Type 2 Diabetes – Can Controlling Blood Sugar Levels Control Necrobiosis Lipoidica?

Necrobiosis lipoidica is sometimes referred to as necrobiosis lipoidica diabeticorum because it was first discovered in people who had been diagnosed with Type 2 diabetes and is often seen with the condition. Collagen, connective tissue, is replaced with…

  • immune cells,
  • fat cells, and
  • thickened blood vessels,

to make what is called a granuloma. Granulomas are used to wall off…

  • infection,
  • inflammation, or anything else
  • the body perceives as undesirable.

Gradually granulomas take on calcium and become as hard as bone. Necrobiosis lipoidica is seen in about 0.3 percent of diabetics and is diagnosed before the diagnosis of Type 2 diabetes in 15 percent of people…

  • 60 percent have a diagnosis of diabetes before necrobiosis lipoidica, while the other
  • 25 percent are diagnosed with both conditions at the same time.

About 30 to 91 percent of Type 2 diabetics will develop some chronic skin disease at some point. On the skin necrobiosis lipoidica can resemble ringworm, a fungal infection, although the two are unrelated. In rare cases, necrobiosis lipoidica can develop cancer, although most are benign. Nonetheless, it is safest to prevent them.

In June of 2017, the International Journal of Dermatology reported on a study from the University of British Columbia and the University of Toronto in Canada. Workers there found all the reports they could on Type 2 diabetes control and necrobiosis lipoidica. They pored over the literature and found ten studies to analyze as one stand-alone large study. Of the 24 participants included in the ten studies, 16 (67 percent) of the participants found their necrobiosis lipidosis cleared up when their diabetes and blood sugar levels were brought under control.

The researchers concluded, since the number of participants was so small, more work needs to be done to establish whether a link exists. Even if there is no such link, positively controlling Type 2 diabetes makes for a healthier, and in some cases, a longer life.

Other skin conditions are seen in people diagnosed with Type 2 diabetes, more than in nondiabetic individuals and include…

  • psoriasis – red, scaly rash, painful when it covers enough skin.
  • acanthrosis nigricans – black, velvety skin in the groin and armpits.
  • infections – especially fungal.
  • scleroderma diabeticorum – thickened skin on the neck and back. Treated with moisturizing lotions and by controlling blood sugar levels.
  • dermopathy – areas of thickened, reddened skin on a person’s legs.
  • diabetic blisters – appear spontaneously. Treated with control of blood sugar levels and tend to occur in Type 2 diabetics with diabetic neuropathy.

Does Your Mind Wander When You Pray in Tongues

Don’t worry, you’re not the first.

I received my prayer language from the Holy Spirit a year after I was saved. Like any new believer, I was worried I wasn’t a “real Christian” yet because the Scripture said that tongues is a sign of the Holy Spirit… and if the Holy Spirit does not live in you then you’re not a Christian.

If you’re like me, you probably went to the nearest church and asked them to pray for you. I did and sure enough, I walked out of there speaking in tongues. What was strange was that the Holy Spirit was already intercessing for me… in my sleep! There were times where I would suddenly wake up and find myself speaking what I thought was gibberish.

There were also times when I wanted to pray and my tongue would be so loose, I just thought I was running out of words! If you haven’t yet started praying in the Spirit, aka tongues, just ask God for it. It’s that simple. If it doesn’t happen immediately, don’t panic. Usually a series of events will just take place and He will lead you to someone who can help you.

In the beginning

The first night I prayed in tongues on my own was amazing. I said my little prayer and asked the Holy Spirit to take over because “I know not what I ought to pray for”. My lips started quivering and next thing I knew, I was praying in the Spirit.

The weird thing about it is that, because it’s the Holy Spirit praying, your mind can easily wander. I found myself thinking about my family, friends, ex-boyfriend and career. I began to imagine what He could be praying about. I also started wondering if I wasn’t just making it up.

The devil’s tricks

Praying in the Spirit is very powerful. So as usual, our age-old enemy will come around and try to disturb you from accessing the power of God. Don’t entertain his thoughts. He’s just doing what he knows best: lying.

So no, you’re not making it up. No, you don’t have to know what the Holy Spirit is saying. No, it’s not a fake language from the devil. When these thoughts come, bring them into captivity to the obedience of Christ. If you call out the Holy Spirit to pray for you, then the Holy Spirit will pray for you, nobody else.

The Reality

The Word of God says that we must pray with our minds and in Spirit. When I read this, it was such a relief. It implies that I have to consciously focus my mind on praying… which effectively means it’s not unusual for my mind to wander.

Because we revere the Holy Spirit of God, I suggest surrendering to Him and allowing Him to pray as long as He needs to. Try not to interrupt. Truth be told, it can range from 5 minutes to an hour or two. Holy Spirit will always give you an option to stop because He loves you but considering how important His prayer is, I suggest you don’t choose to stop.

Try to pray in the morning or a few hours before bed so you don’t get tired and frustrated when you pray.

Side effects to get used to

Long prayer obviously has physical effects like discomfort in the jaw and a dry mouth. I don’t know about you but I also have a funny sensation in my hands like they’re not mine. I can literally feel the person of the Holy Spirit in me so I feel like my body is not even mine… and you know what, it’s not. It belongs to God.

Get used to these side effects because with just little labor, the Holy Spirit can release God’s power, Grace, Love and blessings into your life.

Jesus: Shepherd, Lord, King:)

The Best and Worst Weight Loss Supplement List

If you're one of those people that have tried "everything" to lose weight, then chances are, you've actually come in contact with one or more products in this best and worst weight loss supplement list.

Ephedra

Ephedra contains an active ingredient called ephedrine that stimulates directly the central nervous system. Not only does it increase metabolism, it also increases heart rate and blood pressure. It can also lead to heart attacks, stroke, seizures, and heart rate irregularities. It has also been found to cause insomnia and anxiety, most especially when taken with caffeine. Its use can also lead to dependency.
Products that contain Ephedra have been recaled and many companies have reformulated any weight loss product they have that contains Ephedra. In place of Ephedra, an herb called Citrus Aurantium was substituted.

Chitosan

Chitosan is activated in the digestive tract. After activation, it binds to fat and carries it along the gut unabsorbed. Most notable of its side effects include malabsorption of fat-soluble vitamins like A, D, E, and K. This causes the body to suffer from vitamin deficiency. Its other, less harmful side effects include stomach pain and diarrhea.

Citrimax (Garcinia Cambogia)

Citrimax products come from an herb called Garcinia cambogia. Garcinia cambogia contain hydroxycitric acid that was supposed to increase fat breakdown. Published studies in humans show that people who ingested the herb burned body fat no different individuals individuals who took a sugar pill.

Apple Cider Vinegar

Cider vinegar come from the fermented juice of crushed apples. Like apples, it contains pectin (a fiber), vitamins B and C, and other minerals. However, while not harmful in small amounts, it may not be wise to take in amounts greater than 250 ml (1 cup) each day. A typical dose for weight loss is an ounce of apple cider vinegar plus a teaspoon of honey in a quarter cup of water to be taken before every meal. Does it work? Nobody knows. No studies show that it does or does not work for weight loss though.

Whatever the difference, even if it gives you amazing results, if it causes you any harm no matter how small, then it deserves to be on the best and worst weight loss supplement list. Remember that losing weight is no easy business. This is not to say that you should not be taking any weight loss supplements and should only stick to working out rigorously. God knows even the most disciplined dieters need help every now and then. It's just a word of caution. Stick with weight loss supplements that are proven-safe by your local health officials and are distributed by licensed retailers. If you know what works and what does not, make your own best worst weight loss supplement list and share it with others.

Nine Inch Nails – Driving Their Fans With Rock

Nine Inch Nails or NIN is a one man industrial rock music group. It was formed in the year 1988 and founded in Cleveland, Ohio by Trent Reznor, who is the band’s founder, producer, songwriter, singer and instrumentalist. He is responsible for everything that happens within the band, as he is the only official member.

This band’s music consists of a large variety of genres, but maintaining a single sound by making use of certain electronic instruments. Once he has recorded a new album, Trent normally puts together a live band that will perform with him. For those of you who are die hard NIN fans, know that there is Nine Inch Nails merch available if you are interested.

This touring band has a rotating lineup that sometimes has to rearrange planned songs in order to match a live setting. When on stage, Nine Inch Nails sometimes go to the lengths of employing impressive visual elements to perform with, which often ends in the band demolishing their instruments. Some Nine Inch Nail merch will illustrate such events on their T-shirts if it is possible. In the 1990’s the band produced more than a few records, which managed to become rather popular over many parts of the world. Many of their songs became big hits on the radio. Two of their songs won Grammy Awards, and NIN have sold an astonishing 30 million albums nationwide. Eleven million albums were sold in the United States alone.

