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Nearly everywhere in America, this summer is a scorcher, and we know that as a responsible pet parent, you want to do everything you can to keep your best four-legged friends cool. So when you look at your Pomeranian, Golden Retriever or long-haired cat wearing a thick, fluffy coat, you might feel tempted to break out your grooming tools and give him a serious hair cut.
But hold those clippers! While you or I would hate to sport a fur coat in 100-degree weather, your pets' fur coats are actually providing them with heat relief.
"A dog's coat is kind of like insulation for your house," explains Dr. Louise Murray, Vice President of the ASPCA Animal Hospital. "Insulation stops your home from getting too cold in winter, but it also keeps it from overheating in summer—and your dog's coat does the same thing."
Dogs' coats have several layers, and these layers are essential to your dog's comfort in the heat. Robbing your dog of this natural cooling system can lead to discomfort and overheating. And keeping your dog cool isn't the only reason to leave his coat intact, Dr. Murray warns. Your dog's coat prevents your pup from getting sunburn and helps protect her from skin cancer.
So what can you do? "It's OK to trim your long-haired dog's long hair, such as any hair that hangs down on his legs," Dr. Murray says. Just never attempt to clip mats off your pet's coat with scissors, Dr. Murray adds. And if you've got a long-haired kitty, leave her coat intact. Instead, brush her a little more frequently during the hot summer months.
To protect your pet from sunburn and skin cancer, save longer walks for evenings, and consider applying pet-specific sun block to thinly covered areas like the bridge of your dog's nose, the tips of his ears and his belly, Dr. Murray suggests, noting that pets with thin coats, as well as those with white or light-colored coats, are especially at risk for sun damage.
Of course, pet parents should remember to keep pets inside with plenty of water during hot days—hydration is key! For more important information on summer pet care, visit our Hot-Weather Tips.
Believe it or not, but what you are doing is even more cruel.
If you were to take a dogs temperature at the surface of it's skin outside in the hot sun before shaving it's coat and then do the same afterwards you would see that the skin surface is now MUCH hotter with a shaven coat. Do it the way they described here not the way you think. Or just go on abusing and being cruel to your dog by shaving it in the summer.
I totally agree that it is bad advice. I cut one of my dogs long fur a few days ago and she began to act like a different dog - lots of energy and loving to play. Also, the shorter fur makes it easier to notice external parasites.
I have cut the hair of other long haired dogs in the past. It always made a world of difference in their energy levels.
I think it's a little irresponsible and dramatic for you to say that it's "cruel" to leave your dog's coat intact in hot weather. Wild dogs and wolves don't have the option of being groomed and they survive just fine. I would rather listen to my vet, who is a trained professional, and not shave my dogs in the summertime to protect them from everything the article states. However, dogs that are groomed short on a regular basis acclimate to not having a long coat. If you feel comfortable shaving your dog in the summer, that's fine - but to say that the ASPCA is spreading "thoughtless information" is ridiculous.
I've seen this advice and stuck to it for many years. All of the most reliable sources advise NOT to cut dog hair, IT IS INSULLATION to protect from cold and HEAT, and other protections, i.e. natural oils etc.! That's the way God created them, He doesn't make mistakes, WE DO!!! Please rethink!
Firstly, to the person who stated that "god doesn't make mistakes/we do". THAT is your personal opinion!!
Not everyone believes in a god per se. There are myriad examples in nature of defects, and gross mistakes. They are usually taken care of in the wild by predator consumption, or early death because the specific unit of the species was not viable!!
We are the only animal who spends billions of dollars a year on keeping defective members of our species alive through articial means!!!
Other animals are smart enough to know that the weak, sick, and the old are a grave threat to the herd's survival and must be eliminated forthwith!! Either through predation, or outright culling within the herd!!
Because we humans are capable of hubris, we compromise our species everyday by keeping the weak and inferior alive!!! This is unnatural, and unsustainable!!!
We as a species will suffer greatly, for the last 80 some odd years, of "medical advances" and liberal social policy.
In the wild, the Excess get EATEN!!! Or the entire Herd Dies of Starvation!!
You know it is quite funny that I was just telling my husband the other day how it never ceases to amaze me the stupid things that fall out of mens' mouths. With your stupidity you would have me put my daughter who is 34yrs old down at birth because she was not born "perfect" or my mother down because she is 85. Seriously??? You state that we humans are compromising our species by letting these "outcasts" of yours live and yet the world today is more populated than ever. Go back to sleep, Myke and when you have something valuable to add to the conversation, do some research and then and ONLY THEN, make your comments. By the way I have a Pekeniese and we have shaved her every summer for years and we live in Florida. She is an inside dog and only walks twice a day for exercise and to do her "business".
Domestic dogs are the result of thousands of generations of selective breeding by humans, hardly the way God created them. As a result, many breeds have characteristics that are not natural or in any way beneficial to the dog's health and well-being.
I couldn't agree more. This is a wives' tale. Years ago, I read an article that talked about their coats acting as insulation and asked my vet about it. He said it did act as insulation and also kept heat in as a fur coat would do for humans. He warned about sunburns but I'm careful not to shave them too closely and they are inside dogs. My two large shepherd mixes have gotten hair cuts for 10 years without issue. The fur on my older guy doesn't grow back as quickly now but he's much happier when he has short hair in the Missouri summer heat and I'm happy the shedding is reduced!
This article says nothing about leaving your pets fur untouched. Every pet owner should bathe and groom their furry friends. It simply states that dogs have fur to protect them from the environment. I agree, you should never shave a double coated dog or cat....that is why they shed. If you take a look at dogs and where they came from before we domisticated them, they were wild. Look at all the wild animals with fur that actually live outside. Think about it! They have fur for a reason...protection. I know that we love our pets and want to do our best by them, and yes summer is hot. And just because you're hot you think your pet is hot, but shaving them is not the answer. They were born with fur for a reason. Just take care of your pet with regular groomings....baths, trimming, and brushing. And always make sure they have plenty of water.
Ms. Holcomb, Guess what? You are not a dog and your dog is a fur covered animal. If their fur was meant only to keep them warm in cold temps., don't you think they would shed it all in the summer? Trust that nature is taking care of your dog and the doctors/scientists at ASPCA study the NATURE of all animal species(except for humans). Second to willful cruelty, projecting human comforts and desires onto pets has probably been the root cause of more premature deaths of pets and it borders on negligent abuse. In fact, I think it is abuse when you choose ignorance. A human comparison: Children don't like to wear helmets or use seatbelts because they're uncomfortable. We can relate to that. But informed, responsible adults still make them wear them, in spite of their complaining. And now it's the law because there were too many who chose ignorance and took the path of least resistance, costing lives and taxpayers. Would you continue to shave your dogs if there were laws against it? Maybe there should be...


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Look! Up in the night sky! It's an owl! It's a UFO with its landing lights on! No! It's Supermoon!
OK, calm down.
It's really not that big a deal.
The full moon Sunday will be the biggest of the year, which means it'll be pretty picturesque.
But that much greater than any other full moon?
Probably not.
"I'm a little skeptical," said Steve Danford, a physics and astronomy professor at UNC Greensboro and director of the Three College Observatory in southern Alamance County.
"The minor changes in lunar diameter compared to any other full moon are going to be almost invisible to most people."
Again, let's be clear about this.
Sunday's moon will be big and bright. But those pictures you've seen posted on the Internet that make it look as though our lunar friend is about to swallow the Earth?
Well, that ain't happening.
"There's a lot of hype that's been going around about this," said Richard McColman, Fulldome Theatre manager at UNC Chapel Hill's Morehead Planetarium.
"There may be some effect from the power of suggestion, but as far as people being able to see a size distinction? No, we're not going to be able to see much difference."
Here's the Cliff's Notes version of what's led to this weekend happenings: The moon orbits the Earth about once every month. As it does, the geometry — the angles between the moon, Earth and sun — changes, so we see a different part of the moon each night.
Once per orbit, the moon is basically opposite the Earth, so the half facing us is completely lit. That's the night we say the moon is full.
Since the moon orbits the Earth in an eclipse instead of a circle, the distance between the two changes constantly. When the moon is closest to the Earth in its orbit, it's called perigee. This happens once per lunar orbit or about 13 times per year.
The average perigee distance is a separation of about 225,000 miles between moon and Earth. During this weekend's perigee, the distance will be the closest of the year at 221,300 miles.
That's a tad closer than usual, but still a good ways off. If someone tells you Sunday to take a flying leap at the moon, don't expect to land in the Sea of Tranquility.
All that said, it's a full moon bringing with it all the glory of any full moon. Heck, forecasts are even calling for mostly clear skies Sunday night.
Step outside and enjoy.
"It should still be spectacular," Danford said.

subset: commoncrawl


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Degenerative Disc Center - Pocatello, ID
Pocatello Orthopedic Surgeon Doctors for Degenerative Disc
Type of Physician: Orthopedic Surgeon
What is a Orthopedic Surgeon ?
A certification by the Board of Orthopaedic Surgery; practitioners focus on the investigation, preservation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. Birth defects, trauma, infections, tumors and metabolic disturbances of the musculoskeletal system are problems cared for by the orthopaedic surgeon.
