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vitamin e (generic name)
a vitamin - treats Atherosclerosis, Seizure disorder, Steatohepatitis, Respiratory infection prevention, Osteoarthritis, Parkinson's disease, P...
Table of Contents
Top Learning Centers(Recursos en Español)
Alternate TitleAlpha-tocopherol
CategoryHerbs & Supplements
All rac-alpha-tocopherol, alpha-tocopherol, alpha tocopherol acetate, alpha tocopheryl acetate, alpha tocotrienol, antisterility vitamin, beta-tocopherol, beta-tocotrienol, d-alpha-tocopherol, d-alpha-tocopheryl, d-alpha-tocopheryl acetate, d-alpha-tocopheryl succinate, d-beta-tocopherol, d-delta-tocopherol, delta-tocopherol, delta-tocotrienol, d-gamma-tocopherol, dl-alpha-tocopherol, dl-alpha-tocopheryl acetate, dl-tocopherol, d-tocopherol, d-tocopheryl acetate, dl-tocopherol, gamma-tocopherol, gamma-tocotrienol, mixed tocopherols, RRR-alpha-tocopherol, Spondyvit®, tocopherol, tocotrienol, tocotrienol concentrate, tocopheryl succinate.
Vitamin E is a fat-soluble vitamin with antioxidant properties. Vitamin E exists in eight different forms ("isomers"): alpha, beta, gamma, and delta tocopherol; and alpha, beta, gamma, and delta tocotrienol. Alpha-tocopherol is the most active form in humans. Dosing and daily allowance recommendations for vitamin E are often provided in Alpha-Tocopherol Equivalents (ATE) to account for the different biological activities of the various forms of vitamin E, or in International Units (IU), which food and supplement labels may use. Vitamin E supplements are available in natural or synthetic forms. The natural forms are usually labeled with the letter "d" (for example, d-gamma-tocopherol), whereas synthetic forms are labeled "dl" (for example, dl-alpha-tocopherol).
Vitamin E has been proposed for the prevention or treatment of numerous health conditions, often based on its antioxidant properties. However, aside from the treatment of vitamin E deficiency (which is rare), there are no clearly proven medicinal uses of vitamin E supplementation beyond the recommended daily allowance. There is ongoing research in numerous diseases, particularly in cancer and heart disease.
Recent concerns have been raised about the safety of vitamin E supplementation, particularly in high doses. An increased risk of bleeding has been proposed, particularly in patients taking blood-thinning agents such as warfarin, heparin, or aspirin, and in patients with vitamin K deficiency. Recent evidence suggests that regular use of high-dose vitamin E supplements may increase the risk of death (from "all causes") by a small amount, although a different study found no effects on mortality in women who took vitamin E daily. Caution is warranted.
EvidenceDISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Vitamin E deficiency:
Vitamin E deficiency is rare, and may occur in people with diminished fat absorption through the gut (due to surgery, Crohn's disease, or cystic fibrosis), malnutrition, very low-fat diets, several specific genetic conditions (abetalipoproteinemia, "Ataxia and Vitamin E deficiency" [AVED]), very low birth weight premature infants, or infants taking unfortified formulas. Vitamin E supplementation is accepted as an effective therapy for vitamin E deficiency to halt progression of complications. Diagnosis of this condition and management should be under the care of a physician and nutritionist.
Allergic rhinitis:
Although thought to aid in reducing the nasal symptoms of allergies, vitamin E intake may not be effective. Current evidence is limited, however, and more studies are needed before a firm conclusion can be drawn.
Altitude sickness:
Vitamin E may offer some benefits in exposure to high altitude. Antioxidant supplementation (vitamin E with beta carotene, vitamin C, selenium, and zinc) may improve ventilatory threshold at high altitudes; however, antioxidants may not reduce inflammation after exercise at high altitudes. More research is needed before conclusions can be drawn.
Studies of vitamin E supplementation for anemia have yielded mixed results. Further research is needed before a firm recommendation can be made.
Vitamin E has been suggested and evaluated in patients with angina, although possible benefits remain unclear. Further evidence is necessary before a clear conclusion can be drawn. Patients with known or suspected angina should be evaluated by a physician.
Vitamin E possesses antioxidant activity, but it is not clear if there is any benefit of this property in humans. The American Heart Association has recommended obtaining antioxidants such as vitamin E by eating a well-balanced diet high in fruits, vegetables, and whole grains, rather than from supplements, until further scientific evidence is available.
Vitamin E has been proposed to have a role in preventing or reversing atherosclerosis by inhibiting oxidation of low-density lipoprotein ("bad cholesterol"). Several population studies have suggested that a high dietary intake of vitamin E and high blood concentrations of alpha-tocopherol are associated with lower rates of heart disease. However, while the Cambridge Heart Antioxidant Study supported this hypothesis, the more recent prospective Heart Outcomes Prevention Evaluation (HOPE) study did not. This area remains controversial.
Bladder cancer:
There is preliminary evidence of possible benefits of long-term vitamin E supplementation to reduce the risk of mortality in bladder cancer patients, although additional research is necessary before a clear conclusion can be reached.
Breast cancer:
Vitamin E has been suggested as a possible therapy for the prevention or treatment of breast cancer. Published studies have included measurement of vitamin E levels, laboratory experiments, and population studies. Evidence remains inconclusive, and no clear conclusion can be drawn at this time.
Breast cancer-related hot flashes:
A study of oral vitamin E reports a very small reduction in hot flash frequency (approximately one less hot flash per day), but no preference among patients for vitamin E over placebo.
Cancer treatment:
There is a lack of reliable scientific evidence that vitamin E is effective as a treatment for any specific type of cancer. Caution is merited in people undergoing treatment with chemotherapy or radiation because it has been proposed that the use of high-dose antioxidants may actually reduce the anti-cancer effects of these therapies. This remains an area of controversy and studies have produced variable results. High doses of vitamin E may also cause harm in cancer patients. Patients interested in using high-dose antioxidants such as vitamin E during chemotherapy or radiation should discuss this decision with their medical oncologist or radiation oncologist.
Cardiovascular disease in dialysis patients:
It has been suggested that hemodialysis patients may be under increased oxidative stress, and therefore may benefit from the chronic use of antioxidants (particularly for the reduction of risk of heart disease). There is some research on the use of high-dose chronic vitamin E in dialysis patients for heart disease prevention, although benefits or risks remain unclear in this population. Recent concern has been raised that regular use of high-dose vitamin E supplements may actually increase the risk of death (from "all causes") by a small amount, although this remains an area of controversy and active investigation. Additional research is necessary in this area before a firm conclusion can be reached.
Cataract prevention:
There is conflicting evidence regarding the use of vitamin E to prevent cataracts. Although some studies across populations have suggested some protective effects (which may take up to 10 years to yield benefits), other studies in humans report a lack of benefits when used either alone or in combination with other antioxidants. Additional research is necessary before a clear conclusion can be reached.
Chemotherapy nerve damage (neurotoxicity):
Like other antioxidants, vitamin E has been suggested as a therapy to prevent complications due to chemotherapy, such as nerve damage (neuropathy). There is some evidence of benefits, for example, when it is used with cisplatin. However, caution is merited because it is not known if the use of high-dose antioxidants during chemotherapy may actually reduce the anti-cancer effects of some chemotherapy agents or radiation therapy. This remains an area of controversy and patients interested in using antioxidants during chemotherapy should discuss this decision with their oncologist.
Colon cancer prevention:
There is not sufficient scientific evidence to determine if vitamin E prevents colon cancer. In patients with previous colon cancer, a combination of vitamins A, C, and E has been reported to reduce the risk of developing a new colon cancer. Preventive benefits have also been suggested in those with no prior colon cancer when vitamin E is used in a multivitamin, but not when used alone. Recent results of the Women's Health Study report no overall reduction in cancer risk with daily use of vitamin E, although this study was not large enough to look at colon cancer specifically. Additional research is necessary in this area before a firm conclusion can be reached.
Dementia / Alzheimer's disease:
Vitamin E has been proposed and evaluated for the prevention or slowing of dementia (including Alzheimer's type), based on antioxidant properties and findings of low vitamin E levels in some individuals with dementia. There is some evidence that all-rac-alpha-tocopherol (synthetic vitamin E) is similar in efficacy to selegiline (Eldepryl®) and superior to placebo for slowing cognitive function decline in patients with moderately severe Alzheimer's disease, but no additive effect was observed when used in combination with selegiline. Retrospective data suggests that long-term combination therapy with donepezil (Aricept®) may help slow cognitive decline in patients with Alzheimer's disease. Overall, the evidence remains inconclusive in his area.
Other research suggests that vitamin E from dietary sources or supplements does not affect the risk of developing Alzheimer's disease or vascular dementia.
Diabetes mellitus:
Vitamin E has been proposed for the prevention of types I or II diabetes; for the improvement of abnormal sugar control in diabetes; for prevention of platelet dysfunction and atherosclerosis in diabetes; for the correction of vitamin E deficiency in diabetic patients; and for the prevention of diabetic complications of the eye, kidneys, and nervous system (neuropathy, retinopathy, nephropathy). It is not clear that vitamin E is beneficial in any of these areas, and further evidence is necessary before a clear conclusion can be drawn.
There is preliminary evidence of possible benefits of vitamin E supplementation to reduce chronic menstrual pain, although additional research is necessary in this area before a firm conclusion can be reached.
G6PD deficiency:
Vitamin E supplementation has been studied for the inherited disorder G6PD deficiency with conflicting evidence. Additional research is necessary before a clear conclusion can be drawn.
Glomerulosclerosis (kidney disease):
It has been suggested that proteinuria (protein in the urine) may be reduced with the use of vitamin E in patients with focal segmental glomerulosclerosis, which is refractory to standard medical management. However, further research is necessary before a clear conclusion can be drawn.
Healing after photorefractive keratectomy:
High-dose vitamin E plus vitamin A (taken by mouth) may improve healing of the cornea and improve visual acuity (sharpness) following laser surgery for vision correction. Animal research suggests that topical vitamin E on the eye may be helpful. Additional research is necessary before this use of vitamin E can be concluded as being safe or effective.
Hepatitis (hepatitis C):
In patients with hepatitis C on antiviral therapy, vitamin E has been proposed to prevent inflammation. More studies are needed to examine the effects of vitamin E in chronic hepatitis.
High cholesterol:
The effects if vitamin E on cholesterol levels and atherosclerosis have been studied in numerous laboratory, population, and clinical trials. It remains unclear if there are clinically meaningful benefits, and it is not known what the effects of vitamin E are compared to (or in combination with) other agents that have been clearly demonstrated as beneficial for lowering lipids. Further research is warranted before a clear conclusion can be drawn.
Immune system function:
Studies of the effects of vitamin E supplementation on immune system function have yielded mixed results. Further research is needed before a clear conclusion can be drawn.
Intermittent claudication:
Multiple studies have evaluated the use of vitamin E in patients with peripheral vascular disease, to improve exercise tolerance and intermittent claudication (pain in the legs with walking due to cholesterol buildup in blood vessels). Although some results have been promising, most studies have been small and poorly designed. It remains unclear if vitamin E is beneficial in this condition.
Macular degeneration:
Like other antioxidants, vitamin E has been suggested to prevent, slow progression, or improve macular degeneration. The scientific evidence in this area is not conclusive, although there is some suggestion that alone vitamin E may not be beneficial. In combination with beta-carotene and vitamin C, it may similarly not be significantly beneficial. Additional research is necessary before a clear conclusion can be drawn.
Parkinson's disease:
The scientific evidence is inconclusive in this area.
Premenstrual syndrome:
The scientific evidence is inconclusive in this area.
Prostate cancer prevention:
The role of vitamin E supplementation for the prevention of prostate cancer is controversial. There are numerous laboratory studies that support possible anti-cancer properties. However, the results of population research and human research have been mixed, with some studies reporting benefits and others finding no effects.
Respiratory infection prevention:
Daily supplementation with oral vitamin E does not appear to affect the incidence, duration, or severity of pneumonia (lower respiratory tract infections) in elderly nursing home residents or alter patterns of antibiotic use, although there may be a protective effect against colds (upper respiratory tract infections). Additional research is warranted before a recommendation can be made.
Seizure disorder:
Vitamin E has been evaluated as an addition to other drugs used to prevent seizures, particularly in refractory epilepsy. This evidence is not conclusive enough to make a clear recommendation. The management of seizure disorder should be under medical supervision.
There is some evidence suggesting possible benefits in the management of steatohepatitis in children, although further evidence is necessary before a clear conclusion can be drawn.
Stomach cancer (prevention):
Vitamin supplementation has been proposed to reduce the rate of stomach (gastric) cancer. However, there is some evidence suggesting that vitamin E does not reduce the rates of gastric cancer or pre-cancerous gastric lesions. More research is needed to examine whether vitamin E has any effects on gastric cancer.
Supplementation in preterm and very low birthweight infants:
Premature infants are at risk of vitamin E deficiency, particularly when they are born with very low birth weight. There are numerous studies of vitamin E given to premature infants to try to prevent potentially serious complications such as intraventricular hemorrhage (bleeding into the brain), retinopathy (eye damage), or death. The quality of published research is variable, and is not clearly conclusive. Premature infants should be under strict medical supervision, and decisions regarding vitamin supplementation should be made with the infant's physician.
Tardive dyskinesia :
Vitamin E has been studied in the management of tardive dyskinesia, and has been reported to significantly improve abnormal involuntary movements, although the results of existing studies are not conclusive enough to form a clear recommendation. Vitamin E may be more effective in higher doses and in people who have had tardive dyskinesia for less than five years.
Four-month oral supplementation with vitamin E had no apparent effect on uveitis-associated macular edema or visual acuity in one small study. Additional research is necessary before a clear conclusion can be drawn.
Venous thromboembolism (VTE):
Data suggests that supplementation with vitamin E may reduce the risk of VTE in women, and those with a prior history or genetic predisposition may particularly benefit.
There is preliminary evidence that vitamin E does not provide benefits in individuals with asthma.
Cancer prevention (general):
Recent evidence from a well-conducted randomized controlled trial (the Women's Health Study) reports no reduction in the development of cancer with the use of natural-source vitamin E taken daily. Previously, there have been laboratory, population, and other human trials examining whether vitamin E is beneficial in preventing various types of cancer, including prostate, colon, or stomach cancer. Results of these prior studies have been variable. At this time, based on the best available scientific evidence, and recent concerns about the safety of vitamin E supplementation, vitamin E cannot be recommended for this use.
Heart disease prevention:
Numerous studies of vitamin E oral supplementation have suggested no benefits in the prevention of cardiovascular disease, and there is recent evidence to suggest that regular use of high-dose vitamin E increases the risk of death (from "all causes") by a small amount. These conclusions have been criticized by some experts.
Recently, the Women's Health Study reported a reduction in cardiovascular deaths in women taking vitamin E daily (with 10 year follow-up), but no change in total death rate or number of heart attacks or strokes. Based on the balance of available scientific evidence, and in light of recent safety concerns, chronic use of vitamin E cannot be recommended for this purpose, and high-dose vitamin E should be avoided.
Vitamin E does not appear to reduce symptoms or prevent cartilage loss in knee osteoarthritis. There is a lack of evidence supporting the use of vitamin E in the management of osteoarthritis.
Peyronie's disease:
One study did not show significant improvement in pain, curvature, or plaque size in patients with Peyronie's disease (PD) treated with vitamin E, propionyl-L-carnitine, or vitamin E plus propionyl-L-carnitine compared with those treated with placebo.
Retinitis pigmentosa:
Oral vitamin E does not appear to slow visual decline in people with retinitis pigmentosa and may be associated with more rapid loss of visual acuity, although the validity of this finding has been questioned. Until further evidence is available, vitamin E may not be advisable in this condition. Therapy decisions should be under medical supervision.
Scar prevention:
Application of topical vitamin E does not appear to reduce surgical wound scarring. Because of a risk of contact dermatitis, some authors have recommended against the use of this therapy.
Recent evidence from the Women's Health Study suggests that regular vitamin E supplementation daily does not reduce the risk of stroke. Prior evidence was indeterminate for stroke prevention or stroke recovery. At this time, based on the best available scientific evidence and recent safety concerns, vitamin E cannot be recommended for this use.
TraditionWARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Abortifacient, acne, aging (prevention), aging skin, air pollution protection, allergies, amiodarone pulmonary toxicity prevention, bee stings, benign prostatic hypertrophy, beta-thalassemia, blood disorders (porphyria), breast pain/inflammation (mastitis), bronchopulmonary dysplasia in premature infants, bursitis, cardiomyopathy, chemotherapy extravasation, chorea (chronic progressive hereditary), congestive heart failure, Crohn's disease, cystic fibrosis, dermatitis, diaper rash, digestive enzyme/pancreatic insufficiency, doxorubicin hair loss prevention, Duchenne muscular dystrophy, dyspraxia, energy enhancement, frostbite, gastric ulcer, granuloma annulare (topical vitamin E), hair loss, heart attack, transplant rejection prevention (heart), hereditary spherocytosis, Huntington's disease, hypertension, impotence, inflammatory skin disorders, leg cramps, liver spots, lung cancer prevention, male fertility, menopausal symptoms, menstrual disorders, miscarriage, mucositis, muscle strength, myotonic dystrophy, neuromuscular disorders, nitrate tolerance, oral leukoplakia, labor pain, peptic ulcers, physical endurance, poor posture, post-operative recovery (post-angioplasty restenosis prevention), pre-eclampsia prevention (high blood pressure in pregnancy), radiation-induced fibrosis, reperfusion injury protection during heart surgery, restless leg syndrome, rheumatoid arthritis, sickle cell disease, skeletal muscle damage, skin disorders, sperm motility, sunburn, thrombophlebitis (vein inflammation).
Dietary Sources of Vitamin E
Foods that contain vitamin E include: eggs, fortified cereals, fruit, green leafy vegetables (such as spinach), meat, nuts/nut oils, poultry, vegetable oils (corn, cottonseed, safflower, soybean, sunflower), argan oil, olive oil, wheat germ oil, and whole grains. Cooking and storage may destroy some of the vitamin E in foods.
Adults (over 18 years old)
Most individuals in the United States are believed to obtain sufficient vitamin E from dietary sources, although individuals with very low-fat diets or intestinal malabsorption disorders may require supplementation. Recommended Dietary Allowances (RDAs) for vitamin E are provided in Alpha-Tocopherol Equivalents (ATE) to account for the different biological activities of the various forms of vitamin E, as well as in International Units (IU), which food and supplement labels often use. For conversion, 1 milligram ATE = 1.5 IU. The RDA for men or women older than 14 years old is 15 milligrams (or 22.5 IU); for pregnant women of any age is 15 milligrams (or 22.5 IU); and for breastfeeding women of any age is 19 milligrams (or 28.5 IU).
For adults older than 18 years, the tolerable upper limit of dosing for supplementary alpha-tocopherol recommended by the U.S. Institute of Medicine is 1,000 milligrams per day (equivalent to 1,500 IU). This limit recommendation is not altered during pregnancy or breastfeeding.
Treatment of vitamin E deficiency should be under medical supervision, tailored to the underlying cause of the deficiency, and may include either oral or injected vitamin E. If the cause is due to chronic malnutrition and there is no evidence of malabsorption, an oral dose that is between 2-5 times greater than the RDA may be considered. If the cause is malabsorption that cannot be corrected, then injections of vitamin E may be necessary. Dosing recommendations vary by the underlying cause.
