Rite Aid Allergy Medication, Coated Minitabs

Package Details

Same strength as original, 50% smaller tablet.

200 Coated Minitabs
Antihistamine/Diphenhydramine HCl, 25 mg

*Compare to the active ingredient in Benadryl®

Relieves Runny Nose, Sneezing, Itching of the Nose or Throat, & Itchy, Watery Eyes Due to Allergies

Made in USA

*This product is not manufactured or distributed by Parke-Davis Consumer Health Products Group, owners of the registered trademark Benadryl®.

Indications

Temporarily relieves these symptoms of hay fever or other upper respiratory allergies: runny nose, sneezing, itchy nose or throat, itchy, watery eyes.

Directions

Do not take more than 6 doses in 24 hours.

*
Adults and children 12 years and over: 1-2 minitabs every 4 to 6 hours.
*
Children 6 to under 12 years: 12.5mg** to 25mg (1 minitab) every 4 to 6 hours.
*
Children under 6 years: ask a doctor.

Store at controlled room temperature 15-30 degrees C (59-86 degrees F). Protect from moisture. Use by expiration date on package.

Retain Carton for Complete Product Information.

**This dosage (12.5mg) is not available in this package. Do not attempt to break minitab.

Ingredients
Active Ingredients: Each Minitab Contains: Diphenhydramine HCl (25 mg) (Antihistamine)

Inactive Ingredients: Corn Starch, D&C Red 27, D&C Red 30, DiCalcium Phosphate, Hydroxypropyl Methylcellulose, Magnesium Stearate, Microcrystalline Cellulose, Polyethylene Glycol, Polysorbate 80, Silicon Dioxide, Stearic Acid, Titanium Dioxide

Warnings

Do not use with any other product containing diphenhydramine, including one applied topically.

Ask a doctor before use if you have

* glaucoma
* a breathing problem such as emphysema or chronic bronchitis
* trouble urinating due to an enlarged prostate gland

Ask a doctor or pharmacist before use if you are taking sedatives or tranquilizers.

When using this product

*
you may get drowsy
*
avoid alcoholic drinks
*
alcohol, sedatives and tranquilizers may increase drowsiness
*
be careful when driving a motor vehicle or operating machinery
*
excitability may occur especially in children

If pregnant or breast-feeding, ask a health professional before use.

Keep out of reach of children. In case of accidental overdose, get medical help or contact a Poison Control Center immediately.

Source:www.drugstore.com

Rite Aid Loratadine Antihistamine, Tablets

Package Details

Original Prescription Strength Non-Drowsy*
Value Size

Antihistamine / 24-Hour Allergy
Relief of Sneezing, Runny Nose, Itchy, Watery Eyes, and Itchy Throat or Nose

Rite Aid Satisfaction Guarantee - If you're not satisfied, we'll happily refund your money. (See manufacturer for details).

Compare to Active Ingredients of Claritin®**

*When taken as directed. See Drug Facts Panel

**This product is not manufactured or distributed by Schering-Plough HealthCare Products, Inc., distributor of Claritin®.

Questions? If you have questions of a medical nature, please contact your pharmacist, doctor or health care professional.

Directions:

* Adults and children 6 years and over: 1 tablet daily; not more than 1 tablet in 24 hours.
* Children under 6 years of age: ask a doctor.
* Consumers with liver or kidney disease: ask a doctor.

Store at 15°-30°C (59°-86°F)

Ingredients:
Active Ingredients: Loratadine (10 mg)

Inactive Ingredients: Lactose Monohydrate, Magnesium Stearate, Povidone, Pregelatinized Starch

Warnings:

Do not use if you have ever had an allergic reaction to this product or any of its ingredients.

Ask a doctor before use if you have liver or kidney disease. Your doctor should determine if you need a different dose.

When using this product do not take more than directed. Taking more than directed may cause drowsiness.

Stop use and ask a doctor if an allergic reaction to this product occurs. Seek medical help right away.

If pregnant or breast-feeding, ask a health professional before use.

Keep this all medications out of the reach of children. In case of accidental overdose, seek professional assistance or contact a poison control center immediately.

Safety sealed: do not use if printed foil seal under cap is torn or broken.

Source:www.drugstore.com

Swiffer Sweeper Dry Sweeping Cloths

Package Details

Sweeps Up What Brooms Leave Behind.

Swiffer cloths' deep, V-shaped ridges trap and lock:

* Dirt
* Hair
* Crumbs
* Dust

Questions? 1-800-214-8734

Warnings:

Avoid accidents: keep out of reach of children and pets to avoid accidental ingestion. Do not flush the disposable cloths.

Source:www.drugstore.com

Benadryl Allergy Relief, Ultratab Tablets

Package Details

Diphenhydramine Hydrochloride Antihistamine.

The Histamine Blocker.

For allergy relief:

* sneezing
* runny nose
* itchy throat
* itchy, watery eyes

Economy Size - 100 Ultratab® Tablets - Small Tablet size.

* Easy to Swallow.



Indications:

Temporarily relieves these symptoms due to hay fever or other upper respiratory allergies:

* runny nose
* sneezing
* itchy, watery eyes
* itching of the nose or throat

Temporarily relieves these symptoms due to the common cold:

* runny nose
* sneezing

Directions:

Take very 4 to 6 hours.
Do not take more than 6 doses in 24 hours.

Adults and children 12 years of age and over 25mg to 50mg (1 to 2 tablets)
Children 6 to under 12 years of age 12.5mg** to 25mg (1tablet)
Children under 6 years of age ask a doctor

**12.5mg dosage strength is not available in this package. Do not attempt to break tablets.

Store at 59° to 77°F in a dry place.
Protect from light.

Ingredients:
Active Ingredients: in each tablet: Diphenhydramine HCl (25 mg - Antihistamine)

Inactive Ingredients: Candelilla Wax, Crospovidone, Dibasic Calcium Phosphate Dihydrate, D&C Red 27 Aluminum Lake, Hydroxypropyl Methylcellulose, Magnesium Stearate, Microcrystalline Cellulose, Polyethylene Glycol, Polysorbate 80, Pregelatinized Starch, Stearic Acid, Titanium Dioxide

Warnings:

Do not use with any other product containing diphenhydramine, including one applied topically.

Ask a doctor before use if you have:

* glaucoma
* trouble urinating due to an enlarged prostate gland
* a breathing problem such as emphysema or chronic bronchitis

As a doctor or pharmacist before use if you are taking sedatives or tranquilizers.

When using this product:

* marked drowsiness may occur.
* avoid alcoholic drinks.
* alcohol, sedatives, and tranquilizers may increase drowsiness.
* be careful when driving a motor vehicle or operating machinery.
* excitability may occur, especially in children.

If pregnant or breast-feeding, ask a health professional before use.
Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.

Quality Sealed for your protection. Do not use if the printed (pd) seal under cap is broken or missing.

Source:www.drugstore.com

NeilMed's Sinus Rinse Regular Refill Packets

Package Details

For Soothing Saline Nasal Rinse

* Preservative Free
* pH balanced mixture
* Physician Developed

Box Contains:

* 100 Packets of USP Grade Sodium Chloride & Sodium Bicarbonate Mixture (pH Balanced, Isotonic & Preservative & Iodine Free
* Educational Brochure
* Directions for use

A Volume Therapeutic Saline Nasal Irrigation & Moisturizing System...not an ordinary saline moisturizer spray.

Advantages...

* Preservative, Iodine & Latex Free
* A Volume Therapeutic Saline Lavage
* Soothing, Moisturizing, Non-Burning
* Premixed Packets of USP Grade Sodium Chloride & Sodium Bicarbonate (Natural Ingredients)
* pH Balanced & Isotonic Solution
* Great to use after sinus surgery
* Safe during pregnancy
* Travel-size kit
* Money back guarantee*

*If returned within 90 days from the date of purchase to mfg.

Indications

Helps Alleviate:

* Sinus symptoms
* Nasal Allergies & Common Cold
* Nasal Irritation from Occupational dust, fumes, animal dander, grass, pollen, smoke, smog & house dust
* Post Nasal Drip, Congestion & Dryness

Directions

Store or keep in a cool & dry place.

Warnings

Do not rinse if nasal passage is completely blocked or if you have an ear infection or blocked eats. If you experience any pressure in the ears, stop the rinse and get further directions from your physician. For non-emergency questions, please contact our office. Please read enclosed brochure for more details.

Source:

Claritin 24 Hour Allergy, Tablets

Package Details

Original Prescription Strength
Non-Drowsy* 24 Hour Allergy Tablets

Relief of:

* Sneezing
* Runny Nose
* Itchy, Watery Eyes
* Itchy Throat or Nose

*When taken as directed.

Questions or comments? Call 1-800-CLARITIN (1-800-252-7484)

Indications

Temporarily relieves these symptoms due to hay fever or other upper respiratory allergies: runny nose, sneezing, itchy, watery eyes, itching of the nose or throat

Directions

* Adults and children 6 years and over: 1 tablet daily; not more than 1 tablet in 24 hours.
* Children under 6 years of age: ask a doctor.
* Consumers with liver or kidney disease: ask a doctor.

Store between 2° C and 30° C (36° F and 86° F)
Protect from excessive moisture.

Ingredients
Active Ingredients: Loratadine (10 mg) (Antihistamine)

Inactive Ingredients: Corn Starch, Lactose Monohydrate, Magnesium Stearate

Warnings

Safety sealed: do no use if the individual blister unit imprinted with Claritin® is open or torn.
Do not use if you have ever had an allergic reaction to this product or any of its ingredients.
Ask a doctor before use if you have liver or kidney disease. Your doctor should determine if you need a different dose.
When taking this product do not take more than directed. Taking more than directed may cause drowsiness.
Stop use and ask a doctor if an allergic reaction to this product occurs. Seek medical help right away.
If pregnant or breast-feeding, ask a health professional before use.
Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.

Source:www.drugstore.com

Advil Advanced Medicine for Pain, 200mg, Caplets

Package Details

Ibuprofen Tablets, 200mg.

* Pain Reliever.
* Fever Reducer.
* Coated Caplets - Oval Shaped Tablets.

Made in USA.



Indications

Temporarily relieves minor aches and pains due to:

* headache.
* toothache.
* backache.
* menstrual cramps.
* common cold.
* muscular aches.
* minor pain of arthritis.

Temporarily reduces fever.

Directions

Do not take more than directed.

Adults: Take 1 tablet every 4 to 6 hours while symptoms persist. If pain or fever does not respond to 1 caplet, 2 caplets may be used, but do not exceed 6 caplets in 24 hours, unless directed by a doctor. The smallest effective dose should be used.

Children: Do not give this product to children under 12 unless directed by a doctor.

Read all warnings and directions before use.
Keep Carton.
Store at 20-25°C (68-77°F)
Avoid excessive heat 40°C (above 104°F).

Ingredients
Active Ingredients: in each caplet: Ibuprofen (200 mg)

Inactive Ingredients: Acetylated Monoglycerides, Bees Wax, Carnauba Wax, Croscarmellose Sodium, Iron Oxides, Lecithin, Methylparaben, Microcrystalline Cellulose, Pharmaceutical Glaze, Povidone, Propylparaben, Silicon Dioxide, Simethicone, Sodium Benzoate, Sodium Lauryl Sulfate, Starch, Stearic Acid, Sucrose, Titanium Dioxide

Warnings

Allergy Warning: Ibuprofen may cause a severe allergic reaction which may include:

* hives.
* facial swelling.
* asthma (wheezing).
* shock.

Alcohol Warning: If you consume 3 or more alcoholic drinks every day, ask your doctor whether you should take ibuprofen or other pain relievers/fever reducers. Ibuprofen may cause stomach bleeding.

