#fibrin

[didanawisgi]

A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications

Abstract

Post-acute sequelae of COVID (PASC), usually referred to as ‘Long COVID’ (a phenotype of COVID-19), is a relatively frequent consequence of SARS-CoV-2 infection, in which symptoms such as breathlessness, fatigue, ‘brain fog’, tissue damage, inflammation, and coagulopathies (dysfunctions of the blood coagulation system) persist long after the initial infection. It bears similarities to other post-viral syndromes, and to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Many regulatory health bodies still do not recognize this syndrome as a separate disease entity, and refer to it under the broad terminology of ‘COVID’, although its demographics are quite different from those of acute COVID-19. A few years ago, we discovered that fibrinogen in blood can clot into an anomalous ‘amyloid’ form of fibrin that (like other β-rich amyloids and prions) is relatively resistant to proteolysis (fibrinolysis). The result, as is strongly manifested in platelet-poor plasma (PPP) of individuals with Long COVID, is extensive fibrin amyloid microclots that can persist, can entrap other proteins, and that may lead to the production of various autoantibodies. These microclots are more-or-less easily measured in PPP with the stain thioflavin T and a simple fluorescence microscope. Although the symptoms of Long COVID are multifarious, we here argue that the ability of these fibrin amyloid microclots (fibrinaloids) to block up capillaries, and thus to limit the passage of red blood cells and hence O2 exchange, can actually underpin the majority of these symptoms. Consistent with this, in a preliminary report, it has been shown that suitable and closely monitored ‘triple’ anticoagulant therapy that leads to the removal of the microclots also removes the other symptoms. Fibrin amyloid microclots represent a novel and potentially important target for both the understanding and treatment of Long COVID and related disorders.

[drgolberg]

The key ingredient of the Vampire Facelift® is platelet-rich fibrin matrix, which is derived from the patient’s own blood before being mixed with other factors.

Platelet-rich fibrin matrix starts with a blood draw, just like any normal blood test.

[almekamedicalcentre-blog]

PRFM (Platelet Rich Fibrin Matrix) is a powerhouse of natural growth factors which can be used for hair regrowth.

[vikash-14]

Unraveling the Growth Trajectory: The Fibrin Sealant Market

Introduction: In the realm of modern medicine, fibrin sealants have emerged as invaluable tools in surgical procedures and wound management. Fibrin sealants, also known as fibrin glues or fibrin tissue adhesives, are biocompatible compounds that mimic the final stage of the body's natural clotting cascade, promoting hemostasis and tissue sealing. As surgical techniques continue to advance and the demand for minimally invasive procedures rises, the fibrin sealant market is experiencing robust growth. This article delves into the multifaceted landscape of the fibrin sealant market, exploring its key drivers, applications, innovations, and future prospects.

Understanding Fibrin Sealants: Fibrin sealants are composed of two main components: fibrinogen and thrombin. When combined, these components initiate a cascade of biochemical reactions, culminating in the formation of a stable fibrin clot at the site of application. This clot acts as a sealant, adhering tissue surfaces together and promoting wound healing. Fibrin sealants are available in various formulations, including liquid, spray, and patch forms, catering to diverse surgical and clinical needs.

Market Dynamics:

Rising Surgical Volumes: The growing prevalence of chronic diseases and age-related conditions necessitates an increase in surgical interventions, driving the demand for fibrin sealants in various surgical specialties such as cardiovascular, orthopedic, and general surgery.

Shift towards Minimally Invasive Procedures: With a focus on reducing patient morbidity and healthcare costs, there is a notable shift towards minimally invasive surgical techniques, wherein fibrin sealants play a pivotal role in achieving hemostasis and tissue sealing.

Advancements in Product Development: Continuous innovation in fibrin sealant formulations, delivery systems, and adjunctive technologies is expanding the applicability and efficacy of these products, further fueling market growth.

Expanding Clinical Indications: Fibrin sealants are increasingly being utilized across a spectrum of clinical scenarios, including wound closure, tissue repair, hemostasis in vascular surgery, and augmentation of surgical procedures, broadening their market reach.

Growing Regulatory Approvals: Regulatory agencies are increasingly recognizing the safety and efficacy of fibrin sealants, leading to expedited approvals and market penetrations in both developed and emerging markets.

Applications Across Specialties:

Cardiovascular Surgery: Fibrin sealants are used to achieve hemostasis and seal vascular anastomoses, reducing the risk of postoperative bleeding and complications in cardiac and vascular surgeries.

Orthopedic Surgery: In orthopedic procedures such as total joint replacement and spinal surgery, fibrin sealants aid in tissue adherence, reducing the risk of postoperative leakage and promoting bone and soft tissue healing.

General Surgery: Fibrin sealants find extensive use in various general surgical procedures, including gastrointestinal surgery, hepatic resections, and organ transplantation, facilitating hemostasis and tissue approximation.

