Place the backs of both of your hands together and hold the wrists in forced flexion for a full minute. (Stop at once if sharp pain occurs) . If this produces numbness or "pins and needles" along the thumb side half of the hand, you most likely have Median nerve entrapment (Carpal Tunnel Syndrome). Examination by a health care professional familiar with these conditions is the way to be sure of the diagnosis and get proper treatment.
The articulation between the hindfoot and the midfoot (midtarsal joint) is frequently referred to as Chopart’s joint
Named after surgeon who performed amputations at the calcaneocuboid, talonavicular joint
The articulation between the midfoot and the forefoot is referred to as the Lisfranc joint.
Named after French surgeon Francois Chopart (1743–1795) who performed amputations of the foot at this level
This type of amputation renders the ankle joint unstable as almost all of the points of insertion of the ankle tendons have been remove
All dislocations of the foot are relatively uncommon with the Lisfranc fracture-dislocation being the most common
Most are due to falls from a height or motor vehicle accidents
Males are more likely to have foot dislocations than females
Chopart Fracture
Chopart fracture-dislocation involves the midtarsal joints (talonavicular and calcaneocuboid joints)
Typically caused by falls from a height, motor vehicle accidents and severe twisting injuries such as can occur in basketball players who land on a plantar-flexed and inverted foot
Usually result from severe trauma
Most commonly, there is medial displacement of the distal fragments (80%)
The foot is displaced inward and upward
But displacement in other directions can occur
Eversion injuries result in lateral dislocations
There are frequently associated fractures of the calcaneus, cuboid and navicular
A small percentage are open
The talus remains in the ankle mortise
Chopart's fracture dislocation. Black arrow points to talus which is dislocated from navicular (yellow arrow) at talonavicular joint. Calcaneus (blue arrow) is dislocated from the cuboid (red arrow), which is also fractured. The dislocation is at the calcaneocuboid joint. This is an uncommon dislocation. The forefoot is usually displaced medially rather than laterally as in this case.
Prognosis
Prompt reduction and early range of motion generally result in favorable outcome
High impact injuries with greater soft tissue compromise and associated fractures worsen prognosis
. Diagram of Chopart's fracture-dislocation from Radiographics.
There are some situations where groceries are tax-deductible.Everyone can claim groceries on their taxes. However, most of the time, the IRS sends a very personal note indicating the deduction was disallowed and requesting more money. There are some situations where groceries could become a legitimate expense. This doesn't mean the IRS will accept it immediately. It simply means you have justification to believe it's legitimate and not a frivolous deduction.
Purpose
One of the biggest factors in deciding whether groceries were deductible is the purpose for the groceries. If it was just to feed your family, don't even think of it. Everyone has to eat, even if it seems your kids have a tapeworm and they eat more food than others, it's still not deductible. Don't think about naming the tapeworm you believe your child has and using it as an exemption, either.
Charity
If you purchased food to donate to a food bank or donated the food to another organization that gives to needy families, you have a good shot at receiving the deduction. Charitable donations are deductible on your itemized deductions. If you do random acts of kindness and simply leave a food basket on the doorstep of a needy neighbor, you can't deduct the groceries. It must go to a qualified tax-exempt organization if you want the IRS to allow it.
Educator Expense
There are many types of work situations in which your groceries could be legitimate deductions. For instance, if you're a schoolteacher and you decide the class needs to make cookies for old people for Christmas, the purchase of the groceries is work-related and not for personal use. Educators don't have to itemize to receive the deduction. On the 2009 tax form, line 23, you could put up to $250 of qualified expenses paid for classroom supplies without itemizing.
Other Jobs
If you threw a lavish dinner party in your home for clients or your staff, you can deduct the cost of the groceries you used for the party. The IRS isn't unreasonable. They don't want an exact count on the number of shrimp each person ate but you have to be accurate in your records. For instance, if you had a client over for dinner and deduct $300 for the groceries, the IRS might just raise an eyebrow and require receipts and more information. If you own the business and file Schedule C, show it as a deduction on that schedule under business entertainment. If you are an employee, use the itemized schedule and list it under miscellaneous expenses.
To contact us Click HERE New research has discovered that oxygen levels are higher at acupuncture points. Using a 25 micron amperometric oxygen microsensor, researchers measured the partial oxygen pressure of the distal left Acupuncture pO2forearm of humans. Oxygen levels were significantly higher at the acupuncture points in the measured region: LU9 (Taiyuan), LU8 (Jingqu), PC7 (Daling), PC6 (Neiguan), HT7 (Shenmen), HT6 (Yinxi), HT5 (Tongli), and HT4 (Lingdao). The researchers note that this correlation provides information on the physiology of acupuncture points. The researchers conducted this human study after a clinical investigation of rabbits measured higher partial oxygen pressure at acupuncture points ST36, ST37, CV16 and CV17 compared with the surrounding regions of the acupoints. The researchers note that their human study uses tiny oxygen sensors and is therefore noninvasive. In addition, they conclude that this research provides “clearer evidence on the strong pO2 (partial oxygen pressure)-acupuncture point correlation….” The researchers note that their investigation may “verify the physical existence of acupuncture points….”
