Essential Hypertension – it’s just a name

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Scientist postulated many years ago that: you need hypertension to maintain cerebral perfusion – especially in the case of atherosclerotic disease. The thinking was that, it was essential to maintain cerebral perfusion… because, if you decrease blood pressure you would damage the brain and the heart because of decreased perfusion due to atherosclerotic disease… therefore, elevated blood pressure was presumed to be “essential” to maintain perfusion…

essential, essential… essential hypertension.

Did you ever wonder why they call it “essential hypertension”? because ~ 40 years ago scientists believed that patients had atherosclerotic disease in your brain and your heart and that hypertension was a normal response to it. Therefore, in order to maintain cerebral and cardiac perfusion – Hypertension was “essential” in obtaining perfusion.

We now know that is false, but the name “essential hypertension” has remained.

Why is it essential? it’s not essential it’s just a name.

examples: why is it called “Rocky mountain spotted fever” when the smallest amount of Rocky mountain spotted fever found in the Rocky mountains?  because, it’s just a name.

Why does a lupus ANTICOAGULANT make me clot? because, it’s just a name.

Why does disseminated Intravascular COAGULATION make me bleed? because, it’s just a name.

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Answer to be posted tomorrow

A 78-year old woman was hospitalized 4 days ago after sustaining a left hip fracture due to a fall. She underwent surgical repair with right hip replacement 3 days ago and did not fully awake from general anesthesia until 12 hours after extubation. As her alertness has increased, she has become increasingly agitated. The patients history reveals a 4 year history of Alzheimer dementia. She has no other pertinent personal or family medical history. Current medications include: donepezil, memantine, and low molecular weight heparin.

On physical exam her temperature is 37.2 C, blood pressure is 100/66 mmHg, pulse rate is 100/min and regular and respiration rate is 18/min. The patient can move all four limbs with guarding of the right lower limb. She is inattentive and disoriented to time and place and exhibits combativeness alternating with hypersomnolence. The remainder of the neurologic examination is unremarkable, without evidence of focal findings or meningismus.

Which is the most likely diagnosis?

  1. Acute stroke
  2. Acute worsening of Alzheimer dementia
  3.  Meningitis
  4. Post operative delirium
  5. Pulmonary embolus
  6. Post operative infection

Alzheimer’s disease

Alzheimer’s disease (AD) is a slowly progressive type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

We believe that the dementia of Alzheimer disease is caused by neurofibrillary tangles, neuritic plaques, amyloid deposition and neuronal atrophy specifically cortical atrophy along with ventricular dilatation.

Interestingly enough, the neurofibrillary tangles and neuritic plaques have a strikingly similarity to the art work of Jackson Pollock

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Five medications are currently used to treat the cognitive problems of AD: four are acetylcholinesterase inhibitors(tacrine, rivastigmine, galantamine and donepezil) and the other (memantine) is an NMDA receptor antagonist.

Interestingly enough Acetylcholine increases the “output” of your brain.

But, what is the secretion/output of your brain? I believe that the output or secretion of your brain is: thought, beauty, love, goodness, truth… donepezil, rivastigmine, galantamine acetycholine esterase inhibitors are in essence “positive inotropes” for your brain – these medicines are “cerebral digoxins” which increase the ejection fraction of the cerebral output of the brain.

A poet is someone who pours light into a spoon and he brings it and places it on your beautiful holy and parched mouth.

Quick Note: Bupropion

Bupropion treats depression and aids in quitting smoking. Bupropion also prevents depression caused by seasonal affective disorder (SAD).

Bupropion is an antidepressant that produces its primary effects through the inhibition of the re-uptake of Dopamine, Serotonin and Norepinephrine. It is particularly noted for improving the impaired concentration and diminished energy that many patients suffering from depression experience.

Bupropion does not cause the noted sexual dysfunction commonly associated with most antidepressant medications… making it a good choice for younger patients who are trying to have children or concerned about sexual side effects.

An important side effect of bupropion however is a decreased seizure threshold, which is more commonly seen with higher doses. This medication should therefore be avoided in patients with seizure disorders or conditions that predispose to seizures (concurrent alcohol abuse, benzodiazepine use, eating disorders etc…)

Individuals with anorexia nervosa or bulimia nervosa are especially prone to developing electrolyte abnormalities that can precipitate further into seizures. Therefore, a thorough history should be taken along with an appropriate physical exam.

Inflammation and Weight

I’m often on the receiving end of a lot of well-intended but ultimately dead-end New Year’s resolutions.

Most of my friends resolve to lose weight. Some resolve to eat more vegetables. Many would like to start cooking more at home to save money and eat healthier. Several mom friends I’ve met are determined to take back control of their children’s wayward, kid-food diets.

