Genetic Medicine:

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Psoriasis | Psoriatic Arthritis | MedlinePlus

Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery scales. You usually get the patches on your elbows, knees, scalp, back, face, palms and feet, but they can show up on other parts of your body. Some people who have psoriasis also get a form of arthritis called psoriatic arthritis.

A problem with your immune system causes psoriasis. In a process called cell turnover, skin cells that grow deep in your skin rise to the surface. Normally, this takes a month. In psoriasis, it happens in just days because your cells rise too fast.

Psoriasis can be hard to diagnose because it can look like other skin diseases. Your doctor might need to look at a small skin sample under a microscope.

Psoriasis can last a long time, even a lifetime. Symptoms come and go. Things that make them worse include

Psoriasis usually occurs in adults. It sometimes runs in families. Treatments include creams, medicines, and light therapy.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

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Center for Spinal Cord Injury Recovery – DMC RIM Rehab

Welcome to The Center for Spinal Cord Injury Recovery.

The Center for Spinal Cord Injury Recovery (CSCIR) is a unique, internationally renowned setting where innovation is our focus and recovery is our goal. A place where thinking outside the box and the skys the limit are not just catch-phrases, but the foundation of our program.

The Center for SCI Recovery, is one of the first hospital-based programs of its kind in the U.S., to provide a long-term, high-intensity, non-traditional activity-based therapy program that utilizes innovative exercise techniques to optimize recovery.

The program incorporates therapeutic techniques based on the newest information available from emerging research around the globe. Our experienced team works one-on-one with the client to develop a creative individual therapeutic exercise program, aimed at activating muscles and nerves below the level of injury.

Click here to see what our clients are saying about our program.

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Fracture Cervical Spine Without Spinal Cord Injury …

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor’s Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

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Hyaluronic acid dermal fillers in anti aging medicine …

In the ever growing and evolving, magical world of anti aging medicine, we can use hyaluronic acid dermal fillers as a multi talented tool, filling and wiping away eyebags, straightening noses, performing non surgical facelifts, erasing wrinkles, augmenting lips and rejuvenating the aging skin itself.

But how does the consumer (read patient), make a choice of which filler to choose. What is the best dermal filler? (This is a title of a vintage blog of mine which you can find in these blog pages) Which filler will give the best results? Which is the softest? Which the longest lasting filler? Which is the safest filler?

From the IMCAS conference in Paris (a wonderful yearly non surgical aesthetic medicine conference I am going to this weekend!) to the Anti Aging medicine conference in Monte Carlo, thousands of aesthetic doctors gather every year to hear about yet another batch of hyaluronic acid fillers being launched onto the scene, and there are now hundreds of fillers out there.

But without confusing you too much, here is a quick guide, with some facts, myths and innovations, from 2 of the best and leading dermal fillers currently dominating the European and American markets.

RESTYLANE

FACTS Restylane and Perlane were the first hyaluronic acid fillers invented over 15 years ago by a Swedish genius Bengt Agerup in Upsala. This clever scientist first invented NASHA, non animal ,stabilised hyaluronic acid, and hence transformed the world of aesthetic medicine. There are now many copies and new fillers on the market, but with the longest track record of good results and great safety, this filler is still the gold standard, the original, the coca cola of dermal fillers

MYTHS The biggest myth I hear from patients is that this filler does not last as long as some like Juvederm, and more importantly, that it is a filler which is more likely to leave lumps, and possible the tyndall effect, of a blue line under the skin, in my experience these are facts which are not true. Restylane in my mind is the best filler, with the longest lasting results. Some of my patients for naso labial lines have results for up to 7 years, and eyebags for up to 4 years! And safety of the results? Indeed, this filler is an advanced filler, so yes, in inexperienced hands, lumps or blue lines are more possible than with for instance the Dermavisc filler for instance (discussed below), but in expert hands, Restylane is by far the best tool, allowing the best shaping, moulding and the most efficient natural results

INNOVATIONS It may be the oldest filler, but the innovations from Galderma never stop. The skin rejuvenating SKINBOOSTERS like Restylane Vital and the brand new clicky syringe are incredible, and a little bird tells me that a Restylane mixed with growth factors is just around the corner!

JUVEDERM

FACTS Juvederm is the second oldest filler on the market and with the aesthtetic giant Allergan behind it (Allergan is the pharmaceutical company behind our other friend Botox), Juvederm has taken over a large chunk of the aesthetic market in the US and Europe, and is still the fastest gowing filler in the world. A great filler, with fancy packaging no doubt, but I do have some doubts about this filler, and still believe it to be the second best in the world of fillers, behind the original Restylane. Juvederm in my opinion is a filler which should NEVER be injected in the tear trough areas under the eyes as Juvederm fillers give a lot more swelling than some other brands. Granted, the thicker filler Voluma is probably the best volumising filler on the market, and I use this filler a lot!

