Posted on 06/02/2009 11:56:10 PM PDT by stevelackner
James Kirchick, Assistant Editor of the "New Republic," argues that "in the coming days, we will hear more about how mainstream conservative organizations and media personalities created an 'environment' in which the murder of an abortion doctor became an inevitability. Just as talk radio was blamed for the 1995 Oklahoma City bombing, an attempt will be made to extend the guilt for this crime from the individual who pulled the trigger to the conservative movement writ large. But the Christian right's responsible reaction to the death of George Tiller should put to rest the lie that Judeo-Christian extremists are anywhere near as numerous or dangerous as those of the Muslim variety." Kirchick pointed out the Mike Hendricks of the Kansas City Star has already accused "anyone who had criticized Tiller as a murderer (Tiller aborted healthy, nine-month old fetuses) of being an 'accomplice' to his death." To read his article visit http://online.wsj.com/article/SB124398690567579389.html?mod=googlenews_wsj
The fact remains that soon after late-term abortionist George Tiller was killed, a soldier standing outside a recruiting office was murdered by a convert to Islam opposed to the U.S. military. George Tiller's death has become a story that the media has become fixated upon and continued to report day after day. Yet the story of an Islamoterrorist attack against U.S. soldiers on American soil only merits the coverage of an everyday news story that passes quickly as the next story arises.
The reason for this seems clear to me. Focusing on the killing of George Tiller, a killing which represents a very rare occurence, is a method to partially blame the Christian "religious right" for the murder, and to paint all of the "religious right" with a wide brush as being extremists. It allows the perception that an underbelly of Christian fanatacism is to blame for the killing. If the media were to focus on the killing of the U.S. soldiers it would be viewed as creating the same perception about another religious group, that being Muslims. To focus on the killing of American soldiers by a convert to Islam might be viewed as painting all Muslims with a wide brush as being extremists and fanatics. Political correctness has determined that to be verboten. Christians, of course, are not to be held to that same standard.
Being against abortion is a Christian position. Therefore, any action that furthers that position must be vilified.
On the other issue, the perp was a Muslim, and thereby anti-Christian, so he must be defended.
It’s all about the “cosmic battle”, friends.
And the liberals are on the “other side”.
We Christians are the ones who are faling to follow Machiaveli's advice and ally with the muzzies to behead all of our pedophiles, pornographers, and homosexuals. Go figure. Of course they were stupid enuff to vote for Zero so it would follow that they would be stupid enough to miss all the above but there you have it. Patient information: Gout Author Michael A Becker, MD Section Editor H Ralph Schumacher, MD Deputy Editors Leah K Moynihan, RNC, MSN Jerry M Greene, MD Last literature review version 17.1: January 2009 | This topic last updated: June 2, 2008 (More) INTRODUCTION — Gout is a painful and debilitating condition that develops in some people who have chronically high blood levels of urate (commonly referred to as uric acid). Not everyone with high blood urate levels (called hyperuricemia) develops gout; up to two-thirds of individuals with hyperuricemia never develop symptoms. It is unclear why some people with hyperuricemia develop gout while others do not. Although the joints are the most commonly affected part of the body, other parts of the body can also be affected. Uric acid or urate crystals can be deposited in the kidney or urinary tract, causing kidney stones and occasionally impairing kidney function. Kidney stones caused by uric acid crystals occur in approximately 15 percent of people with gout. This compares to an 8 percent risk of kidney stones in people without gout [1] . Gout is different than pseduogout, which is discussed in a separate topic review. Pseudogout is a form of arthritis that develops in some people in response to the presence of calcium pyrophosphate dihydrate (CPPD) crystals. (See "Patient information: Pseudogout"). RISK FACTORS — Gout is most common in men between 30 and 45, and in women between ages 55 and 70. It is estimated that gout affects approximately 2 percent of people in the United States. The following characteristics increase the risk of developing gout: Obesity High blood pressure Injury or recent surgery Fasting Consuming excessive amounts of alcohol (particularly beer, whiskey, gin, vodka, and rum) on a regular basis Overeating Ingesting large amounts of meat and seafood Taking medications that affect blood levels of urate (especially diuretics) SYMPTOMS — Gout attacks cause sudden severe joint pain, sometimes with redness, swelling, and tenderness of the joint. Although an attack typically affects a single joint, some people develop a few inflamed joints at the same time. The pain and inflammation are worst within several hours, and generally improve completely over a few days to several weeks, even if untreated. It is not clear how the body "turns off" a gout attack. The characteristic pain and inflammation of gout develops when a type of white blood cell, called neutrophils, attempt to surround and digest urate crystal deposits. White blood cells are the body's first line of immune defense, and recognize the crystal deposits as foreign material. Chemical signals released by other types of white blood cells and cells in the joint contribute to the pain, swelling, and redness associated with a gout attack. PHASES OF GOUT — There are three main phases of gout: acute gouty arthritis, intercritical gout, and chronic tophaceous gout. Acute gouty arthritis — Attacks of gout usually involve a single joint, most often the big toe or knee. This attack is known as acute gouty arthritis. People with osteoarthritis in the fingers may experience their first gout attacks in the fingers rather than