Diabetic Type 2 Communication Forum,Forum komunikasi Dibetes tipe 2 :Diabetic Type 2 And Related Info

Forum Komunikasi Diabetes Tipe 2

Diabetic type 2 Communication Forum

Editor

Dr Iwan Suwandy.MHA

Siapa Saja yang berhubungan dengan Diabetes Tipe 2 dapat memanfaatkan forum komunikasi ini secara gratis untuk saling memberikan informasi, baik para profesional medis maupun para pasien

This Forum Special for Medical Professional and Dibetic Patiens and relarted disease communication to exchznge information freely

Editor

Dr Iwan Suwandy,MHA

Komunikasi Dan Konsultasi gratis  klik

https://driwancybermuseum.wordpress.com/2012/11/05/diabetic-type-communication-forumforum-komunikasi-dibetes-tipe-2-diabetic-type-2-and-related-info/

komunikasi liwat comment

The Study report Of Diabetic Type 2

Created by

Dr Iwan suwandy,MHA

copyright@2012

This Study dedicated To

my wife, sons and my brother ,lso for all Diavetic Type 2 community in all over the world,specially( khususnya) Indonesia.

Introductions

Indonesian version

Seseorang dengan diabetes tipe 2 dapat menggunakan latihan untuk membantu mengendalikan kadar gula darah mereka dan memberikan energi otot mereka perlu untuk berfungsi sepanjang hari.

Dengan mempertahankan diet sehat dan olahraga yang cukup, seseorang dengan diabetes tipe 2 NON Insulin dependend diabetes melittus (NIDDM) mungkin dapat menjaga gula darah mereka dalam rentang non-diabetes normal tanpa pengobatan.

Original info

A person with type 2 diabetes can use exercise to help control their blood sugar levels and provide energy their muscles need to function throughout the day.

By maintaining a healthy diet and sufficient exercise, a person with type 2 diabetes NON Insulin Dependend diabetes melittus(NIDDM) may be able to keep their blood sugar in the normal non-diabetic range without medication.

STUDI KEPUSTAKAAN

Diabetes tipe 2

Definisi

Diabetes tipe 2 adalah penyakit (kronis) seumur hidup di mana ada gula tingkat tinggi (glukosa) dalam darah.

Diabetes tipe 2 adalah bentuk paling umum diabetes.

Alternatif Nama Noninsulin-dependent diabetes; Diabetes – tipe 2;

Diabetes onset(Timbul)

saat dewasa Penyebab, kejadian, dan faktor risiko Diabetes disebabkan oleh masalah dalam cara tubuh Anda membuat atau menggunakan insulin. Insulin dibutuhkan untuk memindahkan gula darah (glukosa) ke dalam sel, di mana disimpan dan kemudian digunakan untuk energi.

Pathogenesis

Pada diabetes tipe 2, lemak, hati, dan sel-sel otot tidak merespon dengan benar terhadap insulin. Hal ini disebut resistensi insulin.

Akibatnya, gula darah tidak masuk ke sel-sel ini untuk disimpan untuk energi. Bila gula tidak dapat memasuki sel, gula tingkat tinggi membangun dalam darah. Hal ini disebut hiperglikemia.

Diabetes tipe 2 biasanya terjadi perlahan-lahan dari waktu ke waktu. Kebanyakan orang dengan penyakit kelebihan berat badan ketika mereka didiagnosis. Peningkatan lemak membuat lebih sulit bagi tubuh Anda untuk menggunakan insulin cara yang benar.

Diabetes tipe 2 juga dapat mengembangkan pada orang yang tipis. Ini lebih umum pada orang tua.

Riwayat keluarga dan gen memainkan peran besar pada diabetes tipe 2.

Kegiatan tingkat rendah, pola makan yang buruk, dan berat badan berlebih di sekitar pinggang meningkatkan risiko Anda.

Lihat juga: diabetes tipe 2 untuk daftar faktor risiko. Gejala Sering kali, orang dengan diabetes tipe 2 tidak menunjukkan gejala pada awalnya.

Mereka mungkin tidak memiliki gejala selama bertahun-tahun. Gejala-gejala awal diabetes meliputi:

• Kandung kemih, ginjal, kulit, atau infeksi lain yang lebih sering atau menyembuhkan perlahan • Kelelahan • Kelaparan • Meningkatnya rasa haus • Peningkatan buang air kecil Gejala pertama mungkin juga: • kabur visi • Disfungsi ereksi • Nyeri atau mati rasa pada kaki atau tangan

Tanda dan tes Dokter mungkin menduga bahwa Anda memiliki diabetes jika kadar gula darah Anda lebih tinggi dari 200 mg / dL.

Untuk memastikan diagnosa, satu atau lebih dari tes berikut harus dilakukan. Tes darah Diabetes : • kadar glukosa darah puasa –

diabetes didiagnosis jika lebih tinggi dari 126 mg / dL dua kali • Uji Hemoglobin A1c o Normal: Kurang dari 5,7% o Pra-diabetes: 5,7% – 6,4% o Diabetes: 6,5% atau lebih tinggi Sedamg 6,5-9 Bukurk lebih dari 9

Fakta Uji Hemoglobin A1c

The A1c AccuBase Kit Test adalah tes yang sangat akurat (kurang dari 1,0% CV) mampu mendeteksi varian hemoglobin abnormal dan / atau diam seperti S hemoglobin, dan C dan F dan lebih dari 850 lainnya.

Setiap sampel disaring lebih dulu karena keberadaan hemoglobin abnormal dan / atau kinetika eritrosit terganggu (usia normal atau volume sel darah merah) Contoh, anemia (yang palsu dapat menurunkan nilai A1C). Individu dengan diabetes yang berlangsung lama dapat hadir dengan kondisi yang disebut kekurangan eritropoietin (EPO) .

Kekurangan EPO dan / atau anemia dianggap kondisi serius yang memerlukan intervensi medis yang tepat. DEK dapat mempengaruhi jawaban A1c dan setiap sampel harus diskrining untuk kehadiran DEK.

Perkiraan melaporkan bahwa lebih dari 650.000 orang Amerika Hitam dengan diabetes yang tahu untuk memiliki Trait Sickle Cell (Hb “S, C atau F”) “Jangan tertipu oleh klaim akurasi ketika metode A1c dan / atau perangkat monitoring pakai memiliki CV ( koefisien variasi) lebih besar dari 2,0% atau tidak dapat mendeteksi hemoglobin abnormal “.

“Sebuah metode A1c dan / atau perangkat monitoring dengan CV sebesar 7,0% bisa berarti bahwa jika tingkat A1C Anda yang sebenarnya adalah 6,5% itu bisa dilaporkan di mana saja dari 5,0% menjadi 8,0% memberikan informasi palsu terapi dan / atau menyesatkan,” belum lagi dampak dari hemoglobin abnormal pada nilai A1c bahwa metode tertentu atau perangkat tidak mampu mendeteksi. Setiap sampel A1c AccuBase dianalisis dengan prosedur HPLC-IE dengan hasil Kromatogram dicetak seperti yang ditunjukkan di bawah ini. Staf laboratorium tersedia untuk membahas kromatogram individu dengan dokter Anda dan / atau tenaga medis.

The A1c AccuBase Test Kit adalah non-puasa, tongkat jari, mail-in test, dianggap tes A1C yang paling akurat dan tepat yang tersedia.

Tes ini dianggap sensitif dan cukup spesifik untuk mendeteksi diabetes (kurang dari 2,0% CV). CV berada di bawah 1,0%. CV menunjukkan tingkat akurasi diulang dibandingkan dengan nilai laboratorium diketahui A1c. CV rendah adalah tes yang lebih akurat A1c.

The A1c AccuBase Metode pengujian Kit adalah NGSP bersertifikat (nilai direferensikan ke DCCT). The A1c AccuBase Kit Uji tidak memerlukan waktu pengeringan, sampel dapat dikumpulkan dan dikirimkan dalam beberapa menit. Kit ini dilengkapi dengan pasien botol ID positif dan tabung kapiler plastik / perangkat. Metode analisis gangguan gratis. Sampel yang stabil selama 30 hari un-didinginkan.

Setiap hasil tes dilengkapi dengan perhitungan Glukosa Darah mean berdasarkan Persamaan MBG DCCT:% A1c X 31,7-66,1 = MBG di mg / dl. Hasil tes biasanya tersedia dalam 5 sampai 7 hari mailing bentuk.

Penanganan khusus dapat diatur untuk menyediakan, hari berikutnya, hasil sehari dua hari atau tiga. Ideal untuk diabetes rahasia (rata-rata glukosa darah) skrining, program penjangkauan dan jalur klinis .

Grafik pertama menunjukkan kromatogram normal dengan tidak hadir hemoglobin varian dan tingkat A1C yang normal.

The Kromatogram pada grafik kedua menunjukkan tingkat yang sangat tinggi dari F hemoglobin (25,6%). Tingkat peningkatan Hb F menghasilkan nilai A1c sub-normal 3,2%. Normal berkisar dari uji A1C (4,2% – 6,0%). Kecuali Anda telah disaring untuk varian hemoglobin Anda tidak akan tahu Anda membawa varian persisten turun-temurun, atau menyadari dampaknya terkait pada tingkat A1C Anda.

Peningkatan kadar Hemoglobin F dapat mewakili peningkatan risiko SIDS pada bayi, dan dapat mewakili sebagai asosiasi dalam berbagai jenis leukemia dan / atau tumor padat.

Ibu yang merokok atau telah terkena pencemaran lingkungan selama kehamilan mungkin memiliki tingkat yang jauh lebih tinggi dari Hb F pada bayi yang dapat meningkatkan risiko SIDS pada bayi baru lahir. AccuBase A1c Kit Uji Diselesaikan untuk digunakan OTC oleh FDA (tidak ada resep yang diperlukan di sebagian besar negara). Pasien dapat menerima salinan hasil tes.

Pelaporan elektronik kepada organisasi managed care kesehatan / penyedia tersedia. The AccuBase A1cTest Kit menggunakan “standar emas” HPLC-IE atau BA metodologi untuk mengumpulkan dan menganalisis sampel A1c di lokasi situs alternatif seperti rumah, kantor dokter dan / atau klinik • tes toleransi glukosa oral – diabetes didiagnosis jika kadar glukosa lebih tinggi dari 200 mg / dL setelah 2 jam Skrining diabetes dianjurkan untuk: • Kegemukan anak yang memiliki faktor risiko lain untuk diabetes, dimulai pada usia 10 dan diulang setiap 2 tahun • Kegemukan dewasa (BMI lebih besar dari 25) yang memiliki faktor risiko lain • Dewasa di atas usia 45 setiap 3 tahun Anda harus melihat dokter anda setiap 3 bulan. Pada kunjungan ini, Anda dapat mengharapkan dokter untuk: • Periksa tekanan darah Anda • Periksa kulit dan tulang pada kaki dan kaki • Periksa apakah kaki menjadi mati rasa • Periksa bagian belakang mata dengan alat khusus yang disebut terang ophthalmoscope Tes berikut akan membantu Anda dan dokter Anda memantau diabetes Anda dan mencegah masalah: • Apakah tekanan darah Anda diperiksa setidaknya setiap tahun (darah tujuan tekanan harus 130/80 mm / Hg atau lebih rendah). • Memiliki hemoglobin A1c Anda uji (HbA1c) setiap 6 bulan jika diabetes Anda terkontrol dengan baik, jika tidak setiap 3 bulan. • Apakah kolesterol dan trigliserida diperiksa tahunan (mencapai tingkat LDL di bawah 70-100 mg / dL). • Dapatkan tes tahunan untuk memastikan ginjal Anda bekerja dengan baik (mikroalbuminuria dan serum kreatinin). • Kunjungi dokter mata Anda setidaknya sekali setahun, atau lebih sering jika Anda memiliki tanda-tanda penyakit mata diabetes. • Lihat dokter gigi setiap 6 bulan untuk membersihkan gigi menyeluruh dan ujian. Pastikan dokter gigi dan ahli kesehatan tahu bahwa Anda memiliki diabetes.

Pengobatan

Tujuan pengobatan

pada awalnya adalah untuk menurunkan kadar glukosa darah tinggi.

Jangka panjang Tujuan pengobatan adalah untuk mencegah masalah dari diabetes.

Pengobatan utama untuk diabetes tipe 2 adalah olahraga dan diet. tes baru adalah Aggregasi Thrombosit(hemostasis tes untuk menentukan apakah anda hiper atau normal aggresasi): ADP 1 normal 0-15, ADP 2 normal 11-35, ADP 5 normal 25- 68 dan ADP 10 normal 49-84 (tes ini agak mahal sekitar Rp 300.000) Platelet Function Testing: Light Transmission Aggregometry [LTA] ________________________________________

english version

Introduction

Platelet function testing is difficult, time consuming and prone to a wide-variety of problems due to pre-analytical variables.

Before undertaking any tests of platelet function – consider: Variable Interpretation Clinical History & examination. Some syndromes [e.g. Hermansky Pudlak syndrome, Cheddiak Higashi syndrome, Wiskott-Aldrich syndrome, Velocardiofacial Syndrome (VCFS), Noonan syndrome, MYH9-related disorders] are associated with abnormal platelet function and you may get some idea of the diagnosis from the clinical history and examination. Drug History There are a large number of drugs and especially food substances that can interfere with platelet function. Full Blood Count (FBC) and Blood Film 1. Consider pseudothrombocytopenia often due to cold reacting platelet agglutinins or to platelet satellitism.

Approximately 0.1% of the healthy population show EDTA-induced pseudothrombocytopenia and it is important to exclude this before undertaking more extensive tests of platelet function. Similar findings have also been reported with the use of both citrate and heparin as anticoagulants.

A blood film may identify platelet clumps and provide a clue to the diagnosis. 2. Mean Platelet Volume [MPV – reference range 7-10fL]: the MPV is an often ignored parameter of the FBC but can provide important insights into the causes of a low platelet count. – It can also in some cases give a clue to the diagnosis e.g. the hereditary macrothrombocytopenias, Bernard Soulier Syndrome [BSS] – In individuals with an elevated MPV, an immunological-based platelet count may provide a more accurate and often significantly higher platelet count. –

The MPV can be an indication of platelet turnover – an increased MPV indicating accelerated platelet clearance as in ITP or gestational thrombocytopenia. –

The MPV may be reduced in cases of Wiskott-Aldrich Syndrome and in some cases of bone marrow failure. 3. An examination of the blood film and platelet morphology can be useful in both establishing a diagnosis of pseudothrombocytopenia but also in establishing a primary platelet problem e.g. Gray Platelet Syndrome.

In some cases of thrombocytopenia e.g. May Hegglin anomaly – the blood film may show the presence of Döhle bodies [light blue-gray, oval, basophilic, leukocyte inclusions located in the peripheral cytoplasm of neutrophils.] Pengujian Fungsi Trombosit : Cahaya Transmisi Aggregometry [LTA] ________________________________________

Pengantar

Pengujian fungsi platelet(thrombosit) sulit, memakan waktu dan rentan terhadap berbagai-masalah akibat pra-analitis variabel.

Sebelum melakukan apapun tes fungsi platelet – dipertimbangkan: Variabel Interpretasi Klinis Sejarah & pemeriksaan. Beberapa sindrom [misalnya Hermansky Pudlak sindrom, Cheddiak Higashi sindrom, Wiskott-Aldrich syndrome, Syndrome Velocardiofacial (VCFs), sindrom Noonan, MYH9 yang berhubungan dengan gangguan] yang berhubungan dengan fungsi trombosit yang abnormal dan Anda mungkin mendapatkan beberapa ide diagnosis dari sejarah klinis dan pemeriksaan.

Sejarah Obat Ada sejumlah besar obat dan terutama zat makanan yang dapat mengganggu fungsi trombosit. Darah penuh Count (FBC) dan Film Darah 1. Pertimbangkan pseudothrombocytopenia sering karena dingin agglutinins platelet bereaksi atau satellitism trombosit.

Sekitar 0,1% dari populasi menunjukkan pseudothrombocytopenia sehat EDTA-diinduksi dan penting untuk mengecualikan ini sebelum melakukan tes lebih luas dari fungsi platelet.

Temuan serupa juga telah dilaporkan dengan penggunaan kedua sitrat dan heparin sebagai antikoagulan. Sebuah film darah dapat mengidentifikasi gumpalan trombosit dan memberikan petunjuk untuk diagnosis. 2.

Volume rata-rata trombosit [MPV – referensi kisaran 7-10fL]: MPV adalah parameter sering diabaikan dari FBC tetapi dapat memberikan wawasan ke dalam penyebab dari jumlah platelet yang rendah. –

Hal ini dapat juga dalam beberapa kasus memberikan petunjuk untuk diagnosis misalnya yang turun-temurun macrothrombocytopenias, Bernard Soulier Syndrome [BSS] –

Pada individu dengan MPV ditinggikan, hitungan imunologi berbasis trombosit dapat memberikan jumlah trombosit lebih akurat dan sering lebih tinggi secara signifikan. –

The MPV bisa menjadi indikasi omset platelet – sebuah MPV meningkat menunjukkan izin trombosit dipercepat seperti di ITP atau trombositopenia kehamilan. –

The MPV dapat dikurangi dalam kasus Wiskott-Aldrich Syndrome dan dalam beberapa kasus kegagalan sumsum tulang.

3. Pemeriksaan film darah dan morfologi trombosit dapat berguna di kedua membangun diagnosis pseudothrombocytopenia tetapi juga dalam membangun misalnya masalah utama platelet Gray trombosit Syndrome. Dalam beberapa kasus trombositopenia misalnya Mei Hegglin anomali – film darah dapat menunjukkan adanya badan DOHLE [. Cahaya biru-abu-abu, oval, basofilik, inklusi leukosit terletak di sitoplasma perifer neutrofil]

english version

Principles of Light Transmission [Born] Aggregometry

Platelet aggregation testing measures the ability of various agonists to platelets to induce in vitro activation and platelet-to-platelet activation.

Classically Born aggregometry uses platelet rich plasma [PRP] but whole blood aggregometry can be also used. In the Born aggregometer, PRP is stirred in a cuvette at 37°C and the cuvette sits between a light course and a photocell.

When an agonist is added the platelets aggregate and absorb less light and so the transmission increases and this is detected by the photocell.

You can also see the principles of Born aggregometry as an animation on this site [http://www.platelet-research.org/3/aggregometry.htm] Light

Transmission Aggregometry:

Variable Variable Explanation Pre-Analytical Variables Drugs which can interfere with platelet function include aspirin and anti-inflammatory drugs, specific anti-platelet drugs including clopidogrel and imidazole. However, there are numerous other drugs whose primary role is not to inhibit platelet function but nevertheless can do so e.g. antibiotics, anti-depressants, beta-blockers etc – Click HERE for a list of drugs etc that may affect platelet function tests. Food stuffs – A high fat diet can lead to the presence of chylomicra in the plasma and interfere with light transmission in aggregation testing. –

Others include garlic, turmeric and caffeine. Platelet count: In individuals with very high or low platelet counts, it may be necessary to adjust the platelet count to achieve a count in the region of 200-400 x 109/L.

For very high counts the count can be adjusted with PPP. Platelet counts below 200 x 109/L can give rise to diminished aggregation responses. Although it seems logical to undertake additional centrifugation in such cases to increase the platelet count, in practice this can lead to activation of platelets and is not recommended.

Temperature: Blood samples for platelet aggregation testing should be stored at room temperature. pH: Platelet aggregation should be carried out at physiological pH.

Fibrinogen Concentration:

Platelets will only aggregate (although they may agglutinate) if fibrinogen is present and so it is important to check fibrinogen levels before undertaking platelet aggregation testing.

Anticoagulant: Current guidelines suggest that samples for platelet aggregation testing should be collected into citrate.

However, more recent data suggests that heparin , but not citrate, preserves platelet responses for up to 24 h as determined by a range of techniques Preparation of Platelet Rich Plasma [PRP] Platelets are very sensitive and can be readily activated during the preparation of PRP. Anticoagulant:

Venous blood with minimal venous occlusion, is collected into 3.2%/0.109M citrate in a ratio of 1:9 [1 part anticoagulant to 9 parts blood.] Whole blood samples should be processed within 4 hours of collection.

Blood samples for platelet aggregation testing should be stored at room temperature – cooling platelets can lead to activation. Transport samples to the laboratory at room temperature. PRP is prepared by centrifugation at 20°C for 10-15 minutes at 150-200g.

The PRP is carefully removed and placed into a stoppered plastic tube. PRP should be stored at room temperature. PPP can be prepared by further centrifugation of the remaining plasma at 2700g for 15 minutes. Agonists Addition of a platelet agonist to the PRP leads to platelet activation, a change in their shape from discoid to spiny spheres which is associated with a transient increase in optical density.

The only exceptions to this are epinephrine in which there is no shape change and ristocetin which causes platelet agglutination rather than aggregation i.e. there is no binding of fibrinogen.

There are two types of agonists: Strong Agonists e.g. Collagen, thrombin, TxA2: These directly induce platelet aggregation, TxA2 synthesis and platelet granule secretion. Weak Agonists e.g. ADP & epinephrine:

These induce platelet aggregation without inducing secretion. Platelet secretion can sometimes follow aggregation induced by a weak agonist, when the synthesis of endogenous TxA2 is triggered by the close platelet-to-platelet contact that occurs during platelet aggregation.

Strong agonists, when used at low concentrations, may act like weak agonists, but weak agonists even at high concentrations will not act as strong agonists. With some weak agonists [ADP and adrenaline] at critical concentrations, the platelet aggregation curve has a biphasic appearance: an initial wave of aggregation (primary wave), followed by a secondary wave of aggregation, which is usually irreversible [see illustration below.]

Secondary wave aggregation may not occur and the primary wave may disaggregate. At higher agonist concentrations (except with epinephrine) the two waves of aggregation combine and only a single wave is seen and the biphasic waveform is absent.

The aggregation response to an agonist is amplified by the production of TxA2 from membrane phospholipids and by the secretion of ADP from the dense granules. ADP and TxA2 are agonists, which, by interacting with their specific receptors, amplify the aggregation response of the platelet.

Transmisi cahaya Aggregometry: Variable Variabel Penjelasan Pra-Analytical

Variabel Obat yang dapat mengganggu fungsi trombosit meliputi obat aspirin dan anti-inflamasi, spesifik obat anti-platelet termasuk clopidogrel dan imidazol.

Namun, ada banyak obat lain peran utamanya adalah bukan untuk menghambat fungsi trombosit namun demikian dapat melakukannya misalnya antibiotik, anti-depressants, beta-blocker

obat yang dapat mempengaruhi tes fungsi platelet. Bahan makanan –

Diet tinggi lemak dapat menyebabkan kehadiran chylomicra dalam plasma dan mengganggu transmisi cahaya dalam pengujian agregasi. – Lainnya termasuk bawang putih, kunyit dan kafein. Platelet count: (perhitungan Thrombosit)

Pada individu dengan jumlah trombosit yang sangat tinggi atau rendah, mungkin perlu untuk menyesuaikan jumlah trombosit untuk mencapai hitungan di wilayah 200-400 x 109 / L.

Untuk jumlah yang sangat tinggi menghitung dapat disesuaikan dengan PPP. Jumlah trombosit di bawah 200 109 L x / dapat menimbulkan respon agregasi berkurang.

Meskipun tampaknya logis untuk melakukan sentrifugasi tambahan dalam kasus tersebut untuk meningkatkan jumlah trombosit, dalam praktek ini dapat menyebabkan aktivasi trombosit dan tidak dianjurkan. Suhu: Sampel darah untuk pengujian agregasi platelet harus disimpan pada suhu kamar. pH: agregasi trombosit harus dilakukan pada pH fisiologis.

Konsentrasi fibrinogen: Trombosit hanya akan agregat (meskipun mereka mungkin mengaglutinasi) jika fibrinogen hadir dan sehingga sangat penting untuk memeriksa tingkat fibrinogen sebelum melakukan pengujian agregasi platelet. Antikoagulan:

Pedoman saat ini menunjukkan bahwa sampel untuk pengujian agregasi platelet harus dikumpulkan ke sitrat. Namun, data yang lebih baru menunjukkan bahwa heparin, tetapi tidak sitrat, menjaga respon trombosit sampai 24 jam sebagaimana ditentukan oleh berbagai teknik Persiapan Plasma Kaya trombosit [PRP] Trombosit sangat sensitif dan dapat dengan mudah diaktifkan selama persiapan PRP. Antikoagulan:

vena darah dengan oklusi vena minimal, yang dikumpulkan ke 3,2% / sitrat 0.109M dalam rasio 1:9 [1 bagian antikoagulan untuk 9 bagian darah.]

Seluruh sampel darah harus diproses dalam waktu 4 jam dari koleksi. Sampel darah untuk pengujian agregasi platelet harus disimpan pada suhu kamar – trombosit pendinginan dapat menyebabkan aktivasi. Transportasi sampel ke laboratorium pada suhu kamar.

PRP disiapkan oleh sentrifugasi pada 20 ° C selama 10-15 menit pada 150-200g. PRP ini dengan hati-hati dihapus dan ditempatkan dalam tabung plastik tutup. PRP harus disimpan pada suhu kamar. PPP dapat dibuat dengan sentrifugasi lebih lanjut dari plasma yang tersisa pada 2700g selama 15 menit. Agonis

Penambahan suatu agonis trombosit untuk PRP mengarah ke aktivasi trombosit, perubahan dalam bentuk mereka dari diskoid ke bola berduri yang dikaitkan dengan peningkatan transien dalam densitas optik. Satu-satunya pengecualian untuk ini adalah epinephrine yang tidak ada perubahan bentuk dan ristocetin yang menyebabkan aglutinasi platelet daripada agregasi yaitu tidak ada pengikatan fibrinogen.

Ada dua jenis agonis: Kuat Agonis mis Kolagen, trombin, TXA2: Ini secara langsung menginduksi agregasi platelet, TXA2 sintesis dan sekresi granul trombosit. Lemah Agonis mis ADP & epinefrin: Ini menginduksi agregasi platelet tanpa mendorong sekresi.

Sekresi platelet(thrombosit) terkadang dapat mengikuti agregasi disebabkan oleh agonis lemah, ketika sintesis TXA2 endogen dipicu oleh kontak platelet-to-platelet dekat yang terjadi selama agregasi platelet. Agonis yang kuat, bila digunakan pada konsentrasi rendah, dapat bertindak seperti agonis lemah, tetapi agonis lemah bahkan pada konsentrasi tinggi tidak akan bertindak sebagai agonis yang kuat. Dengan beberapa agonis lemah [ADP dan adrenalin] pada konsentrasi kritis, kurva agregasi platelet memiliki penampilan biphasic: [.

Lihat ilustrasi di bawah ini] gelombang awal agregasi (gelombang primer), diikuti oleh gelombang sekunder agregasi, yang biasanya ireversibel agregasi gelombang sekunder tidak mungkin terjadi dan gelombang primer mungkin memisahkan. Pada konsentrasi agonis yang lebih tinggi (kecuali dengan epinefrin) dua gelombang agregasi menggabungkan dan hanya gelombang tunggal terlihat dan gelombang biphasic tidak ada.

Tanggapan agregasi untuk agonis yang diperkuat oleh produksi TXA2 dari fosfolipid membran dan oleh sekresi ADP dari butiran padat. ADP dan TXA2 adalah agonis, yang, dengan berinteraksi dengan reseptor khusus mereka, memperkuat respon agregasi platelet.

english version

Commonly used Agonists in Light Transmission Aggregometry

Commonly used agonists, their working concentration and mode of action are listed below. In practice many laboratories use a number of agonists and various dilutions but vary the actual agonists or agonist concentration depending upon the results of initial tests and the suspected abnormality. Not all laboratories necessarily use the concentrations shown below e.g. some labs may use collagen at 5μg/mL rather than 4μg/mL.

It is useful to consider the role of these various agonists by looking at an image of a platelet and the various receptors that are activated by the agonists discussed below and how these interact with the platelet.

This LINK takes you to an image that you may find useful to consider with the table below and this REFERENCE is to a paper that summarises the traces seen with various agonists.

Umumnya digunakan Agonis di Aggregometry Transmisi Cahaya Agonis umum digunakan, konsentrasi kerja dan cara kerja yang tercantum di bawah ini. Dalam prakteknya banyak laboratorium menggunakan sejumlah agonis dan pengenceran berbagai tapi bervariasi agonis aktual atau konsentrasi agonis tergantung pada hasil tes awal dan kelainan yang dicurigai.

Tidak semua laboratorium tentu menggunakan konsentrasi yang ditunjukkan di bawah misalnya beberapa laboratorium dapat menggunakan kolagen di 5μg/mL daripada 4μg/mL.

Hal ini berguna untuk mempertimbangkan peran tersebut agonis berbagai dengan melihat gambar trombosit dan reseptor berbagai yang diaktifkan oleh agonis dibahas di bawah ini dan bagaimana berinteraksi dengan platelet ini. LINK ini akan membawa Anda ke gambar yang Anda mungkin menemukan berguna untuk mempertimbangkan dengan tabel di bawah ini dan REFERENSI ini adalah sebuah makalah yang merangkum jejak dilihat dengan berbagai agonis.

Agonist Working Concentration Comment ADP Low dose: 1, 2.5, 5μM High dose: 10μM Dosis rendah: 1, 2,5, 5μM Dosis tinggi: 10ìm ADP binds to the ADP receptor on the surface of platelets.

Initial binding results in the release of intracellular calcium and a change in the shape of the platelet leading to the primary wave of aggregation.

The secondary wave reflects the release of ADP from platelet storage granules. Low dose ADP induces only primary aggregation and the effect is reversible. ADP and arachadonic acid are considered mild platelet agonists.

ADP binds to two G-protein coupled receptors: P2Y1 and P2Y12. Binding of ADP to the P2Y1 receptor induces shape change and initiates primary wave platelet aggregation through calcium mobilisation.

The P2Y12 receptor is considered to be the major ADP receptor and responsible for full platelet aggregation through the inhibition of adenyl cyclase. The P2Y12 receptor is also the target for clopidogrel.

With both ADP and Arachadonic acid – this second wave of aggregation is inhibited by aspirin and NSAID’s.

ADP mengikat ke reseptor ADP pada permukaan trombosit. Awal mengikat hasil dalam pelepasan kalsium intraseluler dan perubahan dalam bentuk platelet (thrombosit) menyebabkan gelombang utama agregasi.

Gelombang sekunder mencerminkan pelepasan ADP dari butiran penyimpanan trombosit. ADP dosis rendah hanya menginduksi agregasi primer dan efeknya reversibel. ADP dan asam arachadonic dianggap agonis trombosit ringan. ADP mengikat dua G-protein reseptor coupled: P2Y1 dan P2Y12.

Pengikatan ADP ke reseptor P2Y1 menginduksi perubahan bentuk dan memulai agregasi platelet gelombang primer melalui mobilisasi kalsium.

Reseptor P2Y12 dianggap reseptor ADP utama dan bertanggung jawab atas agregasi platelet penuh melalui penghambatan adenilat adenyl. Reseptor P2Y12 juga merupakan target untuk clopidogrel.

Dengan kedua ADP dan asam arachadonic – ini gelombang kedua agregasi dihambat oleh aspirin dan

NSAID Collagen 1, 4μg/mL Collagen binds to the GpVI and GpIa/IIa receptors inducing granule release, TXA2 generation and then sustained GPIIb-IIIa activation.

The GpIa/IIa receptor is involved in platelet adhesion. The GpVI receptor is involved in platelet signalling and TXA2 generation.

