What happened to you is actually not that unusual. I do believe that, with some diet changes and maybe a visit to your regular doctor, we may have a chance to make another gout attack much less likely.
Gout is a type of arthritis caused by uric acid crystals forming inside the joint or a space between two bones. The most common location for gout is at the base of a big toe, but it can affect other joints as well.
Uric acid is a product of a breakdown of purines -- substances found in foods like beans, asparagus, mushrooms and certain meats and seafood. The most common symptoms of gout are a red, swollen, painful toe or other joint and, for some, fatigue and fever. The intensity is the worst in the first 12 to 24 hours, but the symptoms may continue for weeks. It is important to know that this is a self-limiting illness, which means that it will eventually go away even when not treated by any medication.
Gout affects about 1 to 2 percent of the population in the United States. It is generally more common in men, but it can attack women, especially after menopause. It is a very old disease -- it was known by Egyptians in ancient times. It has been called the "disease of the kings" due to its presumed association with eating certain foods and alcohol.
Now you may ask why exactly the uric acid crystallizes inside the joints. It is due to one of two reasons. There may be too much of the uric acid made by the body, which happens in about 10 percent of cases. But, more often, the kidneys are unable to get rid of the uric acid properly and, as a result, there is just too much uric acid in the blood. The level of uric acid can be measured by a blood test and, to some extent, can guide treatment and diet modifications. Interestingly enough, gout attacks are influenced by outside temperatures, which is why they happen more often in early morning. Uric acid may also crystallize in other parts of the body, causing funny-looking, small, painless lumps around joints and tendons, which doctors call "tophi." Gout is also associated in some people with kidney stones -- again caused by the uric acid.
This disease does run in families, but just because your dad or mom has had it does not mean you will get it as well.
It is also associated with elevated blood pressure, obesity and elevated cholesterol. As we have mentioned before, excessive alcohol use (more than two drinks daily) is one of the risk factors. Some medications can make gout attacks more likely. Simple aspirin and commonly used water pills -- known in "doctor talk" as thiazide diuretics -- have been associated with gout.
On the other hand, coffee and vitamin C, as well as dairy foods and physical exercise, may be protective for gout sufferers. as they lower uric acid levels in the blood.
2012年1月4日星期三
2011年12月22日星期四
Longtime divers Troy and Justin Dumais still like making a splash
A diving competition in the United States is bound to have several necessities: a springboard, a platform, some deep water and a Dumais -- in fact maybe two of them, or three. Otherwise, it seems, the meet is just a bunch of guys splashing around in the pool. Might as well be a triple Lindy and a cannonball.
On Monday, Olympians Troy Dumais, 31, and his older brother, Justin, 33, finished fourth and fifth on the three-meter springboard event at the USA Diving Winter National Championships in Nashville, qualifying for the Olympic trials at ages when most divers are done. (Younger brother Dwight Dumais, 25, is a Stanford senior majoring in human biology. Though not as accomplished in the sport as his brothers, he is still a five-time national qualifier and bronze medalist at nationals on the one-meter board in 2005.) In Nashville, Troy teamed with Kristian Ipsen, a Stanford freshman, to win the three-meter synchro title. Ipsen recalls asking Troy for his autograph when he was eight years old.
Ipsen and Dumais clinched the meet by scoring nine or higher on five of six dives. They received perfect marks of 10 for a back dive pike, a forward 3 somersault and a forward 2 somersault with a twist. Their partnership is all the more remarkable because Ipsen has been training at his university in Palo Alto Calif., and can only train a few days each month with Dumais, who trains at the University of Texas and works as a Life Advisor for other Longhorns sports teams. His resume for the role comes from a sport that requires ups, downs, twist and turns is vast.
Troy Dumais almost made the Olympic team as a 16-year-old in 1996. In '98, he won a silver medal at the world championships on the one-meter springboard, an event not contested at the Olympics. Two years later, Dumais had an unusually high degree of difficulty at the U.S. Olympic Trials in Federal Way, Wash., and that was for just getting to the pool.
At 2 o'clock one morning, 17 hours before the finals of the men's three-meter event, he was admitted to St. Francis Hospital, trying to pass the large kidney stone that was breaking up in his body. "I felt like my whole side was exploding," he said. To complicate matters, Dumais, one point off the lead after the semifinals, had told doctors not to administer the usual narcotic given to patients in his condition because it was on the IOC's banned list. Instead they hooked him up to an IV bag, injected him with non-steroidal Toradol and sent him on his way at 5 a.m. after he passed a large stone into his bladder. Twelve painful hours later he was back again, taking in a liter of IV fluid and trying to force himself to excrete the stone completely so he could dive without incident or pain. Instead he passed either a second stone, or a fragment of the original, into his bladder and arrived at the Weyerhaeuser Aquatic Center 45 minutes before competition began. In the stands his parents Kathleen and Marc and 28 other supporters wearing light blue shirts saying Dumais Diving had no clue about Troy's illness. "I didn't want my mom to freak," Dumais said, "so only my brother Justin knew."
Justin Dumais, who was then 21 and would finish 13th in the springboard final, was one of four Dumais siblings who followed Troy into diving after his parents chose it as an outlet for Troy's hyperactivity. "Teachers would ask a question," Kathleen recalled, "and Troy would blurt out the answer without being called." One teacher suspected he had Attention-Deficit Disorder and suggested his parents keep him on Ritalin. Instead they kept him on diving boards.
Should he qualify for the squad at the Olympic Trials in Federal Way in June, Troy would be the first U.S. diver to compete in four Olympics. Still, he admits that there is a void without an Olympic medal to show for his toils. He placed fourth in synchro three-meter with David Pichler at the Sydney Games in 2000, missing out on bronze by less than two points. Even after a sixth-place finish in Beijing two summers ago, he sounded like a man who wasn't done with his dives. "What should I do, sit behind a desk and ask myself if I left it out there?" he said. "If I leave the sport, the sport I love, the sport I've been doing my whole life, I have to be ready to walk away saying I did everything I could, and I know I haven't done that yet."