The fame didn’t stop there, as Trent made an appearance in the Time magazine’s listing of the most influential individuals in 1997. In the same year, Spin magazine portrayed Trent as “the most vital artist in music”. The US Based magazine Rolling Stone put NIN at number 94 on a list of the “100 greatest artists of all time”. That is quite an accomplishment for any band, and Nine Inch Nails was proud to be part of it. He was even more proud of what he had achieved when manufacturers started to make Nine Inch Nail merch to sell to the public. Fans bought all different types of merchandise with the bands name, logo and picture featured on it.

Although Nine Inch Nails have had so many compliments and were so successful in the years, they have indeed had many arguments with the business side of the industry. The worst was in 2007, when these petty arguments resulted in Trent proclaiming that the band was going to break away from its independent label and rather release their material on their own. Thankfully, the Nine Inch Nails merch was still the same throughout all these ordeals so impact to fans was not apparent. Let’s hope Nine Inch Nails continue to impress fans with their unique twist on Industrial Rock.

Shrink Fibroids With Herbs – Herbal Treatment For Fibroid Tumors

Herbal treatments have been used for many hundreds, if not thousands of years to treat all manner of conditions and fibroids are no exception. Many women have had great success when they have used strategies to shrink fibroids with herbs.

There is one crucial thing to bear in mind. There is no evidence to suggest that if used in isolation, herbal treatment for fibroid tumors is a complete cure. Herbs can definitely help to relieve symptoms and may indeed have some effect on the size of tumors, but they can not cure them altogether. Many websites sell herbal preparations which come with claims that they will eradicate fibroids, but this is only part of the story.

You can only effectively shrink fibroids with herbs if you use them in combination with other treatment strategies. It is well known that successful treatment may involve various elements and requires commitment and pro-activity. If you have fibroids and want to shrink them without surgery, you will need to be prepared to put in the effort and make lifestyle and diet changes. However, there is little doubt that when followed diligently, such approaches can be very effective, with most women who follow a recommended program finding that they are completely free of fibroid symptoms within a short time.

Any natural remedies which shrink fibroids with herbs will probably include Cinnamon, Nettle and Yarrow. These three, if taken as an infusion around 5 days before menstruation can help to reduce heavy bleeding. Yarrow can also help with period pain. You can also add ginger to the mix to boost the pain relieving element. Other helpful herbs for fibroids include Yam and Willow which, when combined with other strategies, can help reduce inflammation in the body and thus fibroid size.

Zithromax – How Antibiotics Help In Cancer Treatment?

The first stage cancer is often treated with antibiotics like Amikacin, Gentamicin, Kanamycin, Neomycin, and Netilmicin. These can help in precenting the condtions like weight loss, hearing issues, vertigo and even common kidney damages.

The use of Prescription antibiotics is quite common in the routine treatment of Cancer especially for the prevention of infections. The recent study showed that most forms of Cancer start with abnormal cells growth in unusual rate. This can happen in any part of the body including skin, brain, bones or even blood.

In recent years the antibiotics known as the Ansamycins are discovered to be effective in the treatment of the skin cancer too. These were first started as the experimental treatment in Europe in 2005. Their common usage has been in shape of the anti-tumor drugs as well. There are however some antibiotics that are now removed from the list of treatment for cancer including the widely used carbacephems as well.

The traditional process cancer control start with the tests to assess the extent and speed of damage that cancer is doing. In early stages the cancer can often be misdiagnosed unless the patient is aware of the various symptoms that can be quite similar to many common diseases.

The antibiotics can assist in the recovery process to speed up the healing process. This can assist the complicated surgical operations that often involve radiation and or some form of lazar rays. Similarly the chemotherapy and medications involved in this Antibiotic treatment can reduce the chances of infections. With more then hundred active antibiotic remedies to select from, the choice of the right one can be often based upon the individual case.

Similarly the antibiotics like Ertapenem, Doripenem are important for the common gastrointestinal upset, diarrhea, Nausea and the Seizures that might happen in the later stages of this disease. The other common problems associated with the cancer including the headaches, rashes and the allergic reactions can also be prevented with them successfully as well.

The factors like age, gender, family history and even the stage of the cancer can influence in the decision and choice of antibiotics easily too. Similarly the close administration of the antibiotics however is Zithromax often recommended as if misused these can easily backfire and have severe allergic reactions or even toxicity as well. The frequent use of the antibiotics is however done before the surgery too. The bacterial growth can be stopped with this also.

Specific pneumonias in immunocompromised patients

Gram-negative pneumonias

Bacterial pneumonias, particularly Gram-negative infections,are common in neutropenic patients (e.g. followingbone marrow transplantation, or chemotherapy forleukaemia), particularly if the granulocyte count is lessthan 500 x 106/L, and may be associated with lifethreateningsepticaemia. The chest X-ray usually showslocalized shadowing, rather than diffuse infiltration. Followingblood cultures empirical therapy should be started.Common organisms are Pseudomonas aeruginosa,638 Escherichia coli, Klebsiella, Enterobacter and Serratia spp.

Klebsiella pneumonia

The most common clinical setting for this Gram-negativepneumonia is the elderly male patient, often with chroniclung disease, whose ‘immunosuppression’ is due to generaldebility, associated with chronic illnesses such as diabetesor alcoholism. The illness can be severe (mortality20-50%), with high fever, rigors and pleuritic pain, andhaemoptysis occurs more often than in most bacterialpneumonias.

The upper lobes are commonly involved, withconsiderable necrosis and cavitation, often bilateral, andwith bulging of the fissure adjacent to the consolidatedlung. There may be diagnostic confusion with tuberculosis.Patients with klebsiella pneumonia can develop empyema.Treatment is most effective with gentamicin pluscefuroxime, but resolution is often slow and substantialresidual pulmonary damage is not uncommon.

Pneumocystis carinii pneumonia (PCP)

Pneumocystis pneumonia occurs in patients receivingsteroids and other immunosuppressive agents, and is particularlycommon in AIDS. The clinical picture is of fever,a dry cough and progressive breathlessness. On auscultationthe lungs often sound remarkably normal.

When treated early, pneumocystis pneumonia respondswell to therapy with high-dose co-trimoxazole (20 mg oftrimethoprim and 100 mg of sulfamethoxazole per kg bodyweight per day) given for 3 weeks. Mortality has fallenfrom 30% to 5% in recent years. Trimethoprim anddapsone is an effective combination, as is clindamycinplus primaquine, whereas pentamidine, although effective,is more toxic. Unfortunately,recurrence is common. Co-trimoxazole and inhaled pentamidineprovide effective prophylaxis. Because PCP isunusual in HIV until the CD4 lymphocyte count is lessthan 250, it is usual to initiate primary prophylaxis at thatlevel. In AIDS patients with severe pneumocystis pneumoniaand respiratory hypoxia (Pao2 < 9.0 kPa) corticosteroids,given early, improve survival.

Aspergillus pneumonia

Aspergillus fumigatus is a rare cause of pneumonia andpatients usually have severe granulocytopenia or are oncorticosteroid therapy, and have frequently receivedbroad-spectrum antibiotics. Patients receiving therapy forleukaemia are particularly at risk. The clinical picture is offever, dyspnoea, pulmonary infiltrates that resemble pulmonaryinfarction, sometimes with cavitation, and pleuralinvolvement.

There is frequently evidence of aspergillusinfection at other sites, notably the brain, bones and endocardium.Diagnosis is most reliably achieved by open lungbiopsy or transbronchial biopsy. Bronchoalveolar lavagein immunosuppressed patients frequently demonstratesaspergillus, but biopsy material is required to confirm invasivepulmonary infection.

Treatment is with intravenousamphotericin, but mortality is high. High-dose lipidformulations of amphotericin B are commonly used inaspergillus pneumonia to reduce toxicity, but they are very expensive.

Candida albicans is an unusual cause of pneumonia,occurring in the same high-risk group as those who developaspergillus pneumonia and presenting a similar clinicalpicture. Blood cultures are frequently positive. Treatmentis with amphotericin and flucytosine. Fluconazole may bean alternative.

Nocardia pneumonia

Nocardia asteroides can rarely cause a chronic suppurativepneumonia in otherwise normal individuals, but more commonlyit is a cause of an acute pneumonia in the immunocompromisedhost. In addition to lung involvement, inwhich there may be a single lesion or extensive consolidationwith cavitation, pleural disease, empyema andmetastatic spread also occur.

A CT head scan is an importantinvestigation. The sputum shows Gram-positivehyphae which are acid fast and grow rapidly on aerobicculture.Co-trimoxazole (thrice normal dose) is effective; if thereis no improvement in 4-5 days treatment can be changedto ciprofloxacin plus a cephalosporin such as cefotoxime orceftriaxone. Other agents that have been successful includeamitracin, imipenem and meropenem.

Catering Your Wedding Day

Your wedding day is something you have dreamed about forever. Maybe the unicorns that you had in mind when you were ten have now been deemed a little over the top, but nonetheless you want a day to remember. You are marrying the love of your life, your best friend, the one and only. You want everything to be perfect. You have planned, planned and planned some more about every aspect but what about the food?