No specific dosing of vitamin E has been established for other conditions, and there is recent evidence suggesting possible adverse health effects of long-term use of daily supplementation with 400 IU or greater daily. Although controversial, the use of long-term vitamin E supplementation should be approached cautiously until further evidence from prospective clinical trials is available. Various doses and durations have been evaluated in clinical trials, although many have not been proven as effective or safe. Patents are recommended to discuss the choice of dosing and duration with a licensed healthcare professional.
Children (under 18 years old)
Recommended Dietary Allowances (RDAs) for vitamin E are provided in Alpha-Tocopherol Equivalents (ATE) to account for the different biological activities of the various forms of vitamin E, as well as in International Units (IU), because food and supplement labels often use this system. For conversion, 1 milligram ATE = 1.5 IU. There is no RDA for infants, but there is a recommended Adequate Intake (AI) for healthy breastfeeding infants ages 0-6 months old of 4 milligrams per day (6 IU), and for infants ages 7-12 months old of 5 milligrams per day (7.5 IU). The RDA for children ages 1-3 years old is 6 milligrams per day (9 IU); for ages 4-8 years old is 7 milligrams per day (10.5 IU); for ages 9-13 years old is 11 milligrams per day (16.5 IU); for ages greater than 14 years old is 15 milligrams per day (22.5 IU); for pregnant women of any age is 15 milligrams (22.5 IU); and for breastfeeding women of any age is 19 milligrams (28.5 IU).
An upper limit for infants up to 12 months of age has not been established. The tolerable daily upper limit of dosing for ages 1-3 years old is 200 milligrams (300 IU); for ages 4-8 years old is 300mg (450 IU); for ages 9-13 years old is 600 milligrams (900 IU); and for ages 14-18 is 800 milligrams (1,200 IU).
Treatment of vitamin E deficiency should be under medical supervision, tailored to the underlying cause of the deficiency, and may include either oral or injected vitamin E. Selected doses in specific conditions are noted above under adult dosing. Vitamin E absorption may improve if given with meals, and in small doses.
No specific dosing of vitamin E has been well established for other conditions.
SafetyDISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.
Skin reactions such as contact dermatitis and eczema have been reported with topical vitamin E preparations, such as ointments or vitamin E containing-deodorants. Individuals with known or suspected hypersensitivity to vitamin E should avoid these products.
Side Effects and Warnings
Recent evidence suggests that regular use of high-dose vitamin E may increase the risk of death (from "all causes") by a small amount. These conclusions have been criticized by some experts because they are based on re-calculations (meta-analyses) of the results of prior smaller studies, which were of mixed quality, with variable results, and often in patients with chronic illnesses. Nonetheless, this is the best available scientific evidence currently, and therefore chronic use of vitamin E should be used cautiously and high-dose vitamin E should be avoided. Acute overdose of vitamin E is very uncommon.
For short periods of time, vitamin E supplementation is generally considered safe at doses up to the recommended tolerable upper intake level (UL). However, vitamin E is possibly unsafe when used orally at doses exceeding the tolerable upper intake level. The Recommended Dietary Allowance (RDA) obtained through food consumption is considered to be safe and beneficial.
Skin reactions, such as contact dermatitis and eczema, have been reported with topical vitamin E preparations, such as ointments or vitamin E containing-deodorants.
In rare cases, vitamin E supplementation has been associated with abdominal pain, diarrhea, nausea, diarrhea, or flu-like symptoms (particularly when taken at high doses). The risk of necrotizing enterocolitis may be increased with large doses of vitamin E.
In rare cases, vitamin E supplementation has been associated with gonadal dysfunction and diminished kidney function.
High doses of vitamin E might increase the risk of bleeding, due to inhibition of platelet aggregation and antagonism of vitamin K-dependent clotting factors (particularly in patients with vitamin K deficiency). In studies of vitamin E, a small increase in rate of hemorrhagic (bleeding) stroke and gum bleeding has been observed, particularly which used in humans with aspirin. Increased risk of bleeding when used with warfarin (Coumadin®) has been noted in animal studies. However, other studies have not observed a greater incidence of bleeding. Bleeding has been observed in patients given high repeated doses of intravenous all-rac-alpha-tocopherol (synthetic vitamin E). Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
In rare cases, vitamin E supplementation has been associated with dizziness, fatigue, headache, weakness, or blurred vision (particularly when used in high doses).
Oral vitamin E should be avoided in patients with retinitis pigmentosa, as is does not appear to slow visual decline, and may be associated with more rapid loss of visual acuity, although the validity of this finding has been questioned.
Pregnancy and Breastfeeding
Many prenatal vitamins contain small amounts of vitamin E. Natural forms of vitamin E may be preferable to synthetic forms.
Use beyond the Recommended Dietary Allowance (RDA) level in otherwise healthy pregnant women is generally not recommended. There is otherwise insufficient evidence regarding the safety of higher doses of oral, topical, or injected vitamin E during pregnancy and breastfeeding, and therefore it is not recommended.
Interactions with Drugs
The amount of bleeding risk associated with vitamin E remains an area of controversy, and caution is warranted in patients with a history of bleeding disorders or taking blood-thinning drugs such as aspirin, anticoagulants such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Concern has been raised that antioxidants may interfere with some chemotherapy agents (such as alkylating agents, anthracyclines, or platinums), which themselves can depend on oxidative damage to tumor cells for their anti-cancer effects. Studies on the effects of antioxidants on cancer therapies have yielded mixed results, with some reporting interference, others noting benefits, and most suggesting no significant interaction. However, until additional scientific evidence is available, high-dose antioxidants should be avoided during chemotherapy administration, unless otherwise decided in discussion with the treating oncologist.
Cholestyramine (Questran ®), colestipol (Colestid®), orlistat (Xenical®), isoniazid (INH, Lanizid®, Nydrazid®), olestra (Olean® fat substitute), and sucralfate (Carafate®) can reduce dietary vitamin E absorption and blood levels of vitamin E. Gemfibrozil (Lopid®) may decrease serum levels of both alpha- and gamma-tocopherol, although clinical significance is not clear. Anticonvulsant drugs such as phenobarbital, phenytoin, or carbamazepine may decrease blood levels of vitamin E.
Vitamin E use with cyclosporine appears to increase the area under the blood concentration-time curve of cyclosporine. A water-soluble form of vitamin E, tocopheryl succinate polyethylene glycol, may improve the absorption of cyclosporine (observed after liver transplantation).
Vitamin E may have additive effects with cholesterol-lowering medications.
Interactions with Herbs and Dietary Supplements
High doses of oral or injected vitamin E may increase the risk of bleeding including hemorrhagic stroke (bleeding into the brain), and caution is warranted in patients with a history of bleeding disorders or taking herbs or supplements that may also increase the risk of bleeding. For example, multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic or saw palmetto.
Vitamin E may have additive effects with cholesterol-lowering herbs and supplements.
Mineral oil may reduce dietary vitamin E absorption. Blood levels of vitamin E may be decreased with zinc deficiency. Increased intake of omega-6 fatty acids may increase vitamin E requirements, particularly at high doses.
Vitamin E is involved in the absorption, storage, and utilization of vitamin A in the body and contributes to avoiding toxicity with vitamin A intake. Large doses of vitamin E may deplete vitamin A stores.
Aloe is reported to slow the rate of vitamin E absorption, allowing sustained release of vitamin E into the bloodstream.
Vitamin E has been proposed to improve the bioavailability of iron.
This information is based on a systematic review of scientific literature, edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Wendy Chao, PhD (Natural Standard Research Collaboration); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts College of Pharmacy); Christine Ulbricht, PharmD (University of Massachusetts); Wendy Weissner, BA (Natural Standard Research Collaboration).
BibliographyDISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Bairati I, Meyer F, Jobin E, et al. Antioxidant vitamins supplementation and mortality: a randomized trial in head and neck cancer patients. Int J Cancer 2006 Nov 1;119(9):2221-4.
Boshtam M, Rafiei M, Golshadi ID, et al. Long term effects of oral vitamin E supplement in type II diabetic patients. Int J Vitam Nutr Res 2005 Sep;75(5):341-6.
Farvid MS, Jalali M, Siassi F, et al. Comparison of the effects of vitamins and/or mineral supplementation on glomerular and tubular dysfunction in type 2 diabetes. Diabetes Care 2005 Oct;28(10):2458-64.
Fillenbaum GG, Kuchibhatla MN, Hanlon JT, et al. Dementia and Alzheimer's disease in community-dwelling elders taking vitamin C and/or vitamin E. Ann Pharmacother 2005 Dec;39(12):2009-14.
Huang SH, Schall JI, Zemel BS, et al. Vitamin E status in children with cystic fibrosis and pancreatic insufficiency. J Pediatr 2006 Apr;148(4):556-559.
Lee IM, Cook NR, Gaziano JM, et al. Vitamin E in the primary prevention of cardiovascular disease and cancer: the Women's Health Study: a randomized controlled trial. JAMA 2005 Jul 6;294(1):56-65.
Mayer-Davis EJ, Nichols M, Liese AD, et al. Dietary intake among youth with diabetes: the SEARCH for Diabetes in Youth Study. J Am Diet Assoc 2006 May;106(5):689-97.
Murakami Y, Nagai A, Kawakami T, et al. Vitamin E and C supplementation prevents decrease of eicosapentaenoic acid in mononuclear cells in chronic hepatitis C patients during combination therapy of interferon alpha-2b and ribavirin. Nutrition 2006 Feb;22(2):114-22.
Nussenblatt RB, Kim J, Thompson DJ, et al. Vitamin E in the treatment of uveitis-associated macular edema. Am J Ophthalmol 2006 Jan;141(1):193-4.
Subudhi AW, Jacobs KA, Hagobian TA, et al. Changes in ventilatory threshold at high altitude: effect of antioxidants. Med Sci Sports Exerc 2006 Aug;38(8):1425-31.
Vetrugno M, Maino A, Cardia G, et al. A randomised, double masked, clinical trial of high dose vitamin A and vitamin E supplementation after photorefractive keratectomy. Br J Ophthalmol 2001;85(5):537-539.
Vijayaraghavan R, Suribabu CS, Sekar B, et al. Protective role of vitamin E on the oxidative stress in Hansen's disease (Leprosy) patients. Eur J Clin Nutr 2005 Oct;59(10):1121-8.
Walsh PC. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. J Urol 2005 Nov;174(5):1823-4.
Wluka AE, Stuckey S, Brand C, et al. Supplementary vitamin E does not affect the loss of cartilage volume in knee osteoarthritis: a 2 year double blind randomized placebo controlled study. J Rheumatol 2002;29(12):2585-2591.
You WC, Brown LM, Zhang L, et al. Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. J Natl Cancer Inst 2006 Jul 19;98(14):974-83.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.


