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Lethal Pressure Crush 13



For many years, abortion-rights advocates have asserted that abortions after 20 weeks are performed because of maternal health complications or lethal fetal anomalies discovered late in pregnancy.[8] However, wider data from both the medical literature and late-term abortion providers indicates that most late-term procedures are not performed for these reasons. Previous survey studies of late-term abortion patients have confirmed that most late-term abortions are performed because of a delay in pregnancy diagnosis and for reasons similar to those given by first-trimester abortion patients: financial stressors, relationship problems, education concerns or parenting challenges.[9]




Lethal Pressure Crush 13



Based on videos of protests, and interviews with witnesses and a security force member, Human Rights Watch documented numerous incidents of security forces unlawfully using excessive or lethal force against protesters in 13 cities across Iran. Videos showed security forces using shotguns, assault rifles, and handguns against protesters in largely peaceful and often crowded settings, altogether killing and injuring hundreds. In some cases, they shot at people who were running away.


Human Rights Watch verified 16 videos posted on social media that depict protests from September 17 to 22. The videos show police and other security forces using excessive and lethal force against protesters in Tehran, the capital, and the cities of Divandarreh, Garmsar, Hamedan, Kerman, Mashhad, Mehrshahr, Rasht, and Shiraz. They include instances of security forces using firearms, such as handguns and Kalashnikov-pattern assault rifles. Human Rights Watch also interviewed five witnesses to the crackdowns in Sanandaj, Marivan, Saghez, and Mashhad, and a security forces member.


Human Rights Watch also analyzed photos and videos showing grievous, and sometimes lethal, injuries to demonstrators. This research did not include the deadly crackdown by security forces in Zahedan on September 30, nor subsequent attacks against protesters, including on Sharif University Campus in Tehran on October 2.


Videos also show police officers and other security forces members, including plainclothes agents, operating side-by-side with the police, punching, kicking, and beating peaceful protesters and bystanders with batons. Police forces also used less-lethal weapons, including pepper ball launchers and riot guns.


Garlic is a bulbous plant; grows up to 1.2 m in height. Garlic is easy to grow and can be grown in mild climates (Figure). There are different types or subspecies of garlic, most notably hardneck garlic and softneck garlic. Allicin (allyl 2-propenethiosulfinate or diallyl thiosulfinate) is the principal bioactive compound present in the aqueous extract of garlic or raw garlic homogenate. When garlic is chopped or crushed, allinase enzyme is activated and produce allicin from alliin (present in intact garlic). Other important compounds present in garlic homogenate are 1 -propenyl allyl thiosulfonate, allyl methyl thiosulfonate, (E,Z)-4,5,9-trithiadodeca- l,6,11-triene 9- oxide (ajoene), and y-L-glutamyl-S-alkyl- L-cysteine. The adenosine concentration increases several-fold as the homogenate is incubated at room temperature for several hours.


Digoxin is approved by the Food and Drug Administration (FDA) to treat heart failure and to slow the heart rate in patients who develop atrial fibrillation, a common abnormal heart rhythm characterized by an irregular and often rapid heart rate. According to the authors of the Prescrire International review, crushing digoxin tablets before swallowing may increase the risk of other dangerous abnormal heart rhythms.[4] These include heart rhythms that are too slow or too fast and may progress to cardiac arrest and death.


Sustained-release drugs also should not be crushed or chewed before swallowing because doing so will cause the dangerously rapid absorption of a large dose that was intended to be released slowly over many hours. (See text box, below, for stories of patients who have been seriously harmed or killed after ingesting tablets that were chewed or crushed.)


Finally, the authors of the Prescrire International review reported that some medications have a coating that is intended to prevent the active ingredients from causing ulcers and tissue injury in the mouth, stomach or intestines. For example, crushing certain iron supplements available in tablet form can cause ulcers in the mouth due to exposure to the iron.[15] Likewise, crushing certain potassium supplements can cause ulcers in the intestines.[16]


When taking a prescription drug, you should never crush a tablet, open a capsule or chew either without first asking the prescribing health care provider or dispensing pharmacist whether it is safe to do so.


If you are experiencing difficulty swallowing tablets or capsules and are taking a prescription drug that is unsafe to crush, chew or open, consult the prescribing health care professional about other treatment options. There may be a liquid formulation of the same drug. There also may be a smaller tablet or capsule form of the same drug or another drug that you can swallow or that can be safely crushed or opened before ingesting.


For example, although a high-potassium meal might contain enough potassium to raise the serum potassium acutely to lethal levels if the potassium remained in the extracellular space, Na+ -K+ -ATPase rapidly takes up the potassium into cells, thus preventing the development of hyperkalemia. Adrenergic stimulation and insulin are important in maintaining the activity of Na+ -K+ -ATPase. The excess potassium then can be excreted by the kidneys, allowing serum potassium levels to return to normal.