People always seem to ask, how do you plan on losing weight? Will you exercise three times per week? Will you stop keeping cookies in the house? How much weight will you need to lose in order to have achieved your goal?

How will you go about eating more vegetables? Will you join a gym? Will you order a salad for lunch every Monday, Wednesday and Friday?

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Recent studies suggests that increased weight correlates with inflammation which may lead to serious health problems. An accumulation of clinical evidence shows that markers of inflammation correlate with coronary risk. For example, plasma levels of C-Reactive Protein (CRP), as measured by a high-sensitivity assay (hsCRP), prospectively predicts the risk of myocardial infarction (MI). CRP also correlate with the outcomes in patients with acute coronary syndromes.

In contrast to several other novel risk factors, CRP adds predictive information to that derived from already established risk factors i.e. sedentary life style, high LDL, low HDL etc… as well as those included in the Framingham score.

CLICK HERE to asses your risk http://www.mdcalc.com/framingham-coronary-heart-disease-risk-score/

Even though recent Mendelian randomization studies do not support a causal role for CRP in cardiovascular disease, CRP serves as a validated biomarker of risk but probably not as a direct contributor to pathogenesis.

Elevations in acute phase reactants such as CRP and fibrinogen reflect the overall inflammatory burden. There are various proinflammatory cytokines that drive CRP production and may represent a stimulus to elevation of inflammatory markers which are seen especially in overweight individuals.

Indeed, CRP levels rise with body mass index. Weight reduction lowers CRP levels, which lowers inflammation.

There is intriguing evidence that suggests lipid-lowering therapy such as HMG-CoA reductase inhibitors otherwise known as -statins  reduces coronary events in part by muting the inflammatory aspects of the pathogenesis of atherosclerosis. For example, in one trial called the “JUPITER” trial (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin trial) a prescribed analysis showed that those who achieved lower levels of both LDL and CRP had better clinical outcomes than did those who only reached the lower level of either the inflammatory marker or the atherogenic lipoprotein.

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Conclusion:

  1. An accumulation of clinical evidence shows that markers of inflammation correlate with coronary risk.
  2. Increased weight correlates with inflammation which may lead to serious health problems.
  3. plasma levels of C-Reactive Protein (CRP), as measured by a high-sensitivity assay (hsCRP) prospectively predicts the risk of myocardial infarction (MI).
  4. CRP also correlate with the outcomes in patients with acute coronary syndromes.

 

 

Father sings to his dying newborn son

A video showing a father singing the Beatles’ ‘Blackbird’ to his dying newborn son after his wife died in childbirth is being watched worldwide.

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On Saturday, Nov. 8, Lennon James Picco was delivered by emergency C-section at 24 weeks. Hours later, Lennon’s mother, Ashley Picco, passed away in her sleep. She was 30 years old.

According to the YouTube video, Lennon’s lack of movement and brain activity had been a big concern for the doctors and nurses at Loma Linda University Hospital. However, during Ashley’s pregnancy, she would often feel Lennon moving to music. With this in mind Lennon’s dad, Chris Picco, asked if he could bring his guitar into the NICU and play for his dying son.

Several hours a day, Chris played music for Lennon during the last days of his life. Baby Lennon passed away Tuesday, Nov. 11.

Chris wrote this Facebook post after the death of his son:

“Dear friends, family, and supporters; it is with an unbelievably heavy heart that I write this. My little fighter, Lennon James Picco went to sleep in his daddy’s arms late last night. He was surrounded by family, friends, and the best doctors, nurses and hospital staff in the world. He was dressed in an outfit that Ashley bought for him, with little guitars on it, and wrapped in a blanket made by a dear friend. I am so thankful for the four unforgettable days I got to spend with him. His mommy would have been so beyond joy to see him and to hold him, touch him, bathe him, sing to him – as I have had the privilege of doing. I have been so blessed and honored to love him before he was formed, to cherish him while mommy carried him, meet him face to precious face, and hold his perfect little body while we said “goodbye for now”. There are no words, but I wanted to keep you updated, as your love and support has meant more than anything in the world. All you need is love.”

(Watch the video here) https://www.youtube.com/watch?v=0lNBcTkssWA

Jesus came to set us free from fear of death and dying: Jesus said to her, “I am the resurrection and the life. He who believes in me will live, even though he dies; and whoever lives and believes in me will never die. Do you believe this?” (John 11:25-26)

A new book claims Jesus was married to Mary Magdalene and had two kids…

According to The Lost Gospel, Jesus was married to Mary Magdalene…? — who was also the Virgin Mary…? — who also gave birth to Jesus? and they had two children…?

[Get ready to play the Mission Impossible theme song or the Twilight Zone theme song in your head] Also, according to this new book Jesus, Mary, and their children also escaped an assassination attempt years before Jesus was crucified.

