- Thread starter
- #561
Why thank you Shed. 
SweetSue's Class Notes
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- Start date
Derbybud
Well-Known Member
Like Shed said ^^^
- Thread starter
- #563
Description | English: This is a diagram of a typical central nervous system synapse. The presynaptic and postsynaptic neuron are on top and bottom. Mitochondria are light green, receptors dark green, postsynaptic density is in grey, Brown pyramids represent protein clusters composing the active zone, cell adhesion molecules are brown rectangles, synaptic vesicles are tan spheres, endoplasmic reticulumis the tan structure on the bottom left. |
| Date | 5 April 2011 |
| Source | Own work |
| Author | Curtis Neveu |
- Thread starter
- #564
A little piece I picked up from today’s post at Corrine’s, done by Jennifer (last name left out 
) on the safety of combining St. John’ Work with Cannabis sativa.
St. John’s Wort and Cannabis? Is it safe?
In summary, we can make the following claims about using St. John’s Wort and cannabis:
Agreed!
) on the safety of combining St. John’ Work with Cannabis sativa. St. John’s Wort and Cannabis? Is it safe?
In summary, we can make the following claims about using St. John’s Wort and cannabis:
- In general, St. John’s Wort has an outdated prejudice against it due to false claims as a MAO inhibitor (a type of antidepressant)
- St. John’s Wort and cannabis don’t explicitly mingle with each other since they support two different systems in the body:
- St. John’s Wort supports the nervous system,
- Cannabis supports the endocannabinoid system;
- St. John’s Wort has a history of misuse by consumers, researchers and manufacturers by using an isolated compound (hypericin) rather than using the whole plant;
- Cannabis strains and dosage play a huge role in alleviating depression.
Agreed!
Tennessee Tim
Well-Known Member
DescriptionEnglish: This is a diagram of a typical central nervous system synapse. The presynaptic and postsynaptic neuron are on top and bottom. Mitochondria are light green, receptors dark green, postsynaptic density is in grey, Brown pyramids represent protein clusters composing the active zone, cell adhesion molecules are brown rectangles, synaptic vesicles are tan spheres, endoplasmic reticulumis the tan structure on the bottom left. Date 5 April 2011 Source Own work Author Curtis Neveu
Nerve cells also have tiny electrical charges and it passes from positive to neg, as it transfers signals from cell to cell. so, biochemical electrical activity occurs in our bodies ,just as an electric motor uses a battery or grid current, our body derives what it needs from cellular processes that utilize bio chemical electric power from what we and our environment feeds it. 
sometimes I feel like a walking battery that needs charging or sometimes all charged up. Too often my battery terminals are clogged up with man made crap and I need some maintenance. Cannabis to the rescue! Helps me almost every time!
CBD is great,but it works better with THC at it's side! Walnut cco brownies and ice cream is great for recharging my batteries!- Thread starter
- #566
- Thread starter
- #568
From Royal Queen Seeds: Terpinolene
TERPINOLENE: EVERYTHING YOU NEED TO KNOW
We take a closer look at terpinolene, a fragrant terpene found within our Royal Jack Automatic and Pineapple Kush strains here at RQS. The potential benefits combined with its unique flavour make it a terpene to seek out!
Terpinolene is the terpene partly responsible for the woody, piney smell cannabis can often have, and is one of many to feature in the plant. It is not a cannabis exclusive, though. Terpinolene can also be found in tea tree, conifers, apple, cumin, sage, rosemary and lilac.
Also known as delta terpinene, terpinolene's woody aroma, is often accompanied by citrusy and floral tones. It is a permanent member of the numerous terpenes’ families residing in the cannabis flowers, so let’s meet this hydrocarbon.
TERPINOLENE’S ROLE IN THE TERPENES FAMILY
Terpenes are chemicals with a huge array of fragrances, flavours, and effects. Their extractions from plants are the most important components of the essential oils used in herbal medicine, nutritional supplements and cosmetics. Terpinolene is used as an aroma agent in soaps and perfumes, and also as a component of some insect repellents. As opposed to other terpenes found in cannabis, terpinolene is neither an analgesic nor an anti-inflammatory. However, this terpene is studied for its antifungal and antibacterial properties, and also for its mild sedative action. We are interested in terpinolene as users and patients because it is one of the actors in the synergetic performance that enhances the action of THC and CBD.
RELATED STORY
'Entourage Effect'. How Cannabinoids And Terpenes Work Together
SCIENCE ON TERPINOLENE
Terpinolene may possess antibacterial and antimicrobial properties, but research so far has focused on extracts of plants where terpinolene was just one of the many active compounds - making it hard to draw conclusions without further research.
Terpinolene was found to be an antioxidant, also exerting an action that could prevent low-density lipoprotein oxidation. LDL is commonly known as bad cholesterol, a major contributor to heart diseases. The potential prevention of oxidation damage to cells and other molecules showed by terpinolene goes together with the ability to inhibit cancer cell growth. A decrease of the cell proliferation in some forms of cancer is a meaningful result from recent research.