To contact us Click HERE Acupuncture for ProstateResearchers have published clinical strategies for acupuncture in the study and treatment of nonbacterial prostatitis. Professors from the Guangzhou University of Chinese Medicine (Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital) note that chronic nonbacterial prostatitis (CNP) responds to acupuncture treatment as demonstrated in modern research.1 The publication outlines the underlying theory, treatment principles and optimal acupuncture points for the treatment of CNP. The professors note that chronic nonbacterial prostatitis involves Kidney deficiency, damp-heat and Blood stasis. Of note, the Kidney, Bladder, Triple Burner, Liver, Spleen and Lung Zang-Fu organs are important in the treatment of prostatitis. From a channel perspective, the researchers note that the Conception Vessel (Ren Mai), Thoroughfare Vessel (Chong Mai), Governing Vessel (Du Mai), Kidney channel, Bladder channel and Liver channel are closely related to prostatitis. They note several common treatment principles used in the treatment of CNP: eliminate blood stasis, clear heat, expel dampness, soothe Liver Qi, unblock collaterals and meridians. They cite several application methods that have significant clinical efficacy: electroacupuncture, laser acupoint irradiation, warm needling acupuncture, moxibustion, herbal injections. Acupuncture points Guanyuan (CV4), Zhongji (CV3), Qugu (CV2), Ciliao (UB32), Yinlingquan (SP9), Sanyinjiao (SP6), Taichong (LR3), Taixi (KI3), and Zhibian (BL54) are noted as both important and ubiquitous in the treatment of CNP. The professors emphasize the arrival of de qi at the acupuncture points with conduction of sensation to the lower abdomen and perineum as important components of the treatment procedure. Acupuncture points (HT7), Sishenchong (EX-HN1) and Neiguan (PC6) are recommended for the treatment of the psychological side effects associated with CNP.
To contact us Click HERE The very first placebo-controlled, randomized study on the effectiveness of acupuncture for the treatment of chronic obstructive pulmonary disease (COPD) concludes “that acupuncture is a useful adjunctive therapy in reducing” breathlessness in patients with COPD. A decrease in shortness of breath in patients with COPD is directly proportional to increased survival rates indicating that acupuncture prevents mortality associated with COPD. The researchers note that acupuncture improved arterial blood gas, rib cage range of motion, respiratory function (including forced vital capacity) and respiratory muscle strength. The ability to increase exercise capabilities was also greatly increased by acupuncture treatment. Moreover, acupuncture improved the activities of daily living score. In addition, acupuncture significantly improved nutritional levels including BMI (body mass index) and pre-albumin levels, common major nutritional problems for patients with COPD. Acupuncture for COPDA placebo acupuncture group was compared with a real acupuncture group. The placebo group received simulated needling using a Park sham device. The device uses a blunt tipped needle that looks as if it is penetrating the skin but, in reality, telescopes back into the upper part of the needle handle. Both the sham needle and the real needles were 0.35mm X 70mm stainless steel acupuncture needles. The real acupuncture needles were inserted between 5mm to 25mm. Electroacupuncture was not used and manual rotation stimulation was performed at each needle for 3-5 minutes until the de qi sensation was achieved. Total treatment time was 50 minutes for each treatment. Acupuncture treatments were administered once per week for a total of 12 weeks. The acupuncture points chosen for the study were: LU1 (Zhongfu), LU9 (Taiyuan), LI18 (Futu), CV4 (Guanyuan), CV12 (Zhongwan), ST36 (Zusanli), KI3 (Taixi), GB12 (Wangu), UB13 (Feishu), UB20 (Pishu), UB23 (Shenshu). The researchers note, “We demonstrated clinically relevant improvements in DOE (dyspnea on exertion) (Borg scale), nutrition status (including BMI), airflow obstruction, exercise capacity, and health-related quality of life after 3 months of acupuncture treatment.” Points of InterestInterestingly, the researchers did not use Dingchuan (M-BW-1). This modern ‘extra’ acupuncture point is specific for the treatment of dyspnea, wheezing and coughing. Dingchuan is also used for the treatment of urticaria and upper back pain. The researchers chose LU1 (Middle Palace). Located on the lateral aspect of the chest in the first intercostal space, LU1 is the Front Mu point of the Lung and is the Meeting Point of the Lung and Spleen channels. The other Lung channel point used in the study was LU9 (Supreme Abyss). Located at the wrist joint in the depression between the radial artery and the tendon of the abductor pollicis longus, LU9 is the Yuan-Source point of the Lung channel. It is also an Earth point, a Shu-Stream point, and a Hui-Meeting point. LU1 helps the Stomach Qi descend, clears heat, regulates water passages and relieves coughing and wheezing by helping the Lung Qi to descend. LU9 tonifies the Lungs, transforms phlegm, regulates the vessels and relieves pain. LI18 (Support the Prominence) is located on the lateral aspect of the neck, level with the tip of the Adam’s Apple and is between the heads of the SCM (sternocleidomastoid) muscle. LI18 is a Window of Sky point and relieves coughing, wheezing, dysphagia, throat pain and hypotension. CV4 (Gate of Origin) and CV12 (Middle Cavity) are the Front Mu points of the Small Intestines and Stomach respectively. These powerful points tonify Qi as does ST36 (Leg Three Miles). Additional points used in the study were used to benefit Lung function and to harmonize and strengthen the body.
