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The molecular size of the antigen will be important in determining how the immunoreactive material distributes itself in body fluids and tissues purchase generic tadalafil pills. Materials which are immunochemically unstable may be damaged in body fluids or during incubation of the assay discount tadalafil online amex. A variety of protective agents may be tried in an effort to minimize such damage  tadalafil 20 mg cheap. Of particular concern in the area of communicable diseases is the possibility that the antigens may be toxic or associated with toxic or infectious materials. Under these circumstances it may become necessary to take steps to decontaminate samples and assay constituents. For example, methods for detection of specific tuberculoproteins require consideration of the requirement for re moving viable organism from materials to be used as assay standards. An even greater problem is presented by the need to assure that samples which might contain substantial numbers of organisms, such as sputum or culture media, are rendered safe for handling in open laboratories. Our approach to this problem has been to construct assays to measure heat-treated immunoreactive materials [2,3]. Samples may be heat inactivated if antigenic specificity is heat- stable, and if antisera are raised to recognize heat-treated antigen. Since immunogens and standards need not be pure, the méthodologie problems inherent in working with impure material are primarily concerned with the production of adequate labeled antigen. The validity of the assay depends on identical immuno- reactivity of standards and unknowns in their abilities to compete against the binding of labeled antigen and is not dependent on the similarity of the immunoreactivity of labeled antigen to that of standard or unknown. All that is required of the labeled antigen is that it binds to antibody and is specifically displaced by unlabeled antigen. Iodination and Purification of Antigens: The general priniciples of iodination and purification can be reviewed else where . In general, for protein antigens, iodination at neutral or slightly alkaline pH by the chloramine T method is the procedure of choice. Alternatively, the impure material may be labeled and then the desired antigen may be purified from the mixture of labeled materials. First, the desired specific antigen must make up a suf ficient proportion of the total radiolabeled materials. Although it is theoretically possible to work with less pure label, from a prac tical standpoint, at least 50% of the total radioactivity should be capable of binding to antibody so that B/F ratios (bound labeled antigen/free labeled antigen) of 1. Second, the specific activity, or the ratio of radioactiv ity to mass of antigen (e. The concentration of labeled antigen employed should not be much greater than, and preferably should be smaller than, the lowest concentration of unlabeled antigen to be measured. For example, itis unlikely that an antigen concentration of 10 M ( can be detected using a labeled antigen at 10. This is because the error in delivering and counting the labeled antigen may be greater than the 1% increment provided by the unlabeled antigen, and also because a 1% increment in total antigenconcentration will not appreciably alter the B/F ratio. The desired specific activity depends on the sensitivity of the counting system, the volume of incubation mixture to be counted, and the concentration of antigen to be measured. When antigens are found in fluids at concentrations below 200 pg/mL, special attention must be given to the limitations imposed on the labeled antigen. Sensitivity limit ations imposed by labeled antigen of low specific activity can be appreciated by studying the effect of varying the number of counts used in the assay on the total binding of labeled antigen. If, for a given antibody concentration, a reduction in the number of counts per assay tube results in an increase in the B/F and a sharper initial slope for the standard curve, then the labeled antigen can be considered to be limiting because of low specific ^|ivity. The specific activity may be increased by increasing the i/antigen ratio in the iodination mixture and/or by employing a purification procedure which separates components on the basis of charge. Purification of the iodination mixture requires the recovery of the labeled antigen after the removal of damaged antigen and unre acted radioiodide. Damaged peptide antigens frequently adsorb to albumin and a globulins, thereby increasing their molecular size. Rapid purificaiton methods based on the adsorption of the labeled antigens to cellulose and silica granules, or on differences in the molecular size of components are frequently adequate although they generally do not separate labeled from unlabeled antigen. When this is required ion exchange chromatography or electrophoresis may be used to separate the more negatively changed labeled antigen. The standards and unknowns need not be chemically identical, nor do they have to be of identical biologic potencies. The source of standard antigen will depend upon thé biology of the organism and the antigen. It may be a culture medium, a cell wall preparation, an extract of whole cells, or a plasma or other body fluid containing