Do not use if you have ever had an allergic reaction to any other pain reliever/fever reducer.

Ask a doctor before use if you have had problems or side effects with any pain reliever/fever reducer.

Ask a doctor of pharmacist before use if you are:

* under a doctor's care for any continuing medical condition.
* taking otherr drugs on a regular basis.
* taking any other product containing ibuprofen, or any othe pain reliever/fever reducer.

Stop use and ask a doctor if:

* an allergic reaction occurs. Seek medical help right away.
* fever gets worse or lasts more than 3 days.
* pain gets worse or last more than 10 days.
* stomach pain occurs with the use of this product.
* the painful area is red or swollen.
* any new or unexpected symptoms occur.

If pregnant or breast feeding, ask a health professional before use. It is especially important not to use ibuprofen during the last 3 months of pregnancy unless specifically directed to do so by a doctor because it may cause problems in the unborn child or complications during delivery.

Keep out of the reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.

Source:www.drugstore.com

King Bio, Heartburn Relief (2 Oz)

Instructions
Brand:
King Bio Homeopathic

Directions:
All products are best used by the expiration date shown on the label and/or bottle. After opening, keep all products tightly closed in a cool, dry place. Keep all products out of the reach of children.

Storage Instructions:
Always remember to read each and every label and check the expiration date on all packages. Most labels provide specific storage and handling requirements.

Medical Disclaimer:
All information on this site is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. We can not and do not give medical advice. Please consult with your own physician or health care practitioner regarding the suggestions and recommendations made on VitaPal.com
Ordering Options
Online Now:
We utilize state of the art Secure Socket Layer (SSL) technology with 128-bit encryption. Online shopping with VitaPal.com is safe and secure. Guaranteed. Our customers safety & privacy is our #1 priority.

Source:www.vitapal.com

King Bio, Tmj / Jaw Formula (2 Oz)

Product Details

First Aid Products
First Aid is immediate help given to a person who has been injured before they go to hospital.
Instructions
Brand:
King Bio Homeopathic

Directions:
All products are best used by the expiration date shown on the label and/or bottle. After opening, keep all products tightly closed in a cool, dry place. Keep all products out of the reach of children.

Storage Instructions:
Always remember to read each and every label and check the expiration date on all packages. Most labels provide specific storage and handling requirements.

Medical Disclaimer:
All information on this site is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. We can not and do not give medical advice. Please consult with your own physician or health care practitioner regarding the suggestions and recommendations made on VitaPal.com
Ordering Options
Online Now:
We utilize state of the art Secure Socket Layer (SSL) technology with 128-bit encryption. Online shopping with VitaPal.com is safe and secure. Guaranteed. Our customers safety & privacy is our #1 priority.

Phone Orders:
You can call Toll-Free 1-800-909-4759 to place your order over the phone. (Mon. - Fri. 9 AM to 5:00 PM EST)

Source:www.vitapal.com

King Bio Natural Medicine Constitutional Enhnacer 2oz

King Bio Natural Medicine Constitutional Enhnacer 2oz
Information: Product details
Price Range: $11.00 - $18.00 at 6 stores
Constitutional Enhnacer 2 oz. : A natural aid for strengthening the functions of our inner systems including immune, nervous, digestive, cardiovascular, respiratory, reproductive, urinary, musculoskeletal, lymphatic, and skin. Activates detoxificatio

Source:www.shopping.com

Asthma Freee

Asthma Freee
Price Range: $9.00 - $17.00 at 5 stores
Asthma Freee… Indications for Use: For fast relief of minor shortness of breath, wheezing & tightness in chest, mucus congestion, suffocating sensation - Associated with bronchial asthma, helping to activate normal breathing..

Source:www.shopping.com

Dolisos Dolimed Allergy Homeopathic Spray Medicine, So. California Mix, 1 fl oz

Vitamins & Nutrition Type: Homeopathics
Relieves Allergy Symptoms
Part #: Dolisos Dolimed Allergy Homeopathic Spray Medicine, So. California Mix, 1 fl oz
Sellers Found: 2
Available Since: May 26, 2003
Lowest Price: $9.57


Source:www.nextag.com

BLEFARITIS

A. PENDAHULUAN
Blefaritis adalah radang pada kelopak mata. Radang yang sering terjadi pada kelopak merupakan radang kelopak dan tepi kelopak. Radang bertukak atau tidak pada tepi kelopak bisanya melibatkan folikel dan kelenjar rambut. Blefaritis ditandai dengan pembentukan minyak berlebihan di dalam kelenjar di dekat kelopak mata yang merupakan lingkungan yang disukai oleh bakteri yang dalam keadaan normal ditemukan di kulit.
Blefaritis dapat disebabkan infeksi dan alergi yang biasanya berjalan kronis atau menahun. Blefaritis alergi dapat terjadi akibat debu, asap, bahan kimia, iritatif, dan bahan kosmetik. Infeksi kelopak dapat disebabkan kuman streptococcus alfa atau beta, pneumococcus, dan pseudomonas. Di kenal bentuk blefaritis skuamosa, blefaritis ulseratif, dan blefaritis angularis.
Gejala umum pada blefaritis adalah kelopak mata merah, bengkak, sakit, eksudat lengket dan epiforia. Blefaritis sering disertai dengan konjungtivitis dan keratitis.
Biasanya blefaritis sebelum diobati dibersihkan dengan garam fisiologik hangat, dan kemudian diberikan antibiotik yang sesuia. Penyulit blefaritis yang dapat timbul adalah konjungtivitis, keratitis, hordeolum, kalazoin, dan madarosis.

B. PATOFISIOLOGI
Patofisiologi blefaritis biasanya terjadi kolonisasi bakteri pada mata. Hal ini mengakibatkan invasi mikrobakteri secara langsung pada jaringan ,kerusakan sistem imun atau kerusakan yang disebabkan oleh produksi toksin bakteri , sisa buangan dan enzim. Kolonisasi dari tepi kelopak mata dapat ditingkatkan dengan adanya dermatitis seboroik dan kelainan fungsi kelenjar meibom.

C. ANATOMI

Kelopak atau palpebra mempunyai fungsi melindungi bola mata, serta mengeluarkan sekresi kelenjarnya yang membentuk film air mata di depan kornea. Palpebra merupakan alat penutup mata yang berguna untukmelindungi bola mata terhapat trauma, trauma sinar dan pengeringan mata.
Kelopak mempunyai lapisan kulit yang tipis pada bagian depan sedang di bagian belakang ditutupi selaput lendir tarsus yang disebut konjungtiva tarsal.
Pada kelopak terdapat bagian-bagian :
• Kelenjar seperti kelenjar sebasea, kelenjar moll atau kelenjar keringat, kelenjar zeis pada pangkal rambut, dan kelenjar meibom pada tarsus.
• Otot seperti : M. Orbikularis okuli yang berjalan melingkar di dalam kelopak atas dan bawah, dan terletak di bawah kulit kelopak. M. Orbikularis berfungsi menutup bola mata yang dipersarafi N. fasial. M. Levator palpebra berfungsi untuk mengangkat kelopak mata atau membuka mata.
• Di dalam kelopak terdapak tarsus yang merupakan jaringan ikat dengan kelenjar di dalamnya atau kelenjar Meibom yang bermuara pada margo palpebra.
• Septum orbita yang merupakan jaringan fibrosa berasal dari rima orbita merupakan pembatas isi orbita dengan kelopak depan.


D. ETIOLOGI
Terdapat 2 jenis blefaritis, yaitu :
1. Blefaritis anterior : mengenai kelopak mata bagian luar depan (tempat melekatnya bulu mata). Penyebabnya adalah bakteri stafilokokus dan seborrheik. Blefaritis stafilokok dapat disebabkan infeksi dengan Staphylococcus aureus, yang sering ulseratif, atau Staphylococcus epidermidis atau stafilokok koagulase-negatif. Blefaritis seboroik(non-ulseratif) umumnya bersamaan dengan adanya Pityrosporum ovale.
2. Blefaritis posterior : mengenai kelopak mata bagian dalam (bagian kelopak mata yang lembab, yang bersentuhan dengan mata). Penyebabnya adalah kelainan pada kelenjar minyak. Dua penyakit kulit yang bisa menyebabkan blefaritis posterior adalah rosasea dan ketombe pada kulit kepala (dermatitis seboreik).

E. KLASIFIKASI
1. Blefaritis superfisial
Bila infeksi kelopak superfisial disebabkan oleh staphylococcus maka pengobatan yang terbaik adalah dengan salep antibiotik seperti sulfasetamid dan sulfisolksazol. Sebelum pemberian antibiotik krusta diangkat dengan kapas basah. Bila terjadi blefaritis menahun maka dilakukan penekanan manual kelenjar Meibom untuk mengeluarkan nanah dari kelenjar Meibom (Meibormianitis), yang biasanya menyertai.1
2. Blefaritis Seboroik
Blefaritis sebore biasanya terjadi pada laki-laki usia lanjut (50 Tahun), dengan keluhan mata kotor, panas dan rasa kelilipan. Gejalanya adalah sekret yang keluar dari kelenjar Meiborn, air mata berbusa pada kantus lateral, hiperemia dan hipertropi papil pada konjungtiva. Pada kelopak dapat terbentuk kalazion, hordeolum, madarosis, poliosis dan jaringan keropeng.
Blefaritis seboroik merupakan peradangan menahun yang sukar penanganannya. Pengobatannya adalah dengan memperbaiki kebersihan dan membersihkan kelopak dari kotoran. Dilakukan pembersihan dengan kapas lidi hangat. Kompres hangat selama 5-10 menit. Kelenjar Meibom ditekan dan dibersihkan dengan shampoo bayi. Penyulit yang dapat timbul berupa flikten, keratitis marginal, tukak kornea, vaskularisasi, hordeolum dan madarosis.
3. Blefaritis Skuamosa
Blefaritis skuamosa adalah blefaritis disertai terdapatnya skuama atau krusta pada pangkal bulu mata yang bila dikupas tidak mengakibatkan terjadinya luka kulit. Merupakan peradangan tepi kelopak terutama yang mengenai kulit di daerah akar bulu mata dan sering terdapat pada orang yang berambut minyak. Blefaritis ini berjalan bersama dermatitik seboroik.
Penyebab blefaritis skuamosa adalah kelainan metabolik ataupun oleh jamur. Pasien dengan blefaritis skuamosa akan terasa panas dan gatal. Pada blefaritis skuamosa terdapat sisik berwarna halus-halus dan penebalan margo palpebra disertai madarosis. Sisik ini mudah dikupas dari dasarnya mengakibatkan perdarahan.
Pengobatan blefaritis skuamosa ialah dengan membersihkan tepi kelopak dengan shampoo bayi, salep mata, dan steroid setempat disertai dengan memperbaiki metabolisme pasien. Penyulit yang dapat terjadi pada blefaritis skuamosa adalah keratitis, konjungtivitis.
4. Blefaritis Ulseratif
Merupakan peradangan tepi kelopak atau blefaritis dengan tukak akibat infeksi staphylococcus. Pada blefaritis ulseratif terdapat keropeng berwarna kekunung-kuningan yang bila diangkat akan terlihat ulkus yang yang kecil dan mengeluarkan dfarah di sekitar bulu mata. Pada blewfaritis ulseratif skuama yang terbentuk bersifat kering dan keras, yang bila diangkat akan luka dengan disertai perdarahan. Penyakit bersifat sangat infeksius. Ulserasi berjalan lebih lanjut dan lebih dalam dan merusak folikel rambut sehingga mengakibatkan rontok (madarosis).
Pengobatan dengan antibiotik dan higiene yang baik. Pengobatan pada blefaritis ulseratif dapat dengan sulfasetamid, gentamisin atau basitrasin. Biasanya disebabkan stafilokok maka diberi obat staphylococcus. Apabila ulseratif luas pengobatan harus ditambah antibiotik sistemik dan diberi roboransia.
Penyulit adalah madarosis akibat ulserasi berjalan lanjut yang merusak folikel rambut, trikiasis, keratitis superfisial, keratitis pungtata, hordeolum dan kalazion. Bila ulkus kelopak ini sembuh maka akan terjadi tarikan jaringan parut yang juga dapat berakibat trikiasis.
5. Blefaritis angularis
Blefaritis angularis merupakan infeksi staphylococcus pada tepi kelopak di sudut kelopak atau kantus. Blefaritis angularis yang mengenai sudut kelopak mata (kantus eksternus dan internus) sehingga dapat mengakibatkan gangguan pada fungsi puntum lakrimal. Blefariris angularis disebabkan Staphylococcus aureus. Biasanya kelainan ini bersifat rekuren.
Blefaritis angularis diobati dengan sulfa, tetrasiklin dan Sengsulfat. Penyulit pada pungtum lakrimal bagian medial sudut mata yang akan menyumbat duktus lakrimal.
6. Meibomianitis
Merupakan infeksi pada kelenjar Meibom yang akan mengakibatkan tanda peradangan lokal pada kelenjar tersebut. Meibomianitis menahun perlu pengobatan kompres hangat, penekanan dan pengeluaran nanah dari dalam berulang kali disertai antibiotik lokal.