Plastic and Reconstructive Surgery: Fibrin sealants play a crucial role in plastic and reconstructive procedures, promoting tissue adherence and enhancing aesthetic outcomes in tissue flaps, grafts, and microsurgery.

Future Outlook: The future of the fibrin sealant market is promising, driven by ongoing technological advancements, expanding clinical indications, and the growing adoption of minimally invasive surgical techniques. With an aging population and increasing healthcare expenditure worldwide, the demand for fibrin sealants is expected to surge further. Additionally, advancements in biomaterials, tissue engineering, and regenerative medicine are poised to unlock new opportunities for fibrin sealants in tissue repair and regeneration.

Conclusion: The fibrin sealant market is witnessing unprecedented growth, propelled by the burgeoning demand for effective hemostatic agents and tissue adhesives across diverse surgical specialties. As healthcare providers and medical device manufacturers continue to innovate and collaborate, the landscape of fibrin sealants is poised for continuous evolution, offering novel solutions for complex surgical challenges and improving patient outcomes worldwide. By leveraging cutting-edge technologies and embracing a multidisciplinary approach, stakeholders in the fibrin sealant market can capitalize on emerging opportunities and contribute to the advancement of modern surgical practice.

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[mitalipingale]

https://justpaste.it/a9uwj

The Fibrin Sealant Market in 2023 is US$ 1.32 billion, and is expected to reach US$ 2.78 billion by 2031 at a CAGR of 9.72%.

[oreenolivia968]

Platelet Rich Fibrin Treatment Laguna Niguel, California

The Platelet Rich Fibrin procedure offers a way to harness the body’s natural regenerative abilities. Liquid PRF consists of autologous platelets, white blood cells, and fibrin derived from the patient’s own blood. It is prepared by slow centrifugation speeds of a blood sample to separate the upper plasma layer composed of liquid fibrinogen/thrombin from the other components. This concentrated mixture, rich in a multitude of growth factors and cytokines, without the addition of any natural or synthetic preparations is then injected directly into the ovaries or into the uterine cavity. Ovarian rejuvenation refers to the restoration of ovarian function and the enhancement of the ovarian reserve, which is the pool of eggs available for insemination. https://www.acaciofertility.com/services/plasma-rich-fibrin

[informationandcommunication]

The growing prevalence of cardiovascular diseases and blood disorders, increase in the number of surgical procedures as well as growing geriatric population are some of the factors driving the Fibrin Sealants Market growth during the forecast period 2022-2027.

[didanawisgi]

Degradative Effect of Nattokinase on Spike Protein of SARS-CoV-2

Abstract

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged as a pandemic and has inflicted enormous damage on the lives of the people and economy of many countries worldwide. However, therapeutic agents against SARS-CoV-2 remain unclear. SARS-CoV-2 has a spike protein (S protein), and cleavage of the S protein is essential for viral entry. Nattokinase is produced by Bacillus subtilis var. natto and is beneficial to human health. In this study, we examined the effect of nattokinase on the S protein of SARS-CoV-2. When cell lysates transfected with S protein were incubated with nattokinase, the S protein was degraded in a dose- and time-dependent manner. Immunofluorescence analysis showed that S protein on the cell surface was degraded when nattokinase was added to the culture medium. Thus, our findings suggest that nattokinase exhibits potential for the inhibition of SARS-CoV-2 infection via S protein degradation.

[covid-safer-hotties]

Yes, there's hope in the fight against Long Covid.

Hope doesn't come in the form of natural immunity or subpar vaccines rolled out after waves of illness have already peaked. It comes in the form of clean indoor air, widespread masking, and better treatments. In that vein, the NIH is finally launching a new batch of clinical trials focused on Long Covid, five total, dedicated to different aspects of the condition. Institutes like Mount Sinai are running clinical trials on repurposed HIV drugs. So is HealthBio, a startup working on immune diseases. (They're testing maraviroc and atorvastatin.) Post-Viral Trials News is sharing updates as they roll in. Of course, the NIH and FDA need steady pressure to make sure they're funding trials that focus on a range of options. Given the urgency of the crisis, we should be doing far more. As Harvard economist David Cutler has said on developing treatments for Long Covid, "There is no amount that's overdoing it." We're talking about a $16 trillion crisis.

We're talking about an urgent need for dozens of expedited clinical trials for drugs that already exist, which have shown effectiveness in preventing and treating Long Covid in its various incarnations. We're talking about making those drugs accessible right now for off-label use, so that Covid survivors can finally get the help they need.

Long Covid is an emergency.

We're going to talk about prescription treatments first, and then supplements and extracts you can find yourself. Up front, you can try services like RTHM and CURE ID that aim to connect patients with treatments without endless waits. (I'm not endorsing them. I'm just telling you they exist.)

