Schizophrenic

Human Body Trivia

2009-06-08T01:32:00.000-07:00

•	On average women blink nearly twice as much as men.
•	On average a baby's heart will beat about 60 million times before it is born.
•	It has been estimated that 17% of human beings are left handed which is roughly the same figure as for gorillas and chimpanzees.
•	If you are right handed you tend to chew on the right hand side of your mouth and if you are left handed you tend to chew on the left hand side of your mouth.
•	Two out of five American women dye their hair.
•	The average adult falls asleep seven minutes after turning the light off.
•	The average human being will accidentally eat about a pound in weight of insects over the course of a lifetime.
•	Right handed people, on average, live nine years longer than left handed people!
•	In England the chance of a woman having twins has doubled since World War II. At this rate every pregnancy will result in twins by the year 2060!
•	On average 15% of people secretly chew their toenails.
•	If a man farted non-stop for six years and nine months and then lit it he would produce an explosion equal to the power of the first atomic bomb!

Sexy Trivia

2009-06-08T01:28:00.000-07:00

•	When reading horizontally from Shakespeare's original published copy of Hamlet, the furthest left hand side reads 'I am a homosexual' in the last 14 lines of the book. Was this a message, or just a coincidence?
•	Over 50% of all people fantasize more often about money than sex, so technically, Bill Gates is the hearthrob of the world.
•	According to the World Health Organization, there are approximately 100 million acts of sexual intercourse each day.
•	Every year, 11,000 Americans injure themselves while trying out bizarre sexual positions.
•	More than half the American men surveyed in a recent poll admit to having sex with women they disliked. It didn't say how many were referring to their wives ;o)
•	A female orgasm is a powerfull painkiller (because of the release of endorfines), so headaches are in fact a bad excuse not to have sex.
•	In a recent interview with 10 prominent sex therapists, the question was posed, 'What is the most important aspect in love making?' One said 'relaxation', Three said 'honesty', and a whopping Six out of Ten said 'staying awake'.
•	Although Hitler did condemn homosexual acts, he only condemned them between men. Lesbians were not condemned at all. They were rarely (if any at all) sent to concentration camps, because it was not in the laws written by Hitler to condemn women loving other women.
•	Lip stick was said to have been invented in the Eygptian times for women that specialized in oral sex. They wanted their lips to look more inviting.
•	Dolphins and humans are the only known animals that have sex for pleasure.

What Are Clouds Made Of?

2009-05-31T08:52:00.000-07:00

Clouds are collections of water droplets or tiny crystals of ice floating in the air high above ground level. They form when warm air containing moisture moves up into the sky and begins to cool.

Clouds are not all alike. Some are fluffy and white, while others form gray or black coverings over the earth. Clouds float at different heights, have different temperatures, and are made up of varying amounts of water, dust, and ice.

Weather experts, or meteorologists, have named clouds according to their appearance.

Stratus clouds, from the Latin word stratum (sheetlike or layerlike), appear as layers or sheets above the earth.

Cumulus clouds, from the Latin cummulus (pile or heap), are fluffy piles or heaps of clouds.

Cirrus clouds, from the Latin cirrus (curl), are curly white clouds.

Nimbus clouds, from the Latin nimbus (rainstorm), are gray rain clouds.

Cumulonimbus clouds, a combination of cumulus and nimbus clouds, have often reached 60,000 feet in height!

Where is the Hottest Place on Earth?

2009-05-31T08:40:00.000-07:00

Do you think it's hot where you are? Not even close.

The Hottest Place on Earth ever recorded was El Azizia in Libya where the temperature reached a scorching 136 degrees Fahrenheit (57.8 Celsius) on Sept. 13, 1922 -- the hottest ever measured.

Who Has The Shortest Alphabet In The World?

2009-05-31T08:32:00.000-07:00

Bougainville is the largest island in the Solomons, a group of South Pacific islands North East of Australia.

Some of the island natives use an alphabet of only 11 letters, the shortest alphabet on earth.

This alphabet includes the same five vowels as our alphabet: a, e, i, o, and ii. But there are only six consonants in the Bougainville alphabet: b, g, k, p, r, and t.

Think how easy spelling would be with an alphabet of only 11 letters!

Cockroach Facts

2009-05-02T20:38:00.000-07:00

Scientists have actually performed brain surgery on cockroaches.

German cockroaches can survive for up to one month without food and two weeks without water.

A cockroach can change directions up to 25 times in a second.

If a cockroach breaks a leg it can grow another one.

The earliest fossil cockroach is about 280 million years old – 80 million years older than the first dinosaurs!

Cockroach can live up to nine days without its head.

Why Schizophrenic?

2009-04-25T20:41:00.000-07:00

A lot of people ask me. why schizophrenic is the title of my blog? well its very challenging question..:) As we all know that Schizophrenia is a mental disorder, and some people wondering that maybe I have this kind of disorder. All I can say is that I am mentally healthy.. and I just like the word Schizophrenia..hehehe.. It's a very weird and unique word for me.. I encountered a lot of patients who have this disorder and most of them are just because of genetics and depression. I want to share with you just a little description of Schizophrenia hope you will find this helpful..:)

Schizophrenia is a brain disorder that affects the way a person acts, thinks, and sees the world. People with schizophrenia have an altered perception of reality, often a significant loss of contact with reality. They may see or hear things that don’t exist, speak in strange or confusing ways, believe that others are trying to harm them, or feel like they’re being constantly watched. With such a blurred line between the real and the imaginary, schizophrenia makes it difficult—even frightening—to negotiate the activities of daily life. In response, people with schizophrenia may withdraw from the outside world or act out in confusion and fear.

Most cases of schizophrenia appear in the late teens or early adulthood. For men, the average age of onset is 25. For women, typical onset is around the age of 30. However, schizophrenia can appear for the first time in middle age or even later. In rare cases, schizophrenia can even affect young children and adolescents, although the symptoms are slightly different. In general, the earlier schizophrenia develops, the more severe it is. Schizophrenia also tends to be more severe in men than in women.

Although schizophrenia is a chronic disorder, there is help available. With support, medication, and therapy, many people with schizophrenia are able to function independently and live satisfying lives. However, the outlook is best when schizophrenia is diagnosed and treated right away. If you spot the signs and symptoms of schizophrenia and seek help without delay, you or your loved one can take advantage of the many treatments available and improve the chances of recovery.

Tips for Reducing Stress

2009-04-23T02:16:00.000-07:00

If you are one of the millions of stressed-out Americans, there's good news. People can learn to manage stress. Start with these stress management tips:

Keep a positive attitude.
Accept that there are events that you cannot control.
Be assertive instead of aggressive. "Assert" your feelings, opinions, or beliefs instead of becoming angry, defensive, or passive.
Learn and practice relaxation techniques.
Exercise regularly. Your body can fight stress better when it is fit.
Eat healthy, well-balanced meals.
Get enough rest and sleep. Your body needs time to recover from stressful events.
Don't rely on alcohol or drugs to reduce stress.
Seek out social support.
Learn to manage your time more effectively.

Drinking Facts: Women and Alcohol

2009-04-22T19:34:00.000-07:00

Women absorb alcohol into the bloodstream faster and metabolize it slower than men.