A few studies also mention the sedative properties of terpinolene, making it a candidate for a natural remedy against insomnia. Its mild yet effective depressant action on the central nervous system could also be applied to the reduction of psychological excitement and anxiety.
CANNABIS STRAINS WITH GOOD AMOUNTS OF TERPINOLENE
Terpinolene can be an effective companion compound within a medical phytocomplex such as a cannabis extract or combined with vitamins and other substances, rather than a single pharmacological active principle. A little knowledge about this and other terpenes is useful when picking a cannabis strain for specific medical purposes, or just to better understand and appreciate all the slightly different effects and aromas this herb provides.
Terpinolene is most commonly found in strains with a sativa dominance. A notorious genetic that frequently exhibits high concentrations of terpinolene is Jack Herer, together with some of its hybrids. One of these is Royal Jack Automatic,a small yet productive autoflowering strain whose high amount of terpinolene vaporizes in a peppery aroma and spicy herbal taste. A totally different strain is Pineapple Kush, which is bred from the well known OG Kush and has a sweet tropical fruit taste and smell. This is a relaxing strain that might help with anxiety and migraines
From Royal Queen Seeds: Ocimene
CANNABIS TERPENES: OCIMENE
I left guaiol out. I’m researching Carnival terpenes, on my way to better understanding of Devil’s Carnival expressions. .
Cannabis can contain up to 200 different terpenes, all of which work together to give the plant its unique aromas and effects. In this article, we examine ocimene and guaiol, two of the main terpenes in cannabis.
Cannabis contains hundreds of different compounds which combine to give the plant its unique effects and traits. While cannabinoids are often named as the main players responsible for cannabis’ therapeutic potential, terpenes play an equally important role.
In this article, we look at two of the main terpenes found in the cannabis plant, ocimene and guaiol. While there is a lack of in-depth research on these compounds, we’ll shed some light on what we know so far, and what it means for the future application of these terpenes.
RELATED STORY
WHAT ARE TERPENES?
Terpenes are hydrocarbons found within the cannabis plant. They are commonly referred to as the plant’s “essential oils” and play a vital role in giving cannabis its complex aromas and medicinal properties.
The cannabis plant can contain up to 200 different terpenes. However, there are roughly 30 terpenes (10 primary and 20 secondary) that are consistently found in high concentrations in most cannabis varieties. Ocimene and guaiol are two such examples.
The small variations in terpene concentration from one plant to another is what give individual strains their unique smells, characteristics, and effects. Hence, the science behind terpenes has received a lot of attention in the cannabis industry recently.
Terpenes also help the plant defend itself against disease and pests. From what research is available, terpenes are also noted for their medicinal properties, displaying anti-inflammatory, antifungal, antiviral, and other therapeutic benefits.
OCIMENE: A SWEET, YET POWERFUL MEDICAL COMPOUND
Ocimene is a terpene found in a wide variety of fruits and herbs, including mint, parsley, pepper, basil, mangoes, orchids, and cannabis. It is noted for having a sweet, herbaceous, and woody aroma. Some also describe it as fruity and slightly citric.
Ocimene is believed to have a variety of medicinal benefits. A study on the essential oils of the citrus unshiu flower found that ocimene has anti-inflammatory effects. Meanwhile, another study on the essential oils of a specific type of ferulago (a herbaceous plant species) found that ocimene had strong antifungal properties as well.
Finally, a study on seven Lebanon species found that ocimene was a major constituent of the plants’ essential oils, which have been noted for their strong antiviral properties.
Since terpene levels can vary from one phenotypeto the next, it can be hard to pinpoint exactly which strains of cannabis will contain high concentrations of ocimene. However, some renowned aromatic strains that may contain higher concentrations of ocimene include OG Kush and Sour Diesel.
Ocimene is believed to have a boiling point of roughly 65-66°C. Hence, to get the most out of this terpene, we suggest using a good vaporizeron a very low temperature setting.
TERPINOLENE: EVERYTHING YOU NEED TO KNOW
We take a closer look at terpinolene, a fragrant terpene found within our Royal Jack Automatic and Pineapple Kush strains here at RQS. The potential benefits combined with its unique flavour make it a terpene to seek out!
Terpinolene is the terpene partly responsible for the woody, piney smell cannabis can often have, and is one of many to feature in the plant. It is not a cannabis exclusive, though. Terpinolene can also be found in tea tree, conifers, apple, cumin, sage, rosemary and lilac.
Also known as delta terpinene, terpinolene's woody aroma, is often accompanied by citrusy and floral tones. It is a permanent member of the numerous terpenes’ families residing in the cannabis flowers, so let’s meet this hydrocarbon.
TERPINOLENE’S ROLE IN THE TERPENES FAMILY
Terpenes are chemicals with a huge array of fragrances, flavours, and effects. Their extractions from plants are the most important components of the essential oils used in herbal medicine, nutritional supplements and cosmetics. Terpinolene is used as an aroma agent in soaps and perfumes, and also as a component of some insect repellents. As opposed to other terpenes found in cannabis, terpinolene is neither an analgesic nor an anti-inflammatory. However, this terpene is studied for its antifungal and antibacterial properties, and also for its mild sedative action. We are interested in terpinolene as users and patients because it is one of the actors in the synergetic performance that enhances the action of THC and CBD.