Let's dig in.

Healthcare largely abandoned monoclonal antibodies during the first Omicron wave, but some of them remain effective in higher doses as postviral therapies. We've also found new ones. For example: A study in Nature offers 5B8 as a therapy for fibrinogen, a protein in your body that binds to the Covid spike protein during infection. Afterward, that protein starts to behave differently, "forming pro-inflammatory blood clots" that lead to cardiac and brain dysfunction, especially in young patients with mild infections. It also suppresses your natural killer cells, weakening your immune system. So, damaged fibrinogen is the culprit behind a lot of the "mysterious" health problems we're seeing.

As the authors show, "fibrin-targeting immunotherapy may represent a therapeutic intervention for patients with acute Covid-19 and Long Covid." The monoclonal antibody 5B8 "provides protection...without adverse effects." The sooner you get it, the better it works.

A 2024 study in the American Journal of Emergency Medicine also found that the monoclonal antibody regeneron helped Long Covid survivors recover. Researchers "expressed surprise at the swift and comprehensive improvements observed in the patients," adding that "regardless of the duration of their Long Covid experience, significant progress was noted within a mere 5 days of receiving the Regeneron treatment." It might work because it helps your immune system eliminate residual amounts of virus or viral fragments, or it might replace damaged antibodies that attack your cells.

A 2022 study found that another monoclonal antibody, Sotrovimab, helped survivors with persistent viral loads after initial infection who were still reporting fatigue, chest pain, and trouble breathing months after infection. As the researchers note, the patients showed "rapid improvement of symptoms and inflammation markers as well as negative swabs."

Yet another 2022 study in Clinical Infectious Diseases found that a monoclonal antibody treatment called Leronlimab could help Long Covid patients recover by boosting their immune system in cases where Covid downregulated it, causing a drop in their CCR5 levels, a receptor found on a range of cells that fight pathogens, including your CD4 lymphocytes.

The Long Covid Action Project is also developing a list of drugs that desperately need clinical trials and faster deployment. They stress the need for monoclonal antibodies and antivirals like pemivibart, azvudine, ensitrelvir (Xocova), and sofosbuvir. They'll be releasing a full list later this year.

So while these monoclonal antibodies might not save your life during early infection, they can help your recovery.

There should be more clinical trials and off-label use.

Interferon treatments, specifically Interferon-Lambda, have shown the potential to help with immune system problems and cognitive deficits (caused by brain inflammation) after Covid infections.

Also:

A 2022 study in Frontiers in Immunology found that high doses of immunoglobulin have shown "a significant to remarkable clinical benefit" in treating a full range of brain, heart, and lung problems in Long Covid patients. A major 2023 study in Frontiers in Neuroscience confirmed that immunoglobulin lead to significant improvement in neurological problems. As researchers in a third study on immunoglobulins and Long Covid state, we already use this therapy to treat a variety of chronic inflammatory diseases, as well as flu, HIV, and measles. (The NIH has included immunoglobulins in their new clinical trials.)

HIV drugs have also shown promise for helping Long Covid patients. A 2023 study in Clinical Infectious Diseases found that Tenofovir reduced someone's Covid risk regardless of whether they had HIV. A range of studies have supported the use of Tenofovir, Darunavir Ethanolate, and Azvudine for Covid. As we noted earlier, clinical trials are currently testing HIV drugs for Long Covid.

Another study in Antiviral Research found that cobicistat, used to boost HIV antivirals, also fights Covid and leads to a significant reduction in overall risk. The researchers found that higher doses work better. They also found that higher doses work better for ritonavir, one of the key components of Paxlovid. By the way, ritonavir has been used in HIV treatments since the mid-1990s.

The research on repurposed HIV drugs points to the potential of many antiretroviral therapy (ART) medications for Long Covid, given that viral persistence plays a large role in most cases.

When you consider that Paxlovid itself contains an HIV antiviral, it sounds a little less extreme to compare Covid to HIV and discuss repurposing existing drugs.

Finally, studies have shown that molnupiravir and metformin have shown effectiveness against Covid. In particular, a 2024 study in Clinical Infectious Diseases found that metformin prescribed in the early stages of a Covid infection led to a 41 percent drop in Long Covid risk.

Other research has revealed that sometimes it takes a combination of these drugs to help patients recover. In a 2022 study in Clinical Infectious Diseases, researchers used nanopore technology to identify the specific variants patients were infected with and select the most effective treatments for that variant. In one case, a Long Covid patient with severe Paxlovid rebound only got better after doctors prescribed Paxlovid again and added remdesivir. Nobody had thought to try that yet.

It worked.

These are the drugs that demand renewed attention and clinical trials, given that most research on Long Covid points to ongoing infection, viral persistence, and the disruption of your immune system, which could mean a downregulated or weakened immune system or an overactive one. We especially need clinical trials that match drugs with specific conditions.