high concentrations of antigen. It is very helpful to have common standard reference preparations available for general use so that assay results can be compared between labo ratories. Standards should be evaluated for immunochemical stability and for adsorption to glass and plastic surfaces. New lots of standard should always be compared with earlier lots to assure continuity of standardization. Occasionally, spontaneous precipitation of antigen-antibody complexes allows direct separation of bound and free labeled antigen by centrifu gation. Many depend upon the adsorption of free antigen to solid phase material such as cellulose, charcoal, silicates, or ion exchange resins. Others depend upon the adsorption or complexing of antibody to solid phase material. Still others depend upon the precipitation of antigen-antibody complexes by salting out techniques, organic solvents, or double antibody precipitation. It is, however, expensive of second antibody and can frequently be replaced by more rapid, less costly methods. Sensitivity, Specificity and Validation of the Assay: Immunochemical reactions are capable of achieveing a high degree of specificity, but cross reactions with closely related antigens are observed frequently. It will therefore be very important in the field of communicable diseases to consider the possibility of cross reactions from antigenically related organisms. In some circum stances, for example among the disease producing mycobacteria, cross reactivity may be beneficial. Nonetheless, careful characterization of assay specificity by examining antigens derived from a wide variety of organisms will always be required. Immunochemical reactions, like all chemical reactions, are in fluenced by the nature and composition of the milieu within which they occur. In addition, the separation of bound and free antigen may be affected by extraneous substances in the incubation mixtures. Non- immunochemical effects can be produced by the introduction of changes in the pH or ionic strength of the incubation mixture, to temper ature effects, to the presence of anticoagulants or preservatives, or to variable damage of the labeled hormone and/or antibody in the incubation of unknowns as compared to standards. In the area of communicable diseases it should be noted that the presence of organisms or their products in assay incubates may result in enzymatic degradation of antigen and/or antibody.
Those students purchase tadalafil 20 mg with amex, who want to receive bonus points have to take at least a one page handwritten lecture note of the lecture in question cheap tadalafil american express. The bonus points can be used only during the end-of-semester examination period buy tadalafil mastercard, cannot be transferred to the next school-year. Students, who manipulate the attendance sheets will be denied signature in this semester. Second year students may also register for medical genomics, they can even take the examination with their valid signature in their lecture book, even if they did not pass last year. Students not having a signature in the lecture book and/or in the Neptun, have to attend classes to earn a signature. Lectures will be held at times and locations given for medical genetics lectures, during week 9 and 12-15. Practical: week 9-10, in a basement computer room of the Educational Center, according to the advertised timetable. Inspection, 5th week: observation, test results, public health laws concerning to Lecture: Examination methods. Wound healing, Requirements Course description: Place of lectures: 3rd Department of Internal Medicine (Augusta). Pfliegler)Rare 4th week: diseases: organizations Hungarian and international Lecture: The role of biochemical laboratory in the approach (J. Pfliegler)Conditions for acceptance: test 3rd week: Lecture: Genetic disorders (É. Travel induced diseases: deep vein thrombosis,jet-lag, motion sickness, travel psychosis 4. Travel related medical problems: environmental hazards, traffic accidents, safety measurements, crime prevention 5. Malariaprevention, different types of malaria, high risk areas, malaria as an emergency 12. Seminar: Problem based evaluation of anemias 9th week: 2nd week: Seminar: Problem based evaluation of tumors of the Seminar: Problem based evaluation of myeloproliferative urinary tract disorders 10th week: 3rd week: Seminar: Problem based evaluation of prostate cancer Seminar: Problem based evaluation of lymphoproliferative disorders I. What a 12th week: seahorse can teach us about mitochondrial function and Practical: Immunosuppression in action. Students will work in small groups (2-3 students/group) and will be asigned a tutor who will supervise their activities and labwork. During the laboratory sessions, the students perform experiments related to the chosen problem and will learn how to collect data, interpret and evaluate results, how to analyze data statistically and how to draw conclusions. In a closing session, the group and the tutor discuss the results and evaluate the project. Diagnosis and treatment of intracranial space 2nd week: occupying lesions (except hematomas). Causes and management of hydrocephalus (obstructive, communicating, congenital, 9th week: acquired). The convincing knowledge of this material and the active participation of each practical lesson are