Chloroquine

By A. Vigo. Lutheran Theological Seminary at Gettysburg.

The blood pressure recording method used throughout the present work was kymographic method purchase chloroquine 250mg amex. The extract had also effect on isolated heart order 250mg chloroquine with mastercard, isolated intestinal smooth muscle, isolated aortic strip, vascular smooth muscle of rabbit ear and bilateral carotid occlusion reflex. Phytochemical analysis showed presence of flavonoids, glycosides, amino acids, tanninoids and phenolic compounds as organic constituents, and iron, sodium, potassium, magnesium and sopper as inorganic constituents. The results were discussed with regards to possible mechanism of action of Moringa olifera Lam. May Aye Than; Mu Mu Sein Myint; Ohnmar Kyaw; Moh Moh Htun; Khin Taryar Myint; Phyu Phyu Win; San San Myint; Nu Nu Win; Thandar Myint. Thus, the aim of this study was to extract of Bizat was physicochemically and phytochemically standardized by using the methods for it herbal pharmacopoeia. Glycoside, polyphenol, flavonoid, steroid, terpene carbohydrate, saponin, protein, resin and reducing sugar were present. The blood and liver tissue were collected for biochemical and histological assessment of liver damage. The serum enzyme activities and histological appearance of degeneration, necrosis and fibrosis were no significant difference between aqueous extract protected and unprotected groups. Study of the utilization pattern of traditional medicine on the management of malaria. This study was undertaken in 5 townships (Bago, Daik-U, Kyauk-ta-ka, Tharyarwaddy, Oke-Po in Bago Division to determine the use of modern drugs and traditional medicine for malaria. Five hundred and seven respondents with history of malaria fever during the last 3 months were face to face interviewed. Qualitative information was collected through informal conversation with shop owners, interviews with traditional healers, persons with history of malaria fever and focus group discussions with community members. Traditional drugs use included packets with antipyretics (59%), packets with traditional medicine (22. Health education should include emphasis on avoidance of such medicine packets which are not approved by the Traditional Medicine Department. Study on acute and sub-chronic toxicities of Pueraria mirifica Airy Shaw & Suvatab. The use of this plant has been reported as a medicine plant since Poutkam (Bagan) Dynasty. In present study, plant samples were collected from Thar Du Kan, Shwe Pyi Thar Township, Yangon Division. Its habits, morphological characters were documented in this thesis for the plant authenticity purpose. Physicochemical and phytochemical studies were also conducted by using appropriate references and methods. Tests for the absence of pesticide residues, heavy metals, aflatoxins were performed. Dried rhizome powder was tested with the various doses of 2, 4 and 8g/kg for acute toxicity study. In sub-chronic toxicity study, there were no significant differences in the average organ weights of brain, lungs, heart, small intestine, colon, stomach, liver, spleen and kidney of between the rats treated with the dried rhizome powder of P. There were no significant differences in haematological parameters between the rats treated with 1g/kg of dried rhizome powdwe of this plant and control group. But, higher dose 2g/kg of rats total serum bilirubin showed slightly higher than normal range. A study on anthelimintic properties of Holarrhena antidysenterica (Let-htoke-kyi). Helminthiasis especially ascariasis is common in Myanmar and its impact on health and economic status of the country is considerable. Although a lot of anthelmintics are available, some more addition from the indigenous source is highly desirable. It will be highly more so, if the indigenous drugs are proved to be safe and more effective than the currently used anthelmintics. The anticholinesterase activity of alcoholic extract of Let-htoke-kyi was found to be 802u/gm. The attempt to elucidate its mechanism of action on the ascaris was carried out by camparing with other known anthelmintic drugs such as piperazine, pyrantel and levamisole. The toxicity study using the oral route was limited because the dose used cannot go larger than 15. Study on chemical constituents and bioactivity of the tubers of Asparagus racemosus Willd. The tubers of this plant have many activies such as diuretic, antidysentery antibacterial, antioxidant and antidiarrheal activities. The tubers of this plant are used in traditional medicine for cough, gastric ulcers, and blood diseases and for general tonic in local regions.