So at 28, Troy started hitting the weights on the advice of his longtime coach Matt Scoggin. Even though his technique was on par with many of the top Chinese divers, Scoggin felt that a stronger Dumais with a touch more lean muscle could jump a tad higher and have that much more time and space to square himself for cleaner entries that leave a more dramatic impression for the judges. He added between 10 and 15 pounds of muscle thanks to a four-day-a-week program in the gym. He won silver medals in the three-meter springboard and synchronized three meter, diving with Ipsen, at the world championships in Rome in 2009, keeping the elusive Olympic medal within reach.
Justin, 33, is the eldest. He competed with Troy at the 2004 Olympics in Athens, finishing sixth in the synchro springboard event with Troy and won a bronze in synchro with Troy at the worlds in 2005. It was about that time, when doctors diagnosed him with Graves Disease, a thyroid ailment he beat in part by switching medications and keeping diet soda out of his fridge. He has since taken time away from diving for another high-flying vocation, flying F-16 jets for the South Carolina Air National Guard, before his tour of duty in Iraq. Justin had briefly quit the sport to move to Florida with his wife, Amy.
Though they have been each other's rocks throughout the sport, the Dumais boys actually had to be separated in college. Though he is the older diver, Justin had always fought to keep up with Troy. The boys began their collegiate careers at different universities -- Justin at USC and Troy at Texas -- but Justin soon transferred to join the Longhorns. Kenny Armstrong, their coach at Texas, decreed that Troy would compete in springboard events, while Justin jumped from the platform. That kept the two of them from competing against one another instead of for themselves.
On Monday, Olympians Troy Dumais, 31, and his older brother, Justin, 33, finished fourth and fifth on the three-meter springboard event at the USA Diving Winter National Championships in Nashville, qualifying for the Olympic trials at ages when most divers are done. (Younger brother Dwight Dumais, 25, is a Stanford senior majoring in human biology. Though not as accomplished in the sport as his brothers, he is still a five-time national qualifier and bronze medalist at nationals on the one-meter board in 2005.) In Nashville, Troy teamed with Kristian Ipsen, a Stanford freshman, to win the three-meter synchro title. Ipsen recalls asking Troy for his autograph when he was eight years old.
Ipsen and Dumais clinched the meet by scoring nine or higher on five of six dives. They received perfect marks of 10 for a back dive pike, a forward 3 somersault and a forward 2 somersault with a twist. Their partnership is all the more remarkable because Ipsen has been training at his university in Palo Alto Calif., and can only train a few days each month with Dumais, who trains at the University of Texas and works as a Life Advisor for other Longhorns sports teams. His resume for the role comes from a sport that requires ups, downs, twist and turns is vast.
Troy Dumais almost made the Olympic team as a 16-year-old in 1996. In '98, he won a silver medal at the world championships on the one-meter springboard, an event not contested at the Olympics. Two years later, Dumais had an unusually high degree of difficulty at the U.S. Olympic Trials in Federal Way, Wash., and that was for just getting to the pool.
At 2 o'clock one morning, 17 hours before the finals of the men's three-meter event, he was admitted to St. Francis Hospital, trying to pass the large kidney stone that was breaking up in his body. "I felt like my whole side was exploding," he said. To complicate matters, Dumais, one point off the lead after the semifinals, had told doctors not to administer the usual narcotic given to patients in his condition because it was on the IOC's banned list. Instead they hooked him up to an IV bag, injected him with non-steroidal Toradol and sent him on his way at 5 a.m. after he passed a large stone into his bladder. Twelve painful hours later he was back again, taking in a liter of IV fluid and trying to force himself to excrete the stone completely so he could dive without incident or pain. Instead he passed either a second stone, or a fragment of the original, into his bladder and arrived at the Weyerhaeuser Aquatic Center 45 minutes before competition began. In the stands his parents Kathleen and Marc and 28 other supporters wearing light blue shirts saying Dumais Diving had no clue about Troy's illness. "I didn't want my mom to freak," Dumais said, "so only my brother Justin knew."
Justin Dumais, who was then 21 and would finish 13th in the springboard final, was one of four Dumais siblings who followed Troy into diving after his parents chose it as an outlet for Troy's hyperactivity. "Teachers would ask a question," Kathleen recalled, "and Troy would blurt out the answer without being called." One teacher suspected he had Attention-Deficit Disorder and suggested his parents keep him on Ritalin. Instead they kept him on diving boards.
Should he qualify for the squad at the Olympic Trials in Federal Way in June, Troy would be the first U.S. diver to compete in four Olympics. Still, he admits that there is a void without an Olympic medal to show for his toils. He placed fourth in synchro three-meter with David Pichler at the Sydney Games in 2000, missing out on bronze by less than two points. Even after a sixth-place finish in Beijing two summers ago, he sounded like a man who wasn't done with his dives. "What should I do, sit behind a desk and ask myself if I left it out there?" he said. "If I leave the sport, the sport I love, the sport I've been doing my whole life, I have to be ready to walk away saying I did everything I could, and I know I haven't done that yet."
So at 28, Troy started hitting the weights on the advice of his longtime coach Matt Scoggin. Even though his technique was on par with many of the top Chinese divers, Scoggin felt that a stronger Dumais with a touch more lean muscle could jump a tad higher and have that much more time and space to square himself for cleaner entries that leave a more dramatic impression for the judges. He added between 10 and 15 pounds of muscle thanks to a four-day-a-week program in the gym. He won silver medals in the three-meter springboard and synchronized three meter, diving with Ipsen, at the world championships in Rome in 2009, keeping the elusive Olympic medal within reach.
Justin, 33, is the eldest. He competed with Troy at the 2004 Olympics in Athens, finishing sixth in the synchro springboard event with Troy and won a bronze in synchro with Troy at the worlds in 2005. It was about that time, when doctors diagnosed him with Graves Disease, a thyroid ailment he beat in part by switching medications and keeping diet soda out of his fridge. He has since taken time away from diving for another high-flying vocation, flying F-16 jets for the South Carolina Air National Guard, before his tour of duty in Iraq. Justin had briefly quit the sport to move to Florida with his wife, Amy.