Women who drink regularly are at significantly greater risk for liver damage than men even if they drink less or drink for a shorter period of time.

Women develop alcoholic liver disease after a comparatively shorter period of heavy drinking and at a lower level of daily drinking than men.²⁸

Proportionately more alcoholic women die from cirrhosis than do alcoholic men.²⁷

The odds of women experiencing sexual aggression were nine times higher on heavy days of alcohol consumption compared with days of no alcohol consumption.¹

There is a greater incidence of alcohol misuse in women with eating disorders, especially bulimia, than in the general population.²

Girls who start dieting in sixth grade are more likely to engage in alcohol misuse later in life.²

A growing body of literature shows that substance abuse among women and the issues surrounding their abuse differ from that among men.³

I MISS YOU

2009-04-22T17:52:00.000-07:00

I want to share these persons and days of my life that I really miss so much...:)

I miss my boyfriend. we are distance apart for now because he had to work abroad for his future. He is so kind to me. This is for him. ""Distance never separates two hearts that really care, for our memories span the miles and in seconds we are there. But whenever I start feeling sad, because I miss you, I remind myself how lucky I am to have someone so special to miss.""

I miss my UNIKADAS, which means unique barkada. We are friends since higschool, and I really enjoy be withnthis group. I miss hanging out with them, because we don't have so much time to see each other for now..Hope to see you soon guys..miss you..:)

These are my cool goupmates during college days in UM (BSN), I miss them too because we have a lot of memories together... I miss laughing with them.. Wishing you all the best guys!! we made it guys. Congrats RN.

These are my co-trainees and our staff nurses in Davao regional Hospital (Medical Intensive Care Unit). This was last August 2, 2008.. I miss you guys!!

When i was a trainee in Tagum, I had this friend and he is one of the resident Dr. He is a really good friend and adviser.. The girl is my co-trainee, she is cool to be with abd a lot of people sad we have a lot of similarities. I really miss hanging out with them.. I miss Tagum City.

"No distance of place or lapse of time can lessen the friendship of those who are thoroughly persuaded of each other's worth"

Hangover Prevention Tips

2009-04-21T05:05:00.001-07:00

How to Avoid Hangovers from Drinking too Much Alcohol
© Sharon Kirby

It is possible to avoid a hangover caused by excessive alcohol consumption, yet still manage to enjoy a few drinks. Here are some hangover prevention tips.

Wondering how to prevent a hangover from drinking too much alcohol? Extreme thirst, throbbing headaches, tiredness, nausea, vomiting, anxiety, irritability, shakiness, and sensitivity to light and sound are all symptoms of a hangover from overindulging in alcoholic beverages. There are however, some hangover prevention strategies that can be employed to reduce the unpleasant consequences of a night on the booze.

Don't Drink Alcohol on an Empty Stomach
Do not drink alcohol on an empty stomach. Before drinking alcohol, eat a substantial meal, along with a glass of milk to line the stomach and slow down the passage of alcohol into the system. In this instance eating a meal high in fat will be beneficial, because it will slow down the rate of alcohol absorption, delay the feeling of being drunk, and help to prevent irritation of the stomach lining. Eating little and often while drinking alcohol has the same effect.

Don't Mix Alcoholic Drinks, this Makes a Hangover Worse
Mixing different types of alcoholic drinks is a major cause of hangovers. Different drinks contain different chemicals, which when combined, can exacerbate the effects of a hangover because the body has a wider variety of substances to deal with.

Congeners are by-products formed during the fermentation and aging process of dark-coloured alcoholic drinks, such as red wine, brandy, whiskey, dark rum and port, and are thought to make hangovers worse. Drink white wine instead of red, or clear spirits instead of coloured, such as vodka, gin or white rum to help prevent a hangover.

Drink Plenty of Water to Prevent Dehydration
Drinking water in between alcoholic drinks, and before bed, can help prevent a hangover. Alcohol is a diuretic and causes dehydration, which manifests itself as the splitting headache and horrendous thirst with which most people who have experienced a hangover are familiar.

Dehydration leads to an excessive loss of electrolytes and low blood sugar levels. Drinking an isotonic sports drink and eating a simple piece of toast after a drinking session may help to address these imbalances and reduce hangover symptoms in the morning. Don’t drink coffee before bed, it can worsen the effects of dehydration and affect sleep quality.

Drink Less Alcohol to Avoid a Hangover
A hangover can be avoided by limiting the amount of alcohol that is drunk. This is stating the obvious, but there are several ways of limiting alcohol intake while still having a few drinks. Try alternating alcoholic drinks with non-alcoholic ones (such as water or orange juice). If drinking wine, have white wine spritzers. Skip out drinks rounds if necessary.

It is important that people know their individual limits before they start drinking, and that they keep to them - one alcoholic drink per hour is a good rule of thumb.

Get a Good Night's Sleep
One of the symptoms of a hangover is feeling overly tired. Although it may be easy to fall asleep quickly after a few drinks, alcohol disrupts normal sleeping patterns, leading to lethargy and sluggishness. Try to ensure a long, undisturbed night's sleep, and avoid getting up early the next day.

In addition to this, don't go to sleep immediately after finishing drinking. By staying awake and sobering up a bit first, the body's metabolism (which slows down during sleep) will be active enough to get rid of some of the alcohol, and this will help to take the edge off any hangover that is looming.

Implementing one or more of these hangover prevention tips should help to minimize the unpleasant symptoms of drinking too much alcohol.

Read more: http://beercocktailsspirits.suite101.com/article.cfm/hangover_prevention#ixzz0DJSxLMVl&B

FANTASIES AND BEHAVIOUR OF THE ADOPTED CHILD by Marshall D.Schechter. M.D., Beverly Hills California

2009-04-18T22:15:00.000-07:00

In a series of cases seen by him the percentage of adopted children was 13.3 as compared with the national average of 0.134. This indicates a hundredfold increase of patients in this category compared with what could be expected in the general population.

Toussieng (April 1958) of the out patients and admissions service said that one third of all patients coming to the Menninger out patient clinic were adopted.

Schechter, goes on to say. The striking thing in most cases was that the feature of their adoptive status played a significant role in the underlying dynamics of the problem.

He observed in many of his case studies on adopted children symptoms relating to such things as fantasies and "acting out" regarding the real parents, i.e. their appearance, their names and killing and murder especially toward their real mother.

Observations also included outbursts toward the adoptive parents telling them they would not do as the parents say because they were not their real parents. He also goes on to say that adopted children suffer symptoms of depression, feelings of incompleteness, phobic fear of abandonment, anxiety, aloofness and distancing of them selves which made close relationships impossible.

Schechter also noted hyperactivity and unmanageability in children of a young age. He also observed,
particularly with one child, that it had relationships of the same quality with strangers as his parents, namely, superficial and dominated by a driving need to have his impulses satisfied immediately. The child could easily be comforted by a stranger as easily as by his mother.

In the behaviour of young adopted girls Schechter observed instances of such things as sex-play, exhibitionism, seductiveness and regression.

He also noted in cases of adopted boys, problems of lying, stealing, and lack of integration with others.