F. GAMBARAN KLINIK
Gejala :
1. Blefaritis menyebabkan kemerahan dan penebalan, bisa juga terbentuk sisik dan keropeng atau luka terbuka yang dangkal pada kelopak mata.
2. Blefaritis bisa menyebabkan penderita merasa ada sesuatu di matanya.
Mata dan kelopak mata terasa gatal, panas dan menjadi merah.
Bisa terjadi pembengkakan kelopak mata dan beberapa helai bulu mata rontok.
3. Mata menjadi merah, berair dan peka terhadap cahaya terang.
Bisa terbentuk keropeng yang melekat erat pada tepi kelopak mata; jika keropeng dilepaskan, bisa terjadi perdarahan. Selama tidur, sekresi mata mengering sehingga ketika bangun kelopak mata sukar dibuka.
Tanda :
• Skuama pada tepi kelopak
• Jumlah bulu mata berkurang
• Obstruksi dan sumbatan duktus meibom
• Sekresi Meibom keruh
• Injeksi pada tepi kelopak
• Abnormalitas film air mata

G. DIAGNOSA
Diagnosis ditegakkan berdasarkan gejala dan hasil pemeriksaan kelopak mata.

H. PENATALAKSANAAN
Pengobatan utama adalah membersihkan pinggiran kelopak mata untuk mengangkat minyak yang merupakan makanan bagi bakteri. Bisa digunakan sampo bayi atau pembersih khusus. Untuk membantu membasmi bakteri kadang diberikan salep antibiotik (misalnya erythromycin atau sulfacetamide) atau antibiotik per-oral (misalnya tetracycline). Jika terdapat dermatitis seboroik, harus diobati. Jika terdapat kutu, bisa dihilangkan dengan mengoleskan jeli petroleum pada dasar bulu mata.

I. PROGNOSIS
Pada blefaritis prognosis sangat baik dan dapat hilang dengan terapi.
Posted by halfian at 8:59 PM 0 comments
Monday, April 02, 2007
20 tips for permanent weight loss


Permanent weight loss can be a challenge. These 20 ideas can
help.



Weight maintenance is much like weight loss. The principles are essentially
the same: Eat healthy foods, control your portion sizes and exercise regularly.
And to keep the pounds off permanently, you need to incorporate the new, healthy
behaviors into your routine so that they become a natural part of your daily
life.

Here are 20 ideas to reinforce your healthy lifestyle and to keep you
committed to permanent weight loss.

1. Exercise 30 to 60 minutes each day. If
time is limited, exercise for several brief periods throughout the day — for
example, three 10-minute sessions rather than one 30-minute session.
2. Eat three healthy meals during the day, including
a good breakfast. Skipping meals causes increased hunger and may lead
to excessive snacking.
3. Focus on fruits and vegetables. Top off
your morning cereal with sliced strawberries or bananas. Stir berries or peaches
in yogurt or cottage cheese. Liven up your sandwiches with vegetables, such as
tomato, lettuce, onion, peppers and cucumber.
4. Weigh yourself regularly. Monitoring your
weight can tell you whether your efforts are working and can help you detect
small weight gains before they become even larger.
5. Don't keep comfort foods in the house. If
you tend to eat high-fat, high-calorie foods when you're upset or depressed or
bored, don't keep them around. Availability of food is one of the strongest
factors in determining how much a person eats.
6. Plan a family activity. Get the family
together to go for a bike ride, play disc golf or kick the ball around in the
yard.
7. Eat healthy foods first. Eat foods that
are healthy and low in calories first so that when it comes time to enjoy your
favorites — sweets or junk food, for example — you won't be so hungry.
8. Pay attention to portions. Serve meals
already dished onto plates instead of placing serving bowls on the table. Take
slightly less than what you think you'll eat. You can always have seconds, if
really necessary.
9. Create opportunities to be active. Wash
your car at home instead of going to the car wash. Bike or walk to the store.
Participate in your kid's activities at the playground or park.
10. Sit down together for family meals. Avoid
eating in front of the television. TV viewing strongly affects how much and what
people eat.
11. See what you eat. Eating directly from a
container gives you no sense of how much you're eating. Seeing food on a plate
or in a bowl keeps you aware of how much you're eating.
12. Vary your activities. Regularly change
your activity routine to avoid exercise burnout. Walk a couple of days, swim
another and go for a bike ride on the weekend. Seek out new activities — karate,
ballroom dancing, cross-country skiing, tennis or Pilates.
13. De-stress your day. Stress can cause you
to eat more. Develop strategies that can help you relax when you find yourself
becoming stressed. Exercise, deep breathing, muscle relaxation techniques and
even a good laugh can ease stress.
14. Eat at home. People eat more food in
restaurants than at home. Limit how often you eat at restaurants. If you do eat
out, decide what and how much you're going to eat before you start and have the
rest boxed to go.
15. Plan healthy snacks. The best snacks
include fruits, vegetables, whole grains and low-fat dairy products. Fruit
smoothies, sliced fresh fruit and yogurt, whole-grain crackers, and carrot and
celery sticks with peanut butter are all good choices.
16. Start your day with a high-fiber breakfast
cereal, such as bran flakes, shredded wheat or oatmeal. Opt for cereals
with "bran" or "fiber" in the name. Or add a few tablespoons of unprocessed
wheat bran to your favorite cereal.
17. Walk for 10 minutes over your lunch hour
or get up a few minutes earlier in the morning and go for a short walk.
18. Plan a week's worth of meals at a time.
Make a detailed grocery list to eliminate last-minute trips to the grocery store
and impulse buys.
19. Look for a distraction when you're fighting a
craving. Call a friend, put on music and dance or exercise, clean the
house, pull weeds in your garden, or run an errand. When your mind is occupied
with something else, the cravings quickly go away.
20. Reward yourself. Losing weight and
keeping the pounds off is a major accomplishment. Celebrate your success with
nonfood rewards, such as new clothes or an outing with friends.


Posted by halfian at 11:46 AM 2 comments
Thursday, June 29, 2006
KERATOSIS SEBOROIK

Keratosis seboroik merupakan tumor jinak kulit yang paling banyak muncul pada orang yang sudah tua, sekitar 20% dari populasi dan biasanya tidak ada atau jarang pada orang dengan usia pertengahan.
Keratosis seboroik memiliki banyak manifestasi klinik yang bisa dilihat, dan keratosis seboroik ini terbentuk dari proliferasi sel-sel epidermis kulit. Keratosis seboroik dapat muncul dalam berbagai bentuk lesi, bisa satu lesi ataupun tipe lesi yang banyak atau multipel.
Walaupun tidak ada faktor etiologi khusus yang dapat diketahui, keratosis seboroik lebih sering muncul pada daerah yang terpapar sinar matahari, terutama pada daerah leher dan wajah, juga daerah ekstremitas.
Status dermatologi yang dapat dilihat adalah berbatas tegas, berwarna kecoklatan atau hiperpigmentasi, dan sedikit meninggi disbanding permukaan kulit sehingga penampakan keratosis seboroik seperti tertempel dalam permukaan kulit. Kebanyakan dari keratosis seboroik memiliki permukaan seperti veruka, dengan konsistensi yang halus atau lembut. Walaupun biasanya diameter lesi keratosis seboroik berkisar dalam hitungan beberapa millimeter saja, tetapi ada beberapa lesi yang dapat mencapai ukuran diameter dalam sentimeter. Krusta dan dasar yang inflamasi dapat ditemukan jika lesi terpapar dengan trauma.

EPIDEMIOLOGI
Secara global atau internasional, keratosis seboroik merupakan tumor jinak pada kulit yang paling banyak diantara populasi di Amerika Serikat. Angka frekuensi untuk munculnya keratosis seboroik terlihat meningkat seiring dengan peningkatan usia seseorang. Pada tahun 1963, Tindall dan Smith meneliti populasi dari individu yang sudah berusia lebih dari 64 tahun di Carolina Utara dan mendapatkan hasil bahwa 88 % dari populasi tersebut setidaknya memiliki paling kurang satu lesi keratosis seboroik. Dalam penelitian ini, keratosis seboroik ditemukan pada 38 % wanita kulit putih dan 54 % pada pria kulit putih, dan sekitar 61 % pada pria kulit hitam dan sekitar 10 % lebih pada wanita kulit hitam. Pada tahun 1965 Young memeriksa 222 orang yang tinggal di anti jompo Orthodox Jewish di New York dan menemukan bahwa 29,3 % pria dan 37,9 % pada wanita memiliki lesi keratosis seboroik.
Di Inggris, pada tahun 2000, Memon dan kawan-kawan menemukan bahwa populasi dengan usia yang lebih muda dari 40 tahun hanya 8,3 % yang memiliki sedikiktnya satu macam lesi keratosis seboroik pada laki-laki dan 16,7 % sedikitnya satu macam lesi keratosis seboroik pada wanita.
Keratosis seboroik ditemukan lebih banyak pada orang kulit putih dibandingkan dengan orang kulit hitam, tidak ada perbedaan antara laki-laki dan perempuan. Keartosis seboroik lebih sering terjadi pada individu usia tua.

ETIOLOGI
Etiologi dari perkembangan lesi keratosis seboroik pada usia tua tidak dapat diketahui dengan pasti. Meningkatnya jumlah sel yang bereplikasi menunjukkan adanya hubungan dengan terjadinya keratosis seboroik ini. Hal ini telah diketahui melalui penelitian bromodeoxyuridin dan immunohistokimia untuk pengembangan antigen tertentu yang berhubungan. Ada peningkatan yang nyata dan signifikan dari angka terjadinya apoptosis pada semua variasi bentuk dari keratosis seboroik dibandingkan dengan kulit yang normal. Keratosis seboroik biasanya terdapat pada bagian kulit yang paling sering terpajan sinar matahari, dan sebagian tipe keratosis seboroik dapat terbentuk akibat radiasi sinar matahari pada kulit manusia.