Though they have been each other's rocks throughout the sport, the Dumais boys actually had to be separated in college. Though he is the older diver, Justin had always fought to keep up with Troy. The boys began their collegiate careers at different universities -- Justin at USC and Troy at Texas -- but Justin soon transferred to join the Longhorns. Kenny Armstrong, their coach at Texas, decreed that Troy would compete in springboard events, while Justin jumped from the platform. That kept the two of them from competing against one another instead of for themselves.
2011年12月4日星期日
Men in St. Paul's Ujamaa Place program are at bottom, but looking up
Ronnell Roberson has been shot five times and knows too well what prison life is like. But until recently, the 27-year-old former gang member and father of two had never stepped foot inside a history museum.
"As many times as I drove past it in a car or by bus, I did not know that someone like me could go inside there," Roberson said of his trip last month to the Minnesota History Center on Kellogg Boulevard in St. Paul.
Most of us don't think such a visit is a big deal. But for men like Roberson seeking a serious change in their lives, walking into such a place and learning about history and family genealogy is a milestone, an "aha!" moment.
That's one of the reasons he's sticking with Ujamaa Place, an ambitious project in St. Paul that has gained support from an array of people in the Twin Cities' civic, business and faith-based communities. Ujamaa translates to "extended family" in Swahili.
The year-old effort, in a "gang-neutral" site off University Avenue West and Fairview Avenue, may be the last hope for hard-core cases like Roberson.
"It focuses on folks in our community that are at danger of becoming a lost generation of men," said Bill Svrluga, a longtime Twin Cities civic figure and Ujamaa board member who runs a nonprofit consulting firm.
"These are young men with little or no education, from families without fathers or parents; many have gone to prison, and there's really no place for them left to go to become productive members of society," Svrluga said. "They are at the bottom of the ladder, and many end up in jail or dead by 35."
The effort, which officially opened in January, exclusively targets males, predominantly African-American, 18 to 31 years old. Most of the 30-member clientele never finished high school and are chronically unemployed. Roughly 60 percent have criminal histories.
The statistics in recent decades on such men - caught in a cycle of poverty, drug addiction, joblessness, homelessness, violence and criminality - are a national concern:
In 2004, fewer than 8 percent of young African-American men graduated from college. The unemployment rate for young African-American men is more than twice that for young white, Hispanic and Asian-American men. The percentage of young African-American men in prison is nearly three times that of Latino men and nearly seven times that of white men. The homicide death rate for young African-American men is three times the rate for Hispanics, the population group with the next-highest homicide mortality rate.
Roy Barker, the nonprofit's executive director and the driving force behind the effort, might have the toughest job in town. But the 58-year-old Bethel College graduate and others believe it can be done. How? Through a holistic approach that includes completing a high-school diploma equivalency and other training; stable housing; and parenting, life and employment skills.
"As many times as I drove past it in a car or by bus, I did not know that someone like me could go inside there," Roberson said of his trip last month to the Minnesota History Center on Kellogg Boulevard in St. Paul.
Most of us don't think such a visit is a big deal. But for men like Roberson seeking a serious change in their lives, walking into such a place and learning about history and family genealogy is a milestone, an "aha!" moment.
That's one of the reasons he's sticking with Ujamaa Place, an ambitious project in St. Paul that has gained support from an array of people in the Twin Cities' civic, business and faith-based communities. Ujamaa translates to "extended family" in Swahili.
The year-old effort, in a "gang-neutral" site off University Avenue West and Fairview Avenue, may be the last hope for hard-core cases like Roberson.
"It focuses on folks in our community that are at danger of becoming a lost generation of men," said Bill Svrluga, a longtime Twin Cities civic figure and Ujamaa board member who runs a nonprofit consulting firm.
"These are young men with little or no education, from families without fathers or parents; many have gone to prison, and there's really no place for them left to go to become productive members of society," Svrluga said. "They are at the bottom of the ladder, and many end up in jail or dead by 35."
The effort, which officially opened in January, exclusively targets males, predominantly African-American, 18 to 31 years old. Most of the 30-member clientele never finished high school and are chronically unemployed. Roughly 60 percent have criminal histories.
The statistics in recent decades on such men - caught in a cycle of poverty, drug addiction, joblessness, homelessness, violence and criminality - are a national concern:
In 2004, fewer than 8 percent of young African-American men graduated from college. The unemployment rate for young African-American men is more than twice that for young white, Hispanic and Asian-American men. The percentage of young African-American men in prison is nearly three times that of Latino men and nearly seven times that of white men. The homicide death rate for young African-American men is three times the rate for Hispanics, the population group with the next-highest homicide mortality rate.
Roy Barker, the nonprofit's executive director and the driving force behind the effort, might have the toughest job in town. But the 58-year-old Bethel College graduate and others believe it can be done. How? Through a holistic approach that includes completing a high-school diploma equivalency and other training; stable housing; and parenting, life and employment skills.
2011年12月1日星期四
China's Mengniu Dairy Recovers
Mengnuu Dairy Co, a onetime stock market darling that was at the center of one of China’s worst food scandals, announced Thursday that it is once again distributing milk products in Hong Kong after a three-year absence.
The company says its products have passed stringent heat preservation and other tests and have obtained quality hygiene certificates from mainland authorities. The Hong Kong Food and Environmental Hygiene Department are also responsible for assuring quality and safety, according to a news release.
Hong Kong's Center for Food Safety (CFS) said in an email that permission had been granted in October for the import of two Mengniu products and that imported consignments hadbeen inspected and released in November.
In 2008, the Inner Mongolia-based Mengniu, which is privately owned and publicly traded, as well as some of China’s other biggest dairy companies including the state-owned Yili and Yahsli were found to be distributing milk and infant formula and other food products adulterated with melamine, an industrial resin used in a wide variety of laminates, glues, adhesives, molding compounds and other substances.
Mengniu, which paid some of China’s highest prices for raw products, was buying from dairies that were adulterating the milk with melamine in a bid to boost protein content. By November of 2008, an estimated 300,000 children were victims, with six dying from kidney stones and other kidney damage and another 860 babies hospitalized.
The resultant scandal caused a crisis of confidence in China’s food distribution system from which the country still is attempting to recover. Authorities were accused of covering up the scandal for months to avoid national embarrassment in advance of the 2008 Olympic Games.