Specialists are going to decide the right dose for prescription drugs. Generally, the research indicates that if a standard dose doesn't work, a higher dose might as long as it doesn't trigger side effects. A combination of drugs can work when a single drug fails.

What can you do if you don't have access to these drugs?

This:

A major 2023 study in Cells found that eriodictyol, a flavonoid extracted from yerba santa, can help with the brain inflammation caused by Covid infections that leads to cognitive deficits and fatigue. Researchers have found that at least part of the "brain fog" from Long Covid happens when the virus triggers immune cells to attack the brain. Eriodictyol can also be derived from citrus fruits, tomatoes, and grapes. As the authors explain, a range of flavonoids "have been reported to prevent neuroinflammation, provide neuroprotection, and reduce cognitive dysfunction, especially brain fog."

The authors of the Cell study list flavanoids liposomal luteolin, oleuropein, and sulforaphane as all beneficial for recovering brain function. They identify formulas called BrainGain and FibroProtek containing flavonoids that helped Long Covid patients with severe brain fog in previous studies. Those contain luteolin. They ultimately recommend ViralProtek, which combines several flavonoids, "alone or together" with eriodictyol.

These formulas aren't just managing symptoms. According to the studies, they're helping you clear viral remnants and rehabilitate your immune system. They inhibit your microglia and mast cells, immune cells that often drive the brain inflammation behind Long Covid cognitive problems.

What else?

A 2022 study in Molecules found promise in nattokinase, "a popular traditional Japanese food made from soybeans fermented by Bacillus subtilis var." Not so coincidentally, nattokinase also "decreases the plasma levels of fibrinogen," the same protein that drives thrombosis in Long Covid patients and indeed "has drawn central attention in thrombolytic drug studies," as well as tumor treatment. It also inhibits the replication of bovine herpes virus. Clinical trials have found no adverse effects from eating natto. In this particular study, the researchers found that nattokinase degrades the Covid spike protein, inhibiting infection. As they conclude, "nattokinase and natto extracts have potential effects on the inhibition of SAS-cOv-2 host cell entry."

Martha Eckey describes natto extracts in more detail here, along with benefits, recommended dosage, and possible side effects. Respondents to her survey reported the best results when they took Solaray's natto extract along with serrapeptase, an enzyme and commonly used drug in Japan and Europe that helps your body break down proteins. A large number of patients reported improvement after taking the natto-serra combination, often within a week or two. Many of them also benefited from adding lumbrokinase, an enzyme shown to facilitate healing.

Like natto, lumbrokinase breaks down fibrin. We're seeing a theme here. Any kind of treatment that breaks down fibrin, whether it's a monoclonal antibody or an enzyme, helps after a Covid infection.

Take a look for yourself:

Eckey discusses cromolyn for brain inflammation and neurological issues, and some people have said it helps with other problems. She also wrote this great post about protecting kids from Long Covid.

A lot of it also applies to adults.

Another surprising study in Viruses from 2021 found that grapeseed extract (V. vinifera) contained dozens of flavonoid compounds that inhibited viral replication, including for Covid. The researchers used concentrations from 500 μg/ml down to 10 μg/ml.

Studies have even found that taurine supplements can do a lot to reduce your Covid risks, including Long Covid. A 2024 study in PLoS One found that the amino acid can serve as both a biomarker and a target for treatment in Long Covid. As they write, taurine has already "shown benefits such as reducing depressive behavior, improving memory, and mitigating age-related issues by addressing cellular senescence, chronic inflammation, DNA damage, and mitochondrial dysfunction." It can play "a potential protective role" in "alleviating the burdens of PCC." If that weren't enough, "taurine supplementation has demonstrated diverse therapeutic properties, including anti-oxidation, anti-aging, antiepileptic, cytoprotective, and cardioprotective effects in many diseases." Yes, even taurine from energy drinks. (And I guess it's a good thing I drink them.)

A standard diet contains about 40-400 mg of taurine per day. Medical use often starts at 6 grams a day.

There's a reason why many of these treatments don't get the attention they deserve, and Timothy Ferriss of all people describes it very well in the opening to The 4-Hour Body. As he learns from talking with a wide range of doctors and medical researchers, the industry frowns on any kind of treatment that doesn't look or feel "elite" enough. There's not a lot of incentive for major research on supplements or cheap, widely available drugs because they're just not cool enough, even if they work. For drug makers, it can't just work. It also has to generate enough profit.

That's what happens when you privatize medicine.

As a society, we have to overcome that. This shortcoming isn't going to help us address the myriad public health challenges of the future.

It's a little ironic that the catchphrase "do your own research," once levied against anti-vaxxers, is now used to insult Long Covid survivors and advocates who are trying desperately to find treatments. The difference is that we're not rejecting medicines.