the condition of a successful examination. The six lectures will complete the textbook with new data and stress the importance of the symptomatology and diagnostic possibilities of the more frequent neurosurgical diseases, mainly from practical points of view. These will facilitate the understanding of the textbook and the theses of the examination as well. The task of the practicum is the collection of personal practical experience of the neurosurgical diseases at bedside. No more than two misses of lectures and one miss of seminars and accepted written test exam are needed to get the credit. Requirements Aim of the course is to have the students understand the principle of statistical tests, be able to choose the right methods for answering common questions arisen in medical research, and understand their results. Diagnostics test of female and and abnormal sexual development, normal and abnormal male infertility. Intrauterine contraception (medicated and non-medicated Requirements Reproductive Endocrinology covers the physiology and pathophysiology of the female reproductive system, from puberty through the reproductive ages, until and beyond the menopause. Over the decades, advances of genetics, molecular biology and clinical epidemiology resulted in rapidly growing information and threapeutical possibilities in the fields of gynecologic endocrinology, infertility and menopause. Along with the increasing expectation of the patients, these led to the recognition, that professional prevention and restoration of the female reproductive health requires wide knowledge, which goes beyond the basics of Obstetrics and Gynecology. The aim of the course is to gain detailed knowledge on the physiological basics and clinical practice of wide spectum of disorders in the field of gynecologic endocrinology, infertility and menopause. Throughout ten weeks, on each occasion, lectures are followed with interactive seminars, case presentations. The Seminars and Practical sessions are supporting the learning and understanding of the topics. Aims of the course: To teach the molecular and morphological aspects of clinical neurosciences and to provide a solid basis for the clinical studies and medical practice. To refresh the relevant knowledge acquired at the pre-clinical studies (Anatomy, Physiology, Biochemistry) in a clinico-pathological context. Service delivery in rehabilitation (inpatient, outpatient and community-based 4th week: services) - Zsuzsanna Vekerdy-Nagy M. Basic principles of therapy approaches in psychiatric rehabilitation - János Kollár Ph. D Requirements Course description: The aims of the course are understanding the basic principles of the rehabilitation medicine and a special approach to acute medicine with acknowledging the importance of rehabilitation. Dietary problem handicap, deficiency, disability, participation – the health of people with disabilities concept in different cultures and societies). Lecture: Social aspects of disabilities, characteristic features of groups of people with disabilities, homes of 3rd week: people with disabilities, segregated institutes, Lecture: Communicational problems, basic issues of stigmatization, discrimination, employment, psychology. Target group: foreign and Hungarian students of medicine, students of psychology, pedagogy, social workers, physiotherapists, student of Faculty of Public Health. Announced for students in year: from 3rd year students semester: 1st semester, to 5th year semester: 2nd Coordinator: Janos Kollar, PhD. Signature of Lecture Book Lecture attendance may be followed up by the Department. The lectures of the credit course are listed at the web site of the Department of Physiology (http://phys. Examination At the end of the course a written final assessment will be organized in the form of multiple choice questions. The result of this assessment will determine the verification mark of the credit course using the following conversion table: 0-39. The program is conducted between 3rd and 11th academic weeks of the second semester. Tutor can be any professor of the Department, not only her/his seminar/practical instructor. The applicant should contact the chosen professor and request him/her to undertake the tutorship. Professors of the Department maintain the right to accept or refuse to be the tutor of the applicant. Preconditions for the program: mark three (3) or better in Physiology I, successful closing lab and permission of the Department (arranged by the tutor).
The right jugular vein is usually chosen over the left for blood collection because in many birds it is the larger of the two buy tadalafil 2.5 mg low price. To collect blood from the jugular vein purchase tadalafil with visa, the bird is properly restrained with the head and neck extended (Figure 9 purchase tadalafil 10 mg with visa. Blood collected from a toenail clip a featherless tract of skin (apterium) overlying the may yield abnormal cell distributions and cellular artifacts. Blood is collected into a syringe, and the vein, which lies on the medial side of the tibiotarsus size of needle is governed by the size of the vein. Improper atten- of this method over other methods of blood collection tion to technique and hemostasis can cause a large is that the surrounding leg muscles protect the me- hematoma to form during or