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dopamine (Rx)

Hemodynamic Conditions

Treatment of hypotension, low cardiac output, poor perfusion of vital organs; used to increase mean arterial pressure in septic shock patients who remain hypotensive after adequate volume expansion

1-5 mcg/kg/min IV (low dose): May increase urine output and renal blood flow

5-15 mcg/kg/min IV (medium dose): May increase renal blood flow, cardiac output, heart rate, and cardiac contractitlity

20-50 mcg/kg/min IV (high dose): May increase blood pressure and stimulate vasoconstriction; may not have a beneficial effect in blood pressure; may increase risk of tachyarrhythmias

May increase infusion by 1-4 mcg/kg/min at 10-30 min intervals until optimum response obtained

Titrate to desired response

Dosing Considerations

Strong beta1-adrenergic, alpha-adrenergic, and dopaminergic effects are based on dosing rate

Beta1 effects: 2-10 mcg/kg/min

Alpha effects: 10 mcg/kg/min

Dopaminergic effects: 0.5-2 mcg/kg/min

Black Box Warnings

May cause peripheral ischemia in patients with history of occlusive vascular disease

If ischemia occurs, prevent sloughing and necrosis in ischemic areas by infiltrating areas as soon as possible with 5-10 mg of phentolamine (adrenergic blocking agent) in 10-15 mL of saline solution

Contraindications

Hypersensitivity to dopamine, pheochromocytoma, ventricular fibrillation, uncorrected tachyarrhythmias

Cautions

Use caution in angina pectoris, extravasation, hypovolemia, occlusive vascular disease, ventricular arrhythmias, recent use of monoamine oxidase inhibitors, sensitivity to sulfites

Drug is inactivated by alkali

May cause increases in heart rate

Use with caution after myocardial infarction

Monitor blood pressure closely

Use caution in patients taking MAO inhibitors; prolong hypertension may occur with concurrent use

Pregnancy Lactation

Pregnancy category: C

Lactation: Unknown whether drug is excreted into breast milk; use caution

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Pharmacology

Mechanism of Action

Endogenous catecholamine, acting on both dopaminergic and adrenergic neurons

Low dose stimulates mainly dopaminergic receptors, producing renal and mesenteric vasodilation; higher dose stimulates both beta1-adrenergic and dopaminergic receptors, producing cardiac stimulation and renal vasodilation; large dose stimulates alpha-adrenergic receptors

Absorption

Onset: 5 min (adults)

Duration: 10 min

Distribution

Metabolism

Metabolized in liver, kidney, and plasma by monoamine oxidase and catechol-O-methyl transferase

Metabolites: Norepinephrine (active), inactive metabolites

Elimination

IV Incompatibilities

Solution: Sodium bicarbonate 5%

Additive: Acyclovir, alteplase, amphotericin B, ampicillin, gentamicin(?), metronidazole/sodium bicarbonate, penicillin G potassium

Y-site: Acyclovir, aldesleukin(?), alteplase, amphotericin B cholesteryl sulfate, cefepime, furosemide(?; depends on formulation), heparin (in D5W), indomethacin, insulin, thiopental, TNA #222-223

IV Compatibilities

Solution: Most common solvents (eg, D5W, D10W, dextrose/saline, LR, NS, sodium lactate 1/6M)

Additive (partial list): Aminophylline, calcium gluconate, ciprofloxacin, dobutamine, heparin, hydrocortisone, lidocaine, nitroglycerin, potassium chloride, verapamil

Syringe: Caffeine, doxapram, heparin, ranitidine

Y-site (partial list): Amiodarone, cisatracurium, diltiazem, dobutamine, epinephrine, esmolol, fentanyl, heparin (in NS), hydrocortisone sodium succinate, labetalol, lidocaine, lorazepam, morphine sulfate, nitroglycerin, ondansetron, potassium chloride, propofol, tacrolimus, verapamil, vitamins B and C, warfarin, zidovudine

Not specified: Carbenicillin, tetracycline, iron salts, oxidizing agents, alkaline solutions

IV Preparation

Dilute 200-400 mg in 250-500 mL of compatible diluent (eg, D5W, NS, LR, D5/NS, D5/LR); typical concentration range is 0.8-1.6 mg/mL, though up to 3.2 mg/mL has been used

Drug is stable for 24 hours after dilution

Premixed solution may be administered without dilution

Do not use if solution is darker than slightly yellow; discoloration to brown, pink, or purple indicates decomposition

IV Administration

Infuse via central line; umbilical arterial catheter is not recommended

Administer in large vein (eg, antecubital)

Use infusion pump to control flow rate

Titrate dosage to desired hemodynamic values or optimal urine flow

Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.

Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.

Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.

Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.