We're simply not getting them.

This article can't replace a doctor or a nutritionist, but it offers a comprehensive starting point for anyone who needs it. You can do more digging and confirm what's here. You could also just make a list of all the things discussed here and take them to someone you trust, and go from there.

It's crucial for us to develop a range of treatments and therapies for Covid that go beyond the mainstream reliance on Paxlovid and vaccines, conveniently dominated by a single pharmaceutical company.

It won't last forever.

In fact, research has shown that Paxlovid leads increasingly to rebound infections in which "the virus can return unimpeded by the drug, bringing the risk of disease and even death."

That's the part left out by corporate media. Rebound doesn't simply mean another round of Paxlovid. It means decreased effectiveness.

It means evasion.

Just like our mediocre vaccines, Covid is developing resistance to Paxlovid. According to an article in Nature, researchers around the world are now quietly racing to develop alternatives. No doubt, viral evolution offers one of the unspoken reasons why many of us find it so hard to access the drug now. The elites are terrified of losing the thing that enables their denial and wishful thinking.

Here's what one researcher said:

“This type of approach helped to improve HIV drugs, and we think it’s a good way to improve antivirals against SARS-CoV-2,” says Sho Iketani, PhD, assistant professor of medical sciences at Columbia University’s Vagelos College of Physicians and Surgeons and Aaron Diamond AIDS Research Center, who co-led the research..."

Western countries are well behind the curve on these fronts. Japan now offers a drug called Xocova (ensitrelvir), arguably more effective than Paxlovid, and it's been sitting in the FDA approval queue for about a year. China approved HIV antivirals for Long Covid back in 2022. While some healthcare workers in Europe and North America know about combining and repurposing drugs, many of them are still busy pretending Covid is over.

It's time for government agencies to pull their heads out of the sand and do their jobs. If there had been more urgency over the last four years, and less favoritism toward one or two drug giants, we would already have these treatments deployed. As things stand, we need leaders to not only run these long overdue clinical trials but also prepare to scale up production considerably, while making sure that everyone has access, not just those with platinum insurance plans. We could already be doing that for emergency off-label use now. Why aren't we?

Although it's infuriating and demoralizing it took us so long to get here, it's encouraging to know that teams of scientists around the world have been working on this crisis and producing results. We just need the gates unlocked.

There's no time to waste.

Let's get moving.

[survivingcapitalism]

COVID is surging once again and, if you live in British Columbia, you probably already know someone sick with fever, chills and a sore throat.

As of mid-August, about one in every 19 British Columbians were enduring an infection, with or without symptoms.

Although the media routinely dismisses all COVID infections as an inconsequential nuisance, that’s not what the science says. The virus remains deadlier than the flu and repeated infections can radically change your health.

An important new Nature study, for example, has now proven that the spike protein of the virus can bind with a blood protein, fibrin, setting off a chain of blood clots resulting in chronic inflammation and brain damage. Fibrin can actually form a mesh impeding blood flow in arteries to multiple organs in the body.

Repeated studies show in the bluntest terms that the initial acute infection is only the tip of the iceberg. Even a mild bout of COVID can leave a legacy of blood clots, heart failure, diabetes, decreased brain function (see sidebar), long COVID (now affecting 400 million people worldwide) and immune damage that increasingly makes people more vulnerable to a plethora of infectious diseases and possibly cancers.

[soumyafwr]

Fibrin Glue Market Size, Overview, Share and Forecast 2031

[oftenwantedafton]

Vent - Steve Raglan/William Afton/Springtrap x Female Reader

Chapters 34-35 (Finale)

Rating - Explicit

Warnings - sexual content and blood kink

Also available on AO3 Chapter 34 | 35

Chapter 34 ~ the ritual ~

William awakens to find you kissing the mark you’d carved along his rib the previous evening. Your tongue traces along the new scab. The blood flowing within his body instantly pools into his cock.

“Good morning,” you greet him. Your hair is mussed. He attempts to comb it with his fingers.

The older man realizes he’s lying horizontally across the bed. He’d fallen asleep that way apparently. You straddle his hips and bend to kiss his mouth. He can still taste the metal there from the dark ritual you’d shared last night. You impatiently shove at the swathe of hair that falls down and your mouth covers his again. Hungry. Ravenous. You reach for his erection, guiding it to your entrance and sheathing it, moaning at the sensation as he fills your body. William hisses. His thumbs dig into your abdomen as you begin to raise and lower yourself. One pushes along the new laceration and you moan even more, clutching his hand and pressing him more deeply. The fragile fibrin threads holding the cut closed loosen and weep blood. William’s head arches back and he catches sight of himself in the mirror.

It’s the yellow rabbit’s face he sees.

The blood paves the way.

You continue to grind yourself down. In the mirror he sees you working your body against the ravaged yellow suit. The rabbit’s eyes flare.