following jugular dial metatarsal vein from hematoma formation and, venipuncture. However, jugular venipuncture be- in some species, the leg is more easily restrained comes a skill perfected with practice, and complica- than the wing. Blood can be collected from the occipital venous sinus Venipuncture of the ulnar or wing vein is a common of birds. This technique should be reserved for birds method for obtaining blood from medium to large used in research or for blood collection prior to eutha- birds. A needle is inserted into the vein, which is nasia,6,78 because of the potential for injuring the found crossing the ventral surface of the humero-ra- brainstem. Blood is either method can be safely used for collecting repeated aspirated into a syringe or allowed to drip from the blood samples from birds. The head is held firmly in a flexed blood in this manner reduces but does not eliminate position in a straight line with the cervical vertebrae. A variety of these devices is The occipital venous sinus is just below the skin in available. To collect blood from this sinus, an serum separator) or contain heparin (lithium hepa- evacuated tube with needle and holder is required. The needle is passed through the skin at a 30 to 40° Hematoma formation, which can be severe, is com- angle to the cervical vertebrae on the dorsal midline mon when the ulnar vein is used for blood collection. Following penetration through A needle with an extension tube, such as a butterfly the skin, the evacuated tube is advanced in the catheter,d aids in stabilization during sample collec- holder, allowing penetration of the tube stopper by tion to minimize tearing of the vein. The neck and head are held in extension, and the mid-cervical area is lifted slightly to improve the angle for venipuncture. The vessel is occluded at the thoracic inlet (right) to facilitate distention and blood collection. Note the featherless tract (apterium) overlying the right lateral neck and jugular furrow. When this occurs, blood will rapidly fill the evacu- chambers) and frequently results in staining arti- ated tube. Peripheral blood film can be made either from blood containing no films can also be made using a two-coverglass tech- anticoagulant (especially if blood parasites are sus- nique. Therefore, when a film on a microscope slide rather than on cover- using an anticoagulant, a blood film should be made glasses, making the sample easier to stain. Heparin the two-coverglass or microscope slide-coverglass should be avoided whenever possible for hematologic methods should be considered if the standard two- studies. Heparinized blood contains artifacts such as slide wedge technique creates excessive smudging of clumping of cells (especially leukocytes in counting the cells. These de- scriptions also apply to a great ex- tent to the other commonly used quick stains, which essentially are modifications of the classic Wright’s stain procedure. The hemoglobin concentration is measured spectrophotometrically by using the manual or automated cy- anmethemoglobin method after cen- trifugation removal of free red cell nuclei and membrane debris. The vessel (top) is easy to access on the ventral surface of the and Herrick’s method. Note that the bevel of the needle is up and the brachial vein is being occluded with the thumb. A small gauge needle (bottom) is used to method requires the preparation of a minimize hematoma formation and is threaded into the vessel to decrease “wobble” and methyl violet 2B diluent. The red blood cells are counted using the four corner squares and one central square of the A variety of hematologic stains can be used to evalu- central large primary square of the hemacytometer. Appropriate secondary squares are counted on are preferred6,18,34 (see Chapter 10). The current methods of choice for obtaining a total leukocyte count in birds are the indirect metho d using the eosinophil Unopette brand 5877 system or the direct leukocyte count using Natt and Herrick’s method. This vessel is supported by the soft tissues of the leg and in in the vial provided in the system comparison to other blood collection sites, hematoma formation is rare (courtesy of Kathy Quesenberry). The erythro- A total thrombocyte count can be obtained using the cytes are stained with a vital stain, such as new Natt and Herrick’s method; however, thrombocytes methylene blue stain, and the reticulocytes are iden- tend to clump, making an accurate count difficult to tified as red blood cells that contain distinct rings of achieve. A subjective opinion as to the number of aggregated reticulum encircling the cell nucleus 6,34 thrombocytes present can be made from the peri- (Color 9. An average of one to two thrombo- ing amounts of reticulum, but those with the distinct cytes are present in monolayer oil immersion (100 x) ring of aggregated reticulum surrounding the cell fields in blood films of normal birds. Numbers less nucleus appear to be cells that have recently entered than this suggest a thrombocytopenia and those the peripheral circulation, and thus reflect the cur- greater suggest a thrombocytosis. The free red cell nuclei A more accurate method would be to count the num- appear as amorphous, pink-to-purple material on the ber of thrombocytes per 1000 erythrocytes in the film. The number of thrombocytes per 1000 the