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Dr. Stuart Mogul is an internationally recognized best in class foot surgeon specializing in bunions surgery who is in private practice on NYC s Upper East Side. Dr. Mogul has successfully performed over 16,000 foot surgeries. He is particularly sought after as the NYC bunions removal surgeon due to his use of minimally invasive surgical techniques.

  • Dr. Mogul has performed more bunion surgeries than any other bunion surgeon in NYC
  • Diplomate, American Board of Foot Ankle Surgery
  • Fellow, American College of Foot and Ankle Surgeons
  • 25+ years in private practice in NYC
  • Accepts most out of network insurance
  • Awarded United States Patent number 7,182,766 for a surgical device for bunion surgery
  • Published Book: Perfect Feet, Stewart, Tabori and Chang 2002
  • Attending physician at Lenox Hill Hospital,Midtown Surgical Center, The Center for Specialty Care

Please note. A doctor’s referral is NOT necessary from a General Practitioner to see our NYC foot surgeon for a consultation, 2nd opinion, or for treatment at our practice.

Regarding Insurance: We will contact your insurance company and submit your claim for you. You will enjoy the luxury and benefit of academic medicine in a top rated concierge environment without the hassle of long hospital waiting room times and paperwork. Most policies reimburse patients for most of the cost of their foot surgery. Our surgical coordinator will help you with a quote.

By far the best experience in a NYC doctor s office I ve had in 20 years. Friendly, attentive front desk staff, less than 10 minute wait to get in. Dr. Stuart Mogul was very knowledgeable, professional and pleasant. Super beautiful and high tech office. He asked great questions, explained my treatment plan thoroughly. Didn t pressure me to book with him. Offers free consults! Has tons of before and afters that you can look at. I did have my bunions surgery with him – life changer! Surgery and recovery was easy breezy! Highly recommend this place!

Dr. Mogul s Foot Surgery Practice Philosophy is Simple: He provides his patients with the most advanced foot surgery procedures that are minimally invasive, have an easy and short recovery, with results that are beautiful and second to none!

The most common foot surgeries that Dr. Mogul performs include:

Bunion Surgery . Bunions may be corrected by the best in class NYC foot surgeon with conservative treatments or bunion surgery. If the conservative treatment fails to relieve the bunion / bunions pain, then the surgeon may recommend bunionectomy , surgical removal of a bunion. The main goal of the bunion surgery is to remove painful deformities, restore normal bone alignment, and prevent recurrence. View Before After Bunion Surgery Pictures Here

Hammertoe Surgery . Usually when the hammertoe has become rigid and painful, or when an open sore or corn has developed, hammertoe surgery is required. Often patients with hammertoe(s) who have bunions or other foot deformities elect surgical correction at the same time. In selecting the procedure or combination of surgical procedures for your particular case, Dr. Mogul will take into consideration the extent of your foot deformity, the number of toes involved, your age, your activity level, and other factors.

Hallux Rigidus : Surgery for Osteoarthritis of the great toe joint or hallux rigidus is a common surgical procedure performed by Dr. Stuart Mogul. Arthritis at the base of the big toe is known as hallux rigidus . This condition commonly affects professional athletes as a result of repeated trauma or non-athletes or that have a foot structure that predisposes them to developing hallux rigidus. Hallux rigidus may be confused as a bunion, however it is an arthritic condition not a misalignment deformity like a bunion.

Corn Surgery. If Corns are left untreated, they can become very painful and may interrupt the blood supply to the area and cause an ulcer. It is recommended that people with diabetes are regularly screened and treated accordingly to prevent the development of corns that can cause ulcerations. Surgical treatment for this condition is similar to the surgical correction for hammertoes. Surgery to correct soft corns can be performed in the doctor s Upper East Side NYC office or in an outpatient surgery center. A local anesthetic is adequate for corn surgery in most cases.

Neuromas / Morton s Neuroma Surgery. A Morton’s neuroma is in essence an entrapped nerve. Neuromas can cause a multitude of symptoms but typically intermittent forefoot pain and tingling numbness are presented. Surgical excision is described as the most definitive mode of treatment and best practice for symptomatic Morton’s neuroma.

Flat Foot / Flat Feet Surgery. Flat feet can be broadly classified into flexible and rigid in nature. The type of flat foot is determined through clinical testing and surgery may be necessary to correct the deformity. There are a number of surgical procedures available to correct and restore the alignment of the flat foot, including minimally invasive procedures such as the hyprocure extra-articular subtalar joint implants and a multitude of other traditional open tendon and bone re-alignment procedures.