If progressive cheap chloroquine 250mg with amex, ketoacidosis can result in numerous metabolic problems and even coma or death discount 250 mg chloroquine. Patients should be taught to check for ketones in their urine or blood when their glucose is above 250 mg/dl for more than a few hours; if they are feverish or have an infection; if they do not feel well; and regularly during pregnancy, as ketoacidosis is usually fatal to the fetus. The symptoms of diabetic ketoacidosis include fruity breath, disorientation, abdominal tenderness, excessive urination and thirst, hyperventilation, and signs of dehydration. Chronic Complications Much more common than the acute complications of diabetes are certain long-term complications. The main four areas of the body affected most by diabetic complications are the eyes, the kidneys, the nerves, and the lining of blood vessels and organs. These four areas of the body do not require insulin to absorb glucose into their cells, in contrast to the liver, muscle and fat cells, so when glucose levels are elevated in uncontrolled diabetes, glucose floods those cells and causes significant damage. Atherosclerosis Atherosclerosis and other vascular lesions are the underlying factors in the development of many chronic complications of diabetes. Individuals with diabetes have a four- to sixfold higher risk of dying prematurely of heart disease or stroke than a nondiabetic individual, and 55% of deaths in diabetes patients are caused by cardiovascular disease. Retinopathy Diabetic retinopathy is the leading cause of blindness in the United States for people between the ages of 20 and 64. In diabetic retinopathy, the retina is damaged by microscopic hemorrhages, scarring, and the attachment of glucose molecules (glycosylation) to structural proteins in the retina. Studies have shown that 20 years after the diagnosis of diabetes, 80% of type 1 and 20% of type 2 diabetics have significant retinopathy. Neuropathy Neuropathy usually refers to the loss of peripheral nerve function and is characterized by tingling sensations, numbness, loss of function, and a characteristic burning pain. It commonly occurs noticeably in the feet, but if it progresses it can also spread elsewhere in the body, such as in the autonomic nerves of the gastrointestinal tract, causing diarrhea, constipation, and disturbances in stomach emptying. If it progresses, then impaired heart function, alternating bouts of diarrhea and constipation, and inability to empty the bladder may occur. The main problem of peripheral neuropathy is that lack of feeling in the feet can lead to sores and lesions that patients do not notice and that then ulcerate, leading to gangrene and the need for amputation. Kidney Disease (Nephropathy) Nephropathy due to diabetes accounts for 40% of the cases of severe kidney disease and is the most common reason for end-stage kidney disease, dialysis, and kidney transplant in patients in America. Poor Wound Healing and Foot Ulcers Poor wound healing is common in diabetes for several reasons, such as functional nutrient deficiencies and microvascular changes that lead to poor circulation. For these reasons and others (peripheral neuropathy, immune system dysfunction leading to chronic infections), foot ulcers are common in individuals with diabetes. Except for trauma, diabetic wounds are the leading cause of limb amputations in the United States. More than 50% of lower limb amputations in the United States (70,000 each year) are due to diabetic foot ulcers. Immune System Dysfunction Immune system dysfunction often begins to occur long before a diagnosis of diabetes is made. In fact, in many cases a recurrent vaginal or skin yeast infection is the clue that leads to the detection of diabetes. Immune system problems are made worse by poor glucose control, and this puts the diabetic at risk for serious infections or complications of simple infections. Susceptibility to chronic, hidden infections in the oral cavity, blood, or respiratory tract may be a primary reason for increased risk of cardiovascular disease in diabetics. Depression and Cognitive Difficulties Depression and cognitive difficulties are common in diabetics. In fact, depression may begin to occur decades before the onset of type 2 diabetes, when the individual first develops insulin insensitivity. The brain has a greater need for glucose than any other organ, and it appears that the brain cells may suffer from some degree of glucose deprivation when insulin resistance occurs. Cognitive changes begin to occur after the first severe hypoglycemic episode in