For people with heart disease, including heart failure and high blood pressure: Mefenamic acid may cause an increased risk of heart problems, including heart attack, stroke, or blood clot. Your risk may be higher if you already have heart disease and take this medication for a longer period of time. Mefenamic acid may cause you to retain water and can make high blood pressure worse or increase your risk of heart failure.


S-allyl-L-cysteine sulfoxide (alliin) accounts for approximately 80% of cysteine sulfoxides in garlic (Figure 1) (5). When raw garlic cloves are crushed, chopped, or chewed, an enzyme known as alliinase is released. Alliinase catalyzes the formation of sulfenic acids from L-cysteine sulfoxides (Figure 2). Sulfenic acids spontaneously react with each other to form unstable compounds called thiosulfinates. In the case of alliin, the resulting sulfenic acids react with each other to form a thiosulfinate known as allicin (half-life in crushed garlic at 23C is 2.5 days). The formation of thiosulfinates is very rapid and has been found to be complete within 10 to 60 seconds of crushing garlic. Allicin breaks down in vitro to form a variety of fat-soluble organosulfur compounds (Figure 2), including diallyl trisulfide (DATS), diallyl disulfide (DADS), and diallyl sulfide (DAS), or in the presence of oil or organic solvents, ajoene and vinyldithiins (6). In vivo, allicin can react with glutathione and L-cysteine to produce S-allylmercaptoglutathione (SAMG) and S-allylmercaptocysteine (SAMC), respectively (Figure 2) (4).


Crushing garlic does not change its γ-glutamyl-L-cysteine peptide content. γ-Glutamyl-L-cysteine peptides include an array of water-soluble dipeptides, including γ-glutamyl-S-allyl-L-cysteine, γ-glutamylmethylcysteine, and γ-glutamylpropylcysteine (see Figure 1). Water-soluble organosulfur compounds, such as S-allylcysteine and SAMC (Figure 3), are formed from γ-glutamyl-S-allyl-L-cysteine during long-term incubation of crushed garlic in aqueous solutions, as in the manufacture of aged garlic extracts (see Sources).


Most systematic reviews and/or meta-analyses of randomized controlled trials to date have provided mixed results regarding the potential blood pressure-lowering effect of garlic, possibly because most of these trials enrolled both normotensive and hypertensive subjects (90, 101-105).


In a recent 12-week, randomized, placebo-controlled trial in untreated hypertensive subjects, daily intake of aged garlic extract (1.2 g of which contained 1.2 mg of S-allyl-L-cysteine [SAC]) was shown to significantly lower SBP by 11 mm Hg and DBP by 6 mm Hg on average in 50%-60% of participants, but reductions in blood pressure were not reported in 40%-50% of participants compared to placebo (110). Whether interindividual differences in nutritional status and genetic polymorphisms can explain differences in blood pressure response to garlic treatment need to be explored in future studies (53, 110).


The results of randomized controlled trials have suggested that garlic supplementation modestly improves serum lipid profiles in individuals with elevated serum cholesterol and reduces blood pressure in hypertensive subjects. It is not yet clear whether garlic supplementation can reduce atherosclerosis or prevent cardiovascular events, such as myocardial infarction or stroke.


Allium vegetables, including garlic and onions, are the richest sources of organosulfur compounds in the human diet (134). To date, the majority of scientific research relating to the health effects of organosulfur compounds has focused on those derived from garlic. Fresh garlic cloves contain about 2 to 6 mg/g of γ-glutamyl-S-allyl-L-cysteine (0.2%-0.6% fresh weight) and 6 to 14 mg/g of alliin (0.6%-1.4% fresh weight). Garlic cloves yield about 2.5 to 4.5 mg of allicin per gram of fresh weight when crushed. One fresh garlic clove weighs 2 to 4 g (5).


The enzyme alliinase can be inactivated by heat. In one study, microwave cooking of unpeeled, uncrushed garlic totally destroyed alliinase enzyme activity (135). An in vitro study found that prolonged oven heating or boiling (i.e., six minutes or longer) suppressed the inhibitory effect of uncrushed and crushed garlic on platelet aggregation, but crushed garlic retained more anti-aggregatory activity compared to uncrushed garlic (136). Administering raw garlic to rats significantly decreased the amount of DNA damage caused by a chemical carcinogen, but heating uncrushed garlic cloves for 60 seconds in a microwave oven or 45 minutes in a convection oven prior to administration blocked the protective effect of garlic (137). The protective effect of garlic against DNA damage can be partially conserved by crushing garlic and allowing it to stand for 10 minutes prior to microwave heating for 60 seconds or by cutting the tops off garlic cloves and allowing them to stand for 10 minutes before heating in a convection oven. Because organosulfur compounds derived from alliinase-catalyzed reactions may play a role in some of the biological effects of garlic, some scientists recommend that crushed or chopped garlic be allowed to "stand" for at least 10 minutes prior to cooking (135).


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