Sports Injuries : The NYC foot surgeon, Dr. Stuart Mogul, has successfully performed foot surgery on professional ballerinas, football players, hockey players, soccer players, skate-boarders, skiers, as well as non-professional athletes (adults and adolescents). Dr. Mogul provides expert diagnosis and management of all musculoskeletal foot injuries for both elite and recreational athletes but also acute and overuse injuries that occur at work or during everyday activities.

Cosmetic Foot Surgery : Dr. Stuart Mogul is the undisputed innovator of cosmetic foot surgery in NYC and now attracts patients worldwide who seek his expertise. The feet are certainly no less deserving of cosmetic attention than any other part of the body. If you are dissatisfied with the appearance of your feet than cosmetic foot surgery may be right for you.

Foot Fractures : There are two types of foot fractures: stress fractures and general bone fractures. Stress fractures occur in the bones of the forefoot extending from the toes to the middle of the foot. Stress fractures are like tiny cracks in the bone surface. Dr. Mogul is the leader in foot fracture surgery in NYC for professional athletes as well as non-athletes (including children and teenagers).

Heel Pain. Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome which occurs when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation, or even a cyst. If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered. Dr. Mogul will discuss the surgical options with you based on your case and determine which approach would be most beneficial for you.

* Surgery is only considered after conservative management such as stretching, orthotics, exercise and shoe modification has been exhausted or deemed inappropriate. If you are uncertain if foot surgery is the best option for you please schedule a 2nd opinion consultation with the top rated NYC foot surgeon, Dr. Stuart Mogul.

Dr. Mogul takes a compassionate approach to each patient and provides them with detailed information about their condition, expected outcomes and all treatment possibilities including non-operative and surgical solutions. He quickly relieves pain, restores function and returns patients to their regular activities as soon as possible. For more than 30+ years, Dr. Mogul has provided customized, comprehensive care to thousands of satisfied patients and families, from professional athletes on the field to employees in the workplace and adolescents. Dr. Mogul uses the latest techniques in minimally invasive surgery for the correction of foot ailments and deformities.

Dr. Mogul is a nationally recognized foot surgeon / podiatrist. He practices free of the limitations mandated by in-network insurance participation and offers extended time, individualized attention and empathetic expertise.

If you have a question about whether or not your foot problem needs surgical treatment, you can schedule a second option consultation with the doctor by filling out the eForm on the right or by phoning his Upper East Side NYC foot surgery practice.

Dr. Mogul performs foot surgery on patients not only from around the New York City area, but from all over the United States and the world; if you are an out of state patient please follow this link for more information: foot surgery patients traveling to NYC .

If you have any questions for the best in class NYC foot surgeon, Dr. Stuart Mogul. or would like to make a foot surgery consultation with the podiatrist please feel free to contact our Upper East Side office:


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Kevzara
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Radicava
Radicava (edaravone) is a free radical scavenger that relieves the effects of oxidative stress, a likely factor in the onset and.

Imfinzi
Imfinzi (durvalumab) is an anti-PD-L1 (programmed death ligand-1) human monoclonal antibody for the treatment of patients with locally.

Drugs in Development

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Tavalisse
Fostamatinib is an investigational oral spleen tyrosine kinase (SYK) inhibitor in development for the treatment of patients with chronic.

DE-109
DE-109 (sirolimus), an mTOR inhibitor, is an investigational first-in-class targeted, immunoregulator in development for the of.

Yuvvexy
Yuvvexy (estradiol) is an investigational bio-identical 17β-estradiol vaginal softgel capsule formulation for the treatment of dyspareunia.

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Posted yesterday in FDA Alerts

ISSUE: Lupin Pharmaceuticals Inc. announced a recall of lot L600518, Exp 05/18 of Mibelas 24 Fe (Norethindrone Acetate and Ethinyl Estradiol 1 mg/0.02 mg chewable and ferrous fumarate 75 mg) Tablets at the consumer level. A confirmed market complaint indicated a packaging error, where the blister was rotated 180 degrees within the wallet, reversing.

Fresh fruits are loaded with fiber, antioxidants and other great nutrients. And studies show that eating fruit whole gives you the most of this food group’s potential benefits, like helping to prevent heart disease, stroke and some types of cancer. While drinking smoothies can be convenient and healthy if they’re not loaded with added sugar, you lose.

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay: Generic ADHD Drugs Approved by FDA The first generic versions of the attention-deficit/hyperactivity disorder (ADHD) drug Strattera (atomoxetine) have been approved by the U.S. Food and Drug Administration. The generic drugs from Apotex Inc. Teva.

Millions of Americans have had to swear off shellfish, eggs, peanuts or soy to avoid allergic reactions that can range from stomach cramps to life-threatening swelling of the airways, new research shows. Approximately 4 percent of Americans have a food allergy, with women and Asians the most affected, the study found. “Recent reports suggest that.