diabetics. Hypoglycemia is profoundly stressful to the brain, and if severe hypoglycemia occurs many times, significant cognitive impairment is possible. Uncontrolled diabetes is also associated with an increased risk of developing Alzheimer’s disease. Contributors to Long-Term Complications of Diabetes The major factors contributing to the long-term complications of diabetes are listed here, followed by a brief description of each, along with coping measures: • Poor glucose control • Glycosylation of proteins (by means of an action similar to glycosylation of hemoglobin) • Intracellular accumulation of sorbitol • Increased oxidative damage • Nutrient deficiency • Elevated homocysteine levels • Hypertension • Changes in blood vessel linings Poor Glucose Control A large body of evidence indicates that good blood glucose control significantly reduces the development of complications. Maintaining hemoglobin A1C levels near normal (less than 7%) can dramatically help reduce the risk of eye problems (up to 76%), nerve damage (up to 60%), and kidney disease (up to 56%). As described previously, glycosylation refers to the binding of glucose to proteins. The poorer the glucose control, the greater the binding of glucose molecules to proteins. Among the adverse effects of excessive glycosylation are inactivation of enzymes, inhibition of regulatory molecule binding, and formation of abnormal protein structures. As a result, the liver “thinks” there is a shortage of cholesterol in the body and continues to produce more and release it into the blood. This is one reason diabetes is almost always associated with high cholesterol levels.

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Thiamine deficiency-in- perosis cheap chloroquine 250 mg otc, jerky movements and spasmodic convul- duced seizures and neurologic signs may occur in sions order chloroquine 250 mg fast delivery. As with riboflavin deficiency, heterophil counts carnivorous birds fed solely on meat or day-old chick- may increase while lymphocyte counts decrease. Free-ranging honey-eaters in urban ar- bolism, signs of deficiency rarely occur unless dietary eas of southern Australia may develop thiamine de- protein levels are high. This is thought to be deficiency causes reduced egg production and poor associated with the planting of exotic ornamental hatchability. Pyridoxine deficiency was suspected in trees that provide inadequate nutrition but encour- juvenile rheas that developed “goose-stepping” age the birds to remain in an urban area rather than gaits. Pantothenic Acid: Symptoms of pantothenic acid de- Response to treatment in thiamine deficiency cases ficiency in chicks are similar to those of biotin defi- can be dramatic. Affected birds will respond within ciency and include dermatitis on the face and feet, minutes to injectable thiamine. Response to oral perosis, poor growth, poor feathering and ataxia (see thiamine may also be rapid. Severe edema and subcutaneous hemor- Riboflavin (Vitamin B2): In young chicks, riboflavin rhages are signs of pantothenic acid deficiency in developing chicken embryos. Similar clinical signs Cockatiels reared on pantothenic acid-deficient diets thought to be associated with riboflavin deficiency failed to grow contour feathers on their chests and have been reported in young waterfowl, an eagle and backs, and many died at three weeks of age. Biotin deficiency may shell production, blood clotting, nerve impulse trans- also be associated with swelling and ulceration of the mission, glandular secretion and muscle contraction. Fatty liver and kidney syndrome in chick- base balance, fat and carbohydrate metabolism and ens has been associated with marginal biotin defi- calcium transport in egg formation. Although egg yolk is a rich source of biotin, min D-dependent mechanisms are believed to be re- uncooked egg white contains a biotin antagonist sponsible for calcium and phosphorus absorption called avidin, and biotin supplementation of a diet from the intestine. Mycotoxins may also inter- intestine over a prolonged period of time, parathy- fere with biotin uptake. Folic include weakness, polydypsia, anorexia and regurgi- acid is synthesized by bacteria in the digestive tract, tation. Choline: A deficiency of choline caused poor growth Hypocalcemic seizures associated with severe para- and perosis in juvenile turkeys and chickens. In older thyroid enlargement and degeneration occur as a birds, fatty liver infiltration may occur. Vitamin C: Bulbuls and fruit-eating birds may re- At necropsy, there is no apparent calcium mobiliza- quire exogenous vitamin C (ascorbic acid) but in tion from bones as would be expected when blood chickens, and probably most species of seed-eating calcium levels decease in normal birds. Birds have difficulty in mobilizing calcium from body with vitamin E and selenium deficiencies, heat stores, and should be supplemented constantly with stress, trace element toxicity or parasitic infections dietary calcium. There has been some undocumented would be expected to have an increased requirement discussion that the syndrome is limited to imported and decreased production of vitamin C. Natural sources of vitamin C ally, the problem may be regional in nature because include fresh fruits and vegetables (eg, citrus fruits, it appears to be more prevalent on the West Coast, as broccoli, green peppers). Signs of vitamin C deficiency Diets for Birds with Hypocalcemia: Calcium syrup have not been documented in companion birds. Foods contain- ing high levels of calcium such as bones, cheese or yogurt may be provided. Levels of vitamin D in the diet should3 should be encouraged to exercise more and the rate be evaluated and supplemented if needed. High-calcium diets are generally required only until Excess phosphorus consumption can exacerbate normal body reserves are restored. Decreases in egg production, poor egg shell psyllium to the diet may increase the absorption of quality and rickets could occur with phosphorus de- calcium. Its metabolism is closely associated with niles will require higher levels of calcium than non- that of calcium and phosphorus. Excessive amounts may Hypocalcemic seizures are rare in species other than cause diarrhea, irritability, decreased egg production African Grey Parrots. These birds usually respond Iron dramatically (within minutes) to intramuscular cal- Iron is needed for the production of hemoglobin and cium and multivitamin therapy. Normal levels of non- Because calcium metabolism is closely linked with heme iron in the plasma are necessary for feather vitamin D metabolism, many changes caused by cal- pigmentation. Appropriate amounts Diets for Birds with Anemia: Birds with anemia of calcium, phosphorous and vitamin D are necessary should receive a diet that is high in energy and for optimal bone and egg shell formation. The normal protein, and be supplemented with B complex vita- calcium to phosphorus ration for chickens is 2:1. It is mins (including B12, pyridoxine, niacin and folic acid), likely that a similar ratio would be appropriate for iron, cobalt and copper. Most available commercial seeds are ex- Diets for Birds with Hepatopathies: Iron storage tremely calcium deficient: corn=1:37, millet=1:6, disorders have been reported in a variety of non-psit- milo=1:14, oats=1:8 and sunflower seeds=1:7.

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Only B0-counts were arteficially increased (В); (C) shows the concomitant improvement o f fit in terms o f coefficient of correlation and Syx buy 250 mg chloroquine otc. The opposite to this situation is the occurrence of gross errors generic 250mg chloroquine otc, of an “outlier” in between otherwise ideal points. Since, under routine conditions accuracy is not so easy to assess, one has to rely primarily on goodness-of-fit. A: the ideal assay; B: the “real” assay with minor random fluctuation o f standard points; C: the assay with a gross error (“outlier’’) in between accurate points; D: the assay with a gross systematic error in standards. No model should claim to be superior to another model until comparisons have been made under otherwise identical conditions —same data, same criteria”. Thus, the total variation in the interpolated analyte concentration of an unknown sample determined in replicates is —besides the experimental replicate scatter —an additional variable of the position on the standard curve; hence its analyte content. The weight to be assigned to a logit-value is reciprocal to a smooth predicted variance function. The logit-log model is a special case for such general considerations as to heteroscedasticity. A theoretical variance profile obtained from a relation given by Rodbard is shown in Fig. Hence, for curve fitting, a weight that corresponds to the reciprocal of the variance at the respective inhibition (B/B0) level will have to be assigned to each observation of response. Accordingly, points in the middle of the range get the greatest weight (100%), while those approaching the end-points (extremes) are weighted less or receive even zero-weight. The “express route” is depicted by the thick lines and, strictly speaking, is applicable only for the ideal assay. Any