A lag phase is seen with collagen following addition of the agonist to the PRP and usually

3) tidak dibutuhkan oleh mayoritas pasien. APL merupakan faktor risiko yang spesifik untuk kegagalan terapi warfarin, sehingga INR terapetik pasien harus dipertahankan.

“Ada bukti peningkatan risiko APS rekuren, oleh karena itu pemberian warfarin yang tidak perlu atau dalam jangka waktu lama harus dipertimbangkan kembali, terutama setelah tromboemboli vena (VTE) pertama” jelas Ward.

Terapi Low molecular weight-heparin (LMVH) bisa diberikan dan terbukti bermanfaat untuk pasien APS yang gagal dengan warfarin.

Sedangkan antikoagulan oral atau penghambat trombin belum diketahui efikasinya. Pada intinya, manajemen tromboemboli arteri pada APS yang terbaik belum ditemukan.

Namun di awal terapi bisa diberikan kombinasi antikoagulan dan antiplatelet. Untuk mencegah keguguran berulang atau masalah obstetrik lainnya pada wanita dengan APL, bisa diberikan profilaksis heparin plus aspirin secara rutin, namun dasar ilmiahnya juga masih terbatas.

Dipaparkan Lee Lai Heng dari Departemen Hematologi, Singapore General Hospital, LMVH dikombinasikan dengan aspirin cukup efektif seperti halnya UFH plus aspirin dalam mencegah keguguran berulang akibat APS.

Pasien yang tidak tengah menjalani terapi antikoagulan, harus diberi aspirin sebelum konsepsi, dilanjutkan pemberian LMWH atau heparin ketika terjadi kehamilan.

Pasien yang menjalani terapi warfarin dalam waktu lama untuk trombosis yang dialami sebelumnya, harus dipertimbangkan dengan serius sebelum di-switch ke LMWH sebelum konsepsi untuk melihat efek teratogenik warfarin. Jika pasien akan mulai terapi dengan LMWH setelah konsepsi, sebaiknya dilakukan di usia kehamilan 6 minggu.

“Selama terapi harus dilakukan monitoring untuk mendeteksi masalah yang mungkin timbul seperti komplikasi pendarahan akibat trombositopenia terkait penggunaan heparin,” jelas Lee.

Untuk memastikan kelahiran yang aman, terapi antikoagula harus dihentikann 24 jam sebelum kelahiran dengan operasi. Setelah kelahiran, baik warfarin maupun LMWH dikonjugasi dengan stoking kompresi elastis harus dilanjutkan sebagai profilkasis

VTE maternal pada periode post-partum.

Profilaksi Fetal Loss Syndrome dengan kalsium nadroparin

Dijelaskan DR. dr. Djumhana Atmakusuma,

dari Divisi Hematologi dan Trombosis, Departemen Penyakit Dalam FKUI/RSCM, gangguan koagulasi , sebagai konsekuensi penyakit autoimun, menjadi penyebab utama keguguran berulang.

Angkanya mencapai 50-60% jika dibandingkan penyebab lain seperti abnormalitas kromosom (10%), gangguan anatomi (10%), dan masalah hormon (15-20%).

Gangguan koagulasi atau pembekuan darah yang menyebabkan keguguran, amat luas. Bisa disebabkan APS, trombositopenia, trombofilia, defisiensi antitrombin III (AT III), protein C dan Protein S, atau karena hipofibrinolisis, resistensi APC, dan faktor V leiden.

The American College of Chest Physician (APCC) tahun 2001

merekomendasikan terapi LMWH seperti enoxaparin, sebagai profilaksis antikoagulan dalam mencegah risiko keguguran berulang.

Alternatif lain adalah pemberian kalsium nadroparin yang merupakan kelompok antikoagulan parenteral.

Kalsium nadroparin selama ini digunakan untuk mencegah dan menangani VTE. Apakah ia cukup efektif dan aman untuk fetal loss syndrome?

Penelitian pernah dilakukan dengan melihat data pemberian kalsium nadroparin pada perempuan hamil di salah satu rumah sakit di Jakarta, antara tahun 2000-2004. Ada 648 (dari 731) subyek penelitian, yang mendapat terapi dan bisa dievaluasi. 77, 32% subyek memiliki gejala gangguan sirkulasi dan penyakit autoimun.

Dari seluruh subyek, 49% memiliki riwayat aborsi spontan, 6% memiliki riwayat IUFD, 2% memilki riwayat kematian perinatal dan lainnya.

Dari 648 pasien, 239 (73%) tangah hamil saat kunjungan pertama, 126 (20%) hamil setelah beberapa kali kunjungan, dan 283 (45%) dalam kondisi masih hamil.

Hasil tes laboratorium menujukkan pasien-pasien ini mengalami trombositosis (1,8%), hiperagregasi platelet (45,5%), hiperkoagulasi (56%), hiperfibrinogenemia (19,3%), defisiensi protein C (14,7%), defisiensi protein S (36,5%), dan defisiensi AT III (18,6%). Uji antibodi antifosfolipid (APL) menunjukkan ACA IgG moderat pada 2,7% (tes 1), tinggi pada 0,3% (tes 1), ACA IgM moderat pada 5,6% (tes 1), 5,9% (tes 2), dan 4% (tes 3).

Sedangkan ACA IgG tinggi ditemukan pada 2,4% (tes 1), 2,2% (tes 2), dan 4% (tes 3). Ada 234 subyek yang menerima profilaksis suntikan kalsium nadroparin, kebanyakan dikombinasi dengan aspirin dosis rendah. 181 bisa di-follow up dan sebanyak 166 subyek bisa melahirkan bayi dan 14 orang mengalami keguguran.

Efek samping selama terapi adalah gatal di seluruh tubuh (10 orang), gatal di bekas suntikann (43 orang) dan purpura (1 orang) .

Di luar pemberia kalsium nadroparin, ada 12 pasien yang menerima enoxapoarin dan 6 orang riteraoi dengan UFH. APS katastropik Di awal sempat disinggung tentang APS katastropik (CAPS) yang bisa berdampak kematian. Dijelaskan Dr. Inho Kim dari Seoul National University Hospital, Korea Selatan, APS katastropik dilaporkan kurang dari 1% dari prevalensi APS. CAPS didefinisikan sebagai kondisi yang dikarakteristikkan dengan kejadian penyumbatan vaskular yang multipel, biasanya menyerang pembuluh-pembuluh darah mikro dan hasil uji lab menunjukkan adanya antibodi antifosfolipid.

Dulu tingkat kematian akibat CAPS mencapai 50%, meskipu saat ini sudah turun hingga “hanya” 20%.

Turunnya angka kematian akibat CAPS disebabkan peningkatan terapi dengan antikoagulan, kortikosteroid, dan pergantian plasma.

Salah satu studi tentang CAPS menunjukkan bahwa tingkat kesembuhan tertinggi (77,8%) diperoleh melalui terapi kombinasi antikoagulan, kortikosterpid, dan peragntian plasma ini.

Konsensus internasional pun merekpomendasikan kombinasi 3 terapi ini sebagai terapi lini pertama CAPS. Saat ini penggunaan imunoglobulin intravena (IVIG) belum banyak dipraktikkan untuk CAPS.

Terapi kombinasi antikoagulan+ kortikosteroid+ IVIG tidak menunjukkan tambahan manfaat (recovery 69%) dibandingkan kombinasi antikoagulan, kortikosterpid, dan peragntian plasma (77,8%).

Namun penggunaan IVIG bisa digunakan jika tidak ada terapi penggantian plasma. Hanya penggunaannya harus hati-hati pada pasien usia lanjut yang komorbid dengan diabetes, hipertensi atau hiperkolesterolemia.(Ana/Bali)

Method Platelet aggregometry is performed as follows: metode Aggregometry trombosit dilakukan sebagai berikut Step 1 Platelet aggregometry is performed at 37°C. 2 The aggregometer is calibrated by: –

A cuvette containing PRP which equates to 0% light transmission – A second cuvette containing PPP which equates to 100% light transmission. 3 Platelets will only aggregate if they are activated (with an agonist) and in contact with each other – so they must be stirred whilst testing is taking place.

Absence of stirring will lead to an absence of, at least a significant reduction in, aggregation. A check for spontaneous platelet aggregation [SPT] is made. SPA is rare in healthy individuals but seen in some cases of VWD,

in some patients with diabetes, in some lipid disorders and in a variety of other disorders] should be made in all patients by placing undiluted PRP in the aggregometer and stirring for 15 minutes. In cases of SPA, dilution of the PRP may abolish this and if the platelet count remains >200 x 109/L then aggregation testing can proceed.

Trombosit hanya akan agregat jika mereka diaktifkan (dengan agonis an) dan kontak dengan satu sama lain – sehingga mereka harus diaduk sementara pengujian berlangsung.

Tidak adanya pengadukan akan mengakibatkan tidak adanya, setidaknya penurunan yang signifikan dalam, agregasi.

Sebuah cek untuk agregasi platelet spontan [SPT] dibuat. SPA jarang terjadi pada orang sehat, tetapi dilihat dalam beberapa kasus VWD, pada beberapa pasien dengan diabetes, dalam beberapa gangguan lipid dan berbagai gangguan lain harus] dibuat pada semua pasien dengan menempatkan PRP murni di aggregometer dan diaduk selama 15 menit .

Dalam kasus SPA, cairan PRP dapat menghapus ini dan jika jumlah trombosit tetap> 200 x 109 / L maka pengujian agregasi dapat melanjutkan

4 In general – 270μL of PRP is added to the aggregometry cuvette and warmed at 37°C until a steady baseline is achieved. 30μL of the agonist is added the response recorded.

The tests are repeated using a panel of agonists. Secara umum – 270μL

dari PRP ditambahkan ke kuvet aggregometry dan dihangatkan pada 37 ° C sampai dasar stabil tercapai. 30μL agonis tersebut akan ditambahkan respon direkam. Tes diulang dengan menggunakan sebuah panel agonis

The following aggregation trace shows the events in classic biphasic aggregation:

Jejak agregasi berikut menunjukkan peristiwa di agregasi biphasic klasik 1. Baseline

2. Addition of agonist – this results in a change in platelet change and hence a drop in the baseline absorbance

3. Primary wave aggregation

4. Release of nucleotides 5. Secondary wave aggregation

dasar

2. Penambahan agonis – ini menghasilkan perubahan dalam perubahan trombosit dan karenanya penurunan absorbansi dasar

3. Primer gelombang agregasi

4. Pelepasan nukleotida

5. Sekunder gelombang agregasi

Adrenaline and low dose ADP

classically give a biphasic aggregation curve whereas with a number of other agonists only a single wave is seen and it is not possible to distinguish the primary wave from the secondary wave.

Adrenalin dan dosis rendah ADP klasik memberikan kurva agregasi biphasic s

edangkan dengan sejumlah agonis lain hanya gelombang tunggal terlihat dan tidak mungkin untuk membedakan gelombang primer dari gelombang sekunder.

Interpretation

Calculating the slope or the rate of aggregation Look at the image below: interpretasi

Menghitung kemiringan atau tingkat agregasi Lihatlah gambar di bawah ini Historically, percentage [%] maximal aggregation has been reported when analysing aggregation curves.

To calculate the % maximal aggregation, the distance between the baseline [0% aggregation – platelet rich plasma] and platelet poor plasma [100% aggregation] [Y] is divided by the maximal aggregation [X]. S

o in the example above if the Y = 100mm and X = 87mm then percentage maximal aggregation = X/Y = 87%

. Secara historis,

persentase [%] agregasi maksimal telah dilaporkan ketika menganalisis kurva agregasi. Untuk menghitung agregasi% maksimal, jarak antara baseline [agregasi 0% – plasma kaya platelet] dan plasma miskin trombosit [100% agregasi] [Y] dibagi oleh agregasi maksimal [X]. Jadi, dalam contoh di atas jika Y = 100mm dan X = 87mm maka persentase agregasi maksimal = X / Y = 87%

To calculate the slope [and this forms the basis of the VWF:RCo functional assay]:

1. Draw a line at a tangent to the aggregation curve.

2. Determine how many millimetres [mm] the chart recorder records in 1 minute.

3. Measure in mm from the point where the tangent intersects the baseline to the distance equal to 1 minute.

4. Draw a line perpendicular to the baseline from the ‘1 minute’ point to the intersect point of the tangent.

5. Measure the distance [in mm] covered from the baseline to the intersect point [X]. 6. Derive the maximal height of the aggregation [100% aggregation or maximal aggregation] from the y-axis [Y]. Divide X/Y to calculate the slope or rate of aggregation.

In the example above, if X = 23mm and Y = 97mm, the slope is X/Y = 0.24

Untuk menghitung lereng [dan ini membentuk dasar dari VWF: RCo uji fungsional]: 1. Menarik garis di bersinggungan dengan kurva agregasi. 2. Tentukan berapa banyak milimeter [mm] catatan perekam grafik dalam 1 menit. 3. Mengukur dalam mm dari titik di mana garis singgungnya memotong baseline untuk jarak yang sama dengan 1 menit. 4. Gambarkan garis tegak lurus ke baseline dari titik menit ‘1 ‘ke titik berpotongan garis singgungnya. 5. Ukur jarak [di mm] tertutup dari baseline ke titik berpotongan [X]. 6. Turunkan ketinggian maksimal agregasi [agregasi 100% atau agregasi maksimal] dari sumbu y [Y]. Bagilah X / Y untuk menghitung kemiringan atau tingkat agregasi. Dalam contoh di atas, jika X = 23mm dan 97mm Y =, kemiringan adalah X / Y = 0,2

4 Interpretation of Platelet Aggregation Traces

The interpretation of platelet aggregation traces can be difficult. The attached file [click HERE] provides a summary of the abnormalities that may be identified by platelet aggregation testing.

Common aggregation traces that you are likely to encounter in an an exam-type setting are: – Glanzmann’s Thrombasthenia [or afibrinogenaemia] – Bernard-Soulier Syndrome [or Von Willebrand Disease] – Storage Pool Disorder [or release defect] –

The effects of Aspirin [or an aspirin-like defect] – The effects of Aspirin Clopidogrel Representative traces for some disorders and shown below and others are covered in the data interpretation section.

In each case the control is shown in blue and the patient in red. 1. In the patient shown below, the only abnormality is a lack of agglutination with ristocetin. Possible diagnoses are therefore, Von Willebrand Disease or Bernard Soulier Syndrome. Interpretasi Jejak Agregasi trombosit Penafsiran jejak agregasi platelet bisa sulit.

File terlampir [klik DI SINI] menyediakan ringkasan dari kelainan-kelainan yang dapat diidentifikasi dengan tes agregasi trombosit.

Jejak agregasi umum bahwa Anda mungkin menghadapi dalam suasana ujian-jenis adalah: – Glanzmann ini Thrombasthenia [atau afibrinogenaemia] – Bernard-Soulier Syndrome [atau Von Willebrand Penyakit]

– Penyimpanan Renang Disorder [atau cacat release] –

Efek Aspirin [atau cacat aspirin-seperti] – Efek dari Clopidogrel Aspirin Perwakilan jejak untuk beberapa gangguan dan ditampilkan di bawah ini dan lain-lain akan dibahas dalam bagian interpretasi data.

Dalam setiap kasus kontrol ditampilkan dalam warna biru dan pasien dalam merah. 1. Pada pasien yang ditunjukkan di bawah, kelainan satunya adalah kurangnya aglutinasi dengan ristocetin.

Kemungkinan diagnosis karena itu, Von Willebrand Penyakit atau Bernard Soulier Syndrome

2. This is the converse of the patient shown above and the only agglutination [and this is not complete] is seen with the ristocetin.

There is no aggregation with ADP, adrenaline or collagen. Possible diagnoses include Glanzmann’s thrombasthenia or afibrinogenaemia.

Remember, platelet agglutination with ristocetin occurs independently of fibrinogen.

In the traces shown below it is clear that only partial agglutination is seen with ristocetin emphasising that for aggregation to occur, binding of fibrinogen to the GpIIb/IIIa receptor is necessary.

2. Ini adalah kebalikan dari pasien yang ditunjukkan di atas dan aglutinasi satunya [dan ini tidak lengkap] terlihat dengan ristocetin tersebut.

Tidak ada agregasi dengan ADP, adrenalin atau kolagen.

Diagnosis mungkin termasuk Glanzmann ini thrombasthenia atau afibrinogenaemia. Ingat, aglutinasi platelet dengan ristocetin terjadi secara independen dari fibrinogen.

Dalam jejak ditunjukkan di bawah ini jelas bahwa hanya aglutinasi parsial terlihat dengan ristocetin menekankan bahwa untuk agregasi terjadi, pengikatan fibrinogen ke reseptor GpIIb / IIIa diperlukan.

3. In this patient reversible, first wave aggregation is seen with ADP, adrenaline and collagen and only partial agglutination with ristocetin.

The picture is clearly different from the two traces above 1) or 2): the results suggest a failure of granule release and and is consistent with either platelet storage pool disorder or a defect in nucleotide release.

3. Pada pasien ini reversibel, agregasi gelombang pertama terlihat dengan ADP, adrenalin dan kolagen dan hanya aglutinasi parsial dengan ristocetin.

Gambar jelas berbeda dari dua jejak di atas 1) atau 2): hasil menunjukkan kegagalan pelepasan granul dan dan konsisten dengan baik gangguan kolam penyimpanan trombosit atau cacat dalam rilis nukleotida

4. Its useful to summarise the ‘commonly’ described abnormalities seen with light transmission aggregometry although in practice many of these are extremely rare.

The table below summarises these:

Tes ini berguna untuk merangkum kelainan ‘umum’ dijelaskan dilihat dengan aggregometry transmisi cahaya meskipun dalam prakteknya banyak di antaranya sangat langka.

Tabel di bawah ini merangkum ini

Disorder Characteristic

Findings on LTA Glanzmann’s Thrombasthenia OR afibrinogenaemia Absent or markedly impaired aggregation to all agonists except ristocetin. Ristocetin-induced agglutination shows only primary wave – aggregation cannot occur because fibrinogen cannot bind.

Afibrinogenaemia gives similar results.

Absen atau gangguan nyata agregasi

untuk semua agonis kecuali ristocetin. Ristocetin-diinduksi aglutinasi hanya menunjukkan gelombang primer – agregasi tidak bisa terjadi karena fibrinogen tidak dapat mengikat.

Afibrinogenaemia memberikan hasil yang sama Bernard Soulier Syndrome OR Von Willebrand Disease

Absent or markedly reduced platelet agglutination with ristocetin. Absen atau nyata mengurangi trombosit aglutinasi dengan ristocetin S

torage Pool Disorder OR Platelet Release Defect Primary aggregation only with ADP, adrenaline and collagen and only partial agglutination with ristocetin suggesting a failure of granule release or a deficiency of platelet granules .

Primer agregasi hanya dengan ADP, adrenalin dan kolagen dan hanya aglutinasi parsial dengan ristocetin menunjukkan kegagalan pelepasan granul atau butiran kekurangan trombosit Aspirin [or defects in the COX pathway] Absent aggregation to arachadonic acid.

Primary wave aggregation only with ADP. Decreased or absent aggregation with collagen.

Absen agregasi untuk asam arachadonic. Gelombang primer agregasi hanya dengan ADP. Penurunan atau tidak ada agregasi dengan kolagen Clopidogrel

Absent aggregation with ADP 2B VWD/Platelet-type [pseudo]VWD Aggregation with low dose ristocetin e.g. 0.5 mg/mL. What test next? On the basis of an abnormal platelet aggregation trace, you should establish if this fits in with any recognisable disorder. All abnormal results should be repeated and you may wish to undertake flow cytometry and nucleotide studies. Genetic testing can be of value in some cases. Don’t forget to establish a family pedigree – some of the rare platelet disorders are commoner in consanguineous relationships.

Apa tes berikutnya?

Atas dasar suatu jejak agregasi platelet normal, Anda harus menentukan apakah ini cocok dengan gangguan dikenali.

Semua hasil yang abnormal harus diulang dan Anda mungkin ingin melakukan cytometry aliran dan studi nukleotida.

Pengujian genetik dapat menjadi nilai dalam beberapa kasus. Jangan lupa untuk membuat silsilah keluarga – beberapa gangguan trombosit langka biasa dalam hubungan kerabat Data Interpretation

Interpretation Exercises. Comments

1. You can also see the principles of Light Transmission Aggregometry on this site [http://www.platelet-research.org/3/aggregometry.htm].

References

1. Remuzzi, G., et al., Platelet hyperaggregability and the nephrotic syndrome. Thromb Res, 1979. 16(3-4): p. 345-54. 2. Lages, B. and H.J. Weiss, Biphasic aggregation responses to ADP and epinephrine in some storage pool deficient platelets: relationship to the role of endogenous ADP in platelet aggregation and secretion.