the toes or knees. Intercritical period — The time between gout attacks is known as the intercritical period. A second attack typically occurs within two years, and additional attacks may occur thereafter. If gout is untreated over a period of several years, the time between attacks may shorten and attacks may become increasingly severe and prolonged. Over time, the attacks can begin to involve multiple joints at once and may be accompanied by fever. Chronic tophaceous gout — People who have repeated attacks of gout over many years can develop tophaceous gout. This causes large numbers of urate crystals to collect in joints, bones, and cartilage. The urate collection causes a nodule or mass called a tophus (plural tophi) to form. The tophus causes resorption and erosion of the bone, and can potentially cause deformity (show picture 1). The presence of tophi near the knuckles or small joints of the fingers can be a distressing cosmetic problem. Tophi are usually not painful or tender. However, they can become inflamed and cause symptoms like those of an acute gouty attack (show picture 2). Tophaceous gout was more common in the past, when treatment for hyperuricemia was unavailable. Certain groups are still at risk for tophaceous gout, including: People who are treated with cyclosporine after organ transplantation Those who cannot tolerate adequate doses of medications to treat hyperuricemia (for example, due to kidney failure or drug allergy) Women who are postmenopausal, especially those taking a diuretic The risk factors listed previously can also contribute to the development of tophaceous gout. (See "Risk factors" above). URINARY COMPLICATIONS — People with gout are at increased risk of developing kidney stones. Uric acid crystals can collect in the urinary tract and form a stone. If a stone is large enough, it can block one of the tubes (ureters) that carry urine from the kidney to the bladder and out of the body (show figure 1). Rarely, urate crystals collect in the kidney tissue itself, where they can cause inflammation and scar tissue, which reduce kidney function. Medications that increase the amount of uric acid excreted by the kidneys may help to reduce the risk of developing kidney stones. DIAGNOSIS — There are many illnesses that can cause joint pain and inflammation. Gout is strongly suspected if a person has an acute attack of joint pain, followed by a period when there are no symptoms. It is important to confirm the diagnosis of gout to ensure that potentially harmful medications are not taken unnecessarily over a prolonged period of time. The best way to diagnose gout is to examine synovial fluid from an affected joint, to look for urate crystals in the sample. To obtain the fluid, the provider uses a needle and syringe to withdraw a small amount of fluid from inside the joint. Tophi located just beneath the skin can be sampled with a needle to diagnose tophaceous gout. However, some people do not have urate crystals in their synovial fluid when symptoms are present. In this case, the diagnosis is based upon a person's symptoms and a physical examination. Criteria for diagnosing gout include: A history of pain and inflammation involving one joint at a time, especially the joint at the base of the large toe Complete resolution of symptoms between attacks Blood testing showing high levels of urate Rapid improvement in joint inflammation after treatment with colchicine TREATMENT OF GOUT ATTACKS — The goal of treatment of flares of gouty arthritis is to reduce pain and inflammation quickly and safely. It may be necessary to use more than one drug to achieve this goal. Deciding which medication to use is based upon several factors, including a person's risk of bleeding, their kidney health, and whether there is a past history of an ulcer in the stomach. Anti-inflammatory medications are the best treatment for acute gout attacks, and are best started early in the course of an attack. (See "Treatment of acute gout"). People with a history of gout should keep medication on hand to treat an attack because early treatment is an important factor in decreasing the pain and severity of an attack. Nonsteroidal antiinflammatory drugs — Nonsteroidal antiinflammatory drugs (NSAIDs), work to reduce swelling in a joint, and include ibuprofen (Advil®, Motrin®) and indomethacin (Indocin®) (show table 1). NSAIDs are generally recommended for people who have no history of kidney or liver disease, no bleeding problems, do not use anticoagulant medications (blood thinners such as warfarin or Coumadin®), and who have no history of a stomach or duodenal ulcer. (See "Patient information: Nonsteroidal antiinflammatory drugs (NSAIDs)"). NSAIDs are most effective in the treatment of a gout attack when they are started as soon as possible, before the attack is full blown. People who have had previous attacks may start taking an NSAID at the first signs of a recurrence. Although aspirin is an NSAID, it is not usually recommended for the treatment of gout because of it's potential impact on levels of urate in the blood. Colchicine — Colchicine may be prescribed instead of an NSAID. Colchicine does not increase the risk of ulcers, has no known interaction with anticoagulants, and in proper doses, does not affect kidney function. However, colchicine can have bothersome side effects, including diarrhea, nausea, vomiting, and crampy abdominal pain. For this reason, colchicine is generally reserved for patients who cannot tolerate NSAIDs. Some people have a great deal of success with colchicine and do not have side effects; colchicine might be used first for this group. Colchicine is generally taken as a pill. Steroids — Steroids, also known as glucocorticoids, are effective anti-inflammatory agents. Commonly used oral steroids include prednisone, prednisolone, and methylprednisolone. Steroids may be used if NSAIDs and colchicine cannot be used. They may be injected directly into the affected joint (called an intraarticular injection) or they can be given as pills or by intramuscular injection. People who have multiple affected joints or who cannot take NSAIDs or colchicine may be given oral