New research confirms that psychiatric patients are at high risk for suicide immediately after being discharged from a mental health care facility, and that risk can remain high for years. “Discharged patients have suicide rates many times that in the general community,” said a team led by Matthew Michael Large of the University of New South Wales.

Preventing bedbugs in multi-unit housing is cheaper and more effective than dealing with the pests after they’ve settled in, a new report says. The authors looked at dozens of field studies on bedbug management. They concluded that “programs that consider the residents, housing managers and staff and attempt to detect infestations before they are reported.

Modern Egyptians have more DNA from sub-Saharan Africa than mummies entombed in their country, according to the first genome data on mummies. The findings are helping researchers gauge the impact of history on Egyptians’ genetics. The international team of researchers analyzed DNA from 151 mummies from the archaeological site of Abusir el-Meleq. The.

Children with autism spectrum disorders probably aren’t throwing more tantrums because of a lack of ability to communicate, new research suggests. Speech and language problems are common in autism. Many children with autism aren’t able to speak clearly. Some can’t speak at all. But in this study, the researchers found that children with autism who.

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The Turkewitz Law Firm

The Turkewitz Law Firm s Cases of Note

  • $7M settlement for woman brain damaged during childbirth, who subsequently died.
  • $3.45M for Brooklyn Medical Malpractice – Brain Damage After Surgery
  • $1,300,000 verdict from structural collapse of metal grate causing broken wrist and badly broken ankle. This premises liability matter was the subject of two trials in federal court (2010 and 2012) and an appeal to the Second Circuit Court of Appeals (2013).
  • $1.87M for Brooklyn medical malpractice victim – nerve injury and stroke following liposuction
  • $2.5M for a breach of partnership agreement in a Manhattan law firm
  • $1.49M in New York medical malpractice case – amputated leg
  • $3.07M structured payment in Brooklyn due to Erb�s Palsy birth injury from medical malpractice, injuring the brachial plexus
  • $1.475M – Bronx Car Accident, Fractured Hip
  • $1.2M. Queens Medical Malpractice, Injury from Surgery
  • $1.295M in Bronx medical malpractice case – failure to diagnose an impending stroke
  • $2.2M structured payment to Queens child due to birth injury
  • $1.015M – New York medical malpractice – surgical drain errantly left knee, infection, multiple surgeries and leg fusion
  • More cases

Admissions to Practice

State of New York

U.S. District Courts:
Southern District of New York
Eastern District of New York

United States Court of Appeals: Second Circuit
Eleventh Circuit

Professional Memberships

American Bar Association

New York State Trial Lawyers Association

American Association for Justice

Eric Turkewitz has tried personal injury cases to verdict in New York, Bronx, Brooklyn, Queens, Staten Island, Nassau, Suffolk, Westchester, Rockland, Dutchess and Albany counties.

If you are looking for a personal injury attorney it’s probably because you’ve been seriously hurt by the negligence of others. On the other side is a person or company, represented by insurance company lawyers, that is resisting the obligation to provide fair compensation for the injuries. Personal injury lawyers seek to level the playing field so that individuals have their cases heard in court on equal footing with those multi-billion dollar corporations.

We believe in personal responsibility. If people or companies injure others through negligence they should be accountable for the losses. That is fair, that is just, and that accountability not only provides for the needs of the injured but also makes our communities safer.

This firm, therefore, is dedicated to helping accident and medical malpractice victims gain fair compensation for their injuries. Eric Turkewitz, the firm’s founder and principal trial attorney, has argued for over 25 years in front of judges and juries for just that purpose. For eight years in a row, 2009-2016, he was selected by Super Lawyers Magazine. as one of the top 5% of personal injury attorneys in New York.

Over the years, we have litigated numerous cases of:

Some of the more interesting cases that were favorably settled or went to verdict are in the Cases of Note section, or in the right sidebar. The summaries are published here for your reference to show the nature of the claims, the nature of the defenses, and the ultimate recovery. Since no two cases will be exactly the same, you should understand that these are mere examples.

Over the years, Mr. Turkewitz has examined hundreds of medical witnesses under oath in New York court proceedings, litigating across a wide spectrum of medical specialties. He has done this both for his own firm as well as for other attorneys that have sought him out.

Mr. Turkewitz also represented victims of the September 11 attack as a member of Trial Lawyers Care. the largest free legal services project in American history.

The cases we accept are often complex and time consuming. Defendants will often do everything possible to slow the legal process. This necessitates being highly selective in deciding which cases to undertake.