PATOFISIOLOGI
Epidermal Growth Faktor (EGF) atau reseptornya , telah terbukti terlibat dalam pembentukan keratosis seboroik. Tidak ada perbedaan yang nyata dari ekspresi immunoreactive growth hormone receptor di keratinosit pada epidermis normal dan keratosis seboroik.
Ekspresi dari gen bcl-2, suatu gen onkogen penekan apoptosis , rendah pada keratosis seboroik dibandingkan dengan basal sel karsinoma atau skuamos sel karsinoma, yang memiliki nilai yang tinggi untuk jenis gen ini. Tidak ada peningkatan yang dapat dilihat dalam sonic hedgehog signal transducers patched (ptc) dan smoothened (smo) mRNA pada keratosis seboroik dibanding kulit yang normal.
Keratosis Seboroik memiliki banyak derajat pigmentasi. Pada pigmentasi keratosis seboroik, proliferasi dari keratinosit memacu aktivasi dari melanosit disekitarnya dengan mensekresi melanocyte-stimulating cytokines. Endotelin-1 memiliki efek simulasi ganda pada sintesis DNA dan melanisasi pada melanosit manusia dan telah terbukti terlibat sabagai salah satu peran penting dalam pembentukan hiperpigmentasi pada keratosis seboroik.
Secara Immunohistokimia, keratinosit pada keratosis seboroik memperlihatkan keratin dengan berat molekul yang rendah, tetapi ada sebagian kecil pembentukan keratin dengan berat molekul yang tinggi.


Beberapa Varian Klinikopatologi
Ada beberapa bentuk histologi dan terkadang berbeda secara klinis untuk keratosis seboroik:

Common Seborrheic Keratosis
Sinonim: basal cell papilloma, solid seborrheic keratosis.
Jenis ini dianggap sebagai lesi klasik. Bentuknya seperti jamur, dengan epidermis hiperplastik dan berbatas tegas yang menggantung di sekitar kulit. Tumor ini terdiri dari sel-sel basaloid yang seragam. Kista-kista keratin kadang lebih banyak, dan bisa tampak didalam folikel dan diluar folikel. Melanosit terkadang muncul dalam jumlah banyak, dan produksi pigmennya menghasilkan warna luka hitam. Perpindahan pigmen ke keratinosit kelihatan cukup normal.

Reticulated Seborrheic Keratosis
Sinonim: adenoid seborrheic keratosis.
Kumpulan sel-sel basaloid turun dari dasar epidermis. Kista-kista keratin dikelilingi oleh sel-sel ini. Stroma kolagen eosinopilik yang halus membungkus di sekeliling kumpulan sel basaloid dan dapat membentuk lesi yang banyak.

Stucco Keratosis
Sinonim: hyperkeratotic seborrheic keratosis, digitate seborrheic keratosis, serrated seborrheic keratosis, verrucous seborrheic keratosis.
Stucco keratosis muncul berukuran 3-4 mm, berwarna seperti warna kulit atau benjolan berwarna putih abu-abu yang muncul di tungkai bagian bawah. Penampakan sel epidermal seperti puncak menara gereja mengelilingi inti kolagen membentuk hiperkeratosis seperti jalinan keranjang. Keratinosit yang bervakuola yang ada pada veruka vulgaris tidak ditemukan pada lesi ini, meskipun secara klinis lesi ini bisa menyerupai kutil virus yang kecil.

Clonal Seborrheic Keratosis
Jenis keratosis seboroik ini berbentuk sarang-sarang sel basaloid yang tidak selamanya berbatas tegas berbentuk bulat dan terbungkus longgar di dalam jaringan epidermis. Walaupun sel yang paling banyak adalah keratinosit, sarang-sarang tersebut mengandung melanosit dalam jumlah besar. Keratinosit ini ukurannya bisa bermacam-macam.

Irritated Seborrheic Keratosis
Sinonim: inflamed seborrheic keratosis, basosquamous cell acanthoma.
Kelainan kulit eksematous berubah menjadi keratosis seboroik yang khas. Penyebab dari reaksi eksematous ini tidak diketahui. Bisa jadi disebabkan trauma, tapi belum dapat dibuktikan. Secara histologi, suatu keratosis seboroik memperlihatkan bagian-bagian dari perubahan inflamasi, banyak lingkaran atau pusaran dari sel-sel eosinofilik skuamous yang merata dan tertata seperti bawang. Ini menyerupai mutiara keratin dalam sel karsinoma bersisik, tapi bisa dibedakan oleh besarnya jumlah mereka, kecilnya ukuran, dan bentuknya yang terbatas. Keratinosit dalam suatu keratosis seboroik yang iritasi menunjukan tingginya tingkat keratinisasi atau keratosis seboroik yang sudah dewasa dibandingkan dengan common seborrheic keratosis.

Seborrheic Keratosis with Squamous Atypia
Sel atipik dan diskeratosis bisa terlihat pada beberapa keratosis seborrheic. Lesi tersebut bisa sangat mirip dengan penyakit Bowen’s atau karsinoma sel squamous yang invasive. Tidak diketahui sebab-sebab perubahan tersebut, baik itu akibat dari iritasi atau aktivasi, atau tanda karsinoma sel squamous. Sebaiknya untuk menghilangkan lesi ini seluruhnya.

Melanoacanthoma
Sinonim: pigmented seborrheic keratosis.
Melanoacanthoma lebih gelap dari pigmented seborrheic keratosis. Di dalam lesi ini, ada proliferasi melanosit dendritik yang jelas. Melanosit tersebut kaya dengan melanin, sebaliknya di sekitar keratinosit sangat sedikit mengandung melanin. Melanosit dapat berkembang menjadi sarang, yang melebar dari lapisan basal ke lapisan superfisial epidermis. Lesi ini tidak berpotensi menjadi ganas.

Dermatosis Papulosa Nigra
Dermatosis papulosa nigra merupakan papul kecil pada wajah yang tampak pada orang Afrika Amerika, namun terlihat pada orang yang berkulit lebih gelap dari ras lain, nampak merupakan varian dari keratosis seboroik. Lesi ini merupakan erupsi papul yang berpigmen pada wajah dan leher. Mereka menyerupai melanoacanthoma kecil-kecil. Gambaran histologis seperti common seborrheic keratosis tapi berukuran lebih kecil.

The Sign of Leser-Trelat
Erupsi multipel keratosis seboroik, juga dikenal sebagai the sign of Leser-Trelat, disebutkan berkaitan dengan multipel internal malignancies yang tersembunyi dan sering diikuti dengan rasa gatal . Keganasan yang paling sering dihubungkan adalah adenokarsinoma lambung, colon, dan payudara. Tanda ini juga telah dilaporkan dengan berbagai macam tumor, termasuk limfoma, leukemia, dan melanoma. Tanda ini juga disebutkan bahwa berhubungan dengan hiperkeratosis telapak tangan dan telapak kaki terkait dengan penyakit keganasan dan dengan acanthosis nigricans.
Bukti yang mendukung dugaan hubungan keratosis seboroik dengan keganasan sangat sedikit. Banyak kanker yang dikaitkan dengan keratosis seboroik adalah kanker umum. Keratosa seborik juga umum. Membuktikan hubungan kausal yang tidak umum antara kanker umum dan kelainan kulit yang umum merupakan hal sulit.
Fenomena keratosis seboroik yang bisa pecah, mungkin menunjukkan peradangan dermatosis yang berpusat di sekitar papiloma kulit dan keratosis seboroik membuat fenomena itu lebih kelihatan. Tentu saja, dibutuhkan keahlian klinis melihat peninggian lesi keratosis seboroik pada pasien dengan dermatitis generalisata yang disebabkan banyak hal. Kemoterapi, khususnya citarabine, bisa menyebabkan peradangan keratosis seboroik, khususnya ketika dikaitkan dengan tanda Leser-Trelat. Maligna acanthosis nigricans muncul sebanyak 35% pasien dengan tanda Leser-Trelat, yang menunjukkan kesamaan mekanisme. Namun, hubungan sebenarnya antara erupsi keratosis seboroik multipel dengan keganasan organ dalam masih harus dijelaskan.

Pemeriksaan penunjang

Pemeriksaan penunjang yang dapat dilakukan antara lain pemeriksaan histopatologi. Komposisi keratosis seboroik adalah sel basaloid dengan campuran sel skuamosa. Invaginasi keratin dan horn cyst merupakan karakteristiknya. Sarang-sarang sel skuamosa kadang dijumpai, terutama pada tipe irritated. Satu dari tiga keratosis seboroik terlihat hiperpigmentasi pada pewarnaan hematoksilin-eosin.
Setidaknya ada 5 gambaran histologi yang dikenal : acantholic (solid), reticulated (adenoid), hyperkeratotic (papilomatous), clonal dan irritated. Gambaran yang bertumpang tindih biasa dijumpai. Tipe acantholic dibentuk oleh kolumna-kolumna sel basal dengan campuran horn cyst. Tipe reticulated mempunyai gambaran jalinan untaian tipis dari sel basal, seringkali berpigmen, dan disertai horn cyst yang kecil. Tipe hiperkeratotik terlihat eksofilik dengan berbagai tingkat hiperkeratotis, papilomatosis dan akantosis. Terdapat sel basaloid dan sel skuamosa. Tipe clonal mempunyai sarang sel basaloid intraepidermal. Pada tipe irritated, terdapat infiltrat sel yang mengalami inflamasi berat, dengan gambaran likenoid pada dermis bagian atas. Sel apoptotik terdapat pada dasar lesi yang menggambarkan adanya regresi imunologi pada keratosis seboroik. Kadangkala terdapat infiltrat sel yang mengalami inflamasi berat tanpa likenoid, jarang terdapat netrofil yang berlebihan dalam infiltrat.
Pada pemeriksaan dengan menggunakan mikroskop elektron menunjukkan bahwa sel basaloid yang kecil berhubungan dengan sel pada lapisan sel basal epidermis. Kelompok- kelompok melanososm yang sering membatasi membran dapat ditemukan di antara sel.

PROGNOSIS

Keratosis seboroik merupakan tumor jinak dan tidak menjadi ancaman bagi kesehatan individu. Lesi keratosis seboroik umunya tidak mengecil namun akan bertambah besar dan tebal seiring dengan waktu.

PENGOBATAN
1. Krioterapi
Lesi yang mengganggu pasien baik dari segi gejala atau kosmetik bisa diobati. Krioterapi mungkin pilihan pengobatan untuk kebanyakan jenis lesi. Suatu pembekuan seukuran 1 mm diameter di sekitar lesi menggunakan kapas atau semprotan biasanya menghasilkan respon yang bagus. Jika ada bekas lesi, atau muncul lagi, ulangi pengobatan tadi. Setelah krioterapi, pasca peradangan hipopigmentasi atau hiperpigmentasi bisa saja terjadi. Walaupun bersifat sementara, perubahan-perubahan pigmen ini bisa bertahan pada pasien berkulit gelap dan bisa sangat mengganggu.

2. Elektrodesisasi
Cara pengobatan lainnya berupa elektrodesisasi diikuti dengan pengangkatan lesi dengan mudah menggunakan kuret diikuti dengan elektrodesisasi ringan.

3. Laser
Terapi laser menggunakan laser pigmen lesi juga efektif, dan ketika digunakan untuk mengobati keratosis seboroik datar, bisa menyebabkan peradangan pasca pigmentasi atau bekas lesi ketika dibandingkan dengan krioterapi atau elektrodesisasi.

4. Bedah scalpel
Pemotongan melalui cara bedah juga efektif, tapi ini bukan pilihan pengobatan karena efek terbalik dari bekas lesinya.
Salah satu bahaya besar menangani “keratosis seboroik” selain dari pemotongan dengan cara bedah adalah lesi yang ditangani bisa menjadi lesi displastik melanositik atau melanoma maligna. Sangat disarankan kalau lesi itu bukan common seborrheic keratosis, maka harus dilakukan pemeriksaan histologi.