steroids. However, there is an increased risk of recurrent gout attack (called rebound) in people who take oral steroids. For this reason, steroids should be tapered slowly over a period of seven to 10 days. PROPHYLACTIC THERAPY — Prophylactic therapy aims to prevent or reduce the occurrence of acute flares of gouty arthritis. Colchicine is usually recommended as prophylactic therapy; it is taken daily at low doses to avoid gastrointestinal side effects. Colchicine reduces the frequency of acute gout attacks, particularly while starting other drugs that lower urate levels. Prophylactic colchicine is not usually used as a long-term (years) treatment, but is a helpful bridge as a person progresses from an acute flare to preventive therapy. Although not as well documented as colchicine, daily NSAIDs are sometimes used for prophylactic therapy, and may have an advantage (because of pain relieving properties) for people who also have osteoarthritis (show table 1). PREVENTIVE THERAPY — Preventive therapy includes medications and dietary changes that can be used long-term to lower urate levels and prevent the progression of gout. Progressive gout can cause bone destruction and deformity (gouty arthropathy), disability, kidney stone formation, and, possibly, kidney damage. People who have one or more of these complications are strongly encouraged to take a urate-lowering treatment. Not everyone with gout will require preventive therapy; those who have rare or mild attacks are often able to manage their gout by treating the acute attacks alone. On the other hand, people with sporadic gout flares that are unusually prolonged, painful, and/or disabling are often encouraged to take preventive therapy. Medications — Urate-lowering or antihyperuricemic medications lower urate levels by helping to eliminate or decrease production of uric acid. Antihyperuricemic therapy is usually started after a gout attack has resolved. People who take their medication regularly experience fewer attacks. At present, preventive therapy is recommended indefinitely because there is no benefit to taking a break from medication. Probenecid increases the efficiency of uric acid excretion by the kidney, and is called a uricosuric drug. Benzbromarone is a more potent uricosuric drug, but is not available in the United States. Both drugs can cause side effects, including rash, stomach upset, and kidney stone formation. Losartan is used to treat high blood pressure but also has a useful, though weak, urate-lowering effect, as does the lipid-lowering drug fenofibrate. Allopurinol works by preventing the formation of uric acid. It is the most commonly used drug for lowering urate levels in gout. Allopurinol can cause side effects, including rash, lowered white cell and platelet counts, diarrhea and fever, although these problems occur in a relatively small percentage of patients. Lowering urate levels is a process that can take weeks or months. Very rapid urate lowering can cause acute flares of gout. Medications to lower urate are generally started at a low dose and increased slowly until the blood urate level is reduced and maintained at a level where urate crystal formation is unlikely. Increased fluids are recommended during this time (at least two liters per day are recommended). The prophylactic therapy (colchicine or NSAIDs, see "Prophylactic therapy" above") may be discontinued when blood levels of urate are normal and have been stable for about six months. Longer prophylactic therapy may be needed, as in patients with tophi. Blood levels of urate are monitored periodically to ensure that the goal urate level is maintained. Dietary changes — Changes in diet may reduce the frequency of gout attacks in some people. Because obesity is a risk factor for gout, as well as for many other health conditions (heart disease, diabetes, high blood pressure), losing weight is an important goal. However, starvation or fad diets are not recommended [2] . (See "Patient information: Weight loss treatments"). Diet guidelines for patients with gout have changed over time, and it is not completely clear which combination of foods is best. The current recommendations include reducing intake of red meat and seafood, and increasing intake of low fat dairy products and complex carbohydrates [3] . Reducing intake of beer and hard alcohol (eg, gin, vodka) is recommended because these beverages have been shown to increase the risk of a gout attack [4] . A moderate intake of wine (one to two 5 ounce servings per day) is not likely to increase the risk of a gout attack. High-fructose corn syrup products, (such as some types of non-diet soda) increase blood urate levels and are not recommended [5] . Coffee may decrease the risk of gout [6] . Vitamin C (500 mg/day) has a mild urate-lowering effect and may be recommended. Changes in diet are often recommended along with medications, but the reduction in blood urate levels due to diet change alone is modest (15 to 20 percent), even with very strict diets. WHERE TO GET MORE INFORMATION — Your healthcare provider is the best source of information for questions and concerns related to your medical problem. Because no two patients are exactly alike and recommendations can vary from one person to another, it is important to seek guidance from a provider who is familiar with your individual situation. This discussion will be updated as needed every four months on our web site (www.uptodate.com/patients). Additional topics as well as selected discussions written for healthcare professionals are also available for those who would like more detailed information.
Why are we interested in gout?
Almost 48 hours have passed since Monday morning’s shooting, the first terrorist killing of a US soldier on US soil since 9-11.........
....and his Commander-in-Chief has no comment.
Sickening.
The White House quickly leaped to issue a statement on Dr. Tiller. But is now silent.
“Murder Of U.S. Soldier Recieves Much Less Coverage Than Killing Of An Abortionist Doctor. Why?”Because the Left lost one of their much beloved high priests who used to offer their daily sacrifice.
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