Diabetes Mellitus Part 3

Treatment
The goal of diabetes management is to keep blood glucose levels as close to normal as safely possible. Since diabetes may greatly increase risk for heart disease and peripheral artery disease, measures to control blood pressure and cholesterol levels are an essential part of diabetes treatment as well.
People with diabetes must take responsibility for their day-to-day care. This includes monitoring blood glucose levels, dietary management, maintaining physical activity, keeping weight and stress under control, monitoring oral medications and, if required, insulin use via injections or pump. To help patients achieve this, UCSF's Diabetes Teaching Center offers self-management educational programs that emphasize individualized diabetes care. The program enables patients to make more consistent and appropriate adjustments in their therapy and lifestyle.
Dietary Management and Physical Activity
Modifying eating habits and increasing physical activity are typically the first steps toward reducing blood sugar levels. At UCSF Medical Center, all patients work with their doctor and certified dietician to develop a dietary plan. Our Teaching Center conducts workshops that provide patients with information on food nutrient content, healthy cooking and exercise.
Insulin Therapy
People with type 1 diabetes require multiple insulin injections each day to maintain safe insulin levels. Insulin is often required to treat type 2 diabetes too. Using an insulin pump is an alternative to injections. The pump is about the size of a pager and is usually worn on your belt. Insulin is delivered through a small tube (catheter) that is placed under the skin (usually in the abdomen).
There are four major types of insulin:
Rapid-acting
Short-acting
Intermediate-acting
Long-acting
Your doctor will determine your dose and how often you need to take insulin. There is no standard insulin dose as it depends on factors such as your body weight, when you eat, how often you exercise and how much insulin your body produces.
Oral Medications
Sometimes blood sugar levels remain high in people with type 2 diabetes even though they eat in a healthy manner and exercise. When this happens, medications taken in pill form may be prescribed. The medications work in several different ways. These include improve the effectiveness of the body's natural insulin, reduce blood sugar production, increase insulin production and inhibit blood sugar absorption. Oral diabetes medications are sometimes taken in combination with insulin.

Diabetes Mellitus Part 2

What causes Diabetes Mellitus?
The exact cause of diabetes mellitus may not be determined in every case and there are still causes of diabetes mellitus that are unknown. Some of the causes are thought to be:
Genetic susceptibility
as already stated, certain breeds of dogs are at greater risk of developing the disorder
Infectious diseases
viral infections may cause destruction of the beta-cells within the pancreas
Immune-mediated disease
the animal's own immune system may start to attack and destroy the beta-cells within the pancreas
Pancreatitis
this is a relatively common inflammatory condition of the pancreas, particularly in dogs
inflammation results in damage and scarring of the pancreas that, if severe enough, can result in loss of beta-cells
Predisposing diseases
dogs and cats with other underlying diseases (such as a syndrome known as Cushing's disease) are more at risk of developing diabetes mellitus
Drugs
medications such as cortisone and progesterones can predispose an animal to developing diabetes mellitus
Obesity
Cancer of the pancreas
What are the signs of Diabetes Mellitus?
There are four classic signs of diabetes mellitus. They are:
Increased drinking (polydipsia)
Increased urination (polyuria)
Increased appetite (polyphagia)
Weight loss
These signs may take a few weeks to a few months to become noticeable.
Other signs that can develop later in the disease syndrome include:
Anorexia
Lethargy and depression
Vomiting and/or diarrhoea
Muscle wastage along the back in cats
Oily coat with dandruff in cats
Sudden onset of cataracts
Blindness secondary to degeneration of the retina in the eye
Coma and death
Unusual hind limb gait
is seen only in cats
affected cats walk with their hocks (or ankles) touching the ground
Anorexia, lethargy, depression, vomiting, diarrhoea and coma are all indications of a life-threatening form of diabetes mellitus called ketoacidosis. Ketoacidosis occurs in those diabetic animals that are not treated soon enough or correctly. It represents a very serious disruption to the animal's metabolism and will most likely result in the animal's death if left untreated.
Why does my diabetic pet drink and urinate so much?
Blood is made up of two components. These are:
Cellular component
contains such cells as red blood cells and white blood cells
Fluid component
is called plasma
contains a large amount of dissolved chemicals and nutrients
The kidneys act as one of the blood's filter systems. Blood passes through the kidneys and is separated into its cellular and fluid components. Waste materials and toxins are removed from the blood by the kidneys and excreted from the body in the urine. Along with these wastes and toxins, nutrients such as glucose also pass into the urine. In a normal animal, the kidney reabsorbs all of these useful nutrients so they can be utilised by the body. In diabetic animals excessive amounts of glucose pass into the urine. This excessive amount overwhelms the kidneys' ability to reabsorb the glucose. The glucose in the urine attracts more water from the fluid component of the blood into the urine via a process called osmosis. As a result an increased amount of urine is produced. To avoid dehydration from the excessive urine production the animal must drink increasing amounts of water.
Why is my diabetic pet always hungry but has lost weight?
The liver, fat tissue and muscle of the body rely on insulin to allow glucose to pass from the blood stream into the cells so the glucose can be used for energy. Without the glucose the cells essentially "starve". This results in weight loss. As a response to this, the part of the brain known as the "feeding centre" is stimulated to increase the amount of food consumed. In addition to this, the part of the brain called the "satiety centre" is switched off. The "satiety centre" is responsible for creating the sensation of having eaten enough after a meal. This sensation is caused by an increase in the blood sugar after a meal resulting in more glucose passing into the "satiety centre" and switching it on. The passage of the glucose is controlled by insulin. Because diabetic animals have no insulin the glucose is unable to pass into the "satiety centre" and thus it is not switched on and the animal will continue to eat.
How is Diabetes Mellitus diagnosed?
Diabetes mellitus is diagnosed on the basis of:
The animal's symptoms
An abnormally high blood glucose measurement
the normal level of glucose in the blood is 4 to 7 mmol/L
diabetes mellitus is the only common disease that will cause blood glucose levels to rise above and stay above this normal level
Diabetes mellitus is not the only cause of an elevated blood glucose measurement. Stress, particularly in cats, is a common cause of an increased blood glucose level. This increase does not persist but in certain cases it may be difficult to distinguish if the high blood glucose level is due to diabetes mellitus or to stress. An analysis of the animal's urine may be performed. Diabetic animals will consistently have large amounts of glucose in their urine. Alternatively, a blood test to determine the level of a protein called fructosamine can give an indication of the animal's blood glucose level for the previous 3 weeks. Diabetic animals have an increased fructosamine level while those animals with an elevated blood glucose level due to stress have a normal fructosamine level.
Because diabetes mellitus is such a complex disease there are often other metabolic abnormalities or diseases occurring in conjunction with an elevated blood glucose level. These include various degrees of liver dysfunction, dehydration, inflammation, electrolyte abnormalities and urinary tract infections. As a consequence of this, it is often necessary to perform more extensive blood tests to assess the animal's overall health before the correct treatment can be given.