5. Flourouracil topikal dan dermabrasi
Cara pengobatan yang agak awam dipakai untuk keratosis seboroik besar termasuk fluorouracil topikal dan dermabrasi.


DIAGNOSIS
Permukaan keratosis sebororik harus dibedakan dengan lentigo yang simple maupun maligna dan harus dibedakan dengan keratosis aktinik, terutama yang berlokasi pada wajah. Pola dan karakteristik permukaan lesi dapat membantu. Warna dan bentuk permukaannya dapat menyerupai nevus melanositik permukaan keratosis seboroik kurang berkilat bila dibandingkan dengan nevus melanositik.
Lesi yang meradang dapat disalahartikan sebagai melanoma maligna. Jika lesi diobati dengan antibiotik topikal dan dioklusi selama 5 hari, diagnosis dapat menjadi jelas. Tetapi jika terdapat keraguan klinis, maka dapat dilakukan pemeriksaan biopsi eksisi dan pemeriksaan patologi.
Posted by halfian at 7:08 PM 0 comments
MEDULLOBLASTOMA

Adalah suatu tumor yang ditemukan di daerah serebellum ( fossa posterior), termasuk salah satu dari PNET (primitive neuroectodermal tumour). Merupakan 7-8% tumor intracranial dari keseluruhan 30% tumor otak pada anak.
Berkembang dari sel neuroepitel yang berasal dari atap ventrikel IV. Sel ini kemudian bermigrasi ke lapisan granular serebellum. Tumor kemudian sering ditemukan di daerah vermis serebelli dan atap ventrikel IV untuk anak-anak berusia lebih muda. Sedangkan anak yang lebih tua sering terdapat di hemisfer serebelli.

HISTOLOGI
Merupakan tumor padat dengan sel yang kecil, inti basofilik, berbagai macam ukuran dan bentuk, sering dengan multiple miosis. Sebenarnya secara histologik tidak terlalu penting, sebab beberapa tumor embrional lainnya (neuroblastoma dan pineblastoma) dapat menunjukkan tampilan yang sama.
Tampak tampilan Homer-Wrigt rosettes.
Subtipe secara histologis :
a. Medullomyoblastoma; berupa sel sel otot polos dan lurik. Terdiri atas sel-selk dengan differensiasi neuronal maupun glial.
b. Melanotic Medulloblastoma; Sel kecil, tidak berdiferensiasi dan mengandung melanin. Tipe yang paling jarang.
c. Large-Cell Medulloblastoma; Medulloblastoma dengan nucleus dan nucleoli yang besar. Sangat reaktif secara imunulogis terhadap synaptophysin. Ini adalah tipe yang terburuk.

GENETIK,FAMILIAL, ENVIRONMENT
Tampak adanya delesi dari lengan pendek kromosom 17 (17p) yakni segmen kromosom yang mengandung tumor suppressor gen.
Secara familial berkaitan dengan Carcinoma Sel Basal Nevoid yang diwariskan secara Autosomal-dominant ( Gorlin Syndrome)
Lingkungan seperti, latar belakang pekerjaan orang tua, keterpaparan dengan karsinogen, kebiasaaan nutrisi ibu, dll, tidak cukup bukti sebagai precursor prevalensi tumor ini.


KLINIS
70-90% mengalami keluhan sakit kepala, emesis, letargi dalam 3 bulan sebelum diagnosis berhasil ditegakkan.
Peningkatan tekanan intracranial dengan gejala = morning headaches, vomit, letargi. Sakit kepala biasanya hilang bila pasien muntah. Anak sering menjadi irritable , anorexia, pertumbuhannya terlambat, lingkar kepala yang bertambah dan dengan sutura kranial yang terbuka.
Disfungsi Serebellar = Ataxia ekstremitas bawah dan atas, yang bertambah berat bila tumor makin bertambah besar dan menginvasi jaringan sekitar
Ganguan batang otak + infiltrasi tumor ke batang otak ataupun oleh peningkatan tekanan intra cranial menyebabkan diplopia, facial waknes, tinnitus, pendengaran hilang, tilt head dan kaku kuduk.
Pada metastases akan menyebabkan gejala local. Seperti metatase ke tulang akan menyebabkan nyeri pinggang; metastase ke Korda Spinalis menyebabkan kelemahan otot tungkai, dll.

STAGING
Penderajatan kelompok resiko tumor ini ditentukan oleh 3 faktor yakni umur,metastase dan pel;uasan penykit pasca operasi. Untuk metastasenya sendiri dibagi lagi dalam beberapa klasifikasi menurut Chang:
Mo : tidak ada metastase
M1 : tumor mikroskopik ditemukan di cairan serebro spinal
M2 : sel tumor nodular di serebellum, subarachnoid serebral, ventrikel III dan ventrikel IV
M3 : sel tumor nodular di subarachnoid medulla spinalis
M4 : metastase ekstra neural.

KELOMPOK RESIKO :
Average Risk : Berusia lebih dari 3 tahun, Mo, tumor residu pasca operasi < 1,5 cm2. Survival rate untuk 5 tahun = 78%.
Poor Risk : Berusia lebih dari 3 tahun, M1–M4, tumor residu pasca operasi > 1,5 cm2. Survival rate untuk 5 tahun = 30-55 %
Infants : Berusia kurang dari 3 tahun, M1-M4, tumor tetap berkestensi pasca operasi. Survival rate untuk 5 tahun = 30 % ( prognosisnya terburuk ).

PEMERIKSAAN
BIOKIMIAWI
Tidak spesifik. Tapi, beberapa studi molekuler dapat menentukan prognosis Medulloblastoma. Adanya ekspresi protein ErbB2 memiliki prognosis yang lebih baik dibandingkan dengan bila ada ekspresi protein TrkC (suatu reseptor neutropin-3) yang memiliki prognosis lebih jelek.
RADILOGI
CT Scan
- Pada CT Scan non kontras, tumor nampak di garis tengah (midline) dari serebelli dan meluas mengisi ventrikel IV.
- Dengan kontras, tumor nampak hiperdens dibandingkan jaringan otak normal oleh karena padat akan sel. Tampakan hiperdens ini amat membantu dalam membedakannya dengan Astrocytoma Serebellar yang lebih hipodense. Bila area Hiperdense ini tampak dikelilingi oleh area yang hipodense, berarti telah ada vasogenic oedem.
Akibat adanya kompresi pada ventrikel IV dan saluran dari CSS (cairan serebrospinal ), akan tampak tanda-tanda hydrocephalus.
- Medulloblastoma juga dapat dibedakan dari Ependymoma yang juga hiperdens, berdasarkan foto CT. Dimana pada ependymoma akan tampak adanya kalsifikasi.
Demikian juga dengan Plexus Coroideus Papilloma yang juga hiperdens, akan terlihat adanya kalsifikasi pada pencitraan dengan CT. Tumor jenis ini terdapat di ventrikel lateral.

MRI
- MRI dengan Gadolinium DTPA adalah pilihan utama untuk diagnostic MB.
- MEsti berhati-hati dilakukan pada anak-anak yang mendapatkan sedative. Sebab, dengan peninggian tekanan intracranial dan tnpa monitoring yang baik, sering kali level CO2 akan sangat meningkat dan makin memp[erburuk hipertensi.
- Pada T1 weight sebelum pemberian Gadolonium, tumor akan tampak hipo intesnsity. Bentuk berbatas mulai dari ventrikel IV hingga primernya di vermis serebelli. Batang otak tertekan dan terdorong ke depan.
- Dengan Gadolinium, akan tampak penguatan bayangan yang lebih homogen bila pada anak-anak. Sedangkan pada pasien dewasa, penguatan bayangannya tampak lebih heterogen.
- Pada T2 weight dan densitas proton, gambar tampak hiperintensity dan dikelilingi oleh area oedem yang lebih hipointernsity.
- Bila tumor meluas ke rostral, akan terjadi hidrosefali pada ventrikel.
- MRI juga dapat memebedakan MB dengan ependimoma. Pada Glioma batang otak exophytic, akan tampak memiliki area perlekatan yang lebih luas pada lantaiu ventrikel IV dibandingkan MB.

Mielographi
- Dahulu pemeriksaan ini adalah tes diagnostic standar untuk MB. Sekarang, pada pasien dengan kontraindikasi MRI, mielographi bersama Ct scan adalah pilihan utama.

Bone Scan
- Karena MB dapat bermetastase di luar CSS dimana sebagian besar ke tulang, maka bone scan penting untuk mendeteksinya.

Scintigraphy (Nuclear Medicine)
- Tidak spseifik. SPECT ( single proton emission CT ) dan PET ( proton emission tomography ) dapat melengkapi MRI dan CT. 80 % tumor MB pada anak akan meng-up take thalium-201 chloride ( 201 TI ) dimana sifat ini sangat berguna dalam membedakan tumor yang high grade dengan low grade dan untuk mendeteksi tumor residual pasca operasi. Mekanisme uptake belum jelas.

LAINNYA
Sebelum melakukan pemeriksaan sitologik sumsum tulang untuk mendeteksi penyebaran tumor leptomeningeal, perlu dilakukan funduskopi ( selain CT atau MRI ) untuk menyingkirkan hidrosefalus.

TERAPI
Terapi standar meliputi pembdehan yang agresif diikuti oleh radiasi ke seluruh sumbo kraniospinal dengan penguatan radiasi pada tempat tumor primer maupun focal metastasenya. Pemberian kemoterapi juga sangat bermanfaat.


RADIOTERAPI
· Average risk group :
Berdasar pada CCG, dosis radio terapi sebesar 23,4 Gy pada sumbu kranio spinal dengan boost pada tumor primer sebesar 32,4 Gy,hingga total radiasi maksimum adalah 55,8 Gy. Hal ini juga berlaku untuk Poor risk group.

· Poor Risk Group
Direkomendasikan 36 Gy pada sumbu kranio spinal dengan boost sebesar 19,8 Gy pada tumor primer dan fokal metastasenya. Metastase spinal yang berada di rostral corda spinalis terminal, di boost hingga total 45 Gy. Sedangkan bila berda di kaudal dari corda spinalis terminal, boleh di boost hingga 50,4 Gy.

· Infants
Pada kelompok ini, radioterapi masih controversial sebab efek samping radioterapi terhadap perkembangan intelektual, lebih berat pada kelompok ini. Strategi yang dilakukan adalah menunda pemberian ( dengan sementara memberi kemoterapi saja ) atau sama menghilangkannya.
Survival rate untuk 3 tahun dengan hanya kemoterapi saja adalah 29 % (tanpa metastase) dan 11 % (dengan metastase). Sementara, bila dengan kemoterapi + radioterapi yang ditunda, survival rate untuk 2 tahunnya meningkat hingga 34 %.

KEMOTERAPI
- Average risk group
Diberikan Vincristine + Lomustin + Cisplastin. 1 tahun setelah radioterapi Kombinasi radioterapid an kemoterapi meningkatkan SR hingga 80% untuk kelompok resiko ini.
- Poor risk group
Setalah terapi induksi seperti pada Average risk group, diikuti pemberian kemoterapi dosis tinggi (biasanya menggunakan Carboplastin dan Thiolepa) ditambah cangkok sumsum tulang secara autologue
- Infants
Setelah induksi seperti pada Average risk group, diikuti kemoterapi dosis tinggi seperti pada Poor risk group.