RELATED STORY
'Entourage Effect'. How Cannabinoids And Terpenes Work Together
SCIENCE ON TERPINOLENE
Terpinolene may possess antibacterial and antimicrobial properties, but research so far has focused on extracts of plants where terpinolene was just one of the many active compounds - making it hard to draw conclusions without further research.
Terpinolene was found to be an antioxidant, also exerting an action that could prevent low-density lipoprotein oxidation. LDL is commonly known as bad cholesterol, a major contributor to heart diseases. The potential prevention of oxidation damage to cells and other molecules showed by terpinolene goes together with the ability to inhibit cancer cell growth. A decrease of the cell proliferation in some forms of cancer is a meaningful result from recent research.
A few studies also mention the sedative properties of terpinolene, making it a candidate for a natural remedy against insomnia. Its mild yet effective depressant action on the central nervous system could also be applied to the reduction of psychological excitement and anxiety.
CANNABIS STRAINS WITH GOOD AMOUNTS OF TERPINOLENE
Terpinolene can be an effective companion compound within a medical phytocomplex such as a cannabis extract or combined with vitamins and other substances, rather than a single pharmacological active principle. A little knowledge about this and other terpenes is useful when picking a cannabis strain for specific medical purposes, or just to better understand and appreciate all the slightly different effects and aromas this herb provides.
Terpinolene is most commonly found in strains with a sativa dominance. A notorious genetic that frequently exhibits high concentrations of terpinolene is Jack Herer, together with some of its hybrids. One of these is Royal Jack Automatic,a small yet productive autoflowering strain whose high amount of terpinolene vaporizes in a peppery aroma and spicy herbal taste. A totally different strain is Pineapple Kush, which is bred from the well known OG Kush and has a sweet tropical fruit taste and smell. This is a relaxing strain that might help with anxiety and migraines
From Royal Queen Seeds: Ocimene
CANNABIS TERPENES: OCIMENE
I left guaiol out. I’m researching Carnival terpenes, on my way to better understanding of Devil’s Carnival expressions. .
Cannabis can contain up to 200 different terpenes, all of which work together to give the plant its unique aromas and effects. In this article, we examine ocimene and guaiol, two of the main terpenes in cannabis.
Cannabis contains hundreds of different compounds which combine to give the plant its unique effects and traits. While cannabinoids are often named as the main players responsible for cannabis’ therapeutic potential, terpenes play an equally important role.
In this article, we look at two of the main terpenes found in the cannabis plant, ocimene and guaiol. While there is a lack of in-depth research on these compounds, we’ll shed some light on what we know so far, and what it means for the future application of these terpenes.
RELATED STORY
WHAT ARE TERPENES?
Terpenes are hydrocarbons found within the cannabis plant. They are commonly referred to as the plant’s “essential oils” and play a vital role in giving cannabis its complex aromas and medicinal properties.
The cannabis plant can contain up to 200 different terpenes. However, there are roughly 30 terpenes (10 primary and 20 secondary) that are consistently found in high concentrations in most cannabis varieties. Ocimene and guaiol are two such examples.
The small variations in terpene concentration from one plant to another is what give individual strains their unique smells, characteristics, and effects. Hence, the science behind terpenes has received a lot of attention in the cannabis industry recently.
Terpenes also help the plant defend itself against disease and pests. From what research is available, terpenes are also noted for their medicinal properties, displaying anti-inflammatory, antifungal, antiviral, and other therapeutic benefits.
OCIMENE: A SWEET, YET POWERFUL MEDICAL COMPOUND
Ocimene is a terpene found in a wide variety of fruits and herbs, including mint, parsley, pepper, basil, mangoes, orchids, and cannabis. It is noted for having a sweet, herbaceous, and woody aroma. Some also describe it as fruity and slightly citric.
Ocimene is believed to have a variety of medicinal benefits. A study on the essential oils of the citrus unshiu flower found that ocimene has anti-inflammatory effects. Meanwhile, another study on the essential oils of a specific type of ferulago (a herbaceous plant species) found that ocimene had strong antifungal properties as well.
Finally, a study on seven Lebanon species found that ocimene was a major constituent of the plants’ essential oils, which have been noted for their strong antiviral properties.
Since terpene levels can vary from one phenotypeto the next, it can be hard to pinpoint exactly which strains of cannabis will contain high concentrations of ocimene. However, some renowned aromatic strains that may contain higher concentrations of ocimene include OG Kush and Sour Diesel.
Ocimene is believed to have a boiling point of roughly 65-66°C. Hence, to get the most out of this terpene, we suggest using a good vaporizeron a very low temperature setting.
- Thread starter
- #569
Marijuana treatments for autoimmune disorders
Published Thu 28 Nov 2013
By Belinda Weber
Researchers from the University of South Carolina say that tetrahydrocannabinol, the principal constituent of marijuana, may have another medical use - treating those with autoimmune disorders.