Diabetes Mellitus Part 1

Diabetes mellitus is the correct term used to describe the medical condition that is commonly known as "sugar diabetes". "Diabetes" is a general term used to refer to a variety of disorders characterized by increased urine production (or polyuria) and increased water intake (or polydipsia). It is derived from the Greek words dia which means "through" and bainein which means "go". The term "mellitus" is derived from the Latin word mel which means "honey".
Diabetes mellitus is a complex metabolic disorder of carbohydrate, fat, and protein metabolism caused by a deficiency of the hormone, insulin. The pancreas is a small but vital organ that is located near the stomach. It consists of several types of cells. One group of cells called acinar cells produce the enzymes necessary for proper digestion. Another group, called beta-cells, produce insulin. Simply put, diabetes mellitus is a failure of the pancreas to regulate blood sugar.
There are essentially two forms of diabetes mellitus. Both types are similar in that there is a failure to regulate blood sugar, but the basic mechanisms of disease differ somewhat between the two groups:
Type I, or Insulin Dependent Diabetes Mellitus
results from very low or absent insulin secretion secondary to the total or near-total destruction of the beta-cells
this is the most common form of diabetes mellitus seen in dogs and cats
Type II, or Non-Insulin Dependent Diabetes Mellitus
in this form the beta-cells are present but the amount of insulin they produce is reduced or there is a delayed response in secreting it, or the muscle, fat and other tissues become "resistant" to insulin's effect
this form is only rarely diagnosed in dogs and cats
up to 40% of cats with Type II diabetes mellitus will regain the ability to control their blood glucose level and require no further treatment but this may take months to years, during which period treatment is required
Why is insulin so important?
Insulin is required by muscles, fat tissue and the liver to utilise the carbohydrates, proteins and fats ingested in the diet.
The role of insulin is much like that of a gatekeeper: it stands at the surface of body cells and opens the door, allowing glucose to leave the blood stream and pass inside the cells. Glucose is a vital substance that provides much of the energy needed for life, and it must work inside the cells. Without an adequate amount of insulin, glucose is unable to get into the cells and it accumulates in the blood, leading to high blood sugar or hyperglycaemia. When insulin is deficient, the cells become starved for a source of energy. In response to this, the body starts to breakdown stores of fat and protein to use as alternative energy sources. This leads to a series of metabolic changes that result in the signs of diabetes mellitus developing.
How common is Diabetes Mellitus?
Diabetes mellitus is a relatively common disorder and is diagnosed in approximately 1 in every 400 to 500 dogs and cats.
Is my pet at risk of developing Diabetes Mellitus?
Diabetes mellitus is the correct term used to describe the medical condition that is commonly known as "sugar diabetes". "Diabetes" is a general term used to refer to a variety of disorders characterized by increased urine production (or polyuria) and increased water intake (or polydipsia). It is derived from the Greek words dia which means "through" and bainein which means "go". The term "mellitus" is derived from the Latin word mel which means "honey".
Diabetes mellitus is a complex metabolic disorder of carbohydrate, fat, and protein metabolism caused by a deficiency of the hormone, insulin. The pancreas is a small but vital organ that is located near the stomach. It consists of several types of cells. One group of cells called acinar cells produce the enzymes necessary for proper digestion. Another group, called beta-cells, produce insulin. Simply put, diabetes mellitus is a failure of the pancreas to regulate blood sugar.
There are essentially two forms of diabetes mellitus. Both types are similar in that there is a failure to regulate blood sugar, but the basic mechanisms of disease differ somewhat between the two groups:
Type I, or Insulin Dependent Diabetes Mellitus
results from very low or absent insulin secretion secondary to the total or near-total destruction of the beta-cells
this is the most common form of diabetes mellitus seen in dogs and cats
Type II, or Non-Insulin Dependent Diabetes Mellitus
in this form the beta-cells are present but the amount of insulin they produce is reduced or there is a delayed response in secreting it, or the muscle, fat and other tissues become "resistant" to insulin's effect
this form is only rarely diagnosed in dogs and cats
up to 40% of cats with Type II diabetes mellitus will regain the ability to control their blood glucose level and require no further treatment but this may take months to years, during which period treatment is required
Why is insulin so important?
Insulin is required by muscles, fat tissue and the liver to utilise the carbohydrates, proteins and fats ingested in the diet.
The role of insulin is much like that of a gatekeeper: it stands at the surface of body cells and opens the door, allowing glucose to leave the blood stream and pass inside the cells. Glucose is a vital substance that provides much of the energy needed for life, and it must work inside the cells. Without an adequate amount of insulin, glucose is unable to get into the cells and it accumulates in the blood, leading to high blood sugar or hyperglycaemia. When insulin is deficient, the cells become starved for a source of energy. In response to this, the body starts to breakdown stores of fat and protein to use as alternative energy sources. This leads to a series of metabolic changes that result in the signs of diabetes mellitus developing.
How common is Diabetes Mellitus?
Diabetes mellitus is a relatively common disorder and is diagnosed in approximately 1 in every 400 to 500 dogs and cats.
Is my pet at risk of developing Diabetes Mellitus?

It is known that certain breeds of dogs have a higher risk of developing diabetes mellitus than others. These include the Poodle, Dachshund, Miniature Schnauzer, Beagle, King Charles Cavalier Spaniel, Scottish Terrier, Miniature Pinscher and Cairn Terrier. Diabetes mellitus in the Keeshond is an inherited condition ie. is passed from one generation to the next.
No apparent breed predilections have been noted in cats.
Female dogs are diagnosed with diabetes mellitus twice as much as male dogs. Male cats (particularly desexed) are more likely to develop the disorder than female cats.
The average age of dogs that develop diabetes mellitus is 8 years. It is rare for dogs under 6 months of age to become diabetic. 75% of cats that are diagnosed with diabetes mellitus are 8 to 13 years of age.
Overweight dogs and cats have a higher risk of suffering from diabetes mellitus.