Three years later, middle-class Chinese consumers still tend to shy away from domestic milk products, instead looking for safety in western products, according to a study by Synovate Global Market Research. Indeed, as late as July 2010, authorities said they were still seizing melamine-contaminated products in some provinces. It was unclear, however, whether the contaminations were new or resulting from illegal resale of products from the 2008 scandal.
A wide variety of western chains stopped buying Chinese milk products including KFC, McDonalds and Starbucks, which replaced its Mengniu product with soy milk. The market share of foreign brands including Meadjohnson, Dumex, Abbott, and Wyeth soared. A US baby milk powder brand called Bright Beginnings reported sales volume had rise by 600 percent during the first week after the scandal was reported. Eleven countries announced they were stopping all imports of Chinese food products.
A dairy farmer who added the substance to the milk and a salesman who peddled it were executed, three were given life sentences and two more were given 15-year sentences. However, in many cases the families of the children who were affected are still trying to win redress. Officials of Sanlu, the biggest distributor selling milk products to the retail dairy operations, have never been charged or arrested despite the fact that melatonin levels found were among the highest. That has awakened charges that the company was being protected by officials.
In addition, the issue raised far wider concerns in China about the adulteration of lots of different food products including exploding watermelons caused by farmers who used chemicals to promote faster growth, bean sprouts treated with chemicals to make them grow faster, dumplings and steamed buns found to have levels of aluminum far above national standards, pork laced with the steroid clenbuterol to produce lean meat, and many others.
In February this year, reports surfaced that other dairies were using leather-hydrolyzed protein which, like melamine, boosts the protein content of milk. That report resulted in China’s closure of large numbers of dairies, some found to have with up to five times the legal limit of the substance.
The process of recovery for Mengniu has been long and painful. The company estimated a 2008 loss of 900 million yuan from inventory write-offs, plunging sales and damage-control expenditures. The company’s shares, trading at HK$35.80 per share at their 2007 peak, fell to HK$6 before recovering to hover at around HK$9. The shares have since recovered to trade in the HK$26 range.
After the scandal, Mengniu's spent a fortune on advertisements on CCTV, the country's largest TV station, and on outdoor billboards in major cities. It also invited consumers from all over the country to visit its farms and observe the milking process in the attempt to regain trust.
Mengniu said it had pledged US$100 million to upgrade the sources of its milk, investing in small and midsize ranches and dairy farms that it determined it could trust, In an attempt to build quality control, the company said in a prepared release, it has focused on constructing ranches and managing production to seek to maintain product quality. The Group recorded an annual turnover of RMB30 billion in 2010.
None of the scandal was mentioned in the press release issued yesterday announcing Mengniu’s return to Hong Kong. The products, the company said, are being delivered from Inner Mongolia to Hong Kong gradually and have been put on shelves at more than 80 stores. The products are also to be put on shelves at another 90 stores within a month, making a total of more than 170 sales points. That is eventually expected to rise to 400 with the inclusion of Park'N Shop, retail stores and pharmacies. In Macau, Mengniu products are expected to be available for sale within two weeks.
In recent years, Mengniu has focused on constructing ranches and managing production to enhance product quality in every stage of production, with the aim to serve consumers and build strong market awareness in the mainland market.
The group's diversified products range includes liquid milk products, such as UHT milk, milk beverages and yogurt, ice cream and other dairy products such as milk powder. In June 2011, the Group's annual production capacity reached 6.76 million metric tons.
The company says its products have passed stringent heat preservation and other tests and have obtained quality hygiene certificates from mainland authorities. The Hong Kong Food and Environmental Hygiene Department are also responsible for assuring quality and safety, according to a news release.
Hong Kong's Center for Food Safety (CFS) said in an email that permission had been granted in October for the import of two Mengniu products and that imported consignments hadbeen inspected and released in November.
In 2008, the Inner Mongolia-based Mengniu, which is privately owned and publicly traded, as well as some of China’s other biggest dairy companies including the state-owned Yili and Yahsli were found to be distributing milk and infant formula and other food products adulterated with melamine, an industrial resin used in a wide variety of laminates, glues, adhesives, molding compounds and other substances.
Mengniu, which paid some of China’s highest prices for raw products, was buying from dairies that were adulterating the milk with melamine in a bid to boost protein content. By November of 2008, an estimated 300,000 children were victims, with six dying from kidney stones and other kidney damage and another 860 babies hospitalized.
The resultant scandal caused a crisis of confidence in China’s food distribution system from which the country still is attempting to recover. Authorities were accused of covering up the scandal for months to avoid national embarrassment in advance of the 2008 Olympic Games.
Three years later, middle-class Chinese consumers still tend to shy away from domestic milk products, instead looking for safety in western products, according to a study by Synovate Global Market Research. Indeed, as late as July 2010, authorities said they were still seizing melamine-contaminated products in some provinces. It was unclear, however, whether the contaminations were new or resulting from illegal resale of products from the 2008 scandal.
A wide variety of western chains stopped buying Chinese milk products including KFC, McDonalds and Starbucks, which replaced its Mengniu product with soy milk. The market share of foreign brands including Meadjohnson, Dumex, Abbott, and Wyeth soared. A US baby milk powder brand called Bright Beginnings reported sales volume had rise by 600 percent during the first week after the scandal was reported. Eleven countries announced they were stopping all imports of Chinese food products.
A dairy farmer who added the substance to the milk and a salesman who peddled it were executed, three were given life sentences and two more were given 15-year sentences. However, in many cases the families of the children who were affected are still trying to win redress. Officials of Sanlu, the biggest distributor selling milk products to the retail dairy operations, have never been charged or arrested despite the fact that melatonin levels found were among the highest. That has awakened charges that the company was being protected by officials.
In addition, the issue raised far wider concerns in China about the adulteration of lots of different food products including exploding watermelons caused by farmers who used chemicals to promote faster growth, bean sprouts treated with chemicals to make them grow faster, dumplings and steamed buns found to have levels of aluminum far above national standards, pork laced with the steroid clenbuterol to produce lean meat, and many others.