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Wilson and Jacobovici, who have tried on numerous occasions to discredit claims about the historical Jesus before, “decoded” a story, which is about a man name Joseph and his wife, Aseneth — characters they believe are secret code names for Jesus and Mary Magdalene…

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Who are these people? the authors of this incredible story are Barrie Wilson, a professor at a Canadian University, and Canadian-Israeli screenwriter Simcha Jacobovici [a SCREENWRITER!!!! (a person who writes fictional screenplays on which mass media such as films, television programs, comics or video games are based.)]

They are basing their tale off the Ecclesiastical History of Zacharias Rhetor Mytilene), an Aramaic-language text that has been in the British Museum then the British Library for almost 170 years.

But scholars have said that “the new book shares more in common ‘with the fictional book written by Dan Brown (The Da Vinci Code) rather than historical or Biblical texts like Matthew, Mark, Luke or John.”

In my opinion, these pseudo discoveries are nothing more than a scam designed to stir up controversy by money hungry people who are trying to get people to waste their hard earned money on garbage with no substance or truth.

The Journey Of 40 Years As An Atheist Philosopher To Father Lazarus

An astonishing film about Father Lazarus who has been living in solitude on the Mount Colzim for several years now. He is originally Australian and worked at the university lecturing and teaching literature and Philosophy and spent about 40 years of his life as an atheist deriving his philosophy from Marxism.

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After his mother was diagnosed with terminal cancer and died, he abandoned his life in Australia and set out in quest of God and FREE MAN. His honest search and pilgrimage eventually led him to Jesus Christ.

If I were to point the story towards you I would ask, “Where’s Waldo?” and you might recall those popular children’s picture books from the 1980s. That little guy in the red-and-white-striped shirt and hat loved to hide in the pages amid a busy blur of images that made it nearly impossible to find him.

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Thankfully, finding Jesus is a lot easier than finding Waldo. Jesus doesn’t play hide-and-seek. He says, “Behold, I stand at the door and knock” (Rev. 3:20). You can find Him at the door of your heart—the core of your existence—and He is waiting to come in.  He doesn’t just want to meet you at church, or to be kept at bay on the outer edges of your life. Rather, Jesus longs to be in the center of your dreams, deliberations, and desires. He wants a real relationship with the real you.

And as wonderful as that is, I need to warn you that it may be a little unsettling. Your heart is no doubt harboring a few things that He will want to deal with – things that bring sadness, addiction, anger, hate etc… But it’s worth the pain because there is nothing that is more valuable than intimacy with Him.

Welcome Jesus in and He will clear out the clutter until the air is fragrant and fresh with the purity, power, and pleasure of His presence.

Who’s knocking at your heart’s door? It’s Jesus! How wonderful is that!

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To Worship Him Or Not?

Part 1. Only God deserves worship

In these first two verses God clearly states that we should not worship any other god besides Him

  • Exodus 20:2-6 “I am the LORD your God, who rescued you from slavery in Egypt.  “Do not worship any other gods besides me.  “Do not make idols of any kind, whether in the shape of birds or animals or fish.  You must never worship or bow down to them, for I, the LORD your God, am a jealous God who will not share your affection with any other god!
  • 2 Kings 17:38-39 “Do not forget the covenant I made with you, and do not worship other gods…”

In these next verses God clearly states that we will not share His glory with anyone else

  • Isaiah 42:8 “I am the LORD; that is my name! I will not share my glory with another or my praise to idols.
  • Isaiah 48:11 “I will not yield my glory to another.”

Many verses instances the New Testament also forbid worshiping men, angels, or any created thing.

  • Acts 10:25-26 – Cornelius fell down to worship Peter. Peter forbade it saying that he himself was just a man. God deserves worship, but men do not.
  • Revelation 22:8-9 and 19:10 – John sought to worship the angel, but the angel forbade it because he was a “fellow servant.” “Worship God.”
  • Romans 1:25 – People who worship and serve created things, rather than the Creator, have left the truth of God.

To worship any created thing – whether man, angel, heavenly body, or some other object in nature (mountain, ocean, etc.) – constitutes idolatry.

  • Revelation 4:9-11 – God deserves this glory because He created all things. Note again the distinction between the creature and the Creator. [Revelation 5:13; Romans 11:36]
  • Isaiah 42:8; 48:11 – This glory is unique to God in that He refuses to share it with anyone else. Idols and created things have no right to receive this glory.

It follows that it would be blasphemy for anyone but God to receive this unique kind of glory. If anyone does receive this glory with God’s approval, then that one must possess Deity.