Thromb Haemost, 1980. 43(2): p. 147-53. 3. Guidelines on platelet function testing. The British Society for Haematology BCSH Haemostasis and Thrombosis Task Force. 4. Lages, B. and H.J. Weiss, Heterogeneous defects of platelet secretion and responses to weak agonists in patients with bleeding disorders. Br J Haematol, 1988. 68(1): p. 53-62. 5. Hardisty, R.M., Disorders of platelet secretion. Baillieres Clin Haematol, 1989. 2(3): p. 673-94. 6. Michelson, A.D., Flow cytometry: a clinical test of platelet function. Blood, 1996. 87(12): p. 4925-36. 7. Rao, A.K., Congenital disorders of platelet function: disorders of signal transduction and secretion. Am J Med Sci, 1998. 316(2): p. 69-76. 8. Rodgers, G.M., Overview of platelet physiology and laboratory evaluation of platelet function. Clin Obstet Gynecol, 1999. 42(2): p. 349-59. 9. Shapiro, A.D., Platelet function disorders. Haemophilia, 2000. 6 Suppl 1: p. 120-7. 10. Kottke-Marchant, K. and G. Corcoran, The laboratory diagnosis of platelet disorders. Arch Pathol Lab Med, 2002. 126(2): p. 133-46. 11. Handin, R.I., Inherited platelet disorders. Hematology Am Soc Hematol Educ Program, 2005: p. 396-402. 12. Harrison, P., Platelet function analysis. Blood Rev, 2005. 19(2): p. 111-23. 13. Bolton-Maggs, P.H., et al., A review of inherited platelet disorders with guidelines for their management on behalf of the UKHCDO. Br J Haematol, 2006. 135(5): p. 603-33. 14. Hayward, C.P., Diagnostic approach to platelet function disorders. Transfus Apher Sci, 2008. 38(1): p. 65-76. 15. Harrison, P. and A. Mumford, Screening tests of platelet function: update on their appropriate uses for diagnostic testing. Semin Thromb Hemost, 2009. 35(2): p. 150-7. 16. Mezzano, D., T. Quiroga, and J. Pereira, The level of laboratory testing required for diagnosis or exclusion of a platelet function disorder using platelet aggregation and secretion assays. Semin Thromb Hemost, 2009. 35(2): p. 242-54. 17. Zhou L, Schmaier AH. Platelet aggregation testing in platelet-rich plasma: description of procedures with the aim to develop standards in the field. Am J Clin Pathol. 2005 Feb;123(2):172-83. 18. Simon D, Kunicki T, Nugent D. Platelet function defects. Haemophilia. 2008 Nov;14(6):1240-9. 19. Truss, N.J., Armstrong, P.C., Liverani, E., Vojnovic, I. & Warner, T.D. (2009) Heparin but not citrate anticoagulation of blood preserves platelet function for prolonged periods. J Thromb Haemost, 7, 1897-1905. 20. Quiroga et al BJH 2009 21. Nurden A, Nurden P. Advances in our understanding of the molecular basis of disorders of platelet function. J Thromb Haemost 2011;9 Suppl 1:76-91. Data Interpretasi Klik DI SINI untuk pergi ke Latihan Interpretasi data. Komentar 1. Anda juga dapat melihat prinsip-prinsip Aggregometry Transmisi Cahaya di situs ini [http://www.platelet-research.org/3/aggregometry.htm]. Referensi 1. Remuzzi, G., et al., Hyperaggregability trombosit dan sindrom nefrotik. Thromb Res, 1979. 16 (3-4): p. 345-54. 2. Lages, B. dan HJ Weiss, respon agregasi Biphasic ke ADP dan epinefrin dalam beberapa trombosit storage pool kekurangan: hubungan peran ADP endogen dalam agregasi platelet dan sekresi. Thromb Haemost, 1980. 43 (2): p. 147-53. 3. Pedoman pengujian fungsi platelet. Masyarakat Inggris untuk Haemostasis BCSH Hematologi dan Angkatan Trombosis Tugas. 4. Lages, B. dan HJ Weiss, cacat heterogen sekresi platelet dan tanggapan terhadap agonis lemah pada pasien dengan gangguan perdarahan. Br J Haematol, 1988. 68 (1): p. 53-62. 5. Hardisty, R.M., Gangguan sekresi platelet. Baillieres Clin Haematol, 1989. 2 (3): p. 673-94. 6. Michelson, AD, Arus cytometry: tes klinis fungsi platelet. Darah, 1996. 87 (12): p. 4925-36. 7. Rao, AK, gangguan kongenital fungsi trombosit: gangguan transduksi sinyal dan sekresi. Am J Med Sci, 1998. 316 (2): p. 69-76. 8. Rodgers, GM, Ikhtisar fisiologi trombosit dan evaluasi laboratorium fungsi platelet. Clin Obstet Gynecol, 1999. 42 (2): p. 349-59. 9. Shapiro, M, gangguan fungsi trombosit. Hemofilia, 2000. 6 Suppl 1: p. 120-7. 10. Kottke-Marchant, K. dan G. Corcoran, Diagnosis laboratorium kelainan trombosit. Arch Pathol Lab Med, 2002. 126 (2): p. 133-46. 11. Handin, R.I., warisan gangguan trombosit. Hematologi Am Soc Hematol Educ Program, 2005: p. 396-402. 12. Harrison, P., analisis fungsi trombosit. Darah Rev, 2005. 19 (2): p. 111-23. 13. Bolton-Maggs, PH, et al, Sebuah tinjauan gangguan trombosit diwariskan dengan pedoman untuk manajemen mereka atas nama UKHCDO.. Br J Haematol, 2006. 135 (5): p. 603-33. 14. Hayward, CP, pendekatan Diagnostik gangguan fungsi trombosit. Transfus Apher Sci, 2008. 38 (1): p. 65-76. 15. Harrison, P. dan A. Mumford, Screening tes fungsi platelet: update pada penggunaan yang sesuai untuk tes diagnostik. Semin Thromb Hemost, 2009. 35 (2): p. 150-7. 16. Mezzano, D., T. Quiroga, dan J. Pereira, Tingkat pengujian laboratorium diperlukan untuk diagnosis atau pengecualian dari gangguan fungsi trombosit menggunakan agregasi platelet dan tes sekresi. Semin Thromb Hemost, 2009. 35 (2): p. 242-54. 17. Zhou L, Schmaier AH. Agregasi platelet pengujian di platelet-kaya plasma: deskripsi prosedur dengan tujuan untuk mengembangkan standar di lapangan. Am J Clin Pathol. 2005 Feb, 123 (2) :172-83. 18. Simon D, Kunicki T, Nugent D. cacat fungsi trombosit. Hemofilia. 2.008 November, 14 (6) :1240-9. 19. Truss, NJ, Armstrong, PC, Liverani, E., Vojnovic, I. & Warner, TD (2009) Heparin tetapi tidak sitrat antikoagulasi darah mempertahankan fungsi trombosit untuk waktu yang lama. J Thromb Haemost, 7, 1.897-1.905. 20. Quiroga et al BJH 2.009 21. Nurden A, Nurden P. Kemajuan dalam pemahaman kita tentang dasar molekul dari gangguan fungsi trombosit. J Thromb Haemost 2011; 9 Suppl 1:76-91. BELAJAR KETERAMPILAN-KETERAMPILAN Anda harus belajar keterampilan diabetes manajemen dasar. Mereka akan membantu mencegah masalah dan kebutuhan untuk perawatan medis. Keterampilan ini meliputi: • Bagaimana menguji dan merekam glukosa darah Anda (Lihat: pemantauan glukosa darah) • Apa yang harus makan dan kapan • Bagaimana untuk mengambil obat, jika diperlukan • Bagaimana mengenali dan mengobati gula darah rendah dan tinggi • Bagaimana menangani hari sakit • Dimana dapat membeli persediaan diabetes dan bagaimana menyimpannya Ini mungkin membutuhkan beberapa bulan untuk mempelajari keterampilan dasar. Selalu terus belajar tentang diabetes, komplikasi, dan bagaimana mengontrol dan hidup dengan penyakit. Tetap up-to-date pada penelitian baru dan perawatan. MENGELOLA GULA DARAH ANDA Pengujian diri berarti bahwa Anda memeriksa gula darah Anda di rumah sendiri. Memeriksa kadar gula darah Anda di rumah dan menuliskan hasilnya akan memberitahu Anda seberapa baik Anda mengelola diabetes Anda. Perangkat yang disebut glucometer bisa memberi Anda membaca gula darah yang tepat. Ada berbagai jenis perangkat. Biasanya, Anda menusuk jari Anda dengan jarum kecil yang disebut lanset. Ini akan memberikan Anda setetes kecil darah. Anda menempatkan darah pada strip tes dan menempatkan strip ke dalam perangkat. Hasil yang diberikan dalam 30 – 45 detik. Sebuah perawatan kesehatan atau pendidik diabetes akan membantu mengatur jadwal di rumah pengujian untuk Anda. Dokter akan membantu Anda menetapkan tujuan darah gula. • Kebanyakan orang dengan diabetes tipe 2 hanya perlu memeriksa gula darah mereka sekali atau dua kali sehari. • Jika kadar gula darah Anda berada di bawah kontrol, Anda mungkin hanya perlu memeriksa mereka beberapa kali seminggu. • Anda dapat menguji diri sendiri ketika Anda bangun tidur, sebelum makan, dan sebelum tidur. • Anda mungkin perlu menguji lebih sering ketika Anda sakit atau sedang stres. Hasil tes dapat digunakan untuk mengubah makanan Anda, aktivitas, atau obat-obatan untuk menjaga kadar gula darah dalam kisaran yang tepat. Pengujian dapat mengidentifikasi kadar gula darah tinggi dan rendah sebelum Anda memiliki masalah serius. Mencatat gula darah Anda untuk diri sendiri dan penyedia layanan kesehatan Anda. Ini akan membantu jika Anda mengalami kesulitan mengelola diabetes. DIET DAN PENGENDALIAN BERAT Bekerja sama dengan dokter, perawat, dan ahli diet untuk mengetahui berapa banyak lemak, protein, dan karbohidrat yang Anda butuhkan dalam diet Anda. Rencana makan Anda harus sesuai dengan gaya hidup sehari-hari dan kebiasaan, dan harus mencoba untuk memasukkan makanan yang Anda sukai. Mengelola berat badan dan makan makanan yang seimbang adalah penting. Beberapa orang dengan diabetes tipe 2 dapat berhenti memakai obat setelah kehilangan berat badan (meskipun mereka masih memiliki diabetes). Lihat juga: • Diabetes diet • Ngemil bila Anda memiliki diabetes Pasien sangat gemuk yang diabetes tidak dikelola dengan baik dengan diet dan obat-obatan dapat mempertimbangkan bariatrik (berat badan) operasi. Lihat: • operasi pintas lambung • Laparoskopi gastric banding KEGIATAN FISIK REGULER Olahraga teratur adalah penting bagi semua orang. Hal ini bahkan lebih penting Anda memiliki diabetes. Latihan di mana jantung Anda berdetak lebih cepat dan Anda bernapas lebih cepat membantu menurunkan tingkat gula darah Anda tanpa pengobatan. Hal ini juga membakar kalori ekstra dan lemak sehingga Anda dapat mengelola berat badan Anda. Olahraga dapat membantu kesehatan Anda dengan meningkatkan aliran darah dan tekanan darah. Olahraga juga meningkatkan tingkat energi tubuh, menurunkan ketegangan, dan meningkatkan kemampuan Anda untuk menangani stres. Tanyakan pada dokter Anda sebelum memulai program latihan. Orang dengan diabetes tipe 2 harus mengambil langkah khusus sebelum, selama, dan setelah aktivitas fisik yang intensif atau berolahraga. Lihat juga: Diabetes dan olahraga PENGOBATAN UNTUK MENGOBATI DIABETES Jika diet dan olahraga tidak membantu menjaga gula darah pada tingkat normal atau mendekati normal, dokter mungkin meresepkan obat. Karena obat ini membantu menurunkan kadar gula darah dengan cara yang berbeda, dokter Anda mungkin telah mengambil lebih dari satu obat. Beberapa jenis yang paling umum dari obat tercantum di bawah ini. Mereka diminum atau injeksi. • Alpha-glukosidase inhibitor (seperti acarbose) • Biguanides (Metformin) • injeksi obat-obatan (termasuk exenatide, mitiglinide, pramlintide, sitagliptin saxagliptin, dan) • meglitinides (termasuk repaglinide dan Nateglinide) • Sulfonylureas (seperti glimepiride, glyburide, dan tolazamide) • thiazolidinediones (seperti rosiglitazone dan pioglitazone). (Rosiglitazone dapat meningkatkan risiko gangguan jantung Bicarakan dengan dokter Anda..) Obat ini dapat diberikan dengan insulin, atau insulin dapat digunakan sendiri. Anda mungkin perlu insulin jika Anda terus memiliki kontrol glukosa darah yang buruk. Ini harus disuntikkan di bawah kulit menggunakan jarum suntik insulin atau perangkat pena. Hal ini tidak dapat diambil melalui mulut. Lihat juga: Diabetes tipe 1 Tidak diketahui apakah obat hiperglikemia diminum aman untuk digunakan dalam kehamilan. Wanita yang memiliki diabetes tipe 2 dan hamil dapat beralih ke insulin selama kehamilan dan saat menyusui. MENCEGAH KOMPLIKASI Dokter mungkin meresepkan obat atau perawatan lain untuk mengurangi peluang Anda untuk mengembangkan penyakit mata, penyakit ginjal, dan kondisi lain yang lebih sering terjadi pada penderita diabetes. Lihat juga: • Diabetes – mencegah serangan jantung dan stroke Konsultasi dengan dokter ahli Jantung • Komplikasi jangka panjang diabetes PERAWATAN KAKI Orang dengan diabetes lebih mungkin untuk memiliki masalah kaki. Diabetes dapat merusak saraf, yang berarti Anda mungkin tidak merasa cedera pada kaki sampai Anda mendapatkan sakit besar atau infeksi. Diabetes juga dapat merusak pembuluh darah. Diabetes juga menurunkan kemampuan tubuh untuk melawan infeksi. Infeksi kecil dapat dengan cepat memburuk dan menyebabkan kematian kulit dan jaringan lain. Untuk mencegah cedera pada kaki Anda, memeriksa dan merawat kaki Anda setiap hari. Lihat juga: Diabetes kaki Dukungan Grup Untuk informasi lebih lanjut, lihat sumber diabetes. Harapan (prognosis) Setelah bertahun-tahun, diabetes dapat menyebabkan masalah serius dengan mata, ginjal, saraf, jantung, pembuluh darah, atau daerah lain dalam tubuh Anda. Jika Anda memiliki diabetes, risiko serangan jantung adalah sama dengan seseorang yang sudah mengalami serangan jantung. Baik wanita maupun pria dengan diabetes memiliki risiko. Anda mungkin tidak memiliki tanda-tanda normal dari serangan jantung. Jika Anda mengontrol gula darah dan tekanan darah, Anda dapat mengurangi risiko kematian, stroke, gagal jantung, dan masalah diabetes lainnya. Beberapa orang dengan diabetes tipe 2 tidak lagi membutuhkan obat jika mereka menurunkan berat badan dan menjadi lebih aktif. Ketika mereka mencapai berat badan ideal mereka, insulin tubuh mereka dan diet yang sehat dapat mengendalikan kadar gula darah mereka. Komplikasi Setelah bertahun-tahun, diabetes dapat menyebabkan masalah serius: • Anda bisa memiliki masalah mata, termasuk kesulitan untuk melihat (terutama pada malam hari), dan sensitivitas cahaya. Anda bisa menjadi buta. • Kaki dan kulit dapat mengembangkan luka dan infeksi. Setelah lama, kaki atau kaki mungkin perlu dihapus. Infeksi juga dapat menyebabkan nyeri dan gatal-gatal di bagian lain dari tubuh. • Diabetes dapat membuat lebih sulit untuk mengontrol tekanan darah dan kolesterol. Hal ini dapat menyebabkan serangan jantung, storke, dan masalah lainnya. Hal ini dapat menjadi lebih sulit untuk darah mengalir ke kaki dan kaki. • Saraf dalam tubuh Anda dapat rusak, menyebabkan nyeri, kesemutan, dan hilangnya perasaan. • Karena kerusakan saraf, Anda bisa memiliki masalah mencerna makanan yang Anda makan. Anda bisa merasakan kelemahan atau kesulitan pergi ke kamar mandi. Kerusakan saraf dapat membuat lebih sulit bagi pria untuk memiliki ereksi. • gula darah tinggi dan masalah lainnya dapat menyebabkan kerusakan ginjal. Ginjal tidak dapat bekerja dengan baik, dan mereka bahkan dapat berfungsi lagi. Infeksi pada kulit, saluran kelamin wanita, dan saluran kemih juga lebih umum. Untuk mencegah masalah dari diabetes, kunjungi dokter anda atau pendidik diabetes setidaknya empat kali setahun. Bicara tentang masalah yang Anda mengalami. Apa Hubungan antara Trigliserida dan Diabetes? Trigliserida ini telah disebut sebagai “lemak jelek” tapi itu lebih merupakan respons emosional dari satu yang kukuh berakar pada fakta ilmiah. Namun hubungannya dengan diabetes tidak bisa diabaikan. Kolesterol telah diidentifikasi sebagai faktor risiko penyakit jantung. Ada iklan yang tak terhitung jumlahnya dan outlet informasi yang mengkonfirmasi masalah yang berhubungan dengan diet yang tidak terkontrol. Demikian juga ada pil dan pilihan makanan yang dipromosikan sebagai bagian dari solusi. Konsumen mendapatkan hasil yang bervariasi tergantung pada genetik dan tahap di mana kondisi ini ditangkap. Program latihan juga direkomendasikan sebagai bagian dari proses hidup sehat. Pertanyaannya tetap, apakah semua intervensi ini telah efektif atau apakah mereka hanya cara bagi instansi periklanan untuk membuat lebih banyak uang. • Kumpulan lemak yang dapat menyebabkan kerusakan: Dengan konsensus, trigliserida adalah bundel kecil lemak yang ditemukan dalam aliran darah. Mereka meningkat jumlahnya setelah kita mengkonsumsi makanan. Tubuh akan memproduksi lemak-lemak dari makanan yang kita makan terutama jika mereka lemak di alam. Diperkirakan bahwa 90% dari seluruh kandungan lemak non-daging tanpa lemak terdiri dari trigliserida. Oleh karena itu kebiasaan belanja dari kelompok risiko harus mencerminkan bahaya. • Trigliserida tidak universal buruk: Diet yang seimbang harus mengandung semua elemen yang relevan. Telah diperkirakan bahwa trigliserida memiliki proporsi 99% dari semua lemak yang tersimpan dalam tubuh manusia. Anda mendapatkan sumber energi jangka panjang dari deposito ini lemak. Mereka benar-benar disimpan dalam lebih padat daripada protein dari otot atau bahkan pati. Insulin diperlukan untuk membentuk lemak. Antara makan dan semalam, trigliserida diubah menjadi energi. Kadar insulin puasa dan rendah akan memicu reaksi ini. Sel-sel lemak memiliki kapasitas penyimpanan yang sangat tinggi dan ini dapat menyebabkan obesitas pada situasi tertentu. Jika Anda sedang menjalani puasa luas atau sama sekali tidak ada insulin dalam tubuh maka hati akan mengkonversi produk pemecahan lemak menjadi keton. • komplikasi kesehatan dan manifestasi mereka: Hal ini sering terjadi rendahnya tingkat HDL atau kolesterol baik dikaitkan dengan tingkat tinggi trigliserida. Ini kemudian didiagnosis sebagai dislipidemia diabetik. Ini adalah kombinasi dari faktor-faktor yang dapat menempatkan hidup pasien dalam bahaya. Pasien dalam situasi ini akan memiliki kelompok kecil, padat dan akhirnya berbahaya dari LDL atau kolesterol berbahaya. Format yang terakhir ini tidak diinginkan berdasarkan sifat aterogenik nya. Akhirnya orang tersebut akan mengembangkan obesitas sentral. Ini adalah salah satu fitur mendefinisikan sindrom metabolik. • Sekitar 80% dari semua penderita diabetes tipe 2 akan memiliki kondisi ini. Akhirnya orang tersebut meninggal lebih cepat akibat penyakit jantung. • Menetapkan tolok ukur untuk orang yang sehat: Sangat penting bahwa Anda memiliki beberapa tujuan pada seberapa banyak trigliserida yang Anda akan merekam pada skala standar. Ini merupakan indikator yang mendasari kondisi sehat. Oleh karena itu Anda akan berada dalam posisi untuk menerapkan strategi pencegahan bila diperlukan untuk melakukannya. Tingkat normal trigliserida adalah 150 mg / dl. Angka batas adalah antara 150 dan 199. Tingginya adalah antara 200 dan 499 sedangkan apa pun lebih dari 500 adalah hal yang mendesak. Keadaan puasa normal akan memiliki tingkat membaca antara 100 dan 150 mg / dl. Setelah makan yang normal angkanya akan meningkat menjadi 300. Pasien dengan diabetes tipe 2 akan mengalami peningkatan kadar di kedua saat baik puasa dan maupun sesuah makan. Sebelum tes lipid panel, Anda harus memiliki beberapa puasa semalam setidaknya selama 12 jam. Demikian juga tidak dianjurkan untuk mengambil alkohol minimal 24 jam sebelum tes. • Mengelola tingkat trigliserida dalam tubuh Anda: Hal ini untuk keuntungan Anda bahwa Anda menjaga kadar zat ini relatif rendah. Pasien dengan diabetes tipe 2 memiliki faktor risiko tinggi dan perlu bekerja sedikit yang ekstra untuk memastikan bahwa tingkat mereka 150 mg / dl atau bahkan lebih rendah. Ini akan membantu mereka mengurangi kemungkinan terkena penyakit kardiovaskular. Beberapa orang dalam kategori ini telah melakukan tingkat yang lebih dari 400. Setelah Anda mulai memukul tanda 1000 maka Anda akan menderita lesi kulit atau xanthomas, kehilangan memori, pankreas dan sakit perut. Intervensi diperlukan pada tahap ini untuk menyelamatkan hidup Anda. Tips diet diabetic type 2 Tips for Eating Well with Diabetes Knowing what to eat with type 2 diabetes is the best way to feel in control and feel better. This first lesson in your quick-start guide gives an overview of the five simple key things to know: 1. Eating the Right Balanced Mix of Foods 2. Portions: How to Fill Your Plate 3. Calories Needed to Lose Weight 4. How Food Choices Can Lower Blood Sugar 5. Easy Ways to Count Carbs Type 2 Diabetes Diet Plan by American Diabetes Association Posted on December 18th, 2007 by DietMan Diet diabetes tipe 2: Dengan lebih dari 14,6 juta orang Amerika menderita diabetes, telah menjadi masalah kesehatan utama di Amerika Serikat saat ini. Diet Diabetes Tipe 2 perlu dibarengi dengan gaya hidup sehat dalam rangka untuk menempatkan cek pada diabetes tipe 2. Diet diabetes Tipe 2 bersama dengan olahraga teratur, dapat membantu signifikan dalam mengendalikan gula darah Anda dan mengelola diabetes Anda. Dengan mengurangi asupan kalori dan termasuk latihan rutin Anda, Anda dapat membuat tubuh Anda lebih sensitif terhadap insulin nya. Idealnya, Anda harus mengikuti rencana diet yang mengurangi asupan gula sederhana dan karbohidrat olahan. Diet kaya karbohidrat serat dan kompleks direkomendasikan untuk pasien diabetes tipe 2. Karbohidrat kompleks yang ditemukan dalam buah-buahan, biji-bijian, dan sayuran dipecah sangat lambat akibat yang pelepasan glukosa dalam aliran darah diperlambat. Sebaliknya, karbohidrat sederhana dipecah dalam tidak ada waktu yang mengarah ke peningkatan pesat dalam tingkat gula darah. Pasien diabetes tipe 2 dapat mencakup lebih sedikit lemak jenuh dalam makanan mereka. Diabetes rencana diet: Sebuah rencana diet diabetes harus diikuti hanya setelah berkonsultasi seorang dokter ahli. Dokter Anda juga akan mempertimbangkan masalah kesehatan lainnya, jika ada, sebelum resep Anda rencana diet diabetes. Original info Type 2 diabetes diet: With more than 14.6 million Americans suffering from diabetes, it has become a major health concern in the United States today. Type 2 diabetes diet needs to be coupled with a healthy lifestyle in order to put a check on type 2 diabetes. Type 2 diabetes diet along with regular exercise, can be of significant help in controlling your blood sugar and managing your diabetes. By reducing your calorie intake and including exercise in your routine, you can make your body more sensitive to its insulin. Ideally, you need to follow a diet plan that reduces your intake of simple sugars and refined carbohydrates. A diet rich in fiber and complex carbohydrates is recommended for type 2 diabetes patients. Complex carbohydrates found in fruits, whole grains, and vegetables are broken down very slowly as a result of which the release of glucose in the bloodstream is slowed down. On the contrary, simple carbohydrates are broken down within no time leading to a rapid rise in the blood sugar levels. Type 2 diabetic patients can include less saturated fat in their diet. Diabetes diet plan: A diabetes diet plan should be followed only after consulting an expert physician. Your doctor will also take into account any other health problems, if any, before prescribing you a diabetes diet plan. Diet yang direkomendasikan oleh American Diabetes Association: Diet yang direkomendasikan oleh American Diabetes Association adalah semua tentang membuat pilihan makanan sehat. Diet meletakkan lebih menekankan pada buah-buahan, non – sayuran bertepung (wortel, bayam, kacang hijau, brokoli), kacang kering, dan lentil. Anda dapat memilih untuk makan makanan gandum bukan produk gandum olahan dan juga termasuk beras merah dalam diet Anda. Diet yang disarankan oleh American Diabetes Association dapat membantu Anda mengelola diabetes Anda secara efektif asalkan Anda menonton ukuran porsi saat makan. Bahkan makanan sehat, jika dimakan dalam jumlah besar, dapat meningkatkan berat badan Anda membuat manajemen diabetes lebih sulit. Original info Diet recommended by American Diabetes Association: The diet recommended by American Diabetes Association is all about making healthy food choices. The diet lays more emphasis on fruits, non – starchy vegetables (carrots, spinach, green beans, broccoli), dried beans, and lentils. You may choose to eat whole grain foods instead of processed grain products and also include brown rice in your diet. The diet recommended by American Diabetes Association can help you manage your diabetes effectively provided that you watch the portion sizes while eating. Even healthy foods, if eaten in large quantities, can increase your weight making diabetes management more difficult. An Excellent Type 2 Diabetes Diet program Rencana makan sehat Diabetes Tipe 2 adalah hanya untuk mereka yang memiliki tipe yang paling khas dari diabetes, tipe 2. Hal ini terjadi ketika tubuh Anda tidak dapat mengembangkan insulin yang cukup, yang penting untuk membantu Anda menyerap glukosa dalam sel sampai kembali atau keperluan energi. Apa yang menghentikan insulin dari fungsi ini seringkali dibangun lemak, itu sebabnya rencana diet mutlak diperlukan untuk membantu Anda mengendalikan penyakit dan kemudian menghentikannya dari semakin buruk. Maka persis bagaimana seharusnya setiap orang memulai / nya nya 2 rencana diabetes makan agar benar-benar akan menghasilkan efek? 1. Mencatat segala macam hal yang terutama mengkonsumsi dan minum. Tanpa diragukan lagi, kebenaran menyakitkan, tetapi banyak kali orang harus telah mengungkap semua dari mereka dan menghadapi mereka sehingga kami dapat melampaui semua masalah ini. Membuat daftar hanya apa yang Anda sering makan pasti akan membuat Anda menemukan bahwa kita satu-satunya yang dapat tetap mengontrol kesehatan kita sendiri dan kesehatan dan kita dapat melestarikan atau merusaknya. (Menyembuhkan diabetes tipe 2) 2. Temukan produk yang lebih sehat. Sekarang ada tentu akan menjadi pengganti bahkan jika pada awalnya, mereka mungkin tampak tidak mudah untuk menemukan. Misalnya, sangat sangat mudah untuk hanya memindahkan dari roti normal untuk roti gandum! Apa yang perlu Anda lakukan adalah memiliki sedikit kesabaran pada eksplorasi tentang alternatif signifikan lebih sehat yang akan memberikan kesehatan yang lebih baik dalam jangka panjang. 3. Hilangkan Praktik Negatif resep diet diabetes Gula pemanis soda bersama-sama dengan minuman dapat dengan mudah menyebabkan kondisi lebih buruk, jadi tinggal dengan air dan teh sehat. Ketika Anda minum soda terlalu banyak, hal ini dapat meningkatkan gula darah, yang tidak akan menstabilkan perkembangan insulin darah. Demikian juga, daripada makan junk food serta makanan cepat saji, kenapa tidak mencoba buah dan sayuran sebagai camilan? Anda juga bisa mencoba popcorn bebas lemak. Berkaitan dengan saus, Anda juga dapat mencoba mustard bukan mayones terlalu banyak. Mencoba mengatakan pelayaran bon untuk produk makanan goreng hanya karena benar-benar diisi dengan lemak dan kalori. Anda mungkin dapat mencoba memanggang, mengukus, panas sekali, atau panfrying menggunakan sedikit minyak zaitun sebagai pengganti. Tak bisakah kau melihat bahwa ada begitu banyak pilihan? Perlu diingat bahwa tidak ada diet mudah. Jika ingin melihat hasil yang baik, maka Anda benar-benar perlu melalui diet diabetes tipe 2 yang sulit. Original info Type 2 Diabetes Healthy eating plan is just for those who have the most typical type of diabetes, Type 2. This happens when your body cannot develop enough insulin, that is important to help you absorb glucose in the cells for back up or energy purposes. What stops insulin from functioning is oftentimes built up fat, that is why a diet plan is definitely needed to help you control the illness and then stop it from getting worse. And so exactly how should everyone start up her / his 2 diabetes meal plan in order that it’ll really yield effects? 1. Take note of all kinds of things you mainly consume and drink. Without a doubt, the truth hurts, but many times people have to have uncover all of them and face them so that we’re able to go beyond all these issues. Creating listing just what you frequently eat will definitely make you discover that we’re the only ones who can keep control of our own health and wellness and we can conserve it or wreck it. (cure for type 2 diabetes) 2. Discover more healthy products. Now there will certainly be substitutes even if in the beginning, they might seem not easy to discover. For instance, it is very very easy to just move from normal bread to whole wheat bread! What you need to do is to have a little patience on exploring regarding significantly more healthy alternatives which will give you a better health in the long run. 3. Eliminate Negative Practices for the diabetes diet recipes Sugar sweetened sodas together with drinks can easily cause the condition even worse, so stay with waters and healthful teas. When you drink too much soda, this could increase the blood sugar, which will not stabilize the blood insulin development. Likewise, rather than of eating junk food as well as fast food, why not try fruits and vegetables as snacks? You could likewise try fat free popcorn. Relating to sauces, you can also try mustard instead of too much mayo. Attempt saying bon voyage to fried food products simply because these are really stuffed with fats and calories. You possibly can try grilling, steaming, broiling, or panfrying using a bit of olive oil as a substitute. Cannot you see that there are so many choices? Keep in mind that there is no effortless diet. If you’d like see the good results, then you really need to go through a difficult type 2 diabetes diet. Resource: EzineArticles.Com Respon klinis: Kombinasi obat dan manajemen diet dapat memiliki hasil positif. Pertama-tama Anda harus bertujuan untuk pengendalian glukosa. Sebuah resep khas akan mencakup Statin seperti Zocor, Lipitor, Pravachol, Zetia, Crestor dan Vytorin. Obat-obat ini dimaksudkan untuk menurunkan kadar kolesterol Anda secara umum. Pasien diabetes tipe 2 mungkin memerlukan terapi kombinasi untuk mencapai tingkat yang aman dari trigliserida. Anda juga harus memikirkan cara-cara menurunkan kadar LDL Anda. Kadang-kadang dokter akan merekomendasikan serangkaian fibrate seperti gemfibrozil Lopid, Trico fenofibrate dan asam nikotinat atau niasin. Hal ini juga dianjurkan untuk memasukkan minyak ikan dalam diet Anda. Setelah menyadari bahaya yang dapat timbul dari trigliserida dalam kaitannya dengan diabetes, Anda harus datang dengan perubahan gaya hidup praktis yang akan membantu Anda menghindari fase berbahaya. Dalam beberapa kasus Anda mungkin harus membatasi asupan lemak Anda sepenuhnya. Masalahnya adalah bahwa langkah ini dapat menyebabkan Anda mengambil karbohidrat bahkan lebih dan karena itu meningkatkan tingkat trigliserida dalam aliran darah Anda. Beberapa buku merekomendasikan lemak substitusi sehat seperti minyak zaitun dan lemak tak jenuh tunggal lainnya. Tidak meningkatkan asupan produk tepung gula atau putih. Asupan Alkohol harus disimpan ke minimum. Ambil minyak ikan seperti tuna, sarden, salmon, makarel dan ikan. Mereka mengandung asam lemak omega-3 yang dikenal untuk mengurangi trigliserida. Kelainan genetik seperti hipotiroidisme dapat menggabungkan dengan penyakit untuk memperburuk situasi. Mengambil obat-obatan seperti steroid, pil KB dan Tamoxifen juga bisa menimbulkan masalah. Anda beresiko jika Anda menderita penyakit ginjal, gagal hati dan tekanan darah tinggi Original Info Type 2 diabetes Definition Type 2 diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes. Alternative Names Noninsulin-dependent diabetes; Diabetes – type 2; Adult-onset diabetes Causes, incidence, and risk factors Diabetes is caused by a problem in the way your body makes or uses insulin. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy. When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. As a result, blood sugar does not get into these cells to be stored for energy. When sugar cannot enter cells, high levels of sugar build up in the blood. This is called hyperglycemia. Type 2 diabetes usually occurs slowly over time. Most people with the disease are overweight when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way. Type 2 diabetes can also develop in people who are thin. This is more common in the elderly. Family history and genes play a large role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your risk. See also: Type 2 diabetes for a list of risk factors. Symptoms Often, people with type 2 diabetes have no symptoms at first. They may not have symptoms for many years. The early symptoms of diabetes may include: • Bladder, kidney, skin, or other infections that are more frequent or heal slowly • Fatigue • Hunger • Increased thirst • Increased urination The first symptom may also be: • Blurred vision • Erectile dysfunction • Pain or numbness in the feet or hands Signs and tests Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL. To confirm the diagnosis, one or more of the following tests must be done. Diabetes blood tests: • Fasting blood glucose level — diabetes is diagnosed if it is higher than 126 mg/dL two times • Hemoglobin A1c test — o Normal: Less than 5.7% o Pre-diabetes: 5.7% – 6.4% o Diabetes: 6.5% or higher Read more Hemoglobin A1c Test – facts The AccuBase A1c Test Kit is a highly accurate test (CV’s less than 1.0%) capable of detecting abnormal and/or silent hemoglobin variants such as hemoglobin S, and C and F and over 850 others. Each sample is first screened for presence of abnormal hemoglobins and/or disturbed erythrocyte kinetics (abnormal age or volume of red blood cells) Example; anemia (which can falsely lower the A1c value). Individuals with long-standing diabetes may present with a condition called erythropoietin (EPO) deficiency. EPO deficiency and/or anemia are considered serious conditions requiring appropriate medical intervention. DEK can adversely affect the A1c answer and each sample should be screened for the presence of DEK. Estimates report that over 650,000 Black Americans with diabetes are know to have the Sickle Cell Trait (Hb “S, C or F”) “Don’t be fooled by claims of accuracy when an A1c method and/or disposable monitoring device has CV’s (coefficient of variation) greater than 2.0% or can not detect an abnormal hemoglobin”. “An A1c method and/or monitoring device with a CV of 7.0 % could mean that if your actual A1c level was 6.5% it could be reported anywhere from 5.0% to 8.0% providing false and/or misleading therapeutic information,” not to mention the impact of an abnormal hemoglobin on the A1c value that the particular method or device is incapable of detecting. Each AccuBase A1c sample is analyzed by an HPLC-IE procedure with resulting printed Chromatogram as shown below. The laboratory staff is available to discuss individual chromatograms with your physician and/or medical personnel. The AccuBase A1c Test Kit is a non-fasting, finger stick, mail-in test, considered the most accurate and precise A1c test available. The test is considered sensitive and specific enough to detect diabetes (less than 2.0% CV’s). CV’s are under 1.0%. CV’s indicate the level of repeated accuracy compared to a known laboratory A1c value. The lower the CV’s the more accurate the A1c test. The AccuBase A1c Test Kit method is NGSP certified (values referenced to the DCCT). The AccuBase A1c Test Kit does not require any drying time, samples can be collected and mailed within minutes. The kit comes complete with patient positive ID vials and plastic capillary tubes/device. The analytical method is interference free. Samples are stable for 30 day un-refrigerated. Each test result comes with a Mean Blood Glucose calculation based on the DCCT MBG Equation: % A1c X 31.7 – 66.1 = MBG in mg/dl. Test results are typically available within 5 to 7 days form mailing. Special handling can be arranged to provide, next-day, two-day or three day results. Ideal for confidential diabetes (mean blood glucose) screening, outreach programs and clinical trails. The first graph demonstrates a normal chromatogram with no hemoglobin variants present and a normal A1c level. The Chromatogram on the second graph demonstrates an highly elevated level of hemoglobin F (25.6%). This elevated level of Hb F resulted in a sub-normal A1c value of 3.2%. Normal range of A1c assay (4.2% – 6.0%). Unless you have been screened for hemoglobin variants you would not know you carry the hereditary persistent variant, or be aware of its associated impact on your A1c level. Increased levels of Hemoglobin F may represent an increased risk for SIDS in infants, and may represent as association in various types of leukemia and/or solid tumors. Mothers that smoke or have been exposed to environmental pollution during pregnancy may have a much higher level of Hb F in the baby which may increase the risk of SIDS in the newborn. AccuBase A1c Test Kit Cleared for OTC use by the FDA (no prescription needed in most states). Patients can receive a copy of the test results. Electronic reporting to managed care health organizations/providers is available. The AccuBase A1cTest Kit uses the “gold standard” HPLC-IE or BA methodology to collect and analyze A1c samples in alternate site locations such as the home, physicians office and/or clinic • Oral glucose tolerance test — diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours Diabetes screening is recommended for: • Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 2 years • Overweight adults (BMI greater than 25) who have other risk factors • Adults over age 45 every 3 years You should see your health care provider every 3 months. At these visits, you can expect your health care provider to: • Check your blood pressure • Check the skin and bones on your feet and legs • Check to see if your feet are becoming numb • Examine the back part of the eye with a special lighted instrument called an ophthalmoscope The following tests will help you and your doctor monitor your diabetes and prevent problems: • Have your blood pressure checked at least every year (blood pressure goals should be 130/80 mm/Hg or lower). • Have your hemoglobin A1c test (HbA1c) every 6 months if your diabetes is well controlled; otherwise every 3 months. • Have your cholesterol and triglyceride levels checked yearly (aim for LDL levels below 70-100 mg/dL). • Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine). • Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease. • See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes. Treatment The goal of treatment at first is to lower high blood glucose levels. The long-term goals of treatment are to prevent problems from diabetes. The main treatment for type 2 diabetes is exercise and diet. LEARN THESE SKILLS You should learn basic diabetes management skills. They will help prevent problems and the need for medical care. These skills include: • How to test and record your blood glucose (See: Blood glucose monitoring) • What to eat and when • How to take medications, if needed • How to recognize and treat low and high blood sugar • How to handle sick days • Where to buy diabetes supplies and how to store them It may take several months to learn the basic skills. Always keep learning about diabetes, its complications, and how to control and live with the disease. Stay up-to-date on new research and treatments. MANAGING YOUR BLOOD SUGAR Self testing means that you check your blood sugar at home yourself. Checking your blood sugar levels at home and writing down the results will tell you how well you are managing your diabetes. A device called a glucometer can give you an exact blood sugar reading. There are different types of devices. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the device. Results are given in 30 – 45 seconds. A health care provider or diabetes educator will help set up an at-home testing schedule for you. Your doctor will help you set your blood sugar goals. • Most people with type 2 diabetes only need to check their blood sugar once or twice a day. • If your blood sugar levels are under control, you may only need to check them a few times a week. • You may test yourself when you wake up, before meals, and at bedtime. • You may need to test more often when you are sick or under stress. The results of the test can be used to change your meals, activity, or medications to keep your blood sugar levels in the right range. Testing can identify high and low blood sugar levels before you have serious problems. Keep a record of your blood sugar for yourself and your health care provider. This will help if you are having trouble managing your diabetes. DIET AND WEIGHT CONTROL Work closely with your doctor, nurse, and dietitian to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your daily lifestyle and habits, and should try to include foods that you like. Managing your weight and eating a well-balanced diet are important. Some people with type 2 diabetes can stop taking medications after losing weight (although they still have diabetes). See also: • Diabetes diet • Snacking when you have diabetes Very overweight patients whose diabetes is not well managed with diet and medicine may consider bariatric (weight loss) surgery. See: • Gastric bypass surgery • Laparoscopic gastric banding REGULAR PHYSICAL ACTIVITY Regular exercise is important for everyone. It is even more important you have diabetes. Exercise in which your heart beats faster and you breathe faster helps lower your blood sugar level without medication. It also burns extra calories and fat so you can manage your weight. Exercise can help your health by improving blood flow and blood pressure. Exercise also increases the body’s energy level, lowers tension, and improves your ability to handle stress. Ask your health care provider before starting any exercise program. People with type 2 diabetes must take special steps before, during, and after intense physical activity or exercise. See also: Diabetes and exercise MEDICATIONS TO TREAT DIABETES If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medication. Since these drugs help lower your blood sugar levels in different ways, your doctor may have you take more than one drug. Some of the most common types of medication are listed below. They are taken by mouth or injection. • Alpha-glucosidase inhibitors (such as acarbose) • Biguanides (Metformin) • Injectable medicines (including exenatide, mitiglinide, pramlintide, sitagliptin, and saxagliptin) • Meglitinides (including repaglinide and nateglinide) • Sulfonylureas (like glimepiride, glyburide, and tolazamide) • Thiazolidinediones (such as rosiglitazone and pioglitazone). (Rosiglitazone may increase the risk of heart problems. Talk to your doctor.) These drugs may be given with insulin, or insulin may be used alone. You may need insulin if you continue to have poor blood glucose control. It must be injected under the skin using a syringe or insulin pen device. It cannot be taken by mouth. See also: Type 1 diabetes It is not known whether hyperglycemia medications taken by mouth are safe for use in pregnancy. Women who have type 2 diabetes and become pregnant may be switched to insulin during their pregnancy and while breast-feeding. PREVENTING COMPLICATIONS Your doctor may prescribe medications or other treatments to reduce your chances of developing eye disease, kidney disease, and other conditions that are more common in people with diabetes. See also: • Diabetes — preventing heart attack and stroke • Long-term complications of diabetes FOOT CARE People with diabetes are more likely to have foot problems. Diabetes can damage nerves, which means you may not feel an injury to the foot until you get a large sore or infection. Diabetes can also damage blood vessels. Diabetes also decreases the body’s ability to fight infection. Small infections can quickly get worse and cause the death of skin and other tissues. To prevent injury to your feet, check and care for your feet every day. See also: Diabetes foot care Support Groups For more information, see diabetes resources. Expectations (prognosis) After many years, diabetes can lead to serious problems with your eyes, kidneys, nerves, heart, blood vessels, or other areas in your body. If you have diabetes, your risk of a heart attack is the same as that of someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the normal signs of a heart attack. If you control your blood sugar and blood pressure, you can reduce your risk of death, stroke, heart failure, and other diabetes problems. Some people with type 2 diabetes no longer need medicine if they lose weight and become more active. When they reach their ideal weight, their body’s own insulin and a healthy diet can control their blood sugar levels. Complications After many years, diabetes can lead to serious problems: • You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind. • Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be removed. Infection can also cause pain and itching in other parts of the body. • Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, storke, and other problems. It can become harder for blood to flow to your legs and feet. • Nerves in your body can get damaged, causing pain, tingling, and a loss of feeling. • Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection. • High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well, and they may even stop working. Infections of the skin, female genital tract, and urinary tract are also more common. To prevent problems from diabetes, visit your health care provider or diabetes educator at least four times a year. Talk about any problems you are having. Calling your health care provider Call 911 right away if you have: • Chest pain or pressure • Fainting or unconsciousness • Seizure • Shortness of breath These symptoms can quickly get worse and become emergency conditions (such as convulsions or hypoglycemic coma). Call your doctor if you have: • Numbness, tingling, or pain in your feet or legs • Problems with your eyesight • Sores or infections on your feet • Symptoms of high blood sugar (being very thirsty, having blurry vision, having dry skin, feeling weak or tired, needing to urinate a lot) • Symptoms of low blood sugar (feeling weak or tired, trembling, sweating, feeling irritable, having trouble thinking clearly, fast heartbeat, double or blurry vision, feeling uneasy) Prevention You can help prevent type 2 diabetes by keeping a healthy body weight and an active lifestyle. Stay up-to-date with all your vaccinations and get a flu shot every year. References American Diabetes Association. Standards of medical care in diabetes–2011. Diabetes Care. 2011;34 Suppl 1:S11-S61. Eisenbarth GS, Polonsky KS, Buse JB. Type 1 Diabetes Mellitus. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Kronenberg: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 31. Pignone M, Alberts MJ, colwell JA, Cushman M, Inzucchi SE, Mukherjee D, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation. Circulation. 2010;121:2694-2701. Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, Bantle JP, Sledge I. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009 Mar;122(3):248-256.e5. Review. PubMed PMID: 19272486. ACCORD Study Group, Gerstein HC, Miller ME, Genuth S, Ismail-Beigi F, Buse JB, et al. Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med. 2011;364:818-828. Alemzadeh R, Ali O. Diabetes Mellitus. In: Kliegman R, ed. 19th ed. Nelson Textbook of Pediatrics. Philadelphia, Pa: Saunders Elsevier; 2011: chap 583. Review Date: 6/28/2011 Diabetic Diva ~ What is the Relationship between Triglycerides and Diabetes? The triglyceride has been referred to as the “ugly fat” but that is more of an emotional response than one that is firmly anchored in scientific fact. Nonetheless its association with diabetes cannot be ignored. Cholesterol has already been identified as a risk factor for heart disease. There are countless adverts and information outlets which confirm the problems that are associated with an uncontrolled diet. Likewise there are pills and food choices which are promoted as part of the solution. Consumers get variable results depending on their genetic makeup and the stage at which the condition is arrested. Exercise programs are also recommended as part of a healthy living process. The question remains as to whether all these interventions have been effective or whether they are simply a way for the advertizing agencies to make even more money. • Bundles of fat that can cause havoc: By consensus, triglycerides are small bundles of fat which are found in the blood stream. They increase in number after we consume food. The body will manufacture these fats from the foods which we eat especially if they are fatty in nature. It has been estimated that 90% of all the fat content in non-lean meat consists of triglyceride. Therefore the shopping habits of the risk groups have to reflect this imminent danger. • Triglycerides are not universally bad: A balanced diet should contain all the relevant elements. It has been estimated that triglyceride have a proportion of 99% of all the fat stored within the human body. You get long term energy sources from these fatty deposits. They are actually stored in a denser from than muscle protein or even starch. Insulin is required in order to form fat. Between meals and overnight, the triglycerides are converted into energy. Fasting and low insulin levels will trigger this reaction. The fat cells have a very high storage capacity and this can lead to obesity in certain situations. If you are undergoing extensive fasting or there is absolutely no insulin in the body then the liver will convert the fat breakdown products into ketones. • The health complications and their manifestations: It is often the case the low levels of HDL or good cholesterol is associated with high levels of triglyceride. This is then diagnosed as diabetic dyslipidemia. This is a combination of factors that can place the life of the patient in danger. Patients in this situation will have small, dense and ultimately harmful clusters of LDL or harmful cholesterol. The latter format is undesirable by virtue of its atherogenic properties. Eventually the person will develop central obesity. This is one of the defining features of the metabolic syndrome. • Around 80% of all the people with type 2 diabetes will have this condition. Eventually the person will die prematurely from heart disease. • Setting the benchmarks for a healthy person: It is imperative that you have some goals on how much triglyceride which you are going to record on the standard scale. This is an indicator of underlying healthy conditions. Therefore you will be in a position to implement a preventative strategy when required to do so. The normal levels of triglycerides are 150 mg/dl. The borderline figure is between 150 and 199. The high level is between 200 and 499 while anything over 500 is a matter of urgency. The normal fasting state will have levels reading between 100 and 150 mg/dl. After a normal meal the figure will rise to 300. Patients with type 2 diabetes will have elevated levels in both the fasting and even state. Prior to the lipid panel test, you should have some overnight fasting for at least 12 hours. Likewise it is not advisable to take alcohol at least 24 hours prior to the test. • Managing the level of triglyceride in your body: It is to your advantage that you keep the levels of this substance relatively low. Patients with type 2 diabetes have high risk factors and need to work that bit extra to ensure that their levels are 150 mg/dl or even lower. This will help them reduce the possibility of developing cardiovascular diseases. Some people in this category have carried levels that are well over 400. Once you start hitting the 1000 mark then you will suffer skin lesions or xanthomas, memory loss, pancreatic and abdominal pain. Intervention is required at this stage in order to save your life. • The clinical response: A combination of medication and diet management can have positive results. First of all you have to aim for glucose control. A typical prescription will include Statins such as Zocor, Lipitor, Pravachol, Zetia, Crestor and Vytorin. These medications are meant to lower your cholesterol levels in general. Type 2 diabetes patients may require combination therapy in order to reach the safe levels of triglycerides. You also have to think of ways of lowering your LDL levels. Sometimes the clinician will recommend a series of Fibrates such as Lopid gemfibrozil, Trico fenofibrate and Nicotinic acid or niacin. It is also advisable to include fish oil in your diet. Having recognized the dangers that can arise from triglycerides in relation to diabetes, you should come up with practical lifestyle changes that will help you avoid the dangerous phases. In some instances you may have to restrict your fat intake completely. The problem is that this step can cause you to take even more carbohydrates and therefore increase the level of triglyceride in your bloodstream. Some books recommend substitution healthy fats such as olive oil and other monounsaturated fats. Do not increase your intake of sugar or white flour products. Alcohol intake should be kept to a minimum. Take oily fish such as tuna, sardines, salmon, mackerel and anchovies. They contain omega-3 fatty acids which are known to reduce triglycerides. Genetic disorders such as hypothyroidism can combine with diseases in order to exacerbate the situation. Taking drugs such as steroids, birth control pills and Tamoxifen can also be problematic. You are at risk if you suffer from kidney disease, liver failure and high blood pressure. The writer of this article is a blogger of ayurvedic health care tips. BEWARE ALWAYS NO STARCHY FOOD All food that you eat turns to sugar in your body. Carbohydrate-containing foods alter your sugar levels more than any other type of food. Carbohydrates are found in starchy or sugary foods, such as bread, rice, pasta, cereal, potatoes, peas, corn, fruit, fruit juice, milk, yogurt, cookies, candy, soda, and other sweets. Simple carbohydrates are broken down quickly by the body to be used as energy. Simple carbohydrates are found naturally in foods such as fruits, milk, and milk products. They are also found in processed and refined sugars such as candy, table sugar, syrups, and soft drinks. The majority of carbohydrate intake should come from complex carbohydrates (starches) and naturally occurring sugars rather than processed or refined sugars. All food that you eat turns to sugar in your body. Carbohydrate-containing foods alter your sugar levels more than any other type of food. Carbohydrates are found in starchy or sugary foods, such as bread, rice, pasta, cereal, potatoes, peas, corn, fruit, fruit juice, milk, yogurt, cookies, candy, soda, and other sweets. Exercises Food and insulin release Insulin is a hormone secreted by the pancreas in response to increased glucose levels in the blood. Glucose test . Monitor blood glucose – series Part one Set up the meter according to the specific directions that come with your meter. Get the supplies ready, including a new test strip and disposable lancet. Place the lancet into the lancing device. Rabu, 02 Mei 2012 PELATIHAN NASIONAL EDUKATOR DIABETES INDONESIA Jakarta, 21 April 2012 Menteri Kesehatan, diwakili oleh Direktur Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan (PP dan PL), Prof. dr. Tjandra Yoga Aditama, Sp.P(K), MARS, DTM&H, DTCE membuka secara resmi Pelatihan Nasional Edukator Diabetes Indonesia yang ke 10 yang diselenggarakan oleh Perhimpunan Edukator Diabetes Indonesia (PEDI) di Jakarta (20/4/12). Kementerian Kesehatan menyambut baik pelatihan ini, karena 4 hal, yang pertama Diabetes Mellitus (DM) merupakan masalah kesehatan penting di Indonesia, sebab DM merupakan penyebab kematian ke 6, prevalensi DM perkotaan 5,7%, dan prevalensi Toleransi Glukosa Terganggu 10,2%. Alasan kedua karena pengendalian DM haruslah merupakan continum care, dimana edukasi merupakan salah satu faktor amat penting. Kemudian para mereka yang sudah dilatih akan langsung dapat menangani pasien DM dan keluarganya sehingga mereka dapat tetap sehat, bugar dan mandiri. Sedangkan yang terakhir adalah pelatihan ini merupakan bentuk nyata partisipasi aktif masyarakat kesehatan untuk bersama pemerintah menanggulangi masalah kesehatan di Indonesia, dalam hal ini Diabetes Mellitus. Pelatihan berlangsung selama 3 hari dan diikuti lebih dari 200 peserta, terdiri dari dokter, perawat, diietesien, dan petugas lain. Pelatihan sudah berjalan 10 tahun dan mempunyai 3 tingkatan yaitu dasar, lanjut dan berkelanjutan. Metode pelatihan dalam bentuk : teori, loka karya, serta simulasi. Berita ini disiarkan oleh Pusat Komunikasi Publik, Sekretariat Jenderal Kementerian Kesehatan RI. welcome Dear iwansuwandy, Welcome to Diabetic Living Online! Congratulations on taking control now — we’re glad you’re here! We have the information to help you make the best choices for your health. You can live well with diabetes. Get immediate access and must-have information: •More than 1,000 delicious recipes guaranteed by the Better Homes and Gardens® Test Kitchen. •Practical and clear answers to your questions about carb counting, weight loss, diabetes meal plans, medications, and much more! •FREE recipes and tips delivered to your in-box each week. •FREE quick-start diabetes education course on What to Eat with Diabetes. •Great deals on Diabetic Living Magazine subscriptions. Be sure to find our page on Facebook and join our community of people with diabetes for support, information, and day-to-day tips on living well with diabetes. Here’s to our good health, Martha Miller Johnson Editor of Diabetic Living®, wife, mother, friend, PWD type 1 PATHOGENESIS OF DIABETIC NEUUOROPATHY Nerve Complications Elevated blood sugars can damage the peripheral nerves. Symptoms of neuropathy include: • pain, numbness, and tingling of hands and feet • muscle weakness such as trouble climbing stairs • nausea and vomiting • dizziness and lightheadedness Elevated levels of blood sugar can injure the blood vessels supplying the peripheral nerves, irritating and damaging them in the process. Such accumulated nerve damage is called diabetic neuropathy. Better blood glucose control can help restore healthy nerve function. Nerve Disease The nervous system includes our brain (central nervous system) and all of the nerves going from the brain to the rest of the body (peripheral nervous system). The nervous system is always at work. Sometimes – when we move or feel something – we are aware of it. But much happens automatically, including the control of our heart rate, the movement of food through the stomach and intestines and regulation of our blood pressure. Your health care provider can determine that your symptoms are related to diabetes and not to some other condition. The best way to improve all forms of diabetic neuropathy is to control your blood sugar levels. There are two categories of diabetic neuropathy: • Sensory and motor neuropathy • Autonomic neuropathy Symptoms of neuropathy include: • Pain, numbness, and tingling of hands and feet • Muscle weakness such as foot drop, double vision, trouble climbing stairs and getting out of a chair • Stomach symptoms including bloating, nausea, vomiting of undigested food many hours after a meal, feeling full without eating much food. This is also referred to as gastroparesis. • Bowel trouble such as episodes of diarrhea especially at night • Difficulty with bladder emptying • Sexual dysfunction • Dizziness and lightheadedness from a very fast heart rate and trouble keeping the blood pressure high enough when sitting or standing up. What is the treatment? Before any treatment can be decided upon, you need to report any of these symptoms to your health provider. Your provider needs to make sure that the symptoms are due to diabetic neuropathy and not something else. Near normal blood sugar control will usually improve all forms of diabetic neuropathy. Pain medications should be used as needed. Your provider may refer you to an doctor for specialized treatment and evaluation. Foot Complications Taking good care of your feet prevents serious complications. • Get regular foot exams that test for any nerve damage • Wash, dry and inspect your feet each day • Wear shoes and socks that fit • Control your blood glucose Foot problems are caused by neuropathy, poor circulation or a combination of both. The loss of feeling that comes with neuropathy is especially dangerous, as you may not be aware of cuts, blisters and bruises. The loss of sensation can change the way you walk or can damage bones and joints. Delays in treatment can lead to serious problems. Poor blood circulation means that less oxygen and fewer white blood cells that fight infection can get to a wound. It also means that antibiotic treatments that travel through the bloodstream are not as effective because they cannot get to the tissue in proper concentrations. Foot problems Foot problems include: • Changes in sensation from severe pain to numbness • Increased likelihood of infection (bacterial and fungal) • Slow wound healing • Deformation of the joints (Charcot joints, hammertoes, bunions, fallen arches) Recommendations: • If you have foot problems, consult a doctor right away. Early diagnosis can make a dramatic difference. Treatment for infection includes antibiotics and regular wound dressing. • Impaired circulation sometimes can be helped by blood vessel bypass. This procedure also may help heal wounds and ulcers in combination with skin or tissue growth factors. • Unfortunately, in advanced cases of poor circulation and uncontrolled infection, amputation may be necessary, usually just a toe or part of a bone is removed. In the most severe cases, it may necessary to remove part of the foot or leg. It is important to: • Get regular foot exams that test for any nerve damage • Not go barefoot • Not use sharp objects or over-the-counter chemical treatments such as corn/wart removers • Not use excessively hot water, electric blankets or heating pads, hot water bottles • Not smoke • Wash, dry and inspect your feet each day • Check between your toes • Wear shoes and socks that fit • Make sure there is nothing sharp or irritating in your shoes • Report corns and calluses and injuries that don’t heal to your medical provider • Cut toenails straight across and not too close to the quick; this will help prevent ingrown nails and associated infections • Control your blood glucose Eye Complications Eye problems range from minor changes to significant visual loss. Complications include: • Retinopathy • Cataracts • Macular edema • Glaucoma People with diabetes are at risk of eye problems, ranging from minor changes with no effect on vision to significant visual loss. With regular screening and eye exams by an eye doctor (ophthalmologist), and with stable and near normal blood glucose control, most of the serious complications can be avoided or successfully treated. Vision complications Putting off an eye exam is very risky. Usually there are few or no symptoms at the time the damage is occurring. Exams will reveal the problem and allow your eye doctor to treat it. Treatment can slow down the progression and maintain vision even in those who have developed significant eye complications. Eye complications include: • Retinopathy • Cataracts • Macular edema • Glaucoma Healthy eyes require that you: • Control your blood sugar • Control your blood pressure • Control your cholesterol • Don’t smoke and avoid second hand smoke • Use Ultra-violet protected eye glasses • See your ophthalmologist regularly and get retinal exams and eye pressure checked Symptoms of eye emergencies: • Loss of vision, • Holes in vision, • Showers of sparking white lights, • Black curtains over vision, • Spots of fuzzy print, hazy vision, If you have symptoms of any of the eye emergencies, seek medical care or contact your eye doctor immediately Self-assessment Quiz Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Diabetes Complications, take our self assessment quiz when you have completed this section. The quiz is multiple choice. Please choose the single best answer to each question. At the end of the quiz, your score will display. If your score is over 70% correct, you are doing very well. If your score is less than 70%, you can return to this section and review the information Quizzes Take quizzes! Test your knowledge about diabetes management, treatment, complications, and more. You may want to see how much you have learned using this website. Below are a series of self assessment quizzes. The questions cover the most important teaching points in each section. If you have trouble with a quiz, you may want to go back and review the section in the website. Read each section of the site and then take one of our self-assessment quizzes to test your new skills! • Coping With Your Emotions • Facts About Diabetes • Diabetes and Alcohol • Diabetes Complications • Diabetes and Exercise • Insulin Pumps • Managing Your Weight • Traveling with Diabetes • Understanding Carbohydrates • Understanding Fats and Oils • Understanding Food • Understanding Protein • Monitoring Your Type 1 Diabetes • Self-management Solutions for Type 1 Diabetes • Sick Days for Type 1 Diabetes • Treatment of Type 1 Diabetes • Monitoring Your Type 2 Diabetes • Self-management Solutions for Type 2 Diabetes • Sick Days for Type 2 Diabetes • Treatment for Type 2 Diabetes • Treatment of Type 2 Diabetes – Insulin Therapy Diabetes and Exercise Take the Diabetes and Exercise quiz. Test your knowledge about how exercise can help people with diabetes. The benefits of exercise include: Improved insulin sensitivity Lowered risk of heart disease Reduced stress and enhanced quality of life All of the above All of the answers are correct. Aerobic exercise, including brisk walking, swimming and cycling, has a long list of health benefits. Other benefits include reduced body fat, preserved bone mass and improved circulation. Managing Your Weight Take the Managing Your Weight quiz. Test your knowledge about tips and techniques for managing your weight. If you are overweight or obese, the health benefits of losing weight through diet and exercise include: Improved sensitivity to the action of insulin and improved blood sugar levels Lowered risk of developing heart disease, like heart attacks and stroke Prevention or delaying of serious health conditions, like breathing problems, joint and bone disorders All of the above. All of the answers are correct. However, the best answer is “All of the above”. While weight loss may prevent or delay serious health conditions, weight loss also lowers your risk for heart disease, decreases insulin resistance and improves blood sugar levels. Understanding Carbohydrates Take the Understanding Carbohydrates quiz. Test your knowledge about carbohydrates. Carbohydrates are found in which foods? Starch, fruit, milk, starchy vegetables Cheese, steak, chicken Olive oil, butter and fish Starch, fruit, milk, and starchy vegetables contain carbohydrate. Cheese, steak, chicken, and fish are types of protein, while olive oil and butter are types of fat. Understanding Food Take the Understanding Food quiz. Test your knowledge about food. What are the 3 primary sources of nutrition in a balanced diet? Carbohydrate, protein and fat Carbohydrate, protein and alcohol Fat, protein and leafy vegetables Carbohydrate, protein and fat are the 3 primary sources of nutrition in a balanced diet. While alcohol has calories, it is not one of the 3 main sources of nutrition in the diet. Leafy vegetables also have some carbohydrates, but they do not supply all of your daily carbohydrate requirements. Monitoring Your Type 1 Diabetes Take the Monitoring Your Type 1 Diabetes quiz. Test your knowledge about monitoring type 1 diabetes. Monitoring your blood glucose will: Ensure that your blood glucose levels stay normal Give you the feedback you need to keep your blood glucose in target range Not be necessary, as long as you eat right Monitoring alone does not change the blood glucose level, but the only way to know if you are keeping your blood glucose levels in the target range is to monitor your blood glucose. While it is important to eat a healthy diet, diet alone may not be sufficient. Monitoring your blood glucose will give you the feedback you need. Monitoring Your Type 2 Diabetes Take the Monitoring Your Type 2 Diabetes quiz. Test your knowledge about monitoring type 2 diabetes. Monitoring your blood glucose will: Ensure that your blood glucose levels stay normal Give you the feedback you need to keep your blood glucose in target range Not be necessary, as long as you eat right Monitoring alone does not change the blood sugar level, but it does help you know if your treatment plan is successful. The only way to find out if you are keeping your blood sugar levels in the target range is to monitor your blood sugar. Self-management Solutions for Type 1 Diabetes Take the Self-management Solutions for Type 1 Diabetes quiz. Test your knowledge about self-management solutions for type 1 diabetes. When your blood sugar is not well controlled, it is helpful to: Monitor your blood sugar at different times of the day such as before and after meals, bedtime, middle of the night, and whenever feeling low Keep a logbook of your blood sugar test results, food, activity/exercise and medication doses Discuss the problem with your medical provider All of the above All of the above All of the answers are correct. However, the best answer is “All of the above”. When your blood sugar is not well controlled, it is useful to monitor your blood sugar more frequently throughout the day including overnight. Also, keep a logbook of your blood sugar results, exercise/activity, the carbohydrate content of the food, and the insulin dose. You can review the log book with your medical provider to problem solve why you are having difficulty controlling your blood sugar. Self-management Solutions for Type 2 Diabetes Take the Self-management Solutions for Type 2 Diabetes quiz. Test your knowledge about self-management solutions for type 2 diabetes. When your blood sugar is not well controlled, it is helpful to: Monitor your blood sugar at different times during the day Keep a logbook of your blood sugar test results, food, exercise and medication doses Discuss the problem with your medical provider All of the above All of the answers are correct. However, the best answer is “All of the above”. When your blood sugar is not well controlled, it is useful to monitor your blood sugar more frequently and at different times of the day. Also, keep a logbook of your blood sugar results, exercise/activity, the carbohydrate content of the food, and medication doses (including insulin). You can review the log book with your medical provider to problem solve why you are having difficulty controlling your blood sugar. Diabetic Neurophaty treatment Research Front Maps Research front maps are diagrammatic representations of the core papers comprising each front. They are selected from the current Research Front set that are relevant to the featured special topic. The title for this Research Front Map is “DIABETIC NEUROPATHIC PAIN TREATMENT,” containing 30 core papers. Source dates: 1999-February 28, 2009 (first bimonthly period 2009). Each circle represents a highly cited paper whose bibliographic information is displayed when the user clicks on the circle. The solid lines between circles represent the strongest co-citation links for each paper (that is, indicating that the papers are frequently cited together); weaker links are indicated by dashed lines. Papers close to each other on the map are generally more highly co-cited. The most recent paper(s) are indicated in pink. Annotations may have been added to this map which represent the main research themes. These appear as labels attached to specific regions on the maps. Note: For best results use the “landscape orientation” option when printing this page. Treatment of Type 1 Diabetes Take the Treatment of Type 1 Diabetes quiz. Test your knowledge about type 1 diabetes treatment. The ultimate goal of insulin therapy is to mimic normal insulin levels. True False If you have type 1 diabetes, your body is no longer producing enough insulin. We try to mimic normal insulin levels with insulin injections or infusion through an insulin pump. Treatment for Type 2 Diabetes Take the Treatment quiz. Test your knowledge about diabetes treatment. Type 2 diabetes mellitus is treated with: Lifestyle changes – a healthy diet, adequate activity/exercise and, as needed, losing weight Pills that help return the blood sugar (plasma glucose) to the normal range Pills that increase the secretion of insulin from the pancreas Insulin All of the above All of the answers are correct. However, the best answer is “All of the above”. There are many different treatments for type 2 diabetes mellitus. Every treatment regimen starts with lifestyle changes – a healthy diet, adequate activity/exercise, and, as needed, losing weight. If lifestyle changes are not sufficient to control the blood sugar, then medications are added. Usually the first medication to be added is Metformin (a biguanide). It helps to return the blood sugar (plasma glucose) back to the normal, non-diabetic range. Other medications, including insulin, may be added to the metformin and lifestyle therapy. There is not a single treatment plan that is best for everyone. Talk with your provider about the best treatment plan for you. Metformin (a biguanide) Alpha-glucosidase inhibitors Diabetic blood circulation in foot People with diabetes are at risk for blood vessel injury, which may be severe enough to cause tissue damage in the legs and feet. The type one Isulin dependend diabetis mellitus A person with diabetes constantly manages their blood’s sugar (glucose) levels. After a blood sample is taken and tested, it is determined whether the glucose levels are low or high. If glucose levels are too low carbohydrates are ingested.� If glucose in the blood is too high, the appropriate amount of insulin is administered into the body such as through an insulin pump REFERENCES A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC’s accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.’s editorial reviewers. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch). The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsements of those other sites. Copyright 2003 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited. Recognition of Any Warning Symptoms for Diabetic Neuropathy By Hendra Excel Recognition of any warning symptoms for DIABETIC NEUROPATHY happen to be for serious great importance given that that will lose him or her can get daily life switching or violent strikes. Diabetic neuropathy is certainly because of any the wall surfaces within the problematic veins who supply any phobia being more powerful. The decreases the option within the phobia that will run impulses back in the brain. Sorbitol at the same time methods together with gathers during the Schwann debris inducing deeper sensors conduction disadvantages. One can find several different types of neuropathies which can mode utilizing diabetes; polynueropathies together with mononeuropathies. When the warning symptoms seem to be would depend what precisely phobia components happen to be infected. Any warning symptoms may vary among the consumers as well as being impacted by the sum of hurt finished into the phobia. Many other warning symptoms consist of some sort of soreness problems, a good eliminating or simply blasting impression, or simply becoming like your story own frigid your feet. When the neuropathy progresses any warning symptoms consist of drunken sensations for problems, impression, environment, vibration, together with two-point discrimination. In order to remedy polyneuropathy is certainly thru direction within the diabetes again. Mononeuropathies happen to be remoted gatherings the fact that change simple phobia. Any warning symptoms for this style of neuropathy happen to be wholly impacted by which unfortunately a sensor is certainly infected. They’ll change any coulometer sensors which unfortunately lead to annoyance, total eye problems together with some sort of failing to safely move a person’s eye in any focus. Most of the victims of diabetes, irrespective of whether model 1 or simply model a pair of, have to pay attention to any warning symptoms for diabetic neuropathy. The sooner it is actually sent to the interest within the victims of diabetes health-related service providers the sooner it really is monitored thru adequate standard of living opportunities that will be devoted to eating routine, activity, together with adequate health related direction. Diabetic Neuropathy Remedy? The actual DIABETIC NEUROPATHY is actually neural harm to entire body extremities, your toes as well as fingers for instance, in addition neural harm to internal organs, digestive system and also the center for instance . Here Are the Actual Diabetic Neuropathy Treatments *The remedy with regard to diabetic neuropathy very first choice would be to manage the actual blood sugar amounts therefore you will find not really inconsistent levels as well as levels. Administration consists of diet plan as well as physical exercise, in addition medicine in the event that recommended. * In order to avoid heartburn, physicians claim that diabetes sufferers ought to consume lower foods as well as restrict body fat as well as meals full of dietary fiber. Additionally bloodstream stress medicines probably will advantage the actual diabetic as well. An average lotion is actually capsaicin lotion. The Actual Diabetic Neuropathy Details 1 most unfortunate problems associated with diabetes may be the neural harm already been brought on by diabetes. The actual diabetes neuropathy may cause moderate uneasiness for many people, while with regard to other people this particular condition is actually disabling as well as sometimes crucial. Here Are the Actual Diabetic Neuropathy Signs and Symptoms The actual DIABETIC NEUROPATHY signs and symptoms tend to be based on the kind as well as which anxiety which obtained impacted. The actual signs and symptoms consist of muscle mass coordination difficulties, heartburn, weak point, numbness, discomfort or even tingling (usually within the ft or even fingers), nausea or vomiting as well as bladder difficulties. It might curiosity you to definitely realize that extended blood sugar levels extreme conditions blood sugar levels that is possibly excessive or even as well reduced with regard to too much time could cause numerous problems, which can result in the diabetic coma. REFRENCES Core Papers ________________________________________ Label: Dworkin-2003 Title: Advances in neuropathic pain – Diagnosis, mechanisms, and treatment recommendations Journal: ARCH NEUROL, 60 (11): 1524-1534 NOV 2003 Citations: 274 Authors: Dworkin, RH;Backonja, M;Rowbotham, MC;Allen, RR;Argoff, CR;Bennett, GJ;Bushnell, MC;Farrar, JT;Galer, BS;Haythornthwaite, JA;Hewitt, DJ;Loeser, JD;Max, MB;Saltarelli, M;Schmader, KE;Stein, C;Thompson, D;Turk, DC;Wallace, MS;Watkins, LR;Weinstein, SM Addresses: Univ Rochester, Sch Med & Dent, Dept Anesthesiol, 601 Elmwood Ave,Box 604, Rochester, NY 14642 USA Univ Rochester, Sch Med & Dent, Dept Anesthesiol, Rochester, NY 14642 USA [Back to Map] Label: Dworkin-2003 Title: Pregabalin for the treatment of postherpetic neuralgia – A randomized, placebo-controlled trial Journal: NEUROLOGY, 60 (8): 1274-1283 APR 22 2003 Citations: 171 Authors: Dworkin, RH;Corbin, AE;Young, JP;Sharma, U;LaMoreaux, L;Bockbrader, H;Garofalo, EA;Poole, RM Addresses: Univ Rochester, Sch Med & Dent, 601 Elmwood Ave,Box 604, Rochester, NY 14642 USA Univ Rochester, Sch Med & Dent, Rochester, NY 14642 USA Pfizer Global Res & Dev, Ann Arbor, MI USA [Back to Map] Label: Ballantyne-2003 Title: Opioid therapy for chronic pain Journal: N ENGL J MED, 349 (20): 1943-1953 NOV 13 2003 Citations: 162 Authors: Ballantyne, JC;Mao, JR Addresses: Massachusetts Gen Hosp, Dept Anesthesia & Crit Care, Pain Ctr, 15 Parkman St,WACC 333, Boston, MA 02114 USA Massachusetts Gen Hosp, Dept Anesthesia & Crit Care, Pain Ctr, Boston, MA 02114 USA Harvard Univ, Sch Med, Boston, MA USA [Back to Map] Label: Goldstein-2005 Title: Duloxetine vs. placebo in patients with painful diabetic neuropathy Journal: PAIN, 116 (1-2): 109-118 JUL 2005 Citations: 144 Authors: Goldstein, DJ;Lu, YL;Detke, MJ;Lee, TC;Iyengar, S Addresses: Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA PRN Consulting, Indianapolis, IN USA Indiana Univ, Sch Med, Dept Pharmacol & Toxicol, Indianapolis, IN 46202 USA Indiana Univ, Sch Med, Dept Psychiat, Indianapolis, IN 46202 USA McLean Hosp, Dept Psychiat, Belmont, MA 02178 USA Harvard Univ, Sch Med, Boston, MA USA [Back to Map] Label: Finnerup-2005 Title: Algorithm for neuropathic pain treatment: An evidence based proposal Journal: PAIN, 118 (3): 289-305 DEC 5 2005 Citations: 143 Authors: Finnerup, NB;Otto, M;McQuay, HJ;Jensen, TS;Sindrup, SH Addresses: Aarhus Univ Hosp, Danish Pain Res Ctr, Dept Neurol, Aarhus Sygehus, Norrebrogade 44, Aarhus 8000, Denmark Aarhus Univ Hosp, Danish Pain Res Ctr, Dept Neurol, Aarhus Sygehus, Aarhus 8000, Denmark Odense Univ Hosp, Dept Neurol, Odense 5000, Denmark Churchill Hosp, Pain Relief Unit, Oxford OX3 7LJ, England [Back to Map] Label: Gilron-2005 Title: Morphine, gabapentin, or their combination for neuropathic pain Journal: N ENGL J MED, 352 (13): 1324-1334 MAR 31 2005 Citations: 142 Authors: Gilron, I;Bailey, JM;Tu, DS;Holden, RR;Weaver, DF;Houlden, RL Addresses: Queens Univ, Dept Anesthesiol, 76 Stuart St, Kingston, ON K7L 2V7, Canada Queens Univ, Dept Anesthesiol, Kingston, ON K7L 2V7, Canada Queens Univ, Dept Pharmacol & Toxicol, Kingston, ON K7L 2V7, Canada Queens Univ, Dept Math & Stat, Kingston, ON K7L 2V7, Canada Queens Univ, Dept Epidemiol & Community Hlth, Kingston, ON K7L 2V7, Canada Queens Univ, Dept Psychol, Kingston, ON K7L 2V7, Canada Queens Univ, Dept Med, Div Endocrinol, Kingston, ON K7L 2V7, Canada Dalhousie Univ, Dept Med, Div Neurol, Halifax, NS, Canada Dalhousie Univ, Dept Chem, Halifax, NS, Canada [Back to Map] Label: Rosenstock-2004 Title: Pregabalin for the treatment of painful diabetic peripheral neuropathy: a double-blind, placebo-controlled trial Journal: PAIN, 110 (3): 628-638 AUG 2004 Citations: 141 Authors: Rosenstock, J;Michael, TB;LaMoreaux, L;Sharma, U Addresses: Dallas Diabet & Endo Res Ctr, 7777 Forest Lane,C618, Dallas, TX 75230 USA Dallas Diabet & Endo Res Ctr, Dallas, TX 75230 USA Palm Beach Neurol Ctr, Palm Beach Gardens, FL USA Pfizer Global Res & Dev, Ann Arbor, MI USA [Back to Map] Label: Rowbotham-2003 Title: Oral opioid therapy for chronic peripheral and central neuropathic pain Journal: N ENGL J MED, 348 (13): 1223-1232 MAR 27 2003 Citations: 127 Authors: Rowbotham, MC;Twilling, L;Davies, PS;Reisner, L;Taylor, K;Mohr, D Addresses: Univ Calif San Francisco, Sch Med, Pain Clin, Res Ctr,Dept Neurol, 1701 Divisadero St,Ste 480, San Francisco, CA 94115 USA Univ Calif San Francisco, Sch Med, Pain Clin, Res Ctr,Dept Neurol, San Francisco, CA 94115 USA Univ Calif San Francisco, Sch Med, Dept Anesthesia, San Francisco, CA 94115 USA Univ Calif San Francisco, Sch Pharm, San Francisco, CA 94115 USA [Back to Map] Label: Arnold-2004 Title: A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder Journal: ARTHRITIS RHEUM, 50 (9): 2974-2984 SEP 2004 Citations: 122 Authors: Arnold, LM;Lu, YL;Crofford, LJ;Wohlreich, M;Detke, MJ;Iyengar, S;Goldstein, DJ;Duloxetine Fibromyalgia Trial Grp Addresses: Univ Cincinnati, Coll Med, Med Arts Bldg,Suite 8200,222 Piedmont Ave, Cincinnati, OH 45219 USA Univ Cincinnati, Coll Med, Cincinnati, OH 45219 USA Eli Lilly & Co, Indianapolis, IN 46285 USA Univ Michigan, Ann Arbor, MI 48109 USA Indiana Univ, Sch Med, Indianapolis, IN USA Harvard Univ, Sch Med, Boston, MA 02115 USA McLean Hosp, Belmont, MA 02178 USA PRN Consulting, Indianapolis, IN USA [Back to Map] Label: Kalso-2004 Title: Opioids in chronic non-cancer pain: systematic review of efficacy and safety Journal: PAIN, 112 (3): 372-380 DEC 2004 Citations: 122 Authors: Kalso, E;Edwards, JE;Moore, RA;McQuay, HJ Addresses: Univ Helsinki, Pain Clin, Dept Anaesthesia & Intens Care Med, Cent Hosp, POB 340, FIN-00029 HUS, Finland Univ Helsinki, Pain Clin, Dept Anaesthesia & Intens Care Med, Cent Hosp, FIN-00029 HUS, Finland Univ Oxford, Oxford Radcliffe Hosp, Pain Res & Nuffield Dept Anaesthet, Oxford OX3 7LJ, England [Back to Map] Label: Goldenberg-2004 Title: Management of fibromyalgia syndrome Journal: JAMA-J AM MED ASSN, 292 (19): 2388-2395 NOV 17 2004 Citations: 119 Authors: Goldenberg, DL;Burckhardt, C;Crofford, L Addresses: Newton Wellesley Hosp, Dept Rheumatol, 2000 Washington St, Newton, MA 02462 USA Newton Wellesley Hosp, Dept Rheumatol, Newton, MA 02462 USA Tufts Univ, Sch Med, Dept Med, Boston, MA 02111 USA Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR USA Univ Michigan, Sch Med, Dept Internal Med, Div Rheumatol, Ann Arbor, MI USA [Back to Map] Label: Lesser-2004 Title: Pregabalin relieves symptoms of painful diabetic neuropathy – A randomized controlled trial Journal: NEUROLOGY, 63 (11): 2104-2110 DEC 14 2004 Citations: 117 Authors: Lesser, H;Sharma, U;LaMoreaux, L;Poole, RM Addresses: 1415 Portland Ave,Suite 480, Rochester, NY 14621 USA Univ Rochester, Sch Med & Dent, Rochester, NY USA Pfizer Global Res & Dev, Ann Arbor, MI USA Pfizer Global Res & Dev, New London, CT USA [Back to Map] Label: Crofford-2005 Title: Pregabalin for the treatment of fibromyalgia syndrome – Results of a randomized, double-blind, placebo-controlled trial Journal: ARTHRITIS RHEUM, 52 (4): 1264-1273 APR 2005 Citations: 110 Authors: Crofford, LJ;Rowbotham, MC;Mease, PJ;Russell, IJ;Dworkin, RH;Corbin, AE;Young, JP;LaMoreaux, LK;Martin, SA;Sharma, U;Pregabalin 1008-15 Study Grp Addresses: Kentucky Clin, Room J-503,740 S Limestone St, Lexington, KY 40539 USA Kentucky Clin, Lexington, KY 40539 USA Univ Michigan, Ann Arbor, MI 48109 USA Univ Calif San Francisco, San Francisco, CA 94143 USA Rheumatol Associates, Seattle, WA USA Swedish Med Ctr, Seattle, WA USA Univ Texas, Ctr Hlth Sci, San Antonio, TX USA Univ Rochester, Sch Med & Dent, Rochester, NY USA Pfizer Global Res & Dev, Ann Arbor, MI USA [Back to Map] Label: Sabatowski-2004 Title: Pregabalin reduces pain and improves sleep and mood disturbances in patients with post-herpetic neuralgia: results of a randomised, placebo-controlled clinical trial Journal: PAIN, 109 (1-2): 26-35 MAY 2004 Citations: 108 Authors: Sabatowski, R;Galvez, R;Cherry, DA;Jacquot, F;Vincent, E;Maisonobe, P;Versavel, M;1008-045 Study Grp Addresses: Univ Cologne, Anasthesiol Klin, Dept Anaesthesiol, D-50924 Cologne, Germany Univ Cologne, Anasthesiol Klin, Dept Anaesthesiol, D-50924 Cologne, Germany Univ Hosp Virgen Nieves, Pain Clin, Granada, Spain Flinders Med Ctr, Bedford Pk, SA, Australia Pfizer Global Res & Dev, Fresnes, France [Back to Map] Label: Goldstein-2004 Title: Duloxetine in the treatment of depression – A double-blind-placebo-controlled comparison with paroxetine Journal: J CLIN PSYCHOPHARMACOL, 24 (4): 389-399 AUG 2004 Citations: 107 Authors: Goldstein, DJ;Lu, YL;Detke, MJ;Wiltse, C;Mallinckrodt, C;Demitrack, MA Addresses: Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA PRN Consulting, Indianapolis, IN USA Indiana Univ, Sch Med, Dept Pharmacol & Toxicol, Indianapolis, IN 46204 USA Indiana Univ, Sch Med, Dept Psychiat, Indianapolis, IN 46204 USA McLean Hosp, Dept Psychiat, Belmont, MA 02178 USA Harvard Univ, Sch Med, Boston, MA 02115 USA Neuronet Inc, Malvern, PA USA [Back to Map] Label: Freynhagen-2005 Title: Efficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomised, double-blind, multicentre, placebo-controlled trial of flexible- and fixed-dose regimens Journal: PAIN, 115 (3): 254-263 JUN 2005 Citations: 97 Authors: Freynhagen, R;Strojek, K;Griesing, T;Whalen, E;Balkenohl, M Addresses: Univ Klinikum Dusseldorf, Anasthesiol Klin, Moorenstr 5, D-40225 Dusseldorf, Germany Univ Klinikum Dusseldorf, Anasthesiol Klin, D-40225 Dusseldorf, Germany Dept Internal Dis Diabetol & Nephrol, Zabrze, Poland Pfizer Inc, New York, NY USA Pfizer Global Pharamceut, Freiburg, Germany [Back to Map] Label: Detke-2004 Title: Duloxetine in the acute and long-term treatment of major depressive disorder: a placebo- and paroxetine-controlled trial Journal: EUR NEUROPSYCHOPHARMACOL, 14 (6): 457-470 DEC 2004 Citations: 89 Authors: Detke, MJ;Wiltse, CG;Mallinckrodt, CH;McNamara, RK;Demitrack, MA;Bitter, I Addresses: Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA Indiana Univ, Sch Med, Dept Psychiat, Indianapolis, IN 46202 USA McLean Hosp, Dept Psychiat, Belmont, MA 02178 USA Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA Neuronet Inc, Malvern, PA USA Semmelweis Univ Med, Dept Psychiat & Psychotherapy, H-1085 Budapest, Hungary [Back to Map] Label: Richter-2005 Title: Relief of painful diabetic peripheral neuropathy with pregabalin: A randomized, placebo-controlled trial Journal: J PAIN, 6 (4): 253-260 APR 2005 Citations: 83 Authors: Richter, RW;Portenoy, R;Sharma, U;Lamoreaux, L;Bockbrader, H;Knapp, LE Addresses: Beth Israel Med Ctr, Dept Pain Med & Palliat Care, 1st Ave 16th St, New York, NY 10003 USA Beth Israel Med Ctr, Dept Pain Med & Palliat Care, New York, NY 10003 USA St Johns Hosp, Dept Neurol, Tulsa, OK USA Pfizer Global Res & Dev, Ann Arbor, MI USA [Back to Map] Label: Raskin-2005 Title: A double-blind, randomized multicenter trial comparing duloxetine with placebo in the management of diabetic peripheral neuropathic pain Journal: PAIN MED, 6 (5): 346-356 SEP-OCT 2005 Citations: 78 Authors: Raskin, J;Pritchett, YL;Wang, FJ;D’Souza, DN;Waninger, AL;Iyengar, S;Wernicke, JF Addresses: Eli Lilly Canada, Lilly Res Labs, 3650 Danforth Ave, Toronto, ON MIN 2E8, Canada Eli Lilly Canada, Lilly Res Labs, Toronto, ON MIN 2E8, Canada Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA [Back to Map] Label: Eisenberg-2005 Title: Efficacy and safety of opioid agonists in the treatment of neuropathic pain of nonmalignant origin – Systematic review and meta-analysis of randomized controlled trials Journal: JAMA-J AM MED ASSN, 293 (24): 3043-3052 JUN 22 2005 Citations: 75 Authors: Eisenberg, E;McNicol, ED;Carr, DB Addresses: Rambam Med Ctr, Pain Relief Unit, POB 9602, IL-31096 Haifa, Israel Rambam Med Ctr, Pain Relief Unit, IL-31096 Haifa, Israel Technion Israel Inst Technol, Haifa Pain Res Grp, Haifa, Israel Tufts New England Med Ctr, Dept Anesthesia, Boston, MA USA Tufts New England Med Ctr, Dept Pharm, Boston, MA USA Tufts New England Med Ctr, Div Clin Care Res, Boston, MA USA Tufts Univ, Sch Med, Boston, MA 02111 USA [Back to Map] Label: Arnold-2005 Title: A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder Journal: PAIN, 119 (1-3): 5-15 DEC 15 2005 Citations: 68 Authors: Arnold, LM;Rosen, A;Pritchett, YL;D’Souza, DN;Goldstein, DJ;Iyengar, S;Wernicke, JF Addresses: Univ Cincinnati, Coll Med, Womens Hlth Res Program, Dept Psychiat, 222 Piedmont Ave,Suite 8200, Cincinnati, OH 45219 USA Univ Cincinnati, Coll Med, Womens Hlth Res Program, Dept Psychiat, Cincinnati, OH 45219 USA Lilly Res Labs, Indianapolis, IN USA Indiana Univ, Sch Med, Indianapolis, IN 46204 USA PRN Consulting, Indianapolis, IN 46204 USA [Back to Map] Label: Furlan-2006 Title: Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects Journal: CAN MED ASSN J, 174 (11): 1589-1594 MAY 23 2006 Citations: 63 Authors: Furlan, AD;Sandoval, JA;Mailis-Gagnon, A;Tunks, E Addresses: Toronto Western Hosp, Comprehens Pain Program, 399 Bathurst St,Rm 4F811, Toronto, ON M5T 2S8, Canada Toronto Western Hosp, Comprehens Pain Program, Toronto, ON M5T 2S8, Canada Univ Toronto, Ctr Study Pain, Toronto, ON, Canada Univ Toronto, Inst Work & Hlth, Toronto, ON, Canada Toronto Western Hosp, Krembil Neurosci Ctr, Toronto, ON M5T 2S8, Canada McMaster Univ, Chedoke Rehabil Ctr, Hamilton Hlth Sci Hosp, Hamilton, ON, Canada [Back to Map] Label: Attal-2006 Title: EFNS guidelines on pharmacological treatment of neuropathic pain Journal: EUR J NEUROLOGY, 13 (11): 1153-1169 NOV 2006 Citations: 50 Authors: Attal, N;Cruccu, G;Haanpaa, M;Hansson, P;Jensen, TS;Nurmikko, T;Sampaio, C;Sindrup, S;Wiffen, P Addresses: Hop Ambroise Pare, Ctr Evaluat & Traitement Douleur, EFNS Panel Neuropath Pain, Boulogne, France Hop Ambroise Pare, Ctr Evaluat & Traitement Douleur, EFNS Panel Neuropath Pain, Boulogne, France Hop Ambroise Pare, Ctr Evaluat & Traitement Douleur, INSERM, U792, Boulogne, France Univ Versailles St Quentin, Boulogne, France Univ Versailles St Quentin, Boulogne, France Univ Roma La Sapienza, Dept Neurol Sci, Rome, Italy Helsinki Univ Hosp, Dept Anaesthesiol, Pain Clin, Helsinki, Finland Helsinki Univ Hosp, Dept Neurosurg, Pain Clin, Helsinki, Finland Univ Hosp, Karolinska Inst, Dept Mol Med, Stockholm, Sweden Univ Hosp, Karolinska Inst, Surg Sect Clin Pain Res, Stockholm, Sweden Univ Hosp, Karolinska Inst, Pain Ctr, Dept Neurosurg, Stockholm, Sweden Aarhus Univ Hosp, Dept Neurol, DK-8000 Aarhus, Denmark Aarhus Univ Hosp, Danish Pain Res Ctr, DK-8000 Aarhus, Denmark Univ Liverpool, Pain Res Inst, Div Neurol Sci, Sch Clin Sci, Liverpool L69 3BX, Merseyside, England Univ Lisbon, Inst Farmacol & Terapeut Geral, Lisbon Sch Med, P-1699 Lisbon, Portugal Odense Univ Hosp, Dept Neurol, DK-5000 Odense, Denmark Cochrane Pain & Palliat Care Review Grp, Oxford, England [Back to Map] Label: Brannan-2005 Title: Duloxetine 60 mg once-daily in the treatment of painful physical symptoms in patients with major depressive disorder Journal: J PSYCHIAT RES, 39 (1): 43-53 JAN 2005 Citations: 50 Authors: Brannan, SK;Mallinckrodt, CH;Brown, EB;Wohlreich, MM;Watkin, JG;Schatzberg, AF Addresses: Eli Lilly & Co, Lilly Res Labs, Indianapolis, IN 46285 USA Eli Lilly & Co, Lilly Res Labs, Indianapolis, IN 46285 USA Cyberon, Houston, TX 77058 USA Stanford Univ, Dept Psychiat & Behav Sci, Stanford, CA 94305 USA [Back to Map] Label: Martell-2007 Title: Systematic review: Opioid treatment for chronic back pain: Prevalence, efficacy, and association with addiction Journal: ANN INTERN MED, 146 (2): 116-127 JAN 16 2007 Citations: 46 Authors: Martell, BA;O’Connor, PG;Kerns, RD;Becker, WC;Morales, KH;Kosten, TR;Fiellin, DA Addresses: Yale Univ, Sch Med, 333 Cedar St,POB 208025, New Haven, CT 06520 USA Yale Univ, Sch Med, New Haven, CT 06520 USA VA Connecticut Hlth Care Syst, West Haven, CT USA Univ Penn, Sch Med, Philadelphia, PA 19104 USA [Back to Map] Label: Ballantyne-2007 Title: Opioid dependence and addiction during opioid treatment of chronic pain Journal: PAIN, 129 (3): 235-255 JUN 2007 Citations: 32 Authors: Ballantyne, JC;LaForge, KS Addresses: Massachusetts Gen Hosp, Div Pain Med, Pain Ctr, 15 Parkman St,WACC 333, Boston, MA 02114 USA Massachusetts Gen Hosp, Div Pain Med, Pain Ctr, Boston, MA 02114 USA Harvard Univ, Sch Med, Boston, MA 02115 USA Univ Helsinki, Finnish Genome Ctr, FIN-00014 Helsinki, Finland [Back to Map] Label: Ives-2006 Title: Predictors of opioid misuse in patients with chronic pain: a prospective cohort study Journal: BMC HEALTH SERV RES, 6: art. no.-46 APR 4 2006 Citations: 29 Authors: Ives, TJ;Chelminski, PR;Hammett-Stabler, CA;Malone, RM;Perhac, JS;Potisek, NM;Shilliday, BB;DeWalt, DA;Pignone, MP Addresses: Univ N Carolina, Sch Med, Dept Med, Div Gen Internal Med, Chapel Hill, NC 27599 USA Univ N Carolina, Sch Pharm, Div Pharmacotherapy & Expt Therapeut, Chapel Hill, NC USA Univ N Carolina, Sch Med, Dept Pathol & Lab Med, Chapel Hill, NC USA Univ N Carolina Hlth Syst, Ctr Excellence Chron Illness Care, Chapel Hill, NC USA [Back to Map] Label: Arnold-2007 Title: Gabapentin in the treatment of fibromyalgia – A randomized, double-blind, placebo-controlled, multicenter trial Journal: ARTHRITIS RHEUM, 56 (4): 1336-1344 APR 2007 Citations: 28 Authors: Arnold, LM;Goldenberg, DL;Stanford, SB;Lalonde, JK;Sandhu, HS;Keck, PE;Welge, JA;Bishop, F;Stanford, KE;Hess, EV;Hudson, JI Addresses: Univ Cincinnati, Coll Med, Med Arts Bldg,222 Piedmont Ave,Suite 8200, Cincinnati, OH 45219 USA Univ Cincinnati, Coll Med, Cincinnati, OH 45219 USA Newton Wellesley Hosp, Newton, MA USA Tufts Univ, Sch Med, Boston, MA 02111 USA McLean Hosp, Belmont, MA 02178 USA Harvard Univ, Sch Med, Boston, MA 02115 USA [Back to Map] Label: Vinik-2007 Title: Lamotrigine for treatment of pain associated with diabetic neuropathy: Results of two randomized, double-blind, placebo-controlled studies Journal: PAIN, 128 (1-2): 169-179 MAR 2007 Citations: 28 Authors: Vinik, AI;Tuchman, M;Safirstein, B;Corder, C;Kirby, L;Wilks, K;Quessy, S;Blum, D;Grainger, J;White, J;Silver, M Addresses: Eastern Virginia Med Sch, Inst Diabet, 855 W Brandleton, Norfolk, VA 23510 USA Eastern Virginia Med Sch, Inst Diabet, Norfolk, VA 23510 USA Palm Beach Neurol Ctr, Palm Beach Gardens, FL USA Baumel Eisner Neuromed Inst, Bay Harbor, FL USA COR Clin Res, Oklahoma City, OK USA Pivotal Res Ctr, Peoria, AZ USA IMR, Towson, MD USA GlaxoSmithKline Inc, Res Triangle Pk, NC USA [Back to Map] Label: Raskin-2007 Title: Efficacy of duloxetine on cognition, depression, and pain in elderly patients with major depressive disorder: An 8-week, double-blind, placebo-controlled trial Journal: AMER J PSYCHIAT, 164 (6): 900-909 JUN 2007 Citations: 17 Authors: Raskin, J;Wiltse, CG;Siegal, A;Sheikh, J;Xu, J;Dinkel, JJ;Rotz, BT;Mohs, RC Addresses: Eli Lilly Canada, Lilly Res Labs, 3650 Danforth Ave, Toronto, ON M1N 2E8, Canada Eli Lilly Canada, Lilly Res Labs, Toronto, ON M1N 2E8, Canada Eli Lilly & Co, Lilly Res Labs, Indianapolis, IN 46285 USA Geriatr & Adult Psychiat LLC, Hamden, CT USA Stanford Univ, Sch Med, Dept Psychiat & Behav Sci, Stanford, CA 94305 USA [Back to Map] KEYWORDS: NEUROPATHIC PAIN TREATMENT; RANDOMIZED MULTICENTER TRIAL COMPARING DULOXETINE; DIABETIC PERIPHERAL NEUROPATHIC PAIN; CENTRAL NEUROPATHIC PAIN; NEUROPATHIC PAIN EVALUATED. [5770: (2002-2008_6) (CLI-NEU: ST Diabetes)]