SURGERY
Meliputi Craniotomi suboccipital.dan dilakukan ventrikuloperitoneal shunt untuk mengatasi hydrocephalus. 40 % pasien pasca operasi mengalami disfungsi neurologik sperti disfungsi serebellar, mutism, hemiparese dalam 12-48 jam pasca operasi, dll.


wassalam
Posted by halfian at 7:05 PM 0 comments
Sunday, April 10, 2005
Ease Your Conscience About Chocolate

Go ahead, it's good for you!


Should you be feeling pangs of guilt as you lusciously bite off the ears of your chocolate Easter bunnies, don’t worry! You actually are doing something good for your health.
Easter is here and one of the world’s most widespread passions is an integral part of it: chocolate! For many chocolate lovers, there is no match for that happy feeling following the consumption of this sweet. Chocolate’s uplifting quality is a result of a substance it releases in the brain: serotonin, which can heighten the senses and brighten our moods. Serotonin is a neurotransmitter, the chemical involved in the transmission of nerve impulses between nerve cells. Rüdiger Lobitz, a nutritionist at the non-profit consumer protection organization “aid infodienst” in Bonn, explained that in our brains, serotonin is responsible for making us feel good. “If we have a serotonin deficiency, we can get depressed,” said Lobitz. Chocolate’s role in stimulating serotonin Serotonin is formed by the amino acid tryptophan. Since our bodies cannot create it on its own, we have to take it in through our food.


“Chocolate itself doesn’t contain high levels of tryptophan, but it has a lot of sugar and this sparks insulin production,” said Lobitz. Insulin, in turn, ensures that the sugar gets into our cells where it belongs. The tryptophan is left over and can therefore reach our brains in an enhanced form and be synthesized into serotonin. “But generally speaking, you can achieve the same affect, of course, with a banana or another sweet food, like pudding or fruit compote,” Lobitz added. Dark chocolate dips blood pressure People, especially women, have known for years that eating chocolate can make you feel good. But scientific research shows that not only does chocolate make us feel better, it has other benefits, such as battling cardiovascular diseases.


Dirk Taubert from the Institute for Pharmacology at the University of Cologne conducted a pilot study on the effects of chocolate on blood pressure. The institute examined 13 patients who suffered from a form of high blood pressure called “systolic hypertension.” Over a two-week period, the patients consumed a bar of dark chocolate daily. “We determined that their blood pressure dropped in the upper, systolic level,” said Taubert. If a patient’s blood pressure was initially 150 to 100, the chocolate could bring it down to 145 to 100. “But when they received white chocolate, we found no effect,” he added. “Our results indicate that certain substances in cocoa can reduce blood pressure,” said Taubert, since the darker the chocolate, the higher its cocoa content. The antioxidant effects of chocolate According to Taubert, so-called polyphenols in the cocoa bean are most likely the cause of the positive results. “The darker the chocolate, the more polyphenols are in it,” he said.


Polyphenols are common substances in the plant world, and can be found in many other types of food, such as apples, red wine or green tea. Nutritionist Lobitz explained that polyphenols also have an antioxidant effect on the body. “This means they help guard the body’s cells from damage by aggressive free radicals, which normally develop in our metabolism,” said Lobitz. And this can, in fact, protect against cardiovascular diseases and some forms of cancer. In fact, there are more polyphenols in cocoa beans than in green tea or wine, for example. “But I wouldn’t recommend anyone consume masses of chocolate just because of the phenols’ positive anti-oxidative effects,” Lobitz added. Chocolate’s historical uses Chocolate came to Europe in the 17th century, and quickly became a status symbol for the nobility, said Andrea Durry from Cologne’s Chocolate Museum. “People at the time thought a lot about cocoa and did studies to determine whether cocoa or chocolate was good for your health,” she said. There were several medical problems that were treated with chocolate. “For example, if you had an iron deficiency in your blood, they had a chocolate preparation with small pieces of real iron in it,” said Durry. There were also chocolate bars similar to the health bars we know today. “They contained a type of grass for throat problems or coughing.” Chocolate bars with quicksilver in them were used for sexual diseases. “But actually, I’m not really sure if they worked,” she noted. The bad news The industrial revolution, of course, made the production of chocolate easier and less expensive, making the sweet more readily available to everyone.


Today, most people can afford to indulge in the health benefits of chocolate. “But chocolate is first and foremost a treat and should be considered as such,” said nutritionist Lobitz. Chocolate’s very high sugar content is not good for your teeth or your waistline. But if you can’t resist, stick to dark chocolate and eat it in moderation.

Source : Sabina Casagrande



Posted by halfian at 3:20 AM 2 comments
Monday, January 03, 2005
Intro

Medicine is a branch of health science concerned with restoring and maintaining health and wellness. Broadly, it is the practical science of preventing and curing diseases. However, medicine often refers more specifically to matters dealt with by physicians, surgeons, nurses and other health professionals.
Medicine is both an area of knowledge (a science), and the application of that knowledge (by the medical profession and other health professionals such as nurses). The various specialized branches of the science of medicine correspond to equally specialized medical professions dealing with particular organs or diseases. The science of medicine is the body of knowledge about body systems and diseases, while the profession of medicine refers to the social structure of the group of people formally trained to apply that knowledge to treat disease.
There are traditional and schools of healing which are usually not considered to be part of (Western) medicine in a strict sense (see health science for an overview). The most highly developed systems of medicine outside of the Western or Hippocratic tradition are the Ayurvedic school (of India) and traditional Chinese medicine. The remainder of this article focuses on modern (Western) medicine.

Source:medicinestuffs.blogspot.com

Arizona Natural Products, Homeopathic Allergy Medicine (20 Cap)

Product Details

Cold & Allergy Support
Relief for symptoms related to cold and allergies. These symptoms usually include nasal congestion, runny nose, sneezing and itchy, and/or watery eyes.
Instructions
Brand:
Arizona Natural Products

Directions:
All products are best used by the expiration date shown on the label and/or bottle. After opening, keep all products tightly closed in a cool, dry place. Keep all products out of the reach of children.

Storage Instructions:
Always remember to read each and every label and check the expiration date on all packages. Most labels provide specific storage and handling requirements.

Medical Disclaimer:
All information on this site is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. We can not and do not give medical advice. Please consult with your own physician or health care practitioner regarding the suggestions and recommendations made on VitaPal.com

Source:www.vitapal.com

Father John's Medicine Plus for Colds and Allergies 4 Fl.oz

Father John's Medicine Plus for Colds and Allergies 4 Fl.oz
Information: Product details
Nasal Decongestant, Cough Suppressant, Antihistamine (4 fl. oz.) An effective, pleasant tasting, non-narcotic medicine for the temporary relief of coughs, colds, and allergy symptoms.Contains no alcohol nor habit forming drugs.Directions:Adults and children 12 years and over: Take 2 tablespoons every 4 hours. Do... More
Nasal Decongestant, Cough Suppressant, Antihistamine (4 fl. oz.) An effective, pleasant tasting, non-narcotic medicine for the temporary relief of coughs, colds, and allergy symptoms.Contains no alcohol nor habit forming drugs.Directions:Adults and children 12 years and over: Take 2 tablespoons every 4 hours. Do not take more than 12 tablespoonfuls in 24 hours. Children under 12 years old: consult a doctor.Indications:For temporary relief of cough and allergy symptoms including coughing, nasal congestion and runny nose.Warnings:Do not exceed recommended dosage because high doses may cause nervousness, dizziness, sleeplessness and especially in children excitability. Use caution when driving a car or operating machinery as this product may cause drowsiness. Do not take for more than 7 days. If symptoms do not improve or are accompanied by fever, consult a doctor. Do not take this product if you have heart disease, high blood pressure, thyroid disease, difficult urination due to

Source:www.shopping.com

Claritin Reditabs 24 Hour Allergy Relief 40 Orally Disintegrating Tablet Treat Allergy

Information: Product details
Price Range: $28.00 - $30.00 at 2 stores
It's relief from annoying allergy symptoms made convenient! Package contains 40 orally disintegrating tabs!

Source:www.shopping.com

Allergy & Eye Relief by King Bio 2oz

Allergy & Eye Relief by King Bio 2oz

Information: Product details
Price Range: $9.00 - $15.00 at 5 stores
For fast relief of discomforts associated with eye allergies and red eye: dry, itchy, swollen, inflamed, burning, irritated, watery, mucousy, eye secretions and spasm of the lids. For discomforts associated with allergies and hay fever. For conjunctiva.

Source:www.shopping.com

Natrabio, Sinus & Allergy Relief Nasal Spray, 0.8oz (24 Ml)

Natrabio, Sinus & Allergy Relief Nasal Spray, 0.8oz (24 Ml)
Information: Product details
Price Range: $5.39 - $13.93 at 9 stores
No Histamine Rebound Sinus Pressure Sinus Headache Congestion Runny Nose Dry Nasal Passages Sneezing All Regions Formula Natural Homeopathic Medicine No Drowsiness Able to Drive and Operate Equipment No Excessive Dryness or Thirst BioAllers homeopathic medicine provides treatment for sinus and... More
No Histamine Rebound Sinus Pressure Sinus Headache Congestion Runny Nose Dry Nasal Passages Sneezing All Regions Formula Natural Homeopathic Medicine No Drowsiness Able to Drive and Operate Equipment No Excessive Dryness or Thirst BioAllers homeopathic medicine provides treatment for sinus and allergy sufferers. BioAllers Sinus and Allergy Nasal Spray provides year round symptom relief for nasal and sinus symptoms due to respiratory allergies and pollens, animals, molds, yeast or dust. The metered nasal pump sprayer provides precise dose delivery of the soothing spray in a fine mist without contaminating the bottle contents. Symptom relief is attained through stimulation of the natural healing response. Precise levels of homeopathic ingredients work safely to relieve allergy symptoms. BioAllers-for the safest, natural treatment of sinus and allergy symptoms.

Source:www.shopping.com

BioAllers Sinus & Allergy Relief Nasal Spray

# All Regions Formula Sinus Pressure
# Sinus Headache
# Congestion
# Runny Nose
# Dry Nasal Passages
# Sneezing

bioAllers® homeopathic medicine provides treatment for sinus and allergy sufferers. bioAllers® SINUS & ALLERGY Nasal Spray provides year round symptom relief for nasal and sinus symptoms due to respiratory allergies to pollens and animals.

The metered nasal pump sprayer provides precise dose delivery of the soothing spray in a fine mist without contaminating the bottle contents.

Symptom relief is attained through stimulation of the natural healing response. Precise levels of homeopathic ingredients work safely and without side effects.

bioAllers® - for the safest, natural treatment of sinus and allergy symptoms.

* Metered dose pump
* Advanced Formulation
* No drowsiness
* Able to drive and operate equipment
* No excessive dryness or thirst

All Regions Formulas

bioAllers® products are specially formulated to deliver safe and effective allergy relief in any climate and in any region.

bioAllers® is dedicated to producing advanced, natural health products formulated and manufactured to pharmaceutical standards.

Source:www.vitacost.com

Sentencing Documents

FIRST BEING: Proven which, the defendant JULIO ANTONIO VALDES GUEVARA, known by YUYO, of fifty and years of age and other generals before briefed in year thousands nine hundred ninety and four integrated itself to grupúsculo contrarrevolucionario made up of around ten people and who are in the city of Manzamllo, Granma Province.