Specialty: Orthopaedic Surgery
Common Name: Orthopedist
Orthopaedic Surgeon Doctors in Pocatello *
Pocatello Orthopedic/Sports Med
Pocatello Orthopedic/Sports Med
Pocatello Orthopedic/Sports Med
Idaho Orthopedics & Sports Clin
Idaho Orthopedics & Sports Clin
Idaho Orthopedics & Sports Clin
Idaho Orthopedics & Sports Clin
Idaho Orthopedics & Sports Clin
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Pocatello Physicians & Surgeons
Robert J Lee MD
Blackfoot Orthopedic Center
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Oneida County Hosp Long Term Cr
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East Falls Orthopedics
Shoulder & Knee Center
Medical Specialists Clinic
Medical Specialists Clinic
Ronald G Mills MD
Upper Valley Orthopedics
Upper Valley Orthopedics
Gilbert K Crane MD
Ambulatory Surgery Center
Pocatello, Idaho
Degenerative Disc Disease & Sciatica
Degenerative disc disease and sciatica facts
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Sometimes watching this team reminds me of when I had the shingles. It hurts, but there is nothing I can do about it.
Sometimes watching this team reminds me of when I had the shingles. It hurts, but there is nothing I can do about it.
Davis hasn't been what I thought he'd be defensively since the injury. I want to see more effort from him on defense.
Davis standing still gets called for foul... here we go.
Vasquez is faster with the ball in his hand than he is without it .. That's strange
Davis looks a little lost on defense to me. Anyone else?
Is it too early to consider this game a "must lose"? When you look at the standings we have slim hopes of catching Washington for best record since Wall is supposedly done fo' the year, but we could conceivably finish above Cleveland and Toronto for 2nd best if we build up a bit of a lead before EG10's return.
We'll probably play .400 ball after EG10 returns and for as long as he plays significant minutes, meaning that we need to have at least a 3 or 4 game cushion over Cleveland and Toronto (something we currently do not have).
A win tonight on the road against one of the best teams in the league would be a real setback to our long-term goals IMO.
"The only thing Ryno stretches is the 0's on the stat sheet." - BallSoHard
"I'm not going to allow my putative owner to answer that question, this is an NBA related press conference. Paul Tagliabue and Roger Goodell have collectively sung their praises of Tom and if uh ESPN has a problem with that tell Mr. Skipper to call me at my office."
Vasquez take notes from Roberts on how to hit Davis on the pick & roll
Good news is that Raptors are winning big and Cavs are within striking distance at the Q v's the Pace Cars. Hopefully we'll be 2nd in a couple of hours!
Great reporting from Jen Hale: "Don't get too far behind"
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Leisure guests find that our hotel's near everything in Charleston, SC. Guests can easily visit historic sites downtown, take a carriage ride or tour a beautiful plantation like Boone Hall. We're also close to Patriots Point Naval & Maritime Museum. For guests who enjoy a bargain, the Tanger Outlets are just up the road. Charleston hosts great events and festivals such as Spoleto and the Cooper River Bridge Run.
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Don't Have an Account? Join the IHG® Rewards Club
Redeem when you want, for what you want.
Reward Nights
When redeeming points for a Reward
Night, you may only book one room at a time.
Once you complete your Reward Night
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** Best Available Rate Search does not include affiliation rates.
To book more than 9 rooms for one stay or request a quote, please use our Easy Meetings tool, call 1-800-MEETING (in United States, Mexico and Canada) or contact a Global Sales Office.
The Holiday Inn Express Lincoln Airport provides a comfortable and convenient stay just minutes from the Lincoln Airport (LNK), University of Nebraska-Lincoln, and Memorial Stadium, the home of the Huskers. Our hotel offers a free airport transportation.
Business travelers will appreciate the hotel's proximity to several major Lincoln corporations. Husker fans will enjoy being so close to the University of Nebraska's main campus, the Husker's historic Memorial
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Business travelers will appreciate the hotel's proximity to several major Lincoln corporations. Husker fans will enjoy being so close to the University of Nebraska's main campus, the Husker's historic Memorial Stadium, and the State Capitol building. Lincoln also offers a wide variety of attractions and entertainment for the whole family. The Lincoln Zoo, Lied Center and Children's museum is just minutes away. Within 30 minutes of our Lincoln hotel is Mahoney State Park, which features both hiking trails and a waterpark. You can choose to stay a little closer to our hotel and explore the Haymarket, where you will find the best shopping and dining that Lincoln has to offer.
Come stay with us in our pet-friendly Lincoln airport hotel and bring your favorite furry friend along for a small fee. With an indoor pool and whirlpool spa, you will have no trouble relaxing after a long day. Our hotel offers hot complimentary breakfast and evening reception Monday -Thursday. We offer 24-hour spa like fitness room, free high-speed Internet and meeting room availability. Book your trip now and enjoy our great Lincoln hotel room deals.
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For several years now, Reethi beach has been consciously pursuing environment friendly actions and policies but as is usual with all good things, it took a long time for these actions and their results to be noticed by the world outside. But noticed it has certainly been, and it gives us a great sense of pride and pleasure to announce that Travelife has awarded Reethi Beach its "Travelife Gold status" acknowledging that RBR has met Travelife's strict sustainability criteria in managing social and environmental issues in a sustainable way.
Enhancing this achievement, is our simultaneous receipt of the highest possible ranking of "5 leaves", from the 5 Leaves System based in Madrid, for our environmental sustainability efforts.
Importantly, on the service front too, Reethi Beach has won Holidaycheck's "Best 99 Hotels of the World" and Tripadvisor's "Certificate of Excellence". This proves beyond doubt that superior service experience is not in conflict with criterion for sustainability as long as conscientious effort is made keeping environment as a non-negotiable priority.
We do believe that our environmentally friendly actions coupled with good value for money and excellent guest service, are giving us record occupancies and record repeaters. So far this year total number of repeat clients has reached almost 1/3rd of all our guests.


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Photorefractive Keratectomy Center - Providence, RI
Providence Eye Doctor Doctors for Photorefractive Keratectomy
Type of Physician: Eye Doctor
What is a Eye Doctor?
A certification by the Board of Ophthalmology; practitioners provide comprehensive eye and vision care. They are trained to diagnose, monitor and medically or surgically treat all eyelid and orbital problems affecting the eye and visual pathways, and to diagnose, monitor and treat all eye and visual disorders. They often prescribe vision services (glasses and contact lenses) as well as serve as a consultant to physicians and other professionals.
Specialty: Ophthalmology
Common Name: Eye Doctor
Ophthalmologist Doctors in Providence *
Eye Clinic
Southern New Englnd Retna Assoc
Southern New Englnd Retna Assoc
Janigian Retina Associates
Janigian Retina Associates
Ophthalmic Plastic Surgery
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Rhode Island Eye Institute
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Rhode Island Eye Institute
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Providence Eye Associates
Ezra L Galler MD
S Deborah Murphy MD
William G Tsiaras MD & Assocs
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William G Tsiaras MD & Assocs
Kendall A Gibbs MD
Eye Specialists
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Donald V Fargnoli MD Inc
Musco Center For Sight
Peter F Deblasio MD
Koch Eye Associates
Christopher C Way MD
Francis X Figueroa MD
Associates In Ophthalmology
Optix Rhode Island
Optix Rhode Island
Salvatore J Laporchio MD
Ophthalmic Surgeons Ltd
Rhode Island Eye Institue
Eye Associates
Koch Eye Associates
Koch Eye Associates
Koch Eye Associates
Thomas R Leddy MD
Koch Eye Associates
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Kent Ophthalmology Inc
Peter C Brasch MD LLC
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East Greenwich Ophthalmology
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Retina Consultants
Rhode Island Eye Institute
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Rhode Island Eye Institute
Gill & Gabriel Mds
Naval Health Clinic-New England
Eye Health/Laser Vision Center
Seacoast Eye Associates
Thames Eye Group
Thames Eye Group
Vision Care Associates
Providence, Rhode Island
Photorefractive Keratectomy
What is photorefractive keratectomy (PRK)?
Photorefractive keratectomy (PRK) is a procedure used to reduce the need for corrective eyewear by reshaping the cornea of the eye with a laser, thereby changing the way the eye focuses light. A...
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Rhode Island Hospital
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Purple Passion Massager
Pleasure that will satisfy your every desire. This Purple Passion massager features sensuous pleasure nubs to deliver intense erotic sensations and a soft flexible shaft that bends to fit your body's curves. Controlled by a simple turn-dial base, a whisper-quiet multi-speed motor provides powerful vibrations for passion inspiring pleasure. Waterproof. Uses 2 AAA batteries (not included). 6"L.
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NYC construction worker-turned-designer Matt Bernson describes the aesthetic of his women's footwear line as "downtown meets the beach," and we think the shoe fits. Designed in TriBeCa and handmade by traditional artisans, Bernson's boots and shoes feature bright colors, ample hardware, and metallic leathers ideal for idylls urban or exotic. From sky-high T-strap wedge sandals and ankle booties to low-heel tundra boots and gladiator flats, each pair of Bernson's shoes is constructed from eco-friendly materials and features luxuriously padded insoles. And when it comes to elasticized ballet flats, his Waverly cap-toe sets the bar high with a patent-pending padded moleskin system that preserves the integrity of the stretchy heel. In addition to his own line, Bernson has designed camouflage canvas shoes for Edun, the socially conscious clothing label founded by U2 singer Bono and his wife, Ali Hewson.