Finding the right caterer is tough, and unless you happen to have one in the family, you’ll have to go hunting for one on your own. The best place to start, like with most things is to ask your friends and family who they used or if they know of anyone who caterers weddings. Armed with this information you can then go and visit with the caterers to see if they would be a good fit. It’s not use waiting till the last minute, however, as they can get booked up. Give yourself a good year if not more (if you live in a highly populated place) to find the perfect one for you.

Menus can be tricky. What do you want to feed your guests? Do you want the food to fit the theme of the wedding (like a barbecued feast for an outside barn style wedding or a lobster tail sit down dinner for a black tie affair) or will a simple menu do? Luckily caterers will have set menus that you can choose from and most will also let you customize what you want served. Maybe you want a little of this and a little of that? They can do that.

Caterers can also be in charge of your dessert table, a candy table or anything else that you wish to incorporate into your big day. Remember that they have done it all before and are experts in making food look and taste great.

Once you have found a caterer and have settled on a budget the fun can begin. You will have your dream wedding dinner all set. Some venues will do in house catering which will save you a lot of time and effort in finding another one, but if you aren’t a fan of their offerings, then by all means bring in your own. After all, this is your once in a lifetime, and you don’t want to be disappointed at the dinner.

5 Ways to Cope With Agoraphobia

I. Know Your Enemy

Phobias are an extreme form of anxiety. The better informed you are about anxiety in general and agoraphobia in particular, the better you’ll be able to cope with your symptoms.

The first thing to realize is that anxiety is normal and actually serves a useful purpose. When you are in a potentially dangerous situation the body amps you up in several ways to prepare you to either fight your way out of danger or escape it by running away.

Anxiety becomes a problem when this natural danger response happens when you are not in any danger at all. Whether this results in mild uneasiness or uncontrollable terror is a matter of degree.

When your symptoms don’t involve the classic fear of being out in the open, you might not recognize that you are agoraphobic at all. But this fear can take many forms. What they all have in common is a situation you want to escape but feel you cannot.

II. Learn Relaxation Techniques

There are two physical techniques you can practice and become competent with that will help you control feelings of anxiety or panic.

1 Breath Control – Just as over stimulation can cause you to breath faster and possibly to hyperventilate, you can force yourself to calm down by intentionally slowing your breathing. As you take deep slow breaths it actually calms you down. This fact is well known to martial artists and stage performers alike.

2. Progressive Muscle relaxation – Go through your body first flexing a particular muscle and then relaxing it. This technique is sometimes used during hypnotic induction to help the subject relax.

The thing to remember is that you are only taking action to make yourself comfortable. So first calm your mind by focusing on the fact that there is no real danger and then take steps to calm your body.

III. Argue With That Inner Voice

While in a panic we hear whispers of thoughts we would normally find ridiculous. The best thing to do is to counter these thoughts immediately with more reasonable ones.

When your scared brain thinks “I’m going to die.” respond with “The last time I felt the same way and I’m still alive.” When you hesitate to walk into a room because you think “Everyone is going to laugh at me” remind yourself “I’ve been around these same people many times and that never happened.”

Even though you know logically that the things your scared brain spouts off don’t make sense, the longer you let them go uncontested the stronger they affect you.

It may not be so easy to do this in the grip of fear. So carry index cards with reasonable counterarguments printed on them to use when your typical negative thoughts pop into your head.

IV. Go Back Into the Lion’s Den

Start going back to places and situations that you have been avoiding. You are not doing this hoping that this time the attack won’t happen. You want it to happen so you can ride it out.

Panic attacks are normally for a short duration, maybe 15 to 30 minutes. I know it may seem like an eternity but when it’s over you’ll be completely unharmed. It’s important to prove that to yourself even though you already “know” it logically.

Start with the least scary places and gradually work your way up to the ones that make your knees knock together.

V. Practice These Techniques

It’s not enough to just read over these suggestions and think “Yeah that makes sense.” Learn the initial sensations that indicate you’re beginning to panic. Practice your relaxation techniques until they become natural to you. Visualize yourself in those situations you used to avoid.

As Robin Sharma said; “Everything is created twice, first in the mind and then in reality.” When you can see it clearly in your mind, then you can make it happen

Carmine "Lilo" Galante – The Cigar

He was as vicious as Mafia boss Vito Genovese, as ambitious as Vito Genovese, and he was deeply involved in the heroin business as was Vito Genovese. However, Carmine “The Cigar” Galante, would not die of natural causes as did Vito Genovese (albeit in prison). Instead, Galante was murdered in one of the most memorable mob hits of all time. After his body was filled with lead, he lay sprawled on his back in the tiny backyard patio of a Queens restaurant, his trademark cigar clenched tightly between his teeth.

Camillo Galante was born on February 21st, 1910, at 27 Stanton Street on the Lower East Side of Manhattan. Because both his parents, Vincenzo, a fisherman, and his wife (maiden name Vingenza Russo) had been born in the seaside village of Castellammarese del Golfo in Sicily, Galante was a pure first generation Sicilian/America. Galante had two brothers and two sisters, and when he was in grade school, Galante ditched his given name Camillo, and insisted he be called Carmine instead. Over the years it was shortened to “Lilo,” which was the name most of his associates called Galante.

Galante first got into trouble for petty theft from a store counter when he was fourteen years old. But since he was a juvenile at the time, an account of this arrest is not in his official police record.

At various times, Galante attended Public High Schools 79 and 120, but he dropped out of school for good at the age of fifteen. Galante was in and out of reform school several times, and was considered an “incorrigible delinquent.”

From 1923 to 1926, Galante was ostensibly employed at the Lubin Artificial Flower Company at 270 West Broadway. However, this was a ruse to satisfy the law that Galante was gainfully employed, when, in fact, he was engaged in a very lucrative criminal career.

In December 1925, Galante was arrested for assault. However, money changed hands between Galante’s people and crooked policemen, and as a result, Galante was released without serving any prison time. In December 1926, Galante was arrested again, but this time he was found guilty of second degree assault and robbery, and sentenced to two-to-five years in prison. Galante was released from prison in 1930, and in order to satisfy his parole officer, he got another sham “job” at the O’Brien Fish Company at 105 South Street, near the Fulton Fish Market.

However, it was not Galante’s nature to stay on the right side of the law. On March 15th, 1930, five men entered the Martin Weinstein’s shoe factory on the corner of York and Washington Streets in Brooklyn Heights. On the 6th floor of the building, Mr. Weinstein was in the process of getting his weekly payroll together, under the protection of police officer Walter De Castillia of the 84th Precinct. The five men took the elevator to the 6th floor. While one man stood guard at the elevator, the other four men burst into Mr. Weinstein’s office. They ignored the $7,500 sitting on the table, and opened fire on Officer De Castillia, a married father of a young girl, with nine years on the force. Officer De Castillia was hit six times in the chest and he died instantly.

The four men walked calmly back to the elevator and joined their cohort, who was guarding the elevator operator Louis Sella. Stella took the five men down to the ground floor. He later told the police that the men had exited the building, calmly walked to a parked car, got into the car, and fled the scene. When the police arrived minutes later from the station house just 2 blocks away, the killers were nowhere to be seen. Sella described the five men as “early to mid-twenties, with dark skin and dark hair.” Sella said the men were all “very well-dressed.”

The police theory was, that since no money had been taken, that this was a planned hit on Officer De Castillia. On August 30, 1930, Galante, along with Michael Consolo and Angelo Presinzano, were arrested and indicted for the murder of Officer De Castillia. However, all four men were soon released due to lack of evidence.

On December 25th, 1930, four suspicious men were sitting in a green sedan on Briggs Avenue in Brooklyn. Police detective Joseph Meenahan just happened to be in the area. He spotted the men in the sedan, drew his gun, and approached the sedan cautiously. One of the men shouted at Meenahan, “Stop right there copper, or we’ll burn you.”

Before Meenahan could react, the firing commenced from the green sedan. Meenahan was shot in the leg, and a six-year-old girl walking nearby with her mother was seriously wounded. The driver of the sedan had trouble starting the car, so the four men leaped from the sedan and tried to escape on foot. Three of the men manged to flee the area by jumping on a passing truck, but the fourth man slipped as he tried to get onto the truck and was apprehended by the wounded Meenahan. That man was Carmine Galante.

When Meenahan brought Galante to the station house, a group of detectives, angry that one of their own had been wounded, started to give Galante the “police station tuneup.” Despite getting his lumps, Galante refused to give up the identities of the men who had escaped. He was subsequently tried and convicted as one of the four men who had robbed the Lieberman Brewery in Brooklyn. On January 8th, 1931, Galante was remanded to Sing Sing Prison in Ossining, New York. He was later transferred to the Clinton Correctional Facility in Dannemora, New York, where he remained until his release on May 1st, 1939.