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'"Lindy Ruff, as a player he was a competitive individual that went out and worked hard, committed to his team night in, night out," Carlyle said. "Obviously in his coaching aspect of it, he's done a tremendous job in Buffalo. Just look forward to at some point talking about it. We've got a mutual friend that has a strong relationship with him in Mike Foligno. I played with Mike in junior and played a little bit with him in summer hockey. There was always that Buffalo mentality. Being with the Pittsburgh Penguins at the time, it was one of those things we were competitive, but there was an understanding we respected one another."'
You are here: Home / SabresBeat / Coaching berths fitting result for Carlyle, Ruff


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NICK Blackwell maintains he needs one big break to send his career rocketing to the next level – and the Trowbridge boxer is hoping that it comes in 2014.
The two-time British middleweight title challenger, 23, nearly sent out a major statement of intent in September as he knocked down European champion Max Bursak in his native Ukraine before coming out on the wrong end of a controversial decision in their WBA Continental contest.
Blackwell, last in action when he beat Max Maxwell in Trowbridge in October, is hoping to box for either the IBO continental or inter-continental middleweight crown or a similar WBC belt (he lifted the WBC youth silver title in May 2012) at the University of Bath on March 15.
Details are currently being finalised for the Errol Johnson-promoted show but the Contender Gym fighter said: "I've been back in the gym since the start of the year and I kept myself ticking over at Christmas – hopefully, it's going to be a big year for me.
"I need to try and get the fights in but I know that I just need to win one big fight and then away I go.
"I'm spending all of next week in London, sparring with Billy Joe Saunders (who he challenged for the British title in December 2012) and Frank Buglioni.
"Then, I should be going out to spar with Matthew Macklin (former European middleweight champion) in Marbella in February.
"I sparred with him once ages ago and this should all be some good experience."
Mark Kent, Blackwell's trainer, said: "Nick's already got a ranking with the WBC so maybe we'll be able to move up to the full youth title and if not, maybe look at an IBO one.
"Three or four big fights this year and he'd then be ready to step up to a world title fight in 2015.
"Unfortunately, the Ukraine thing was down to home advantage and that's the way boxing is so there's no point crying about it anymore."
Fellow Contender Gym fighter Gareth Heard, from Bradford on Avon, is due to feature in March's show, along with Malmesbury's Joe Hughes, who is set to step up to 10 rounds for the first time.
The Bath bill is also due to feature Southampton's King Davidson defending his WBO international light-middleweight belt, as well as Bristol's Danny Butler, the current English middleweight title holder.
FOR MORE SPORTS NEWS, REPORTS & PICTURES SEE FRIDAY'S WILTSHIRE TIMES AND FOLLOW US ON TWITTER @WTSport