SECTION A: Proven that, the defendant like person in charge within grupúsculo, of the self-appointed Independent Library, it accumulated, books, magazines and pamphlets of editions and been contrarrevolucionarios authors abroad, mainly of Miami, State of Florida, the United States of America, that exhorts to the civil disobedience, distorts the historical events and the performance of personalities and I illustrate thinkers and patriotic revolutionaries, with vindication towards the market economy and to the liberation of the regulating function of the State on the economic activity of the country, with noticeable political interest of subvertir ideologically to the reader, with the clear intention, of by means of the confusion, adding people to the counterrevolution and to cause the destruction of political, economic and social the order existing in Cuba, that is defended by the immense and overwhelming majority of its town; bibliography that it disclosed between the members of his group and other people, occupying him to it in registry conducted in its address in date nineteen of March of two thousands the three, the units of this library; consisting of: thirty and two pamphlets on the letter of the human rights; manual on Security and a Hygiene of the Work; a bulletin of the Cuban committee pro human rights in Spain; three named Letters of Cuba, published magazines in Puerto Rico; two units of the Vitral magazine; folletín with photocopies of the news of the TIME newspaper of the United States; eight units of Dissident magazine EI; two units with information of the Diocese of the Rescuing Santísimo; thirteen unit of pamphlet CUBANET published in the United States; a bulletin of the foundation published in Spain; a unit of the magazine Spaces; two units of folletín By Cuba published in the United States; two units of folletín Forge, published in the United States; a bulletin Arena published in the United States; photocopy on Cuban exile in Miami; photocopies of the Christian Movement of Liberation; folletín on Participativa Democracy; two units of the Classic text book, published in Dominican; two units of Secret the Martí book, published in New York; a unit of the Martí book in its own words; two units of the Dengue book, published in the United States; five magazines Hispanic Cuban, published in Spain; folletín twenty-four of February; a unit of the book Jose Martí the invention of Cuba, published in Spain; two units of the book the repressive Machinery of Cuba, published in the United States one in Spanish and another one in Ingles; a unit of the book the Conquest of the Nature and the Environmental legacy of the Socialism in Cuba, published in Mexico; a unit of the book Letters from Burma, published in Spain; a unit of the magazine Encounter, published in Spain; a unit of the book Looking for an Economic Model in Latin America, published in the United States; folletín on the Letter of the Fundamental Duties of the Cubans; two units on declarations of Geroge W. Busch on policy towards Cuba; two pamphlets on the political realism of Christian; three newspaper units without censorship published in the United States, unit Cuba a newspaper Free Press, published in Miami; a unit of the pamphlet on: independent sociocconómica information; copy of an article of the Miami Herald, published in the United States; paskin on the freedom published by the Christian movement of liberation: paskin on censorship to the collaborators; capias of several pronounced speeches even different people,en the delivery of awards Sajarov to Osvaldo Paya Sardines.

SECTION B: Proven that, from their incorporation to the contrarrevolucionario group in year thousands nine hundred ninety and four, the defendant JULIO ANTONIO VALDES GUEVARA have been dedicated to spread the false news, inexact, intentionally manipulated that distort the Cuban reality, sending them directly and through self-appointed people independent journalists to the emitting radio ironically call "Radio Marti '" who trasmite from Miami, State of Florida, the United States, which has made of set with its wife CRUZ DELIA AGUILAR MOOR, ROBERTO MARTINEZ SCALLION and other members of the group which are not judged by these facts, with the clear intention to confuse the people who listen to the transmitter so that they distorsionadamente receive events, or done false and to generate irritation, displeasure, opposition to the economic, political and social system created and that are sustained with the popular support to obtain their destruction thus,

SECTION C: Proven which, the defendant JULIO ANTONIO VALDES GUEVARA in the month of February of the present year two thousand three along with other two members of his grupúsculo, personó in the Office of Interests of the United States of America, been in city of Havana, Cuba, giving itself to civil employees of this office documents that contained information on supposed retaliation against members of their group and other denunciations on presumed violations of the Human rights in Cuba, receiving the blame their request, books and pamphlets of subversive character that added to their library, as well as a radius mobile receiver, with capacity to recepcionar with high fidelity emitting foreigners. Also day three of March also of present three year two thousands the defendant next to other contrarrevolucionarias people received the visit of the second representative and the one in charge of economic subjects of the Office of Interests of the United States of America, carrying out a meeting to doors opened in the address located in the Loynaz street number one hundred twenty-seven between Martí and Jose Miguel Go'mez, Manzanillo, Granma, where the citizen resides Tania of Torre Montesino, and in which she informed to these civil employees, presumed violations of the human rights, referred among others, to its even halting the Police, by to have participated

in a public disorder in the city of Manzanillo, receiving praises of the referred civil employees by its activity and stimuli to continue making its illegal acts to destroy economic, political and social the system effective in Cuba.

That to make its activities contrarrevolucionaria, before described grupúsculo has received material benefits like member of his, mainly ample variety of medicines and three radios mobile receivers, occupying to it him in the registry carried out in its address in date nineteen of March of year two thousands three; a radius marks TECSON in good technical state, with two batteries marks Digitalis of 1,5 volt; a radius marks KAIWA, in good technical state, with two batteries marks Digitalis of 1,5 volt, with a black lining; a radius marks SILVER, without batteries and that it needs the cover of the deposit of the batteries; a shipper of batteries marks Digitalis; an electrical transformer of black color without mark, with its cable; an antenna for radio with its cable black color; two pairs of portable headsets with its connections and cables; a box of drops NOV ASPIRIN with a sealed bottle and its gotero; a bottle of nasal drops marks NASAL SPRAY; two bottles of capsules KIR LAUN mark ASPIRIN, one sealed and another opening to US and in use; two cream tubes of Hidrocortisona; two bottle of IBUCROFEA, one sealed and another one in use; two vitamin bottles C in use; a calcium bottle marks CALCIUN in use; a bottle of capsules DAILY MULTI in use; a bottle of vitamin and in use; two aspirin bottles in use; a bottle of tablets already marks CHILDRENS with several types of capsules in use; a bottle of tablets marks B-50; a bottle of tablets marks ONE DAY MULTIS in use, a bottle of tablets marks to ALERGI MEDICINE; two bottles of tablets mark BETA CAROTENE, one sealed and one in use; two bottles of fó1ico acid tablets (FOLIC ACID) in use; a bottle of tablets marks STOOL SOFTENER in use; a cream bottle marks ANTI DIARRHEAL with nine complete cases and one in use; a syrup bottle marks to sealed IBUPROFEN and a thread package of surgical suture.

That in addition in the conducted registry the nineteen to March of two thousands the three took care to the defendant registry to him of inscription of CRUZ DELJA AGUILAR MOOR like president of the group Golfo of the Guacanayabo before the association of independent economists; an almanac with logotipo of the independent libraries in Cuba; Several documents referred to the denominated Project Varela, including listings of companies; two notebooks mark Caribbean TRD, one with listing of medicine distribution and one in target; a notebook marks Caribbean TRD, that contains other papers written by hand with names, directions and number of identity meat of several people; a libretica like telephone agenda that contains among others the telephone numbers of VIKY RUIZ, ELIZARDO SANCHEZ SANTACRUZ and MARITZA LUGO; three documents of the press of the office of interests of the United States on visa negation; a model in target to promote the civil society in Cuba; documents typed on the project a Hand friend; seven official citation models of the Revolutionary National Police in target; three comprobantes on the medicine shipment to CRUZ DELIA by company/signature CARIBBEAN FAMILY TRVL, been in Miami; thirty documents written by hand or typed with denunciations of supposed violations of the human rights; twenty-two manuscripts on acts of meetings of the group Gulf of the Guacanayabo; eleven documents written by hand on correspondences with people with subjects related to the denunciations; cintillo of the independent library with a listing of deceaseds in tugboat thirteen of March; a magnetic compass with its plastic case green and black color; a typewriter old in good state and its tape; a Cuban Flag of medium size, a wood group to construct a boat prow, a metallic group in prow form, eight aluminum tubas with its ends covered with poliespuma, cassete of audio mark Gaussian of sixty and two minutes and a photographic negative to color.

That to the defendant criminal records do not consist to him, nevertheless has not been making any useful activity socially for several years in spite of being apt fisica and mentally for it, nor no other than of honest form it allows him to satisfy its necessities and those with its family; characterizing itself in addition by an aggressive conduct since it has altered to the order, disturbing the citizen tranquillity and the most elementary norms of social coexistence, by means of contemptuous offenses and gestures against other people, as well as other alterations and manifestations

public of crude form; standing out that although is and it catalogues as a contrarrevolucionario does not manage to behave suitable and respectfully as opposed to the immense majority of the population that defends and loves its Mother country, its Revolution and the Socialism.

SECOND BEING: That the Court considers the justiciables facts proven and forms his conviction in the test results practiced in the act of the oral judgment, in such sense the ample examination of the documentary one contributed by the Office of the public prosecutor, consisting of the civil registry and occupation of fojas eleven of the summary in which the books, magazines are detailed and pamphlets that the defendant, diverse types of medicines, the radius receiving with his additions had, and that are signed by the operating one properly, one of the inhabitants of the house and two eyewitnesses, document very detailed and precise in the conducted battles; the own occupied bibliography that are very suggestive only of its simple examination, and ilustrativas of the character of its content and its intentions; the notebook annexed number one that to the performances that group all the documentation related to acts of meetings of grupúsculo to which the defendant, the uninformed ones belongs made, of denunciations and information that were sent to the subversive transmitter already mentioned that are in Miami, specially, those of folios forty, forty and one, from forty and the three to forty and the five, from forty and the eight to the fifty, fifty and three, fifty and six, fifty and eight, from the sixty to sixty and the four and of sixty and the six to the sixty and eight, very ilustrativas of distortions and falsifications that inquire; as well as the report of conduct of the defendant who in detail refers his behavior; the negative certification of criminal records that were emitted by the Central Registry of Sanctioned and the one that in that sense it emitted the investigator, fulfilling both its requirement formal; shooting in video format, ilustrativo of the visit of the civil employees of the Office of Interests of the United States from America to Granma, of the halting of the defendant and the registry carried out in its address, Also pertaining to a witness practiced, the referring one, to the examination of the Yordanis witness Fonseca Leon who with all precision detailed his direct knowledge on the recibimiento that offered the representatives of the Office of Interests of the United States of America, in which the defendant, the deposition of the witnesses Edgardo Arrebola Bring participated, Modesto Rosabal Alarcón and Blaza Belkis Sanchez Arevich, neighbors of the encartado one, who narrated the present aggressiveness in conduct of the defendant, repudio that this one cause in the members of the community of neighbors, his to act irrespetuoso towards the agents of the Public Order, and the testimony of Luis Alberto Rodriguez

Castle, one of the witnesses who participated in the conducted registry, which I corroborate all the occupied one. The expert opinion that builds to folio thirty and four and thirty and thirty and five of the investigativo file, in which ample and in detail it explains the subversive character of books, magazines and pamphlets occupied, according to a deep analysis of his content and format and that was emitted by known and prestigious specialists in the art of the expert Manuel Lauredo Roman; the contentiva documentation of the expert work made on the characteristics and occupied receiving the three technical aspects of radio, that fulfills the requirements formal and that were emitted by a specialist of several years of experience, engineer in communications; the expert ruling issued by the specialist in documentología, with many years of experience in the activity, that presented/displayed its report before the Court in the act of the oral judgment with much precision, on the use of the machine of, to write mechanical occupied in the house of the defendant in the document elaboration of grupúsculo.

THIRD BEING: That the Fiscal Ministry maintained and elevated to definitive at its opportune procedural moment, its obrantes provisional conclusions to fojas from the three to the seven of the roll,

QUARTER BEING: That the lawyer of the defense maintained and elevated to definitive at her opportune procedural moment her provisional conclusions that seventeen and eighteen of the cause at their opportune procedural moment conform folios.