Consultations and Access

The firm provides a consultation at no charge. As needed, we speak with witnesses, obtain records, and consult with experts that are specialists with outstanding credentials in their fields, in order to determine if a suit should be brought. The firm generally covers the New York counties of Manhattan, Bronx, Brooklyn, Queens, Staten Island, Nassau, Westchester, Suffolk, Rockland, Putnam, Dutchess, Orange and Albany. For serious cases we will travel elsewhere.

How to Choose a Lawyer

If you are in need of a lawyer and that’s the only logical reason to be on this site here are some things to consider:

The New York Personal Injury Law Blog

The Turkewitz Law Firm also sponsors the New York Personal Injury Law Blog to discuss issues of medical malpractice, personal injury, appellate decisions, cases of interest in the press, and public policy regarding the justice system.

In July 2008, ALM (American Legal Media) publisher of the New York Law Journal. American Lawyer and the National Law Journal among its many publications added the blog to its roster of 30 affiliated blogs at Law.com. Turkewitz’s publication thus became the first personal injury blog in the nation to become affiliated with Law.com.

In November 2008 the American Bar Association Journal. read by half the nation’s one million lawyers, selected the New York Personal Injury Law Blog as one of the nation’s top 100 law blogs. It was the only plaintiff’s oriented personal injury blog in the country to receive this honor. The New York Personal Injury Law Blog was honored again in 2009 as one of the top law 100 blogs, for a third time in 2010. a fourth time in 2011. and a fifth time in 2012. At this point his law blog was inducted into the American Bar Association’s new Blawg Hall of Fame . one of only 10 law blogs in the nation to be so honored.

About This Website

This website is the firm’s electronic brochure, a form of attorney advertising. You only found this site because you looked for us. We do not engage in television, radio, print, mail or spam email-advertising campaigns of any kind. Frankly, we find many of them somewhat offensive. Mr. Turkewitz does, however sponsor his son’s youth baseball team. Because that kind of advertising we like. You can read more about our views on attorney advertising here .

Throughout this site you will see examples of cases we have handled. Since all cases are different, and legal authority may change from year to year, it is important to remember that prior results cannot, and do not, guarantee or predict similar outcomes with respect to any future matter, including yours, in which any lawyer or law firm may be retained.


Comment: The dark side of gay dating sites – PinkNews #dating #sites #reviews


#gay dating sites

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Comment: The dark side of gay dating sites

The internet provides many gay men with their first sexual experiences (Photo: Flickr adikos)

Although gay dating sites provide a useful platform in allowing men to meet each other, Christopher Halton writes for PinkNews of how they can also put some gay men at risk.

On Monday, I was one of 30 or so men to take part in the filming of an advert for Survivors UK, a lottery funded charity set up to support men who have been raped or sexually abused. Fortunately, I have never been a victim myself, and attended the shoot merely as an extra.

Beforehand, I researched the charity and read the testimony of a young man who had met someone he had been chatting to on an internet dating site. It was the first contact he had had with other gay men. Initially the date had gone well, but it ended badly and he was raped.

As a user of gay dating sites, this made me think about the danger inherent in meeting men who I know nothing about, other than what they choose to tell me, which may or may not be true. My experience of meeting men from these sites has been overwhelmingly positive, and I have always prided myself on being a good judge of character. But as the saying goes, pride comes before a fall. In reality, I never really know if the person I am about to meet is a safe bet. It’s a risk I take.

This realisation was further compounded when I recently re-joined Grindr. My love affair with Grindr has always been more of a regrettable fling which invariably ends with me deleting the app from my phone within a couple of days. My latest foray is the last one I will make. If previously, my feelings towards the platform were ambivalent, they have now been crystallised: I actively dislike it.

Grindr has acquired a somewhat iconic status in the gay community and understandably so. It was the first geosocial networking based site and as such, it made the gay-dating game mobile in a way which no other site had achieved before. It allowed men to identify and meet other men wherever they were, and therefore, implicitly at least, it promoted sex-on-the-go for which there is considerable demand.

Personally, the McDonald’s Drive-Thru approach to dating has never been my thing. I’m not aggressive enough, I don’t like engaging in anonymous sex and to be frank, I am too neurotic to clamber up nine flights of stairs to the dingy flat of a man I have never even met before to partake in intimate relations. I always figured that there would be other guys like me on Grindr. And I’m sure there are. I just haven’t met any of them.

What really put me off the whole thing was a message I received within 24 hours of re-activating my account. It is unprintable in its original guise, but the subtext was that this ‘gentleman’ was going to come and find me and then forcibly penetrate me whether I liked it or not. I duly reported him and made the decision that I just didn’t need Grindr in my life. I’m confident it’s one I will stick with.