Targeted Therapy

Cancer remains the second leading cause of death in the United States, despite the significant advances in cancer therapy made over the past several decades. Many factors contribute to our limited success in fighting cancer. Late diagnosis, often after the cancer has already spread to distant locations, is certainly a major reason why many patients are incurable. Equally problematic are the limitations of our current therapeutic armamentarium. The modern-day approach to cancer management is a multidisciplinary one, consisting primarily of surgery, radiation therapy and chemotherapy, in varying combinations. However, any approach is only as good as its components. All three of these treatments function within a limit called the "therapeutic window". This concept refers to the ability of a treatment to kill cancer cells while minimizing the toxicity to healthy, normal cells. Every surgical procedure, radiation course, and chemotherapy agent is bound by this window, and can not exceed it without causing undue harm to the patient. Thus, conventional therapies of today can only achieve so much success in the fight against cancer.
Naturally, physicians and scientists are vigorously investigating ways in which to improve the efficacy of these treatment modalities. This includes things like modifying surgical techniques, refining radiation delivery methods (e.g.: see IMRT and Proton Therapy), and developing new chemotherapy agents. These efforts certainly help, but ultimately, there is still room for improvement. Both surgery and radiation therapy have often been described as physical solutions to a biological problem. Chemotherapy, often the cornerstone of treatment in advanced and palliative cases, can be viewed as more of a chemical solution to a biological problem. From the ongoing quest to improve our therapeutic arsenal, a newer, fourth weapon has emerged in the fight against cancer: targeted therapies. This is an ever-growing and exciting new field of research and development. This section will attempt to describe targeted therapies in general, and then take a closer look at some specific types of targeted agents. Many of these have received much publicity recently, and will undoubtedly revolutionize the future of clinical cancer trials and research.
What is targeted therapy?
Targeted therapy is a general term that refers to a medication or drug that targets a specific pathway in the growth and development of a tumor. By attacking or blocking these important targets, the therapy helps to fight the tumor itself. The targets themselves are typically various molecules (or small particles) in the body that are known or suspected to play a role in cancer formation.
How are targeted therapies named?
The names of the major classes of targeted therapies typically include the word "anti-", or "inhibitor", together with the name of the target itself. This means that the drug blocks, (is "anti"), that particular target. Then within each class of inhibitors, there is/are the actual drug(s).
It is important to realize that a single drug can have several names, including a generic name and a brand name, which can differ in various parts of the world. This can be confusing because often the generic and brand names are used interchangeably in the literature and the media. Throughout this educational section, we will use primarily the generic name of the drug.
What are the different classes of targeted therapy? In other words, what are the different targets?
There are a number classes of targeted therapies, with new potential targets being discovered all the time. Let’s review a few of the major classes and some of the medications in those categories.
I) Tyrosine kinase receptor inhibitors
A tyrosine kinase receptor is a molecular structure or site on the surface of a cell that binds with substances such as hormones, antigens, drugs, or neurotransmitters. When it binds with one of these triggering substances, the receptor performs a chemical reaction, which in turn triggers a series of reactions inside the cell. These reactions include cell multiplication, death, maturation, and migration. In tumor cells, all of these reactions are critical for the tumor to survive, thrive and spread throughout the body. By blocking the receptor, the goal is to prevent the cascade of reactions and prevent tumor survival.
There are many different types of tyrosine kinase receptors in the body. One family of tyrosine kinase receptors is called the human epidermal receptor family, or the HER family. The members of the family are:
HER1 (also called the Epidermal Growth Factor Receptor or EGFR)
HER2 (also called ErbB2 or HER2/neu)
HER3 (also called ErbB3)
HER4 (also called ErbB4)
The first 2 family members, EGFR and HER2/neu, are the two most extensively studied targets in oncology.

Biaxin

Clarithromycin is a semi-synthetic macrolide antibiotic. Chemically, it is 6-0-methylerythromycin. The molecular formula is C38H69NO13, and the molecular weight is 747.96. The structural formula is:

Clarithromycin is a white to off-white crystalline powder. It is soluble in acetone, slightly soluble in methanol, ethanol, and acetonitrile, and practically insoluble in water.
BIAXIN is available as immediate-release tablets, extended-release tablets, and granules for oral suspension.
Each yellow oval film-coated immediate-release BIAXIN tablet (clarithromycin tablets, USP) contains 250 mg or 500 mg of clarithromycin and the following inactive ingredients:
250 mg tablets: hypromellose, hydroxypropyl cellulose, croscarmellose sodium, D&C Yellow No. 10, FD&C Blue No. 1, magnesium stearate, microcrystalline cellulose, povidone, pregelatinized starch, propylene glycol, silicon dioxide, sorbic acid, sorbitan monooleate, stearic acid, talc, titanium dioxide, and vanillin.
500 mg tablets: hypromellose, hydroxypropyl cellulose, colloidal silicon dioxide, croscarmellose sodium, D&C Yellow No. 10, magnesium stearate, microcrystalline cellulose, povidone, propylene glycol, sorbic acid, sorbitan monooleate, titanium dioxide, and vanillin.
Each yellow oval film-coated BIAXIN XL tablet (clarithromycin extended-release tablets) contains 500 mg of clarithromycin and the following inactive ingredients: cellulosic polymers, D&C Yellow No. 10, lactose monohydrate, magnesium stearate, propylene glycol, sorbic acid, sorbitan monooleate, talc, titanium dioxide, and vanillin.
After constitution, each 5 mL of BIAXIN suspension (clarithromycin for oral suspension, USP) contains 125 mg or 250 mg of clarithromycin. Each bottle of BIAXIN granules contains 1250 mg (50 mL size), 2500 mg (50 and 100 mL sizes) or 5000 mg (100 mL size) of clarithromycin and the following inactive ingredients: carbomer, castor oil, citric acid, hypromellose phthalate, maltodextrin, potassium sorbate, povidone, silicon dioxide, sucrose, xanthan gum, titanium dioxide and fruit punch flavor.