Schechter's observations of the adoptive parents were that often the adoptive mothers had intense feelings of inadequacy regarding their womanly functions that contributed to an over protectiveness to the children. These feelings also served as a constant reminder of her barrenness, stimulating her need to tell the story of "the chosen one".

Prior to adoption, some of these people had recognized emotional problems within themselves. Some had thought of the children as potential saviours of their marriage. Some felt that a child was essential to prove their masculinity.

Toussieng. (1958) commenting on the repetition of the story of adoption and of how "we picked you" suggests that the real parents did not want him and therefore were bad parents. Therefore, though the parents stress the wanting aspect they at the same time play the "abandonment theme".

The belief of "I'm no good: because my parents gave me away because I was no good and I am going to prove them right" is not uncommon in adoptive children.

In his comments Schechter reports we could see how the idea of adoption had woven itself into the framework of the childs personality configuration. It played a role in symptom formation and object relationships. It certainly had an effect in later development, giving the stamp of antisocial behaviour and that of a paranoidal system.

He summarises by stating " The patients in this paper do not have a fantasy about being adopted, they were adopted. Their daydream, which cannot be combated by denial, is the connection with their real parents. Who were they? What were they? Why did they give me up? Do I have any living relatives? What was my name, etc?

Clothier. (April;1943) states. A deep identification with our fore-bears as experienced originally in the mother-child relationship, gives us our most fundamental security. . . Every adopted child at some point in his development has been deprived of his primitive relationship with his mother. This trauma and the removal of the individual from his racial antecedent lie at the core of what is peculiar to the psychology of the adopted child.

Toussieng (1958) states; the adolescence of the adopted child seems to be a particularly difficult one because it is harder for adoptive adolescents to accept their rebellion against the adoptive parents, to give them up as love objects. Furthermore, I have now seen a number of cases in which children in adolescence start roaming around almost aimlessly, though some times they are seeking someone or some thing. They seem to be seeking the fantasised "good real parents".

Benedek (1938) presents an important concept regarding the development of confidence based on
mother-child relationship. This is the area so sensitive in these adopted children and which can be found to under-lie so many of their disturbances.

Monalisa.."see the difference"

2009-04-18T21:54:00.001-07:00

what can u say? add your comment here..

Scared Monkey

2009-04-14T21:50:00.000-07:00

Butterfly and Moths Facts

2009-04-13T21:32:00.000-07:00

Butterflies get their name from the yellow brimstone butterfly of Europe that is first seen in the early spring or "butter" season.

Female Queen Alexandra butterflies, from Papua and New Guinea, are the largest in the world, some with wingspans larger than 26 cm.

Butterflies and moths are found on all land masses except Antarctica.

The atlas moth, one of the largest silk moths, can be mistaken for a medium-sized bat when flying.

There are over 2,000 species of butterflies in the rainforests of South America.

Butterflies belong to, alongside with moths to an order called Lepidoptera.

The fastest flying butterfly is the Monarch, which has been clocked with a speed as high as 17 miles per hour.

Butterflies are further divided into 30 orders, the main basis of classification being their wing structure.

The main features of butterflies have in common are:
6 legs
one pair of antennae
a segmented body in which three body parts, a head, a thorax and an abdomen can be distinguished.

Night butterflies have ears on their wings so they can avoid bats.

A butterfly's taste sensors are located below their feet.

The color in a butterfly's wings does not come from pigment. The color is produced prism-like by light reflected by their transparent wing scales.

The largest butterfly is the Queen Alexandra's birdwing butterfly from Papua New Guinea. The wingspan of the butterfly can reach to be almost one foot.

A butterfly has to have a body temperature greater than 86 degrees to be able to fly.

A butterfly can see the colors red, green, and yellow.

Illusion that Will Blow your Mind

2009-04-12T21:41:00.000-07:00

Follow the Instructions

Was Jesus a real person?

2009-04-09T21:29:00.000-07:00

Was Jesus a real person?

Did Jesus Christ really exist, or is Christianity built upon a legend? Few scholars question Jesus' existence, but some enemies of Christianity are attempting to prove otherwise.

In a lawsuit against the Vatican, the Church was accused of inventing the story of Jesus' existence. Although the case was thrown out of court in February, 2006, the plaintiff, Luigi Cascioli, appealed, but ultimately his case was closed.

The argument against Jesus' existence was made public on CNN TV when Ellen Johnson, president of American Atheists, declared:

“The reality is there is not one shred of secular evidence there ever was a Jesus Christ. Jesus Christ and Christianity is a modern religion. And Jesus Christ is a compilation from other gods: Osiris, Mithras, who had the same origins, the same death as the mythological Jesus Christ.” - Ellen Johnson, atheist

Johnson and a blue-ribbon panel of religious leaders were discussing the question, “What happens after we die?” on a Larry King Live CNN broadcast. The usually unflappable King paused reflectively and then replied, “So you don’t believe there was a Jesus Christ?”

With an air of certainty, Johnson responded, “There was not. It is not what I believe; there is no secular evidence that JC, Jesus Christ, ever existed.”

King had no follow-up and went to a commercial break. No discussion of any evidence for or against Jesus’ existence was forthcoming. The international television audience was left wondering.

ifty years earlier, in his book Why I Am Not a Christian, atheist Bertrand Russell shocked his generation by questioning Jesus’ existence. He wrote: “Historically it is quite doubtful whether Christ ever existed at all, and if He did we do not know anything about Him, so that I am not concerned with the historical question, which is a very difficult one.”2

Is it possible that the Jesus so many believe to be real never existed? In The Story of Civilization, secular historian Will Durant posed this question: “Did Christ exist? Is the life story of the founder of Christianity the product of human sorrow, imagination, and hope—a myth comparable to the legends of Krishna, Osiris, Attis, Adonis, Dionysus, and Mithras?”3 Durant pointed out how the story of Christianity has “many suspicious resemblances to the legends of pagan gods.”4 Later in this article we will see how this great historian answered his own question about the existence of Jesus.

So, how can we know for sure that this man, whom many worship and others curse, was real? Is Johnson right when she asserts that Jesus Christ is a “compilation from other gods”? And is Russell right when he says that Jesus’ existence is “quite doubtful”?

GRADUATION DAY by Vitamin C

2009-03-30T21:21:00.000-07:00

And so we talked all night about the rest of our lives
Where we're gonna be when we turn 25
I keep thinking times will never change
Keep on thinking things will always be the same
But when we leave this year we won't be coming back
No more hanging out cause we're on a different track
And if you got something that you need to say
You better say it right now cause you don't have another day
Cause we're moving on and we can't slow down

These memories are playing like a film without sound
And I keep thinking of the night in June
I didn't know much of love, but it came too soon
And there was me and you, and then it got real blue
Stay at home talkin' on the telephone and
We would get so excited, we'd get so scared
Laughing at our selves thinking life's not fair
And this is how it feels

Chorus:
As we go on, we remember
All the times we had together
And as our lives change,
*Come* whatever
We will still be, friends forever

So if we get the big jobs and we make the big money
When we look back now, will *our jokes* still be funny?
Will we still remember everything we learned in school?
Still be trying to break every single rule
Will little brainy Bobby be the stockbroker man?
Can Heather find a job that won't interfere with her tan?
I keep, I keep thinking that it's not goodbye
Keep on thinking it's a time to fly
And this is how it feels

As we go on, we remember
All the times we had together
And as our lives change,
Come whatever
We will still be, friends forever

La, la, la la; (repeat) yeah, yeah, yeah
La, la, la, la, (repeat) we will still be friends forever

Will we think about tomorrow like we think about now?
Can we survive it out there? Can we make it somehow?
I guess I thought that this would never end
And suddenly it's like we're women and men
Will the past be a shadow that will follow us 'round?
Will these memories fade when I leave this town
I keep, I keep thinking that it's not goodbye
Keep on thinking it's a time to fly

Repeat chorus 3x

Masturbation: 5 Things You Didn't Know

2009-03-23T02:08:00.000-07:00

Experts talk about whether masturbation is safe, normal, or can lead to sexual dysfunction.