Go-anywhere sandals, colorblocked loafers, and more from two casual-cool favorites.
Scoop up a mix of the season's best styles before it's too late.
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Real Sports with Bryant Gumbel
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Taking Dental Medications Center - South San Francisco, CA
WebMD Physician Directory
South San Francisco, California
Taking Dental Medications
Questions to Ask Your Dentist About Your Medication
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Subacute Saratoga Childrns Hosp
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Leonardo DiCaprio stars as J. Edgar Hoover, who ruled the FBI with an iron-fist from the 1920s to the '70s.
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The University Greys: Maud Morrow Brown's book and opera
Local historian Jack Lamar Mayfield continues his series about the University Greys this week. He writes about Maud Marrow Brown's book that was written about students who fought for the Southern cause. Her book inspired a professor's wife, Zoe Lund Schiller Kreutz, who wrote an opera based on Brown's book. (February 4, 2011, Page 2B)


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"Are you ready for some blues?" Buddy Guy asked as his face wrinkled into a sly grin.
Night two at Philadelphia's Wachovia Center started much like the first, with a thrilling opening set from Guy that drew most of the Heartbreakers and much of their crew to the side stage to watch the blues legend work his magic on his last night on the tour.
Guy covered a lot of ground during his hour-long set, from his own "Damn Right I've Got the Blues" and "Skin Deep" to blues classics "Hoochie Coochie Man" and "She's Nineteen Years Old" to a medley of John Lee Hooker's "Boom Boom," Cream's "Strange Brew" and Jimi Hendrix' "Voodoo Chile." It was a real treat to have Buddy on the tour, and everyone " from his management to the crew to the man himself " will be missed.
At a few minutes past 9 pm, Tom and the band took the stage to thunderous applause and launched straight away into a jangling "Listen to Her Heart." "Kings Highway" returned to the show after a month-long absence from the setlist, but the real treat tonight was the seemingly impromptu take on Chuck Berry's "Carol" sandwiched in between encores "Running Down a Dream" and "American Girl."
Oh Carol, don't let him steal your heart away I'm gonna learn to dance if it takes me all night and day
That's it for the second leg of the Mojo Summer 2010 tour! Keep checking back for videos from the last few shows of the tour and come see us when we return to the road in Atlanta on August 11!


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The Bureau of Labor Statistics (BLS) reported that nonfarm payroll employment increased by a seasonally adjusted 175,000 during May. Private sector payrolls added 178,000 payroll jobs. The unemployment rate ticked up 0.1 percentage point to 7.6%.
In his press statement, Chairman Brady referred to today's report as "The Good, the Bad, and the Ugly Employment Report." Chairmen Brady noted that the good news was that the economy added private sector payroll jobs for the 39th consecutive month. Over the last 39 months the economy private sector payroll employment has risen by 6.5% or 6.9 million (an average of 178,000 jobs per month).
The bad news in today's report is that the current recovery has produced the equivalent of 4.0 million fewer private sector jobs than the average of other post-World War II recoveries. The average recovery produced an average gain of 10.3% over the comparable 39 months. And there are still 1.9 million or 1.7% fewer private sector payroll jobs than there were in January 2008 when private sector payroll peaked at 115.7 million.
The Really Ugly News in today's report is that a smaller percentage of adult Americans are employed now (58.6%) than were employed when the recession ended in June 2009 (59.4%). In fact, the employment-to-population has only risen 0.1 percentage point since October 2009 when the unemployment rate peaked at 10.0%.
The labor force participation rate ticked up to 63.4% from 63.3%. These rates remain the lowest seen since the late 1970s. The decline in the labor force participation has been a primary factor in the decline in the official unemployment rate from the October 2009 peak of 10.0%. In fact, if labor force participation had not declined from its January 2009 level of 65.7%, the unemployment rate would be 10.7%.
We often get requests for comparisons of the current recovery with the strong Reagan recovery of the 1980s. The Reagan recovery saw private sector payroll employment grow by 12.9% over a comparable 39 months or the equivalent of 13.8 million private sector payroll jobs. That puts the current recoveries private sector jobs gap compared to the Reagan recovery at 6.8 million.
A brief table is pasted below as a quick reference to information on the growth and jobs gap in this recovery compared to the average of other recoveries and the Reagan recovery.


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Maryland Live! offers an information session as they look to train people to become dealers at the casino
Similar imagesView all
April Herron of Millersville, MD, watches a video presentation about... News PhotoBethesda,Horizontal,Human Interest,Maryland - State,USAPhotographer The Washington PostCollection: The Washington Post 2012 The Washington PostBETHESDA, MD - NOVEMBER 20: April Herron, 54, of Millersville, MD, watches a video presentation about Maryland Live! Tuesday, November 20, 2012 in Bethesda, MD. She was one of four people to join the second informational session held at the Doubletree Hotel in Bethesda. The Wawa deli worker would love to become a dealer at the casino. (Photo by Katherine Frey/The Washington Post via Getty Images)


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Biggest mass layoffs of all time
POSTED: 06:06 AM PDT Jul 17, 2014
Microsoft is laying off the most people in its 39-year history -- 18,000 over the next year. But it's still far from the biggest mass layoffs of all time.
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Follow the next three easy steps to take part in this amazing offer.
- Purchase a new Motorola DROID TURBO with new 2yr activation or on Edge.
- Within 5 days of activating your new DROID TURBO you will receive a promotion code via email and text message to use when you trade in your smartphone. (Smartphone must be in good working condition.)
- Follow the steps from your email to complete your trade-in with your promotion code. Once we receive your device and confirm it is in good working condition we will send you a Verizon Wireless gift card via mail.


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Michigan travelers choose from 28 Best Western hotels.
Michigan is ready for your spring time visit. With more fresh-water shores than any other state, spring is an adventure in Michigan. Catch the Motown beat in Detroit, stroll down the Riverfront, or head out to Ann Arbor for the University of Michigan – just one of a long list of MI universities. Don't miss Lansing, the state capitol and home of the R.E. Olds Transportation Museum, or Battle Creek for a nod to your favorite childhood cereal. While many visitors also hit Kalamazoo.
Head over the Mackinac Bridge to the Upper Peninsula and the Great Lakes of Huron, Michigan and Superior – not many residents, and that's OK. Spring is ideal for a trek in Porcupine Mountains Wilderness State Park and wildlife spotting in Seney National Wildlife Refuge, only a fraction of the outdoor recreation available in Michigan.
Spring in Michigan will always yield exciting sports action – visit Comerica Park for Detroit Tigers home games. Joe Louis Arena is home to the Detroit Redwings of the NHL; spring is just about the end of the NHL regular season, so make your way over before it's too late. While the sports are a major draw, you can also take the kids over the Binder Park Zoo in Battle Creek, or to the Kellog Bird Sanctuary in Augusta.


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This page discusses the options of elastic persistence and how they compare
Main MongoDB vs CouchDB differences
- MongoDB is binary JSON and native language drivers, CouchDB is JSON with a REST interface
- MongoDB has master-slave replication, and CouchDB has master-master replication. The difference is that MongoDB can replicate changes from a primary to a secondary database server and that CouchDB provides full replication with scenarios like working offline and syncing both ways when you're online again.
- MongoDB provides adhoc query support, CouchDB doesn't.
- MongoDB does updates-in-place, which means existing documents are modified. CouchDB uses MVCC and creates new versions of documents when there's an update. MongoDB write operations are therefore typically faster in performance, CouchDB can do more fine grained replication and master-master replication because of this document versioning feature.
- MongoDB uses asynchronous write operations by default, where CouchDB ensures that the write operations are synced. MongoDB provides functionality to ensure syncen both to disk as well as to a minimum number of nodes in the replication set, by using the getLastError command. Because CouchDB write operations are always synced there's no need for a shutdown process. Which means that a kill -9 doesn't prevent CouchDB from starting up as normal again. MongoDB does have a shutdown process to verify integrity etc. Therefore a kill -9 means that you are advised to run a repair command before starting up the MongoDB server again.
- MongoDB has out-of-the-box sharding and clustering (via replication sets) support, CouchDB doesn't. There are frameworks like CouchDB Lounch which do provide sharding and clustering support.
- Comparing MongoDB and CouchDB --> http://nosql.mypopescu.com/post/298557551/couchdb-vs-mongodb
- Comparing MongoDB, CouchDB and RavenDB --> http://nosql.mypopescu.com/post/978742866/document-databases-compared-couchdb-mongodb-ravendb
- Comparing MongoDB and CouchDB --> http://www.mongodb.org/display/DOCS/Comparing+Mongo+DB+and+Couch+DB
- Comparing lots of NoSQL databases --> http://kkovacs.eu/cassandra-vs-mongodb-vs-couchdb-vs-redis
Main characteristics
- BSON format (binary JSON), so more efficiency in data transfer and storage
- Apache license
- Supports updates in-place, which means that no new documents have to be created but the existing document is modified. This improves the write performance a lot.