Tetrahydrocannabinol (THC) is known to have analgesic effects so can be used to treat pain. It also aids relaxation and can reduce feelings of nausea and stimulate appetite, making it useful for those undergoing chemotherapy.
Now, a new study, published in the Journal of Biological Chemistry, explores how microRNAs are influenced by THC.
MicroRNAs (miRNAs) are small, single-stranded, non-coding RNAs that play a vital role in regulating gene expression. And the authors claim that the ability to alter miRNA expression may be the key to successful treatment for many autoimmune diseases, including multiple sclerosis, arthritis and type 1 diabetes.
The researchers, from the university's School of Medicine, injected mice with THC and analyzed their RNA. Of the 609 miRNAs tested, the researchers identified 13 that were highly altered by the THC.
Stopping gene expression
MiRNAs greatly influence the immune system, acting as "brakes" that target more than 60% of all gene expression. Since miRNAs usually suppress the expression of genes, when a miRNA is over-expressed, the affected gene gets silenced.
But when a miRNA is turned off, the affected gene is expressed at a higher level.
The report states that the regulation of gene expression by miRNAs is thought to be vital in a wide range of biological processes. The authors point to emerging evidence that suggests miRNAs "regulate the development, differentiation and function of a variety of immune cells including myeloid cells."
For this study, the researchers also explored one specific miRNA - miRNA-690 - that was greatly over-expressed by the presence of THC and targets an important protein called C/EBPα. This protein, in turn, triggers myeloid-derived suppressor cells (MDSC), which suppress inflammation.
When the researchers successfully knocked out the miRNA-690, the effect of THC was reversed.
The current study, led by Dr. Venkatesh Hegde, suggests the effects of marijuana may be "a double-edged sword." Its ability to suppresses inflammation provides effective treatment against inflammatory and autoimmune diseases, but that very action may leave the body open and vulnerable to other diseases.
Lead authors Drs. Prakash and Mitzi Nagarkatti have studied how marijuana can alter immune functions and inflammation for over a decade. They were the first to show that marijuana components trigger MDSC to suppress inflammation.
Dr. Mitzi Nagarkatti, chair of the Department of Pathology, Microbiology and Immunology at USC's School of Medicine, says the latest study demonstrates that understanding how to control microRNA expression holds tremendous potential for new medical breakthroughs.
She explains:
Published Thu 28 Nov 2013
By Belinda Weber
Researchers from the University of South Carolina say that tetrahydrocannabinol, the principal constituent of marijuana, may have another medical use - treating those with autoimmune disorders.
Tetrahydrocannabinol (THC) is known to have analgesic effects so can be used to treat pain. It also aids relaxation and can reduce feelings of nausea and stimulate appetite, making it useful for those undergoing chemotherapy.
Now, a new study, published in the Journal of Biological Chemistry, explores how microRNAs are influenced by THC.
MicroRNAs (miRNAs) are small, single-stranded, non-coding RNAs that play a vital role in regulating gene expression. And the authors claim that the ability to alter miRNA expression may be the key to successful treatment for many autoimmune diseases, including multiple sclerosis, arthritis and type 1 diabetes.
The researchers, from the university's School of Medicine, injected mice with THC and analyzed their RNA. Of the 609 miRNAs tested, the researchers identified 13 that were highly altered by the THC.
Stopping gene expression
MiRNAs greatly influence the immune system, acting as "brakes" that target more than 60% of all gene expression. Since miRNAs usually suppress the expression of genes, when a miRNA is over-expressed, the affected gene gets silenced.
But when a miRNA is turned off, the affected gene is expressed at a higher level.
The report states that the regulation of gene expression by miRNAs is thought to be vital in a wide range of biological processes. The authors point to emerging evidence that suggests miRNAs "regulate the development, differentiation and function of a variety of immune cells including myeloid cells."
For this study, the researchers also explored one specific miRNA - miRNA-690 - that was greatly over-expressed by the presence of THC and targets an important protein called C/EBPα. This protein, in turn, triggers myeloid-derived suppressor cells (MDSC), which suppress inflammation.
When the researchers successfully knocked out the miRNA-690, the effect of THC was reversed.
The current study, led by Dr. Venkatesh Hegde, suggests the effects of marijuana may be "a double-edged sword." Its ability to suppresses inflammation provides effective treatment against inflammatory and autoimmune diseases, but that very action may leave the body open and vulnerable to other diseases.
Lead authors Drs. Prakash and Mitzi Nagarkatti have studied how marijuana can alter immune functions and inflammation for over a decade. They were the first to show that marijuana components trigger MDSC to suppress inflammation.
Dr. Mitzi Nagarkatti, chair of the Department of Pathology, Microbiology and Immunology at USC's School of Medicine, says the latest study demonstrates that understanding how to control microRNA expression holds tremendous potential for new medical breakthroughs.
She explains:
This is not the first study to herald the medicinal qualities of marijuana. Medical News Today reported last month that chemicals within the plant may protect the body against multiple sclerosis.