The blood lights the path.

You touch his injury. It’s fire.

William rolls and pins you beneath him. The yellow rabbit reaches a steel encased hand for your throat. He thrusts forward and the motion reopens his wound. The lifeforce leaks out, warm and sticky. It flows down, down, down. He fucks it into you. Smears it on his fingers and feeds it into your eager mouth.

The blood opens the door.

The hand on your throat tightens. The reflected image of the rabbit’s costume is violent against you. Your hands caress the damaged metal and fur, tucking into the open spaces, touching forbidden things. The alloys and cables and computer chips and circuit boards were never meant to be stroked like this. Your lips worship the frayed ends and hollowed spaces when the grinning, decaying face dips down to kiss you.

William spills his seed and the yellow rabbit rejoices.

Free.

Chapter 35 ~ remember ~

You don’t know what’s happening to you.

You’d thought yourself so full. Full of William’s love for you. Full of your love for him. But you’re still so hungry. The blood sates you but it never lasts. You want more.

You sit at a desk in Parts and Service. Your sketchbook is open before you, turned back many pages to the image of the yellow rabbit. How long it had been since you’d last seen him. How long since he had warned you.

How long it had taken for you to finally remember what had happened that summer day nine years ago, the barrier your mind had shielded you with for so long finally surrendering as easily as your and William’s flesh had parted beneath the knife.

The yellow rabbit had come to you. Whispered sweet words and comforted you. You’d just been a lost little girl, drifting away like that purple balloon from your dream, tapping against the glass, trying to escape. He’d lured you with false promises. Then he’d tried to murder you.

The man inside the yellow rabbit craves your demise.

***

Afton finds you sitting there an hour later, still staring at the drawing. You hear him inhale sharply when his eyes fall on the page before you.

“The yellow rabbit knows you,” you say softly. “Do you know him? I think you must.”

“Yes.” The admission is dry, harsh, as if he hates issuing it.

“He warned me about you.”

“I know.” The words sound as if they are choking him.

Your eyes meet his. “I remember now.”

***

William’s hand closes over the edge of the desk to steady himself.

“Remember what?” He inquires, even though he knows.

“The yellow rabbit tried to kill me. The man inside of it. In this room, nine years ago.” Your voice is so calm. Resigned. Accepting. “He took a knife from the desk. He reached out to grab me, but I ran. I ran and ran and I got away.” You pause. “Or so I thought. It’s you, isn’t it? The one inside the suit. You brought me back here. You want to—”

“—I would never hurt you,” he interrupts quickly, cupping the side of your face. “Never in a million years. I’ve pushed you too far with the cutting and I’m sorry for that…”

“But why? I like it. I enjoy everything you’ve ever done to me. For me.”

His poor sweet girl. Once so gray. Now painted red. Bloodstained. Beloved, but broken, because of him. He’s gotten exactly what he’s always wanted, hasn’t he? A witness. A partner. A soulmate. A match made in the deepest, darkest depths of hell.

You grab a handful of his tie and pull his mouth to yours.

William moans inside that kiss. If it was what you wanted, he’d give it to you. He would deny you nothing. His spine straightens and he lifts you to your feet. Links your hands together. Calloused in smooth that’s now a little rougher than it had been several months ago. The budding engineer, the new architect of his designs already bearing signs of dedication. He guides you forward, back to the dining room crowded with guests. He still has much to teach you and it begins here, in this very room.

”Choose one,” he whispers beside your ear.

[mitalipingale]

The Fibrin Sealant Market in 2023 is US$ 1.32 billion, and is expected to reach US$ 2.78 billion by 2031 at a CAGR of 9.72%.

[tarotfairy0919]

✧—⊹ ˖🥟⊹ ˖—✧Health meanings in tarot Minor Arcana edition - Suit of Cups✧—⊹ ˖🥟⊹ ˖—✧

©tarotfairy0919 - all rights reserved. do not copy, translate, alter or repost my work.

Please REBLOG if you find this information useful! ༄˖°🪐.ೃ࿔*

The Cups get their health meaning from the astrological connection to Cancer, Scorpio , and Pisces.

Cancer rules the breast, diaphragm, stomach, esophagus, taste, and left side of the body.

Scorpio rules the bladder, urethra, genitals, ovaries/testes, prostate, sigmoid colon, pubic bone, and nose.

Pisces rules the feet, toes, thalamus, and blood fibrin.

💊Ace of cups ~ Watch out for people sucking you dry. Depression.

💊Two of cups ~ Two of cups in a health reading speak of how the Seeker absorbs love. Inability to absorb love can give issues with the stomach.

💊Three of cups ~ Three of cups in a health reading can also mean depression and health issues from feeling betrayed or the fear of being betrayed.

💊Four of cups ~ Four of cups can indicate health problems due to unresolved issues with abuse.