- Adhoc queries, which means that indexes are not mandatory because in a lot of cases MongoDB can find an optimal query path.
- Language specific drivers
- Only atomic transactions
- Master-Slave replication
- Out-of-the-box clustering and sharding support
- MongoDB is lead by 10gen
- Active community with around 20 posts on user list per day
- Main users: Github, bit.ly, Foursquare, sourceforge (http://www.mongodb.org/display/DOCS/Production+Deployments)
- Supported on CloudFoundry
Core concepts
- Replication set, http://www.mongodb.org/display/DOCS/Replica+Sets. Replication sets are asynchronous master/slave replications to increase availability. A replication set consists of at least 3 servers, 3 full servers or 2 full servers and one arbiter.
- Primary. A replication set always selects a primary (or master), which is the entry point for writing data. When a primary crashes another primary is automatically selected.
- Secondary. A secondary receives replication messages from the primary to keep them synchronized. When a primary crashes one of the secondaries will become the primary. Most MongoDB database drivers support the option to enable read operations on slave. This is not enabled by default. When you allow reads from a secondary, there's a possibility that new write data is not yet synced from the primary.
- Arbiter. An arbiter is a node in a replication set that only participates in elections (who becomes the primary). An arbiter never becomes a primary and data is not replicated to this node. An arbiter is needed when you have an even numbers of secondaries to prevent a deadlock in elections.
- Sharding, http://www.mongodb.org/display/DOCS/Sharding+Introduction. Sharding is the partitioning of data among multiple servers in an order-preserving manner.
With sharding one can divide collections in data chunks that are managed on different database servers. The definition of these data chunks is done by shard keys which look like index definitions. When a shard reaches a specified maximum size limit (for example 1 GB) the data chunks managed by this shard get divided over the other shards automatically. Typically a shard consists of a replication set of database servers.
- Routing processes (mongos). Routing or coordination process that make the cluster of servers look like one system for a database driver. You can have multiple mongos running in parallel as they get their data from a config server and don't have any relationship with eachother. The overhead of a mongo is minimal.
- getLastError, http://www.mongodb.org/display/DOCS/getLastError+Command, http://www.mongodb.org/display/DOCS/Verifying+Propagation+of+Writes+with+getLastError. By default MongoDB write operations are asynchronous and don't give back a response code. To know that a write operation has succeeded or to know the error, the getLastError command can be used. In addition the getLastError command provides functionality to ensure that the data is being replicated over a specified number of servers in the replication set. With the fsync parameter of the getLastError command you can also ensure that the data is fsynced to the drive.
Detailed information
- MongoDB was designed with a multi server architecture in mind. The idea is to increase availability and durability by adding more servers to a replication set and/or to a shard. Single server durability was no priority until the addition of journalling in the recent release. To ensure that important data is at least replicated over x servers in a replication set, you have to invoke the getLastError command.
- When you execute a kill -9 on a mongodb server you'll have to run the repair command to get it nicely started again. With journalling enabled and by using getLastError for important write operations, this seems to be no problem. CouchDB has a crash only design, with no additional shutdown process so you can do a kill -9 without causing a problem. CouchDB will startup normally again.
- How to work with update commands? Write side? Is our idea valid?
- How to test scalability?
- How to deal with relations?
- How to handle schema updates in the code?
- How to make a versioned update like [update ... where oid = ... and version = 2] and then check how many documents were updated.
- From version 1.7.5. journalling support is added. We hear mixed feedback about the maturity and the functionality of this journalling support, could you share your standpoints with us?
- Two phase commit with MongoDB --> http://www.mongodb.org/display/DOCS/two-phase+commit
- MongoDB issues --> http://leifw.wickland.net/2011/04/weird-buggy-and-disappointing-behavior.html
- Journalling explained --> http://www.mongodb.org/display/DOCS/Journaling
- MongoDB on amazon --> http://www.mongodb.org/display/DOCS/Amazon+EC2
- MongoDB is a supported service on CloudFoundry --> http://www.mongodb.org/display/DOCS/VMware+CloudFoundry
- BSON (binary JSON) instead of JSON, which optimizes the storage and communication of documents
- Native drivers for a lot of languages (including Java, C++, C#, PHP, Javascript, Groovy etc)
- Good support for queries
- High read and write performance
- Less durability (no crash-only design) because writes are not immediately synced with the file system. This means that the write performance is higher, but data can get lost after a crash. From version 1.7.5 journalling is supported which provides more durability, but this seems to be work-in-progress.
Main characteristics
- JSON format
- Erlang
- Apache license
- MVCC (Multi-Version Concurrency Control), which means that updates always result in new documents with a version+1. This leads to less performance in writes, but contributes to the crash-only design of CouchDB. This approach also enables you to use versioned updates, so you can check if the document still has the same version identifier to check if there was another update.
- No adhoc query, so indexes have to be created
- General REST interface that can be used for CRUD operations. There are several driver projects which make it easier to use the REST interface.
- Only atomic transactions
- Master-Master replication, which means that it's very well suited for offline work getting synced to the database server.
- No out-of-the-box sharding. There are additional frameworks for CouchDB available which do provide sharding support.
- No out-of-the-box clustering support. There are additional frameworks for CouchDB available which do provide sharding support.
- Apache project, the main supporting company is CouchBase. Cloudant provides CouchDB hosting and has created the BigCouch project.
- User mailing list has around 5-10 posts per day
- Main users: BBC, WWF, Ubuntu One, and others (http://www.couchbase.com/customers/case-studies, http://wiki.apache.org/couchdb/CouchDB_in_the_wild)
- Nice documentation book at http://guide.couchdb.org/
Core concepts
- Master/master replication. CouchDB can do replication in a lot of different use cases:
- Replicate a whole database
- Get the changes between two dates
- Replicate the changed collections and documents.
- Support for offline work. So replicate all changes made on a mobile phone to the server and replicate all server changes to the mobile phone.
- Replication with conflict resolution.
- Replication. Replication is supported out-of-the-box by the CouchDB API. So you can replicate one-way between two databases via the API. This replication can be made continuous, however at a server restart this continuous replication is aborted and must be manually started again. Frameworks like CouchDB Lounch provide support to create clusters with replication enabled.
Detailed information
- BigCouch is a fork of the CouchDB project by Cloudant (https://github.com/cloudant/bigcouch), which provides out-of-the-box support for creating clusters without breaking the CouchDB REST interface API. Seems to be a lot like the replication set functionality of MongoDB, but with CouchDB all nodes are equal masters, so requests can be handled by all nodes of a cluster.
- Sharding is not supported out-of-the-box, but there are frameworks like Lounch and Pillow that provide sharding support for CouchDB --> http://nosql.mypopescu.com/post/683838234/scaling-couchdb
- Durable crash-only design, which makes sure no data gets lost after a crash
- Versioning is natively supported with MVCC
- Master-master replication for offline work
- No additional drivers needed due to REST interface
- JSON and REST interface make it less optimal in network traffic
- Query support is more limited than with MongoDB
Main characteristics
- Binary format
- BSD license
- Writes (and also reads) are very fast, because Redis keeps a large in-memory set. The in-memory set is synced to disk at certain intervals (for example each 60 seconds).
- Key-value pair database
- Native language drivers
- Transaction support
- Master-Slave replication
- Sponsored by VMWare
- User list has between 1-5 posts a day
- Main users: Github, Stackoverflow, Guardian (http://redis.io/topics/whos-using-redis)
- Supported on CloudFoundry
- Redis on CloundFoundry --> http://blog.springsource.com/2011/04/27/getting-started-redis-spring-cloud-foundry/
Main characteristics
- Binary format
- Java
- Apache license
- Cassandra is designed to run on multiple servers, so its writing mechanism is mostly designed to replicate write actions across the network of servers.
- Key-value pair database, query options are limited
- Thrift communication protocol (binary)
- Apache project, Datastax provides support for Cassandra. In the PMC are employees of Facebook, Twitter, LinkedIn and Datastax
- Active community with around 20 posts per day on the user list
- Main users: Facebook, Twitter (not for the tweets), Rackspace, Cisco WebEx
- Introduction --> http://www.mikeperham.com/2010/03/13/cassandra-internals-writing/
- Architecture --> http://wiki.apache.org/cassandra/ArchitectureInternals


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Saturday, January 24, 2009
Interpreting Lab Work
Gluten sensitive patients not only have to do their own research regarding their symptoms but they have to self-diagnose and sometimes are forced to interpret their own lab tests!
I just received the following question:
A lady in my group has the following blood work and I need help with
Tissue Transglutaminase AB is 1.2
Endomysial Antibody is Negative
Gliadin IgA is 1
Gliadin IgG is 1
IgA (Immunoglobulin A) is 152
What does this last one mean? Is that a positive reading?
She had been previously diagnosed a few years ago with DH [dermatitis herpetiformis], but the doctor never told her about the GF [gluten-free] diet, so it was just forgotten. Fast forward a few years and now she was diagnosed with MS [multiple sclerosis]. The doctor at the Cleveland Clinic told her she should go on a GF diet because she probably also has celiac.
She met with me to learn about the GF diet. I suggested she get tested
for celiac first, which she did. Soon after she was tested and read the
information I gave her, she read about the DH and then mentioned she
had already been diagnosed with that. The diet is helping, but she would like to
know the meaning of her blood work. It looks to be negative except for the
IgA, but I don't know what the normal range is for that test.