By David Freeman
WebMD Feature

Reviewed by Louise Chang, MD

Experts say that just about every man who can masturbate does -- and why not? You don't need an expert to tell you that solo sex feels good, relieves stress, and is a terrific sleep aid. But here are five things you may not know about masturbation:

1. There's no such thing as "abnormal" masturbation.

Men often wonder if there's something abnormal about the way they masturbate. But experts are loath to offer specific definitions of "normal" and "abnormal," pointing out that men show great variations in both frequency and technique. "We humans are too diverse to establish a norm," says Betty Dodson, PhD, a New York City-based sexologist and the author of Sex for One. Every man masturbates in his own way, says Martha Cornog, the author of The Big Book of Masturbation, whether he "uses his hands, rubs against something, uses a sex toy or household object, wears special clothing, fantasizes, looks at a book or magazine, tries different positions, or looks in a mirror."

2. Masturbation is very safe -- but not entirely safe.

Unlike sex with a partner, masturbation can't give you a sexually transmitted disease. Nor will it subject you to the muscle strains, pokes in the eye, and awkward moments that can come with partner sex. But masturbation safety isn't guaranteed. "Masturbation is just about the safest sex there is," says Cornog. "But the laws of physics and biology don't stop operating just because someone is masturbating."

Frequent or overly vigorous masturbation can irritate the skin of the penis, as the average guy knows all too well. Less well known is that habitually masturbating face down -- for example, by thrusting against a sheet, pillow, or even a carpeted floor -- can injure the urethra in such a way that urine exits the penis not in a stream but in a hard-to-control spray. Barbara Bartlik, MD, a psychiatrist and sex therapist in New York City, says she's seen facedown masturbators with urethral trauma so severe that they are no longer able to use a urinal and must urinate while seated.

In certain extremely rare instances, masturbation and partner sex alike can cause penile fracture. This painful condition -- actually a tear in the tunica albuginea, the whitish tissue surrounding the penis's spongy layers -- occurs when an erect penis strikes a hard object or is forced downward. A medical emergency, it often necessitates surgery.

3. Solo sex can supercharge your sex life -- or scuttle it.

For various reasons, solo sex can be a real boon to sex with a partner. It helps teach men about their own sexual response -- what feels good to them and what doesn't -- so they will be better able to explain to their partners just how they like to be touched. It helps men learn to recognize the "moment of inevitability" just before orgasm and helps teach them how to avoid premature ejaculation. Perhaps most significant, it's a great coping mechanism for any man whose partner is temporarily unavailable for sex -- because of absence or illness -- or has a sex drive that doesn't quite match his own (something sex therapists call a disparity in frequency preference).

Of course, some men become so obsessed with solo sex that they begin to lose interest in having sex with their partner. The resulting hurt feelings and alienation a partner feels can make it hard to sustain the relationship. But experts are quick to point out that masturbation is perfectly OK even for men in a committed relationship. "We cannot assume that just because a man masturbates that there is a problem with his primary relationship," says Bartlik.

4. Certain forms of masturbation can lead to sexual dysfunction.

Experts warn that men who frequently stimulate themselves in ways that don't simulate sex with a partner -- for example, stroking very rapidly or with great pressure or friction -- can develop retarded ejaculation. That's a type of sexual dysfunction in which it is difficult or even impossible to climax during partnered sex. "Any man experiencing any sexual dysfunction should ask himself if he's masturbating in ways that produce sensations that differ from those he gets from his partner's hand, mouth, or vagina," says Michael A. Perelman, PhD, clinical associate professor of psychiatry, reproductive medicine, and urology at Weill Cornell Medical College in New York City and the president of the Society for Sex Therapy and Research "Then he should consider what he could say to her to make the stimulation more similar -- and how he could change the way he masturbates to make it feel more similar to what his partner does."

5. Masturbation may affect the risk for prostate cancer.

The relationship between masturbation and prostate cancer is a bit hazy.

A 2003 Australian study published in BJU International linked frequent ejaculation early in life with reduced risk for prostate cancer later on. But in a 2004 study published in The Journal of the American Medical Association, a researcher reported that "ejaculation frequency is not related to increased risk of prostate cancer." In both these studies, ejaculation frequency included sexual intercourse and masturbation.

In a study published this past January in BJU International, researchers found that frequent masturbation in young men raised the risk for prostate cancer but that frequent masturbation in older men lowered the risk. Sexual intercourse did not affect prostate cancer risk.

The researchers theorize that it may not be the masturbation itself which is increasing risk of prostate cancer in men who masturbate frequently in their 20s and 30s. Men who masturbate more may do so because they have high levels of male sex hormones -- and young men genetically predisposed to have hormone-sensitive prostate cancer will be at higher risk if they have more male hormones. In men over age 50, the researchers theorize, frequent masturbation helps drain the prostate of fluids that may contain cancer-causing substances.

14 Tips for Surviving College

2009-03-15T20:41:00.000-07:00

14. Minimize food budget by scheduling classes around Happy Hour.

13. Enjoy being a Sophomore -- It will be the best three years of your life.

12. Wear an athletic cup to panty raids, because it's all fun and games until someone loses their 'nads.

11. Lemon juice and baking soda make an excellent bong water stain remover.

10. Earn extra cash by parlaying chemistry knowledge into lucrative "home pharmaceuticals" business.

9. If an 8:00 am class is required for your major, change your major.

8. Boring lecture? Start a wave!

7. College-level algebra: 5 returnable bottles = 1 delicious Ramen Noodle dinner.

6. "I Phelta Thi" is *not* a real fraternity, except at state colleges.

5. Remember - almost no one complains when you puke in a dumpster.

4. Clever margin manipulation can turn a 4-page outline into a 100-page senior essay.

3. Football games were never meant to be observed by sober people.

2. Don't think of it as sleeping with your professor -- think of it as "acing Biology."

and the Number 1 Tip for Surviving College...

1.In a pinch, milk can be used as a beer substitute in your breakfast cereal.

Depression: Recognizing the Physical Symptom

2009-02-23T02:20:00.000-08:00

Most of us know about the emotional symptoms of depression. But you may not know that depression can cause physical symptoms, too.

