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The ﬁrst group includes reduction in urine volume (dehydration) and an increased rate of excretion of stone constituents purchase provera menstruation occurs when there is a decrease in. The second group of factors is related to stagnation of urine ﬂow (urinary stasis) generic provera 2.5mg on line breast cancer walk san diego, pH changes proven 10mg provera womens health and wellness, foreign bodies buy toradol 10 mg visa, and reduction in levels of substances that normally keep stone constituents from forming crystals purchase 100 mg viagra jelly overnight delivery. Therapeutic Considerations The high frequency of calcium-containing stones in afﬂuent societies is directly associated with the following dietary patterns: • Low fiber intake1 • High consumption of refined carbohydrates2,3 • High alcohol consumption4 • Consumption of large amounts of animal protein4,5 • High fat consumption6 • High consumption of soft drinks7 • Excessively acid-forming diet Today conventional medicine classiﬁes most stones as having an “unknown cause” (idiopathic), but this ignores the dietary factors that lead to stone formation. The cumulative effect of these dietary factors is undoubtedly the reason for the rising incidence of kidney stones. Depending on the type of stone, this ability to alter urinary pH may help prevent and treat stones. Blackcurrant juice increased urinary pH (made the urine more alkaline), leading to excretion of citric acid and loss of oxalic acid. These results indicate that blackcurrant juice could support the prevention and treatment of uric acid and oxalate stones, while cranberry juice could be useful in the treatment of oxalate stones as well as magnesium ammonium phosphate stones. Another study showed that cranberry juice reduced the amount of calcium in the urine by over 50% in patients with recurrent kidney stones. Because most cranberry juice products on the market are loaded with sugar, it might be better to take a cranberry extract. For prevention of kidney stones in those at high risk, take the equivalent of 16 fl oz cranberry juice or follow dosage recommendations given on the product’s label. Drinking more water has long been recognized as one of the main approaches to preventing kidney stones. Numerous clinical trials have found that consumption of more than about 48 ﬂ oz of water per day lowers the long-term risk of kidney stone recurrence by approximately 60%. Urinary calcium excretion increases approximately 40 mg for each 2,300 mg increase in dietary sodium in normal adults; those who form kidney stones have an even greater increase in urinary calcium with an increase in salt intake. The best approach is to combine increased water intake with decreased sodium intake. Magnesium and Vitamin B6 A magnesium-deﬁcient diet is one of the quickest ways to cause kidney stones in rats. Supplemental vitamin B6 is known to reduce the production and urinary excretion of oxalates. Calcium Most conventional doctors tell their patients with kidney stones to avoid calcium supplements; the thinking is that because calcium-containing stones are so common, restricting the amount of calcium in the diet will help reduce the formation of stones. However, studies show that calcium supplementation (300 mg per day of calcium, given as calcium carbonate, citrate, or malate) actually reduced oxalate absorption and excretion, and thus would help to prevent stone formation.
Acquired Diseases In mammals buy provera 2.5mg women's health yakima, myocarditis can occur secondary to many common viral purchase 2.5 mg provera visa menstrual fatigue remedies, bacterial discount provera amex menstruation 35 day cycle, mycotic and proto- zoan infections 500 mg zithromax with visa. Cardiomyopathy has been associated with thyroid diseases proven kamagra soft 100mg, anemia, malnutrition, meta- bolic disorders, parasitic infections, pancreatitis, toxemias and neoplasia. Electrocardiography revealed a Fowl plague has been associated with myocardial heart rate = 120, P-wave = 0. Echocardiography indicated a large mass on the has been reported as a component of neuropathic aortic valve. A six-year-old curassow was presented with lethargy and a cool edematous left leg. Lesions consist generally of an enlarged Chlamydia Pasteurella and yellowish heart. A few affected birds may have Salmonella Chlamydia an excess of gelatinous fluid in the pericardial sac or Reovirus (Galliformes) Polyomavirus 69,75 Concurrent respiratory Avian serositis virus peritoneal cavity. Cardiomegaly Neuropathic gastric Polyomavirus dilatation Vitamin E and selenium deficiencies are well known Hemochromatosis Selenium and vitamin E 78 deficiencies as causes for cardiomyopathy in gallinaceous birds. Epicarditis Salmonella Hydropericardium Selenium and vitamin E deficiencies have also been Pasteurella Polyomavirus suggested as causes for myocardial and skeletal mus- Reovirus (Galliformes) Furazolidone toxicity cle degeneration in ratites less than six months old Genetics that died after a brief period of depression (see Chap- ter 48). Histologic lesions in the heart of these birds a relatively greater increase in the left. Af- oxygen levels in the incubator and poor ventila- fected birds typically have increased activities of tion). Electrocardiography has been shown to be effective for diagnosing both spontaneous and fura- zolidone-induced cardiomyopathy. Digoxin can be used when cardiac output is diminished due to myocardial disease, but is contraindicated when persistent ventricular ar- rhythmias are present. Digoxin treatment should be discontinued if the severity of an arrhythmia in- creases. Epicardial and Pericardial Diseases31 Pericardial effusion is a common finding in birds. The accumulated fluid may be a result of cardiac or sys- temic disease and may be of an inflammatory or noninflammatory nature (see Color 14). Fibrinous pericarditis is most common and may lead to adhesions of the epi- cardium to the pericardium and to constrictive heart failure (see Color 14). A serofibrinous pericarditis may occur in conjunction with a variety of bact-erial (eg, E. Hemopericardium may be the result of puncture of the epicardium by a foreign body, iatrogenic puncture of the heart, cardiac tumors, rupture of the left atrium or myocardial rupture.