And with DH, can you test negative via regular blood testing? According to
Dr. Green, you can, but I was wondering if anyone has come across this.
She is trying to understand all this and I want to give her the correct information.
Thanks everyone,
Mansfield, OH
What a sad story. I would like to say it's unique and uncommon but unfortunately quite the opposite is true. The lack of understanding of the damage gluten sensitivity can cause is staggering.
Here's a woman who several years ago was diagnosed with dermatitis herpetiformis, a very uncomfortable, unsightly skin condition for which the ONLY known treatment IS a gluten-free diet and she is never told about it. Adding insult to injury the gluten she continued to eat may very well be responsible for the autoimmune, degenerative nerve disease she is now diagnosed with, multiple sclerosis.
To answer the question posed regarding lab tests, let's take them one at a time. First I'd like to mention that if you want accurate data from a doctor regarding a lab result long distance, don't just include the result itself but also the reference range of the test. Labs differ in this regard and a result is only as valuable as the reference range is also included.
The data below comes from our book, The Gluten Effect – available February 13, 2009.
Anti-tissue Transglutaminase Antibodies - Anti-tissue Transglutaminase Antibodies (tTG antibodies) are auto-antibodies directed against "self" tissue. After gliadin crosses the intestinal lining, a special enzyme called tissue transglutaminase binds to gliadin and takes off a portion of the protein. This portion is called glutamine. tTG antibodies are antibodies that are directed against the complex of gliadin attached to the tissue transglutaminase enzyme. tTG antibodies are 90 percent accurate in Celiac disease because they represent immune system attack at the level of the intestinal lining. Gluten sensitivity that involves minor intestinal injury or no villous atrophy will be less likely detected by tTG antibodies. Therefore, tTG antibodies correlate best with villous atrophy as several studies have supported, and a negative tTG antibody test (or EM antibody test for that matter) does not rule out gluten sensitivity when intestinal involvement is minimal or absent.
Anti-Endomysial Antibodies - Anti-Endomysial Antibodies (EM antibodies) are auto-antibodies. Gliadin is a gluten protein so therefore when the immune system attacks it, is not attacking "self" tissues but instead a foreign food protein. In contrast, as gliadin is absorbed through the intestinal lining, it attaches to the smooth muscle cells of the intestinal wall. EM antibodies are directed against proteins of these smooth muscle cells, and therefore EM antibodies are directed against "self" tissue. This defines them as auto-antibodies.Because EM antibodies attack the smooth muscle of the small intestine, these antibodies correlate better with damage to the intestine wall. Studies have supported an accuracy rate of approximately 90 percent for Celiac disease. Actually in one study, EM antibodies were present in 100 percent of individuals when total villous atrophy was present. However, EM antibodies are ineffective in detecting individuals with silent or subclinical gluten sensitivity. If minor involvement of the intestinal lining occurs or if no intestinal involvement is present, EM antibodies are much less accurate.As with Anti-Gliadin Antibodies, EM antibody testing should evaluate IgG and IgA forms of antibodies. If a gluten sensitive patient is IgA deficient, IgA EM antibodies may be falsely negative even for Celiac disease.
Anti-Gliadin Antibodies - Gliadin is the protein component of gluten that triggers the immune reactions in sensitive people, and therefore many people with gluten sensitivity have antibodies to this protein. Testing for anti-gliadin antibodies (AGA) is a simple blood test, but studies have shown that it is less sensitive for detecting Celiac disease compared to other antibodies. The confusion is that the ability of AGA to detect gluten intolerance has been defined in conjunction with a positive intestinal biopsy. While this may be a standard for Celiac disease, we now know that this is an inaccurate standard for gluten sensitivity. In fact, AGA may be the best current diagnostic test when considering all gluten related disorders. In testing for AGA, antibodies of both the IgG and IgA classes are checked since low total levels of IgA may be present. If a person has low total IgA levels, antibody tests for IgA may be falsely negative.
Total Serum IgA Level - Low total levels of IgA antibodies are rarely found in the normal population with one out of every six hundred people having this condition, but in gluten sensitivity, low IgA levels are more common. This reflects the increased IgA antibody production in the intestine to fight off gluten as it attempts to enter our bodies. If a low level of IgA is present, then certainly IgG varieties of the antibody tests described above will be more accurate in diagnosing gluten related conditions. In general, total IgA levels are not ordered often since IgG antibody tests are usually ordered concurrently. Therefore, defining a low IgA level adds little information in making a diagnosis. There is a general theory however that a lower IgA level suggests greater inflammation of the intestinal lining and greater chronicity of disease. A low IgA level may provide some insight into duration of disease.
A high serum IgA level as seen in the above test is likely indicating an infection. Increased serum IgA is common in skin, gut, respiratory and renal infections. We know this patient has DH so secondary skin infections do make sense.
The reader also asks if blood tests can be negative with DH. Yes they can. Also remember that even those diagnosed with celiac disease via biopsy show negative blood results 15% of the time.
That's why the moral of the story at this time is to evaluate how you feel when you eat 100% gluten-free for a couple of months. Until we have highly sensitive tests we can rely on to accurately diagnose gluten sensitivity, diagnosing will involve "building a case" by pulling together many pieces of information about the patient including symptoms, response to a gluten-free diet, lab tests, genetic history, presence of intestinal infections, etc.
This leads us to explain some things about this particular patient. She has known DH which is solely due to gluten intolerance, yet it can be present with negative blood tests. Does that make the diagnosis or need for a gluten-free diet in question? Not at all. She is now diagnosed with MS. We know that, second to the digestive tract, the most common system to be affected by gluten is the nervous system with autoimmune diseases occurring at a very high rate. Does the negative test ensure that gluten had nothing to do with the development of MS? No, it doesn't. We'd need to know a lot more about this patient (which by the way is the most difficult part of hearing from readers long distance – I want more data.) but I wouldn't be surprised to find other factors which point to gluten as the culprit.
To Your Good Health!
Dr Vikki Petersen
57 comments:
Was told im not celiac....But I feel horrible. What do you think?
Found my old results:
Gliadin Antibody IGG 31 High Range <11
Gliadin Antibody IGA 6 Range <6
Reticulin igg ab <1:10 Range <1:10
Reticulin IGA AB <1:10 Range <1:10
Tissue Transglut. IGA <3 Range <5
Then last year Everything the same but Gliadin IgG 23.4 High Range <10
What does it mean that eveything is normal BUT the Gliadin IgG?
- The HealthNOW Doctors said...
I cannot diagnose you over the internet, of course, but I can tell you that the test the was performed was looking for indicators of both celiac disease and gluten sensitivity. That's good.
And while the celiac indicators are negative, gliadin antibody testing, whether IgG or IgA, is an indicator of gluten sensitivity.
I would be happy to assist you with more specific advice. Just give us a call for a free health analysis. Call 408-733-0400.
To your good health,
Dr Vikki
My daughter recently had the following blood work results. These were ordered by General Doctor as she was experiencing diarehha. No other major symptoms. The results were/are:
Gluten Sensitivity Panel
Endomysial Ab IgA negative
Tissue Transglutaminase Antibody
t Transglutaminase Ab IgA 23* 0-20 EU/ml
She was advised that she is allergic to all glutens.
Is that correct?
She has been referred for an ?endoscopic examination with a specialist.
Also does being a vegan contribute to this?
Please let us know about the results.
Thanks very much
: )
- The HealthNOW Doctors said...
A positive tTG test is indicative of celiac disease. You doctor is recommending a biopsy to confirm that diagnosis.
Even if the biopsy comes out negative, there has to be a reason the tissue of your daughter's small intestine is being destroyed.
If the biopsy is positive then there is no argument, of course, but do let me know if any confusion arises should the biopsy be negative.
Do understand that celiac is a genetic disease and being a vegan has absolutely nothing to do with its development. Personally I am pro-vegan, but that's beside the point.
If it critical that your daughter avoid all gluten plus get assistance in healing her gut. Typically general doctors don't excel at that.
Feel free to call me for a free health analysis and we can discuss specifics - 408-733-0400.
Your daughter can enjoy excellent health if the right things are done now. By the way, the rest of the family should be checked also - it is a genetic disease.
Dr Vikki
- Patricia V said...
I have been having stomach issues. I went for a blood test and they performed a celiac disease panel. This is the results:
Transglutaminase IgG <15
Transglutaminase IgA 27.3
Gliadin IgG: <15
Gliadin IgA <15
My primary dr. said he thinks I have Celiac Disease (and so does my mother). He wants me to make an appt with a Gastrointerologist. Just by the numbers (after all my research) it looks like Celiac. Transglutaminase is elevated isn't that indicative of Celiac? I am just confused by the might.
Any thoughts?
- Patricia V said...
I have been feeling lousy and so my dr did a blood test to check for Celiac since my mother has it. When he called me back he said I need to see a Gastrointerlogist because I probably have Celiac. He sent my my resuls and I am a little confused after doing some research.
These are my results.
Transglutaminase IgG <15
Transglutaminase IgA 27.3
Gliadin IgG <15
Gliadin IgA <15
Using numbers only since you don't know me. Do I have Celiac? I am a little confused when my primary care dr says I may have Celiac.