What this all too common sort of unwanted communication illustrates is that whilst gay dating sites provide a useful platform for meeting men you may never otherwise have had access to, they also further diminish the importance of intimacy in favour of instant sexual gratification. That’s not to say that anonymous sex is inherently wrong, it’s merely an observation I have made, and one which has greater implications for our gay youth than any other demographic.

Sex education in schools is, at best, perfunctory, and for gay kids it’s largely non-existent. For most young gay men, sex education is something that is acquired through exposure to sex itself, via porn, and later with partners who are often more experienced than they are. In many cases, these will be positive experiences, but not always.

When I was younger, more inhibited and less trusting of others, I used to hang around on Gaydar for hours, chatting with men I wasn’t even brave enough to meet. At the time, I used to berate myself quite severely for it, but I may have been doing myself a favour. If any of these men had been abusive or put pressure on me to do things I wasn’t comfortable doing, I could well have found myself going along with them. A decade ago, I just didn’t have the emotional confidence to refuse.

I suspect that while there are a lot of young gay men who are sexually empowered and psychologically well-adjusted, there are also many who suffer from low self-esteem as a result of having grown up gay in homophobic environments. They may also be uneducated in regards to gay sex, isolated and emotionally vulnerable, with the result being that they look for validation in the arms of strangers.

The problem is that by doing so, these young men are making themselves incredibly vulnerable to exploitation, sexual abuse and even rape. They are risking both their physical and mental health, and they are willing to do it because they crave the love, acceptance and security they haven’t found at home, in their communities or within the educational system.

Anyone who has spent time on Grindr or Gaydar will know that it is common to receive sexually aggressive messages accompanied by photographs of the sender in provocative poses, often naked. Sometimes, the only photographic evidence of themselves they wish to send are close-up shots of their penises. It has always baffled me that these men presume that a picture of a disembodied phallus should be enough to warrant me arranging a ‘meeting’ with them. I can’t envisage the same trick working for heterosexual guys on straight sites.

Perhaps I’m uptight and maybe this is all the bait some men need to be lured off to a not-so-glamorous location for some afternoon delight, but the practice makes me uneasy. If sex has been debased to the level where men are willing to submit to each other on the basis of the size and shape of their respective members, then surely this is symptomatic of a larger sexual dysfunction. Whilst sex should be fun and experimentation should be promoted in order that we can all have fulfilling and liberated sexual lives, simply using each other as receptacles for penises totally negates the emotional and psychological aspects of healthy sexuality.

More pertinently, the most vulnerable individuals on these sites, the young, inexperienced men who really need positive sexual role-models are being taught that in order to receive the attention and intimacy they crave, they must allow themselves to be used as sex objects. Unfortunately, many of these young men do just that, and acquire for themselves a sex education which dictates that submission, relinquishment of power and subserviently allowing yourself to be used sexually are the modes by which you can most expediently access affection, however fleeting and ephemeral it may be.

Gay dating sites have revolutionised the way we connect with each other and have provided opportunities for interaction that were impossible before. They have an important place in gay culture and will continue to positively affect the lives of millions of gay men around the world. They also have a responsibility to their users though.

Maybe it’s time for these sites to moderate more comprehensively the types of photos people are allowed to send, especially when the individuals they are sending them to haven’t even asked for them. Maybe it’s time stricter policies were put in place so that men who send abusive and sexually threatening messages can be identified and penalised. It’s hard to police and I understand this, but I think we owe it to our gay youth to make the attempt.

Most of all, we need to ensure that gay youngsters are made sexually aware and that’s a matter for our educational infrastructures. As a society, it is time we provided adequate sex education that includes everyone so that all gay men learn how to respect both themselves and each other.

As with all comment pieces the views expressed do not necessary reflect those of PinkNews.co.uk


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    Types of Refractive Laser Eye Surgery #eye #surgery, #refractive, #laser, #vision, #eyesight, #eye, #lasik, #lasek, #prk, #ak, #alk, #rk, #ltk, #side #effect, #recovery, #insurance, #healing, #complication


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    A Guide to Refractive and Laser Eye Surgery

    Vision correction surgery, also called refractive and laser eye surgery, refers to any surgical procedure used to fix vision problems. Recent years have seen huge advances in this field. Refractive and laser eye surgery allow many patients to see better than any other time in their lives.

    Most types of vision correction surgery reshape your cornea, the clear front part of your eye. That lets light travel through it and focus properly on the back of your eye. or retina. Other procedures replace your eye’s natural lens. Types of surgery include:

    LASIK . or laser in-situ keratomileusis. It works for people who are nearsighted. farsighted. or have astigmatism. The doctor reshapes the tissue underneath your cornea so it can focus light properly. She also makes a flap in the outer layer of the cornea so she can get to the tissue underneath. The flap is what makes LASIK different from other procedures. The doctor may also use a type computer imaging called wavefront technology to create a detailed image of your cornea that she can use as a guide.