In fact, many people with depression feel pain or other physical symptoms. These include:

Headaches. These are fairly common in people with depression. If you already had migraine headaches, they may become worse if you're depressed.
Back pain. If you already suffer with back pain, it may get worse if you become depressed.
Muscle aches and joint pain. Depression can make any kind of chronic pain worse.
Chest pain. Obviously, it's very important to get chest pain checked out by an expert right away. It can be a sign of serious heart problems. But chest pain is also associated with depression.
Digestive problems. You might feel queasy or nauseous. You might have diarrhea or become chronically constipated.
Exhaustion and fatigue. No matter how much you sleep, you may still feel tired or worn out. Getting out of the bed in the morning may seem very hard, even impossible.
Sleeping problems. Many people with depression can't sleep well anymore. They wake up too early or can't fall asleep when they go to bed. Others sleep much more than normal.
Change in appetite or weight. Some people with depression lose their appetite and lose weight. Others find they crave certain foods -- like carbohydrates -- and weigh more.
Dizziness or lightheadedness.

Many depressed people never get help, because they don't know that their physical symptoms might be caused by depression. A lot of doctors miss the symptoms, too.

These physical symptoms aren't "all in your head." Depression can cause real changes in your body. For instance, it can slow down your digestion, which can result in stomach problems.

Depression seems to be related to an imbalance of certain chemicals in your brain. Some of these same chemicals play an important role in how you feel pain. So many experts think that depression can make you feel pain differently than other people.

Treating Physical Symptoms

In some cases, treating your depression -- with therapy or medicine or both -- will resolve your physical symptoms.

But make sure to tell your health care provider about any physical symptoms. Don't assume they'll go away on their own. They may need additional treatment. For instance, your doctor may suggest an antianxiety medicine if you have insomnia. Those drugs help you relax and may allow you to sleep better.

Since pain and depression go together, sometimes easing your pain may help with your depression. Some antidepressants, such as Cymbalta and Effexor, may help with chronic pain, too.

Other treatments can also help with painful symptoms. Certain types of focused therapy -- like cognitive behavioral -- can teach you ways to cope better with the pain.

MOUTH FACTS

2009-02-22T20:32:00.000-08:00

In a month, a fingernail grows an eighth of an inch.

People whose mouth has a narrow roof are more likely to snore. This is because they have less oxygen going through their nose.

While sleeping, one man in eight snores, and one in ten grinds his teeth.

It takes food seven seconds to go from the mouth to the stomach via the esophagus.

BEWARE OF GIRLS

2009-02-19T20:28:00.000-08:00

One day, a girl, 16yrs old, heard from her mother that if she does a regular prayer for 4 yrs, a divine "Angel" would come to her in her dreams & give her 3 boons. So she decided to do it. She completed 4 years successfully, doing prayer regularly.

Now it was a day for "Angel" to come. So she slept earlier with thoughts in her mind to ask. And, really an "Angel" comes in her dreams. Now this is the dialogue between them.

Angel: O Girl, you prayed to me regularly within last 4 yrs, so I am very very happy with you. I will complete any of your 3 wishes. You can ask anything you like, but there is one condition.

Girl: Condition!, what is that?

Angel: You have a boy-friend?

Girl: Yes.

Angel: When you were doing a prayer, he was waiting for you, so he also sacrificed same as you. Moreover, he didn’t know anything about boon and all, so he is also eligible for the boons. So whatever you will ask, he will get 10 times more than that of you. If you are agreed, then proceed for the 1st boon.

Girl: (After thinking for some time …): Yes, I am ready.

Girl: 1st, make me 10 times richer than the richest person in the world.

Angel: But your boy-friend will be 10 times richer than you.

Girl: It’s OK.

Angel: Be as you wish!

Girl: 2nd, Make me 10 times more beautiful than the most beautiful girl in the world. Angel: But your boy-friend will be 10 times handsome than the most handsome boy in the world.

Girl: It’s OK.

Angel: Be as you wish.

Angel: Now the last boon remains.

Girl: O Angel, please give me a MILD HEART-ATTACK.

Angel: What? Are you sure!

Girl: Yes. Very sure!

Angel: Be as you wish.

Think friends, what happened to her boy-friend, he got a severe heart-attack & died at once, while the girl remained alive. Thus, the girl became the world’s most beautiful girl and the richest one, too.

Moral of the story: So intelligent the girls are! Girls are really more intelligent than we believe about them to be. So be careful boys!

Now, girls please stop reading … boys scroll down…

******

******

******

******

******

******

******

******

Dear boys, don't worry, actually what happened is something different than what you all think! Actually, the girl’s boy-friend got a heart-attack, 10 TIMES MILDER than that of the girl. So the boy-friend lived longer than the girl, being world’s richest and the most handsome boy.

Moral of the story: Dear boys, the girls are not really that much intelligent than what we believe them to be. So don't worry if you think that you have girl-friend, intelligent than you.

Hey….I told u girls not to read…

Just for fun with truth…

DISEASES FACTS

2009-01-18T07:52:00.000-08:00

People that use mobile phones are 2.5 time more likely to develop cancer in areas of the brain that are adjacent to the ear they use to talk on the mobile phone.

Over 90% of diseases are caused or complicated by stress.

Over 436,000 U.S. Troops were exposed to depleted uranium during the first Gulf war.

On average, 90% of the people that have the disease Lupus are female.

Many cancer patients that are treated with chemotherapy lose their hair. For some when the hair grows back, it can grow back a different colour, or be curly or straight.

Diabetes is the fourth leading cause of death in the U.S., accounting for about 180,000 deaths per year.

Chances of a women getting breast cancer are increased by excessive use of alcohol.

A popular superstition is that if you put a piece of bread in a baby's crib, it will keep away diseases.

A person that is struck by lightning has a greater chance of developing motor neurons disease.

Every year in the U.S., there are 178,000 new cases of lung cancer.

Every three minutes a woman is diagnosed with breast cancer.

Asthma affects one in fifteen children under the age of eighteen.

Every eleven minutes in the U.S., a woman dies of breast cancer.

Due to eating habits in the USA, one in three children born in the year 2000 have a chance of getting type II diabetes.

The oldest known disease in the world is leprosy.

SHOWER HABITS

2009-01-08T07:39:00.000-08:00

Male and Female Showering Habits

Shower like a woman...

Take off clothing and place it in a sectioned laundry hamper according to lights, darks, whites, man made or natural.

Walk to bathroom wearing long dressing gown. If husband seen along the way cover up any exposed flesh and rush to the bathroom.

Look at womanly physique in the mirror and stick out belly. Complain and whine about getting fat.

Get in shower. Look for facecloth, armcloth, loin cloth, long loofah, wide loofah and pumice stone.

Wash hair once with Cucumber and Lamprey shampoo with 83 added vitamins.Wash hair again with Cucumber and Lamprey shampoo with 83 added vitamins.

Condition hair with cucumber and lamprey conditioner with enhanced natural crocus oil. Leave on hair for 15 minutes.

Wash face with crushed apricot facial scrub for ten minutes until red raw.

Rinse conditioner off hair taking at least 15 minutes to make sure that it's all come off.

Shave armpits and legs. Consider shaving bikini area but decide to get it waxed instead.