While Galante was in prison he was given an IQ test that revealed he had a lame IQ of only 90, which, even though Galante was well into his twenties, equated to a mental age of 14-years-old. It was also noted that Galante was diagnosed as having a “neuropathic psychopathic personality.” A physical evaluation showed that he had a head injury incurred in a car accident when Galante was 10-years-old, a fractured ankle when he was eleven, and that Galante was showing the early signs of gonorrhea, probably incurred at one of the many brothels controlled by the mob.

In 1939, after he was released from prison, Galante was again given sham employment at his old job at the Lubin Artificial Flower Company. In February of 1941, Galante obtained membership in Local 856 of the Longshoreman’s Union, where he ostensibly worked as a ” stevedore.” However, it is likely Galante very rarely showed up for work; one of the perks of being a member of the Mafia.

There is no record of the exact date, but Galante was induced as a made member of the Bonanno Crime Family in the early 1940’s. Despite the fact his boss was Joe Bonanno, at the time the youngest Mafia boss in America, Galante performed many hits for Vito Genovese, all throughout the 1930’s and 1940’s.

While Genovese was in self-imposed exile in Italy (he was wanted on a murder charge and flew the coop before he could be arrested), Genovese became fast pals with Italian fascist dictator Benito Mussolini. Mussolini had a stone in his shoe in America called Carlo Tresa. Tresa was causing Mussolini much agita by incessantly writing anti-fascist sentiments in his radical Italian-language newspaper, Il Martello, which was sold in Italian communities in America.

Genovese sent word back to America to Frank Garofalo, underboss to Joseph Bonanno, that Tresa had to go. Garofalo gave Tresa contract to Galante, who shadowed Tresa for a few days to determine the best time and place to whack him.

On January 11th, 1943, Tresa was walking along Fifth Avenue near 13th Street, when a black Ford sedan pulled up along side him. The Ford stopped and Galante jumped out, hot gun in hand. Galante blasted Tresa several times in the back and in the head, killing the newspaper editor instantly. Amazingly, Galante was seen by his parole officer fleeing the scene, but due to the wartime rationing of gasoline, the parole officer was unable to follow the black Ford containing Galante and the smoking gun. No arrest were ever made for the Tresa slaying.

In 1953, Bonanno sent Galante to Montreal, Canada to take control of the Bonanno Family interests north of the boarder. Besides the very lucrative Canadian gambling rackets, the Bonannos were heavy into the importation of heroin, from France into Canada, and then into America – the infamous French Connection. Galante supervised the Canadian drug operation for three years. But in 1956, the Canadian police caught wind of Galante’s involvement. Not having enough evidence to arrest Galante, they instead deported Galante back to America, classifying Galante as “an undesirable alien.”

In 1957, Genovese called for a big summit of all the top Mafioso in America, to take place at the upstate New York Apalachin residence of Joseph Barbara, a captain in the Buffalo crime family of Stefano Magaddino. In preparation for this meeting, on October 19th, 1956, several New York crime bigwigs were summoned to Barbara’s home to go over the guidelines of the proposed meeting; the prime purpose of which was to anoint Genovese as the Capo di Tutti Capi,” or “Boss of all Bosses.”

After the meeting ended, driving on his way back to New York City, Galante was nabbed for speeding near Birmingham, New York. Because his driver’s license had been suspended, Galante gave the police a phone one. He was immediately arrested and sentenced to 30 days in prison. However, the tentacles of the Mafia also reached right into the police department in upstate New York. After a few mobbed-up New York lawyers made the right phone calls to upstate New York, Galante was released within 48 hours. Yet, a state policeman named Sergeant Edgar Roswell took note of the fact that Galante had admitted to the police he had stayed the night before at the Arlington Hotel, as host of a local businessman named Joseph Barbara. This prompted Roswell to pay especial attention to the Barbara residence in Apalachin, New York.

Less than a month later, on November 17th, 1957, at the insistence of Don Vito Genovese, Mafia members from all over America made their way to the Barbara residence. These men included Sam Giancana from Chicago, Santo Trafficante from Florida, John Scalish from Cleveland, and Joe Profaci and Tommy Lucchese from New York City. Galante’s boss Joe Bonanno decided not to attend, and he sent Galante instead.

Sergeant Roswell took note of the fact that on the day before the nearby Arlington Hotel had been booked to the rafters with suspicious-looking out-of-towners. Roswell asked the right questions, and he was able to confirm that the man who made the reservations for these men was Joseph Barbara himself. Roswell drove to the Barbara resident and he spotted dozens of luxury cars parked outside, some with out-of-town plates.

Roswell called for back-up, and in minutes, dozens of state troupers arrived with guns drawn. The troupers raided the Barbara residence and chaos ensued. Men wearing expensive suits, hats, and shoes bolted from the house. Some were immediately arrested; some made it to their cars and drove off the property before roadblocks could be put in place by the police. Others jumped out of the windows and hightailed in through the thorny woods. One of these men was Carmine Galante, who hid in a cornfield until the police had left the Barbara residence. Then made his way back to Barbara’s home, and made arrangements for his safe passage back to New York City.

The next day, when the news of the raid on Barbara’s house hit American newspapers, blowing the lid off the misguided idea that the Mafia was a myth, Galante went into the wind, or in mob terms, he “pulled a lamski.” On January 8th, 1958, the New York Herald Tribune wrote that Galante had run to Italy to hook up with old pal Salvatore “Lucky” Luciano, who was in exile in Italy, after serving nine years in American prison on a trumped-up prostitution charge. Another report said that it was not Luciano Galante was with, but rather Joe “Adonis” Doto, another mob boss in exile in Italy. On January 9th, the New York Journal American said Galante was not in Italy at all, but in Havana, Cuba, with Meyer Lansky, a longtime member of the National Crime Commission, who had numerous casino interests in Cuba.

In April 1958, it was somehow leaked that Galante was now back in the United States and living somewhere in the New York area. The local law went to work, and in July, Galante was arrested by the Federal Bureau of Narcotics while he was driving near near Holmdale, New Jersey. He was charged with taking part in a major heroin deal, one of many Galante had been involved with. Also arrested in the same case were Vito Genovese, John Ormento, Joe Di Palermo, and Vincent Gigante. Galante, again making use of his cadre of New York attorneys, was released on $100,000 bail. Galante’s lawyers were able to delay any further legal proceedings for almost two years. It wasn’t until May 17th, 1960, that Galante was formally indicted, and again released on bail.

On January 20th, 1961, Galante’s trial finally began, and the judge, Thomas F. Murphy, revoked Galante’s bail, ordering Galante to be put right into the slammer. However, Galante’s luck held up when, on May 15th, a mistrial was declared. It seemed the foreman of the jury, a poor chap named Harry Appel, a 68-year-old dress manufacturer, had the misfortune of falling down a flight of stairs in a building on 15th Street in Manhattan. After the medics arrived and Appel was taken to a nearby hospital, it was determined that Appel had suffered a broken back. No one had seen Appel fall, nor did the hurt and frightened Appel say that anyone had pushed him. However, although they had no definite proof, law enforcement believed that Appel had been pushed by a cohort of Galante’s, with a warning not to say anything to anybody, and they would allow Appel and members of his family to live.

Galante, now feeling alive and chipper, was released from prison, secured by a bond of $135,000.

Alas, but all good things must come to an end.

In April 1962, Galante’s second trial commenced.

At the trial, there was a bit of mayhem in the courtroom, when one of Galante’s co-defendants, a nasty creature named Tony Mirra (who was said to have killed 30-40 people) became so unhinged, that he picked up a chair and flung it at the prosecutor. Luckily for the prosecutor, the chair missed him and landed in the jury box, forcing the frightened jurors to scatter in all directions. Order was restored to the court, and the trial proceeded, which was bad news for both Galante, and for Mirra. Both men were found guilty, and on July 10th, 1962, Galante was sentenced to thirty years in prison. Mirra also was sent to prison for a very long time. It is not clear if any additional time was tacked onto Mirra’s sentence for the chair-throwing incident.

Galante first was sent to Alcatraz Prison, which was located on an island fortress in San Francisco Bay. He was then moved to the Lewisburg Penitentiary, in Leavenworth, Kansas, before serving the final years of his prison term in the United States Penitentiary in Atlanta, Georgia. Galante was finally released from prison on January 24th, 1974, all full of fire and brimstone, and ready to get back into business. However, Galante was to be on parole until 1981, so he had to be careful not to keep a high profile. Unfortunately, being in the background was not in Galante’s makeup.

While he was in prison, Galante made it known that when he got out of prison he was going to take control of the New York Mafia by the throat. The accepted head of the five New York City Mafia families at the time was Carlo Gambino, the head of the Gambino crime family. Gambino was shrewd, and generally quiet and reserved; well-respected for his business acumen, and his ability to keep peace amongst his own family, as well as the other Mafia families. However, Galante had to use for Gambino, or his method of doing business.