    PRK. or photorefractive keratectomy, is used to correct mild to moderate nearsightedness. farsightedness, or astigmatism. Like LASIK. a surgeon uses a laser to reshape your cornea. But it only affects the cornea’s surface, not the tissue underneath. Your doctor may also use computer imaging of the cornea.

    LASEK. or laser epithelial keratomileusis, is a lot like PRK. The doctor creates a flap. She’ll use an alcohol solution to loosen the tissue and a laser to reshape your cornea. After that, she’ll use a soft contact lens to hold the flap in place while your eye heals. It can treat nearsightedness, farsightedness, and astigmatism .

    RLE stands for refractive lens exchange. Other names include PRELEX, clear lens exchange (CLE), clear lens extraction (CLE), and refractive lens replacement (RLR). It’s the same as cataract surgery. The doctor makes a small cut at the edge of your cornea. She removes your natural lens and replaces it with a silicone or plastic lens. It can correct extreme farsightedness or nearsightedness. It works well for people with thin corneas, dry eyes. or other minor cornea problems. A LASIK or LASIK-related procedure can be combined with RLE to correct astigmatism.

    Continued

    Epi-LASEK. The doctor cuts a small flap in your cornea and uses an alcohol solution to help separate a thin layer of tissue from your cornea. She reshapes it with a laser. The area is protected with a soft contact lens that holds the flap in place while it heals.

    Epi-LASIK. The doctor separates a thin layer of tissue from your cornea and reshapes it with a laser. The area is protected with a soft contact lens that holds the flap in place while it heals.

    PRELEX. Short for presbyopic lens exchange, this procedure is used for presbyopia. or loss of flexibility in your eye. The doctor removes your lens and replaces it with a multifocal lens.

    Intacs. also known as intracorneal ring segments, or ICR. The doctor makes a small incision in your cornea and places two crescent-shaped plastic rings at the outer edge. The rings flatten your cornea and change the way light rays focus on your retina. ICR was used to treat nearsightedness, but that has been replaced by laser-based procedures. Now it’s used to fix keratoconus. an irregular-shaped cornea that causes your cornea to thin and results in vision loss .

    Phakic intraocular lens implants are designed for people who are too nearsighted for LASIK and PRK. The doctor makes a small incision at the edge of your cornea and either attaches the implant lens to your iris or inserts it behind your pupil. Unlike RLE, your natural lens stays in place.

    AK or LRI is short for astigmatic keratotomy. It isn’t laser eye surgery, but a surgical procedure used to correct astigmatism. When you have astigmatism, your eye is shaped like a football instead of being round. The doctor makes one or two incisions at the steepest part of your cornea. This helps it relax and makes it more rounded. This procedure can be done alone, or in combination with other laser eye surgeries like PRK, LASIK, or RK.

    RK, or radial keratotomy, was once a common way to correct nearsightedness. However, with the development of more effective laser eye surgeries, such as LASIK and PRK, it’s rarely used today.

    Continued

    Are These Surgeries Safe and Effective?

    Their good results are well-documented, but like any surgery, there can be side effects. It’s important to keep them in mind.

    Infection and delayed healing. A tiny number of people get an infection after PRK or LASIK. It generally means added discomfort and a longer healing process.

    Undercorrection or overcorrection. You won’t know how well the surgery worked until your eye has healed properly. You may still need glasses or contacts. If your vision isn’t great, a second laser surgery, called laser enhancement, can help.

    Worse vision. It’s rare, but some people see worse than before the surgery. Irregular tissue removal or excess corneal haze are the usual culprits.

    Excess corneal haze. This is a part of the natural healing process after some refractive or laser eye surgeries. It usually has no effect on your vision after and can only be seen through an eye exam. Sometimes it can affect your vision. You may need a second procedure. Corneal haze is less common with LASIK than PRK. Also, a medication called mitomycin during PRK surgery can prevent it.

    Regression. Sometimes the effects of surgery go away over a period of months or years. You may need a second surgery to improve your vision.

    Halo effect. This happens in dim light and can make it hard to drive or see in dark places. As your pupil opens, the untreated area outside your cornea produces a second image. It can happen after LASIK or PRK. Your doctor can use laser optical zones or wavefront technology, which creates a 3-D version of your eye so your surgery is more precise, to make it less likely.

    Flap damage or loss. LASIK leaves a hinged flap on the center of your cornea. It may need to be repositioned during the first few days after surgery or after a severe direct injury to your eye.

    WebMD Medical Reference Reviewed by Brian S. Boxer Wachler, MD on December 06, 2016

    Sources

    The University of Iowa: “Other Vision Correction Options.”