The Ming Dinasty Kungfu Style Cup Which Found In Indonesia

source

 https://driwancybermuseum.wordpress.com/2012/11/01/the-ming-dinasty-kungfu-design-decoration-cup-which-found-in-indonesia/

Copyrighy @ Dr Iwan suwandy,MHA 2012 

Photo: koleksi mangkuk dinasti ming dengan lukisan gerakan kungfu saya temukan di jawa barat, bagi yang memiliki yang sama harap laporkan.If you have the same design please report,I have just research about this amizing cup

Hallo Teman-teman Kolekstor Keramik dan Pecinta oleh raga silat Wushu dan Kungfu , saya baru saja menemukan mangkuk kecil untuk minum arak dari Dinasti ming akhir(Ming Wanli) biru putih.

Ternyata oleh raga Kungfu sudah ada sejak abak ke-empat belas tersebut dan sudah diminati di indonesia, mangkuk ini merupakan bukti,

Saya sudah mengupload i facebook saya ilustrasi dibawah ini dengan harapan mendapat info lebih lanjut.

  • the closeup illustration of my collections Ming Kungfu design cup,who have the same please upload for added my research,thanks
    Photo: the closeup illustration of my collections Ming Kungfu design cup,who have the same please upload for added my research,thanks
    •  
  • Iwan Suwandy was at Vietnam and 2 other places.
    See All Stories
  • koleksi mangkuk dinasti ming dengan lukisan gerakan kungfu saya temukan di jawa barat, bagi yang memiliki yang sama harap laporkan.If you have the same design please report,I have just research about this amizing cup
    Photo: koleksi mangkuk dinasti ming dengan lukisan gerakan kungfu saya temukan di jawa barat, bagi yang memiliki yang sama harap laporkan.If you have the same design please report,I have just research about this amizing cup
    • Iwan Suwandy please look the closeup of this Kungfu cup above, I am waiting for all my friend comment

Bagi yang memiliki keramik dengan dekorasi sperti ini harap berkenan menguploadnya buat saya jadi bahan yang melengkapi penelitian sudi banding gerakan Kungfu tempo dulu dengan saat ini.

Terima kasih atas komentar,saran dan info dari teman-teman

Jakarta November 2012

Dr Iwan suwandy,MHA

english version

machinal  translate

Hello Friends and Lovers by Pottery Collector sport Wushu martial arts and martial arts, I’ve just discovered a small bowl to drink wine from the late Ming dynasty (Ming Wanli) blue and white.

Apparently the sport of martial arts has been around since abak all fourteen and already popular in Indonesia, this bowl is a testament,

I’ve uploaded my facebook i illustrated below with the hope of getting more info.

Photo: the closeup illustration of my collections Ming Kungfu design cup,who have the same please upload for added my research,thanks

the closeup illustration of my collections Sun Kungfu cup design, who have the same added please upload for my research, thanks

Photo: koleksi mangkuk dinasti ming dengan lukisan gerakan kungfu saya temukan di jawa barat, bagi yang memiliki yang sama harap laporkan.If you have the same design please report,I have just research about this amizing cup

collection ming dynasty bowl with painting my kungfu movements found in western Java, for those who have the same hope you have the same laporkan.If please report design, I have just research about this amizing cup

Iwan Suwandy please look the closeup of this Kungfu cup above, I am waiting for all my friend comment
For those who have ceramic décor is just as pleasing please upload it for me so material that complements willing comparative study of martial arts movements of the past with the present.

Thanks for the comments, suggestions and info from friends

Jakarta, November 2012

Dr Iwan Suwandy, MHA

Studi banding

Comparative study

Old Kungfu style from Ming era on small cup

Photo: the closeup illustration of my collections Ming Kungfu design cup,who have the same please upload for added my research,thanks

the sma kungfu style now llok below

 

for young generation please look the Kungsu Boy Style cartoon below

The complet report of svompareative study will uplad in E-Book CD-ROM which limited private edition by Dr Iwan suwandy,MHA

 

the end @ copyright 2012

The Legend Singer History Collections:”Enrico Caruso The Singer With Golden Voice “

Sumber Info

https://driwancybermuseum.wordpress.com/2012/10/27/the-legend-singer-history-collectionsenrico-caruso-golden-voice-singer/

Pengantar

Para pecinta musik tentunya masih ingat dengan penyanyi suara emas bariton almarhum Pavaroti, dan bagi yang senior penyanyi legendari bersuar emas Mario Lanza yang saya sudah pernah menulis artikel tentar penyannyi ini lengkap dengan kolekis piringhitam(Record player) yang saya miliki.

Sebenarnya masih ada seorang penyanyi legendari yang memiliki sura emas yang bagi generasi muda banyak tidak diketahui yaitu

introduction

The music lovers surely remember the golden voice baritone singer Pavaroti deceased, and for the senior gold bersuar legendary singer Mario Lanza I’ve written this article tentar penyannyi complete with kolekis piringhitam (record player) that I have.

Actually there are a legendary singer who has gold sura for many young people do not know that

Enrieco Caruso yang berasal dari negara yang yang sama dengan Mario Lansa yaitu Italia.

Sudah lama saya mencari informasi dan koleksi yang terkait dengannya, barulah hari ini saya menemukan sebuah majalah berbahasa Belanda yang lama tenta penyanyi tersebut.

Untuk pecinta musik Internasional dan khususnya Indonesia saya akan menterjemahkan infomasi tersebut kedalam bahasa Indonesia dan bahasa Inggris, serta melakukan penellitian lebih lanjut dari beberapa sumber yang ada agar seluruh pecinta musik di dunia khususnya penyanyi bariton mengenalnya dan menginggatnya lebih baik.

Selamat menikmati karya tulis ini

Enrieco Caruso from the same country with Mario Lansa namely Italy.

I’ve been looking for information and collections associated with it, then today I found an old Dutch-language magazine tenta singer.

For music lovers and especially International Indonesia infomasi I will translate it into Indonesian language and English, as well as doing further penellitian from several sources that there will be music lovers all over the world especially baritones and menginggatnya know him better.

Enjoy this paper

Jakarta Oktober 2012

Dr Iwan Suwandy,MHA

Terjemahan Artikel

Zo was  Het Leven  van Enrico Caruso  De Zanger  Met De Gouden Stem

sorry the tyranslation  only for the  premium member

Maaf terjemahan hanya untuk anggota Premium saja

Untuk membaca Informasi Lebih Lengkap silahkan klik sumber data

 

Caruso, Enrico - Golden Voice Of Enrico Caruso Volume 3 DB Cover Art

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Golden Voice Of Enrico Caruso Volume 3 album by Enrico Caruso was released Oct 01, 2010 on the Hallmark label. Golden Voice Of Enrico Caruso Volume 3 CD music contains a single disc with 9 songs.

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Untitled

Caruso received the highest ever paid opera fee of 15.000 $ for a single performance in Mexico-City in 1919, which would match with roundabout 195.000 $ of today!!! —Preceding unsigned comment added by 87.184.125.61 (talk) 14:02, 19 February 2010 (UTC)

Birthdate

Enrico Caruso is probably born on February 25 and not 27, as given in many reference books (See: allmusic.com) – Puck 13:08, 13 Feb 2005 (UTC)

None of the sources I have seen ever give the “sources” of either February 25th or 27th. Neither does allmusic.com. What is the reason to believe Feb 25th and not 27th?

Enrico Caruso, originally Errico, was born Febr. 25th 1873 and baptazied the following day Febr. 26th in the church next to his birthplace.