💊Five of cups ~ . In a health reading Five of cups speak of health issues in relations to sexual organs, colon, prostate, rectum, bladder.

💊Six of cups ~ Six of cups in health reading can indicate problems with groin and organs of elimination.

💊Seven of cups ~ Seven of cups in a health reading can also mean abusive people and arguments causing health problems. Serious infections. Environmental toxins. Dangerous sexual encounters.

💊Eight of cups ~ Eight of cups in a health reading can mean problems with prescription drugs.

💊Nine of cups ~ Nine of cups in a health reading can also indicate too much celebration, excess living, hidden alcoholism, drug addictions, obesity, hidden liver issues, high blood pressure, high blood sugar levels.

💊Ten of cups ~ Ten of cups in a health reading can indicate unexpected surgeries (especially to the feet) and nutritional deficiencies.

💊Page of cups ~ Anxiety, groin problems, evil behaviour.

💊Knight of cups ~ Problems with the feet, malnutrition, and addictions.

💊Queen of cups ~ Problems with the breasts, ovaries, uterus.

💊King of cups ~ Problems with the stomach and digestive system, unhealthy belly fat, hereditary illnesses, lifestyle habits learnt from an early age.

ʕ•ᴥ•ʔﾉ♡ ʕ•ᴥ•ʔﾉ♡oopsie you already reached the end ʕ•ᴥ•ʔﾉ♡ʕ•ᴥ•ʔﾉ♡

[monratarot]

Health indicators in tarot - Minor Arcana - Suit of Cups

Please like and reblog if you find this information useful! 🌸🎀💕

//don’t claim it as your own and/or repost it on other platforms//

The Cups get their health meaning from the astrological connection to Cancer, Scorpio and Pisces.

Cancer rules the breast, diaphragm, stomach, esophagus, taste, left side of the body.

Scorpio rules the bladder, urethra, genitals, ovaries/testes, prostate, sigmoid colon, pubic bone, nose, haeme.

Pisces rules the feet, toes, thalamus, blood fibrin.

❃Ace of cups ~ Watch out for people sucking you dry. Depression.

❃Two of cups ~ Two of cups in a health reading speak of how the Seeker absorbs love. Inability to absorb love can give issues with the stomach.

❃Three of cups ~ Three of cups in a health reading can also mean depression and health issues from feeling betrayed or the fear of being betrayed.

❃Four of cups ~ Four of cups can indicate health problems due to unresolved issues with abuse.

❃Five of cups ~ . In a health reading Five of cups speak of health issues in relations to sexual organs, colon, prostate, rectum, bladder.

❃Six of cups ~ Six of cups in health reading can indicate problems with groin and organs of elimination.

❃Seven of cups ~ Seven of cups in a health reading can also mean abusive people and arguments causing health problems. Serious infections. Environmental toxins. Dangerous sexual encounters.

❃Eight of cups ~ Eight of cups in a health reading can mean problems with prescription drugs.

❃Nine of cups ~ Nine of cups in a health reading can also indicate too much celebration, excess living, hidden alcoholism, drug addictions, obesity, hidden liver issues, high blood pressure, high blood sugar levels.

❃Ten of cups ~ Ten of cups in a health reading can indicate unexpected surgeries (especially to the feet) and nutritional deficiencies.

❃Page of cups ~ Anxiety, groin problems, evil behaviour.

❃Knight of cups ~ Problems with the feet, malnutrition, and addictions.

❃Queen of cups ~ Problems with the breasts, ovaries, uterus.

❃King of cups ~ Problems with the stomach and digestive system, unhealthy belly fat, hereditary illnesses, lifestyle habits learnt from an early age.

[themiscyradobermans]

Myxomatous Mitral Valve Disease vs Dilated Cardiomyopathy (Part 1)

Hope you are ready to do some learning today! I didn't want to bog down Nadia's post too much so I figured I'd do something a little more in depth, separately. I also hope that the information here might help anyone seeking information about either disease. Might want to go and make yourself a drink and/or a snack because this will be a long read.

What is MMVD? Myxomatous Mitral Valve Disease also called Degenerative Mitral Valve Disease is the most common cardiac disease affecting dogs. It is an acquired disease (aka "adult onset") that is most typically seen in small breed geriatric dogs. It is characterized by a progressive thickening of the Mitral valve, which is the valve on the left side of the heart - in other words, the valve that connects the left ventricle (LV) to the Left Atrium (LA). The thickening results in it becoming more rigid and overtime it loses the ability to close properly, causing a leak (or regurgitation) from the left ventricle to the left atrium. Over time, the valve has a tendency to become so fibrinous that the leak becomes more important with time, and for some dogs with very advanced MMVD the valve may not even really close much at all anymore.