Any opinions until I see the gastro dr would be great!
What are abnormal results? My tests. were tissue Transglutaminase igG
0.15. IgA 0.50 is this celiac??
- The HealthNOW Doctors said...
It depends on the lab. There is a normal range. Anything above that would be highly suspicious.
If you want to give me more data I'd be happy to help with further questions.
Dr Vikki
- The HealthNOW Doctors said...
Dear Patricia V,
Yes, you are correct. An elevated tTG level IS indicative of celiac disease.
Too often, even positive tests are not acted upon aggressively by clinicians who aren't expert in the area of gluten.
Please consider calling us for a free health analysis. We are here to help! Call 408-733-0400.
Dr Vikki
This are my test results:
Gliadin Ab (IGA) 49
units (<20)---[Is it very high? What would be the highest number?]
Gliadin Ab (IGG) 13
>or 20 Antibody detected
Endomysial Ab Scrn: Positive
Those were tests I had for celiac. Doctor told me to go on gluten free diet since tests are positive for celiac disease. But what does it mean that IGG is negative? And IGA 49 confirms celiac?
I didn't have a biopsy performed. I am 4 months on gluten free diet and I am not feeling better. :(
Thank you
- The HealthNOW Doctors said...
@ Ada,
It is the positive endomysial test that is causing your doctor to diagnose celiac disease.
The AGA tests, one of which is positive is indicative of gluten intolerance, but doesn't make a distinction between celiac and gluten sensitivity. But with the endomysial positive, that indicates celiac.
Understand that anything positive is positive.
Either you have celiac or you don't. There's no such thing as 'mild celiac' or 'a little celiac'. In other words, whether the number was 21, 31 or 81, it wouldn't matter - the point is that it's positive.
The reason you don't likely feel better is that the secondary effects associated with gluten are not being addressed for you.
That is our specialty and it's not difficult to address. If you'd like help please consider calling us for a free health analysis. Call 408-733-0400 - we are here to help.
Dr Vikki
I have a transglutaminase IgG of 34.7 which said 15 is average. The endomysial Iva is negative. Tirer is negative. Immounoglobulin a is 136. Primary said maybe is celiac. Gastronomic said both could be false positives need to do endoscopy. I have to go to specialist but why is level high and do u think this is celiac. Any other blood test that could help diagnose with endoscopy. Thank you
- The HealthNOW Doctors said...
The positive tTG is quite suspicious of celiac disease. I don't know what your symptoms are but a biopsy is a way to confirm.
With that said, do understand that biopsies are not perfect and it is possible to have celiac disease with a negative biopsy.
If you'd like a free health analysis so that I can better understand your health status, you are welcome to do so. Call 408-761-3900.
It is very important that you find out conclusively if a gluten-free diet is something that you need to implement.
I'm happy to assist you.
My results are:
Transglutaminase Ab (Iga) <3
IGA SERUM 52 low
c-reactive is high
speckled 1:80
Feel awlful, weight gain, have high blood pressure,imflammation and pain.
- The HealthNOW Doctors said...
Dear Anonymous,
When you're general IgA results are low, any test utilizing that immunoglobin will be false. Therefore we cannot tell whether you have a positive tTG or not. It's too bad that the lab did not also measure IgG. Most labs these days do that for this exact reason.
The high C-reactive protein shows inflammation, so it is important to figure out where that it coming from.
You can contact us for a free health analysis (408-733-0400) if you'd like.
Dr Vikki
My mother has celiac disease and I been having stomach pain a day or two after eating wheat product. I was tested and the results are confusing;
IMMUNOGLOBULIN A 248 mg/dL [46-287]
TISSUE TRANSGLUTAMINASE IgA 3 units [<19]
Can you advise if this may be false negative? Why is the IgA so low?
- The HealthNOW Doctors said...
It's not actually confusing, just potentially incomplete.
The tTG is negative and the IgA is normal too. While one could say this is a negative celiac test, it really should include a blood test for anti-gliadin antibodies and deaminated giadin - 2 more blood tests used in a celiac panel.
It is unfortunate that we don't have one perfect test, but we don't. Another great test, if you're still consuming gluten is Cyrex Labs comprehensive profile for both celiac and gluten sensitivity.
You obviously feel poorly after eating gluten, now we just need to find out if you're gluten sensitive or celiac. A genetic test is another option.
Hopefully I'm not confusing you!
If you'd like a free health analysis where we could speak more personally, consider calling us at 408-733-0400.
Dr Vikki
- Rosanne Zimmerman said...
Hello Dr. Vikki
My daughter is gluten sensitive and was having general ill health and CNS problems ie. muscle ticks. Gluten free two month and lost 20lbs and said she did not know she could have so much energy. Muscle ticks are minute now. Anyways before going gluten free we did have the celiac test done. Gliadin AB: IgA was <3(ref 0-20), Gliandin AB: IgG was 5(ref0-20) and Tissue Transglutaminase was 3(ref 0-20). Now I get these numbers are below the ref range for celiac and I know due to a gluten free diet she is sensitive or intolerant. I am just trying to interpret her numbers. Her neurologist said the if she did not have gluten intolerance then she would not have antibodies. Is this true? Would a healthy person without gluten problems have 0 antibodies. Does the indication of any antibodies indicate gluten sensitivity? I am reading your wonderful book and just trying to understand all of this as I just had my testing done as well. I was gluten free before having the test done so may not be so accurate but read that as long as one is not gluten free more than 6 months they can still have blood test do to antibodies still being produced. Is that true? Just want to know how to interpret my tests when they come back. This is so complex. I recommend your book to everyone. Very easy to read on such as complex issue.
I recently had blood work done because my dr suspects I have celiac. Here are my blood work results:
TISSUE TRANSGLUTAMINASE ANTIBODY, IGA 1 U/mL
IMMUNOGLOBULIN A 508 (Standard Range is 81-463 mg/dL)
GLIADIN ANTIBODY (IGA) 11 Units
My doctor said she thinks it's positive for celiac but suggested I follow up with a GI doctor.
I can see by IGA is above standard range, but what do the other numbers mean? They both seem to indicate that there is no antibody detected - does that mean it is positive for celiac?
Any thoughts would be appreciated!
I recently had blood work done because my dr suspects I have celiac. Here are my blood work results:
TISSUE TRANSGLUTAMINASE ANTIBODY, IGA 1 U/mL
IMMUNOGLOBULIN A 508 (Standard Range is 81-463 mg/dL)
GLIADIN ANTIBODY (IGA) 11 Units
My doctor said she thinks it's positive for celiac but suggested I follow up with a GI doctor.
I can see by IGA is above standard range, but what do the other numbers mean? They both seem to indicate that there is no antibody detected - does that mean it is positive for celiac?
Any thoughts would be appreciated!
- The HealthNOW Doctors said...
The tTG is definitely negative at 1, but depending on the lab used, I don't know if the AGA at 11 is considered to be positive. It would be for my lab but different labs have different reference ranges.
The IgA is a bit high indicating some immune system stress, but unclear as to why at this point.
So, I need more data. Also, realize that these tests aren't perfect so a negative test could still mean a positive gluten intolerance.
I know that's a little frustrating, but we can figure it out. If you'd like assistance please consider calling us for a free health analysis - 408-733-0400.
- yasmin said...
my 4 yearold daughter was diagonised for celiac disease 1 year before.she was confirmed after a biopsy. Since then she eats gluten freefood.After 6 mnths her endomysium Abs (IgA)become 5.87.it has dropped down from >200 which was at the time of diagonisis.now after an year her level is 13.47.i wud like to know y it has increased?
- The HealthNOW Doctors said...
Dear Yasmin,
Each lab has different reference ranges. Is the '13' above the reference range? In other words was 5 negative and is the 13 positive?
If the 13 is still below the reference range, I wouldn't be concerned. As long as the number is negative, your daughter is doing well.
If the 13 is positive, then I would be looking at contamination, hidden gluten and potentially cross-reactive food reactions.
Consider contacting us for a free health analysis if you would like some assistance figuring it out. Call 408-733-0400.
Dr Vikki
My Tissue Transglutamianse IgA serum result is 23.05, range is <18. does it mean i have celiac disease?
My Tissue Transglutamianse IgA result is 23.05, range is <18. does it mean i have celiac disease?
- The HealthNOW Doctors said...
It is quite suspicious. What does your doctor say? Do you have symptoms of celiac disease? Can you get a genetic test? Does celiac disease run in your family?
As you can see I have many questions. Please feel free to write back.
i would so much appreciate help with labs.pediatrician ran celiac panels and kids were under 19(=negative) for tTG igG and tTG IgA, so the lab did not perform the endomys igA. they tested under 19(=negative) for dgp IgG and igA, too.i am still worried because i have two dq8's, out of range occludin/zonulin IgM and lipopolysaccarides IgM. my transglutaminase-6 IgG is 2.29(should be below 1.5).can my kids still have transglutaminase-6 damage from other proteins that they need tested for?
- anonymous said...
I asked for gluten blood tests at a private lab on my own (without a doctor) because I'm living overseas right now. This was after reading symptoms online. Can someone help me interpret the results?