deviations from this behaviour, however, call for weighting, for a “roundabout route”. Two principal approaches are in principle feasible: on the basis of observation, and on the basis of prediction. Strategy o f calibration curve calculation, plotting, inspection, weighting and fitting. If there are standards outside this range, accept them if they fit and reject them if they don’t. Owing to the central location, it is certainly on a sound statistical basis that the working range becomes thereby not at all diminished. If, however, it occurs somewhere at the extremes, rejection must obviously become associated with truncation of the analytical working range. The far more complex approach, both with respect to the mathematical- statistical procedures involved and with respect to the philosophical implications as to their particular justification behind it, is weighting on the basis o f prediction. Rodbard’s smooth function [B/B0(1 -B /B 0)B0]2 w eight=— r r i — Í--------- r to Draw J A0 = Î ; J = generally 1. The sophistication in data processing can be even further increased by iterative adjusting procedures during the curve-fitting process. Which is generally the best and what are the specific conditions that make a particular method break down? Relationship between B/B0 and logit B/B0 ( x -----x); relationship between L (or standards l-32U /tube, S1-S6) and logit В/В0 ( • ------• ); relationship between 2. It has already been implied that, by sticking to these “natural confines” in assay design and expectation, and later in assay use, mathematical weighting would become dispensable, even in logit-log which is known to “blow up” at the extremes. In addition we have superimposed a theoretical precision profile that was generated by inter­ polating a set of unknowns of a constant error in the original response variable (raw counts) of exactly 2. The ideal assay in the left lower corner ( 1), the “real” assay with minor fluctuations of random nature in the centre of the lower row (15 and 16), and the worst assay with progressive gross (= systematic) error in the right lower corner (14). It is impossible to account for all the details that emerged in this study, only the principal points being given here. What clearly emerged from this study is the fact that goodness-of-fit and accuracy of calibration curves behave, in principle, independently. This implies that the routinely available parameters for goodness-of-fit do not necessarily allow a reliable prediction regarding the accuracy. One must remember that it is the accuracy which is required, goodness-of-fit is only a by-phenomenon of a precise but not necessarily accurate calibration curve. Hence, the criterion to be placed above the criteria of goodness-of-fit and accuracy is concordance between these two. This question stresses the importance of using a standardized procedure and of extracting as many parameters as possible for goodness-of-fit and accuracy. This clearly shows the importance of good documentation of these parameters, and the necessity to include as many parameters as possible in continuous statistical calculations. This is a further indication for using only one model in order to understand what the model provides in numbers. As shown previously, they can be derived just as well by manual curve fitting of B/B0 vs.

Discussion of a bird’s previous medical prob- Has there been a change in food or water con- lems order chloroquine 250 mg with amex, and how they were diagnosed and treated generic chloroquine 250 mg on-line, may sumption? Subtle increases or decreases in food or provide important information to the clinician. It is referral cases, all available records should be care- important to distinguish between the food offered to fully reviewed. Young immune system and encouraging the proliferation of birds are more susceptible to malnutrition and will secondary bacterial or fungal pathogens. Knowing develop acute signs of disease, while mature birds which antibiotics have been administered will influ- are more likely to suffer from chronic malnutrition. Unfortunately, Changes in behavior that should be noted include many of these birds will be switched by the new excessive sleeping, resting in a fluffed condition and owners to a seed-based diet, which induces obvious a decrease in talking, singing or playing. Personality changes, including pets or family members are ill, the clinician should increased aggression, screaming, intolerance of consider a common etiologic agent (infectious disease strangers or biting the enclosure or toys also may or exposure to an environmental