MYTHS The main myth I would like to dispel is that Juvederm is somehow magically the filler which gives the longest lasting results! Great marketing from Allergan, as with great adverts and convicning medical proof, many now truly believe that this filler does ineed do exactly what is says on the tin, but dear readers, my 10 year experience in the industry has taught me that ALL hyaluronic acid fillers have a similar longevity, and indeed how long your results will last relies more on the skill of your doctor!

INNOVATIONS The Juvederm range has always like a cameleon, had a great capacity to reinvent itself, and the latest is the launch of their new Vycross technology, which includes the new fillers Voluma, Volift and Volbella. Nice fillers, and with less swelling than with the older Juvederm 3, and Juvederm 4. Indeed, Allergan were the first to come out with fillers with lidocaine local anaesthetic, but is the Vycross technology truly new and innovative? Many in the industry claim that this is just an older technology like Surgiderm, relaunched and repackaged! Allegedly!

Festina Lente Lets move on quickly but carefully. For in order not to lose you at this point of what is proving to be a longish blog, lets take a look at 3 more popular European fillers, but a little more concisely.

TEOSYAL

FACTS The favourite for some aesthetic greats such as Jean Louis Sebagh, and I can understand why. From Teoxane laboratories, Switzerland, Teosyal has firmly established itslef as the third best filler in the industry. A solid filler, with good moulding capacity and a wide range of fillers, it is a good but not a great filler. Their tear trough filler for instance (Teosyal Redensity) is in my experience not an effective one at all!

MYTHS As with all companies, Teoxane claims that their hyaluronic acid is a product from the most supreme state of the art technology, BUT , in truth ALL hyaluronic acid fillers come from very similar technologies, with slight twists and differences which make some better than others. And did you know, most of the bacterial hyaluronic acid on the market is bought from a large factory in China, before it is stabilised in to various filler brands?

INNOVATIONS Teosyal certianly has the widest range of fillers, forever coming up with new ones, and has innovative names for their fillers such as Teosyal Kiss, and I will let you guess where that filler is used!

EMERVEL

FACTS A great new filler which over the last couple of years has entered the market. Also from Galderma, I guess the only problem is that only a few months after a big launch of the Emervel range of fillers, Galderma took over Q-med , the makers of the king of fillers Restylane!! Oh my goodness, what do we do now? I am sure was the cry by the Galderma bosses, and hence this good filler has taken a while to come to the fore, but with good thicker fillers like Emervel Volume, this range is making its mark on the market for sure.

MYTHS Newest is not always the best, and the myth that just because this new hyaluronic acid technology is the latest and the most cutting edge, that it is the best is not of course true. Restylane was the original formula, (like in the Cola world where Coca Cola which is still the best formula), and is still the top filler to beat, and has the longest safety record.

INNOVATIONS – Nothing particularly new or bold has come from this range, but being a new kid on the block, new members to the range, and innovations with their nice syringes are always around the corner.

DERMAVISC

FACTS I thought I would throw this filler into this blog to make things a little more interesting! A filler which is becoming ever more popular on the continent and in countries like Sweden and Croatia, and one which is on its way to the UK for sure. The fascinating fact about this filler is that it is the first successful filler on the market which is not bacterial in origin, but actually of animal origin!! Animal! I hear you say, but this is a perfectly safe filler harvested from rooster combs (poor roosters!), and a filler which can be injected safely without the need for an allergy test. I have tried it, and indeed even gave some courses on it. It is an OK filler, with some not bad results, but it is different from other fillers, and it does not give as strong results, and they do not last as long. And I must admit, the short safety track record worries me, as does the animal origin. Non animal fillers for me!

MYTHS Bochus Biotech, the makers of Dermavisc will claim that this purer filler of animal origin is much better and safer than the laboratory non animal fillers, but my dear reader, I would claim completely the opposite!

INNOVATIONS This being the first good animal origin filler is an innovation in itself, and an innovations to be applauded despite som of my doubts described above. However, this filler is the only one on this list which does not have lidocaine added to it (treatments with fillers with lidoacine are much less painful), an innovation which Biotech will have to push through quickly if this filler is to survive this tough market!

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Enbrel (etanercept)

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about ENBREL?

ENBREL is a medicine that affects your immune system. ENBREL can lower the ability of your immune system to fight infections. Serious infections have happened in patients taking ENBREL. These infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections. Your healthcare provider should test you for TB before you take ENBREL and monitor you closely for TB before, during, and after ENBREL treatment, even if you have tested negative for TB.

There have been some cases of unusual cancers reported in children and teenage patients who started using tumor necrosis factor (TNF) blockers before 18 years of age. Also, for children, teenagers, and adults taking TNF blockers, including ENBREL, the chances of getting lymphoma or other cancers may increase. Patients with RA may be more likely to get lymphoma.