- Thread starter
- #570
I stumbled upon this case study and thought it might be interesting to see how a case is handled conventionally.
Source
A Painless Scleritis?
Faye Therese Gamboa, O.D.
Resident Optometrist - Captain James A. Lovell FHCC (708) 620-9295 // fgamboa23@yahoo.com
ABSTRACT: This case presents an atypical scleritis with hyperemia, decreased vision, and no pain, presumed to be secondary to immune-compromise. Proper dose of non-steroidal anti- inflammatory drugs or oral steroids is imperative to protect vision.
I. Case History
a. 68 year-old Caucasian Male
b. Painless, progressive red eye with mild irritation and associated watering OD. Started 3 mo ago. Separately, the patient notes mild crusting AM with foreign body sensation OD as well. No fevers, night sweats, weight loss, diplopia, light sensitivity, itching, burning, discharge, change in vision as. Denies previous red eye episodes OU.
c. Last eye exam:
1 month ago with optometrist who prescribed antibiotic drops that did not help d. Pertinent Medical History:
Ulcerative Colitis (UC) x 13-14 yrs. – in remission
Anemia
e. Systemic Medications:
Humira® immunosuppressive injections sig 2 wks x 1 yr. for UC OTC supplements:
Multivitamin
Folic Acid 1mg
Cyanocobalamin
B12
Fish Oil 1000 mg
Flaxseed
Glucosamine
f. Family History:
Thyroid disorder – daughter
g. Social History
Quit smoking ~ 45 yrs. ago
Social drinker
Infrequent marijuana use
h. Retired Engineer x 30 yrs.
II. Pertinent Findings
a. Clinical (Initial Visit)
b. Follow-up (2 weeks later) – after patient prescribed FML QID OD
c. Follow-up (1 mo later) after prescribed Naproxen po QID
III. Differential Diagnosis
a. Scleritis
b. Episcleritis
c. Allergic Conjunctivitis
IV. Diagnosis and Discussion
a. Diagnosis
b. Ulcerative Colitis
c. Scleritis is an intense inflammation of the sclera that is often painful and can result in blindness.
d. Humira® (Adalimumab)
6. Preventative Care and Maintenance through Diet (8)
b. This patient was started on Naproxen 250mg po QID and Omeprazole 20mg po QD.
VI. Conclusion
a. Scleritis is a common extra-intestinal manifestation of Ulcerative Colitis. It is important to confirm the diagnosis and classification. Furthermore, it is important to determine complications and evaluate for an underlying cause, especially if there is a systemic etiology. (5)
b. Optometrists can play strong role in quickly diagnosing and treating this condition with prompt work up and proper referral to prevent severe vision loss.
c. In addition, as general physicians we can also consider determining natural and safe supplementation for preventative care.
Source
A Painless Scleritis?
Faye Therese Gamboa, O.D.
Resident Optometrist - Captain James A. Lovell FHCC (708) 620-9295 // fgamboa23@yahoo.com
ABSTRACT: This case presents an atypical scleritis with hyperemia, decreased vision, and no pain, presumed to be secondary to immune-compromise. Proper dose of non-steroidal anti- inflammatory drugs or oral steroids is imperative to protect vision.
I. Case History
a. 68 year-old Caucasian Male
b. Painless, progressive red eye with mild irritation and associated watering OD. Started 3 mo ago. Separately, the patient notes mild crusting AM with foreign body sensation OD as well. No fevers, night sweats, weight loss, diplopia, light sensitivity, itching, burning, discharge, change in vision as. Denies previous red eye episodes OU.
c. Last eye exam:
1 month ago with optometrist who prescribed antibiotic drops that did not help d. Pertinent Medical History:
Ulcerative Colitis (UC) x 13-14 yrs. – in remission
Anemia
e. Systemic Medications:
Humira® immunosuppressive injections sig 2 wks x 1 yr. for UC OTC supplements:
Multivitamin
Folic Acid 1mg
Cyanocobalamin
B12
Fish Oil 1000 mg
Flaxseed
Glucosamine
f. Family History:
Thyroid disorder – daughter
g. Social History
Quit smoking ~ 45 yrs. ago
Social drinker
Infrequent marijuana use
h. Retired Engineer x 30 yrs.