toxin). To overcome this problem, the crouched copulatory stance and masturbatory ac- examination room should be free of extraneous tions with certain family members, toys, mirrors, noises and interruptions, and a bird should be accli- other animals or inanimate objects are suggestive of mated to the examination room for five to ten min- breeding behavior. Reproductively active cocka- ity level of the bird should be determined while it toos, especially Umbrella Cockatoos, may pant rap- remains securely within its enclosure. Some birds, especially the observed at a distance are more likely to feel un- larger macaws, may incubate balls or other round threatened and exhibit changes associated with leth- objects and will defend stuffed toys as if they were argy and depression (Color 8. Single cockatiel hens can lay 20 to 40 eggs a birds can best be initially viewed from a distance year for several years then gradually reduce, and with the aid of binoculars. These birds may continue to Observational clues that a patient is seriously ill go through the behavioral motions of egg laying and include ruffling of feathers, partially closed eyes, develop egg-related peritonitis (eg, depression, ano- frequent blinking, tucking the head under a wing, rexia, swollen abdomen) weeks to months after ceas- labored breathing, sitting on the bottom of the enclo- ing oviposition. Birds that are stressed may shiver, causing a rapid movement of the body feathers. A bird that is de- pressed and lethargic will respond poorly to external Physical Examination stimuli when disturbed and then return to a calm, detached state (Color 8. Abnormalities in body function may include lame- The physical examination can be viewed as a three- ness, wing droop, standing on one leg, shifting weight part process: observing a bird’s response to its envi- from one leg to another, resting on the sternum or ronment, examining the bird’s environment and sys- standing on the metatarsus rather than the foot. A bird that is hot or excited A mental picture of a free-ranging bird (slick, solidly may hold the wings out from the body, yet still in a colored feathers; clear, dry skin; bright inquisitive symmetrical position. One drooping wing is an indi- attitude) should serve as a comparative model for cation of an abnormality (eg, fracture, arthritis, ten- evaluating the condition of avian patients (Color 8. Small birds have higher respira- Evaluating the Bird in its Environment tory rates; large birds have lower respiratory rates. Some avian species (notably Amazon parrots and Birds that are stressed will frequently alter their Pionus spp. This physiologic response should not be misinterpreted as is particularly true while a patient is in the examina- disease-induced dyspnea. A bird that the client signs are best detected while the bird is in its enclo- describes as listless at home may appear bright, alert sure. Except in pied and pearl mutations, males over Weight (Rest) (Restraint) (Rest) (Restraint) one year of age lose these horizontal bars, while 25 g 274 400-600 60-70 80-120 females do not. In pieds, some or all of the gray 100 g 206 500-600 40-52 60-80 feathers are white. Pearls will have a splotched, 200 g 178 300-500 35-50 55-65 repeated pattern of interspaced grey and white feath- 300 g 163 250-400 30-45 50-60 ers. This pearl pattern is retained in the adult female 400 g 154 200-350 25-30 40-60 and lost in the adult male. A lutino is characterized 500 g 147 160-300 20-30 30-50 by the replacement of gray feathers with white feath- 1000 g 127 150-350 15-20 25-40 ers that contain various shades of yellow. Hepatitis, 1500 g 117 120-200 20-32 25-30 chlamydiosis or heredity should be considered in 2000 g 110 110-175 19-28 20-30 cockatiels that are dark yellow (Color 8. A young 5000 g 91 105-160 18-25 20-30 pied has stripes in the central tail feathers, which are 10 kg 79 100-150 17-25 20-30 retained in the mature female but replaced with 100 kg 49 90-120 15-20 15-30 solid-colored central tail feathers in the mature male. In these birds, endoscopic breathing, neck stretching, yawning, extending the or genetic testing for gender is required. The male tends to have Dyspnea associated with the upper respiratory tract a “halo” or lighter colored ring around the nares. As or lungs is frequently accompanied by open-mouthed the male matures, the cere turns from light pink to breathing. Sexually maturing females develop a brown lems are usually associated with a rhythmic jerking cere. The color varieties with excessive fluid production may cause gurgling are more difficult to visually sex.

