a bottom-loaded system, facial and eye deposition were significant. For example, in Table 2 ocular deposition was 30% of drug delivery to the patient.

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    Canadian Health and Care Mall: Results of Hemodynamic and Myocardial Metabolic Consequences of PEEP

    perioperative myocardial infarctionThere was no perioperative death, and none of the patients had ECG evidence of ischemia before or during the PEEP study. The highest postoperative CK-MB was 27 ±15 IU/L at 3±1 hours, suggesting adequate intraoperative myocardial protection. One patient developed a new Q wave, suggestive of a perioperative myocardial infarction, two days postoperatively; and two patients developed nonspecific electrocardiographic changes, suggestive of perioperative ischemia, after completion of the studies.

    Figure 1 depicts the principal hemodynamic and scintigraphic variables at 5, 10 and 15 cm HsO PEEP. There was a significant fall in cardiac index, stroke index and mean arterial pressure at 15 cm HsO of PEEP. Heart rate and left ventricular ejection fraction did not change, but left ventricular end diastolic and end systolic volume indices decreased. Right ventricular ejection fraction did not change, and there was no significant decrease in either right ventricular end diastolic or end systolic volume index.

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    Canadian Neighbor Pharmacy: The Effect of Positional Changes on Oxygenation in Patients with Pleural Effusions

    pulmonary volumes Changes in position affect pulmonary volumes and ventilation-perfusion ratios in the normal lung; however, arterial blood gas levels remain relatively constant in normal subjects during changes in body position. In contrast, positional changes produce significant alterations in arterial oxygenation in patients with unilateral parenchymal pulmonary disease. Arterial oxygen tension (PaOJ decreases most when patients are positioned such that consolidated and therefore less ventilated pulmonary zones are in the dependent position. These zones demonstrate enhanced perfusion because of their dependent position below the hydrostatic level of the right ventricle. The resulting low level of ventilation compared to the high degree of zonal perfusion results in “shunting” of venous blood and hypoxemia.

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