II. Pertinent Findings
a. Clinical (Initial Visit)
1. Entering VA (sc) 20/20 OD, 20/20 OS
2. Pupils, EOM’s, Confrontation VF’s: WNL OD, OS
3. Slit lamp:
OD: 2-3+ diffuse conjunctival injection, tr-1+ diffuse papillae on upper/lower lid, no corneal involvement, (-) cell/flare, (-) foreign body OS: normal findings
4. Goldmann IOP: 11mm Hg OD, 11 mmHg OS
5. Blood pressure: 134/83 mmHg
6. External exam:
OD: mild injection along lid margins, no exophthalmos, mild tenderness over ethmoid sinus only (-)frontal sinus, no preauricular lymphadenopathy OS: within normal
7. DFE: within normal (-)vitritis/retinopathy OU
b. Follow-up (2 weeks later) – after patient prescribed FML QID OD
1. All findings stable except:
A. Entering VA (sc): 20/25 OD, 20/20 OS B. Slit lamp:
OD: 1-2+ edema/erythema sup./inf. lid, (-) tenderness, 3+ deep, diffuse conjunctival injection, no corneal involvement
OS: within normal
c. Follow-up (1 mo later) after prescribed Naproxen po QID
1. All findings stable except:
A. Entering VA (sc): 20/30 OD, 20/25 OS B. Slit lamp:
OD: 1-2+ edema/erythema superior and inferior lid, (-) tenderness, 2+ deep conjunctival injection temporal and nasal, 1+ conjunctival injection superior and inferior, no corneal involvement
OS: within normal
d. Work-up1. No Fluorescein staining on cornea OU at all visits
2. Mild blanching with phenylephrine 2.5% but not completely OD at all visits 3. CRP within normal range one month prior to initial visit
4. Vitamin D, 25 OH levels inadequate two months prior to initial visit
III. Differential Diagnosis
a. Scleritis
b. Episcleritis
c. Allergic Conjunctivitis
IV. Diagnosis and Discussion
a. Diagnosis
1. Diffuse Anterior Scleritis OD secondary to Ulcerative Colitis and probable immunosuppression
b. Ulcerative Colitis
1. Form of chronic inflammatory bowel disease (IBD)
A. HLA B-27+
2. Extra-intestinal manifestations are common. Ocular symptoms occur in 2-5% of patients with IBD. (7).
A. Episcleritis
B. Scleritis
C. Uveitis
c. Scleritis is an intense inflammation of the sclera that is often painful and can result in blindness.
1. Diagnosis is based upon clinical presentation: scleral inflammation with involvement of the superficial and deep episcleral venous plexuses. (5)
A. Phenylephrine 10% can be instilled to rule out episcleritis. (5)
2. Pain is almost always present, but can be absent if the patient is currently on immunosuppressive treatment. (5)
3. * Scleritis can be the first manifestation in 20% patients with systemic autoimmune disease. (5)
4. Types:
A. Anterior or Posterior
B. Diffuse or Nodular
C. Necrotizing or Non-necrotizing
D. * Diffuse anterior scleritis is the most common in about 45-61% of all cases. (5)
5. One case report presented a patient with very similar ocular symptoms as the case above and was also diagnosed with a painless posterior scleritis. (2)
d. Humira® (Adalimumab)
1. Tumor necrosis factor (TNF) inhibitors prevent TNF from inducing systemic inflammation caused by macrophages, CD4+ lymphocytes, and natural kills cells (1).
A. Use of tumor necrosis factor inhibitors has been proven to decrease ocular inflammation, particularly Infliximab and Adalimumab. (1)
B. Adalimumab is a humanized monoclonal antibody that recognizes and binds to TNF. (1)
C. It is FDA approved for the treatment of ulcerative colitis. (1)
D. It is given subcutaneously with a loading dose of 80mg, and then 40 mg every week or 20 mg every two weeks. Weekly dosing may be required for ocular disease. (1)
E. Humanized to decrease the risk of developing antibodies to the TNF inhibitor and thus decreasing its efficacy. (1)
F. No current studies that evaluate adalimumab as effective systemic treatment for scleritis and systemic effects limit their use. (1)Local administration is preferred, but may not be effective (4)
1. One case report of significant improvement of a nodular scleritis in a patient diagnosed with rheumatoid arthritis (6)
2. Difficult to proper assess effectiveness of systemic therapy due to small incidence, range of disease, and low pharmaceutical interest. (3)
B. Topical corticosteroids are not as effective. 2. Oral Steroids
A. Prednisone 1mg/kg/day 3. Immunosuppressants
A. Methotrexate
B. Azathioprine
C. Cyclophosphamide
4. Biologic Agents
A. TNF inhibitors
1. Infliximab
2. Adalimumab
5. Surgery
A. Cataract removal
B. Transplantation if perforation
6. Preventative Care and Maintenance through Diet (8)
A. "IBD-AID" diet - consists of lean meats, poultry, fish, omega-3 eggs, select sources of carbohydrate/fruits/vegetables, nut and legume flours, limited aged cheeses, fresh cultured product rich with probiotics, prebiotics that contain beta-glucans and inulin are suggested. (8)
B. Vitamin D as protective measure. (9)
1. Natural Vitamin D through sun exposure
2. Cholecalciferol supplementation
3. In this particular case, the patient was Vitamin D deficent on testing 1 month prior to reported symptoms.
C. Fish Oil (10)
b. This patient was started on Naproxen 250mg po QID and Omeprazole 20mg po QD.
1. Mild resolution of scleritis after one month of follow-up. Still no pain.
2. We believe that the patient is immunocompromised and, thus, delayed resolution of the patient’s ocular condition is expected.
3. Current Vitamin D, 25 OH levels results still pending for this patient. We expect mildly higher levels due to increased sun exposure of summer. However, it is likely not adequate.