    Council for Refractive Surgery Quality Assurance USAeyes.org: “Refractive Lens Exchange (RLE) — Clear Lens Exchange (CLE),” “Glossary of Lasik Laser Eye Surgery Related Terms.”

    American Optometric Association: “Presbyopia.”

    University of Houston College of Optometry: “Presbyopia: Exploring the Final Frontier. “

    University of Texas Southwestern Medical Center: “Ophthalmology — Laser and Surgical Vision Correction — LTK.”

    University of Illinois Millennium Park Eye Center: “CK (Conductive Keratoplasty).”

    The University of Michigan Kellogg Eye Center: “Conductive Keratoplasty (CK),” “Intacs or Intracorneal Ring Segments (ICRS).”

    University of Rochester Medical Center: “Verisyse Phakic Intraocular Lens Implant.”

    Eye Surgery Education Council: “Clear Lens Extraction.”

    University of Florida Department of Ophthalmology: “University of Florida Refractive Surgery Service.”

    American Academy of Ophthalmology: “Alternative Refractive Surgery Procedures.”

    The Cleveland Clinic Cole Eye Institute.

    Ophthalmology Management: “Think PRELEX for Ultimate Patient Satisfaction.”

    American Academy of Ophthalmology: “Surface Ablation: Photorefractive Keratectomy, LASEK, Epi-LASIK, and Epi-LASEK.”

    Stanford Eye Laser Center: “There are clear alternatives to glasses and contacts.”

    © 2016 WebMD, LLC. All rights reserved.


    Side Effects Of Dates by y #dating #gratis


    #date side

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    Side effects of dates are really tough to think for as these dry fruits are full of health benefits. But people who regularly take dates have witnessed certain complications if the fruit is eaten in large quantity. It also becomes prohibited in many health conditions. So, let’s see what are the negative effects associated with eating dates which otherwise is a very healthy item.

    Some Rare Side Effects Of Dates

    Can Increase The Blood Sugar Level

    Dates are rich in sugar content which do not cause harm to healthy persons. But diabetics should not consume dates as it increases the risk of high blood sugar in them.

    Not Good For People On Diet

    People on diet should avoid eating this sweet dry fruit as weight gain is one of the side effects of dates. Though, the sugar present in them is natural and it doesn’t contribute much to the weight but people on weight loss might find it difficult to control weight while having dates.

    Not Advisable During Diarrhea

    If you are suffering from diarrhea, avoid taking dates as the fruits may worsen the condition. It can also trigger vomiting and cause uneasiness.

    Dates are rich source of nutrients including vitamins, minerals, proteins and fibers. All these contribute to the health benefits of eating dates. In addition it is also rich in potassium which if taken in excess can trouble the stomach. If the fruit is eaten in excess amount, all these nutrients can lead to stomach cramps. So, never over eat dates and avoid stomach irritations.

    Drinking a glass of water after eating fresh dates can cause bloating. Though it is one of the rare side effects of dates but one should take necessary precautions.

    Uneasiness In Chest

    Many people have reported uneasiness in chest and lungs after eating fresh dates. This negative effect is the outcome of the coarseness of the dry fruits. So, if you experience such symptoms, take care and contact you health provider if the situation gets out of control.

    Obstruction In Intestines

    In many cases it has been observed that excessive eating of green dates causes obstruction in the intestines. The situation is not worrisome but over eating should be avoided to reduce the risk of such health hazards.

    Scientists have reported certain allergies which are associated with eating dates. So, if you observe any adverse symptoms after eating the fruit, consult your doctor.

    These were some of the side effects of dates which are not worrisome. If taken precautions, one can easily remain protected from these ill effects and enjoy the several health benefits of date fruit.


    How do I list dates evenly on the right side of the page – Microsoft Community #seattle #dating


    #date side

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    How do I list dates evenly on the right side of the page

    I am always confused when I am dealing with margins.

    I think that acheiving some clarity on this issue will help me with other margin issues.

    As I said in an earlier reply I figured out by trial and error that I should set the tab on the right at 7.5.–just as you say But I am not clear at all about why this is the case.

    My question is how do I figure out where to set the tab for different margins?

    Do I subtract my margin from the length of the ruler?

    How long is the ruler in total?

    According to what you are saying the ruler must be 8 in total, if I am setting the margin at 7.5.

    If the length of the ruler is 8 and my margin is 0.5 then that gives me 7.5.

    Supposing that I had a 1 inch margin on all sides.

    Then if I wanted a tab on the right margin I would subtract the 1 inch from the length of the ruler and that would give me a 7.

    So I would set the right tab stop in the dialogue box at 7.

    Is that correct?

    If so then I can figure it out for every case.

    Be the first person to mark this helpful