IgA 1,7
IgG 0,9
Anti-IgA 19,4
Anti-IgG 3,0
- The HealthNOW Doctors said...
Dear Anonymous,
Labs have reference ranges - meaning a range that they consider normal. You'd need to include that information for me.
Was the IgA for tTG, endomysial, anti-gliadin? That seems to be missing as well.
You need to look carefully at the report that you received and include all the data.
Dr Vikki
thank you for your help.
Yes it has references which I found difficult to understand. Here they are with my numbers there also:
IgA 1,7 antibodies to tissue transglutaminase
negative: 0,0-10,0 U/ml positive: => 10,0 U/ml
IgG 0,9 antibodies to tissue transglutaminase
negative: 0,0-10,0 U/ml positive: => 10,0 U/ml
Anti-gliadin IgA 19,4
negative: 0,0-12,0 U/ml positive: => 12,0 U/ml
Anti-Gliadin IgG 3,0
negative: 0,0-12,0 U/ml positive: => 12,0 U/ml
Apologies if you receive this 2x-hadn't logged on.
Thank you for helping! Here is is again with the references:
1,7 IgA antibodies to tissue transglutaminase
Negative 0,0-10,0 U/ml Positive >/= 10,0- U/ml
0,9 IgG antibodies to tissue transglutaminase
Negative 0,0-10,0 U/ml Positive >/= 10,0- U/ml
19,4 Anti-gliadin IgA
Negative 0,0-12,0 U/ml Positive >/= 12,0- U/ml
3,0 Anti-gliadin IgG
Negative 0,0-12,0 U/ml Positive >/= 12,0- U/ml
Elisa (test name?) written under numbers
- The HealthNOW Doctors said...
The positive result is the AGA IgA. This test being positive is consistent with gluten sensitivity, although it is possible to be positive in celiac disease. With the other results being negative the more likely disorder is gluten sensitivity but this would need to be corroborated with other information.
I cannot diagnose you over the internet, of course, but if you'd like some assistance, consider contacting us for a free health analysis - call 408-733-0400.
We are here to help!
- The HealthNOW Doctors said...
Dear Anonymous asking about your children. Yes, they could have tTG-6 possibly. Have you done genetic testing on the children.
That might be a good place to go next.
If you need assistance, consider calling us for a free health analysis - 408-733-0400. We are here to help!
Hi - I think I'm dealing with the opposite problem of most people here. My lab results seem to say that, if anything, I only have a mild gluten allergy yet I have a doctor saying I can never eat wheat, gluten or dairy again for the rest of my life (the last shows in very low positive - just .06 over the Equivocal range into 'Out of Range' - and Equivocal ranges on a Cyrex lab).
I have LabCorp tests:
Deamidated Gliadin Abs, IgA=4 units (1-19 Negative; 20-30 Weak Positive; >30 Moderate to Strong Positive)
Deamidated Gliadin Abs, IgG=2 units (1-19 Negative; 20-30 Weak Positive; >30 Moderate to Strong Positive)
t-Transglutaminase (tTG) IgA = <2 U/ml (0-3 = Negative; 4-10 Weak Positive; >10 Positive)
t-Transglutaminase (tTG) IgG = <2 U/ml (0-5 = Negative; 6-9 Weak Positive; >9 Positive)
Endomysial Antibiody IgA Negative
Immunoglobulin A, Qn, Serum = 222 mg/dl (91-414 Limit range)
Is this doctor trying to hit me with a "Every problem is Gluten sensitivity or Celiacs!" hammer when that's not my problem? (I'm also fighting Lymes Disease.)
- The HealthNOW Doctors said...
Dear Anonymous,
I understand your confusion; let me explain. The Lab Corp results you cite are for celiac disease and those are negative.
The Cyrex test you received, based on the value you gave me, is stating positive for gluten sensitivity. I know Cyrex quite well and they feel that anything in the 'equivocal' range, let alone the 'positive' one is cause for serious consideration. In other words, even if you hadn't just barely crossed out of equivocal into out of range, your doctor would still likely have recommended you go gluten-free and I don't disagree.
Have you tried it? Do you feel better on a gluten-free diet? These too are valid questions.
It's hard to give you more information without a conversation. If you'd like a free health analysis, consider calling us at 408-733-0400.
I hope that helped!
Dr Vikki
Thanks, Dr. Vikki!
I've asked for Cyrex Array 3 to be done (that was never done) and I think that will clear things up for me. Your explanation helps as well. So, not Celiac but mild gluten crossover allergies given the following:
- Cow's Milk 1.11 (Noted as Equiv; - range=0.1-1.3)
- Casein 1.26 (range=0.1-1.2)
- Casomorphin listed as negative at 0.58 even though the range=0.2-1.6???? What the heck?? Why is this not listed as Equiv?)
- Milk Butyrophilin 1.15 (Noted as Equiv; range=0.1-1.3)
- Whey Protein 1.35 (range=0.1-1.3)
- Chocolate (milk) 1.01 (Noted as Equiv; range=0.1-1.4 - thank goodness I like dark chocolate which I was told is ok)
- Coffee 2.30 (range=0.2-1.2 - was told this is only for instant coffee but I rarely have more than a sip of good quality coffee a month so no big loss)
- Sesame 2.79 (range=0.1-1.3)
Oddly, while Sesame is my strongest response, I'm told I can not have any for 6 months and then I can try adding it back in. Dairy response numbers are so much lower and yet Sesame is going to be ok with me in 6 months vs. dairy is something I'm never again supposed to have?? That and the value vs. the range of Casomorph make no sense to me.
I've seen some Cyrex array 4 lab results online where 80% or more are listed as problems so I'm told I'm lucky. That being said, I did great on SCD which includes butter, hard cheeses, and homemade yogurt that's been fermented 30+ hours. I stopped living that way 100% of the time because it was a) expensive, b) inconvenient, and c) time consuming.
While I absolutely do better keeping dairy (and even wheat) in moderation, I certainly don't wreck myself when I have the occasional ice cream or grain product. In fact, when I am regularly working out, I don't seem to have any problems with such things at all. Further, I don't have a problem with these foods when I'm overseas (but, for grain products, that's more to do with an inability to use folic acid and being MTHFR C677T homozygous - another kettle of fish. Thyroid is mixed in there too as I hurt when I eat these things if I'm not on T3/T4 but, again, only in the United States - I don't have a thyroid issue while in 4 other countries I've been for work.
- Annie Garrie said...
Hi, both my sons were told to go on gluten free diet after one of the four tests had come back pos. I don't know what test came back pos for my oldest, but I am going to get to the bottom of that soon. My other sons IgG was 56. What exactly does this mean? Everything else is normal range. I have been reading up and it scares me that he may not have celiac, but maybe a different autoimmune disease. I have him on a gf diet for 3 months now, and not sure what to do next to make sure this is all we need to do. Please help
- Annie Garrie said...
Hi, I just was told my sons IgG was what came back pos on his Celiac panel. His IgG was 56, and I'm not sure what exactly that means. I was told put him on a gf diet. I did more research online and am now wondering if it's possible with it being so high that he may have a different autoimmune disease. What are your thoughts?
- The HealthNOW Doctors said...
Hello Annie,
I'm sorry for the delay in getting back to you. We get a lot of traffic and every once in a while an email gets missed, I apologize.
I would need more information in order to answer your question. IgG is a part of the immune system, not the name of the test. There would be more to it. Also a "56" doesn't mean much without the reference range.
I know as a parent how frustrating it can be to not fully understand or get answers as regards your children's health.
I would like to offer you a free health analysis (just call 408-733-0400) and then we can talk and I can better assist you and your children.
I look forward to hearing from you.
- The HealthNOW Doctors said...
Hello again Annie,
Well I no sooner post my last comment and another question appears from you that did clarify things quite a bit.
So it was a celiac test and "56" was quite high - got it. There are other criteria to use to determine if it's truly celiac and do know that a biopsy doesn't have to be one of them as it in quite invasive for a child.
As I mentioned earlier, I'd be happy to discuss it further with you over the phone and I can give you specific ideas of how best to proceed.
- The HealthNOW Doctors said...
I cannot give medical advice to you over the internet but speaking generally, I can give you some ideas. The positive amongst these is the anti-gliadin antibody, IgA. While not conclusive, this test is often used as an indicator for gluten sensitivity.
I'm assuming you were eating gluten at the time of the test- correct?
The best next step I could suggest is to consider contacting us for a free health analysis - call 408-733-0400. That way we could speak directly and I could get more information.
I wouldn't ignore these results. I would behoove you and your health to find a clinician who is an expert in this field if you choose not to contact us.
Good luck!
- The HealthNOW Doctors said...
@Roseanne- Gluten tests aren't really accurate if you're perfectly off it much beyond 3 weeks after elimination.
As regards your daughter, did the test her total IgA. I'm wondering if the total was low - that would skew her tests. Low IgA is quite common in those w/ gluten issues.
I'm glad you enjoy the book!
If you or your daughter needs some assistance, consider contacting us for a free health analysis - call 408-733-0400. Then we can speak and create the best approach to optimize your and her health.
We are here to help!