location of the cell nucleus within the cell and erythrocytes is multiplied by the erythrocyte count nuclei having indentations, constrictions or protru- and divided by 1000 to obtain an estimated thrombo- sions (Color 9. Ag- estimated thrombocyte count (est T) can be corrected glutination of erythrocytes in the blood film is a rare, using the following formula: abnormal finding. The red cell nuclei vary with age, becoming more condensed and darker staining as the cells age. Avian erythrocytes frequently demonstrate diffuse This formula can be simplified by using the formula: polychromasia. These developmental stages have been de- % heterophils + eosinophils scribed in this chapter with the discussion of the evaluation of hematopoietic tissue. Occasionally, round erythrocytes with oval nuclei may be found, The Natt and Herrick’s method is a direct method for obtaining a especially in anemic birds. The dark-staining leukocytes are counted in the nine large squares of the hemacytometer cham- cytoplasm, probably owing to accelerated erythropoi- ber. The shape of the red blood cell may or simplified to: appear irregular, or smudging may occur as a result of artifacts created by the preparation of the film. As maturation c) Refractile artifact caused by water or air progresses, the nuclear chromatin pattern trapped between the cell membrane and condenses, the cytoplasm becomes less ba- mounting medium or immersion oil. This sophilic and the nuclear and cell shapes artifact is commonly mistaken for a transform from round to elliptical. Ribosomes are e) Intact erythrocyte nucleus following cel- stained and aggregate as particulate mate- rial around the nucleus. As erythrocytes continue a) Thromboblast containing an indistinct to mature or age, the cell and nuclear nucleolus, finely granular chromatin pat- shapes become more elongate, and the chro- tern and basophilic cytoplasm. These cells are observed most com- matin pattern and moderately blue cyto- monly in bone marrow smears but are rare plasm. These cells may assume a variety of with a round-to-oval nucleus, condensed shapes including a unipolar-to-bipolar, chromatin pattern and light-blue vacuo- spindle appearance.
Take Coumadin and products that contain iron buy cheap tadalafil on-line, magnesium purchase tadalafil 5mg on-line, or zinc products at least two hours apart order 2.5mg tadalafil with mastercard. To reduce the likelihood of bleeding and easy bruising with Coumadin, we recommend taking 150 to 300 mg of either grape seed or pine bark extract per day. In double-blind studies both have been shown to be useful in promoting recovery from a stroke. In all cases, citicoline was begun within 24 hours after stroke onset and continued for six weeks. At the three-month check-up, results indicated that citicoline improved by 29% the probability that the patient would recover the ability to participate in activities of daily living and by 42% the probability of recovering functional capacity. Nonetheless, these results are very encouraging, as any improvement over a placebo can have profound real-life benefits. The single largest trial was conducted at 176 centers in Italy and included 2,044 patients. Acupuncture There is some clinical research showing that acupuncture can facilitate recovery from a stroke. Speciﬁcally, acupuncture can often help stroke patients perform self-care better, can mean that patients require less nursing and less rehabilitation therapy, and can possibly cut health care costs. Possible mechanisms of its effects include stimulation of nerve cell regrowth, facilitation of improved nerve cell function, reduction of poststroke inﬂammatory reactions, and prevention of nerve cell death. Given its safety and possible benefits, acupuncture is very much worth the effort. That being the case, appropriate prevention of further strokes involves following the recommendations in the chapter “Heart and Cardiovascular Health. The primary therapeutic goal in the recovery from a stroke is to enhance the blood and oxygen supply to the brain as well as improve nerve cell function. In autoimmune diseases the immune system attacks the body’s cells and tissue, resulting in inﬂammation and tissue damage. There are often times of remission interrupted by periods of illness (called ﬂares). It most often affects women in their childbearing years (ages 15 to 35) and is also more common in women of non-European descent. Speculation and investigation have centered on genetic factors, abnormal bowel permeability, lifestyle, nutritional factors, food allergies, and microorganisms. However, research indicates that this predisposition requires an environmental trigger. Another important way in which a vegetarian diet may be helpful is that is has a higher alkalinity than a meat-based diet. Eight of the 10 patients reported improvements in overall well- being, fatigue, energy, and/or other symptoms. For the group as a whole, there was a signiﬁcant improvement in the physician’s overall assessment of disease activity. However, research indicates that this predisposition requires an environmental trigger. Botanical Medicines Please consult the chapter “Rheumatoid Arthritis” for more information. Symptom relief can also be attained through the use of nutritional supplements, botanical medicines, and physical medicine