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For children two to four years old buy chloroquine 250 mg fast delivery, the dosage is 40% of the low end of the range given; for children four to eight years old purchase chloroquine 250mg visa, the dosage is 60% of the low-end adult dosage; and for children nine years old or older the full adult dosage is sufficient. Elderly people living in nursing homes or at northern latitudes should supplement at the high range. It may be more cost-effective to take vitamin E separately rather than as a component of a multiple vitamin. Women who have or who are at risk of developing osteoporosis may need to take a separate calcium supplement to achieve the recommended level of 1,000 mg per day. Most women who have gone through menopause and most men rarely need supplemental iron. Potassium needs are best met through diet and the use of potassium salts used as salt substitutes. Read labels carefully to find multiple vitamin/mineral formulas that contain doses in these ranges. Be aware that you will not find a formula that provides all of these nutrients at these levels in one single pill—it would be too big. Usually you’ll need to take at least three to six tablets per day to meet these levels. While many once-daily supplements provide good levels of vitamins, they tend to be insufficient in the amount of some of the minerals they provide. If you are taking more than a couple of pills, you may find that taking them at the beginning of a meal is more comfortable. Recommendation 2: Take Extra Plant-Based Antioxidants Such as Flavonoid Extracts or “Green Foods” The terms free radical and antioxidant are becoming familiar to most health-minded individuals. Loosely defined, a free radical is a highly reactive molecule that can bind to and destroy cellular structures and blood components. Free radicals have also been shown to be responsible for the initiation of many diseases, including the two biggest killers of Americans—heart disease and cancer. Antioxidants, in contrast, are compounds that help protect against free radical damage. Antioxidant nutrients such as beta-carotene, selenium, vitamin E, and vitamin C have been shown to be very important in protecting against the development of heart disease, cancer, and other chronic degenerative diseases. Based on extensive data, it appears that a combination of antioxidants will provide greater protection than a large dosage of any single antioxidant. Therefore, in addition to consuming a diet rich in plant foods (especially fruits and vegetables) and taking a high-potency multiple vitamin and mineral formula as detailed above in Recommendation 1, we recommend using some form of plant- based antioxidant to ensure broader antioxidant protection. Flavonoids are plant pigments that exert antioxidant activity and have effects that are more potent and more effective against a broader range of oxidants than the traditional antioxidant nutrients vitamins C and E, beta-carotene, selenium, and zinc. Besides lending color to fruits and flowers, flavonoids are responsible for many of the medicinal properties of foods, juices, herbs, and bee pollen. More than 8,000 flavonoid compounds have been characterized and classified according to their chemical structure. Flavonoids are sometimes called “nature’s biological response modifiers” because of their anti-inflammatory, antiallergenic, antiviral, and anticancer properties. For example, one of the most beneficial groups of tissue-specific plant flavonoids are the proanthocyanidins (also referred to as procyanidins). These molecules are found in high concentrations (up to 95%) in grape seed and pine bark extracts. We recommend either grape seed or pine bark extract for most people under the age of 50 for general antioxidant support, as each appears to be especially useful in protecting against heart disease. If there is a strong family history of cancer, however, the best choice is clearly green tea extract (see below). Identify which flavonoid or flavonoid-rich extract is most appropriate for you and take it according to the recommended dosage. There is tremendous overlap among the mechanisms of action and benefits of flavonoid-rich extracts; the key point here is to take the one that is most specific to your personal needs. May provide the best protection against cancer; Green tea extract (60–70% 150 to 300 mg best choice if there is a family history of cancer. Grape seed extract or pine Systemic antioxidant; best choice for most people under age 50. Also bark extract (95% 100 to 300 mg specific for the lungs, diabetes, varicose veins, and protection against procyanidolic oligomers) heart disease. Milk thistle extract (70% 200 to 300 mg Best choice for additional antioxidant protection of liver or skin needs. These products—packed full of phytochemicals, especially carotenes and chlorophyll—are more convenient than trying to sprout and grow your own source of greens. An added advantage is that they tend to taste better than, for example, straight wheatgrass juice. Because of this effect (and others), throughout this book we recommend using grape seed extract or pine bark extract.