In February this year, reports surfaced that other dairies were using leather-hydrolyzed protein which, like melamine, boosts the protein content of milk. That report resulted in China’s closure of large numbers of dairies, some found to have with up to five times the legal limit of the substance.
The process of recovery for Mengniu has been long and painful. The company estimated a 2008 loss of 900 million yuan from inventory write-offs, plunging sales and damage-control expenditures. The company’s shares, trading at HK$35.80 per share at their 2007 peak, fell to HK$6 before recovering to hover at around HK$9. The shares have since recovered to trade in the HK$26 range.
After the scandal, Mengniu's spent a fortune on advertisements on CCTV, the country's largest TV station, and on outdoor billboards in major cities. It also invited consumers from all over the country to visit its farms and observe the milking process in the attempt to regain trust.
Mengniu said it had pledged US$100 million to upgrade the sources of its milk, investing in small and midsize ranches and dairy farms that it determined it could trust, In an attempt to build quality control, the company said in a prepared release, it has focused on constructing ranches and managing production to seek to maintain product quality. The Group recorded an annual turnover of RMB30 billion in 2010.
None of the scandal was mentioned in the press release issued yesterday announcing Mengniu’s return to Hong Kong. The products, the company said, are being delivered from Inner Mongolia to Hong Kong gradually and have been put on shelves at more than 80 stores. The products are also to be put on shelves at another 90 stores within a month, making a total of more than 170 sales points. That is eventually expected to rise to 400 with the inclusion of Park'N Shop, retail stores and pharmacies. In Macau, Mengniu products are expected to be available for sale within two weeks.
In recent years, Mengniu has focused on constructing ranches and managing production to enhance product quality in every stage of production, with the aim to serve consumers and build strong market awareness in the mainland market.
The group's diversified products range includes liquid milk products, such as UHT milk, milk beverages and yogurt, ice cream and other dairy products such as milk powder. In June 2011, the Group's annual production capacity reached 6.76 million metric tons.
2011年11月21日星期一
Kidney Stone Prevention: 'Fact versus Fiction'
According to current estimates, kidney stones will develop in one in 10 people during their lifetime. This translates into nearly 30 million people in the United States. The prevalence is highest among those aged 30-45 years. High urinary calcium can be the cause of kidney stones in upwards of 80% of cases. The most prevalent stone composition is calcium oxalate. Once kidney stones develop, patients have a 50%-75% likelihood of developing another stone. The yearly cost of kidney stones in the United States was $2 billion (treatments, hospitalizations, lost work, etc.) in 1994 and is now estimated at $5 billion.1
Clearly, prevention is paramount when dealing with kidney stones. General guidelines for prevention include moderate protein intake, minimal salt ingestion, and drinking enough clear liquids to generate two liters of urine per day. A low oxalate diet has proved beneficial for preventing calcium oxalate stones. Reducing elevated urinary calcium levels helps to improve urinary saturation kinetics. Uric acid stones require dietary manipulation, adequate fluid intake to optimize volumes, and manipulation of urinary pH. Cystine stones, while relatively rare, require their own preventive measures.
Which fluid to drink is controversial. While water is the mainstay, a number of articles tout the benefit of different juices. For example, lemon juice increases urinary citrate and may prevent calcium stones. Whether one uses the recommended half cup of lemon juice per day straight up or diluted, is a personal choice. Lemonade is another frequently recommended choice. There are various opinions when it comes to the benefits of orange juice. It, too, increases urinary citrate levels, but there is concern that it could raise oxalate levels. Apple and cranberry juice contain oxalates and have been associated with a higher risk of calcium oxalate stones. Likewise, grapefruit juice has been associated with increased risk of stone formation. Soft drinks, via their phosphorus content, may lead to increased risk for kidney stones.2,3 The choice of fluid depends on other variables in the patient's urinary chemical composition.
What about sugar? Analysis from the Nurses Health Study II has shown that sugar increased kidney stone risk in young women by more than 30%. Whether this was an independent variable was unclear but the message is that high sugar, whether fructose or other sugar, is probably detrimental in the prevention of further kidney stones.
And the calcium controversy? Calcium supplements, in excess, will increase your risk for forming kidney stones. Given all of the studies and commentaries, the simple take home message is that a diet containing normal amounts of calcium along with salt and animal protein reduction will likely protect against stones better than a low calcium regimen. It is accepted that a diet too low in calcium intake will allow preferential absorption of oxalate in the gut and increase the risk of calcium oxalate stones.
If diet alone is not helpful in correcting an abnormal urinary chemical environment, then medications are sometimes offered. These include thiazide diuretics for high urinary calcium levels, citrate supplementation for low urinary citrate levels, cystine binding drugs (i.e., penicillamine) for cystine stone prevention, as well as new options on the horizon, including oxalate degrading enzymes. But, like most drugs, these options have side effects. Thiazides, for instance, can worsen glucose tolerance, cause electrolyte imbalance, and aggravate triglyceride levels.
Clearly, prevention is paramount when dealing with kidney stones. General guidelines for prevention include moderate protein intake, minimal salt ingestion, and drinking enough clear liquids to generate two liters of urine per day. A low oxalate diet has proved beneficial for preventing calcium oxalate stones. Reducing elevated urinary calcium levels helps to improve urinary saturation kinetics. Uric acid stones require dietary manipulation, adequate fluid intake to optimize volumes, and manipulation of urinary pH. Cystine stones, while relatively rare, require their own preventive measures.
Which fluid to drink is controversial. While water is the mainstay, a number of articles tout the benefit of different juices. For example, lemon juice increases urinary citrate and may prevent calcium stones. Whether one uses the recommended half cup of lemon juice per day straight up or diluted, is a personal choice. Lemonade is another frequently recommended choice. There are various opinions when it comes to the benefits of orange juice. It, too, increases urinary citrate levels, but there is concern that it could raise oxalate levels. Apple and cranberry juice contain oxalates and have been associated with a higher risk of calcium oxalate stones. Likewise, grapefruit juice has been associated with increased risk of stone formation. Soft drinks, via their phosphorus content, may lead to increased risk for kidney stones.2,3 The choice of fluid depends on other variables in the patient's urinary chemical composition.