By the time of Galante’s release, his boss Joe Bonanno had been forced to “retire,” and was living in Tuscon, Arizona. The new Bonanno boss was Rusty Rastelli. But since Rastelli was in the slammer at the time, Galante took over as the “street boss” of the Bonannos. Still, Rastelli was considered the boss of the Bonannos, and was none too happy about how Galante was strutting his stuff on the streets of New York City.

Galante took the unusual step, and not appreciate by other Bonanno crime family members, of surrounding himself with Sicilian born Mafioso like Caesar Bonventre, Salvatore Catalano, and Baldo Amato. Theses men were derisively called “zips” by the American Mafia, due to the quick way they zipped through the Italian language. These zips were heavily involved in the drug trade, and in direct opposition to those in the Genovese Crime Family, which was run by Funzi Tieri, every bit as cunning and vicious as Galante.

Galante had a minor setback, when in 1978, he was arrested by the Feds for “associating with known criminals,” which was a violation of his parole. While Galante stewed in prison, he began ordering his men to kill mobsters in the Genovese and Gambino crime families, who were cutting in on Galante’s worldwide drug operation. With Carlo Gambino now dead (from natural causes), Galante figured he had the muscle to push the other crime family bosses into the background. From prison he sent out the message to the other bosses, “Who among you is going to stand up against me?”

On March 1st, 1979, Galante’s was released from prison and walking on air because he truly believed the other crime bosses were afraid of him. Like Vito Genovese before him, Galante envisioned himself as “Boss of All Bosses,” and it was only a matter of time before the other bosses cowered before Galante and handed him the title.

However, Galante underestimated the might and will of the other Mafioso bosses in New York City. While Galante swaggered around the streets of New York City, the other bosses held a meeting in Boca Raton, Florida, deciding Galante’s fate. At this meeting were Funzi Tieri, Jerry Catena, Paul Castellano, and Florida boss Santo Trafficante. These powerful men voted unanimously, if mob peace was to exist in the streets of New York City, Galante had to go. Rastelli, who was still in jail, was consulted, and even the aged Joe Bonanno, living in Arizona, was asked if he had any reservations at his former close associate being hit. Both Rastelli and Bonanno signed off on Galante’s murder contract, and Galante’s days were numbered.

On July 12th, 1979, it was a hot and sticky summer day, as the 69-year-old Carmine Galante’s Lincoln pulled up at 205 Knickerbocker Avenue, in the Bushwick section of Brooklyn. For more than 50 years, Knickerbocker Avenue had been the turf of the Bonanno crime family, and over the years numerous mob sit-downs had taken place in one of several storefronts on the block.

Carmine Galante stepped out of the Lincoln, then he waved goodbye to the driver: his nephew James Galante. Carmine Galante was wearing a white short-sleeved knit shirt, and, as was his custom, he was sucking on a huge Churchill cigar. Galante strutted inside the tiny restaurant, and was greet by Joe Turano, the owner of Joe and Mary’s Restaurant. Galante had made this visit to meet with Turano, and with Leonard “Nardo” Coppola, a close associate of Galante’s, over some undetermined mob business.

At approximately 1:30 p.m., Cappola strolled into the restaurant, accompanied by zips Baldo Amato and Cesare Bonventre, who were cousins, and from the same village as Galante’s parents: Castellammarese del Golfo. By this time Galante and Turano had already finished their meal, so while the three newcomers sat inside and had their lunch, Galante and Turano slipped outside into the backyard patio, and sat under a yellow-and-turquoise checked umbrella. After Cappola, Bonventre, and Amato finished dining, they joined the other two men outside. Galante and Turano were smoking cigars and drinking espresso coffee laced with Anisette (only tourists and non-Italians drink Sambuca).

Galante was sitting with his back to a small garden, while Amato sat to his left and Bonventre to his right. Turano and Cappola sat on the opposite side of the table, their backs to the door leading to the restaurant.

At approximately 2:40 p.m., a four-door, blue Mercury Montego double parked in front of Joe and Mary’s Restaurant. The car had been stolen about a month before. The driver, wearing a red-striped ski mask that covered his face, stepped out of the car and stood guard, holding a.3030 M1 carbine rifle menacingly in his hands. Three other men, also wearing ski masks, jumped out of the car and jogged into the restaurant. They sped past the few startled diners who were still eating lunch, and rushed into the patio area.

As they entered the patio, one masked man said to the other, “Get him, Sal!’

The gunman called “Sal” began firing a double-barrel shotgun several times at Galante, propelling Galante, as he was rising from his chair, onto his back. Galante was hit with 30 pellets, one knocking out his left eye. Galante was probably dead before he hit the ground, his cigar still stuck tightly between his teeth.

As Galante was shot, Joe Turano yelled,”What are you doing?”

The same gunman turned to Turano, and with the shotgun pressed against Turano’s chest, he blasted Turano into eternity.

Cappola jumped up from the table, and either Amato, or Bonventre (it’s not clear which one did the shooting) shot Cappola in the face, then five times in the chest. Cappola landed face down, and the killer with the shotgun, blasted off the back of Coppola’s head.

The three masked men then hurried from the restaurant, and into the waiting getaway car. According to witnesses outside the restaurant, the car sped up Knickerbocker Avenue to Flushing Avenue, then disappeared around the corner. Bonventre and Amato, who were both wearing leather jackets despite the stifling heat, soon followed the three gunman out of the restaurant. They calmly walked down the block, got into a blue Lincoln, and drove away, like they had nary a care in the world.

Galante’s body was laid out in the Provenzano-Lanza Funeral Home at 43 Second Avenue on the Lower East Side. The crowds that usual accompany a Mafia wake of this kind were notably absent. Galante was buried on July 17th at Saint John’s Cemetery in Queens. With the Feds doing the counting, only 59 people attended Galante’s funeral mass and burial. The Feds also reported that not one Mafia made man was captured on surveillance cameras, either at the wake, or at the funeral.

One Fed, commenting at the sparse turnout, said, “Galante was so bad, people didn’t want to see him, even when he was dead.”

Even though the newspapers played up the killing with gruesome front page photos, the general public seemed imperious to the magnitude of the event. A young boy strolled up to a police officer standing guard the wake.

“Was he an actor?” the kid said to the cop.

The cop replied, “No, he was a gangster.”

Physiotherapy And Treatment For Osteoporosis

Osteoporosis is a worldwide problem, though mostly documented in countries with advanced healthcare systems, and affects many millions of people across all countries. Women have a higher lifetime risk of a fracture due to osteoporosis with about thirty to forty percent chance in their life, whilst men have a much smaller but still significant risk of 13%. Osteoporosis is a condition which occurs slowly and quietly with the sufferer mostly not aware there is anything amiss until it is too late and they have a problem. The assessment of risk and the preventative treatment of this condition are vital and very active areas in research and treatment.

With 1.5 million fractures in the United States alone, osteoporosis is a common diagnosis and 50% of women over 50 years old suffer from this condition, rising to almost 90% of women aged seventy-five years. Osteoporosis causes fractures and this is the main clinical problem, with significant disability and pain from spinal fractures and a 5-20 percent chance of dying after a hip fracture due to the complications. Apart from the personal costs osteoporosis is also costly to health services dealing with high levels of fractures in post-menopausal women.

The greatest risk factor for getting osteoporosis is passing through the menopause, when the bone-protecting hormones stop being produced or are greatly reduced. The bone density of the person can then drop steeply unless they are diagnosed and treated. Other risk factors include being female, age, having a family history of osteoporosis, a hormone deficiency, having low calcium levels, drinking excessive alcohol and smoking cigarettes. If there is the menopause plus a number of risk factors, the woman is 65 years old or older or the person has had a fracture without significant trauma then they should be investigated for low bone density.

The signs and symptoms of osteoporosis are not that many. With an acute vertebral fracture on lifting or bending then the pain is extremely severe and long lasting, an indication that something significant has occurred. Back pain is common and there may be an increased thoracic kyphosis (upper back curve), an increased cervico-thoracic curve (dowagers hump) and a noticeable loss of height. Any fracture without significant trauma is suspicious and should be investigated. If the patients bones look thin on x-ray and there are compression fractures in the thoracic spine, the diagnosis may be clear, but a bone density scan (DEXA) can indicate the degree of osteoporosis and monitor change.

Osteoporosis prevention encompasses lifestyle change, eating a diet rich in vitamin D and calcium, avoiding smoking and excessive alcohol and engaging in weight bearing exercise. HRT (hormone replacement therapy) is used to prevent this condition in women who are past the menopause. Drugs include bisphosphonates, HRT, selective oestrogen receptor modulators and calcium and vitamin D supplements. The development of new bone rather than stopping the loss might be achievable with an anabolic drug. When we are young we lay the groundwork for our bone mass so should be encouraged to eat well and engage in weightbearing exercises to ensure a good bone density.