Before starting ENBREL, tell your healthcare provider if you:

What are the possible side effects of ENBREL?

ENBREL can cause serious side effects including: New infections or worsening of infections you already have; hepatitis B can become active if you already have had it; nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; blood problems (some fatal); new or worsening heart failure; new or worsening psoriasis; allergic reactions; autoimmune reactions, including a lupus-like syndrome and autoimmune hepatitis.

Common side effects include: Injection site reactions and upper respiratory infections (sinus infections).

In general, side effects in children were similar in frequency and type as those seen in adult patients. The types of infections reported were generally mild and similar to those usually seen in children.

These are not all the side effects with ENBREL. Tell your healthcare provider about any side effect that bothers you or does not go away.

If you have any questions about this information, be sure to discuss them with your healthcare provider. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see Prescribing Information and Medication Guide.

INDICATIONS

Moderate to Severe Rheumatoid Arthritis (RA)

ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with moderately to severely active rheumatoid arthritis. ENBREL can be taken with methotrexate or used alone.

Moderately to Severely Active Polyarticular Juvenile Idiopathic Arthritis (JIA)

ENBREL is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis (JIA) in children ages 2 years and older.

Psoriatic Arthritis

ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with psoriatic arthritis. ENBREL can be used with or without methotrexate.

Ankylosing Spondylitis (AS)

ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.

Moderate to Severe Plaque Psoriasis

ENBREL is indicated for chronic moderate to severe plaque psoriasis (PsO) in children 4 years and older and adults who may benefit from taking injections or pills (systemic therapy) or phototherapy (ultraviolet light).

IMPORTANT SAFETY INFORMATION: What is the most important information I should know about Enbrel (etanercept)?

ENBREL is a medicine that affects your immune system. ENBREL can lower the ability of your immune system to fight infections. Serious infections have happened in patients taking ENBREL. These infections include tuberculosis(TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections. Your healthcare provider should test you for TB before you take ENBREL and monitor you closely for TB before, during, and after ENBREL treatment, even if you have tested negative for TB.

There have been some cases of unusual cancers reported in children and teenage patients who started using tumor necrosis factor (TNF) blockers before 18 years of age. Also, for children, teenagers, and adults taking TNF blockers, including ENBREL, the chances of getting lymphoma or other cancers may increase. Patients with RA may be more likely to get lymphoma.

Before starting ENBREL, tell your healthcare provider if you:

What are the possible side effects of ENBREL?

ENBREL can cause serious side effects including: New infections or worsening of infections you already have; hepatitis B can become active if you already have had it; nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; blood problems (some fatal); new or worsening heart failure; new or worsening psoriasis; allergic reactions; autoimmune reactions, including a lupus-like syndrome and autoimmune hepatitis.

Common side effects include: Injection site reactions, upper respiratory infections (sinus infections), and headache.

In general, side effects in children were similar in frequency and type as those seen in adult patients. The types of infections reported were generally mild and similar to those usually seen in children.

These are not all the side effects with ENBREL. Tell your healthcare provider about any side effect that bothers you or does not go away.

If you have any questions about this information, be sure to discuss them with your healthcare provider. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see Prescribing Information and Medication Guide.

INDICATIONS

Moderate to Severe Rheumatoid Arthritis (RA)

ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with moderately to severely active rheumatoid arthritis. ENBREL can be taken with methotrexate or used alone.

Moderately to Severely Active Polyarticular Juvenile Idiopathic Arthritis (JIA)

ENBREL is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis (JIA) in children ages 2 years and older.

Psoriatic Arthritis

ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with psoriatic arthritis. ENBREL can be used with or without methotrexate.

Ankylosing Spondylitis(AS)

ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.

Moderate to Severe Plaque Psoriasis

ENBREL is indicated for the treatment of adult patients (18 years or older) with chronic moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

At Enbrel.com, you can learn about Enbrel (etanercept), a self-injected biologic medicine used to treat inflammatory diseases with long-term effects. You can find information about moderate to severe rheumatoid arthritis(RA), moderate to severe plaque psoriasis, psoriatic arthritis, moderately to severely active polyarticular juvenile idiopathic arthritis(JIA), and ankylosing spondylitis(AS). You can learn about symptoms, treatment, how Enbrel (etanercept) works for each condition, results for each condition, results for each condition, and safety information.

Enbrel.com supports you and your loved ones from diagnosis to treatment. You can find resources like injection demonstrations, patient testimonial videos, questions to ask your doctor, and even help with finding a rheumatologist or dermatologist near you.

Enbrel.com also provices ongoing assistance with ENBREL SupportTM, a patient support program to help with out-of-pocket costs and connect you with registered nurses and ENBREL Nurse Partners. The resources available will help you get started. Resources include the ENBREL Starter Kit, injection and medicine refill reminders, free needle disposal containers, travel packs, and ongoing education.

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