Scream loudly when husband flushes toilet and water loses pressure and turns red hot.

Turn off shower.

Squeegee all wet surfaces in shower. Spray mould spots with Tilex. Get out of shower. Dry with towel the size of small African country.

Wrap hair in super absorbent second towel.

Check entire body for remotest sign of spots. Attack with nails and or tweezers (if you can find them).

Return to bedroom wearing long dressing gown and towel on head. If husband seen, cover up any exposed areas and then rush to bedroom to spend hour and a half getting dressed.

Shower like a man...

Take off clothes while sitting on bed and leave them in a pile.

Walk naked to bathroom. If wife seen, shake knob at her while shouting "Way Hey!!"

Look in mirror and suck in gut to see your manly physique.

Admire size of knob in mirror, scratch bollocks and smell fingers for one last whiff.

Get in shower.

Don't bother to look for wash cloth, don't need one.

Wash face.

Wash armpits.

Laugh at how loud farts sound in the shower.

Wash bollocks and the surrounding area.

Wash arse, leaving hair on soap.

Shampoo hair but do not use conditioner.

Make Mohican hairstyle with shampoo. Pull back curtain to see self in mirror.

Piss in shower.

Rinse off and get out of shower. Fail to notice water on floor because shower curtain outside bath for whole shower time.

Partially dry off.

Look at self in mirror, flex muscles and admire size of knob again.

Leave shower curtain open and wet bath mat on floor.

Leave bathroom light and fan on.

Return to bedroom with towel around waist. If you pass wife, pull off towel, grab knob, go "Yeah baby" and thrust pelvis at her.

Put on yesterday's clothes.

When Will The Century End

2009-01-01T20:31:00.000-08:00

There are people going to celebrate the end of the century with a party on 31/12/1999 and others on 31/12/2000. Which is correct?

Probably a lot are going to parties on both! In fact any period of 100 years is a century. 1897 to 1996 is a century, and a new century starts on the 1st of January every year. Similarly 1997 to 2996 is a new millennium. But these are not useful, and people have named some decades, centuries and millennia. Strangely, they have named the centuries and millennia differently from the decades.

Despite changes in the past our calendar is now calculated from a specific date when something may [or may not have happened]. That date is the 1st of January, year 1: there was no year nought! So the "first" century was years 1 to 100, the second 101 to 200, ... the twentieth century is 1901 to 2000 and the twenty-first century will be 2001 to 2100. Similarly the first millennium was 1 to 1000, the second is 1001 to 2000, and the third will be 2001 to 3000.

However, decades are different. We refer to the nineties [short for nineteen-nineties]: these are 1990 to 1999. If we used the equivalent names to centuries, then we would call the current decade the "two hundredth" decade, which is 1991 to 2000. Remember, there was no year nought.

If we called the century the nineteen hundreds then it would end on 31/12/1999: but we don't, and the twentieth century and the second millennium end on 31/12/2000. Have fun at both your parties!

Nun Jokes

2008-12-30T07:34:00.000-08:00

Tricking Nun

A hippie gets onto a bus and sits next to a nun in the front seat. The hippie looks over and asks the nun if she would have sex with him.

The nun, surprised by the question, politely declines and gets off at the next stop. When the bus starts again, the bus driver says to the hippie, "If you want, I can tell you how you can get that nun to have sex with you."

The hippie of course says that he'd love to know, so the bus driver tells him that every Tuesday evening at midnight the nun goes to the cemetery to pray to the lord. "If you went dressed in robes and some glowing powder," says the bus driver, "You could tell her you were God and command her to have sex with you."

The hippie decides to try this out. That Tuesday, he goes to the cemetery and waits for the nun. Right on schedule, the nun shows up. While she's in the middle of praying, the hippie walks out from hiding, in robes and glowing with a mask of god. "I am God, I have heard your prayers and I will answer them but you must have sex with me first," he says.

The nun agrees but asks for anal sex so she might keep her virginity. The hippie agrees to this and quickly sets about having sex with the nun.

After the hippie finishes, he rips off his mask and shouts out, "Ha ha, I'm the hippie! "

The nun replies by whipping off her mask and shouting, "Ha ha, I'm the bus driver!"

The Christmas Carol of the Birds by Mrs. G. Hall

2008-12-25T21:13:00.000-08:00

Do you know, when we are having such good times at Christmas, what sweet music they have in Norway, that cold country across the sea? One day in the year the simple peasants who live there make the birds very happy, so that they sing, of their own free-will, a glad, joyous carol on Christmas morning.

And this is why they sing on that morning more than on any other. After the birds have found shelter from the north wind on Christmas-eve, and the night is still and bright with stars, or even if the storm be ever so severe, the good people bring out sheaves of corn and wheat from their storehouses. Tying them on slender poles, they raise them from every spire, barn, gatepost, and gable; then, when the Christmas sun rises over the hills, every spire and gable bursts forth into joyous song.

You can well believe that these songs of the birds make the people of Norway very happy. They echo, with all their hearts, their living, grateful anthem, "Glory to God in the highest, on earth peace, good-will to men!"

Top 10 signs your partner needs a vacation

2008-12-15T07:24:00.000-08:00

1) He keeps handcuffing himself by accident.

2) He is starting to develop a crush on one of the transvestite hookers he arrested.

3) He wants to transfer to a K-9 unit because he thinks he'd look good in a collar.

4) He talks to himself. Half of him is the "good cop", and the other half is the "bad cop."

5) He wants you to call him "Judge Dredd", and he insists that all suspects should be executed right there on the spot.

6) He keeps asking you if his bullet proof vest makes him look fat.

7) He is exchanging donut recipes with complete strangers.

8) The perpetrators beg him to stop talking about his hemorrhoids.

9) Every Tuesday he insists it's his turn to be the siren.

10) He wants to hear less talk and more music on the police channel.

THE BLACK PARADE

2008-12-02T07:11:00.000-08:00

BLACK PARADE

When I was
A young boy,
My father
Took me into the city
To see a marching band.
He said,
“Son when
You grow up,
Would you be
The savior of the broken,
The beaten and the damned?”
He said
“Will you
Defeat them,
You demons,
And all the non believers,
The plans that they have made?
Because one day
I’ll leave you,
A phantom
To lead you in the summer,
To join the black parade.”

When I was,
A young boy
My father, took me into the city
To see a marching band
He said, “Son when you grow up,
will you be the savior of the broken,
the beaten and the damned?”

Sometimes I get the feeling, she’s watching over me
And other times I feel like I should go
Went through it all, the rise and fall
The bodies in the streets
And when you’re gone we want you all to know

We’ll carry on, We’ll carry on
And though you’re all dead and gone believe me
Your memory will carry on
We’ll carry on
And in my heart I can’t contain it
The anthem won’t explain it

A woman sends you reeling from decimated dreams
Your misery and hate will kill us all
So paint it black and take it back
Let’s shout out loud and clear
Defiant to the end we hear the call

bad dog

2008-11-24T03:29:00.000-08:00

haha..bad dog!!