Franco Bastiano Voice agent —Preceding unsigned comment added by 87.184.97.92 (talk) 10:37, 6 May 2010 (UTC)

The officials of Naples confirm that Enrico Caruso was born on february 25th 1873 an baptized the following day. The ENRICO CARUSO MUSEUM OF AMERICA in Brooklyn is in possession of a copy of Carusos parochial record. There clearly can be seen that he was baptized on february 26th 1873. So it is impossible that he was born february 27th. Get in touch with Cavaliere Ufficiale Aldo Mancusi — Pres. Founder and Curator of the Enrico Caruso Museum of America. Franco Bastiano — Preceding unsigned comment added by 87.184.59.125 (talk) 19:30, 22 July 2011 (UTC)
This no longer in dispute. Look at the article. It states the facts as you have indicated. Markhh (talk) 02:52, 23 July 2011 (UTC)

[edit] Earthquake

Would it be relevant to mention that he performed in San Francisco the night before and became a survivor of the great quake?

[edit] Improvement

I am starting an improvement drive for this article. I will nominate it for collaboration of the week.

Capitalistroadster 10:38, 13 September 2005 (UTC)

To that end, let me add 2 things: he opened at the Met 17 times, a record only broken by Domingo, & he was the first recording artist (on wax, no less!). Trekphiler 19:34, 8 December 2005 (UTC)
      • easy record that: Caruso died with 48, Domingo is 75 not 68. Caruso sang 863 times at the Met within 17 years, Domingo 631 times within 43 years. By the way Domingo suffers from a Caruso-Neurosis. He will never reach the greatest tenor and singer of all times. Xavier Madrid —Preceding unsigned comment added by 87.184.83.88 (talk) 10:50, 25 July 2009 (UTC)

Caruso was the first opera tenor who appeared in a large stadium. That was when he sang Radames in Aida on 2nd November 1919 in the bullfight arena of Mexico-city in front of 25.000!!! people. The success was of that kind that the world press turned upside down and the excitement held on half the night. So Caruso sang in a stadium long before the so called three tenors did. And what they offered was rather mediocre. JDT


Seeing as how his career started in 1894, some seven years after commercial recording began, it’s unlikely that he could possibly be “the first recording artist”. In fact, he first recorded in 1902, which much postdates all sorts of artists. Is there a Billy Murray article?24.22.172.6006:12, 10 December 2005 (UTC)
Yes, Billy Murray (singer). — Infrogmation 16:25, 3 September 2006 (UTC)

[edit] Unsourced quotes

These 2 quotes were recently added – anyoen have a source?

  • He was initially reluctant to become a professional singer. When asked why he replied that he knew many tenors and they were all starving.
I have read numerous books and articles on Caruso and never heard this even as a legend or rumor. —Bluejay Young (talk) 07:11, 5 February 2010 (UTC)
Pure nonsense. Caruso did not want to be anything else but an operasinger from that moment at sixteen when he took lessons with Guglielmo Vergine renowned neapolitan teacher. —87.184.45.21 (talk) 06:08 14 May 2010
  • He was a collegue and friend of the Irish tenor John McCormack. One day when they met by chance in a shop he asked McCormack “How is the greatest tenor in the world today?” McCormack replied that he must be referring to himself.

AKeen 20:07, 16 April 2006 (UTC)

I know a different story about this subject. Apparently, it was McCormack who asked Caruso “How is the greatest tenor in the world today?”, and Caruso answered with a question: “Since when have you retired?” —MPM43 (talk) 05:01, 25 April 2009 (UTC)

Or “Since when did you become a baritone?” —Bluejay Young (talk) 07:11, 5 February 2010 (UTC)

[edit] Haunting in Oklahoma

http://www.ghouli.com/GHOSTSTORY/HauntedOklahoma.htm

Enrico Caruso is said to haunt the Brady Theater in Tulsa, OK

  • * * * * *

the page linked above has disappeared, and defaults to another page related to ghosts, but not to Caruso.

our local legend is that Caruso performed at the Tulsa Municipal Auditorium (still standing, known as the Brady Theater, or, more fondly, the Old Lady on Brady). Afterwards, J. Paul Getty asked Caruso if he had ever seen an oil well. apparently, the weather was quite bitter, and Caruso caught cold, leading to the illness that sent him home to his deathbed. the link above may have referred to some people’s belief that the ghost of Caruso may haunt the old theater. 63.165.44.53 (talk) 15:12, 9 March 2008 (UTC)

[edit] Trivia

Certain recordings of his were predominantly used in Woody Allen’s Match Point, an Academy Award-nominated thriller starring Scarlett Johansson and Jonathan Rhys Meyers.

I think this footnote to the main article belongs more properly in Trivia. Orbicle 09:27, 16 July 2006 (UTC)

Why did you put Daily Rotten? It’s not a reliable source! —Jack 23:27, 3 Feb 2007 (UTC)

[edit] high notes??

I consider it impossible that “Caruso must have had problems with very high notes”!
– The high C (“do di petto”) is the trademark of every single opera piece, usually the highest dramatic moment in the developement of the story. Not a “very high note”, therefore, but simply what a tenor is expected to achieve.
– Caruso has been the most famous tenor in history…the supposedly incapability of yielding a good high C would have no doubt condemned him to eternal oblivion.
– Instead: he had an incredibly versatile voice, powerful and flexible, and I have personally heard many of his recordings with a full, powerful “do di petto” that did not show any incertaincy.
– I think the distortion to B might have been because of other constraints, or for technical reasons. And the choice of doing one falsetto (in an opera that I don’t know, so I’m guessing) could be an artistical decision.

According to this source [[1]] it seems he may have had trouble with high notes early in his career, but that he resolved them around the time he gained fame. —Chapuisat 21:24, 7 September 2007 (UTC)

Caruso had a certain high C. His distortion to b was so perfect on rare nights when his voice was not in top form which happens to every singer, that almost nobody could tell the difference. Those who heard him say that his singing was in every way overwhelming and to compare to the dimensions of an organ. By the way Domingo never had a certain high c.


      • You obviously are no expert and never really listend to his roundabout 260 recordings. All of them are available.My grandfather heard Caruso twice as Radames in Aida at the MET. That role asks for 26 high B’s and a handful of high C’s. It was one of Carusos most successful parts. My grandfather was so overwhelmed, that he could not sleep all night after hearing Caruso. He said: I thought I had dreamt and therefore I went once more to hear him in this role within a month. He told me that Carusos high C’s were clarionlike and not to compare to any other singer. He never forgot those performances all his life.

Jan de Turovski opera voice agent


—Preceding unsigned comment added by 87.184.89.237 (talk) 14:23, 31 July 2009 (UTC)

[edit] Wow!

Nothing about the time the Teatro Nacional in Cuba was bombed during Caruso’s performance? Murderbike (talk) 22:36, 24 November 2007 (UTC)

Caruso arrived two days after the incident to make his debut. The rest is a fairytale. Jan de Turovski —Preceding unsigned comment added by 87.184.45.21 (talk) 14:21, 13 May 2011 (UTC)

 

[edit] Jussi Björling less robust and golden-toned than Caruso?

The statement that Jussi Björling’s voice was “less robust and golden-toned than Caruso’s” seems very POV to me. Could somebody explain this to me? Jussi’s recording sure sound pretty robust and golden-toned to me… —Preceding unsigned comment added by 217.151.192.10 (talk) 13:21, 6 January 2008 (UTC)

The comparation of Caruso and Björling was always a product of anglosaxon audiences, among them his widow, who wanted, as many others, stablish Björling as “only of principal Caruso’s heir”. Latin audiences, even admiring Jussi for all his qualities, generaly thought that nothing more different than the singing of those tenors, most of all in the inerpretative field. Björling was a great failure as an interpreter of italian opera and Caruso one of its greatest ones. With this only point, the comparation falls. —MPM43 (talk) 05:26, 25 April 2009 (UTC)

[edit] Martha by Flotow

He first sang in this opera in 1906. How often did he appear in it afterwards? I’m asking because we say in the Martha article that it was popular till around the turn of the 20th century. That would fit if Caruso and others didn’t sing it much past 1906. But Caruso didn’t die till 1921. — JackofOz (talk) 23:14, 20 June 2008 (UTC)

That info is or should be in Pierre Key’s book. If I remember right, he did quite a few Marthas. (And woops, that was me, sometime in May 09 — —Bluejay Young (talk) 19:52, 30 May 2009 (UTC))
Thanks. I don’t know Key’s book, but if anyone has access to it, they might advise the details. — JackofOz (talk) 21:31, 30 May 2009 (UTC)
Caruso sang Martha throughout his career at the Met. 41 performances from 1906 to 1920. Martha continued to be performed at the Met through the 1920s. See the Met Opera Database for details. A 1906 review in the database suggests that the 1906 revival constituted a return to favor for the opera which had previously fallen out of the repertoire. Markhh (talk) 22:41, 30 May 2009 (UTC)
Belated thanks. — Jack of Oz (Speak!) 12:07, 10 December 2009 (UTC)
And here’s Pierre Key’s entire book online for future reference. Enrico Caruso, A Biography by Pierre KeyBluejay Young (talk) 19:39, 5 September 2011 (UTC)

[edit] Did he ever sing Verdi’s Requiem?

He doesn’t appear to have recorded any of it, but I’d be interested to know if he ever sang in it. — JackofOz (talk) 11:05, 8 July 2008 (UTC)

Caruso recorded the “Ingemisco” from the Verdi Requiem on 7 January 1915. —Preceding unsigned comment added by 70.134.85.172 (talk) 06:44, 11 August 2008 (UTC)

Excellent, thanks. Can you tell me where you got that info from – because I couldn’t find it anywhere. — JackofOz (talk) 05:03, 14 August 2008 (UTC)
See yahoo music which has a sample part of complete caruso:

The Complete Caruso: Including The Original Victor Talking Machine Co. Master Recordings … http://music.yahoo.com/track/29836451 /s/ Lil Caruso, “and he sings to the people” , EF 76.194.81.120 (talk) 12:49, 19 August 2008 (UTC)

Thank you. I must get a copy of it. — JackofOz (talk) 05:15, 20 August 2008 (UTC)

[edit] Incidental information

Suggest that this vague catchall category be deleted and the information moved into the main article where appropriate. Markhh (talk) 04:06, 19 May 2009 (UTC)

[edit] Introduction

Suggest this article seems top heavy and out of balance. The intro seems far too long for the length of the total article. It should only summarize the main points of interest. Consider shortening intro and adding the other content to the main article. Markhh (talk) 04:43, 20 May 2009 (UTC)

its ok, as long as intro has full content
many articles r like that on wikipedia totally lowly! —Preceding unsigned comment added by 64.107.1.187 (talk) 21:41, 13 June 2009 (UTC)
interesting article Photo Standalone 2 — No Title

Chicago Daily Tribune (1872-1963); Sep 4, 1921; Chicago Tribune (1849 – 1986) pg. C8

204, thanx for restoring what vandal markhh removed! —Preceding unsigned comment added by 192.148.105.4 (talk) 00:15, 23 June 2009 (UTC)

[edit] NPOV

This article needs some good housekeeping when it comes to non-verifiable, subjective statements. Phrases like “tremendous international renown”, “extraordinary voice”, and “unequaled richness” do not belong in an encyclopedia. Toscaesque (talk) 21:29, 27 July 2009 (UTC)

 

Yah?Well why don’t you clean out all that language? Stop leaving it to everyone else to do! —Preceding unsigned comment added by 76.89.66.135 (talk) 03:12, 20 November 2009 (UTC)

I’m removing the tag, which has now been there four months. The claim is not an NPOV issue anyway. Few would disagree on the substance of the claims or say they are an effort to bias the encyclopedia. Rather it is a matter of encyclopedic language and tone. – Wikidemon (talk) 19:05, 27 November 2009 (UTC)

 

[edit] Black Hand

No mention of the threats to his life (or voice by poisoning him with lye)? —MartinezMD (talk) 01:04, 26 February 2010 (UTC)

[edit] Online sources

Enrico Caruso at archive.org

Dorothy Caruso’s biography used to be on archive.org also, but apparently someone renewed the copyright. I have PDFs from when it was free, if anyone is interested. —Bluejay Young (talk) 19:42, 5 September 2011 (UTC)

thSelesesai @ hak cipta 2012

The End @ Copyrigght 2012

Mesjid Islam Haram esh Sharif dan El Aqsa Di Yerusalem

Koleksi Sejarah

Mesjid Islam Haram esh Sharif dan  El Aqsa   Di Yerusalem

The History OF Temple Mount (Haram esh Sharif) with Dome of the Rock and El Aqsa Mosque, Jerusalem

Temple Mount (Haram esh Sharif) with Dome of the Rock and El Aqsa Mosque, Jerusalem, Israel Photo

Oleh

Dr Iwan suwandy,MHA

Khusus Untuk teman-Teman Muslim Indonesia

 sumber info Wiki

Bagi Umat Islam Indonesia yang belum pernah ke Jerusalem tentunya ingin mengetahui sejarah dari  mesjid  Islam Haram Esdh Sjarif dan El Aqsa di kota suci tersebut

 

Stepping on to the Temple Mount (in Arabic Haram esh-Sharif  the “Noble Sanctuary”), the site of Solomon’s Temple and the Second Temple.
Now the site of both the El-Aqsa Mosque and the Dome of the Rock.
[antiquity-strewn area in front of the Museum of Islamic Art]
2006-032
[The Temple Mount is a vast esplanade constructed atop huge archways. Beneath the deck of the mount are mostly unaccessible catacombs and the rock outcropping believed to be the site of where: Abraham was asked to sacrifice Isaac, the site of the Holy of Holies of Solomon’s Temple and later where Muhammad left the Earth on his Night Journey (the one and only possible reference to Jerusalem in the Koran, and then, not by name).] 
The El-Aqsa mosque itself was “closed to all non-Muslims, on this day,
pending negotiations between the Palestinian and Israeli authorities.”  Damn politics!
2006-033
[Shown here are four of the seven facade bays of entry. Twice in history, this building was razed to the ground by earthquakes.  It’s present form dates to the 11th Century.] 
So we head across the Temple Mount to the Dome of the Rock.
2006-034
[One of the first and greatest achievements of Islamic architecture. Built in 688-691, The Dome of the Rock has become more a shrine and a symbol of the city than a mosque.  The dome was originally made of copper, but is now covered with gold leaf, thanks to King Hussein of Jordan.  Beneath the dome, the drum is decorated with verses from the Koran telling of the Night Journey.  Leading up to the dome in all directions are eight sets of stairs topped by a set of archways. Each set of stairs and archways (called qanatir) are unique in size and length and date from different periods.  Some column capitals were recycled from Roman-era buildings.] 
Joan and one of the Qanatirs leading up to the main entrance of the Dome.
This Qanatir is unique in that it’s stairs are carved out of the stone of the platform.
2006-035 
The place is HUGE!   But, “closed to all non-Muslims, on this day,
pending negotiations between the Palestinian and Israeli authorities.”  Politics, damn!
2006-036 
The top band of mosaics contains passages from the Koran.
2006-037 
Everywhere on the grounds are little buildings.  This one is a public water fountain.  Behind the fountain can be seen the Cotton Merchant’s Gate, thru which non-Muslims are not allowed to pass (although it is the best way to get into the Jerusalem market).  We didn’t know the Muslim password for the day, so we were turned away and had to walk 35-minutes to the non-Muslim passage.
2006-038
[The Sabil of Qaitbey fountain was built on the order of the Mameluke sultan Qaitbey (1468-1498).  It has a carved stone dome, the only one of its kind in Israel.] 
Dome of the Prophet, a qanatir, Ashrafiyya Madrasa (Islamic Religious School) and minaret in the background.  From this minaret (one of four on the Temple Mount), the call to prayer can be heard five times daily throughout the entire Old City
(thanks to Bogen pre-amps, amps and dome-horned speakers).
2006-039 
Nowhere a sign of hostility.  People couldn’t have been nicer.
2006-040 
Another archway.
2006-041 
Another worshipper.
2006-042 
Untuk melihat informasi yang lengkap silahkan klik
 
 

Temple Mount

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Temple Mount
הַר הַבַּיִת, Har haBáyith
الحرم الشريف, al-Haram ash-Sharīf,
Temple mount.JPG
Elevation 740 m (2,428 ft)
Location
Temple Mount is located in Jerusalem

Temple Mount

Jerusalem

Range Judean
Coordinates 31°46′40.7″N 35°14′8.9″E / 31.777972°N 35.235806°E / 31.777972; 35.235806Coordinates: 31°46′40.7″N 35°14′8.9″E / 31.777972°N 35.235806°E / 31.777972; 35.235806
Geology
Type Limestone[1]

The Temple Mount, known in Hebrew (and in Judaism) as Har haBáyith (Hebrew: הַר הַבַּיִת‎) and in Arabic (and in Islam) as the Haram Ash-Sharif (Arabic: الحرم القدسي الشريف‎, al-haram al-qudsī ash-sharīf, Noble Sanctuary), is one of the most important religious sites in the Old City of Jerusalem.[citation needed] It has been used as a religious site for thousands of years. At least four religions are known to have used the Temple Mount: Judaism, Islam, Christianity, and Roman paganism.

Biblical scholars have often identified it with two biblical mountains of uncertain location: Mount Moriah where the binding of Isaac took place, and Mount Zion where the original Jebusite fortress stood; however, both interpretations are disputed.

Judaism regards the Temple Mount as the place where God chose the Divine Presence to rest (Isa 8:18); according to the rabbinic sages whose debates produced the Talmud, it was from here the world expanded into its present form and where God gathered the dust used to create the first man, Adam. The site is the location of Abraham’s binding of Isaac, and of two Jewish Temples. According to the Bible the site should function as the center of all national life—a governmental, judicial and, of course, religious center (Deut 12:5-26; 14:23-25; 15:20; 16:2-16; 17:8-10; 26: 2; 31: 11; Isa 2: 2-5; Oba 1:21; Psa 48). During the Second Temple Period it functioned also as an economical center. From that location the word of God will come out to all nations, and that is the site where all prayers are focused. According to Jewish tradition and scripture (2 Chronicles 3:1-2), the first temple was built by Solomon the son of David in 957 BCE and destroyed by the Babylonians in 586 BCE. The second was constructed under the auspices of Zerubbabel in 516 BCE and destroyed by the Roman Empire in 70 CE. Jewish tradition maintains it is here the Third and final Temple will also be built. The location is the holiest site in Judaism and is the place Jews turn towards during prayer. Due to its extreme sanctity, many Jews will not walk on the Mount itself, to avoid unintentionally entering the area where the Holy of Holies stood, since according to Rabbinical law, some aspect of the Divine Presence is still present at the site.[2] It was from the Holy of Holies that the High Priest communicated directly with God.

Among Sunni Muslims, the Mount is widely considered to be the third holiest site in Islam. Revered as the Noble Sanctuary (Bait-ul-Muqaddas) and the location of Muhammad‘s journey to Jerusalem and ascent to heaven, the site is also associated with Jewish biblical prophets who are also venerated in Islam.[citation needed] After the Muslim conquest of Jerusalem in 637 CE, Umayyad Caliphs commissioned the construction of the al-Aqsa Mosque and Dome of the Rock on the site.[3] The Dome was completed in 692 CE, making it one of the oldest extant Islamic structures in the world, after the Kaabah. The Al Aqsa Mosque rests on the far southern side of the Mount, facing Mecca. The Dome of the Rock currently sits in the middle, occupying or close to the area where the Bible mandates the Holy Temple be rebuilt.[4]

In light of the dual claims of both Judaism and Islam, it is one of the most contested religious sites in the world. Since the Crusades, the Muslim community of Jerusalem has managed the site as a Waqf, without interruption.[5] As part of the Old City, controlled by Israel since 1967, both Israel and the Palestinian Authority claim sovereignty over the site, which remains a major focal point of the Arab-Israeli conflict.[6] In an attempt to keep the status quo, the Israeli government enforces a controversial ban on prayer by non-Muslim visitors.

Contents

 [hide

[edit] Location and dimensions

Model of Jerusalem in the Late 2nd Temple Period. Note that the large flat expanse was a base for the temple located there

The Temple Mount forms the northern portion of a very narrow spur of hill that slopes sharply from north to south. Rising above the Kidron Valley to the east and Tyropoeon Valley to the west,[7] its peak reaches a height of 740 m (2,428 ft) above sea level.[8] In around 19 BCE, Herod the Great extended the Mount’s natural plateau by enclosing the area with four massive retaining walls and filling the voids. This artificial expansion resulted in a large flat expanse which today forms the eastern section of the Old City of Jerusalem. The trapezium shaped platform measures 488 m along the west, 470 m along the east, 315 m along the north and 280 m along the south, giving a total area of approximately 150,000 m2 (37 acres).[9] The northern wall of the Mount, together with the northern section of the western wall, is hidden behind residential buildings. The southern section of the western flank is revealed and contains what is known as the Western Wall. The retaining walls on these two sides descend many meters below ground level. A northern portion of the western wall may be seen from within the Western Wall Tunnel, which was excavated through buildings adjacent to the platform. On the southern and eastern sides the walls are visible almost to their full height. The platform itself is separated from the rest of the Old City by the Tyropoeon Valley, though this once deep valley is now largely hidden beneath later deposits, and is imperceptible in places. The platform can be reached via Bridge Street – a street in the Muslim Quarter at the level of the platform, actually sitting on a monumental bridge; the bridge is no longer externally visible due to the change in ground level, but it may be seen from beneath via the Western Wall Tunnel.

[edit] History

[edit] Israelite period

The hill is believed to have been inhabited since the 4th millennium BCE.

Assuming colocation with the biblical Mount Zion, its southern section would have been walled at the beginning of the 2nd millennium BCE, in around 1850 BCE, by Canaanites who established a settlement there (or in the vicinity) named Jebus.

Biblical scholars have also identified it with Mount Moriah where the binding of Isaac took place. According to the Hebrew Bible, Mount Moriah was originally a threshing-floor owned by Araunah, a Jebusite. The prophet Gad suggested the area to King David as a fitting place for the erection of an altar to YHWH, since it was there a destroying angel was standing when God stopped a great plague in Jerusalem.[10] David then bought the property from Araunah, for fifty pieces of silver, and erected the altar. YHWH instructed David to build a sanctuary on the site, outside the city walls on the northern edge of the hill. The building was to replace the Tabernacle, and serve as the Temple of the Israelites in Jerusalem.[11] The Temple Mount is an important part of Biblical archaeology.

[edit] Achaemenid Persian, Hasmonean periods, and Herod’s expansion

A stone (2.43×1 m) with Hebrew inscription “To the Trumpeting Place” excavated by Benjamin Mazar at the southern foot of the Temple Mount is believed to be a part of the Second Temple

Much of the Mount’s early history is synonymous with events pertaining to the Temple itself. After the destruction of Solomon’s Temple by Nebuchadnezzar II, construction of the Second Temple began under Cyrus in around 538 BCE, and completed in 516 BCE. Evidence of a Hasmonean expansion of the Temple Mount has been recovered by archaeologist Leen Ritmeyer. Around 19 BCE, Herod the Great further expanded the Mount and rebuilt the temple. The ambitious project, which involved the employment of 10,000 workers,[12] more than doubled the size of Temple Mount to approximately 36 acres (150,000 m2). Herod leveled the area by cutting away rock on the northwest side and raising the sloping ground to the south. He achieved this by constructing huge buttress walls and vaults, filling the necessary sections with earth and rubble.[13] A basilica (the Royal Stoa) was constructed on the southern end of the expanded platform, which provided a focus for the city’s commercial and legal transactions, and which was provided with separate access to the city below via the Robinson’s Arch overpass.[14] In addition to restoration of the Temple, its courtyards, and porticoes, Herod also built Antonia Fortress abutting the northwestern corner of the Temple Mount, and a rainwater reservoir, Birket Israel, in the northeast. As a result of the First Jewish-Roman War, the fortress was destroyed by Roman emperor Vespasian, in 70 CE, under the command of his son and imperial heir, Titus.

[edit] Middle Roman period

Stones from the walls of the Temple Mount thrown onto the street by Roman soldiers in 70 CE

The city of Aelia Capitolina was built in 130 CE by the Roman emperor Hadrian, and occupied by a Roman colony on the site of Jerusalem, which was still in ruins from the First Jewish Revolt in 70 CE.

Aelia came from Hadrian’s nomen gentile, Aelius, while Capitolina meant that the new city was dedicated to Jupiter Capitolinus, to whom a temple was built on the site of the former second Jewish temple, the Temple Mount.[15]

Hadrian had intended the construction of the new city as a gift to the Jews, but since he had constructed a giant statue of himself in front of the Temple of Jupiter and the Temple of Jupiter had a huge statue of Jupiter inside of it, there were now two enormous graven images on the Temple Mount. It was also the normal practice of the adherents of the Hellenic religion to sacrifice pigs before their deities. In addition to this, Hadrian issued a decree prohibiting the practice of circumcision. These three factors, the graven images, the sacrifice of pigs before the altar, and the prohibition of circumcision, constituted for non-Hellenized radical Zealot Jews a new abomination of desolation, and thus Bar Kochba launched the Third Jewish Revolt. After the Third Jewish Revolt failed, all Jews were forbidden on pain of death from entering the city.

[edit] Late Roman period

About 325 it is believed that Constantine‘s mother, St. Helena, built a small church on the Mount in the 4th century, calling it the Church of St. Cyrus and St. John, later on enlarged and called the Church of the Holy Wisdom. The church was later destroyed and on its ruins the Dome of the Rock was built.[16] Since it is known that Helena ordered the Temple of Venus to the west of the Temple Mount to be torn down to construct the Church of the Holy Sepulchre, presumably she also ordered the Temple of Jupiter on the Temple Mount to be torn down to construct the Church of St. Cyrus and St. John.

In 363, Emperor Julian, on his way to engage Persia, stopped at the ruins of the Second Temple in Jerusalem. Julian granted the Jews permission to begin rebuilding the Temple.[17] To Christians, the destroyed Temple was a symbol of Christianity’s triumph over Judaism, and Julian, was an opponent of Christianity.[17] Rebuilding work began, but was ended by the Galilee earthquake of 363.[17][18]

There are records of Jews continuing to offer sacrifices on the Foundation Stone after the destruction of the Temple and into the Byzantine period.[17]

[edit] Byzantine period

Archaeological evidence in the form of an elaborate mosaic floor similar to the one in the Church of the Nativity in Bethlehem and multiple fragments of an elaborate marble Templon (chancel screen) prove that an elaborate Byzantine church or monastery or other public building stood on the Temple Mount in Byzantine times, presumably the aforementioned Holy Wisdom Church.[19]

[edit] Sassanid vassal state period

See Jewish revolt against Heraclius
See also Byzantine-Sassanid War of 602-628
In 610, the Sassanid Empire drove the Byzantine Empire out of the Middle East, giving the Jews control of Jerusalem for the first time in centuries. The Jews in Palestine were allowed to set up a vassal state under the Sassanid Empire called the Sassanid Jewish Commonewealth which lasted for five years. Jewish rabbis ordered the restart of animal sacrifice for the first time since the time of Second Temple and started to reconstruct the Jewish Temple. Shortly before the Byzantines took the area back five years later in 615, the Persians gave control to the Christian population, who tore down the partially built Jewish Temple edifice and turned it into a garbage dump,[20] which is what it was when the Caliph Omar took the city in the 630s.

[edit] Arabic period

Southwest qanatir of the Haram al Sharif

A model of the Haram-al-Sharif made in 1879 by Conrad Schlick. The model can be seen in the Bijbels Museum in Amsterdam

Upon the capture of Jerusalem by the victorious Caliph Omar, Omar immediately headed to the Temple Mount with his advisor, Ka’ab al-Ahbar, a formerly Jewish rabbi who had converted to Islam, in order to find the holy site of the “Furthest Mosque” or Al Masjid al Aqsa which was mentioned in the Quran and specified in the Hadiths of being in Jerusalem.Ka’ab al-Ahbar suggested to Caliph Omar to build the Dome of the Rock monument on the site that Ka’ab believed to be the Biblical Holy of the Holies, arguing that this site is where Mohammad ascended to heaven during the Isra and Mi’raj miracle. The actual construction of the Muslim monuments at the southeast corner, facing Mecca, near which the al-Aqsa Mosque were built 78 years later. The original building is now known to have been wooden and to have been constructed on the site of a Byzantine public building with an elaborate mosaic floor. (The Persian conquest that immediately preceded the Arab conquest makes it uncertain who destroyed the building.)[19]

In 691 an octagonal Islamic building topped by a dome was built by the Caliph Abd al-Malik around the rock, for a myriad of political, dynastic and religious reasons, built on local and Koranic traditions articulating the site’s holiness, a process in which textual and architectural narratives reinforced one another.[21] The shrine became known as the Dome of the Rock (Qubbat as-Sakhra قبة الصخرة). The dome itself was covered in gold in 1920. In 715 the Umayyads led by the Caliph al-Walid I, rebuilt the Temple’s nearby Chanuyot into a mosque (see illustrations and detailed drawing) which they named al-Masjid al-Aqsa المسجد الأقصى, the al-Aqsa Mosque or in translation “the furthest mosque”, corresponding to the Islamic belief of Muhammad’s miraculous nocturnal journey as recounted in the Qur’an and hadith. The term al-Haram al-Sharif الحرم الشريف (the Noble Sanctuary) refers to the whole area that surrounds that Rock as was called later by the Mamluks and Ottomans.[22]

For Muslims, the importance of the Dome of the Rock and al-Aqsa Mosque makes Jerusalem the third-holiest city, after Mecca and Medina. The mosque and shrine are currently administered by a Waqf (an Islamic trust). The various inscriptions on the Dome walls and the artistic decorations imply on symbolic eschatological significance of the structure.

From the Arabic Conquest to the Crusades there seems to have been good relations between the Arab rulers and the Jewish minority. A Jewish synagogue was built on the Temple Mount. Its location has not been established, but it was destroyed by the Crusaders when they took the city and massacred the Jews and Muslims in 1099.

[edit] Ottoman period

Following the Ottoman conquest of Palestine in 1516, the Ottoman authorities continued the policy of prohibiting non-Muslims from setting foot on the Temple Mount until the early 19th-century, when non-Muslims were again permitted to visit the site.[17]

In 1867, a team from the Royal Engineers, led by Lieutenant Charles Warren and financed by the Palestine Exploration Fund (P.E.F.), discovered a series of underground tunnels near the Temple Mount. Warren secretly excavated some tunnels near the Temple Mount walls and was the first one to document their lower courses. Warren also conducted some small scale excavations inside the Temple Mount, by removing rubble that blocked passages leading from the Double Gate chamber.

[edit] British Mandate period

Between 1922 and 1924, the Dome of the Rock was restored by the Islamic Higher Council.[23]

[edit] Jordanian period

Jordan undertook two renovations of the Dome of the Rock, replacing the leaking, wooden dome with an aluminum dome in 1952, and, when the new dome leaked, carrying out a second restoration between 1959 and 1964.[23]

Neither Israeli Arabs nor Israeli Jews could visit their holy places in the Jordanian territories during this period.[24][25]

[edit] Israeli period

During the 1967 Six-Day War Israel captured the Temple Mount together with all of East Jerusalem and the West Bank from Jordan, who had controlled it since 1948. The Chief Rabbi of the Israeli Defense Forces, Shlomo Goren, led the soldiers in religious celebrations on the Temple Mount and at the Western Wall. The Israeli Chief Rabbinate also declared a religious holiday on the anniversary, called “Yom Yerushalayim” (Jerusalem Day), which also became a national holiday that commemorates the reunification of the city. Many Jews saw the capture of Jerusalem and the Temple Mount as a miraculous liberation of biblical-messianic proportion.[citation needed]

A few days after the war was over 200,000 Jews flocked to the Western Wall in the first mass Jewish pilgrimage near the mount since the destruction of Temple in 69 CE. However, the Israeli government subsequently left the Islamic waqf in control of the site. The site has become a flash-point between Israel and the Muslim world.