Aromatherapy

Aromatherapy is used to affect the emotions of a person and to relieve physical ailments. Essential oils are thought to relieve stress, improve sluggish circulation, ease pain, reduce swelling, or cleanse the body of impurities. Aromatherapists believe that some essential oils can help relieve viral or bacterial infections, burns, hypertension, respiratory conditions, insomnia, depression and many other illnesses. However, it is wise to always see a doctor for a diagnosis before using aromatherapy, and to keep your doctor informed about all complementary therapies that you use.

The most common ailments where aromatherapy may be used as an adjunct to mainstream medical treatment are:
bladder infections;
bronchitis;
common colds and flu;
migraine and headaches;
depression, stress related conditions, anxiety;
flatulence and digestive problems, such as indigestion;
skin conditions, such as acne and eczema;
insomnia;
laryngitis and tonsillitis;
menopausal symptoms;
muscle strains and sprains;
nausea and motion sickness;
toothache and gum disease; and
yeast and fungal infections.

How are essential oils used?
Essential oils enter the body in 2 ways — by inhalation and through absorption. They can be used in a variety of ways.
Inhalation — by direct inhalation or steam inhalation.
Diffusers and vaporisers — either electrical, burners that use candles or a ceramic ring that is warmed by a light bulb.
Massage — this is the most common form of treatment used by aromatherapists because of its effectiveness.
Baths — these can be scented with chosen oils. Footbaths can also be used for conditions such as chilblains.
Compresses — these can be applied to relieve bruising, skin conditions and muscle and period pain.
Neat — a very few oils can be used by applying them directly to the skin, however, most oils should not be used undiluted on the skin as they can cause irritation.
NEVER take aromatherapy oils internally. They are extremely potent and many can be poisonous.
Popular oils used in aromatherapy practice
Bay laurel — used to help digestive problems and appetite loss, and assist with colds, flu, tonsillitis and other respiratory conditions. It is also used to help treat lice and scabies and is useful with rheumatic pain and to reduce swollen lymph nodes. Do not use if pregnant.
Clary sage — this oil is used to ease anxiety and stress and is helpful with menstrual and menopausal symptoms. Aromatherapists believe it relieves burns and eczema. It should be avoided if pregnant.
Eucalyptus — this oil is thought to reduce fever and fight colds, flu, sinusitis and accompanying coughs. It is used to alleviate the symptoms of bronchitis and is commonly used to help relieve skin conditions such as boils and pimples. It must never be taken internally.
German chamomile — a popular and versatile oil that is used to relieve digestive problems, menstrual and menopausal problems, inflamed or damaged skin, burns, (including sunburn), acne and boils.
Lavender — one of the most popular and well-known of the essential oils, it is used to ease headaches, depression, insomnia and any form of nervous stress and tension. It is also used to relieve muscular aches, sprains and strains and menstrual pain and cramping. It can be used for nausea and is regularly used for skin conditions including cuts, wounds, insect bites and burns.
Peppermint — this well-known oil is used to relieve indigestion, nausea and headache. It can also be used in cases of neuralgia and muscle pain and can help with bronchitis, sinusitis and motion sickness. However, this oil should be used in moderation and should not be used with children under the age of 3.
Rosemary — the essential oil from this popular culinary herb is thought to alleviate indigestion, flatulence and liver problems. It is also used to assist with the symptoms of bronchitis. It is also thought to reduce fluid retention and relieve the symptoms of depression. It should be avoided during pregnancy or in cases of epilepsy or high blood pressure.
Tarragon — again a culinary herb that is an extremely useful essential oil, helping with menstrual and menopausal symptoms, digestive ailments including indigestion, flatulence, hiccups, and anorexia (loss of appetite). It is also used in stress-related conditions and in cases of shock. It should not be used in pregnancy.
Tea tree — a popular Australian essential oil gaining popularity worldwide for respiratory conditions such as colds, flu, tonsillitis, bronchitis and sinusitis. It is also recognised for its healing properties for skin conditions such as abscess, acne and burns. It can also be used to ease the symptoms of vaginal thrush, vaginitis and bladder infections.
Thyme — another culinary herb that is used in aromatherapy practice to assist in the treatment of laryngitis and coughs. It is also thought to alleviate infections affecting the skin and bladder, joint pain, infectious diarrhoea and flatulence. It should be avoided in pregnancy and in cases of high blood pressure.
Ylang-ylang — an exotic essential oil that aromatherapists believe can alleviate acne and other oily skin problems. It may also aid depression, insomnia, impotence and some stress-related conditions. However, it should be used in moderation or it may cause headache or nausea.
Special note of caution
Because the essential oils used in aromatherapy are now freely available from many sources, such as chemists, health food stores and even some supermarkets, and because they are ‘natural’ and come from plants, some people assume that they are all safe. However, many oils can have potentially serious side effects, including neurotoxicity and effects on menstruation, as well as cause skin reactions, allergies, liver damage and induce uterine contractions. Overexposure by inhalation can produce headache and fatigue.
The following are basic guidelines for care when using oils. If in doubt, always contact a trained aromatherapist.
Never ingest essential oils or use them internally unless under the guidance of a trained professional aromatherapist.
Do not use the same oils for weeks without a break as constant use can cause irritation, and toxic constituents can build up in the body.
Before using any oil a patch test should be done. This is done by applying a small amount of diluted oil on a small part of the skin and, 24 hours later, checking to see if there has been any type of allergic reaction.
Don’t use undiluted oils on the skin — there are some exceptions, such as lavender, but these should be administered only under the guidance of a qualified aromatherapist.
Essential oils can have strong properties and may assist some people, but they may cause a negative reaction in others, so care must be taken when using any oils.
Some oils can trigger menstruation and uterine contractions and therefore should not be used by pregnant women. If pregnant, women should always check with a professional aromatherapist before using any essential oils.
People with asthma, epilepsy or high blood pressure should consult a trained aromatherapist before using essential oils.
Care should be taken with some oils if you have hypertension (high blood pressure), epilepsy, highly sensitive skin or allergies. In these cases, always consult a trained aromatherapist.
Some oils can reduce or change the effectiveness of some types of medications and should not be used if undergoing chemotherapy. Always check with a trained aromatherapist.