I just received results from a celiac panel and am having a hard time interpreting the results based on the research I've done.
gliadin antibody iga 4 (less than 20 is normal)
gliadin antibody igg 3 (less than 20 is normal)
ttg iga 5 (less than 20 is normal)
ttg igg 4 (less than 20 is normal)
According to this report everything is normal...but in some of my research it looks like Iga levels less than 7 indicate another problem. Am I misunderstanding my research?
- The HealthNOW Doctors said...
Hello Anonymous,
What you are thinking of is that if the total IgA is low then tests measuring IgA such as the tTG and AGA can be falsely negative.
This is true. It doesn't appear that they tested your total IgA. At least you don't mention it.
So your tests could very well be negative, but without the total IgA number we can't know for sure.
Let me know if you need any assistance.
Hi please can you help decipher my blood test results.
Tissue transglutaminase IgA level =1.8 kU/L (<5.0) and IgM = 0.76 g/L and IgA= 2.76 g /l and IgG =14.2 g /L.
I was told to go on gluten free diet the month before.
Doctor said my previous Tissue Transglutaminase IgA level was 17.9 kU/L. So its come down greatly to 1.8. I'm still confused as she fully explain my results. Please can you help? Thanks.
Hello I just received my blood results
Tissue Transglutiminase, 0.4
Tissue Transglutimnase, IgG <0.6
Gldn Antibody,IgA(Deamid) 1.0
Gldn Antibody,IgG(Deamid) <0.4
Tissue Transglutiminase, IgA <7 IU/mL 0.4
Tissue Transglutimnase, IgG <7 IU/mL <0.6
Gldn Antibody,IgA(Deamid) <7 IU/mL 1.0
Gldn Antibody,IgG(Deamid) <7 IU/mL <0.4
Positive or negative??
Tissue Transglutiminase, IgA <7 IU/mL 0.4
Tissue Transglutimnase, IgG <7 IU/mL <0.6
Gldn Antibody,IgA(Deamid) <7 IU/mL 1.0
Gldn Antibody,IgG(Deamid) <7 IU/mL <0.4
- The HealthNOW Doctors said...
@ Anonymous who recently posted. All the values you wrote down are negative.
That doesn't necessarily mean you don't have a problem w/ gluten as there are more comprehensive tests, but the ones you cite are negative.
If you're having health difficulties and want to get to the root cause of what's happening, consider contacting us for a free health analysis (call 408-733-0400). We are here to help and treat patients from across the country and internationally.
- The HealthNOW Doctors said...
@Anonymous whose doctor stated the tTG level for IgA has come down:
The IgG level is still elevated based on the values you wrote down.
I would be happy to help. My best suggestion is to call us for a free health analysis (call 408-733-0400) so that we can discuss how you're feeling and what you've done thus far.
We are a destination clinic and treat patients from across the country and internationally. We are here to help!
I look forward to hearing from you.
- Amy said...
My 3 year old son was just tested. His older sister has confirmed Celiac. Two years ago, his test was negative. This is now his panel:
Total Serum IgA: 30 (44-189)
Gliadin IgA AB: 6 (No reference)
Gliadin IgG AB: 21 (High)
Transglutaminase IgA AB <2 (0-3)
Translutaminase IgG AB 6 (0-5)
Endomysial AB IgA Negative
Help! What does this mean??
- The HealthNOW Doctors said...
Hello Amy,
I understand your confusion. I very much want to help you and your son.
Please consider contacting me at the clinic for a free health analysis - it's no charge and then we can speak. It's a better format than this one to ensure I answer all your questions.
Just call 408-733-0400.
I look forward to hearing from you!
Dr Petersen
Here are my test results
Coeliac serology
Deaminated Gliadin Iga 1 U/mL (<15)
Deaminated Gliadin IgG <1 U/mL (<15)
Tissue Transglutaminase IgA <1 (<15)
Tissue Transglutaminase IgG <1 (<15)
Told its a normal result fir a person who eats wheat.
I also have done a simtomax test which indicated positve for coeliac disease and IgA deficient, I am confused. Any comments appreciated thanks
- Kamber said...
So I am trying to understand what some tests mean. If there are gliadin antibodies present but not necessarily at the level to be classified as Celiac disease, or if there are transglutaminase antibodies present even if they are not over the levels considered to be celiac, would that mean that there is gluten sensitivity?
- Kamber said...
Trying to understand gluten sensitivity. Do you all people have antibodies towards gluten? If labs indicate that there are antibodies present but not at "celiac levels", then would this be classified as gluten sensitivity?
- The HealthNOW Doctors said...
Tests have ranges. There is a normal range and above that level a patient is considered "positive" for a certain disease or condition. So if a celiac panel is negative, in the normal range, the patient is told they don't have celiac disease. Similarly if a patient is tested for anti-gliadin antibodies to see if they may have gluten sensitivity, there too is a range of normal and abnormal that would be evaluated.
And, now that I've made it sound so simple, I'd be remiss to not mention that tests aren't perfect and there are ways to "read between the lines" and issues to consider when evaluating labs.
If you are not feeling well and need assistance, consider contacting us for a free health analysis - call 408-733-0400.
We are a destination clinic and treat patients from across the country and internationally.
We are here to help!
I look forward to hearing from you!
- The HealthNOW Doctors said...
@ Anonymous w/ test results.
A deficient IgA will skew the results of tests that use it as a yardstick, which many coeliac tests do.
I'm not familiar with the symtomax test, but I do often find deficient IgA in those patients with coeliac or gluten sensitivity, so that part does ring true.
I'd need a bit more information to assist you. Consider contacting us for a free health analysis - call 408-733-0400.
We are a destination clinic and treat patients from across the country and internationally.
We are here to help!
I look forward to hearing from you!


text:
Reviewer: Thomas Dilling, MD
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 18, 2002
Presenter: V.M.P. Johnson
Presenter's Affiliation: Brown University Medical School
Type of Session: Scientific
Materials and Methods
Author's Conclusions
Clinical/Scientific Implications
Oncolink's ASCO Coverage made possible by an unrestricted Educational Grant from Bristol-Myers Squibb Oncology.
Sep 15, 2010 - Terminal cancer patients who die in the hospital have higher distress levels and worse quality of life at the end of life than those who die at home with hospice care, and their bereaved caregivers are more likely to experience psychiatric illness, accord
May 22, 2015


text:
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|The Nixon Showoff Wallet is a made of leather and features clear picture id slot, plenty of room for your credit cards and essentials, with custom woven label trims.


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Strawberry Slicer
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Diamond Bar Dermatologist Doctors for Bed Bugs
Type of Physician: Dermatologist
What is a Dermatologist?
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RBGB Dermatology Group
RBGB Dermatology Group
RBGB Dermatology Group
RBGB Dermatology Group
RBGB Dermatology Group
Diamond Bar, California
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Emergency Contact for Diamond Bar
Nearby Diamond Bar Hospitals *
Lanterman Developmental Center
American Recovery Center
Kindred Hospital-Brea
San Dimas Community Hospital
Pomona Valley Hospital Med Ctr
Landmark Medical Center
Aurora Charter Oak Hospital
Citrus Valley Medical Center
Kindred Hospital
Citrus Valley Medical Center
Casa Colina Hospital For Rehab
Placentia Linda Hospital
California Institution For Men
Canyon Ridge Hospital
Doctors Hospital Of West Covina
Chino Valley Medical Center
East Valley Hospital Med Ctr
Montclair Hospital Medical Ctr
Foothill Presbyterian Hospital
St Jude Medical Center
Kaiser Permanente Medical Ctr
Orange Cnty Anaheim Med Cntr
Whittier Hospital & Medical Ctr
Kindred Hospital Ontario
City Of Hope National Med Ctr
Kindred Hospital La Mirada
Anaheim Regional Medical Center
Greater El Monte Community Hosp
Presbyterian Intercommunity
San Antonio Community Hospital
Anaheim General Hospital
Western Medical Center Anaheim
Metropolitan State Hospital
Chapman Medical Center
Healthbridge Children's Hosp
Norwalk Community Hospital
BHC Alhambra Hospital
UCI Medical Center
CHOC Children's Hospital Orange
Methodist Hospital Southern CA
St Joseph Hospital Of Orange
Beverly Hospital
West Anaheim Medical Center
La Palma Intercommunity Hosp
Anaheim General Hospital
Garden Grove Hospital & Med Ctr
Silver Lake Medical Center
Coast Plaza Hospital
Kindred Hospital Of Santa Ana
San Gabriel Valley Medical Ctr
Western Medical Center
Corona Regional Medical Center
Garfield Medical Center
College Hospital Cerritos
Healthsouth Tustin Rehab Hosp
Aurora Las Encinas Hospital
Downey Regional Medical Center
Monterey Park Hospital
Kaiser Permanente Medical Ctr
Corona Regional Rehabilitation
Tri-City Regional Medical CT
Newport Specialty Hospital
Alhambra Hospital Medical Ctr
Kindred Hospital-Westminster
Bellflower Medical Center
Los Alamitos Medical Center
Rancho Los Amigos Hospital
Lapaz At Paramount
Los Angeles Community Hospital
Coastal Communities Hospital
East Los Angeles Doctors Hosp
Huntington Memorial Hospital
Lakewood Regional Medical Ctr
Promise Hospital Of East LA
Fountain Valley Regional Hosp
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