What about sugar? Analysis from the Nurses Health Study II has shown that sugar increased kidney stone risk in young women by more than 30%. Whether this was an independent variable was unclear but the message is that high sugar, whether fructose or other sugar, is probably detrimental in the prevention of further kidney stones.
And the calcium controversy? Calcium supplements, in excess, will increase your risk for forming kidney stones. Given all of the studies and commentaries, the simple take home message is that a diet containing normal amounts of calcium along with salt and animal protein reduction will likely protect against stones better than a low calcium regimen. It is accepted that a diet too low in calcium intake will allow preferential absorption of oxalate in the gut and increase the risk of calcium oxalate stones.
If diet alone is not helpful in correcting an abnormal urinary chemical environment, then medications are sometimes offered. These include thiazide diuretics for high urinary calcium levels, citrate supplementation for low urinary citrate levels, cystine binding drugs (i.e., penicillamine) for cystine stone prevention, as well as new options on the horizon, including oxalate degrading enzymes. But, like most drugs, these options have side effects. Thiazides, for instance, can worsen glucose tolerance, cause electrolyte imbalance, and aggravate triglyceride levels.
2011年10月19日星期三
Patient Sues Hospital, Nurse in Painkiller Theft
Hearing Larry King describe his kidney stone surgery from last November can make anyone squirm.
“It felt to me like someone was taking needles and pushing them down through your back and into your kidney,” says King.
On Tuesday, King filed a lawsuit against Allina Health Systems, Abbott Northwestern Hospital, and his former nurse, Sarah Casareto.
Earlier this year, Hennepin County prosecutors accused Casareto of stealing King’s pain medication during surgery. Through a plea deal, the charge was dismissed. As long as Casareto does not violate her three year probation, she will avoid jail time, fines, and her record will remain clean.
“I think that was one of the deciding factors with going forward with the civil case. Justice was not served,” said King’s attorney, Tony Nemo from the Meshbesher and Spence law firm. “Michael Vick was mean to some dogs. He got 23 months. This woman was mean to a patient and walked. She's not going to walk in this case."
King says everything started off normal at Abbott Northwestern Hospital on Nov. 8, 2010. But when his nurse started wheeling him toward radiology, things started to get weird.
“It was at that point she said to m, 'You are going to have to man up here and take some pain because you are going into surgery and we can't give you that much medication,'” said King. "That made me nervous because my radiologist said it would be fine and, ''You won't feel any significant pain.'”
King said he felt extraordinary pain and heard conversations going on around him during surgery, but said Casareto was noticeably absent.
“At one point, I could hear him talk to the nurse again and say, 'Get over here.' I didn't know where she was, but at one point when I was locked up tight -- I don't know if I was panicking at that point, but I lifted myself up with my forearm and turned to look where she was. I couldn't see her. I didn't know where she was. Doctor took his forearm and just rested it on my back,” recalled King. “Finally, a tech reached over and said "breathe" and put me out. At that point, I don't remember anything more.”
That was about half way through the hour-long procedure.
“He was supposed to be given Fentanyl and Versed, which gives you sort of amnesia,” said Nemo. “So, the fact that he remembers anything is shocking.”
King’s attorney and Hennepin County prosecutors have said he was given about a third of the medication Casareto had signed out from the hospital. Coworkers told investigators she was acting bizarre, dropping syringes, staggered in the operating room and was later found with at least two unlabeled syringes in her pockets.
“Falling asleep, rocking back and forth, and talking about going to a happy place. This guy was having a procedure done without anesthetic. He wasn't in a happy place and she was not going to put him there,” said Nemo. “She was in such a state, I don't think she could add and subtract -- and she could have easily killed him by overdosing him.”
Casareto’s lawyer, Brian Toder, said statements from the same surgical staff contradict what King claims. After the criminal case was dismissed, Toder says he is surprised by the civil suit.
During the criminal proceedings earlier this year, Casareto missed some court appearances because she was in drug treatment. Toder says she is no longer in treatment and said she never lost nursing license.
“She simply agreed not to practice until after there was resolution to the criminal case, followed by an appearance before the Nursing Board," Toder said.
“It felt to me like someone was taking needles and pushing them down through your back and into your kidney,” says King.
On Tuesday, King filed a lawsuit against Allina Health Systems, Abbott Northwestern Hospital, and his former nurse, Sarah Casareto.
Earlier this year, Hennepin County prosecutors accused Casareto of stealing King’s pain medication during surgery. Through a plea deal, the charge was dismissed. As long as Casareto does not violate her three year probation, she will avoid jail time, fines, and her record will remain clean.
“I think that was one of the deciding factors with going forward with the civil case. Justice was not served,” said King’s attorney, Tony Nemo from the Meshbesher and Spence law firm. “Michael Vick was mean to some dogs. He got 23 months. This woman was mean to a patient and walked. She's not going to walk in this case."
King says everything started off normal at Abbott Northwestern Hospital on Nov. 8, 2010. But when his nurse started wheeling him toward radiology, things started to get weird.
“It was at that point she said to m, 'You are going to have to man up here and take some pain because you are going into surgery and we can't give you that much medication,'” said King. "That made me nervous because my radiologist said it would be fine and, ''You won't feel any significant pain.'”
King said he felt extraordinary pain and heard conversations going on around him during surgery, but said Casareto was noticeably absent.
“At one point, I could hear him talk to the nurse again and say, 'Get over here.' I didn't know where she was, but at one point when I was locked up tight -- I don't know if I was panicking at that point, but I lifted myself up with my forearm and turned to look where she was. I couldn't see her. I didn't know where she was. Doctor took his forearm and just rested it on my back,” recalled King. “Finally, a tech reached over and said "breathe" and put me out. At that point, I don't remember anything more.”
That was about half way through the hour-long procedure.
“He was supposed to be given Fentanyl and Versed, which gives you sort of amnesia,” said Nemo. “So, the fact that he remembers anything is shocking.”
King’s attorney and Hennepin County prosecutors have said he was given about a third of the medication Casareto had signed out from the hospital. Coworkers told investigators she was acting bizarre, dropping syringes, staggered in the operating room and was later found with at least two unlabeled syringes in her pockets.