Photo of Vitamin C (ascrobic acid/E330)

Zyrtec-D ----Treat cold and allegery

ZYRTEC-D® Tablets (cetirizine hydrochloride 5 mg and pseudoephedrine hydrochloride 120 mg) Extended Release Tablets for oral administration contain 5 mg of cetirizine hydrochloride for immediate release and 120 mg of pseudoephedrine hydrochloride for extended release in a bilayer tablet. Tablets also contain as inactive ingredients: colloidal silicon dioxide, croscarmellose sodium, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose.
Cetirizine hydrochloride, one of the two active components of ZYRTEC-D Tablets, is an orally active and selective H1-receptor antagonist. The chemical name is (+/-)- [2-[4-[(4-chlorophenyl)phenylmethyl]-1-piperazinyl] ethoxy] acetic acid, dihydrochloride. Cetirizine hydrochloride is a racemic compound with an empirical formula of C21H25ClN2O3•2HCl. The molecular weight is 461.82. Cetirizine hydrochloride is a white, crystalline powder and is water-soluble.
Pseudoephedrine hydrochloride, the other active ingredient of ZYRTEC-D Tablets, is an adrenergic (vasoconstrictor) agent with the chemical name (1S.2S)-2-methylamino-1-phenyl-1-propanol hydrochloride. The molecular weight is 201.70. The molecular formula is C10H15NO•HCl. Pseudoephedrine hydrochloride occurs as fine, white to off-white crystals or powder, having a faint characteristic odor. It is very soluble in water, freely soluble in alcohol, and sparingly soluble in chloroform.

Cetirizine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.
Pseudoephedrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).
The combination of cetirizine and pseudoephedrine is used to treat cold or allergy symptoms such as nasal and sinus congestion, sneezing, itching, watery eyes, or runny nose.
Cetirizine and pseudoephedrine may also be used for other purposes not listed in this medication guide.

Food reservative: Sodium Benzoate 211 (part 2) Dangerous or NOT?

Sodium benzoate is a kind of salt that may be present naturally in some foods, but is more likely to be chemically produced and added as a preservative to foods. As a preservative, sodium benzoate is added to foods in small amounts only. If too much is added, food may acquire an extremely bitter taste.
The reason sodium benzoate is listed in the ingredients of so many foods is because it is very effective at killing bacteria, fungi and yeast. Most commonly it used as a preservative in high acid content foods, as it only work when the pH balance of foods is less than 3.6. Thus it is effective in most sodas, fruit juice, vinegar as well as in mixed ingredients like salad dressing. It is also used to stop the fermentation process in wines.
Fruits such as apples, cranberries and plums naturally contain sodium benzoate. Cinnamon and cloves also contain small amounts. However, the presence of sodium benzoate in these foods doesn’t necessarily act to preserve them.
You may be able to taste sodium benzoate in the foods to which it has been added - around 75% of people can taste it. These people describe its taste in various ways - bitter or salty, and sometimes even on the sweet side. Many people drink soft drinks regularly, and they are fairly used to tasting this preservative and in the whole think nothing of it.
However, there have been health concerns about the combination of sodium benzoate and vitamin C/ascorbic acid. When these are mixed, they can form the chemical benzene, a carcinogenic. But, alone, sodium benzoate is not thought of as a carcinogen. Apparently, large amounts would have to be ingested in order to have toxic levels in ones body.
Some studies have been carried out on mice, where they were fed sodium benzoate, to no ill avail, and the mice’s life expectancies were not shortened, nor was their health affected in any way.
Benzene on the other hand, has been proven by researchers to have the ability to affect mitochondria in cells - mitochondrial degeneration plays an important part in the aging process, and is referred to as one of the seven primary causes of aging - and cause cell death.
Scientists have called for the US FDA (Food and Drug Administration) to retest the potential dangers of sodium benzoate and citric acid in soft drinks, as tests proving its safety are pretty much outdated. Until then perhaps we should all at least cut down on the amount of soft drinks consumed - especially kids. Personally, I don’t drink soft drinks. I would never, ever allow my daughter to drink these. 2 of my family members have acid burns on their teeth from soft drinks. One has had it on no less than 8 teeth and required fillings (she had alternative white fillings, NOT Amalgam. Related link: Mercury Poisoning Amalgam the Toxic Time Bomb).
What is Benzene?
Benzene is an organic chemical compound, and is also known as benzol. It is a colourless, flammable liquid with a particularly sweet smell. This is a major industrial solvent, used in the production process of oil, synthetic rubber, plastic and many dyes.
Benzene was discovered by the scientist Michael Faraday in 1825. He separated it from oil gas and named it bicarburet of hydrogen. Volcanoes and forest fires produce it naturally. As mentioned before it is a carcinogen, and a major element in cigarette smoke. Until WWII, benzene was made as a by-product from coal production, mainly in the steel industry.
The demand for benzene grew in the 1950‘s, especially within the plastics industry. Because of this manufacturers began making benzene from petroleum. Today, most benzene comes from the petrochemical industry, with only a small amount taken from coal.
The chemical benzene has many uses. In the 19th Century it was used as an aftershave thanks to its sweet smell. Pre-1920s, it was widely used as an industrial solvent, until people became aware of the dangers of its toxicity. It was once widely used as an additive to gasoline, but this eventually halted due to health concerns.
The most common use for benzene is as an additive for other chemicals. It is used to make styrene, which in turn is used to make plastics and polymers. It is also used to help producee nylon.
Benzene is used in small quantities in the manufacturing processes of detergents, pesticides, drugs and explosives.
Being exposed to benzene can lead to serious health issues. High levels of exposure can cause drowsiness, headaches, dizziness, unconsciousness, breathing disorders and nausea. If one would consume food or drink containing benzene, a fast heart rate, being sick and stomach irritation may be the result. Long-term exposure can potentially affect bone marrow and blood production. Very high exposure levels to benzene can ultimately result in death
Research has proven benzene to be a carcinogen (cancer-causing). With exposures from less than 5 years to over 30 years, individuals have developed and died from leukaemia.
A breath or blood test can be done to show whether a person has been exposed to the chemical. However, this must be done shortly after exposure because the chemical disappears quickly from the body. In the USA, the maximum amount of benzene allowed in water is 0.005 milligrams per litre. I say it should be 0 milligrams!

E110: Sunset Yellow (artificial clouring) Children will be more active?