To contact us Click HERE Acupuncture Affects CD4A new acupuncture study reviews the history and research associated with the beneficial effects of scalp acupuncture for the treatment of intracerebral hemorrhage (ICH). The researchers note, “The evidence from clinical studies suggested that SA (scalp acupuncture) therapy may produce significant benefits for patients with acute ICH.” ICH is a potentially life-threatening type of stroke with a higher death rate and higher disability rate than ischemic strokes. Strokes and cerebrovascular disease account for approximately 11 percent of all worldwide deaths annually and is second only to heart disease as a cause of death. The researchers note that studies confirm that scalp acupuncture “has rapid and powerful effects to remove limb paralysis caused either by cerebral infarct or by cerebral haemorrhage in rats.” In human studies, ICH patients showed rapid and beneficial responses to scalp acupuncture and scalp acupuncture increases electrical activity in the brain following ICH. The researchers investigated the mechanisms by which scalp acupuncture prevents pathophysiological responses due to ICH. CT (computerized tomography) shows that acupuncture at GV20 (Baihui) and Taiyang (EX-HN5) improves the “abosorption rate of hematoma.” Research also shows that scalp points GV20 and GB7 (Qubin) reduce “brain edema.” ICH research shows that acupuncture at GV20, GV26 (Shuigou), LI4 (Hegu), and LR3 (Taichong) accelerates “the extenuation of brain edema and diminish(es) cerebral vessel permeability and brain tissue damage.” The research also demonstrates that electroacupuncture from GV20 to Taiyang promotes tissue repair of the blood-brain barrier. Research shows that acupuncture at GV20 and Taiyang benefits immune system function with measurable increases in CD3 and CD4 levels. CD3 is required for T-cell activation, a type of white blood cell important in cell-mediated immunity responses. CD4 is a subtype of T-cell known as a Helper T-cell. The researchers note the ability of scalp acupuncture to prevent deleterious chemical responses in the brain due to ICH. Modern research shows that acupuncture at GV20 and GB7 regulates the expression of brain chemicals including protease-activated receptors (PARs), MMP9 and AQP4. The cellular effects of thrombin are mediated by protease-activated receptors and PARs contribute to pro-inflammatory responses. MMP9 is an enzyme involved in ICH and tissue remodeling. AQP4 is a protein that conducts water through cell membranes and is upregulated by disturbances to the central nervous system. Research also shows that acupuncture at GV20 and GB7 regulates the cascade of endogenous inflammatory chemicals released after a stroke. These acupuncture points prevent inflammation by inhibiting IL-1beta in the brain tissue region of a hematoma. IL-1beta is a pro-inflammatory cytokine, a cell-signaling protein molecule used in intercellular communication. Also, scalp acupuncture causes a rapid decrease of IL-6 (Interleukin-6), another cytokine involved in the inflammatory response. Left unchecked, IL-6’s pro-inflammatory effects are pathological. IL-6 mediates fevers, crosses the blood-brain barrier and is found in high levels in patients with metastatic cancer. The researchers note that acupuncture at GV20 and Taiyang has an “inhibitory effect on the immune-inflammatory reaction mediated by TNF-(alpha) expression….” TNF (Tumor Necrosis Factor) is a cytokine that is involved in various biological functions including septic shock and wasting syndrome. Additionally, acupuncture at GV20 and GB7 “promoted heat shock protein 70 (HSP70) mRNA expression in brain tissue….” HSP70’s help cells fold proteins and have the ability to protect cells from stress. Other scalp acupuncture research shows “improved mitochondrial energy metabolism in (the) brain….” Neuro-electrophysiology scalp acupuncture studies show that that acupuncture at GV20 and Taiyang improves “coordination and compensation functions among cortical functional areas” in ICH patients. Scalp acupuncture has also been shown to beneficially affect the electrical activity of pain-reaction neurons. Also noted, GV20 and GB7 promote the expression of glial cell neurotrophic factor (GDNF). GDNF is a protein that promotes the survival of neurons. Moreover, the researchers note even more biochemical, bioelectrical and biophysiological benefits of scalp acupuncture on brain tissue related to ICH. History of Scalp Acupuncture The researchers give an interesting historical account of scalp acupuncture. First recorded in 5 BCE, Bian Que successfully revived