ILLUSION (5)

2008-11-10T20:01:00.000-08:00

If you take a look at the following picture , let me tell you it is not animated. Your eyes are making it move. To test this, stare at one spot for a couple seconds and everything will stop moving. Or look at the black center of each circle and it will stop moving. But move your eyes to the next black center and the previous will move after you take your eyes away from it.... Weird

ILLUSIONS (4)

2008-11-05T19:23:00.000-08:00

You should see a man's face and also a word...
Hint: Try tilting your head to the right, the world begins with 'L'

ILLUSION (3)

2008-10-29T06:59:00.000-07:00

Do you see gray areas in between the squares?
Now where did they come from?

Are the purple lines straight or bent?

2008-10-27T23:00:00.000-07:00

Are the purple lines straight or bent?

ILLUSION (1)

2008-10-11T22:31:00.000-07:00

Is This Possible??

WHAT OPRAH WINFREY HAD TO SAY ABOUT MEN

2008-09-28T06:56:00.000-07:00

Beautiful Ladies,
HEAR WHAT OPRAH WINFREY HAD TO SAY ABOUT MEN
If a man wants you, nothing can keep him away.
If he doesn't want you, nothing can make him stay.
Stop making excuses for a man and his behaviour.
Allow your intuition (or spirit) to save you from heartache.
Stop trying to change yourself for a relationship that's not meant to be.

Slower is better.

Never live your life for a man before you find what makes you truly happy.

If a relationship ends because the man was not treating you as you deserve then heck no, you can't "be friends". A friend wouldn't mistreat a friend.
Don't settle.

If you feel like he is stringing you along, then he probably is
Don't stay because you think "it will get better"
You'll be mad at yourself a year later for staying when things are not better.
The only person you can control in a relationship is you.

Avoid men who've got a bunch of children by a bunch of different women..

He didn't marry them when he got them pregnant, why would he treat you any differently?

Always have your own set of friends separate from his.
Maintain boundaries in how a guy treats you. If something bothers you, speak up..

Never let a man know everything.* He will use it against you later.

You cannot change a man's behavior.* Change comes from within.

Don't EVER make him feel he is more important than you are...
Even if he has more education or in a better job.

Do not make him into a quasi-god.
He is a man, nothing more nothing less.
Never let a man define who you are.
Never borrow someone else's man.
If he cheated with you, he'll cheat on you.
A man will only treat you the way you ALLOW him to treat you.

All men are NOT dogs.

You should not be the one doing all the bending...
Compromise is two way street.

You need time to heal between relationships. ..
There is nothing cute about baggage...
Deal with your issues before pursuing a new relationship

You should never look for someone to COMPLETE you...
A relationship consists of two WHOLE individuals. ..
Look for someone complimentary. ...not supplementary.

Dating is fun...even if he doesn't turn out to be Mr. Right.

Make him miss you sometimes... when a man always know where you are, and you're always readily available to him - he takes it for granted

Never move into his mother's house.. Never co-sign for a man.

Don't fully commit to a man who doesn't give you everything that you need.*
Keep him in your radar but get to know others.

Scared of being alone is what makes a lot of women stay in relationships that are abusive or hurtful: Dr. Phill

You should know that:
You're the best thing that could ever happen to anyone and if a man mistreats you, he'll miss out on a good thing. If he was attracted to you in the 1st place, just know that he's not the only one.

They're all watching you, so you have a lot of choices.
Make the right one.

Ladies take care of your own hearts....

Share this with other women and men (just so they know)...

You'll make someone smile, another rethink her choices, and another woman prepare..

ILLUSION (2)

2008-09-11T22:57:00.000-07:00

ZeroDiet

2008-09-09T21:23:00.000-07:00

THE NEW EFFECTIVE SELF-THERAPY FOR LOSING WEIGHT
EVOLUTION OF AURICULAR ACUPUNCTURE

SIMPLE
2 small magnets to be applied to the ear at any time during the day

PRATICAL
It does not waste any of your precious time because it works by itself
without the need to consult doctors or specialised centres

SAFE
There are no contraindications or side effects

VERSATILE
It can be used alone or at the same time as other products or dietary regimens designed for reducing body weight
EFFECTIVE
Makes it possible to lose from 4.1 to 9.8 Kg per month
It is an innovative patented therapy that combines the advantages of valid systems that have already been used in auricular therapy and acupuncture with a technology that is yielding excellent results for WEIGHT LOSS TREATMENT with no effort on the part of the user.

It is well known to medical science that when acupuncture or auricular therapy stimulate certain points on the ear this induces the neurotransmitters to produce endorphins; the same ones what we produce when WE FEEL SATISFIED WHILE EATING.

The ZeroDIET uses two biomagnets made of natural material which, when positioned as described later on, create pressure that noticeably reduces hunger and appetite.
The two magnets used in the ZeroDIET therapy stimulate two neurotransmitters that carry out two activities simultaneously:

the second at the brain level with the production of a particular kind of endorphin that accelerates the satiety process.

and the second at the physical level in the digestive system, giving
the sensation of food saturation and hence causing the
individual to eat less than what would have been eaten
without these stimuli,all achieved without difficulty and effort on the part of the individual.

Tested and recommended by the I.S.I.A.
Higher Institute of Food Hygiene
and by specialised medical centres in the USA and Canada.

Global research on obesity that is not caused by medical disorders attribute the cause of excess weight to overeating by approx. 30%.

Using the ZeroDIET pmagnets will help you to eat from 25 al 39% than what you would have eaten without them, and hence lead to a weight loss of from 3.6 to 5.3 kg. All in 30 days without sacrifices and without following a particular dietary regimen.

The ZeroDIET also be an important aid when following controlled eating regimens or programmed diets, leading in this case to even better results, up to 9 kg of weight loss in 30 days.

The magnets are covered with gold, a precious noble metal, long known for its conductive properties and the fact that it does not cause any kind of allergy.

How to use the magnets

To start the ZeroDIET therapy position the two magnets on the left ear 3/4 times a day for about half an hour at a time, as explained in the attached instruction leaflet.

YOU DO NOT MAKE A HOLE IN THE EAR, and the magnets are able to stay in the correct position by attraction.

The operation should be repeated every day for the first month and then as often as needed.

As you can see from the illustrations, the magnets are of different size and shape. They should be positioned on the front protuberance over the entrance to the ear canal: one on the outside (the smaller one with the hole in the centre) and the other on the inside (the larger one). Just position them so they do not fall off and then after a few minutes they will find the exact position by themselves.
The induced reaction will be a sensation of fullness even on an empty stomach and this will increase at the table or as you open the fridge door, causing you to eat less and hence reduce your body weight.

ADVANTAGES

1. You can easily carry out the therapy alone at home without having to visit doctors’ surgeries or specialised centres.
2. Unlike other systems, you do not need help from other people to carry out the therapy.
3. You do not have to take any pills or potions and you do not need to change your eating habits. There are no electric shocks, no injections, so that you will not experience any discomfort or side effects.
4. You decide for yourself when is the best time of day to use the magnets.
5. There are no contraindications.
6. You do not have to take any time off from your other activities.
7. It costs only 49 euros, which you spend once and for all, because the magnets can be re-used, having a charge that lasts about 100 years.

For further information send an e-mail to info@zerodiet.org
You will find qualified staff who will give
you all the information you need.