“Falling asleep, rocking back and forth, and talking about going to a happy place. This guy was having a procedure done without anesthetic. He wasn't in a happy place and she was not going to put him there,” said Nemo. “She was in such a state, I don't think she could add and subtract -- and she could have easily killed him by overdosing him.”
Casareto’s lawyer, Brian Toder, said statements from the same surgical staff contradict what King claims. After the criminal case was dismissed, Toder says he is surprised by the civil suit.
During the criminal proceedings earlier this year, Casareto missed some court appearances because she was in drug treatment. Toder says she is no longer in treatment and said she never lost nursing license.
“She simply agreed not to practice until after there was resolution to the criminal case, followed by an appearance before the Nursing Board," Toder said.
2011年3月28日星期一
Breaking Brad: March 28
On the news I thought I was watching a defendant walking into court holding his hands over his face so the cameras can't see him. Turns out it was Dana Altman arriving in Omaha for tonight's CBI game.
How awkward does Dana Altman feel playing Creighton in Omaha tonight? The only thing more awkward would be if Trev Alberts and Mike Denney somehow ended up sharing the same cab.
A woman was arrested at Boston Airport for smuggling cocaine inside a diaper. Initially airport security began by asking her why she was wearing a diaper. Of course the correct response should have been, "Have you been in an airliner bathroom?"
In Oakland the first "cannabis college" has opened; it's an actual university devoted to the use and science of marijuana. This sets up a good news/bad news scenario for parents. "Mom, Dad - good news. I was accepted into college. Now the bad news..."
How about all those upsets and Cinderella stories? Butler made it into the Final Four, VCU made the Final Four, Richmond made it into the Sweet 16, a victorious coalition military campaign was led by the French ...
A few weeks ago if someone told you that today Ohio State and Kansas would be done for the season and Creighton would still be playing basketball you would've had them committed.
Kentucky made the Final Four. The big concern now is that several of the players will turn pro before the title game.
On the heels of the no-fly zone there's an effort to create a "no-drive zone" in Libya. In order to make it literally impossible to drive anywhere, President Obama is going to put the Omaha Public Works Department in charge of Libyan street maintenance.
Another new goal in Libya — make it impossible for the leaders to communicate. So President Obama is switching all their calling plans to Verizon.
On April 15, a Civil War demonstration in Kearney is going to feature an "Abraham Lincoln impersonator." How lame are our elected leaders going to seem after we've been exposed to an Abraham Lincoln impersonator? You go from, "Four score and seven years ago" to "I hereby demand a 10 cent per roll toilet paper tax."
Over the weekend, Earth Hour was held to promote the environment. A very popular event. So many turned out for a ceremony in Brazil, 10 acres of the rain forest had to be leveled to create parking.
For Earth Hour, cities went dark for 60 minutes to encourage people to refrain from using non-essential electricity. Then at 8:30 everyone returned to their Play Stations, crawled under their electric blankets and played video poker on their 100,000 megabyte computers with "power boost."
We've learned from the Messenger rover that daytime temperatures on Mercury average 840 degrees F and nighttime temps dip down to -356 F. In Omaha we call temperature shifts that dramatic "spring."
Dan Quayle said there's no reason President Obama can't play golf and run the country at the same time. Then Quayle attempted to demonstrate by walking and chewing gum at the same time, but screwed up and had to start over.
According to a man-on-the-street survey, 29 percent of people in this country could not name the vice president. In these surveys people keep getting dumber. Where does it end? In 2025 when according to a survey 17 percent of Americans don't know their own names?
A fire broke out at the Miami airport as a flight was boarding. Fortunately because it was Miami, 95 percent of passengers were old enough for pre-boarding and were already on the plane.
There's more fallout over that sleeping air traffic controller at Ronald Reagan Airport. Here's my question: Why was there only one controller on duty at a major international airport? Last night I went to 7-Eleven and there were six guys behind the counter.
Singer Chris Brown trashed a room backstage at "Good Morning America." You know how derivative early morning TV is. Now Brown has been invited to trash rooms at the "Today" show and "CBS Morning Show."
A small meteorite crashed through the ceiling of an examination room at a Virginia medical office. Ironically, when the meteorite crashed into the room at 3,000 miles per hour a patient was passing a kidney stone. "What the heck?"
According to a new study exercising or having sex can increase your chance of having a heart attack in the next few hours. This is expected to greatly reduce the number of Americans who exercise.
Detroit's population has dropped 25 percent in the past decade. Here's the really embarrassing thing for Detroit — lots of the people who left moved to Cleveland.
ABC is reportedly on the brink of canceling the soap "All My Children" which has been on the air 41 years. Which I think makes it the newest soap opera on television.
London may be getting a Harry Potter-themed hotel. This will address the acute shortage of Harry Potter-esque things in the world today.
How awkward does Dana Altman feel playing Creighton in Omaha tonight? The only thing more awkward would be if Trev Alberts and Mike Denney somehow ended up sharing the same cab.
A woman was arrested at Boston Airport for smuggling cocaine inside a diaper. Initially airport security began by asking her why she was wearing a diaper. Of course the correct response should have been, "Have you been in an airliner bathroom?"
In Oakland the first "cannabis college" has opened; it's an actual university devoted to the use and science of marijuana. This sets up a good news/bad news scenario for parents. "Mom, Dad - good news. I was accepted into college. Now the bad news..."
How about all those upsets and Cinderella stories? Butler made it into the Final Four, VCU made the Final Four, Richmond made it into the Sweet 16, a victorious coalition military campaign was led by the French ...
A few weeks ago if someone told you that today Ohio State and Kansas would be done for the season and Creighton would still be playing basketball you would've had them committed.
Kentucky made the Final Four. The big concern now is that several of the players will turn pro before the title game.
On the heels of the no-fly zone there's an effort to create a "no-drive zone" in Libya. In order to make it literally impossible to drive anywhere, President Obama is going to put the Omaha Public Works Department in charge of Libyan street maintenance.
Another new goal in Libya — make it impossible for the leaders to communicate. So President Obama is switching all their calling plans to Verizon.