techniques. However, do not abandon natural measures, because they will actually enhance the effectiveness of the drugs, allowing for lower dosages when drugs are necessary, while providing a foundation for healing by addressing the underlying causative factors and utilizing modalities that are both safe and beneﬁcial in long-term use. Please see the chapter “Rheumatoid Arthritis” for a more complete discussion of our recommended treatments. Diet The ﬁrst step is a therapeutic fast or elimination diet, followed by careful reintroduction of individual foods to detect those that trigger symptoms. Although any food can cause a reaction, the most common are wheat, corn, dairy products, beef, foods in the nightshade family (tomatoes, potatoes, eggplant, peppers), pork, citrus, oats, rye, egg, coffee, peanuts, cane sugar, lamb, and soy. After all allergens have been isolated and eliminated, a vegetarian or Mediterranean- style diet rich in organic whole foods, vegetables, cold-water ﬁsh (mackerel, herring, sardines, and salmon), olive oil, and berries and low in sugar, meat, reﬁned carbohydrates, and animal fats is indicated. Positive results from other tests may indicate that treatment for intestinal permeability, dysbiosis, and environmental toxicity is advisable. Uterine Fibroids • The majority are without symptoms but may be associated with vague feelings of discomfort, pressure, congestion, bloating, and heaviness; can include pain with vaginal sexual activity, urinary frequency, backache, abdominal enlargement, and abnormal bleeding • Abnormal bleeding in 30% of women with fibroids Uterine ﬁbroids are bundles of smooth muscle and connective tissue that can be as small as a pea or as large as a grapefruit. However, because they disrupt the blood vessels and glands in the uterus, they can cause bleeding and loss of other ﬂuids. Uterine ﬁbroids are classiﬁed according to their location, as follows: • Submucosal (just under the lining of the uterus) • Intramural (within the uterine muscle wall) • Subserosal (just inside the outer wall of the uterus) • Interligamentous (in the cervix between the two layers of the broad ligament) • Pedunculated (on a stalk, either submucosal or subserous) Causes Increases in local estrogen (specifically estradiol) concentration within the fibroid itself are thought to play a role in the development and growth of ﬁbroids. Concentrations of estrogen receptors are higher in ﬁbroid tissue than in the surrounding tissue. In addition to an excess of estrogen production within the body, a strong case can be made for the role of the most signiﬁcant environmental factor assaulting female hormonal health—compounds known as xenoestrogens. These compounds are also known as endocrine or hormone disrupters, environmental estrogens, hormonally active agents, estrogenic substances, estrogenic xenobiotics, and bioactive chemicals. Examples of xenoestrogens include phthalates (used in plastics), pesticides, tobacco smoke by-products, and various solvents. Xenoestrogens enhance or block the effects of estrogen in the body by binding to estrogen receptors. They also promote a shift from healthy estrogen breakdown products to cancer-causing estrogen metabolites. Therapeutic Considerations Reducing the size as well as the symptoms of uterine ﬁbroids with natural medicines is easily accomplished in most cases. Unfortunately, this statement is supported more by the clinical experiences of naturopathic physicians than by scientiﬁc evidence, though the approach is scientiﬁcally rational—that is, if uterine ﬁbroids are caused by an excess of estrogen produced in the body as well as the effects of xenoestrogens, it makes sense that reducing estrogenic inﬂuences should shrink uterine ﬁbroids. Keep in mind that as women pass through menopause there is less estrogen and so there will also be a tendency for the fibroid to shrink on its own. Diet The most important dietary recommendations are to eat a high-ﬁber diet rich in phytoestrogens (plant estrogens) and to avoid saturated fat, sugar, and caffeine. These simple changes can dramatically reduce circulating estrogen levels and reduce estrogen’s inﬂuence on the ﬁbroid. One study looked at what happened when women switched from the standard American diet (40% of calories from fat; only 12 g ﬁber per day) to a healthier diet (25% of calories from fat; 40 g ﬁber). That’s a good thing, because when phytoestrogens occupy the receptors, estrogen can’t affect cells. By competing with estrogen, phytoestrogens cause a drop in estrogen effects, and are thus sometimes called antiestrogens. Great sources of phytoestrogens include soy and soy foods, ground ﬂaxseed, and nuts and seeds. These dietary recommendations have extreme signiﬁcance not only in treating uterine ﬁbroids but also in reducing endometrial cancer. Women with uterine ﬁbroids have a fourfold increase in the risk of endometrial cancer. In a case-control study of a multiethnic population (Japanese, white, Native Hawaiian, Filipino, and Chinese) examining the role of dietary soy, ﬁber, and related foods and nutrients in the risk of endometrial cancer, 332 women with endometrial cancer were compared with women in the general multiethnic population, and all women were interviewed by means of a dietary questionnaire.
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