FIRST CONSIDERING: That the proven facts integrate three Crimes against National Independence and the Economy of Cuba, anticipated first in I articulate six,

section one three, interjections a) and b) since in agreement appears in the facts to the defendant was occupied him ample bibliographical material of subversive character that it had in his power, second anticipated and sanctioned in I articulate seven section one and three, because it was proven that he is a permanent collaborator with a foreign transmitter that illegally invades the radioelectronic space of the country and that it has like objective ideologically to attack the Cuban town; and another sanctioned anticipating and in I articulate four section one and two interjections a) and b) then in agreement the defendant is stated provided to civil employees and representatives of the Government of the United States of America information, activities in which always participated with the aid of several people and by that systematically he received material resources as they are medicines and electronic equipment, and in order to facilitate the objectives of the Law Helms Burton, the blockade and the economic war, to break the internal order, to destabilize the country and to eliminate the Socialist State, all these crimes anticipated in Law eighty and eight "Of Protection of National independence and the Economy of Cuba ",

SECOND CONSIDERING: That the defendant is responsible penal for the three crimes described in the previous one considering, for author as settles down it I articulate eighteen two section one and interjection a) of the Penal Code, by to have executed the facts in case

same.

THIRD CONSIDERING: That in the commission of the crimes the aggravating one does not concur that imputes the Public prosecutor anticipated in three article fifty and interjection n) of the Penal Code, because the official warning to that it talks about east interjection must be made by means of act in that consists the causes that determine it, which on the matter it express the warned one and it closes under the company/signature of this one and the operating one, in agreement seventy and five of section two of the own referred Law establish article; formalities that are not appraised when not appearing like documentary evidence any act where consist official warning to the defendant; as ch) of the Penal Code alleged by the defense is not appraised either extenuating predicted in two article fifty and interjection, the defendant limited itself, to only recognize the imputations that were formulated to him, his confession was not spontaneous as he is demanded in the own norm, that he estimates ignorance of authorities corresponding, that must inquire into their participation, indeed by the own defendant, whom he requires therefore of the initiative of the encartado one, which has not happened in this case; also any other extenuating or aggravating circumstance does not concur.

QUARTER CONSIDERING: That he is not indispensable to the defendant civil responsibility by his participation in the proven facts.

FIFTH CONSIDERING: That to adapt the measurement of the sanction to impose, in agreement the established thing in articles twenty-seven and forty and seven of the Penal Code, this Court considers that acting of the defendant of is elevated social danger, because putting itself in fact, to the service of foreign the power, most powerful and aggressive of history, beside the point enemy of the Cuban Revolution and its town, has persistently attacked the stability social and cooperated intentionally with aggressive and pertinaz enemy propaganda that is sent against the Cuban town and that looks for to obtain the disrepute in the socialist system and the Revolution that maintains it, as well as of his main political leaders and of its military institutions, becoming mercenario when receiving material benefits of this power by its illegal activities and to be in permanent disposition to fulfill its orders directed to destroy the economic, political and social order established in the country; behavior that firmly is repudiado by the members of the community where resides and of the immense majority of the town. The present circumstances of the international relations in which an aggressiveness is pronounced every greater time of the referred superpower and a weakening of the mechanisms of the Community the International to guarantee the world order, La Paz and the equality of all the States, as well as a well-known increase of the injerencista activity in our country, specially of the civil employees of the Office of Interests of the United States of America in Havana, accentuates the danger of activities like which it has made the defendant, who characterizes itself in addition by an aggressive conduct and irrespetuosa in the social order and in spite of not consisting criminal records to him he is deserving ofa severe sanction.

SIXTH CONSIDERING: That necessarily it is had to strip to the defendant of the goods and objects that were used for the commission of the crime or were destined to those effects as establishes I articulate forty and three, separated one and two from the Penal Code, because by its nature evidence that these constituted an essential aid to the criminal for the commission of the illicit described penitentiaries; as well as other nontie goods to the judged facts, in which it turns out originating to arrange his confiscación in accordance with the established thing in I articulate forty and four ordinal one and two of the own Law before briefed, because it is evident that they bear relation to criminal acting of the defendant.

WE FAILED: That we must sanction and we sanctioned to the defendant JULIO ANTONIO VALDES GUEVARA like author of the crimes anticipated in four article two section one and interjection a), to Fifteen years of freedom deprivation, by the crime anticipated in article six, separated one and three interjections a) and b), to Seven years of freedom deprivation and by the crime anticipated in article seven, separated one and three, Five years of freedom deprivation, and is dominated to him like joint and unique sanction to fulfill the one of TWENTY YEARS OF FREEDOM DEPRIVATION; sanction that it will extinguish in the penitentiary center that determines the Department of the Interior conforms the established thing in the corresponding regulations. The accessory sanction of deprivation of rights anticipated in seven prevails to him article thirty and section one and two of the Penal, consisting of Code the loss of the right to the active and passive suffrage, as well as of the right to hold positions of direction in the organs corresponding to the administrative political activity of the State, in State Economic Units and Organizations of Social Masses and.

Also as accessory sanction has comiso the goods and occupied, consisting of objects a box of drops NOV ASPIRIN with a sealed bottle and its gotero; a bottle of nasal drops marks NASAL SPRAY; two bottles of capsules KIR LAUN mark ASPIRIN, one sealed and another opening to US and in use; two cream tubas of Hidrocortisona; two bottle of IBUCROFEA, one sealed and another one in use; two vitamin bottles C in use; a calcium bottle marks CALCIUN in use; a bottle of capsules DAI L and MULTI in use; a bottle of vitamin and in use; two aspirin bottles in use; a bottle of tablets already marks CHILDRENS with several types of capsules in use; a bottle of tablets marks B-50; a bottle of tablets marks ONE DAY MULTIS in use, a bottle of tablets marks to ALERGI MEDICINE; two bottles of tablets mark BETA CAROTENE, one sealed and one in use; two bottles of fólico acid tablets (FOLIC ACID) in use; a bottle of tablets marks STOOL SOFTENER in use; a cream bottle marks ANTI DIARRHEAL with nine complete cases and one in use; a syrup bottle marks sealed IBUPROFEN; a thread package of surgical suture; thirty and two pamphlets on the letter of the human rights; manual on Security and a Hygiene of the Work; a bulletin of the Cuban committee pro human rights in Spain; three named Letters of Cuba, published magazines in Puerto Rico; two units of the Vitral magazine; folletín with photocopies of the news of the TIME newspaper of the United States; eight units of the magazine the Dissident; two units with information of the Diocese of the Rescuing Santísimo; thirteen unit of pamphlet CUBANET published in the United States; a bulletin of the foundation published in Spain; a unit of the magazine Spaces; two units of folletín By Cuba published in the United States; two units of folletín Forge, published in the United States; a bulletin Arena published in the United States; Photocopy on Cuban exile in Miami; photocopies of the Christian Movement of Liberation; folletín on Participativa Democracy; two units of the Classic text book, published in Dominican; two units of Secret the Martí book, published in New York; a unit of the Martí book in its own words; two units of the Dengue book, published in the United States; five magazines Hispanic Cuban, published in Spain; folletín twenty-four of February; a unit of the book Jose Martí the invention of Cuba, published in Spain; two units of the book the repressive Machinery of Cuba, published in the United States one in Spanish and another one in Ingles; a unit of the book the Conquest of the Nature and the Environmental legacy of the Socialism in Cuba, published in Mexico; a unit of the book Letters from Burma, published in Spain; a unit of the magazine Encounter, published in Spain; a unit of the book Looking for an Economic Model in Latin America, published in the United States; folletín on the Letter of the Fundamental Duties of the Cubans; two units on declarations of Geroge W. Busch on policy towards Cuba; two pamphlets on the political realism of Christian; three newspaper units without censorship published in the United States, unit Cuba a newspaper Free Press, published in Miami; a unit of the pamphlet on independent socioeconomic information; registry of inscription of CRUZ DELIA AGUILAR MOOR like president of the group Golfo of the Guacanayabo before the association of independent economists; an almanac with logotipo of the independent libraries in Cuba; several documents referred to the denominated Project Varela, including listings of companies; two notebooks mark Caribbean TRD, one with listing of medicine distribution and one in target; a notebook marks Caribbean TRD, that contains other papers written by hand with names, directions and number of identity meat of several people; a libretica like telephone agenda that contains among others the telephone numbers of VIKY RUJZ, ELIZARDO SANCHEZ SANTA CRUZ and MARITZA LUGO; three documents of the press of the office of interests of the United States on visa negation; a model in target to promote the civil society in Cuba; documents typed on the project a Hand friend; seven official citation models of the Revolutionary National Police in target; three comprobantes on the medicine shipment to CRUZ DELIA by company/signature CARIBBEAN FAMILY TRVL, been in Miami; a comprobante on the medicine shipment to CRUZ DELIA of company/signature CFTS, been in Miami; a comprobante on the medicine shipment to CRUZ DELIA of INC. company/signature V ACUBA, been in Miami; several written by hand documents, autobiography and endorsement of Roberto

Martinez Scallion, like member of the group; thirty written by hand documents or

typed with denunciations of supposed violations of the human rights; twenty-two manuscripts on acts of meetings of the group Gulf of the Guacanayabo; eleven documents written by hand on correspondences with people with subjects related to the denunciations; cintillo of the independent library with a listing of deceaseds in tugboat thirteen of March; copy of an article of the Miami Herald, published in the United States; paskin on the freedom published by the Christian movement of liberation; paskin on censorship to the collaborators; copies of several speeches pronounced by different people in the delivery from the Sajarov prize from Osvaldo For Sardiñas; a radius marks TECSON in good technical state with two batteries marks digitalis of the 1,5 volt; a radius marks KAIW, in good technical state with two batteries marks digitalis of 1,5 volt, with a black lining; a radius marks SILVER, without batteries and lacks the cover of the deposit of the batteries;a shipper of batteries marks digitalis; an electrical transformer of black color without mark, with its cable; an antenna for radio with its cable black color; two pairs of portable headsets with its connections and cables.

The confiscación is had a wood group to construct boat prow; a metallic group in prow form; eight aluminum tubas with its ends covered with poliespuma; cassete of audio mark GAUSSIAN of 62 minutes; a photographic negative to color; a magnetic compass with its plastic case green and black color and a typewriter

old in good state and its tape.

One arranges that on the photographic negative, cassete of audio, medicines, books, magazines, pamphlets and the rest of documents it procédase to his destruction by means of incineration to lack utility; on the three radio receiving with its batteries, the shipper, the transformer and its cable, the antenna with its cable and its case and the headsets has its delivery to the Headquarters of the Inner Ministry of Granma so that they are conserved like material test of the injerencista activity, of the United Government of the State of America against the Republic Cuba; the typewriter entréguese to the Basic Unit of Services of Manzanillo; the magnetic compass with its case entréguese to Gcocuba de Granma; the wood group and metallic and the previous aluminum tubes its disarmament to give to the Company Provincial de Prime Materias of Granma for its advantage.

As far as the Cuban Flag of medium size, its definitive delivery is had to the Municipal Direction of Education of Manzanillo so that him the use that really deserves our national standard.

As far as the measurement to prevent of provisional prison is ratified until as much begins the sanctioned one to fulfill the sanction main.

Sign this sentence, remítase copy of the same one, to the centers that come.

Notifíquese the present resolution to the defendant and the Public prosecutor, doing to know to him that in case of inconformidad it will be able to establish Resource of Abrogation stops before the Room of the Crimes against the Security of the State of the Popular Supreme Court, within the three following working days to the one of its notification to the part that establishes it.

Source:www.ruleoflawandcuba.fsu.edu