4. Upon next follow-up, we expect continuous improvement of this patient's ocular condition and will determine proper diet and Vitamin D and Fish oil supplementation for long-term preventative care.
VI. Conclusion
a. Scleritis is a common extra-intestinal manifestation of Ulcerative Colitis. It is important to confirm the diagnosis and classification. Furthermore, it is important to determine complications and evaluate for an underlying cause, especially if there is a systemic etiology. (5)
b. Optometrists can play strong role in quickly diagnosing and treating this condition with prompt work up and proper referral to prevent severe vision loss.
c. In addition, as general physicians we can also consider determining natural and safe supplementation for preventative care.
They had tried her on methotrexate and it didn’t agree with her, some flares took as high as 80 mg of prednisone to for around a year I believe to get it under control then took a while to slowly taper her down to where she is now at 10mg a day and keeps the flares at bay but she can still feel the pressure in her eye. Humira is also given, this is crazy to read another case with pretty much exact same symptoms... she’s been dealing with this for over 2 years now unfortunately
- Thread starter
- #572
They had tried her on methotrexate and it didn’t agree with her, some flares took as high as 80 mg of prednisone to for around a year I believe to get it under control then took a while to slowly taper her down to where she is now at 10mg a day and keeps the flares at bay but she can still feel the pressure in her eye. Humira is also given, this is crazy to read another case with pretty much exact same symptoms... she’s been dealing with this for over 2 years now unfortunately
Try rephrasing this inside your mind to something like
"It's been two years looking for answers we know are there, and we're certain we'll find."
Language matters greatly in the healing arts. I like to think of it as creating a road map for the ECS. There's so much opportunity to go negative, and the cells pick that vibration up. As much as possible I try to rewrite the things I say about my health out of habit into statements that I feel lead to homeostasis.
I have a theory that the ECS runs on joy. In a joyful state you're free of tension, and most likely to be laughing, the best possible medicine. Less tension means the ECS can hear the vibrations of cells in trouble and respond quickly. Tension slows the signaling, making it difficult for cells to be in constant communication with each other, a prerequisite for a homeostatic tonality.
Derbybud
Well-Known Member
And stress is the worst on the ECS system.
- Thread starter
- #574
Source: Indiana University
The Kinds of Fats
And Why It Matters To You
trans-Fats
As the US population migrated from the farms to the cities, but largely maintained the same diet, the frequency of heart disease increased. This was linked to the consumption of large amounts of animal fat -- cooking with lard, frying eggs and toast in bacon grease, etc. Other possibilities may not have been entirely ruled out, but it was logical, and so began the campaign against animal fat. We now refer to saturated fats, but a half-century ago, the first-named culprit was "animal" fat.
Plant oils are also technically fats, but liquid at room temperature. These were thought to be healthier, but their cooking properties were different from those of solid animal fat. To modify them so that they could be used in similar ways to animal fats, food chemists used -- and still used -- the process of of hydrogenation. In this process, hydrogen is combined with the unsaturated plant oils, converting some of the molecules into saturated fats.
Hydrogenation of Fats
Complete hydrogenation converts healthful unsaturated fats into fully saturated fats, making them entirely equivalent to regular, saturated, animal fat. This would not do as a substitute for animal fat, since it is essentially the same. The solution seemed to be to partially hydrogenate the plant oil. This way, some unsaturated molecules would remain, and keep the product healthy.
Thus was born partially hydrogenated vegetable oil.
cis and trans Configurations
But partial hydrogenation has a down-side. Natural unsaturated fatty acids are in configuration that is called cis, but partial hydrogenation can flip the chemical bonds into a different configuration that is called trans. The difference between cis and trans is that the two H atoms are on the same side of the double bond (cis), compared to being on opposite sides (trans).
This may not seem like much of a difference, but it affects the shapes of the molecules. In a cis configuration, the double bond creates a kink in the fatty acid. In the trans configuration, there is no kink. Therefore, a trans-fatty acid is structurally similar to a saturated fatty acid (which has no kinks, either). The kinks in the molecules determine whether the material is solid or liquid at room temperature.
Health Issues
In recent decades, as more has been learned about the biology of different forms of fats, the story has become much more complicated than it seemed in the 1950's. The following are a few of the issues:
Avoid foods containing trans-fatty acids.
Unfortunately, this is not as straightforward as reading the Nutrition Facts label on the package. US law permits manufacturers to establish the "serving size" of their product at will, and to round to zero grams the amount of any component that is present in less than 0.5 grams per serving. If the Nutrition Facts label claims "zero grams of trans-fat," this does not mean the food contains no trans-fat. The only way to be certain is to look for "partially hydrogenated vegetable oil" in the list of ingredients.
The Kinds of Fats
And Why It Matters To You
trans-Fats
As the US population migrated from the farms to the cities, but largely maintained the same diet, the frequency of heart disease increased. This was linked to the consumption of large amounts of animal fat -- cooking with lard, frying eggs and toast in bacon grease, etc. Other possibilities may not have been entirely ruled out, but it was logical, and so began the campaign against animal fat. We now refer to saturated fats, but a half-century ago, the first-named culprit was "animal" fat.