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NetWellness is a global, community service providing quality, unbiased health information from our partner university faculty. NetWellness is commercial-free and does not accept advertising.
Wednesday, September 20, 2017
OAB and Removal of Sling
I have had a monarc sling done september 2008. I am now experiencing leakage as well as being over active. I am thinking of removing the sling to help remove my over activeness. Would this help? I am fed up with my bladder taking over my daily thought process. I am depressed about the whole thing. I prefer the leakage than the OAB. I now wear a contiform to assist with my leakage and I am prepared to continue with this until stem surgery becomes available in Australia. Many questions but I need HELP.
I am wondering if you had OAB before the Monarc was placed? However when the sling is in its position it will be entwined with the surrounding tissue and would not be free to be removed. Scar tissue also will play a role in continence of urine as well. One of the reasons for OAB after the sling operation is inability to empty the bladder content and hence, frequent urination. This condition can be treated with urethrolysis or releasing the urethra from the attachment to tissues around it, The other cause can be due to erosion of the mesh into the urethra or bladder. This has to be treated by removal of the exposed mesh.
Ahmad Hamidinia, MD
Formerly, Professor of Clinical Surgery
College of Medicine
University of Cincinnati


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Although North America is the largest market for Chilean fresh fruit — with more than 900,000 tons of Chile's total 2.6 million tons imported there in 2012-13 — the average U.S. consumer doesn't necessarily know where the apples, grapes or kiwi came from or how they got there.
"There seems to be a lack of knowledge among consumers about the range of product and the vast volume of fresh fruit from Chile," said Karen Brux, North American managing director for the Chilean Fresh Fruit Association, San Carlos, Calif.
"We've had a lot of questions from foodservice, retailers and consumers about Chile. They want to know what's being grown and when, and they also want to know about food safety."
Offering resources
The association has developed a document that addresses those questions.
The document highlights the fact that Chile is surrounded by desert to the north, the Pacific Ocean to the west, the Andes Mountains to the east, and the Patagonia ice fields to the south. Those natural barriers protect Chile's growing areas from pests and diseases.
The document also promotes Chile's sustainability and food safety practices and includes an availability chart and a map illustrating where various commodities are grown.
The association isn't stopping there.
This season, retailers also will be able to promote Chilean fruit and educate consumers with new point-of-sale materials.
"In the past, we had a whole set of POS materials — bin wraps, recipes, care and handling tips — but people have seen it for a number of years," Brux said. "We're starting fresh."
Brux said the association hopes to work with retailers to develop customized, commodity-specific materials that meet the unique needs of each retailer.
"We want to have a whole new look and feel for POS," she said. "It's difficult to go out with a one-size-fits-all approach. We want to sit down with retailers and find out what works for them."
The Chilean Fresh Fruit Association also plans to supply retailers with videos that can be used online or with in-store TVs.
The association promoted its citrus season with videos, filmed in an orchard, that informed viewers about availability, transit times, health benefits, and harvesting methods.
Brux said retailers used the videos on their websites and Facebook pages.
"There's a lot of interest," she said. "We'll be developing videos for other commodities.
"It's about giving it to (retailers) in an effective way so they can get the message out to their customers. Retailers are really gravitating to social media."
The association also hopes to reach consumers by building relationships with dietitians.
The Produce for Better Health Foundation offered a three-day symposium for supermarket dietitians during the Produce Marketing Association's Fresh Summit convention in October in New Orleans.
The event offered companies and associations a chance to work with more than two dozen dietitians, representing 22 retail chains and nearly 4,500 stores nationwide.
Brux said it was an excellent opportunity.
"Retail dietitians are on the front line," she said. "They're the ones interacting directly with consumers and shippers, so we can work with them to educate consumers about fruit from Chile and talk about our standards, safety, health benefits, and why it's a great choice for consumers."


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Very pleased with quality of products. Just what I was looking for.
Site & Contents © BaxterBoo.com®. BaxterBoo is located in the United States.


text: Verb's hosted CMS doesn't get in your way. Just write HTML and CSS like you normally do and design your CMS structures through our backstage interface. Then you can use VerbML or PHP to integrate CMS data into your pages. Verb includes a hosted shopping cart and E-Mail marketing tools so you can build online stores too. No fussing with templates or databases. Local development server allows websites to be edited and previewed on your local machine. When ready, a simple command deploys your code to the staging environment or the hosted live site.


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iPad apps for science and medicine
One of the nicest things about about going to scientific meetings is that you get to meet interesting people. Instead of swapping cards and going about your way, in the modern world social media allows you to stay in touch more frequently personally while sharing cancer and scientific information over time. The discussions can be very insightful and enriching.
Two recent PhDs from MD Anderson Cancer Center (MDACC), Drs Angela Alexander and Jeannine Garnett are two of those research scientists I met while at cancer meetings and now keep in touch with – congratulations on your well earned doctorates this summer, ladies!