Sunset Yellow FCF is a colourant that may be added to foods. It has E number E110. It is an azo yellow dye useful in fermented foods which must be heat treated.
It may be found in orange squash, orange jelly, marzipan, Swiss roll, apricot jam, citrus marmalade, lemon curd, sweets, hot chocolate mix and packet soups, trifle mix, breadcrumbs and cheese sauce mix and soft drinks. Also the capsules of DayQuil (in high concentrations) and some extra strength Tylenol.
Sunset Yellow FCF is a prohibited food additive in Norway. A study commissioned by the UK's Food Standards Agency found that when used in a mixture of other preservatives, increased levels of hyperactivity in children were observed.
Formal Chemical Name (IUPAC)dissodium (E)-6-hydroxy-5-((4-sulfonatophenyl)diazenyl)naphthalene-2-sulfonate

Diagrams of E110 sunset yellow

Kidney failure treatment, don't worry!!! Treatment 1: Hemodialysis

Purpose
Hemodialysis cleans and filters your blood using a machine to temporarily rid your body of harmful wastes, extra salt, and extra water. Hemodialysis helps control blood pressure and helps your body keep the proper balance of important chemicals such as potassium, sodium, calcium, and bicarbonate.
Dialysis can replace part of the function of your kidneys. Diet, medications, and fluid limits are often needed as well. Your diet, fluids, and the number of medications you need will depend on which treatment you choose.
How Hemodialysis Works
Hemodialysis uses a special filter called a dialyzer that functions as an artificial kidney to clean your blood. The dialyzer is a canister connected to the hemodialysis machine.

Getting Ready
Arteriovenous fistula.Several months before your first hemodialysis treatment, an access to your bloodstream will need to be created. You may need to stay overnight in the hospital, but many patients have their access created on an outpatient basis. This access provides an efficient way for blood to be carried from your body to the dialyzer and back without causing discomfort. The two main types of access are a fistula and a graft.
A surgeon makes a fistula by using your own blood vessels; an artery is connected directly to a vein, usually in your forearm. The increased blood flow makes the vein grow larger and stronger so it can be used for repeated needle insertions. This kind of access is the preferred type. It may take several weeks to be ready for use.
A graft connects an artery to a vein by using a synthetic tube. It doesn’t need to develop as a fistula does, so it can be used sooner after placement. But a graft is more likely to have problems with infection and clotting.
Before dialysis, needles are placed into the access to draw out the blood.
If your kidney disease has progressed quickly, you may not have time to get a permanent vascular access before you start hemodialysis treatments. You may need to use a catheter—a small, soft tube inserted into a vein in your neck, chest, or leg near the groin—as a temporary access. Some people use a catheter for long-term access as well. Catheters that will be needed for more than about 3 weeks are designed to be placed under the skin to increase comfort and reduce complications.

Kiny failure treatment 2 :Peritoneal Dialysis

Purpose
Peritoneal dialysis is another procedure that removes wastes, chemicals, and extra water from your body. This type of dialysis uses the lining of your abdomen, or belly, to filter your blood. This lining is called the peritoneal membrane and acts as the artificial kidney.
How Peritoneal Dialysis Works
A mixture of minerals and sugar dissolved in water, called dialysis solution, travels through a catheter into your belly. The sugar—called dextrose—draws wastes, chemicals, and extra water from the tiny blood vessels in your peritoneal membrane into the dialysis solution. After several hours, the used solution is drained from your abdomen through the tube, taking the wastes from your blood with it. Then your abdomen is refilled with fresh dialysis solution, and the cycle is repeated. The process of draining and refilling is called an exchange.

Getting Ready
Before your first treatment, a surgeon places a catheter into your abdomen or chest. The catheter tends to work better if there is adequate time—usually from 10 days to 2 or 3 weeks—for the insertion site to heal. Planning your dialysis access can improve treatment success. This catheter stays there permanently to help transport the dialysis solution to and from your abdomen.
Types of Peritoneal Dialysis
Three types of peritoneal dialysis are available.
Continuous Ambulatory Peritoneal Dialysis (CAPD)CAPD requires no machine and can be done in any clean, well-lit place. With CAPD, your blood is always being cleaned. The dialysis solution passes from a plastic bag through the catheter and into your abdomen, where it stays for several hours with the catheter sealed. The time period that dialysis solution is in your abdomen is called the dwell time. Next, you drain the dialysis solution into an empty bag for disposal. You then refill your abdomen with fresh dialysis solution so the cleaning process can begin again. With CAPD, the dialysis solution stays in your abdomen for a dwell time of 4 to 6 hours, or more. The process of draining the used dialysis solution and replacing it with fresh solution takes about 30 to 40 minutes. Most people change the dialysis solution at least four times a day and sleep with solution in their abdomens at night. With CAPD, it’s not necessary to wake up and perform dialysis tasks during the night.
Continuous Cycler-assisted Peritoneal Dialysis (CCPD)CCPD uses a machine called a cycler to fill and empty your abdomen three to five times during the night while you sleep. In the morning, you begin one exchange with a dwell time that lasts the entire day. You may do an additional exchange in the middle of the afternoon without the cycler to increase the amount of waste removed and to reduce the amount of fluid left behind in your body.
Combination of CAPD and CCPDIf you weigh more than 175 pounds or if your peritoneum filters wastes slowly, you may need a combination of CAPD and CCPD to get the right dialysis dose. For example, some people use a cycler at night but also perform one exchange during the day. Others do four exchanges during the day and use a minicycler to perform one or more exchanges during the night. You’ll work with your health care team to determine the best schedule for you.
Who Performs Peritoneal Dialysis
Both types of peritoneal dialysis are usually performed by the patient without help from a partner. CAPD is a form of self-treatment that needs no machine. However, with CCPD, you need a machine to drain and refill your abdomen.
Possible Complications
The most common problem with peritoneal dialysis is peritonitis, a serious abdominal infection. This infection can occur if the opening where the catheter enters your body becomes infected or if contamination occurs as the catheter is connected or disconnected from the bags. Infection is less common in presternal catheters, which are placed in the chest. Peritonitis requires antibiotic treatment by your doctor.
To avoid peritonitis, you must be careful to follow procedures exactly and learn to recognize the early signs of peritonitis, which include fever, unusual color or cloudiness of the used fluid, and redness or pain around the catheter. Report these signs to your doctor or nurse immediately so that peritonitis can be treated quickly to avoid additional problems.
Diet for Peritoneal Dialysis
A peritoneal dialysis diet is slightly different from an in-center hemodialysis diet.
You’ll still need to limit salt and liquids, but you may be able to have more of each, compared with in-center hemodialysis.
You must eat more protein.
You may have different restrictions on potassium. You may even need to eat high-potassium foods.
You may need to cut back on the number of calories you eat because there are calories in the dialysis fluid that may cause you to gain weight.
Your doctor and a dietitian who specializes in helping people with kidney failure will be able to help you plan your meals.
Pros and Cons
Each type of peritoneal dialysis has advantages and disadvantages.
Peritoneal Dialysis
CAPD
Pros
+ You can do it alone.
+ You can do it at times you choose as long as you perform the required number of exchanges each day.
+ You can do it in many locations.
+ You don’t need a machine.
+ You won’t have the ups and downs that many patients on hemodialysis feel.
+ You don’t need to travel to a center three times a week.
Cons
- It can disrupt your daily schedule.
- It is a continuous treatment, and all exchanges must be performed 7 days a week.
CCPD
Pros
+ You can do it at night, mainly while you sleep.
+ You are free from performing exchanges during the day.
Cons
- You need a machine.
- Your movement at night is limited by your connection to the cycler