You have taken the first step towards losing weight
by entering this website and reading its contents.

Take the decisive step! Order now and in a few days
you will be able to say:

I am losing weight!

What is Torsades de Pointes?

2008-09-09T20:07:00.000-07:00

Torsades de pointes, or simply torsades is a French term that literally means "twisting of the points". It was first described by Dessertenne in 1966 and refers to a specific variety of ventricular tachycardia that exhibits distinct characteristics on the electrocardiogram (ECG).

Torsade de pointes is a distinctive polymorphic ventricular tachycardia in which the QRS amplitude varies and the QRS complexes appear to twist around the baseline. Torsade de pointes is associated with a prolonged QT interval, which may be congenital or acquired. It is usually not sustained and terminates spontaneously but frequently recurs unless the underlying cause is corrected and may degenerate into sustained ventricular tachycardia or ventricular fibrillation. Torsade is a life-threatening arrhythmia and may present as sudden cardiac death in patients with structurally normal hearts.

Epidemiology

The corrected QT interval is longer in the white population than in the black population, and longer in females than males. Therefore torsade de pointes is more common in white races and in females.
Torsade occurs at any age. If it occurs at an early age, the cause is usually due to congenital long QT syndrome. In later years, the cause is usually due to acquired long QT syndrome.

Risk factors

Congenital long QT syndromes, e.g. Jervell and Lange-Nielsen syndrome, Romano-Ward syndrome
Acquired long QT syndromes:
- Acute phase of acute myocardial infarction
- Drugs; e.g. antiarrhythmic agents of classes 1a and III, erythromycin, ketoconazole, tricyclic antidepressants, antipsychotics
- Electrolyte disturbances; hypokalaemia, hypomagnesaemia, hypocalcaemia
- Metabolic; hypothyroidism, anorexia nervosa, starvation
- Bradycardia; sinoatrial disease, AV block
- Toxins; heavy metals, insecticides

Presentation

Episodes of torsade in patients with congenital long QT syndromes may be triggered by stress, fear or physical exertion.
Patients with torsade usually present with recurrent episodes of palpitations, dizziness, and syncope. Sudden cardiac death can occur with the first episode.
Nausea, pallor, cold sweats, shortness of breath and chest pain also may occur.
Physical findings depend on the rate and duration of tachycardia and the degree of cerebral hypoperfusion. Findings include rapid pulse, low or normal blood pressure or transient or prolonged loss of consciousness.
Other physical signs depend on the cause of torsade, e.g. features of a congenital disorder.

Differential diagnosis

Polymorphic ventricular tachycardia
Monomorphic ventricular tachycardia
Supraventricular tachycardia with aberrant conduction
Other causes of syncope or sudden cardiac death

Investigations

ECG:
- Paroxysms of 5-20 beats, with a heart rate faster than 200 beats per minute. Sustained episodes are occasionally seen.
- Progressive change in polarity of QRS about the isoelectric line occurs with complete 180 degree twist of QRS complexes in 10-12 beats.
- Usually, a prolonged QT interval and pathological U waves are present, reflecting abnormal ventricular repolarisation. The most consistent indicator of QT prolongation is a QT of 0.60 s or longer or a QTc (corrected for heart rate) of 0.45 s or longer.
- A short-long-short sequence between the R-R interval occurs before the trigger response.
Electrolytes; hypokalaemia, hypomagnesaemia and hypocalcaemia.
Cardiac enzymes; rule out myocardial ischaemia.
Chest x-ray and echocardiography; rule out structural heart disease if any clinical suggestion is present.

Management

Short-term treatment

Resuscitation
Defibrillation:
- Although torsade frequently is self-terminating, it may degenerate into ventricular fibrillation, which requires defibrillation.
- In an otherwise stable patient, DC cardioversion is kept as a last resort because torsade is paroxysmal in nature and frequently recurs after cardioversion.
Discontinuation of any offending agent and correction of any underlying cause such as hypokalaemia, hypomagnesaemia and bradycardia.
Suppression of early after depolarisations:
- Intravenous magnesium is the drug of choice for torsades de pointes. Magnesium is effective even in patients with normal magnesium levels.
- Acceleration of the heart rate can be achieved by using beta 1-adrenergic agonists such as isoproterenol or overdrive electrical pacing.
- Isoproterenol is used as an interim treatment until overdrive pacing can be started:
  - Can be used in bradycardia-dependent torsade that is usually associated with acquired long QT syndrome. It is given as a continuous IV infusion to keep the heart rate faster than 90 beats per minute.
  - Isoproterenol accelerates AV conduction and decreases the QT interval by increasing the heart rate and reducing temporal dispersion of repolarisation.
  - Beta-adrenergic agonists are contraindicated in the congenital form of long QT syndrome.
- Temporary transvenous pacing:
  - Pacing can be effective in terminating torsade by increasing the heart rate and so reducing the QT interval.
  - Atrial pacing is the preferred mode because it preserves the atrial contribution to ventricular filling. In patients with AV block, ventricular pacing can be used to suppress torsade.

Long-term treatment

Patients without syncope, ventricular tachyarrhythmia or a family history of sudden cardiac death can be observed without starting any treatment.
Congenital long QT syndrome:
- Beta-adrenergic antagonists are used as a first-line long-term therapy in congenital long QT syndrome. Propranolol is has been the most extensively used.
- Beta-blockers are contraindicated in acquired cases because bradycardia produced by these agents can precipitate torsade. They should also be avoided in those congenital cases in which bradycardia is a prominent feature.
- Permanent pacing benefits patients who remain symptomatic despite receiving the maximally tolerated dose of beta-blockers and can be used in addition to beta-blockers.
- High left thoracic sympathectomy is effective in patients who remain refractory to beta-blockade and pacing.
- Implantable cardioverter-defibrillators (ICDs) are useful in rare instances when torsade still continues despite all of these treatments. Beta-blockers should be used along with ICDs because shock can further precipitate torsade by adrenergic stimulation.
Acquired long QT syndrome:
- Long-term treatment in acquired cases is usually not required because the QT interval returns to normal once the predisposing factor has been corrected.
- Pacemaker implantation is effective in cases that are associated with heart block or bradycardia.
- Implantable cardioverter-defibrillators are indicated in cases that cannot be managed by avoidance of any specific precipitating factor.

Complications

Monomorphic ventricular tachycardia
Ventricular fibrillation
Sudden cardiac death

Prognosis

Patients may revert spontaneously or convert to a non-polymorphic ventricular tachycardia or ventricular fibrillation.
Torsade is a life-threatening arrhythmia and may present as sudden cardiac death in patients with structurally normal hearts. In congenital long QT syndrome, the mortality rate for untreated patients is 50% in 10 years, which can be reduced to 3-4% with treatment.
In acquired long QT syndrome, the prognosis is excellent once any precipitating factor has been removed.

Prevention

Avoid offending drugs that prolong the QT interval.
Prevent predisposing conditions such as hypokalaemia, hypomagnesaemia, and hypocalcaemia, especially in patients shown to have long QT interval.
Screen families of patients with torsade for whom the cause for prolonged QT is suggested to be congenital.