As a skilled and experienced Pain Medicine Interventionalist, Dr. Levin evaluates each patient very thoroughly and carefully to help determine appropriate treatment options in order to provide the most effective individualized care. These treatment options may include: Lumbar, Thoracic and Cervical Epidural Steroid Injections utilizing targeted transforaminal techniques, Lumbar and Cervical Sympathetic Blocks, Sphenopalatine, Facial and Head and Neck Procedures, Discography, Percutaneuos Discectomy or Disc Decompression procedures, precision joint and nerve injections, Radiofrequency Neuroablative procedures, Peripheral or Spinal Cord Stimulator trials and implants, Foraminoplasties and several patented and patent pending advanced interventional procedures.
Anabolic steroids differ in their characteristics, which means there are steroids that are only suitable for specific uses. For instance, Trenbolone is not recommended for bulking but it is an outstanding fat burner. This makes it perfect for a lean mass cycle or a cutting cycle. Always take the side effects of a particular compound into consideration whenever you plan a stack. Do not combine anabolic steroids that show similar side effects. For example, never combine Anapolon and Dianabol because they are already quite toxic and if you combine them, the toxicity will increase exponentially and cause serious damage to your body.
A very typical case of severe cholestasis due to anabolic steroid use. Because the steroids were being used without medical supervision, the dose and actual duration of use of each preparation was unclear, but cholestasis usually arises within 4 to 12 weeks of starting a C-17 alkylated androgenic steroid. The jaundice can be severe and prolonged and accompanied by severe pruritus and marked weight loss. The serum enzymes are typically minimally elevated except for a short period immediately after stopping therapy. The pattern of enzyme elevations can be hepatocellular, cholestatic or mixed. Liver biopsy shows a “bland” cholestasis with minimal inflammation and hepatocellular necrosis. Ma Huang has also been implicated in cases of drug induced liver injury, but is associated with an acute hepatocellular pattern of injury.
Let us look at a model of a phosphoglyceride, such as phosphatidyl choline. Its overall shape is roughly rectangular ( Figure ). The two hydrophobic fatty acid chains are approximately parallel to each other, whereas the hydrophilic phosphoryl choline moiety points in the opposite direction. Sphingomyelin has a similar conformation, as does the archaeal lipid depicted. Therefore, the following shorthand has been adopted to represent these membrane lipids: the hydrophilic unit, also called the polar head group , is represented by a circle, whereas the hydrocarbon tails are depicted by straight or wavy lines ( Figure ).