Radiactive treatment is no dangerous!! Thyroid cancer

Radioactive Iodine I-131 (also called Radioiodine I-131) therapy is a treatment for an overactive thyroid, a condition called hyperthyroidism. Hyperthyroidism can be caused by Graves' disease, in which the entire thyroid gland is overactive, or by nodules within the gland which are locally overactive in producing too much thyroid hormone.
Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to diagnose or treat a variety of diseases, including many types of cancers, heart disease and certain other abnormalities within the body.
The thyroid is a gland in the neck that produces two hormones that regulate all aspects of the body's metabolism, the chemical process of converting food into energy. When a thyroid gland is overactive, it produces too much of these hormones, accelerating the metabolism.
You will be able to return home following radioactive iodine treatment, but you should avoid prolonged, close contact with other people for several days, particularly pregnant women and small children. The majority of the radioactive iodine that has not been absorbed leaves the body during the first two days following the treatment, primarily through the urine. Small amounts will also be excreted in saliva, sweat, tears, vaginal secretions, and feces.
If your work or daily activities involve prolonged contact with small children or pregnant women, you will want to wait several days after your treatment to resume these activities. Patients with infants at home should arrange for care to be provided by another person for the first several days after treatment. Your radiologist can be more specific for your given situation, but usually this time period is only two to four days.
Your treatment team will give you a list of other precautions to take following your treatment with I-131. The following guidelines comply with the Nuclear Regulatory Commission:
Use private toilet facilities, if possible, and flush twice after each use.
Bathe daily and wash hands frequently.
Drink a normal amount of fluids.
Use disposable eating utensils or wash your utensils separately from others.
Sleep alone and avoid prolonged intimate contact. Brief periods of close contact, such as handshaking and hugging, are permitted.
Launder your linens, towels, and clothes daily at home, separately. No special cleaning of the washing machine is required between loads.
Do not prepare food for others that requires prolonged handling with bare hands.
If you breast-feed, you must stop.
You should avoid becoming pregnant for about one year after treatment.
You must be sure you are not pregnant before receiving I-131. Many facilities require a pregnancy test within 24 hours prior to giving I-131 in all women of child-bearing age who have not had a surgical procedure to prevent pregnancy.
Patients who need to travel immediately after radioactive iodine treatment are advised to carry a letter of explanation from their physician. Radiation detection devices used at airports and federal buildings may be sensitive to the radiation levels present in patients up to three months following treatment with I-131. Depending on the amount of radioactivity administered during your treatment, your endocrinologist or radiation safety officer may recommend continued precautions for up to several weeks after treatment.
Radioiodine should never be used in a patient who is pregnant. I-131 given during pregnancy can damage the baby's thyroid gland. When given to a nursing mother, radioactive iodine can reach a baby through her breast milk. Most physicians feel that this procedure should not be used in women who are breastfeeding unless they are willing to cease breastfeeding their newborn. Also, pregnancy should be delayed until at least six to 12 months after I-131 treatment, since the treatment exposes the ovaries to radiation.
Women who have not yet reached menopause should fully discuss the use of I-131 with their physician.
Radioactive iodine (I-131) is an isotope created from iodine to emit radiation for medical use. When a small dose of I-131 is swallowed, it is absorbed into the bloodstream in the gastrointestinal (GI) tract and concentrated from the blood by the thyroid gland, where it begins destroying the gland's cells.
Radioactive iodine I-131 may also be used to treat thyroid cancer.

Ucler

Definition of Ulcer
Ulcers are crater-like sores (generally 1/4 inch to 3/4 inch in diameter, but sometimes 1 to 2 inches in diameter) which form in the lining of the stomach (called gastric ulcers), just below the stomach at the beginning of the small intestine in the duodenum (called duodenal ulcers) or less commonly in the esophagus (called esophageal ulcers).
In general, ulcers in the stomach and duodenum are referred to as peptic ulcers.