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who do you think will end up having the better season between these two
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who do you think will end up having the better season between these two
his game is farther along.
this is based on one preseason game though. Paul looked more assertive than last year, but his game still looks the same. almost but not quite there.
Paul. He will arrive this year. The three G's are going to get some fame this year.
When I played basketball I had the same problem with handles that Paul had last year. My dribbling was good, but incredibly sloppy. Eventually someone pointed out that I needed to do a better job of keeping my dribble as low as possible to the ground. It took me about a week to get used to that and my dribbling drastically improved. He is dribbling a lot lower than in years past so I wouldn't be surprised if his handles REALLY improved as long as he doesn't get lazy with the ball.
I think Paul will show more improvement, while Roy will be more consistent. Paul wil average more points and most likely will get more notoriety, but Roy will be our "rock".
Roy will still probably have a better season, stince he's starting from ahead and probably will average a double double if he plays a few more minutes. But Paul won't be far behind, his game is improved and it will look even better once he's playing with the other starters.
I think PG will average more points, but Roy will be more of a all around player.
PG: 18ppg, 5rpg, 1spg
Roy 15ppg, 10rpg, 2bpg
One thing to consider is that Vogel has stated that not only does he want to ride his starters more this year, but that he expects each starter above 30 mpg. PG would have likely gotten far more mpg last season had he not gotten into foul trouble early as often as he did, I expect him to play around the same mpg as Danny, which will be 32-36, especially since he can slide over to the 3 when necessary too. Roy I could see 31/32 mpg.
As for numbers-
I think Paul will average 16-18 ppg 6-7 rpg 2-3.5 apg on 44-45/38-39/82-85
Roy I see 14-16 ppg 9.5-10.5 rpg 2 apg on 51%
Roy will still probably be our most important player and our anchor, but Paul won't be far behind. I'm more bullish on Paul's potential to score this year than I was before pre-season. He gets into trouble going completely on his own, but with the other starters on the floor with him who have to be respected I think he'll shine.
As I don't expect Roy to regress, it'll be a good thing for the Pacers if PG has the better season.
That being said, despite how highly I think of PG, I think it's a little early to be expecting the things some are expecting of him. And I still think he's in a position (with Danny, Roy, GH, and West) where he's going to feel like the fourth or fifth option. And I don't see that as a negative, because the Vets probably see him that way too.
Likely G-squared will shock the world and lead the Pacers this year, while Paul George shifts to the 3 and readjusts and becomes a more solid team player on both ends of the court. Roy will play better when he has size next to him who can take pressure off of him in the post (hopefully West has been saving energy here in the preseason so far since he apparently cannot get off the ground from what other posters have said), likely being a combination of Ian and our newest "stretch 4" in Granger.
As far as the original question, Paul George will get the accolades, Roy will do the work in a supporting role.
You guys realize that Roy Hibbert is an all-star, right?
I am nearly 100% sure that Hibbert will have a better season and that's no knock on Paul.
He also has the potential to get to the line alot, which can bump scoring averages, I don't think that 16-17 ppg is out of the question, as Frank is supposedly going to be playing the starters more minutes, and George is well equipped to play quite a bit more between fresh legs and positional flexibility.
Roy may well have a better season, for one I think he'll be more consistent (he was dominate at times last season) and we'll be able to get him the ball in his spots more consistently, but if we're talking who improves more relative to last season it's probably Paul, since Roy started off higher.
Last edited by Noodle; 10-14-2012 at 08:37 AM.
Better season is not the same as better player IMHO. Instead, it's relative to what a player has done previously.
Of course Hibbert is going to be the better player in terms of value to the team. That's almost a certainty. I expect in his third year for George to make that leap and get real notoriety. That will help all the players by taking the focus off of them. I think we will be significantly better this year.
Hibbert and it won't even be close...... ...
Paul George has some room to become somewhat better but he is never going to an all star caliber player. If he had that kind of potential, he would have shown it by now. That said, he can be a very solid player for a long time.... ...
I think people are saying they have seen flashes of it. And not just PD posters, journalists across multiple media spectrums. But I understand what you are saying. Until the flashes become consistent, he will never be an All-Star type player.
Apples and oranges, big men take a long time to develop. How many shooting guards suddenly became all stars after playing good but not great their first three or four years? I thought Hibbert had the best chance on the team to be an all star a long time ago. That was because true centers are a rare commodity and he had the best chance to be named to the team....... ...
Tracy mcgrady, joe johnson, chauncey billups, etc etc.....
whether pg becomes an all star or not- i have no idea. as long as he keeps working to get better like roy has- that is what i am looking for. if he keeps up with building his game, things will likely turn out for the better.
Paul George has only been in the league 2 years, how can you assume that Paul won't be very good this year before it happens? Also, not many wings with all-star potential are drafted on to teams that get the 5th best record in the NBA their second year. Most of them are thrown into the fire, Paul wasn't.
...Reggie Miller
Also to add, this is only PGs third year.
Never half-a** two things. Whole-a** one thing.
The 3 G's. I like it. As for the question, I think its Paul. I think he will learn his game and step it up, since he is in a contract year after all.
"What you do is so loud, I can't hear what you say" -Andrew LuckJunior at the University of Louisville
"If you turn the other cheek, I'm gonna hit you in the other cheek, too" -Charles Barkley
"Ego is edging greatness out" -Rick Pitino
Greenfield-Central High School Alum '14
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1000th post - 4/16/12 2000th post - 6/24/12 3000th post - 3/8/13


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Buehrle ready for season after final tuneup
MONTREAL -- It's been a pretty good spring for Mark Buehrle, and he's hoping that carries over once the meaningful games get underway.
Buehrle made his fourth appearance of the spring on Friday night, giving up two runs on four hits while striking out two and walking one in four innings against the Mets. His homerless streak throughout the exhibition season remained intact as he tossed 73 pitches, 45 for strikes.
"At times you go through those stretches where you almost say, 'Man, I wish I was giving up some hits and home runs, and kind of get them out of the way for the season,' but I feel good," Buehrle said.
Manager John Gibbons liked what he saw.
"He pitched great," Gibbons said. "I thought that one mistake he made was to [Chris] Young, [who hit a two-run double], but he finally got him. He's the old warhorse. He knows what he needs to do to get ready and I think he's really excited because he's felt so good."
The veteran Buehrle, 35, finishes camp with seven runs allowed on 17 hits, three walks and five strikeouts in 15 1/3 innings, but the stats line isn't what he's focused on heading into the season.
"Obviously, the results in Spring Training don't mean [anything], but you still want to get people out, if it's in Spring Training or during the season," he said. "I feel good, and I think that's the biggest thing I'm taking out of this camp. I feel healthy, I'm ready to go, and hopefully, the results are there."
Heather Engel is a contributor to MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.


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Kaige Chamberlain
Former RTE Tag-Team Champion(w/ Xavier Hightower[1])
Former EWNCW Tag-Team Champion (Solo; 3/30/14) [1]'Father' Black Angel:
Preacher of the Voices
Winner of BotN[Seraphim]
I'm trying to be number one, why would I settle?
@IWACreative_Parody Tweeter
We all judge others even if it isn't our place to judge, but supposedly at the end we are all judged by one!!!
Wrestling, women and money who could ask for more???
If I am not back in five minutes...just wait longer!--Ace Ventura
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Liquid Force Melissa Wakeboard With Melissa Bindings
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Aggressive, continuous rocker for fluid carving
Triple stringers provide central control
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Liquid Force's Melissa board was built to take a punishment on rails with a GRIND base and Liquid Rails, but it performs equally well behind the boat. The challenge was to create a board that would let women riders perform equally well in all conditions, and this board hits the mark. Aggressive, continuous rocker allows smooth, fluid carves with a high arcing pop. CNC milled wood/PU composite core. Triple stringers provide central control and responsive tip flex: all precision cut in the perfect hull shape. Double-inside-single-concave hull softens landings and maintains board speed. Triax glass layup provides torsional control while delivering the proper spring and snappy flex. Melissa Hybrid 127: 50"L. For 50-90 lb. riders. Melissa Hybrid 131: 51.8"L. For 60-130 lb. riders. Melissa Hybrid 135: 53.1"L. For 100-170 lb. riders.
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but, who turns down the TV volume and listens to Mark and Slick?
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Yes, every game
Just on local games
Just on nationally televised games
Mix of both
but, who turns down the TV volume and listens to Mark and Slick?
I almost always do, although I did give Reg a listen tonight for about 3 qtrs....
I would like to listen to slick and mark, but the 3 second delay buggs the crap outta me, it makes it less exciting. like when Slick yells "boom baby" before the ball is shot.
side note.. I thought Reggie did a good job, though maybe it's just my fascination with how he views this team that made it so interesting. I liked how they gave Reggie the gameball (especially after his comments last night ) There was alot of interaction with the pacer players and Reg, like JO saying " I told ya so!" after he hit that toe on the line almost 3pter. And Fred lettin Reggie know that he didn't really foul Dwade. Great game, seemed like Playoff intensity to me.
Yeah I loved Reggie's interaction with the players too, I hope he does more of our games.Originally Posted by Burtrem RedneckThis quote is hidden because you are ignoring this member. Show Quote
It's kinda hard to watch, and I know it's gotta kill him, to see the Pacers playing and Reggie in a suit. You think during the pre-game he goes out and warms up with 'em?
It's a new day for Pacers Basketball.
Usually just to catch the post game shows.
You know how hippos are made out to be sweet and silly, like big cows, but are actually extremely dangerous and can kill you with stunning brutality? The Pacers are the NBA's hippos....Matt Moore CBS Sports....
When I lived in Indy, I did that all the time.
Up here, I'd have to sync my League Pass and TiVo with the audio league pass over the internet.
And I'm just not that good.
Why do the things that we treasure most, slip away in time
Till to the music we grow deaf, to God's beauty blind
Why do the things that connect us slowly pull us apart?
Till we fall away in our own darkness, a stranger to our own hearts
And life itself, rushing over me
Life itself, the wind in black elms,
Life itself in your heart and in your eyes, I can't make it without you
I hardly ever do because radio is a little ahead of the TV and it gets on my nevse.
I don't because I hardly ever watch the games live.