On April 15, a Civil War demonstration in Kearney is going to feature an "Abraham Lincoln impersonator." How lame are our elected leaders going to seem after we've been exposed to an Abraham Lincoln impersonator? You go from, "Four score and seven years ago" to "I hereby demand a 10 cent per roll toilet paper tax."
Over the weekend, Earth Hour was held to promote the environment. A very popular event. So many turned out for a ceremony in Brazil, 10 acres of the rain forest had to be leveled to create parking.
For Earth Hour, cities went dark for 60 minutes to encourage people to refrain from using non-essential electricity. Then at 8:30 everyone returned to their Play Stations, crawled under their electric blankets and played video poker on their 100,000 megabyte computers with "power boost."
We've learned from the Messenger rover that daytime temperatures on Mercury average 840 degrees F and nighttime temps dip down to -356 F. In Omaha we call temperature shifts that dramatic "spring."
Dan Quayle said there's no reason President Obama can't play golf and run the country at the same time. Then Quayle attempted to demonstrate by walking and chewing gum at the same time, but screwed up and had to start over.
According to a man-on-the-street survey, 29 percent of people in this country could not name the vice president. In these surveys people keep getting dumber. Where does it end? In 2025 when according to a survey 17 percent of Americans don't know their own names?
A fire broke out at the Miami airport as a flight was boarding. Fortunately because it was Miami, 95 percent of passengers were old enough for pre-boarding and were already on the plane.
There's more fallout over that sleeping air traffic controller at Ronald Reagan Airport. Here's my question: Why was there only one controller on duty at a major international airport? Last night I went to 7-Eleven and there were six guys behind the counter.
Singer Chris Brown trashed a room backstage at "Good Morning America." You know how derivative early morning TV is. Now Brown has been invited to trash rooms at the "Today" show and "CBS Morning Show."
A small meteorite crashed through the ceiling of an examination room at a Virginia medical office. Ironically, when the meteorite crashed into the room at 3,000 miles per hour a patient was passing a kidney stone. "What the heck?"
According to a new study exercising or having sex can increase your chance of having a heart attack in the next few hours. This is expected to greatly reduce the number of Americans who exercise.
Detroit's population has dropped 25 percent in the past decade. Here's the really embarrassing thing for Detroit — lots of the people who left moved to Cleveland.
ABC is reportedly on the brink of canceling the soap "All My Children" which has been on the air 41 years. Which I think makes it the newest soap opera on television.
London may be getting a Harry Potter-themed hotel. This will address the acute shortage of Harry Potter-esque things in the world today.
2011年3月20日星期日
Gently Does it - Safe and Gentle Stone Retrieval
Around 5-10% of adults in Central and Western Europe suffer from kidney and ureteral stone
disease. These solid formations occur when substances that normally dissolve in the urine are
separated out and deposited as fine crystals in those organs. Such stones can be found in the
renal calyces, renal pelvis and lower urinary tract (ureter, bladder, urethra).
About 80% of all kidney stones pass out of the body with the urine. In the remaining 20%,
medical assistance is required for removal. Men are affected twice often as women.
Formerly, the treatment of kidney and ureteral stones was performed mostly by ESWL in the
last 15 years.
Due to immense improvements of the equipment for and training in ureteroscopy this is
currently the therapeutic procedure carried out more and more often. Ureteroscopy is a
minimal invasive intervention by which a flexible endoscope is passed through the urethra
into the ureter to capture stones and/or stone fragments.
With its complete portfolio and its innovative Sur-Catch NT retrieval basket, Olympus
provides a specially developed, gentle and fast treatment for kidney and ureteral stone
removal.
Thanks to its tipless design with rounded wires, the basket is extremely soft and smooth to
prevent bleeding and injury to the tissue. The Nitinol material gives the basket the
additional advantage of the ultimate flexibility to move easily and safely toward to the
stone - even in patients with difficult anatomy. Nitinol is a nickel and titan shape memory
alloy and possesses properties like biocompatibility and high flexibility. Even when changing
its shape, Nitinol can remember its previous form and change back.
Because the stones can be completely removed in just a single session in almost all cases,
the procedure is highly effective.
The additional portfolio supplied by Olympus enable surgeons to render accurate and exact
diagnoses while accomplishing a fast, safe and effective intervention:
- the flexible endoscope (ureteroscope) produces crystal clear and 3-times larger images,
allowing visibility directly onto the stone and its location.
- The new NBI function enables a better diagnosis of suspicious structures and simulates a 3D
view of the mucosa.
disease. These solid formations occur when substances that normally dissolve in the urine are
separated out and deposited as fine crystals in those organs. Such stones can be found in the
renal calyces, renal pelvis and lower urinary tract (ureter, bladder, urethra).
About 80% of all kidney stones pass out of the body with the urine. In the remaining 20%,
medical assistance is required for removal. Men are affected twice often as women.
Formerly, the treatment of kidney and ureteral stones was performed mostly by ESWL in the
last 15 years.
Due to immense improvements of the equipment for and training in ureteroscopy this is
currently the therapeutic procedure carried out more and more often. Ureteroscopy is a
minimal invasive intervention by which a flexible endoscope is passed through the urethra
into the ureter to capture stones and/or stone fragments.
With its complete portfolio and its innovative Sur-Catch NT retrieval basket, Olympus
provides a specially developed, gentle and fast treatment for kidney and ureteral stone
removal.
Thanks to its tipless design with rounded wires, the basket is extremely soft and smooth to
prevent bleeding and injury to the tissue. The Nitinol material gives the basket the
additional advantage of the ultimate flexibility to move easily and safely toward to the
stone - even in patients with difficult anatomy. Nitinol is a nickel and titan shape memory
alloy and possesses properties like biocompatibility and high flexibility. Even when changing
its shape, Nitinol can remember its previous form and change back.
Because the stones can be completely removed in just a single session in almost all cases,
the procedure is highly effective.
The additional portfolio supplied by Olympus enable surgeons to render accurate and exact
diagnoses while accomplishing a fast, safe and effective intervention:
- the flexible endoscope (ureteroscope) produces crystal clear and 3-times larger images,
allowing visibility directly onto the stone and its location.
- The new NBI function enables a better diagnosis of suspicious structures and simulates a 3D
view of the mucosa.
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