A recent development in the treatment of hyper acute spinal fractures with their very severe and disabling pain is vertebroplasty. In this procedure a radiologist introduces a needle under x-ray control into the front of the body of the vertebra which has collapsed and then injects a cement material which mechanically bolsters the area, with great relief of pain. Falls are particularly dangerous due to the high risk of fracture and exercise can improve balance, stability, co-ordination and muscle strength to reduce the risk. As this may be a long term condition it may be necessary to provide both practical and psychological help to enable patients to cope best with their condition.

Exercise and bone mass are closely linked and physiotherapists work in osteoporosis classes and clinics to educate people of all ages in the benefits of movement. Children and young people are encouraged to have plenty of exercise so their bone mass builds to a good level. Exercise can slow down the bone loss process and impact exercises which jar the bones are more beneficial than cycling or swimming. Anybody of any age can start a suitable exercise programme and make a difference, guided by a skilled physiotherapist.

A Detox Day to Overcome a Lack of Energy

When you are chronically tired, it is probably the result of many factors. Inadequate sleep, feeling overstressed, eating poorly, and being inactive leaves your body full of harmful toxins. These toxins slow down your metabolism and other body functions, leaving you severely fatigued.

Correcting the issues that caused your tiredness is the only way to overcome your lack of energy. However, it can take a while for the toxins to leave your system. You can speed up the process with a detox day.

If you are always feeling tired, a detox day is a simple way to immediately cleanse your system and boost your energy. A detox day takes very little planning. The only preparation needed is to buy your groceries and supplements beforehand.

The first step to a detox day is to eat only organic, natural foods. You should start the day with a “green” power drink that is made from green foods. Green foods include whole, “raw” dairy products like yogurt, coconut milk, rice bran, and fresh fruits. You can combine ingredients until you find a recipe that appeals to you. Make sure your power drink also includes protein powder to give you a boost of energy throughout the day.

The next step is to get physically active. No matter how bad your lack of energy is, getting active is a critical step to detoxifying. You will want to perform an aerobic exercise for at least 30 minutes. This will increase your heart rate and speed up the release of toxins in your body tissue.

You should also try to sit in a sauna for at least 30 minutes. If you find it difficult to stay in that long, try lowering the heat temperature. The goal is to increase your sweat production, which is the easiest way to purge the contaminants and toxins in your system.

There are also supplements you can take to increase the productivity of your detox day. A good multi-vitamin will help as will green tea leaf extract. Niacin helps your body tissue release toxins. You should also take magnesium to keep your bowel movements regular so that the toxins will be removed from your body more quickly.

When you are always feeling tired, the simplest ways to increase your energy are the best. This is why a detox day is such a great technique. It is not difficult and you will quickly feel reinvigorated. This energy will sustain you as you move on to more long-term methods to increase energy. The best part is that you can use a detox day anytime you feel you need an extra boost of energy.

Thiamine (Vitamin B1) How, Why and When to Supplement

Vitamin B1 (Thiamine)

Sources and Physiologic Functions

Requirements and Sources: Pork, whole grains, and legumes are the richest sources of thiamine. Outer layers of seeds are particularly rich in this vitamin.

Populations at Risk: The populations most at risk of developing a thiamine deficiency are chronic alcoholics in Western countries and those with an over dependence on polished rice as a staple in undeveloped nations. In alcoholics it may be caused by decreased intake, reduced absorption, and impaired ability to use the absorbed vitamin. Thiamine is spared by fat, protein, sorbitol, and Vitamin C. High carbohydrate intake, parenteral glucose, pregnancy, lactation, high basal metabolic rate, and antibiotics will increase needs. Also, it is readily lost in persons consuming raw fish, tea, coffee, blueberries, red cabbage, and cooking with excess water and baking soda. Breast fed infants of thiamine deficient mothers are particularly at risk, as death from cardiac failure can result within a few hours, even though the mother appears healthy. Other risk factors include chronic colitis, fever, malignant disease, sprue, and thyrotoxicosis. Intestinal absorption of thiamine appears to be controlled and limited, and modest increases in the serum concentration were accompanied by active renal clearance.

Signs and Symptoms of Deficiency: Children present with aphonia, cardiomyopathy, and polyneuritis. Symptoms involving the heart include tachycardia, cardiomegaly, and cardiac failure. Neurological symptoms include mental confusion, anorexia, ataxia, nystagmus, and weakness of hands, calves, and feet as a result of degeneration of sensory and motor nerves. Thiamine deficiency in adults is called Beri-beri and is characterized by dry skin, irritability, disorderly thinking, and progressive paralysis. In chronic alcoholics, a syndrome of Wernicke’s – Korsakoff”s Psychosis develops. Ataxia and Nystagmus (Wernicke’s ) develop early and, if left untreated progresses to amnesia, confusion, and polyneuropathy ( Korsakoff’s ). Complete recovery at this stage is seen in only 25% of the patients. Vomiting, diarrhea, edema, and weight loss are other non-specific symptoms.

Safety:

Due to relative increase in sympathetic activity, nervousness, sweating, tachycardia and tremors can be seen with excess thiamine. Edema and vascular hypotension occur as a result of capillary leakage. Allergies, fatty liver and herpes are common. Folates and thiamine cause seizures and excitation when administered in high dosage directly into the brain or cerebrospinal fluid (CSF) of experimental animals, but have rarely been reported to cause human neurotoxicity, although fatal reactions to i.v. thiamine are well known.

Biochemistry: The biologically active form of thiamine is TPP (thiamine pyrophosphate). It acts as a coenzyme in the oxidative decarboxylation at the pyruvate and the alfa-ketoglutarate steps in the energy producing Kreb’s cycle and is particularly important in the tissues of the nervous system. It also acts as a coenzyme in the oxidative decarboxylation ( of alfa-keto acids and in the formation or degeneration of ketols ) by transketolase in the Pentose phosphate pathway, the intermediary products of which are used in the synthesis of ribonucleotides such as ATP & GTP, deoxyribonucleotides such as dATP & dGTP, and nucleic acids DNA & RNA. Thiamine is also essential for protein catabolism, acetyl choline synthesis, normal muscle tone in cardiac and GI tissues, and for normal growth and appetite.

In human the storage of thiamine is is in greatest concentrations in skeletal muscle, heart, brain, liver, and kidneys. The human stores about 25 to 30mg of thiamine. ThMP and free (unphosphorylated) thiamine is present in plasma, milk, cerebrospinal fluid, and just about all extracellular fluids. Unlike the highly phosphorylated forms of thiamine, ThMP and free thiamine are capable of crossing cell membranes.

Recommendations: RDA in mg

  • Infants birth to 6 mos – 0.3mg
  • Infants 6 mos to 1 yr – 0.4mg
  • Children 1 yr to 3 yr – 0.7mg
  • Children 4 yr to 6 yr – 0.9mg
  • Children 7 yr to 10 yr – 1mg
  • Adolescent males 11yr to 14 yr – 1.3mg
  • Adolescent females 11 yr to 14 yr – 1.1mg
  • Adolescent males 15 yr to 18 yr – 1.5mg
  • Adolescent females 15 yr to 18 yr – 1.1mg
  • Adult males 19 yr to 50 yr – 1.5mg
  • Adult females 19 yr to 50 yr – 1.1mg
  • Adult males 51 yr plus – 1.2mg
  • Adult females 51 yr plus – 1.0mg
  • Pregnant Women – 1.5mg
  • Lactating Mothers – 1.6mg

Thiamine hydrochloride is the common supplemental form. Thiamine therapy for alcoholics may involve a single injection of 10-mg thiamine or 50 mg of oral fat-soluble thiamine propyl disulfide that permits efficient absorption in alcoholics. Erythrocyte transketolase activity is considered the most reliable index of the functional state of thiamine.

Thiamine B1

Food Source – Serving Size – Number of milligrams per serving

  • Pork (lean arm braised) – 3.5 oz – 0.60mg
  • Pork (bacon cured/pan fried) – 4.48oz – 0.88mg
  • Navy beans (canned) – 1 cup – 0.37mg
  • Pinto beans (canned) – 1 cup – 0.24mg
  • Pinto beans (boiled) – 1 cup – 0.32mg

Literature:

A cross-sectional investigation of patients with congestive heart failure being treated with loop diuretic therapy showed that thiamine deficiency may occur in a substantial proportion of patients with congestive heart failure (CHF) and dietary inadequacy may contribute to increased risk. Men and nonwhite patients with CHF appeared most likely to have evidence of thiamine deficiency, although this reflects, in part, the gender composition of the patients recruited for the study. Patients with more severe CHF (as indicated by lower percentages of left ventricular ejection fractions) had greater biochemical evidence of thiamine deficiency. Another study found left ventricular ejection fraction to be adversely affected by thiamine deficiency and described that, when these patients were supplemented with thiamine intravenously, the ejection fraction improved significantly. Thus, nutritional assessment of thiamine status, including dietary intake, may be an important component of care for patients with CHF who are being treated with loop diuretic therapy.