On October 8, 1990, Israeli forces patrolling the site blocked worshipers from accessing it. A tear gas canister was accidentally detonated among the female worshipers, which caused events to escalate.[26] Rocks were eventually thrown, while security forces fired rounds that ended up killing 20 people and injured around 140 more. An Israeli enquiry found Israeli forces at fault, but it also concluded that charges could not be brought against any particular individuals.[27]

Between 1992 and 1994, the Jordanian government undertook the unprecedented step of gilding the dome of the Dome of the Rock, covering it with 5000 gold plates, and restoring and reinforcing the structure. The Salah Eddin minbar was also restored. The project was paid for by King Hussein personally, at a cost of $8 million.[23]

The Second Palestinian Intifada is often cited as being sparked by a visit made to the Temple Mount by Israeli opposition leader Ariel Sharon. He toured the site, together with a Likud party delegation and a large number of Israeli riot police, on September 28, 2000. The visit was seen as a provocative gesture by many Palestinians, who gathered around the site. Demonstrations soon turned violent, with both rubber bullets and tear gas being used. This event is often cited as one of the catalysts of the Second Intifada.[28]

Also in this period, Palestinian authorities have begun excavations at the Temple Mount, damaging the structural integrity of the site; see below.

[edit] Management and access

Sign in Hebrew and English outside the Temple Mount stating what the Torah says about entering the area

An Islamic Waqf has managed the Temple Mount continuously since the Muslim reconquest of the Kingdom of Jerusalem in 1187. On June 7, 1967, soon after Israel had taken control of the area during the Six-Day War, Prime Minister Levi Eshkol assured that “no harm whatsoever shall come to the places sacred to all religions”. Together with the extension of Israeli jurisdiction and administration over east Jerusalem, the Knesset passed the Preservation of the Holy Places Law,[29] ensuring protection of the Holy Places against desecration, as well as freedom of access thereto.[30] Israel agreed to leave administration of the site in the hands of the Waqf.

Although freedom of access was enshrined in the law, as a security measure, the Israeli government currently enforces a ban on non-Muslim prayer on the site. Non-Muslims who are observed praying on the site are subject to expulsion by the police.[31] At various times, when there is fear of Arab rioting upon the mount resulting in throwing stones from above towards the Western Wall Plaza, Israel has prevented Muslim men under 45 from praying in the compound, citing these concerns.[32] Sometimes such restrictions have coincided with Friday prayers during the Islamic holy month of Ramadan.[33] Normally, West Bank Palestinians are allowed access to Jerusalem only during Islamic holidays, with access usually restricted to men over 35 and women of any age eligible for permits to enter the city.[34] Palestinian residents of Jerusalem, which because of Israel’s annexation of Jerusalem, hold Israeli permanent residency cards, and Israeli Arabs, are permitted unrestricted access to the Temple Mount.

[edit] Current features

An additional flat platform was built above the portion of the hill rising above the general level of the top of the Temple Mount, and this upper platform is the location of the Dome of the Rock; the rock in question is the bedrock at the peak of the hill, just breaching the floor level of the upper platform. Beneath the rock is a natural cave known as the Well of Souls, originally accessible only by a narrow hole in the rock itself, Crusaders hacked open an entrance to the cave from the south, by which it can now be entered. There is also a smaller domed building on the upper platform, slightly to the east of the Dome of the Rock, known as the Dome of the Chain — traditionally the location where a chain once rose to heaven. Several stairways rise to the upper platform from the lower; that at the northwest corner is believed by some archaeologists be part of a much wider monumental staircase, mostly hidden or destroyed, and dating from the Second Temple era.

The al-Kas ablution fountain for Muslim worshipers on the southern portion of the lower platform.

The lower platform – which constitutes most of the surface of the Temple Mount – has at its southern end the al-Aqsa Mosque, which takes up most of the width of the Mount. Gardens take up the eastern and most of the northern side of the platform; the far north of the platform houses an Islamic school.[35] The lower platform also houses a fountain (known as al-Kas), originally supplied with water via a long narrow aqueduct leading from pools at Bethlehem (colloquially known as Solomon’s Pools), but now supplied from Jerusalem’s water mains. There are several cisterns embedded in the lower platform, designed to collect rain water as a water supply. These have various forms and structures, seemingly built in different periods by different architects, ranging from vaulted chambers built in the gap between the bedrock and the platform, to chambers cut into the bedrock itself. Of these, the most notable are (numbering traditionally follows Wilson’s scheme[36]):

  • Cistern 1 (located under the northern side of the upper platform). There is a speculation that it had a function connected with the altar of the Second Temple (and possibly of the earlier Temple),[37] or with the bronze sea.
  • Cistern 5 (located under the south eastern corner of the upper platform) — a long and narrow chamber, with a strange anti-clockwise curved section at its north western corner, and containing within it a doorway currently blocked by earth. The cistern’s position and design is such that there has been speculation it had a function connected with the altar of the Second Temple (and possibly of the earlier Temple), or with the bronze sea. Charles Warren thought that the altar of burnt offerings was located at the north western end.[38]
  • Cistern 8 (located just north of the al-Aqsa Mosque) — known as the Great Sea, a large rock hewn cavern, the roof supported by pillars carved from the rock; the chamber is particularly cave-like and atmospheric,[39] and its maximum water capacity is several hundred thousand gallons.
  • Cistern 9 (located just south of cistern 8, and directly under the al-Aqsa Mosque) — known as the Well of the Leaf due to its leaf-shaped plan, also rock hewn.
  • Cistern 11 (located east of cistern 9) — a set of vaulted rooms forming a plan shaped like the letter E. Probably the largest cistern, it has the potential to house over 700,000 gallons of water.
  • Cistern 16/17 (located at the centre of the far northern end of the Temple Mount). Despite the currently narrow entrances, this cistern (17 and 16 are the same cistern) is a large vaulted chamber, which Warren described as looking like the inside of the cathedral at Cordoba (which was previously a mosque). Warren believed that it was almost certainly built for some other purpose, and was only adapted into a cistern at a later date; he suggested that it might have been part of a general vault supporting the northern side of the platform, in which case substantially more of the chamber exists than is used for a cistern.

The eastern set of Hulda gates.

Robinson’s Arch, situated on the southwestern flank, once supported a staircase that led to the Mount.

The walls of the platform contain several gateways, all currently blocked. In the east wall is the Golden Gate, through which legend states the Jewish Messiah would enter Jerusalem. On the southern face are the Hulda Gates — the triple gate (which has three arches) and the double gate (which has two arches, and is partly obscured by a Crusader building); these were the entrance and exit (respectively) to the Temple Mount from Ophel (the oldest part of Jerusalem), and the main access to the Mount for ordinary Jews. In the western face, near the southern corner, is the Barclay’s Gate – only half visible due to a building on the northern side. Also in the western face, hidden by later construction but visible via the recent Western Wall Tunnels, and only rediscovered by Warren, is Warren’s Gate; the function of these western gates is obscure, but many Jews view Warren’s Gate as particularly holy, due to its location due west of the Dome of the Rock. Traditional belief considers the Dome of the Rock to have earlier been the location at which the Holy of Holies was placed; numerous alternative opinions exist, based on study and calculations, such as those of Tuvia Sagiv.[40]

Warren was able to investigate the inside of these gates. Warren’s Gate and the Golden Gate simply head towards the centre of the Mount, fairly quickly giving access to the surface by steps.[41] Barclay’s Gate is similar, but abruptly turns south as it does so; the reason for this is currently unknown. The double and triple gates (the Huldah Gates) are more substantial; heading into the Mount for some distance they each finally have steps rising to the surface just north of the al-Aqsa Mosque.[42] The passageway for each is vaulted, and has two aisles (in the case of the triple gate, a third aisle exists for a brief distance beyond the gate); the eastern aisle of the double gates and western of the triple gates reach the surface, the other aisles terminating some way before the steps – Warren believed that one aisle of each original passage was extended when the al-Aqsa Mosque blocked the original surface exits.

East of and joined to the triple gate passageway is a large vaulted area, supporting the southeastern corner of the Temple Mount platform – which is substantially above the bedrock at this point – the vaulted chambers here are popularly referred to as King Solomon’s Stables.[43] They were used as stables by the Crusaders, but were built by Herod the Great – along with the platform they were built to support. In the process of investigating Cistern 10, Warren discovered tunnels that lay under the Triple Gate passageway.[44] These passages lead in erratic directions, some leading beyond the southern edge of the Temple Mount (they are at a depth below the base of the walls); their purpose is currently unknown – as is whether they predate the Temple Mount – a situation not helped by the fact that apart from Warren’s expedition no one else is known to have visited them.

The existing four minarets include three near the Western Wall and one near the northern wall. The first minaret was constructed on the southwest corner of the Temple Mount in 1278. The second was built in 1297 by order of a Mameluk king, the third by a governor of Jerusalem in 1329, and the last in 1367.

[edit] Alterations to antiquities and damage to existing structures

Due to the extreme political sensitivity of the site, no real archaeological excavations have even been conducted on the Temple Mount itself. Protests commonly occur whenever archaeologists conduct projects near the Mount. Aside from visual observation of surface features, most other archaeological knowledge of the site comes from the 19th century survey carried out by Charles Wilson and Charles Warren and others. This sensitivity has not prevented the Muslim Waqf from destroying archeological evidence on a number of occasions.[45][46][47][48]

After the Six-Day War of 1967, Israeli archeologists began a series of excavations near the site at the southern wall that uncovered finds from the Second Temple period through Roman, Umayyad and Crusader times.[49] Over the period 1970–88, a number of tunnels were excavated in the vicinity, including one that passed to the west of the Mount and became known as the Western Wall Tunnel, which was opened to the public in 1996.[50][51] The same year the Waqf began construction of a new mosque in the structures known since Crusader times as Solomon’s Stables. Many Israelis regarded this as a radical change of the status quo, which should not have been undertaken without first consulting the Israeli government. The project was done without attention to the possibility of disturbing historically significant archaeological material, with stone and ancient artifacts treated without regard to their preservation.[52]

In October 1999, the Islamic Waqf, and the Islamic Movement conducted an illegal[citation needed] dig which inflicted much archaeological damage. The earth from this operation, which has archeological wealth relevant to Jewish, Christian and Muslim history, was removed by heavy machinery and unceremoniously dumped by trucks into the nearby Kidron Valley. Although the archeological finds in the earth are already not in situ, this soil still contains great archeological potential. No archeological excavation was ever conducted on the Temple Mount, and this soil was the only archeological information that has ever been available to anyone. For this reason Israeli archaeologists Dr. Gabriel Barkay and Zachi Zweig established a unique project for sifting all the earth in this dump: the Temple Mount Antiquities Salvage Operation. Among finds uncovered in rubble removed from the Temple Mount were:

  • The imprint of a seal thought to have belonged to a priestly Jewish family mentioned in the Old Testament’s Book of Jeremiah.
  • More than 4300 coins from various periods. Many of them are from the Jewish revolt that preceded the destruction of the Second Temple by Roman legions in 70 CE emblazoned with the words “Freedom of Zion”
  • Arrowheads shot by Babylonian archers 2,500 years ago, and others launched by Roman siege machinery 500 years later.
  • Unique floor slabs of the ‘opus sectile‘ technique that were used to pave the Temple Mount courts. This is also mentioned in Josephus accounts and the Babylonian Talmud.

In late 2002, a bulge of about 700 mm was reported in the southern retaining wall part of the Temple Mount. A Jordanian team of engineers recommended replacing or resetting most of the stones in the affected area.[53] In February 2004, the eastern wall of the Mount was damaged by an earthquake. The damage threatened to topple sections of the wall into the area known as Solomon’s Stables.[54] A few days later, a portion of retaining wall, supporting the earthen ramp that led from the Western Wall plaza to the Gate of the Moors on the Temple Mount, collapsed.[55] In 2007 the Israel Antiquities Authority started work on the construction of a temporary wooden pedestrian pathway to replace the Mugrabi Gate ramp after a landslide in 2005 made it unsafe and in danger of collapse.[56] The works sparked condemnation from Arab leaders.[57]

In July 2007 the Muslim religious trust which administers the Mount began digging a 400-metre-long, 1.5-metre-deep trench[58] from the northern side of the Temple Mount compound to the Dome of the Rock[59] in order to replace 40-year-old[60] electric cables in the area. Israeli archaeologists accused the waqf of a deliberate act of cultural vandalism.[59]

Southern Wall of Temple Mount, southwestern corner.

Israelis allege that Palestinians are deliberately removing significant amounts of archaeological evidence about the Jewish past of the site and claim to have found significant artifacts in the fill removed by bulldozers and trucks from the Temple Mount. Muslims allege that the Israelis are deliberately damaging the remains of Islamic-era buildings found in their excavations.[61] Since the Waqf is granted almost full autonomy on the Islamic holy sites, Israeli archaeologists have been prevented from inspecting the area; although they have conducted several excavations around the Temple Mount.

[edit] Religious attitudes

This section needs additional citations for verification. (December 2009)

[edit] In Judaism

Presumed to be The Foundation Stone, or a large part of it

Jewish connection and veneration to the site arguably stems from the fact that it contains the Foundation Stone which, according to the rabbis of the Talmud, was the spot from where the world was created and expanded into its current form.[62][63] It was subsequently the Holy of Holies of the Temple, the Most Holy Place in Judaism.[17] Jewish tradition names it as the location for a number of important events which occurred in the Bible, including the Binding of Isaac, Jacob‘s dream, and the prayer of Isaac and Rebekah.[64] Similarly, when the Bible recounts that King David purchased a threshing floor owned by Araunah the Jebusite,[65] tradition locates it as being on this mount. An early Jewish text, the Genesis Rabba, states that this site is one of three about which the nations of the world cannot taunt Israel and say “you have stolen them,” since it was purchased “for its full price” by David.[66] David wanted to construct a sanctuary there, but this was left to his son Solomon, who completed the task in c. 950 BCE with the construction of the First Temple.

In 1217, Spanish Rabbi Judah al-Harizi found the sight of the Muslim structures on the mount profoundly disturbing. “What torment to see our holy courts converted into an alien temple!” he wrote.[67]

Due to religious restrictions on entering the most sacred areas of the Temple Mount (see following section), the Western Wall, a retaining wall for the Temple Mount and remnant of the Second Temple structure, is considered by some rabbinical authorities the holiest accessible site for Jews to pray. Jewish texts record that the Mount will be the site of the Third Temple, which will be rebuilt with the coming of the Jewish Messiah.

[edit] Jewish religious law concerning entry to the site

During Temple times, entry to the Mount was limited by a complex set of purity laws. Maimonides wrote that it was only permitted to enter the site to fulfill a religious precept. After the destruction of the Temple there was discussion as to whether the site, bereft of the Temple, still maintained its holiness or not. Jewish codifiers accepted the opinion of Maimonides who ruled that the holiness of the Temple sanctified the site for eternity and consequently the restrictions on entry to the site are still currently in force.[17] While secular Jews ascend freely, the question of whether ascending is permitted is a matter some debate among religious authorities, with a majority holding that it is permitted to ascend to the Temple Mount, but not to step on the site of the inner courtyards of the ancient Temple.[17] The question then becomes whether the site can be ascertained accurately.[17] A second complex legal debate centers around the precise divine punishment for stepping onto these forbidden spots.

There is debate over whether reports that Maimonides himself ascended the Mount are reliable.[68] One such report[69] claims he did so on Thursday, October 21, 1165, during the Crusader period. Some early scholars however, claim that entry onto certain areas of the Mount are permitted. It appears that Radbaz also entered the Mount and advised others how to do this. He permits entry from all the gates into the 135×135 cubits of the Women’s Courtyard in the east, since the biblical prohibition only applies to the 187×135 cubits of the Temple in the west.[70] There are also Christian and Islamic sources which indicate that Jews accessed the site,[71] but these visits may have been made under duress.[72]

1978 sign warning against entry to the Mount

[edit] Opinions of contemporary rabbis concerning entry to the site

In August 1967 after Israel’s capture of the Mount, the Chief Rabbis of Israel, Isser Yehuda Unterman and Yitzhak Nissim, together with other leading rabbis, asserted that “For generations we have warned against and refrained from entering any part of the Temple Mount.”[73] A recent study of this rabbinical ruling suggests that it was both “unprecedented” and possibly prompted by governmental pressure on the rabbis, as well as “brilliant” in preventing Muslim-Jewish friction on the Mount.[17][74]

Rabbinical consensus in the post-1967 period in the Religious Zionist stream of Orthodox Judaism held that it is forbidden for Jews to enter any part of the Temple Mount,[75] and in January 2005 a declaration was signed confirming the 1967 decision.[76]

Nearly all Haredi rabbis are also of the opinion that the Mount is off limits to Jews and non-Jews alike.[77] Their opinions against entering the Temple Mount are based on the danger of entering the hallowed area of the Temple courtyard and the impossibility of fulfilling the ritual requirement of cleansing oneself with the ashes of a red heifer.[78][79] The boundaries of the areas which are completely forbidden, while having large portions in common, are delineated differently by various rabbinic authorities.

However, there is a growing body of Modern Orthodox and national religious rabbis who encourage visits to certain parts of the Mount, which they believe are permitted according to most medieval rabbinical authorities.[17] These rabbis include: Shlomo Goren (former Ashkenazi Chief Rabbi of Israel); Chaim David Halevi (former Chief Rabbi of Tel Aviv and Yaffo); Dov Lior (Rabbi of Kiryat Arba); Yosef Elboim; Yisrael Ariel; She’ar Yashuv Cohen (Chief Rabbi of Haifa); Yuval Sherlo (rosh yeshiva of the hesder yeshiva of Petah Tikva); Meir Kahane. One of them, Shlomo Goren, states that it is possible that Jews are even allowed to enter the heart of the Dome of the Rock, according to Jewish Law of Conquest.[80] These authorities demand an attitude of veneration on the part of Jews ascending the Temple Mount, ablution in a mikveh prior to the ascent, and the wearing of non-leather shoes.[17] Some rabbinic authorities are now of the opinion that it is imperative for Jews to ascend in order to halt the ongoing process of Islamization of the Temple Mount. Maimonides, perhaps the greatest codifier of Jewish Law, wrote in Laws of the Chosen House ch 7 Law 15 “One may bring a dead body in to the (lower sanctified areas of the) Temple Mount and there is no need to say that the ritually impure (from the dead) may enter there, because the dead body itself can enter”. One who is ritually impure through direct or in-direct contact of the dead cannot walk in the higher sanctified areas. For those who are visibly Jewish, they have no choice, but to follow this peripheral route as it has become unofficially part of the status quo on the Mount. Many of these recent opinions rely on archaeological evidence.[17]

The law committee of the Masorti movement in Israel has issued two responsa (a body of written decisions and rulings given by legal scholars) on the subject, both holding that Jews may visit the permitted sections of the Temple Mount. One responsa allows such visits, another encourages them.

[edit] In Islam

Facade of the Al-Aqsa Mosque

In Islam, the Mount is called al-haram al-qudsī ash-sharīf, meaning the Noble Sanctuary. Muslims view the site as being one of the earliest and most noteworthy places of worship of God. For a few years in the early stages of Islam, Muhammad instructed his followers to face the Mount during prayer, as the Jews did.

The site is also important as being the site of the “Farthest Mosque” (mentioned in the Qur’an as the location of Muhammad’s miraculous Night Journey) to heaven.:

“Exalted is He who took His Servant by night from al-Masjid al-Haram (the Sacred Mosque) to al-Masjid al-Aqsa (the Further Mosque), whose surroundings We have blessed, to show him of Our signs. Indeed, He is the Hearing, the Seeing.” Quran 17:1 [81]

The hadith, a collection of the sayings of the Prophet Mohammad, confirm that the location of the Al-Aqsa mosque is indeed in Jerusalem:

“When the people of Quraish did not believe me (i.e. the story of my Night Journey), I stood up in Al-Hijr and Allah displayed Jerusalem in front of me, and I began describing Jerusalem to them while I was looking at it.” Sahih Bukhari: Volume 5, Book 58, Number 226. [82]

Muslim interpretations of the Qur’an agree that the Mount is the site of a Temple built by Sulayman, considered a prophet in Islam, that was later destroyed.[83]

After the construction, Muslims believe, the temple was used for the worship of one God by many prophets of Islam, including Jesus.[84][85][86] Other Muslim scholars have used the Torah (called Tawrat in Arabic) to expand on the details of the temple.[87]

[edit] In Christianity

The Mount has significance in Christianity due to the role the Temple played in the life of Jesus. During the Crusades, the Dome of the Rock was given to the Augustinians, who turned it into a church, and the Al-Aqsa Mosque became the royal palace of Baldwin I of Jerusalem in 1104. The Knights Templar, who believed the Dome of the Rock was the site of the Temple of Solomon, gave it the name “Templum Domini” and set up their headquarters in the Al-Aqsa Mosque adjacent to the Dome for much of the 12th century.

Though some Christians believe that the Temple will be reconstructed before, or concurrent with, the Second Coming of Jesus (also see dispensationalism), the Temple Mount is largely unimportant to the beliefs and worship of most Christians. To wit, the New Testament recounts a story of a Samaritan woman asking Jesus about the appropriate place to worship, Jerusalem or the Samaritan holy place at Mt. Gerazim, to which Jesus replies, “Woman, believe me, the hour is coming when neither on this mountain nor in Jerusalem will you worship the Father. You worship what you do not know; we worship what we know, for salvation is from the Jews. But the hour is coming, and is now here, when the true worshipers will worship the Father in spirit and in truth, for the Father is seeking such people to worship him. God is spirit, and those who worship him must worship in spirit and truth.”(John 4:21-24)

The place is of some importance to Eastern Christians because there was a fully consecrated church on that spot during the Byzantine period. According to Eastern Church canons, once a church has been fully consecrated, it cannot ever serve as anything other than a church. Of course, this is just one example of the thousands of churches that were either destroyed, or converted to mosques, during the long decline of the Eastern Roman Empire. The most notable example is the Hagia Sophia in Istanbul.

[edit] Recent events

March 2005
Allah inscription: The word “Allah“, in approximately a foot-tall Arabic script, was found newly carved into the ancient stones, an act viewed by Jews as vandalism. The carving was attributed to a team of Jordanian engineers and Palestinian laborers in charge of strengthening that section of the wall. The discovery caused outrage among Israeli archaeologists and many Jews were angered by the inscription at Judaism’s holiest site.[88]
October 2006
Synagogue proposal: Uri Ariel, a member of the Knesset from the National Union party (a right wing opposition party) ascended to the mount,[89] and said that he is preparing a plan where a synagogue will be built on the mount. His proposed synagogue would not be built instead of the mosques but in a separate area in accordance with rulings of ‘prominent rabbis.’ He said he believed that this will be correcting a historical injustice and that it is an opportunity for the Muslim world to prove that it is tolerant to all faiths.[90]
October 2006
Minaret proposal: Plans are mooted to build a new minaret on the mount, the first of its kind for 600 years.[91] King Abdullah II of Jordan announced a competition to design a fifth minaret for the walls of the Temple Mount complex. He said it would “reflect the Islamic significance and sanctity of the mosque”. The scheme, estimated to cost $300,000, is for a seven-sided tower – after the seven-pointed Hashemite star – and at 42 metres (138 ft), it would be 3.5 metres (11 ft) taller than the next-largest minaret. The minaret would be constructed on the eastern wall of the Temple Mount near the Golden Gate.
February 2007
Mugrabi Gate ramp reconstruction: Repairs to an earthen ramp leading to the Mugrabi Gate sparked Arab protests.
May 2007
Right-wing Jews ascend the Mount: A group of right-wing Religious Zionist rabbis entered the Temple Mount.[92] This elicited widespread criticism from other religious Jews and from secular Israelis, accusing the rabbis of provoking the Arabs. An editorial in the newspaper Haaretz accused the rabbis of ‘knowingly and irresponsibly bringing a burning torch closer to the most flammable hill in the Middle East,’ and noted that rabbinical consensus in both the Haredi and the Religious Zionist worlds forbids Jews from entering the Temple Mount.[93] On May 16, Rabbi Avraham Shapiro, former Ashkenazi Chief Rabbi of Israel and rosh yeshiva of the Mercaz HaRav yeshiva, reiterated his opinion that it is forbidden for Jews to enter the Temple Mount.[94] The Litvish Haredi newspaper Yated Ne’eman, which is controlled by leading Litvish Haredi rabbis including Rabbi Yosef Sholom Eliashiv and Rabbi Nissim Karelitz, accused the rabbis of transgressing a decree punishable by ‘death through the hands of heaven.’[79]
July 2007
Temple Mount cable replacement: The Waqf began digging a ditch from the northern side of the Temple Mount compound to the Dome of the Rock as a prelude to infrastructure work in the area. Although the dig was approved by the police, it generated protests from archaeologists.
October 2009
Clashes: Palestinian protesters gathered at the site after rumours that an extreme Israeli group would harm the site, which the Israeli government denied.[95] Israeli police assembled at the Temple Mount complex to disperse Palestinian protesters who were throwing stones at them. The police used stun grenades on the protesters, of which 15 were later arrested, including the Palestinian President’s adviser on Jerusalem affairs.[96][97] 18 Palestinians and 3 police officers were injured.[98]
July 2010
A public opinion poll in Israel showed that 50% of Israelis believe that the Temple should be rebuilt. The poll was conducted by channel 99, the government owned Knesset channel, in advance of the 9th day of the Hebrew month of Av on which Jews commemorate the destruction of both the first and second Temples that both stood at this site.[99]
July 2010
Knesset Member Danny Danon visited the Temple Mount in accordance with rabbinical views of Jewish Law on the 9th of the Hebrew Month of Av, which commemorates the destruction of both the First and Second Temples in Jerusalem. The Knesset Member condemned the conditions imposed by Muslims upon religious Jews at the site and vowed to work to better conditions.[citation needed]