Plant oils are also technically fats, but liquid at room temperature. These were thought to be healthier, but their cooking properties were different from those of solid animal fat. To modify them so that they could be used in similar ways to animal fats, food chemists used -- and still used -- the process of of hydrogenation. In this process, hydrogen is combined with the unsaturated plant oils, converting some of the molecules into saturated fats.
Hydrogenation of Fats
Complete hydrogenation converts healthful unsaturated fats into fully saturated fats, making them entirely equivalent to regular, saturated, animal fat. This would not do as a substitute for animal fat, since it is essentially the same. The solution seemed to be to partially hydrogenate the plant oil. This way, some unsaturated molecules would remain, and keep the product healthy.
Thus was born partially hydrogenated vegetable oil.
cis and trans Configurations
But partial hydrogenation has a down-side. Natural unsaturated fatty acids are in configuration that is called cis, but partial hydrogenation can flip the chemical bonds into a different configuration that is called trans. The difference between cis and trans is that the two H atoms are on the same side of the double bond (cis), compared to being on opposite sides (trans).
This may not seem like much of a difference, but it affects the shapes of the molecules. In a cis configuration, the double bond creates a kink in the fatty acid. In the trans configuration, there is no kink. Therefore, a trans-fatty acid is structurally similar to a saturated fatty acid (which has no kinks, either). The kinks in the molecules determine whether the material is solid or liquid at room temperature.
Health Issues
In recent decades, as more has been learned about the biology of different forms of fats, the story has become much more complicated than it seemed in the 1950's. The following are a few of the issues:
- It is less clear (and to some researchers, not clear at all) whether saturated fat is responsible for the ailments attributed to it, particularly heart disease.
- Although nutritional advice gradually moved toward the recommendation that we banish all fat from our diets, there is compelling evidence that some fats are good. Indeed, ω-3 and ω-6 fatty acids are essential for survival.
- Both saturated fats and cis-unsaturated fats are natural. We produce the necessary enzymes to metabolize these. However, there is no evidence that we produce the enzymes to metabolize trans-fatty acids.
- Fat-free and low-fat prepared foods typically replace the fat with something else that tastes good to us. Given our evolutionary history, the really-tasty things tend to be fat, sugar, and salt. Removing fat often makes things taste "flat." Sugar and salt make it palatable again. These have their own health problems when consumed in large amounts, as it typical of the Western Diet.
- Even among unsaturated fats, there are complexities. The ω-3 and ω-6 fatty acids are not equivalent medically, and have distinct differences with respect to chronic inflammatory diseases.
Avoid foods containing trans-fatty acids.
Unfortunately, this is not as straightforward as reading the Nutrition Facts label on the package. US law permits manufacturers to establish the "serving size" of their product at will, and to round to zero grams the amount of any component that is present in less than 0.5 grams per serving. If the Nutrition Facts label claims "zero grams of trans-fat," this does not mean the food contains no trans-fat. The only way to be certain is to look for "partially hydrogenated vegetable oil" in the list of ingredients.
- Thread starter
- #575
I just read the summary of a study donenin Costa Rica showing that those who ate the highest levels of butter produced from the milk of grass-fed cows had a 49% reduction in the incidence of heart attack.
It can’t prove causation, but it sure makes you wonder.
Evidence is extremely strong that we’ve been lied to about saturated fats too. It brought us the industry that processes trans fats, and we can’t let this damage that industry now, can we?
The things we do for money.
Trans fats. There’s the problem.
It can’t prove causation, but it sure makes you wonder.
Evidence is extremely strong that we’ve been lied to about saturated fats too. It brought us the industry that processes trans fats, and we can’t let this damage that industry now, can we?
The things we do for money.
Trans fats. There’s the problem.
Margarine used to be almost entirely hydrogenated vegetable oil as I recall. When I gave up sugar in the mid-1980s I also gave up all hydrogenated oils. It used to be hard to find snacks back then, but it's gotten easier in the last 10 years or so with the info coming out about trans-fats.
- Thread starter
- #577
Ahhh.... there’s a catch. The government allows them to use minuscule amounts, and round down to zero.
So it could be in your food, and you wouldn’t know it without reading the ingredients label. If you only ate it once this probably wouldn’t be a concern.- Thread starter
- #578
My mother never went to margarine, or if she did my grandmother convinced her otherwise almost immediately. I refused to eat it as a child. 
I read a review of an interesting study done in Costa Rica, where butter is made with milk from grain-fed cows. They were surprised to discover that those who ate the highest levels of butter in the diet had a 49% reduced chance of heart attack.
I’m switching when I come back from California.
I read a review of an interesting study done in Costa Rica, where butter is made with milk from grain-fed cows. They were surprised to discover that those who ate the highest levels of butter in the diet had a 49% reduced chance of heart attack.
I’m switching when I come back from California.
- Thread starter
- #579
For my quick reference:
Those are truly "class notes."
My wife reads the label on everything she buys...she's good to me like that
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My wife reads the label on everything she buys...she's good to me like that
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