Cognitive functioning

A study by Benton et. al demonstrated the association between improved thiamine status and improved performance on a range of measures of cognitive functioning in females. No such association was found in males. Although it was not possible to establish the reason for a beneficial response in females rather than males, there is evidence that females respond differently to dietary factors.

Alzheimer’s disease:

Results of one study suggest that probable Alzheimer’s Disease (pAD) is associated with a decrease in plasma thiamine levels. In another study, a 40-50% decrease of thiamine diphosphate (TDP) was found in patients with frontal lobe degeneration of the non-Alzheimer’s type (FNAD). As TDP is an essential co-factor for oxidative metabolism and neurotransmitter synthesis, and because low thiamine status (compared with other species) is a constant feature in humans, a nearly 50% decrease in cortical TDP content may contribute significantly to the clinical symptoms observed in FNAD. This study also provides a basis for a trial of thiamine to improve the cognitive status of the patients. A mild beneficial effect in patients with Alzheimer’s disease was observed on supplementation with Fursultiamine (TTFD), a derivative of thiamine, at an oral dose of 100 mg/day in a 12-week open trial. Similar benefits were observed in another trial with high dose thiamine (3-8 g/d), while a 12 month study with 3 g/d of thiamine showed no apparent benefit in slowing the progression of dementia of the Alzheimer’s type. Thus, weak and contradictory evidence suggests that vitamin B1 may be helpful for Alzheimer’s disease.

Assessment of thiamine status

In several human studies during the past 10 years, thiamine status was assessed either by measuring thiamine pyrophosphate response alone or by using TPP response measures in conjunction of calculated estimates of thiamine intake from diet histories. Some investigators have combined estimates of thiamine intake with measures of thiamine status other than TPP response, such as erythrocyte TPP [18] or plasma TPP In several of these reports, poor thiamine status, as defined by TPP response, could not be related to less-than-adequate thiamine intake. Several authors have noted that valid TPP response measures depend on a kinetically normal enzyme. Hence, disease states, such as alcoholic encephalopathy, may affect enzyme-cofactor binding, and thus, TPP response. Rigorous statistical analysis of relationship between urinary thiamine excretion and TPP response seems to be lacking in the report generally cited as evidence of the validity of TPP response measures. In the ICNND report, categories of thiamine status appear to relate superficially to urinary thiamine excretion, but when there is no clear break-point in the curve for thiamine intake plotted against urinary excretion, it is difficult, in contrast to the case with urinary riboflavin excretion, to define deficiency. One author has demonstrated that in non-human species, pyruvate dehydrogenase appears to be a more sensitive indicator of tissue thiamine deficiency than is transketolase. A study by Gans et. al. raises questions about the usefulness of the TPP response as the sole indicator of marginal thiamine status. Thiamine status was measured in 137 incarcerated and 42 nonincarcerated adolescent males by use of both dietary intake data and a standard biochemical assay, thiamin pyrophosphate (TPP) response. Although average daily thiamine intake of nonincarcerated subjects was significantly higher than that of incarcerated subjects, both groups appeared to be at minimal risk for marginal thiamine status. Comparison of TPP response values indicated that there was no significant difference between groups. However, approximately 24% of the total population appeared to have less than adequate RBC thiamine on the basis of current standards for TPP response. Neither dietary intake nor reported previous alcohol intake was correlated with TPP response. Thus, clinical standards of thiamine deficiency seem to lack firm definition. Perhaps a better, more valid metabolic measure, such as thiamine or TPP in plasma, should be investigated and adopted. Also, intake data as well as some appropriate measure of enzyme activity or function may be important values to assess to describe the thiamine status of a group more correctly.

Summary:

Thiamine is essential in the metabolism of proteins, carbohydrates, and fats. It is also needed in the synthesis of ATP and GTP and nucleic acids DNA and RNA. It acts as a coenzyme in the energy producing Kreb’s cycle and is particularly important in the tissues of the nervous system. Thiamine is also essential for acetylcholine synthesis, maintenance of normal tone of muscle in cardiac and GI tissues, and for normal growth and appetite.

A number of claims have been made about the beneficial effects of thiamine on numerous conditions. (Fibromyalgia, HIV Support, Pregnancy and postpartum support, Canker sores – mouth ulcers, and Minor injuries)

Evidence strongly suggests that patients with CHF may benefit from thiamine supplementation. Patients with CHF who are on loop diuretics are shown to have thiamine deficiency and patients with more severe CHF showed greater biochemical evidence of thiamine deficiency. Thiamine supplementation is shown to improve the left ventricular ejection fraction significantly.

Thiamine supplementation may improve cognitive functioning and has been shown to improve performance on a range of cognitive tests in females.

Populations who are prone to be deficient in this vitamin, like chronic alcoholics, patients with malabsorption syndromes, and those who consume high carbohydrates should receive supplementation. Pregnancy, lactation, high basal metabolic rate, and parenteral glucose therapy will increase the requirements of thiamine. Breast-fed infants of thiamine deficient mothers should receive adequate supplementation, as death from cardiac failure can result within hours, even though the mother appears normal.

Our recommendation for adults is 25 mg/d. This amount can be obtained from approximately 41 servings of Pork (lean arm braised), 28 servings of Pork (bacon cured/pan fried), and 80 servings of Pinto Beans (boiled). The RDA for adults is 1.5 mg/d, although a range of doses from 1-25 mg/d is usually consumed. Thiamine therapy for alcoholics may involve a single injection of 10-mg thiamine or 50 mg of oral fat-soluble thiamine propyl disulfide that permits efficient absorption in alcoholics. Wernicke’s syndrome, which involves ataxia and nystagmus, develops early and, if left untreated, may progresses to Korsakoff’s psychosis, the neurological manifestations of which are irreversible in 75% of the patients. Fatal reactions to high doses of I.V. thiamine have been reported.

Interview With J Matthew Neal, Author of "Specific Gravity"

Dr. J. Matthew Neal was born in Muncie, Indiana, where he has resided much of his life. Although he has been a medical writer for many years, “Specific Gravity” is his first novel. As a physician and residency program director, he has found plenty of inspiration in the medical field for his fiction.

Tyler: Welcome, Matt. Thank you for joining me today. To begin, I understand “Specific Gravity” is a thriller with Dr. Alexander (Alex) Darkkin as its main character. Will you tell us a little bit about Alex and why you think readers will find him to be an attractive character?

Matt: Alex is a complicated guy with lots of problems, and at first probably won’t seem likeable to readers at all. He’s a brilliant cancer specialist who has also created his own medical software company. He’s good-looking, smart, and has money-but is also an obnoxious, womanizing alcoholic who is unhappy with his superficial life and self-destructing relationships. He’s tried therapy, AA, and religion, none of which seem to be working.

But he has a deeper side that he doesn’t yet realize, and much of the story revolves around his self-reflection and realization that he can do much to help those other than himself. He just needs a special person to show him the way.

Tyler: Is Alex haunted by demons that led him to womanizing and alcoholism? Would you tell us a little bit about his past before the book begins?

Matt: Alex felt he didn’t have a very good paternal role model; his father Conrad was an alcoholic who cheated on Alex’s mother on numerous occasions. His sister left town after high school and developed a relationship with a normal, “surrogate” family (the Mendozas); meanwhile Alex stayed fairly close to home, and lives in Nashville. He never saw his parents in a loving marriage, and as a result, finds it difficult to engage in lengthy relationships. Despite seeming arrogant, he actually suffers from low self-esteem and depression, and this has resulted in dependence on alcohol and frequent one-night stands.

Tyler: What is the situation Alex finds himself in that is the focus of the novel?

Matt:Alex, hoping that a change of location will do him some good, relocates to San Diego for six months to fill in for his sister Wendy’s friend who is taking a sabbatical. After his arrival, he curiously inspects the files of a patient who recently died-billionaire pharmaceutical CEO John Markham. His software background leads him to discover that Markham’s medical records may have been altered, and he comes up with a theory that Markham may in fact have been murdered. Unfortunately, he can’t seem to convince the police or anyone else, and realizes he can’t do it alone. He then reluctantly seeks the aid of Wendy’s best friend, Bonnie Mendoza.

Tyler: Tell us a little bit about Bonnie and her involvement in the story.

Matt: The arrogant Alex finally meets his match in deaf forensic scientist Bonnie Mendoza-a mathematical and lexical genius who inherited from her mother the rare neurological trait “synesthesia,” which means, literally, “a union of the senses.” She sees numbers and letters as colors, for example. Living humans have unique colors and smells as well. These odd sensory perceptions allow her easily to manipulate words and numbers.

Her physical disability has compelled her to exceed in other ways, also. Like her other family members, she is a gifted athlete. She cares deeply about sick and disabled children, and she frequently performs for charity as stage magician “Mendoza the Miraculous.” Her mathematical powers allow her to perform amazing mentalist tricks, but she is best known for being an escape artist who has become somewhat of a local celebrity. The last ability is extremely important in the plot of the story.