[edit] Panorama

Panorama of the Temple Mount, seen from the Mount of Olives

[edit] See also

Wikimedia Commons has media related to: Temple Mount

[edit] References

  1. ^ New Jerusalem Finds Point to the Temple Mount
  2. ^ Maimonides, Mishneh Torah, Avoda (Divine Service): The laws of the Temple in Jerusalem, chapter 14, rule 16
  3. ^ Nicolle, David (1994). Yarmuk AD 636: The Muslim Conquest of Syria. Osprey Publishing.
  4. ^ Rizwi Faizer (1998). “The Shape of the Holy: Early Islamic Jerusalem”. Rizwi’s Bibliography for Medieval Islam. Archived from the original on 2002-02-10. http://web.archive.org/web/20020210164811/http://us.geocities.com/rfaizer/reviews/book9.html
  5. ^ Haram al-Sharif, ArchNet
  6. ^ Israeli Police Storm Disputed Jerusalem Holy Site
  7. ^ Gonen (2003), pp. 9-11
  8. ^ Lundquist (2007), p. 103
  9. ^ Finkelstein, Horbury, Davies & Sturdy (1999), p. 43
  10. ^ II Sam. xxiv. 16 et seq.; I Chron. xxi. 15 et seq.
  11. ^ “Moriah”. Easton’s Bible Dictionary. http://www.ccel.org/ccel/easton/ebd2.html?term=Moriah. Retrieved July 14, 2008. 
  12. ^ Gonen (2003), p. 69
  13. ^ Negev (2005), p. 265
  14. ^ Mazar (1975), pp. 124-126, 132
  15. ^ Encyclopædia Britannica 11th Edition
  16. ^ Wilkinson, Jerusalem Pilgrims Before the Crusades, p. 204
  17. ^ a b c d e f g h i j k l m “Entering the Temple Mount – in Halacha and Jewish History,” Gedalia Meyer and Henoch Messner, PDF available at [1], VOl 10, Summer 2010, Hakirah.
  18. ^ See “Julian and the Jews 361-363 CE” and “Julian the Apostate and the Holy Temple”.
  19. ^ a b Was the Aksa Mosque built over the remains of a Byzantine church?[dead link], By ETGAR LEFKOVITS, Jerusalem Post, November 16, 2008]
  20. ^ Karmi, Ghada (1997). Jerusalem Today: What Future for the Peace Process?. Garnet & Ithaca Press. p. 116. ISBN 0-86372-226-1
  21. ^ The Dome of the Rock as Palimpsest, Necipoglu, Muqarnas 2008
  22. ^ Oleg Grabar, The Haram ak-Sharif: An essay in interpretation, BRIIFS vol. 2 no 2 (Autumn 2000).</ref name=MeyerMessner>”Entering the Temple Mount – in Halacha and Jewish History,” Gedalia Meyer and Henoch Messner, PDF available at [2], VOl 10, Summer 2010, Hakirah.
  23. ^ a b c “Hashemite Restorations of the Islamic Holy Places in Jerusalem”, Jordanian government website.
  24. ^ Martin Gilbert, Jerusalem in the Twentieth Century (New York: John Wiley & Sons, 1996, p254.
  25. ^ Israeli, Raphael (2002). “Introduction: Everyday Life in Divided Jerusalem”. Jerusalem Divided: The Armistice Regime, 1947–1967. Jerusalem: Routledge. p. 23. ISBN 0-7146-5266-0
  26. ^ “RECONSTRUCTION OF EVENTS (REVISED) AL-HARAM AL-SHARIF, JERUSALEM MONDAY, 8 OCTOBER 1990”. UN. October 8, 1990. http://unispal.un.org/UNISPAL.NSF/0/C6AA06BDFB5B5453052566DB0055512F. Retrieved April 12, 2012. 
  27. ^ “Judge Blames Israeli Police In Killing Of Palestinians”. Sun Sentinel. July 19, 1991. http://articles.sun-sentinel.com/1991-07-19/news/9101260807_1_criminal-charges-killings-ezra-kama. Retrieved April 12, 2012. 
  28. ^ “2000: ‘Provocative’ mosque visit sparks riots”. BBC. April 12, 2012. http://news.bbc.co.uk/onthisday/hi/dates/stories/september/28/newsid_3687000/3687762.stm. Retrieved April 12, 2012. 
  29. ^ Preservation of the Holy Places Law, 1967.
  30. ^ Jerusalem – The Legal and Political Background, Ministry of Foreign Affairs, Government of Israel.
  31. ^ Nadav Shragai, Three Jews expelled from Temple Mount for praying.
  32. ^Heavy security around al-Aqsa,” Al Jazeera English, October 5, 2009.
  33. ^PROTECTION OF CIVILIANS 16 – 29 SEPTEMBER 2009“, UNITED NATIONS Office for the Coordination of Humanitarian Affairs occupied Palestinian territory.
  34. ^ http://news.yahoo.com/palestinians-flock-jerusalem-israeli-restrictions-eased-152403694.html
  35. ^ Photograph of the northern wall area
  36. ^ Wilson’s map of the features under the Temple Mount
  37. ^ Kaufman, Asher (May 23, 1991). “The Temple Site” (Abstract). The Jerusalem Post: p. 13. http://pqasb.pqarchiver.com/jpost/access/99716364.html?dids=99716364:99716364&FMT=ABS&FMTS=ABS:FT&date=May+12%2C+1991&author=Asher+Kaufman&pub=Jerusalem+Post&edition=&startpage=13&desc=THE+TEMPLE+SITE. Retrieved March 4, 2007. “The most important findings of the superposition of the Second Temple on the Temple area are that the Dome of the Rock was not built on the site of the Temple, and that the Temple was taper-shaped on the western side, a form hitherto unknown to the scholars.” 
  38. ^ “Researcher says found location of the Holy Temple”. Ynetnews. February 9, 2007. http://www.ynetnews.com/articles/0,7340,L-3362927,00.html. Retrieved March 4, 2007. “Archaeology Professor Joseph Patrich uncovered a large water cistern that points, in his opinion, to the exact location of the altar and sanctuary on the Temple Mount. According to his findings, the rock on which the Dome of the Rock is built is outside the confines of the Temple.” 
  39. ^ Under the Temple Mount
  40. ^ Tuvia Sagiv, Determination of the location of the Temple
  41. ^ Photograph of the inside of the Golden Gate
  42. ^ image of the double gate passage
  43. ^ Photograph of King Solomon’s Stables
  44. ^ Photograph of one of the chambers under the Triple Gate passageway
  45. ^ See “The Washington Post, Opinion Columns, July 17, 2000 Protect the Temple Mount by Hershel Shanks
  46. ^ Policeman Assaulted Trying to Stop Illegal Temple Mount Dig – Jewish World – Israel News – Arutz Sheva
  47. ^ Jerusalem’s Temple Mount Flap
  48. ^ Waqf Temple Mount excavation raises archaeologists’ protests – Haaretz – Israel News
  49. ^ Jacqueline Schaalje, Special: The Temple Mount in Jerusalem.
  50. ^ Violent clashes at key Jerusalem mosque on ‘day of anger’, timesonline, accessdate=5 May 2009
  51. ^ Mayor halts Temple Mount dig, BBC, accessdate = 5 May 2009
  52. ^ Temple Mount destruction stirred archaeologist to action, February 8, 2005 | by Michael McCormack, Baptist Press [3]
  53. ^ Esther Hecht, Battle of the Bulge
  54. ^ Jerusalem Post
  55. ^ On-the-Spot Report from the Kotel Women´s Section Construction
  56. ^ Fendel, Hillel (February 7, 2007). “Jerusalem Arabs Riot, Kassams Fired, After Old City Excavations”. Arutz Sheva. http://www.israelnationalnews.com/news.php3?id=121064. Retrieved February 7, 2007. 
  57. ^ Weiss, Efrat (February 7, 2007). “Syria slams Jerusalem works”. Yedioth Ahronoth. http://www.ynetnews.com/articles/0,7340,L-3362024,00.html. Retrieved February 7, 2007. “Israeli excavation works near the al-Aqsa mosque in the holy city of Jerusalem have led to a dangerous rise in Middle East tensions and could derail revival of Arab-Israeli peace talks… what Israel is doing in its practices and attacks against our sacred Muslim sites in Jerusalem and al-Aqsa is a blatant violation that is not acceptable under any pretext” 
  58. ^ Fendel, Hillel (September 9, 2007). “Silence in the Face of Continued Temple Mount Destruction”. Arutz Sheva. http://www.israelnationalnews.com/News/News.aspx/123622. Retrieved 2007-09-07. 
  59. ^ a b Rapoport, Meron (July 7, 2007). “Waqf Temple Mount excavation raises archaeologists’ protests”. Haaretz. http://www.haaretz.com/hasen/spages/880761.html. Retrieved 2007-07-11. 
  60. ^ Teible, Amy (August 31, 2007). “Jerusalem Holy Site Dig Questioned”. The Guardian. http://www.guardian.co.uk/worldlatest/story/0,,-6887208,00.html. Retrieved 2007-09-07. [dead link]
  61. ^ Al-Ahram: “Revoking the death warrant”
  62. ^ Babylonian Talmud Yoma 54b
  63. ^ http://www.torah.org/features/israelmatters/eye.html#
  64. ^ Toledot 25:21
  65. ^ 2 Samuel 24:18–25
  66. ^ Genesis Rabba 79.7: “And he bought the parcel of ground, where he had spread his tent…for a hundred pieces of money.” Rav Yudan son of Shimon said: ‘This is one of the three places where the non-Jews cannot deceive the Jewish People by saying that they stole it from them, and these are the places: Ma’arat HaMachpela, the Temple and Joseph’s burial place. Ma’arat HaMachpela because it is written: ‘And Abraham hearkened unto Ephron; and Abraham weighed to Ephron the silver,’ (Genesis, 23:16); the Temple because it is written: ‘So David gave to Ornan for the place,’ (I Chronicles, 21:26); and Joseph’s burial place because it is written: ‘And he bought the parcel of ground…Jacob bought Shechem.’ (Genesis, 33:19).” See also: Kook, Abraham Issac, Moadei Hare’iya, pp. 413–415.
  67. ^ Karen Armstrong (29 April 1997). Jerusalem: one city, three faiths. Ballantine Books. p. 229. http://books.google.com/books?id=v5_ZAAAAMAAJ. Retrieved 25 May 2011. 
  68. ^ Sefer ha-Charedim Mitzvat Tshuva, Chapter 3; Shu”t Minchas Yitzchok, vol. 6
  69. ^ Hebrew language site
  70. ^ Shaarei Teshuvah, Orach Chaim 561:1; cf. Teshuvoth Radbaz 691
  71. ^ Moshe Sharon. “Islam on the Temple Mount” Biblical Archaeology Review July/August 2006. p. 36–47, 68. “Immediately after its construction, five Jewish families from Jerusalem were employed to clean the Dome of the Rock and to prepare wicks for its lamps”
  72. ^ The Kaf hachaim (Orach Chaim 94:1:4 citing Radvaz Vol. 2; Ch. 648) mentions a case of a Jew who was forced onto the Temple Mount.
  73. ^ Lapidoth, Ruth E.; Moshe Hirsch (1994). The Jerusalem Question and Its Resolution: Selected Documents. Jerusalem: Martinus Nijhoff. p. 542. ISBN 0-7923-2893-0
  74. ^ Hassner, Ron E., “War on Sacred Grounds,” Cornell University Press (2009), pp.113-133
  75. ^ Rabbis who support this opinion include: Mordechai Eliyahu, former Sefardi Chief Rabbi of Israel; Zalman Baruch Melamed, rosh yeshiva of the Beit El yeshiva; Eliezer Waldenberg, former rabbinical judge in the Rabbinical Supreme Court of the State of Israel; Avraham Yitzchak Kook, Chief Rabbi of Palestine (Mikdash-Build (Vol. I, No. 26)); Avigdor Nebenzahl, Rabbi of the Old City of Jerusalem.
  76. ^ These rabbis include: Rabbis Yona Metzger (Ashkenazi Chief Rabbi of Israel); Shlomo Amar (Sefardi Chief Rabbi of Israel); Ovadia Yosef (spiritual leader of Sefardi Haredi Judaism and of the Shas party, and former Sefardi Chief Rabbi of Israel); Eliyahu Bakshi-Doron (former Sefardi Chief Rabbi of Israel); Shmuel Rabinowitz (rabbi of the Western Wall); Avraham Shapiro (former Ashkenazi Chief Rabbi of Israel); Shlomo Aviner (rosh yeshiva of Ateret Cohanim); Yisrael Meir Lau (former Ashkenazi Chief Rabbi of Israel and current Chief Rabbi of Tel Aviv). Source: Leading rabbis rule Temple Mount is off-limits to Jews
  77. ^ These rabbis include: Yaakov Yisrael Kanievsky (Thoughts on the 28th of Iyar – Yom Yerushalayim); Yosef Sholom Eliashiv (Rabbi Eliashiv: Don’t go to Temple Mount)
  78. ^ Yoel Cohen, The political role of the Israeli Chief Rabbinate in the Temple Mount question
  79. ^ a b Yated Ne’eman article
  80. ^ Haaretz
  81. ^ http://www.qurandislam.com/coran/trans/?currSura=17&currAya=1&currTrans=tafsir_en_sahih
  82. ^ http://haditsbukharionline.blogspot.ca/2010/11/merits-of-helpers-in-madinah-ansaar.html
  83. ^ “The Farthest Mosque must refer to the site of the Solomon’s Temple in Jerusalem on the hill of Moriah, at or near which stands the Dome of the Rock… it was a sacred place to both Jews and Christians… The chief dates in connection with the Temple in Jerusalem are: It was finished by Solomon about 1004 BCE; destroyed by the Babylonians under Nebuchadnezzar about 586 BCE; rebuilt under Ezra and Nehemiah about 515 BCE; turned into a heathen idol temple by one of Alexander the Great‘s successors, Antiochus Epiphanes, 167 BCE; restored by Herod, 17 BCE to 29; and completely razed to the ground by the Emperor Titus in 70. These ups and downs are among the greater signs in religious history.” (Yusuf Ali, Commentary on the Koran, 2168.
  84. ^ “The city of Jerusalem was chosen at the command of Allah by Prophet David in the tenth century BCE. After him his son Prophet Solomon built a mosque in Jerusalem according to the revelation that he received from Allah. For several centuries this mosque was used for the worship of Allah by many Prophets and Messengers of Allah. It was destroyed by the Babylonians in the year 586 BCE., but it was soon rebuilt and was rededicated to the worship of Allah in 516 BCE. It continued afterwards for several centuries until the time of Prophet Jesus. After he departed this world, it was destroyed by the Romans in the year 70 CE.” (Siddiqi, Dr. Muzammil. Status of Al-Aqsa Mosque, IslamOnline, May 21, 2007. Retrieved July 12, 2007.)
  85. ^ “Early Muslims regarded the building and destruction of the Temple of Solomon as a major historical and religious event, and accounts of the Temple are offered by many of the early Muslim historians and geographers (including Ibn Qutayba, Ibn al-Faqih, Mas’udi, Muhallabi, and Biruni). Fantastic tales of Solomon’s construction of the Temple also appear in the Qisas al-anbiya’, the medieval compendia of Muslim legends about the pre-Islamic prophets.” (Kramer, Martin. The Temples of Jerusalem in Islam, Israel Ministry of Foreign Affairs, September 18, 2000. Retrieved November 21, 2007.)
    • “While there is no scientific evidence that Solomon’s Temple existed, all believers in any of the Abrahamic faiths perforce must accept that it did.” (Khalidi, Rashid. Transforming the Face of the Holy City: Political Messages in the Built Topography of Jerusalem, Bir Zeit University, November 12, 1998.)
  86. ^ A Brief Guide to al-Haram al-Sharif, a booklet published in 1925 (and earlier) by the “Supreme Moslem Council”, a body established by the British government to administer waqfs and headed by Hajj Amin al-Husayni during the British Mandate period, states on page 4: “The site is one of the oldest in the world. Its sanctity dates from the earliest (perhaps from pre-historic) times. Its identity with the site of Solomon’s Temple is beyond dispute. This, too, is the spot, according to universal belief, on which ‘David built there an altar unto the Lord, and offered burnt offerings and peace offerings.'(2 Samuel 24:25)”
  87. ^
    • “The Rock was in the time of Solomon the son of David 12 cubits high and there was a dome over it…It is written in the Tawrat [Bible]: ‘Be happy Jerusalem,’ which is Bayt al-Maqdis and the Rock which is called Haykal.” al-Wasati, Fada’il al Bayt al-Muqaddas, ed. Izhak Hasson (Jerusalem, 1979) pp. 72ff.
  88. ^ “Arabs Vandalize Judaism’s Holiest Site”. Arutz Sheva. March 31, 2005. http://www.israelnationalnews.com/News/News.aspx/79391. Retrieved July 11, 2007. 
  89. ^ Rightist MK Ariel visits Temple Mount as thousands throng Wall
  90. ^ Wagner, Matthew (October 10, 2006). Rabbis split on Temple Mount synagogue plan. The Jerusalem Post.
  91. ^ The Times, October 14, 2006
  92. ^ Ynetnews
  93. ^ Haaretz
  94. ^ Sela, Neta (May 16, 2007). “Rabbi Shapira forbids visiting temple Mount”. Ynet. http://www.ynetnews.com/articles/0,7340,L-3400750,00.html. Retrieved May 17, 2007. 
  95. ^ Kyzer, Liel (October 25, 2009). Israel Police battle Arab rioters on Temple Mount; PA official arrested. Haaretz.
  96. ^ Arrests at holy site in Jerusalem. BBC News. October 25, 2009.
  97. ^ Jerusalem holy site stormed. The Straits Times. October 25, 2009.
  98. ^ Clashes erupt at Aqsa compound. Al Jazeera. October 25, 2009.
  99. ^ Israel National News 15 July, 2010

[edit] Bibliography

Books

 

Israeli Police, taking five.  (remember them)
2006-043 
Dome of the Chain.  Stands at the approximate center of the Temple Mount (or, the center of the world, according to one story).  The 13th-century interior tiling surpasses even that of the Dome of the Rock.  But, on this day it was being used by lots of shrouded ladies and little children, so we didn’t venture “inside” to have a look-see.
2006-044 
Looking east from the Dome of the Chain towards the Mount of Olives.
The Russian Orthodox Church at Gethsemane.  (lower left)
2006-045 
Looking north to some more arches.
2006-046 
Guess what?
2006-047 
Guess Who?
2006-048

 

Koleksi Perang Vietnam Yang Dahsyat Tahun 1970

The Driwan’s  Cybermuseum

                    

(Museum Duniamaya Dr Iwan)

                    Please Enter

                   

              DVWC SHOWROOM

sumber

https://driwancybermuseum.wordpress.com/2012/10/25/koleksi-perang-vietnam-yang-dahsyat-tahun-1970/

 

 Perang Vietnam dan Dokumen Sejarah Pos 1969-1975

THE VIETNAM WAR 1.970

C.VIETNAM WAR

1.970..

. Kelompok Tentara Australia di Nui Dat di Phuoc Tuy provinsi awiting dukungan helikopter untuk Operasi Puckapunyal sekitar tahun 1970, selama Perang Vietnam. Sumber: The Daily Telegraph

COMBAT MEDIC VIETNAM WAR 1.970

Viet Nam Perang Protes, 1970 UCSF fakultas, mahasiswa, dan staf protes invasi AS Kamboja, Mei 1970.

Vietnam War

Iconic image … Australian soldiers group at Nui Dat in Phuoc Tuy province awiting helicopter support for Operation Puckapunyal circa 1970, during the Vietnam War. Source: The Daily Telegraph

                   

The Vietnam War Document

       and

 

    

Postal History

       1969-1975

 

Part

THE VIETNAM WAR 1970

Vietnam War - Map

C.VIETNAM  WAR 1970

 

COMBAT MEDIC VIETNAM WAR 1970

 
 
 The connection between the war in Vietnam and Iraq.  Combat Medic Vietnam 1970.  More than 2 million Vietnamese people died in the attack on Vietnam by the US.  Estimates of deaths are between 2 million and 4 million people.  Photo: Mike Hastie Vietnam Veteran
  
Viet Nam War Protest, 1970
UCSF faculty, students, and staff protest the US invasion of Cambodia, May 1970.

 Information From David J.Graham

I was a member of MACV Advisory Team 14 on Phu Quoc for about 6 months in 1970, before being moved to MAVC HQ Tan Son Nhut under Col Thornton Ireland.

I have been trying to locate or find out the fate of certain of my team members, particularly one SSG John Shaffrey who was reassigned to a Dog Unit near Pleiku in 1971.

Is there anywhere you can suggest searching? Or perhaps do you know of a site with more info or photos?

Finally, I want to thank you for posting the picture above.

It is the only trace I can find of Team 14 on the web (so far!)

I would also be interested in hearing from any other members of Team 14, MACV PMG 1971, The 41st MP Detachment, St Louis 1971 or The 291st MP Co, Redstone Arsenal 1969.

Thanks again!

Informasi Dari David J.Graham

Saya adalah anggota Tim Penasehat MACV 14 di Phu Quoc selama sekitar 6 bulan pada tahun 1970, sebelum dipindahkan ke MAVC HQ Tan Son Nhut di bawah Kolonel Thornton Irlandia.

Saya telah mencoba untuk mencari atau mengetahui nasib tertentu anggota tim saya, terutama yang SSG John Shaffrey yang ditugaskan ke Satuan Anjing dekat Pleiku pada tahun 1971.

Apakah ada di mana saja Anda dapat menyarankan mencari? Atau mungkin Anda tahu dari sebuah situs dengan info lebih lanjut atau foto?

Akhirnya,Saya ingin mengucapkan terima kasih untuk posting gambar di atas.

Ini adalah satu-satunya jejak saya dapat menemukan Tim 14 di web (sejauh ini!)

Saya juga akan tertarik untuk mendengar dari setiap anggota lain dari Tim 14, MACV PMG 1971, The Detasemen MP 41, St Louis 1971 atau MP 291 co, Redstone Arsenal 1969. Terima kasih lagi!

Januari 1970

(A) 1 Januari 1970 Operasi Cuu Long

—————————————- —————————————-

Setelah mengakhiri Operasi QUYET THANG, yang ARVN IV Korps meluncurkan kampanye Corps-lebar baru di IV CTZ bernama Operasi CUU PANJANG.

The 1st ARVN Divisi Operasi dimulai SON LAM 249 dan 250 di Quang Tri Propinsi.

The 41 ARVN Resimen dari Divisi 22d dimulai Operasi NGUYEN HUE/41/1 di Provinsi Binh Dinh.

Anggota Resimen ARVN 5th menemukan delapan mayat, ternyata warga sipil yang tewas sekitar satu minggu sebelumnya. Semua korban telah tangan terikat di belakang punggung mereka dan sebagian besar memiliki tengkorak retak.

Dua jam setelah gencatan senjata berakhir Tahun Baru, sebuah elemen dari Brigade 1, Divisi Infanteri ke-25 melibatkan 50 musuh 10 km sebelah barat laut dari Go Dau Ha di Provinsi Tay Ninh. Hasil adalah 16 musuh tewas dan tidak ada korban yang ramah. __________________

(B) Trinh Duc info:

“Awal tahun 1970 saya disergap bersama dengan delapan orang lain dalam kliring hutan. Sembilan dari kita berjalan file tunggal di seluruh sayuran diajukan bahwa desa telah diukir dari hutan, dalam perjalanan dari satu dusun ke yang lain, itu adalah berawan ninght.

Bulan sebagian ditutupi dan tidak ada yang bisa melihat banyak. Aku tahu aku harus mengambil jalur di sekitar kliring, menjaga ke hutan, tapi saya berada di terlalu banyak terburu-buru.

Menjelang tengah clearinh yang ada rumpun pisang sebagai trees.Just aku menarik bahkan dengan mereka.

Saya menyadari ada beberapa bentuk di trees.They melihat saya di persis sama cepat, dan instictively saya rata dengan tanah. Tepat pada saat itu tambang Claymore api dari di jalan di belakang saya, instan explotions.the besar mereka berhenti aku merangkak kembali di sepanjang jalan tepat di atas mana mereka telah pergi.

Seperti yang saya merangkak saya merasa beberapa mayat, kemudian menggeliat turun di sudut kanan toard hutan. Penembakan yang terjadi di sekitar. ” g=”At least two bullets hit my backpack before I got to the tree line>” j=”Setidaknya dua peluru menghantam ransel saya sebelum saya sampai ke garis pohon> “>Setidaknya dua peluru menghantam ransel saya sebelum saya sampai ke garis pohon>

Aku harus meninggalkan mayat ada di lapangan. Aku terus berfikir bagaimana demoralisasi itu akan untuk petani. “

 January 1970

(a)January 1, 1970

 Operation Cuu Long

  • After terminating Operation QUYET THANG, the ARVN IV Corps launches a new Corps-wide campaign in IV CTZ named Operation CUU LONG.
  • The 1st ARVN Division begins Operations LAM SON 249 and 250 in Quang Tri Province.
  • The 41st ARVN Regiment of the 22d Division begins Operation NGUYEN HUE/41/1 in Binh Dinh Province.
  • Members of the 5th ARVN Regiment find eight bodies, apparently civilians who had been killed approximately one week earlier. All victims had hands tied behind their backs and most had fractured skulls.
  • Two hours after the New Year truce ends, an element of the 1st Brigade, 25th Infantry Division engages 50 enemy 10 km northwest of Go Dau Ha in Tay Ninh Province. Results are 16 enemy killed and no friendly casualties.

__________________

 (b)Trinh Duc info:

“Early in 1970 I was ambushed along with eight others in jungle clearing. The nine of us were walking single file across a vegetable filed that the Villagers had carved out of the jungle, on our way from one hamlet to another ,It was a cloudy ninght. The moon was partially covered over and no one could see much. I knew I should have taken the line around the clearing,keeping to the jungle,but I was in too much of a hurry.Toward the middle of the clearinh there was a clump of banana trees.Just as I pulled even with them. I realized there were some  shapes in the trees.They saw me at exactly the same instant,and instictively I flattened to the ground. Just at that moment claymore mines fire off on the path behind me,huge explotions.the instant they stopped I crawled back along the path right over where they had gone off. As i crawled I felt some of the bodies,then squirmed off at a right angle toard the jungle. Firing was going on all around. At least two bullets hit my backpack before I got to the tree line>I had to leave the bodies there in the field. I kept thingking how demoralizing it would be for the peasant.”

(3) 2 Januari 1970

————————————————– ——————————

Zona ARVN 44 Taktis khusus dimulai Operasi CUU LONG/44/01 di Chau Doc Provinsi.

The 2nd ARVN Divisi Operasi dimulai QUYET THANG 45, 54 dan 63 di Tin Quang Ngai Quang dan Provinsi. Sipil penebang sengaja perjalanan musuh Claymore mine 3 km sebelah barat daya dari Hoi An di Provinsi Quang Nam. Tujuh warga sipil tewas dan 21 terluka.

Sebuah elemen dari Divisi Marinir 1 mengamati 25 musuh dengan senjata bergerak ke barat 15 km sebelah barat daya dari An Hoa di Quang Nam Province.

Artileri dipecat dalam reaksi, menewaskan 20. AS infanteri komandan kompi yang dibebastugaskan dari jabatannya setelah sappers musuh menyelinap melalui posisi malam defensif unit yang menewaskan 8 orang dan melukai 5.

__________________

 (3)January 2, 1970


  • The 44th ARVN Special Tactical Zone begins Operation CUU LONG/44/01 in Chau Doc Province.
  • The 2nd ARVN Division begins Operations QUYET THANG 45, 54 and 63 in Quang Tin and Quang Ngai Provinces.
  • Civilian woodcutters accidentally trip enemy claymore mine 3 km southwest of Hoi An in Quang Nam Province. Seven civilians are killed and 21 wounded.
  • An elements of the 1st Marine Division observes 25 enemy with weapons moving west 15 km southwest of An Hoa in Quang Nam Province. Artillery is fired in reaction, killing 20.
  • US infantry company commander is relieved of his command after enemy sappers slipped through his unit’s night defensive positions killing 8 and wounding 5.

__________________

(4) Jan.4th.1970

Operasi Cliff Dweller

————————————————– ——————————

Brigade 1, Divisi Infanteri ke-25 dengan 4-9 Inf, 3-22 Inf dan Co A, 2-34 Arm dimulai Operasi CLIFF Dweller IV untuk membersihkan lereng Nui Ba Den digunakan oleh musuh sebagai area pementasan untuk serangan terhadap Tay Ninh Kota.

Brigade 1, Divisi Infanteri ke-4 dimulai Operasi THRUST WAYNE di utara Provinsi Binh Dinh.

Operasi WAYNE BREAKER berakhir. Operasi dimulai 18 Oktober 69 di daerah Khe An bawah kontrol dari Brigade 1, Divisi Infanteri ke-4.

Hasil adalah 154 musuh tewas, 7 ditahan, 1 US KIA dan 9 US WIA. Sebuah serangan mortir VC di sebuah kamp pengungsi dekat An Hoa, Quang Nam Province membunuh 12 warga sipil dan 72 luka lainnya

. __________________

(4)Jan.4th.1970

Operation Cliff  Dweller

 

  • The 1st Brigade, 25th Infantry Division with 4-9 Inf, 3-22 Inf and Co A, 2-34 Arm begins Operation CLIFF DWELLER IV to clear the slopes of Nui Ba Den used by the enemy as a staging area for attacks on Tay Ninh City.
  • The 1st Brigade, 4th Infantry Division begins Operation WAYNE THRUST in northern Binh Dinh Province.
  • Operation WAYNE BREAKER terminates. Operation was initiated 18 Oct 69 in the An Khe area under control of the 1st Brigade, 4th Infantry Division. Results are 154 enemy killed, 7 detained, 1 US KIA and 9 US WIA.
  • A VC mortar attack on a refugee camp near An Hoa, Quang Nam Province kills 12 civilians and wounds 72 others.

__________________

(5) 6 Januari 1970

————————————————– ——————————

ROK Kavaleri Resimen (Buruk Bagus CRid) dimulai Operasi DOK 7Q SU RI di Provinsi Binh Dinh.

ROK 26 Resimen (Buruk Bagus CRid) dimulai Operasi JANG BI 1 di Provinsi Binh Dinh.

Sebuah elemen dari Marinir 7 di posisi defensif malam 10 km sebelah tenggara dari An Hoa di Quang Nam Province menerima lebih dari 200 putaran mortir 82mm dan serangan darat oleh jumlah yang tidak diketahui musuh.

Marinir membalas tembakan dengan senjata organik dan artileri pendukung. Sappers menembus perimeter dan jijik.

Hasil adalah 39 musuh tewas, 13 US KIA dan 63 US WIA.

Sebuah kekuatan musuh ukuran tidak diketahui bergerak oleh unsur-unsur dari Brigade 1, 1st Kavaleri Divisi 12 km sebelah timur laut dari Tay Ninh Kota dengan dukungan dari helikopter tempur dan Wings 3d dan 35 Fighter Taktis. Hasil adalah 37 musuh tewas, 1 US KIA dan 6 US WIA.
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(5)January 6, 1970


  • The ROK Cavalry Regiment (CRID) begins Operation DOK SU RI 7Q in Binh Dinh Province.
  • The ROK 26th Regiment (CRID) begins Operation JANG BI 1 in Binh Dinh Province.
  • An element of the 7th Marines in night defensive positions 10 miles southeast of An Hoa in Quang Nam Province receives more than 200 rounds of 82mm mortar and a ground attack by unknown number of enemy. The Marines return fire with organic weapons and supporting artillery. Sappers penetrate the perimeter and are repulsed. Results are 39 enemy killed, 13 US KIA and 63 US WIA.
  • An enemy force of unknown size is engaged by elements of the 1st Brigade, 1st Cavalry Division 12 km northeast of Tay Ninh City with support from helicopter gunships and the 3d and 35th Tactical Fighter Wings. Results are 37 enemy killed, 1 US KIA and 6 US WIA.

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(6)January, 10(6) 10 Januari 1970
Sampul pos gratis dari The Airforce VNAF dengan gambar  pesawat temput  dan penutup roket, mengirim dari “KBC 4652 LDPT” VNAF 4 Divisi Phong Dinh, untuk Dinh Vu Jadi 332-1 “3319 KBC” pusat Cam Ranh Pelatihan Naval dengan CDS Quan Buu 1970/01/10. dan merah KBC 4652 lingkaran ganda dicap.

1971-aut)th 1970

The Airforce VNAF free postal airoplane and rocket cover,  send from “KBC 4652 LDPT”VNAF 4th Division Phong Dinh, to Dinh Vu So 332-1 “KBC 3319” Cam Ranh Naval Training center with CDS Quan Buu 10.1.1970. and red KBC 4652 double circle stamped . At the top of cover handwritten “ Thu Ta The Ve Bien Nhatrang mien Cac nay”(what the meaning ?).

 _____________________________________________________________ (Gratis udara-roket VNAF 4th Air Divisi penutup, postally digunakan dengan merah KBC 4652 dan Black Quan Buu dicap 1972/10/01 dari KBC 4652 (Phong Dinh Angkatan Udara) LDPT (?) Ke CTTT chong Thu literaly berarti Building Gouverment, Tao Tac harfiah berarti Building & Construc-tion, CTTT berarti Corps of Engineers, Ve Bien Nha Trang mien Cac Truong, Dinh Vu sro 332-1 (?), KBC 3319 (Naval Training center Cam Rahn) .

Sisi belakang penutup pensil ditulis Nhan Ngay (tiba) 17,01-1970. satu minggu setelah tanggal pos auth dicap), dan surat fron jenis pengirim yang sama untuk “Huyen Trin Qui” dari Phong Dinh 1970/02/20.

 

Inside the letter in Vietnamese language:

   

              Con Tho ngay 31.12.69

                                                Chu Ngen

Hom nay tap nhan dtuoc Tho Qui, tep Lay Lam Ngung, Vi Qui dta chon dtuoc nganh Hai Phoa theo tap nghi thi Qui se La chanh thuc La nguoi lungcua dai duong.

Vi qui Se dti tau bien Luc Qui nang Khoa nganh hai Phai Xem xen, voi nganh Bom dtau cua nganh H.Q.vey,Khi Ban dtuoc dti tau Bien Bau se dtuoc dti tat ca cac tinh cua V,N.

Tap lat tiet La dta mot Phen tinh nguyen dti nganh Xa thu, De Lau nguoi hung o Giang Nghung tap o toai nguyen dtuoc, vi tap dta La RQ ma o dtuoc tren Trei Anh Ban dtuoc, nhung Ban dti hoi Pkao Eoi Chung Cuoi o co vo dto vi no so Ban thut Sap Nha dto Q suen tap cang quen luc qui dti co gei Lai cho thieu Ba lo noi o?———.

Can dtoi voi tap thi o co nhung noi o co thi o dtuoc ngoi nhung nguo: Qui biet Ra con tiet nhiem nhung tap dtem tu choi vi  tap ho mat cam ve van dte am uong vay le lat ra nhung au o tap cung xen xen voi ban ma thu.

Con phep thi Bi cap roi tai du ky roi nen o duoc ve cuoi thu tep cung chuc qui dtuoc nhiem mai mang ve  suc khoc nan nay tap cung nhu qui au tet tai dton vi cung nhu noel vua roi nhung C.T.cung Vui vui dto ban.

Thoi tap xin tau dtung biet va mong tho qui dtien neu Ban co dti dtan coi tap o mai ta dta chi cu.

                                                            Thau ly

                                    Tap luc nay ngheo quc qui vi

                  _____________________________________________________________

 

(Free  airmail –rocket VNAF 4th Air Division  cover, postally used with red KBC 4652 and Black Quan Buu stamped 10.1.1972  from KBC 4652(Phong Dinh Air Force)  L.D.P.T (?)  to CTTT Chong Thu literaly mean Gouverment Building,Tao Tac literally mean Building & Construc-tion, CTTT means Corps of Engineers , Ve Bien Nha Trang mien Cac Truong, Dinh Vu Sro 332-1(?),KBC 3319(Naval Training center Cam Rahn).

Huyen Trin Qui penutup adalah koleksi terbaik untuk menunjukkan karena banyak variasi selama perang 1969 sampai

The back side of the cover pencil written nhan ngay (arrive) 17.01-1970. one week after postal date stamped auth), and the type letter fron the same sender to “Huyen Trin Qui” from Phong Dinh 20.2.1970. Huyen Trin Qui covers were the best collection for showed because many variations during the war 1969 until 1971-aut)

read more click

https://driwancybermuseum.wordpress.com/2011/04/06/driwan-vietnam-war-cybermsueumthe-vietnam-war-1970/

untuk melihat koleksi yang lengkap silahkan klik

 https://driwancybermuseum.wordpress.com/2011/04/06/driwan-vietnam-war-cybermsueumthe-vietnam-war-1970/

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