Description of Ulcer
The stomach is a bag of muscle that crushes and mixes food with the digestive "juices" - hydrochloric acid and pepsin. If the lining of the stomach (or duodenum) is damaged in one place or another, the acid and pepsin go to work on the lining as they would on food, breaking it down as though to digest it.
An ulcer is the result of an imbalance between aggressive and defensive factors. On one hand, too much acid and pepsin can damage the stomach lining and cause ulcers. On the other hand (and more commonly), the damage comes first from some other causes, making the stomach lining susceptible to even an ordinary level of gastric acid.
If a person does not receive treatment for ulcers, it could lead to a bleeding ulcer (the ulcer has eaten into blood vessels and the blood has seeped into the digestive tract), a perforated ulcer (the ulcer has eaten a hole in the wall of the stomach or duodenum and bacteria and partially digested food has spilled into the hole, causing inflammation) or a narrowing and obstruction of the intestinal opening preventing food from leaving the stomach and entering the small intestine.
Causes and Risk Factors of Ulcer
The stomach defends itself from hydrochloric acid and pepsin by creating a mucus coating (that shields stomach tissue), by producing bicarbonate and by circulating blood to the stomach lining to aid in cell renewal and repair. If any of these functions are impaired it can lead to the formation of an ulcer.
The primary cause of ulcers is the bacterium called Helicobacter pylori (H. pylori). H. pylori is a spiral-shaped bacterium found in the stomach. Unlike other bacterium, H. pylori is able to twist through the layer of mucous that protects the stomach cavity and attach to cells on the surface of the stomach wall, where it produces urease, an enzyme that generates ammonia.
Urease generates substances that neutralize the stomach's acid and allows H. pylori to thrive. H. pylori weakens the stomach's defenses by thinning the mucous coating of the stomach, making it more susceptible to the damaging effects of acid and pepsin; inflaming the area; poisoning nearby cells and producing more stomach acid.
Although H. pylori is the primary cause of ulcers, there are other factors that play a role in ulcer development. These factors are the use of nonsteroidal anti-inflammatory drugs (NSAIDs), a person's lifestyle and the stomach's inability to defend itself against digestive fluids, hydrochloric acid and pepsin.
NSAIDs such as aspirin, ibuprofen (Motrin, Advil, Nuprin), naproxen (Naprosyn, Anaprox), or piroxicam (Feldene) interfere with the stomach's ability to produce mucus and bicarbonate (a chemical produced in the stomach that neutralizes and breaks down the hydrochloric acid and pepsin into substances less harmful).
NSAIDs also affect blood flow to the stomach, hinder cell repair and cause the stomach's defense mechanisms to fail.
Lifestyle factors such as smoking, drinking caffeine, consuming alcohol and stress are also associated with ulcers.
Smoking slows the healing of ulcers and makes them likely to recur.
Caffeine stimulates acid secretion in the stomach, thus aggravating the pain of an existing ulcer.
Studies on alcohol consumption and ulcers have been less conclusive, although alcoholic cirrhosis has been linked to an increased risk of ulcers, and heavy drinking has been shown to delay the healing of ulcers.
Although emotional stress is no longer thought to be a cause of ulcers, people with ulcers often report that emotional stress increases ulcer pain. However, physical stress increases the risk of developing gastric ulcers.

Symptoms of Ulcer
There may be no symptoms of ulcers or the individual may experience:
A gnawing or burning pain in the abdomen between the breastbone and the navel. The pain is usually worse a couple of hours after a meal or in the middle of the night when the stomach is empty.
Nausea
Vomiting
Loss of appetite
Loss of weight
Tiredness (a symptom of a bleeding ulcer)
Weakness (a symptom of a bleeding ulcer)
Blood in vomit or stool. When blood is in the stool, it appears tarry or black (symptom of a bleeding ulcer).

Diagnosis of Ulcer
Doctors have a number of options available for diagnosing ulcers, such as performing endoscopic and x-ray examinations, as well as testing for H. pylori. Endoscopy is a diagnostic procedure that gives the doctor a direct view of the upper digestive tract from within the body itself. By means of an instrument called a fiber-optic endoscope, the doctor is able to illuminate and follow the same path that food takes, examining the esophagus, stomach and duodenum from within. Along the way, the doctor will look closely at inflamed, ulcerated or infected areas, as well as growths and malformations.
If the doctor suspects ulcers, an upper GI (gastrointestinal) series (x-rays) of the esophagus, stomach and duodenum will usually be performed. The patient will swallow a chalky liquid that contains barium, which makes the ulcer visible on the x-ray.
The doctor may also order a gastroscopy, in which a flexible tube-shaped device with a special light-conducting properties will be put down the throat to enable the doctor to see the ulcer and obtain tissue samples for microscopic examination to determine if the ulcer is cancerous.
Confirming the presence of H. pylori is important in diagnosing an ulcer because elimination of H. pylori is likely to cure the ulcer. H. pylori can be detected using a blood, breath or tissue test. The blood test uses a blood sample to identify and measure H. pylori antibodies. Approved in 1996, the Meretek UBT Breath Test requires that a person first drink a liquid or swallow a capsule containing a small amount of a protein. The person is then asked to blow through a straw into a balloon. A lab technician checks the exhaled air for evidence of the H. pylori bacteria. If the doctor previously performed an endoscopy, the tissue obtained through that procedure is cultured and watched for growth of H. pylori organisms.

Treatment of Ulcer
Along with reducing stress and modifying lifestyle, doctors treat gastric and duodenal ulcers with several types of medicines, including H2-blockers, proton-pump inhibitors and mucosal protective agents. When treating H. pylori, these medications are used in combination with antibiotics. If medication is ineffective or complications arise, surgery may be required.
Medications
H2-blockers reduce the amount of acid that the stomach makes. These medicines include cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid) and nizatidine (Axid). A single bedtime dose starts healing a duodenal ulcer in four weeks and a gastric ulcer in six to eight weeks.
Proton-pump inhibitors modify the stomach's production of acid by stopping the stomach's acid pump - the final step of acid secretion. The recently approved and now available drug, omeprazole (Prilosec), is 10 times more powerful in suppressing stomach acid production than the H2-blockers, able to promote duodenal ulcer healing in two to four weeks. This potent acid-inhibitor can suppress about 95 percent of stomach acid production. It is especially useful for treating people whose ulcers fail to respond to H2-receptor blockers or other medications and those with Zollinger-Ellison syndrome.
Mucosal protective agents protect the stomach's mucous lining from acid. The prescription medications are sucralfate (Sulcrate or Carafate) and misoprostol (Cytotec). The non-prescription medications are antacids (such as Tums and Rolaids) and bismuth subsalicylate (Pepto-Bismol).
Antibiotics. With the discovery of the link between ulcers and H. pylori peptic ulcers can be treated by a short course of combined high dose antibiotic therapy rather than acid-suppression alone. Without antibacterial therapy, there is a 75 percent chance of the ulcer reoccurring. With antibacterial therapy, there is a 1 percent chance of the ulcer reoccurring. There are two types of combination therapies currenly being used: triple therapy and dual therapy.
Triple therapy involves:
Metronidazole (Flagyl)*, an antibiotic taken four times a day
Tetracycline (Achromycin or Sumycin)**, an antibiotic taken four times a day
Pepto-Bismol taken four times a day
This regimen lasts two weeks. This treatment is 90 percent effective in destroying the H. pylori bacteria and in reducing the risk of reoccurrence. (*doctor may substitute amoxicillin (Amoxil or Trimox); **doctor may substitute clarithromycin (Biaxin))
Dual therapy involves:
Amoxicillin two to four times a day or Biaxin three times a day
Prilosec two times a day
This regimen lasts two weeks. This treatment is 80 percent effective in destroying the H. pylori bacteria and in reducing the risk of reoccurrence.