The seemingly perfect Bonnie has many flaws, though-she often seems to lack common sense and makes rash decisions. Like many strong synesthetes, she has perceptual problems-she cannot tell left from right, for example, and has poor direction sense. The geeky, mild-mannered scientist has a bad temper, is virtually fearless, and can be lethal to anyone who tries to harm her. Her training as a forensic scientist has given her the knowledge of how to use weapons most effectively. But, despite these abilities, she has an almost childlike, naïve quality, and Alex becomes strongly attracted to her.

Tyler: Wow, she sounds like quite a character. Where did you get your ideas for Bonnie, and how do her abilities enhance the novel’s plot?

Matt: Alex is an arrogant blowhard who always wants his way, and I needed a strong female character who can take anything he dishes out and throw it right back at him. At first, they have strong disdain for one another, but, paradoxically, this strength eventually attracts Alex to her, and they develop an unlikely relationship. She seems, on the surface, quite different from Alex, but we soon learn that they share many tendencies.

In addition, I have long been a fan of magic and escapology, and wanted to feature a character who used those abilities in the story. To my knowledge, other female escape artist characters in the popular media are pretty nonexistent.

Alex is a skilled physician and software engineer, but doesn’t understand the intricacies of forensics and police work, and needs Bonnie for that. In addition, her abilities are important in solving several puzzles and getting them out of a number of tight situations.

Tyler: Tell us a little bit about Alex’s sister Wendy, who appears to be an important character in the story.

Matt: Wendy is Alex’s younger sister by two years, and is also a physician. The extroverted, plus-sized pediatrician moved to San Diego after high school to attend college. She began volunteering at a pediatric rehabilitation center, where she met wiry deaf teen Bonnie Mendoza. Over the years, the two developed a special friendship, and Wendy helped Bonnie improve her self-esteem and physical strength.

She is an avid charity fund-raiser who often performs magic acts with Bonnie. She even has a local public access TV show, “Dr. Wendy’s Science Squad,” which teaches children about science and technology. She is married and has one child.

Tyler: I understand “Specific Gravity” is categorized as a techno-thriller. Will you give us a bit of a definition of a “techno-thriller” and explain why this kind of novel appeals to you?

Matt: Techno-thrillers are works of fiction where “technology” is, in essence, a character in the story. They tend to include a large amount of technical detail in subject matter, and focus on the inner mechanics of science. Much of the novel centers on the detailed workings of computers, medical information systems, forensic science, and even magic tricks. This genre allows me to do what I like to do best-write in great technical detail about science and its inner workings.

Tyler: What difficulties do you find in writing a techno-thriller? Do you have concerns about readers following the details around technology, and does technology give you artistic license to create technologies and make them believable to readers?

Matt: I think one problem is that it’s possible to include too much technical detail. I have gone to great trouble to ensure the accuracy of the science and disciplines in the book-but I realize that some readers may not have the same interest in detail as I.

Personally, I enjoy reading techno-thrillers where I may not understand all the science and technology-this allows me to read about it elsewhere and learn new things. I think, in a way, techno-thrillers may be harder to write than other types of fiction, because the science must be believable. Attention to detail is a must, and requires a lot of revision. The research takes almost as much time as writing the book.

Tyler: Are techno-thrillers a form of science-fiction, or do you see a difference between them? Are techno-thrillers striving more for realism, or at least to appear realistic?

Matt: I think there are a lot of similarities between the two genres. To me, science fiction tends to explore scientific disciplines (such as robotics, time travel, cloning, etc.) for its own sake. Techno-thrillers are kind of a hybrid of science fiction and mystery, usually about espionage or a threat to society that the protagonists must solve. There is a subgenre of science fiction called “hard SF” where there is rigorous attention to accurate detail in the quantitative sciences (such as physics and chemistry). I think there is some overlap.

Both genres can be realistic, but I think the main difference is the mystery/puzzle angle of the techno-thriller. The latter also may focus on societal and political issues; “Specific Gravity” takes aim at some of those.

Tyler: What sorts of influences have you had in writing techno-thrillers? For example, other writers or medical TV dramas?

Matt: I’m actually more of a non-fiction reader than fiction. For fiction, my major influences have been Michael Crichton, Martin Caidin, Robin Cook, and Tom Clancy, all of whom go into great technical detail in their stories. I also read a lot of Isaac Asimov’s science fiction stories growing up. Although I enjoy watching medical TV dramas, they really don’t influence my writing.

Tyler: Why did you choose the title, “Specific Gravity”?

Matt:”Specific Gravity” refers to the physical measurement of the relative density of a liquid to water. The mystery unfolds when the protagonists decipher some of John Markham’s unusual laboratory values, which leads them into a heap of trouble. I chose the title because of its importance in the story. It also sounds scientific and technical.

Tyler: Matt, I understand you’re a doctor yourself. How has your profession lent to your interest in writing novels?

Matt: Well, most physicians’ lives are not nearly as exciting as they are portrayed in the popular media. Nevertheless, medicine gives one many plot ideas, and a large hospital gives a writer access to many interesting people. It’s like a small city, in a way.

Tyler: Why did you decide to write, “Specific Gravity”? Is there a message about our modern world in the book that you were trying to express?

Matt: As our healthcare information becomes more and more electronic, we must be certain that safeguards are present to protect those data and their possible manipulation. My novel shows what could happen if malicious individuals tried to use that information for their own evil gain. These events, however unlikely, could happen.

But most real-world medical errors aren’t malicious in intent-they are simply mistakes, but mistakes that can cost lives. We must carefully examine our own healthcare delivery systems to make certain that hospitals are the safest places in the world.

The book is also about a selfish, unhappy physician’s journey to redemption-to try and do something for someone other than himself, to make the world a better place. To succeed, Alex has to confront his demons, and also must face his greatest “moment of desperation”-the possibility of losing the most important thing in his life. During these times, he finds inner strengths he never knew he had.

Tyler: Matt, would you tell us one of the plot twists, or what you find to be the most exciting moment in the novel?

Matt: There are many, and I don’t want to divulge too much-but I think one of the most exciting parts is when Alex and Wendy discover that the true villain is someone who has been lurking right under their noses all along. Another is Alex’s realization of what the murder weapon is-something so bizarre that it’s almost incomprehensible.

Tyler: Would you give us an example of how the novel is a techno-thriller? What kind of technology is involved in the plot?

Matt: There is much detail in the description of computers and medical informatics-the theoretical development of a “quantum” computer, for example. The unusual murder weapon also demands a great deal of explanation. Bonnie’s forensic science tactics, such as voiceprint, mathematical, chemical, and facial analyses, are explored in detail. Finally, the intricacies of Bonnie’s escape artist tricks probably qualify as “technology,” and are discussed in depth.

Tyler: Matt, what made you first want to be a novelist?

Matt: I had wanted to write a novel for years but simply hadn’t found the time. Believe me, it was a lot more work than I thought it would be. The best part of writing fiction to me is creation of characters-you can make them whoever you want them to be. It’s fun, but also a lot of frustration and hard work; some ideas simply end up in the trash can.

Tyler: I understand you also write books for the medical field. Will you tell us a little bit about those works, and what challenges you find in writing both fiction and non-fiction?

Matt: I have written three medical textbooks which have been used in traditional classroom settings. After I began writing a novel, I soon realized that the lessons learned in medical writing don’t necessarily apply to fiction-it’s totally different. Each has its own set of challenges. One similarity in a techno-thriller to a medical textbook is that both must pay meticulous attention to detail. But the structure and pacing of a novel is vastly different. I went to several writers’ conferences and took several courses on fiction writing, and I owe a lot to those instructors who critiqued my manuscript mercilessly!

Tyler: Do you see Alex as a recurring character in future novels?

Matt: I am currently writing a sequel, “Ontario Lacus,” which is set about three years from the end of “Specific Gravity.” Alex and Bonnie unwittingly uncover a pro sports steroid scandal that turns out to be something far, far worse-one of the greatest scientific discoveries of all time has been perverted into a government bio-genetic experimentation project. Bonnie must risk everything to save the friend who did so much to help her twenty years ago.

As far as a long-term recurring character, I don’t know about Alex. Part of his motivation in “Specific Gravity” is conquering his personal demons, which he accomplishes for the most part. He’s appreciably more mellow in “Ontario Lacus,” which is more Bonnie’s and Wendy’s story than his. We’ll see.

Tyler: Thank you for joining me today, Matt. Before we go, would you tell us your website address and what further information our readers may find there about “Specific Gravity”?

Matt: Further information about the book can be found on my website, http://www.jmneal.com.

Tyler: Thank you, Matt. I wish you lots of luck with your next book and hope you’ll join us again when it is available.

Today, Tyler R. Tichelaar of Reader Views is pleased to be joined by J. Matthew Neal, who is here to discuss his new book “Specific Gravity,” Dunn Avenue Press (2007), ISBN 9780615141374.

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