text:
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Holiday Inn Express IQUIQUE3 Self rated
Talbot Hotels Sa,Av. Arturo Prat #1690, Iquique, 00000
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Iquique, Chile Hotel With Oceanfront Views With a convenient location on the sandy shores of Playa Brava beach, our hotel offers business and leisure travelers relaxing accommodations to help them escape their everyday routine. Here at the Holiday Inn Express® Iquique Hotel, our excellent service staff is always on hand to make sure that all your needs are taken care of during your stay. While staying with us at Playa Brava beach, hotel guests have easy access to Iquique's historic downtown, the Zofri Convention Center and Mall, where you can find more than 100 tax-free stores, the Diego Aracena International Airport (IQQ) and the Dreams Iquique Casino.
Enjoy all of our amenities, including an outdoor pool, a whirlpool and a Fitness Center. The hot and free Express Start Breakfast Bar helps gives you a great start to your day and our Express Market is good for late night snacks. We also have a 24-hour Business Center, complimentary high-speed, wireless Internet access and a 1,075 sq ft meeting room for up to 30 people.
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Marshall Manufacturing Company was chosen by Dr. Emil Verban to manufacture DrillStops, a device created by Dr. Verban that increase the safety and precision of dental implant procedures. In use, a tiny set screw locks the stop to the drill bit, and the stop rotates with the drill bit while avoiding tissue damage as the drill penetrates the bone.
Marshall was chosen to machine the stop because the company is a registered medical device component manufacturer with complete Swiss machining capabilities. This means it can suggest process changes that make the product easier to manufacture and improves product performance.
Marshall's new multi-function Swiss machines were best suited for the job because DrillStops demand numerous turning and milling operations. Its machines could perform all of the needed operations on one machine in a single setup.
"We chose Marshall Manufacturing because of its up-to-date capabilities and willingness to help us with our early prototypes," Dr. Verban says. "These included the efficient planning of the machining for all 22 components in a DrillStops kit. The company's manufacturing experience resulted in improvements to the component finishes and the addition of laser marking for permanent product identification."
DrillStop collars were designed in a range of diameters and lengths to accommodate different implant requirements and to fit the range of drill bit sizes customarily used by dentists. The collar diameters range from 6 to 13 mm and collar lengths from 10 to 14 mm. DrillStops do not include drill bits, which are purchased separately.
Marshall Manufacturing machines these collar components on their Citizen L20 Swiss machines equipped with CAV20-IS bar feeders. Designed for ultra-precision, high productivity work, these machines have a main spindle and secondary spindle that share machining operations. The main spindle offers maximum rotational speed of 10,000 rpm while the secondary spindle offers 8,000 rpm.
The Citizen CNC Swiss machine on which DrillStop components are machined are specifically designed for small diameters. The components are machined from 303 stainless steel in 12-foot barstock lengths in 3/16 and ¼ inch diameters. 303 stainless steel is an FDA-approved material used in the manufacture of dental instruments.
Marshall's single-setup Swiss machining operation of the DrillStops include turning the OD to size by the machine's primary spindle, followed by facing, drilling and boring to specified depth. A cross hole is drilled and tapped for the DrillStop set screw. A flat is milled on the part with the machine's end mill. The machine's secondary spindle then grips onto the part, at which point the part is cut from the barstock. The secondary spindle then faces off the back-side of the part, puts a radius on the part's outer diameter and the part's inner diameter through-hole.
Spindle speeds vary according to the operation and ramp up to the machine maximum where possible. The machining process takes less than 2 minutes per part. Accuracy on critical surfaces is 0.0005 inch. Certain components in the DrillStop kit are bead-blasted to a matte finish to minimize glare when in use, while others in the kit are laser marked for easy identification. As a final step, all collar components are passivated to remove surface impurities, avoiding corrosion.


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Webster summonded to start in Doubront's spot
BOSTON -- Highly touted pitching prospect Allen Webster, who was impressive in his Major League debut for the Red Sox on April 21, will get another chance on Wednesday night when he starts against the Twins.
Webster was summoned from Triple-A Pawtucket to take the roster spot of Joel Hanrahan, who was sent to the disabled list with a right forearm strain.
Webster is taking Felix Doubront's spot in this turn around the rotation. Doubront, a left-hander, has been inconsistent this season and his velocity has been diminished in recent starts.
Doubront will be available as a reliever for both Tuesday and Wednesday's games against the Twins. Manager John Farrell said that the plan for now is to get him back into the rotation the next time around.
"I think everyone looks forward to seeing that guy on the mound," Farrell said of Webster. "He's got great stuff. He showed he's got very good poise in the first outing that he made for us. We'll see it again tomorrow night."
The Red Sox hope that perhaps some of Doubront's velocity will come back during his short stint in the bullpen. The club is puzzled by his fastball decreasing, given that they can't find any health problems with him.
Webster had a 2.70 ERA with 26 strikeouts in 20 innings with Pawtucket.
In his lone start for the Red Sox, Webster allowed two earned runs over six innings, walking one and striking out five.
Ian Browne is a reporter for MLB.com. Read his blog, Brownie Points, and follow him on Twitter @IanMBrowne. Jason Mastrodonato is a reporter for MLB.com. Follow him on Twitter @jmastrodonato. This story was not subject to the approval of Major League Baseball or its clubs.


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I was off this week, and it was a cut back week, so I was hoping to get a little energy back. I have been pretty worn down these last few weeks. Between the hours at work, Marathon training, and running Cross Country, it just get's to be a lot.
I've already blooped about the first half of the week. Nothing special there. 5.71 miles with the XC Team, 19.08 miles on Sunday, Monday a split workout 3 with my Wife followed by 12.12 with the XC kids, Tuesday was 8.86 miles with the XC kids again.
Wednesday was supposed to be speed work for me, but I was still feeling really tired. I had decided to just put that off till the end of the week. I ran 3 with my Wife again, and when I finished that my right Achillies started hurting. The only thing that I have been doing differently is some slow running. More time with the girls on the team, and the addition of those short slow runs with my Wife. The Team did 3x800's, 5x400's, and 8x 200's. I refrained from running with the boys until they did the 200's, I did run those and that went fine. So 6 miles for Wednesday.
Thursday became a full rest day because we took my daughter down to Columbus so that she could get moved in to her College Dorm. Traffic was bad both going out and coming back so I missed practice. It had rained a little in the afternoon, so I guess a bunch of kids thought that practice would be cancelled. Of course these were new kids, the ones that I had for Track all showed up.
Friday was an easy day, and again I spread myself out so that I could run with everyone from the top boys to the last girls in. I finished that practice with 5.54 miles, including 1 mile of pick up's on the track. Then I went out and ran 3 more with my Wife. 8.55 miles for Friday.
At this point my Achillies is still sore, but it doesn't hurt when I run. I am going to work on it with the roller, and hope that I can get this loosened up. I only did one day of Cross Training this week, I'm just still tired. I need to get back to that over the next 3 weeks, and stick with it after I run this Marathon.
Have fun, and I will have to do a write up about Saturday's XC meet.