the crowned prince of Guo from a near lifeless state using scalp acupuncture. The Huangdi Neijing (Yellow Emperor’s Internal Classic) notes that the head is the: meeting of all Yang meridians, house of the original spirit, convergence between Qi and Blood. Head acupuncture points regulate: Yin and Yang, Qi and Blood, Zang-Fu Organs. The Huangdi Neijing also notes that the brain is the: sea of marrow, master of Zang-fu organs, master of channel function. Scalp acupuncture continued to develop over the years including extensive writings in the Jin Dynasty work, the Zhenjiujiayijing (A-B Classic of Acupuncture and Moxibustion). Modern History In the 1970s, scalp acupuncture combined with biomedicine using neuroanatomy, neurophysiology and bioholographic principles. Luminaries such as Jiao Shunfa, Fang Yunpeng, Zhu Longyu, Zhang Mingjiu, Tang Songyan, Dr. Toshikatsu Yamamoto and Lin Xuejian contributed to the early development of this integrated form of scalp acupuncture. Prof. Mingqing Zhu began developing what is now a highly regarded system of scalp acupuncture in the 1970s and published his successes in journals and books. Prof. Mingqing Zhu developed a zone system of scalp acupuncture and incorporated advanced needling techniques into this system. He brought the system to the United States and opened scalp acupuncture centers in Santa Cruz, San Jose and San Francisco, California. Today, many practitioners use at least one of eight different styles of scalp acupuncture in clinical practice.
Acupuncture pO2forearm of humans. Oxygen levels were significantly higher at the acupuncture points in the measured region: LU9 (Taiyuan), LU8 (Jingqu), PC7 (Daling), PC6 (Neiguan), HT7 (Shenmen), HT6 (Yinxi), HT5 (Tongli), and HT4 (Lingdao). The researchers note that this correlation provides information on the physiology of acupuncture points.
Acupuncture for ProstateResearchers have published clinical strategies for acupuncture in the study and treatment of nonbacterial prostatitis. Professors from the Guangzhou University of Chinese Medicine (Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital) note that chronic nonbacterial prostatitis (CNP) responds to acupuncture treatment as demonstrated in modern research.1 The publication outlines the underlying theory, treatment principles and optimal acupuncture points for the treatment of CNP.
Acupuncture for COPDA placebo acupuncture group was compared with a real acupuncture group. The placebo group received simulated needling using a Park sham device. The device uses a blunt tipped needle that looks as if it is penetrating the skin but, in reality, telescopes back into the upper part of the needle handle. Both the sham needle and the real needles were 0.35mm X 70mm stainless steel acupuncture needles. The real acupuncture needles were inserted between 5mm to 25mm. Electroacupuncture was not used and manual rotation stimulation was performed at each needle for 3-5 minutes until the de qi sensation was achieved. Total treatment time was 50 minutes for each treatment. Acupuncture treatments were administered once per week for a total of 12 weeks. The acupuncture points chosen for the study were: LU1 (Zhongfu), LU9 (Taiyuan), LI18 (Futu), CV4 (Guanyuan), CV12 (Zhongwan), ST36 (Zusanli), KI3 (Taixi), GB12 (Wangu), UB13 (Feishu), UB20 (Pishu), UB23 (Shenshu). The researchers note, “We demonstrated clinically relevant improvements in DOE (dyspnea on exertion) (Borg scale), nutrition status (including BMI), airflow obstruction, exercise capacity, and health-related quality of life after 3 months of acupuncture treatment.”
Acupuncture Affects CD4A new acupuncture study reviews the history and research associated with the beneficial effects of scalp acupuncture for the treatment of intracerebral hemorrhage (ICH). The researchers note, “The evidence from clinical studies suggested that SA (scalp acupuncture) therapy may produce significant benefits for patients with acute ICH.” ICH is a potentially life-threatening type of stroke with a higher death rate and higher disability rate than ischemic strokes. Strokes and cerebrovascular disease account for approximately 11 percent of all worldwide deaths annually and is second only to heart disease as a cause of death. The researchers note that studies confirm that scalp acupuncture “has rapid and powerful effects to remove limb paralysis caused either by cerebral infarct or by cerebral haemorrhage in rats.” In human studies, ICH patients showed rapid and beneficial responses to scalp acupuncture and scalp acupuncture increases electrical activity in the brain following ICH.