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Part 2. Jesus receives the unique worship, glory and honor of God

A. Jesus is worshipped

  • Matthew 2:11 As soon as the Magi laid eyes on the infant Christ, “they bowed down and worshiped Him
  • John 9:38 After Jesus had healed the blind man, He revealed Himself to be the Son of God. The man said he believed in Jesus, and he worshipped Jesus.
  • Matthew 14:33 “those who were in the boat worshiped him, saying, ‘Truly you are the Son of God’”
  • Revelation 5:12-14Both the Father and the Lamb (Jesus) were worshipped and praised by the created things, who attributed to them “blessing and honor and glory and power.” Note that the same glory and honor belongs to both Father, Son and Holy Spirit.
  • Matthew 28:9 When they realized it was Jesus, they “came to Him, clasped his feet and worshiped him

B. Jesus receives Glory and Honor

  • John 5:23 – All men should honor the Son (Jesus) “just as” they honor the Father. To fail to give this honor to the Son is to fail to properly honor the Father.
  • John 17:5 – Jesus prayed to the Father to “glorify Me together with Yourself, with the glory which I had with You before the world was”

The clear implication is that Jesus and the Father both possessed the same glory before the world began. However, we have already learned that no one but God can receive the glory God has (Isaiah 42:8; 48:11). However, Jesus did receive that glory with the approval of the Father. Therefore, Jesus possesses Deity.

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Part 3. Conclusion

If Jesus is not Deity, then who is He? Who is this man who received glory, honor and worship equal to the Father in heaven? To understand God we must realize that God is not part of the created things. God is the Creator, separate and far above the creatures.

If we accept that Jesus is in fact God then we realize that He always has been God and always will be God, since God’s unique nature cannot change (Hebrews 13:8). God cannot cease to be God nor can God lose the characteristics of God. He can take on non-Divine characteristics as Jesus added the characteristics of a man when He came to earth, and He can limit the use of His powers in order to accomplish His Divine purposes as Jesus did on earth. But He cannot cease to be God and He cannot lose the power and characteristics of God.

Jesus possesses Deity.

A Tree Will Be Known By Its Fruit

LAHORE Pakistan (Reuters) –

A mob of Muslims were gathered by the towns mullah (the towns expert teacher of the koran and Islamic laws) outside the house of Shehzad Masih, 32, and his wife Shama, in her 20s, dragged them out and beat them to death, their bodies were then set on fire in a brick kiln where they worked while a mob of Muslims celebrated and jeered chanting “Islam is peace” according to police and witnesses.

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The Christian couple was charged with blasphemy (desecrating a koran) — however, no one could verify whether or not the charges were true.

Blasphemy charges, (in countries were the ruling population are Muslims) even when they go to court, are punishable by death. They are hard to fight because the law does not define clearly what is blasphemous. Presenting the evidence can sometimes itself be considered a fresh infringement.

  • Quick fact: Christians make up about four percent of Pakistan’s population and tend to keep a low profile in a country where Sunni Muslim militants frequently bomb targets they see as heretical, including Christians, and Sufi and Shi’ite Muslims.

Punjab police spokeswoman Nabila Ghazanfar said the couple, like many other poor Christians in the area, worked in a brick kiln owned by a local man who has also been arrested.

“Three days ago, a co-worker alleged that they had burnt pages of the Koran. On Tuesday morning, a mob gathered outside their house, dragged them out, beat to death and burnt them in the same kiln where they worked,” she said.

Pakistan’s minorities feel that the state fails to protect them, and even tolerates violence against them because the koran explicitly commands Muslims to kill, beat and treat poorly those who are non-Muslims.

  1. Quran (2:191-193) “And kill them (non-Muslims) wherever you find them, and turn them out from where they have turned you out.”
  2. Quran (3:151)“Soon shall We cast terror into the hearts of the Unbelievers…”
  3. Quran (8:12)“I will cast terror into the hearts of those who disbelieve. Therefore strike off their heads and strike off every fingertip of them”
  4. Quran (2:191) “murder them (Christians and Jews) and treat them harshly

A local journalist, who spoke on condition of anonymity for security reasons, said Islamic police are slow to act to protect non-Muslims.

  • Last month a British man with a history of mental health illness, sentenced to death for blasphemy earlier this year, was shot by a prison guard in his cell.
  • Also in October, a Pakistani court upheld the death penalty against a Christian woman, Asia Bibi, who is also accused of blasphemy, in a case that drew global headlines after two prominent politicians who tried to help her were assassinated.

Jesus said in Luke 6:43-45

43 “No good tree bears bad fruit, nor does a bad tree bear good fruit. 44 Each tree is recognized by its own fruit. People do not pick figs from thornbushes, or grapes from briers. 45 A good man brings good things out of the good stored up in his heart, and an evil man brings evil things out of the evil stored up in his heart…