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'Q: Did you have any idea a trade was coming? "No, that's why I said I was surprised. I woke up going into the same routine I used to do, go eat breakfast, and Doug Wilson said 'I need to talk to you.' I was surprised but at the same time stuff happens for something and I hope it's going to be good."'
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Florette Duvet Cover + Sham, Lavender
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- Overview
Fanciful flower clusters line up in geo style on our bedding for a look that's both eye-catching and easy to mix and match.
- Made of 100% cotton percale with 5% organic fibers.
- Oeko-Tex® Certified: tested in a third-party lab and verified to be free from over 300 harmful substances.
- Duvet cover and sham reverse to self.
- Duvet cover has interior ties and a hidden button closure; sham has an envelope closure.
- Twin-sized duvet cover fits both standard twin and twin XL dorm mattresses.
- Duvet cover, sham and insert sold separately.
- Extra pillowcases are available in sets of 2.
- Personalization is available for an additional $9.50.
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Mix + match our bedding to create your own unique look with our Design Your Own Bed Tool.
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Duvet Cover
- Twin: 68 x 86"
- Full/Queen: 88 x 90"
- Standard: 20 x 26"
- Flange: 2" wide
- A percale weave is noticeably denser and wears well over time.
- Oeko-Tex® Certified: tested in a third-party lab and verified to be free from over 300 harmful substances.
- Machine wash in warm water, gentle cycle.
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It's the middle of winter and that time of the year for the temperatures to drop! Even the Deep South is experiencing this frigid weather which is rare for this part of the country. Winter storm Leon has made its debut stretching hundreds of miles from San Antonio to the Carolinas creating snow throughout Atlanta, Charlotte, and . . .


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Unfortunately, because Washington refuses to meet these challenges head-on, the Defense Department faces a half-trillion-dollar cut Friday. Border security, law enforcement and aviation safety programs are bracing for the impact as well.
Secretary of Defense Leon Panetta has compared the strategic impact of these cuts to "shooting yourself in the head." Already our men and women in uniform are feeling the consequences across the country and right here in Indiana.
The USS Abraham Lincoln is waiting to be refueled, Marines are not being deployed to strategic regions in the Pacific, maintenance on equipment is delayed and 170 full-time personnel at Fort Wayne's Air National Guard could be furloughed.
Astonishingly, this devastating $500 billion blow to our national defense is the commander in chief's idea and the consequence of Washington's runaway spending habits. After refusing to join House Republicans in seriously tackling the federal government's $16 trillion debt, President Obama introduced the idea of across-the-board cuts to defense, known in Washington as the sequester.
According to Washington Post Associate Editor Bob Woodward, the sequester was first suggested during the summer of 2011 debt negotiations by President Obama's then-Chief of Staff Jack Lew and included in the final debt ceiling package at the president's insistence.
So where do we go from here? Hoosiers understand two simple truths: First, we must tackle our nation's massive $16 trillion debt, and, second, our men and women in uniform shouldn't pay the price for Washington's failures.
Although I voted against the flawed deal that included President Obama's sequester because I don't believe politicians should saddle our armed services with Washington's failures, I am committed to replacing the president's devastating cuts with matching cuts to wasteful spending and reforms to entitlement programs. In fact, during the past six months my Republican colleagues and I in the House passed two bills to replace the president's sequester with common-sense cuts to protect our national defense.
Unfortunately, these bills are stuck in the Democrat-controlled Senate while President Obama wages a fear campaign against the very cuts he proposed. Instead of threatening the American people with massive layoffs and furloughs, the president should encourage the Senate to vote on the bills we passed out of the House or negotiate a sensible solution. Unfortunately, the only solution the president can come up with is another oppressive tax hike.
Punishing middle-class families and small businesses is no way to promote lasting growth. In fact, the federal government will take in more revenue this year than ever before. New tax increases will only prevent growth and fuel the same government extravagance that created this mess.
Instead of offering a fact-based conversation, the president is misleading the American people with the false choice between weakened security abroad or stifling tax hikes at home.
It's time for the president to get serious about our nation's $16 trillion debt and keep our national defense strong. Hoosiers are waiting to see if President Obama will put away the threats and stand with service members and taxpayers.


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Kansas City Chiefs NFL 6-Pack Can Shaft
Made from heavy duty vinyl with insolating foam, the 28 in long Can Shaft when empty folds up out of the way for easy storage. Sling a 6-pack of cold drinks over your shoulder with the sturdy, adjustable strap, or hang it on your golf bag, beach bag, or back pack with the attached clip. Covered with logo name logo art. The entire side zipping open for easy access, the Can Shaft is perfect for sports fans, picnickers, hikers, coaches, and soccer moms.
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I happened to hear some of the comments by United Nations Secretary General Ban Ki-moon in Washington today. The comments regarded the Secretary General's "Sustainable Energy for All" initiative.
Downsizing Blog
U.S. Conference of Catholic Bishops and Spending Cuts
House Budget Committee chairman Paul Ryan (R-WI) and Speaker John Boehner (R-OH) are pushing back against criticism from the U.S. Conference of Catholic Bishops over the GOP's proposed cuts to domestic spending programs. They should.
Federal Funds for Cleaning Up Abandoned Mines
An article in the Wall Street Journal offers another example of the problem with the federal government tackling issues that should be left to the states to resolve. Congress passed a law in 1977 requiring coal companies to pay a fee that was to be used to help the states clean up abandoned mines. As is often the case, the distribution of funds to the states has been distorted by politics:
Milton Friedman on Tax Freedom Day
The Tax Foundation reported that Tuesday was Tax Freedom Day (TFD), which is the day that Americans stop "working for the government" through their tax payments and start working for themselves.
U.S. Postal Service and Rural America
This morning I discussed rural America's resistance to downsizing the U.S. Postal Service with Stuart Varney on the Fox Business Channel:
The Tax-Code Mess
In recent weeks President Obama has been on a quixotic search-and-destroy mission for the few remaining millionaires who aren't already paying a huge pile of taxes. Meanwhile, the rest of us face the real-world struggles of filing our IRS returns and dealing with the hugely complex tax system that the president has done nothing to fix.
Welfare and Private Charity
A new policy paper from my colleague Michael Tanner analyzes the growth in the American welfare state and concludes that "throwing money at the problem has neither reduced poverty nor made the poor self-sufficient." Michael makes an important point that—in my experience—most journalists don't seem to appreciate:
ALEC's Rich States, Poor States
The American Legislative Exchange Council (ALEC) released the fifth edition of its "Rich States, Poor States" report yesterday. For fiscal wonks the report is a fun read, as it is chock full of tax and economic comparisons between the 50 states.
About Those Postal Retiree Health Benefits
While Congress is busy trying to figure out how it's going to continue screwing up the U.S. Postal Service, postal expert Michael Schuler has been busy analyzing the reasons why it's so screwed up to begin with. Last week, Michael released a paper on congressional micromanagement of the USPS. A new paper looks at the complicated and controversial topic of postal retiree health benefits.
Federal Job Training Programs
The New York Times worries that "federal funds to train the jobless are drying up." It's not until the end of the article that the Times bothers to quote an economist who says that "Traditionally, we have found that job training has not been very effective for people who have lost their job recently."