Because of the leak, over time the left ventricle and the left atrium will enlarge. When the left atrium becomes severely enlarged the patient will progress to congestive heart failure. Because of the stiffening of the valve the chordae tendineae that hold it together are also at risk of rupturing as the disease progresses. When a dog ruptures a major chord, they are at risk of an acute episode of CHF without dilation of the left atrium (because the left atrium does not have a chance to adjust or adapt to the sudden backflow) and patients in this situation will often require critical hospitalization care for 24-48 hours before normalizing. In some very uncommon or rare cases the disease can be self limiting. We have seen it in one or two patients where the dog actually improved after being in B2, with the heart reducing in size because the mitral valve thickened so much it started plugging the leak again. What causes MMVD? It is unknown what exactly causes this process. In certain breeds there is a very strong genetic, hereditary and familial component like in Cavalier King Charles Spaniels, Dachshunds, Cocker Spaniels, Yorkies, Pomeranians and others. It mostly affects small breeds, but any dog breed can get MMVD. How is it diagnosed? MMVD can only truly be diagnosed exclusively via cardiac ultrasound (echocardiography) by a cardiologist. It can be listed as a differential with the help of other diagnostic tools like x-ray, auscultation (presence of a heart murmur on the left side), age/breed of the patient and clinical symptoms (late stages). There are other diagnostic, clinical tests but they are non-specific blood tests that can merely serve to further refer out to a Cardiologist. Can you treat it? Yes. The primary treatment for MMVD will be the administration of Pimobendan once the disease progresses to moderate stage MMVD classified as ACVIM B2. Because it is so prevalent in dogs there is empirical data on it, and one in particular the groundbreaking EPIC study has helped establish very specific guidelines for the classification of Moderate Stage MMVD and the early (pre-clinical) administration of pimobendan. In order to be classified as B2 and qualify for early administration of pimobendan the dog must meet 4 criteria:

Grade III heart murmur or higher

Left Atrium/Aortic (LA/Ao) ratio of 1.6 or higher

Left Ventricle Internal Diameter in Diastole Normalized for weight (LVIDDN) of 1.7 or higher

VHS (Vertebral Heart Score) of 10.5 or higher on xray

Where an echo is not possible, in order to qualify for pimobendan, it is recommended to wait until the the VHS is equal to 11.5 or higher. What is miraculous about the EPIC study is that it offers proof that administering Pimobendan to a dog in B2/moderate MMVD will slow down significantly the progression of the disease. The median time it takes for a B2 moderate MMVD to progress to a Stage C heart failure is 766 days without the administration of Pimobendan. With pimobendan that median increases by 60% 1228 days. Once a dog reaches CHF typically the prognosis is 6-12 months post diagnosis of CHF. With pimobendan it adds about 10% overall time without clinical signs or quality of life issues. Some Cardiologists will also prescribe an ACE Inhibitor (Angiotensin-converting-enzyme inhibitors) alongside Pimobendan even while still in Moderate/B2 stage, while others will prescribe it rather only once the dog progresses to a Stage C (aka severe stage with congestive heart failure). Once the dog reaches Stage C, typically a diuretic will be added to the treatment. Management can include adjusting dosage of the medication and on occasion adding in additional diuretics, or if exhibiting new cardiac symptoms, adding additional medication. For example in large breed dogs you can see Atrial fibrillation, and in some individuals you'll also see Ventricular Premature Contractions (VPCs or PVCs which doberman people will be familiar with due to its role in DCM) so medications can be added to control these aspects too. Now what is interesting with MMVD is that there are currently two surgical procedures/interventions with very limited availability. One is an open heart surgery that is curative and consists in repairing the Mitral Valve. There is the JASMINE Animal Referral Hospital in Japan where the procedure was developed by Dr Uechi Masami, who has then gone on to train teams in the UK at the Queen Mother Hospital Royal Veterinary College as well as a team in France at HOPIA. Currently Dr Uechi is performing mitral valve repair procedures at the University of Florida in the USA, with the goal to try and train as many teams in the USA and around the world. The likelihood of this surgery ever becoming widespread or common place or even accessible to most people is fairly low, given the high demand, and how resource intensive it is both in equipment and specialized teams. The other very recent intervention is the TEER mitral valve repair, a minimally invasive procedure that consists in installing a clamp on the mitral valve to bring it back closer together and thus reduce or eliminate the leak. Can I do anything to prevent it? While there's nothing you can do to prevent MMVD from occurring, if you intend to purchase a puppy from a small breed or medium breed, especially one of the breeds known to have high prevalence of the disease, it is imperative to ask the breeder if the parents have been screened and are being monitored for cardiac disease by a cardiologist, whether that's with a yearly auscultation or a yearly echocardiogram (because MMVD is always associated with a murmur, for regular owner it is acceptable to auscultate yearly, and only do an echo if/once a murmur is heard). Ask about the pedigree also. I strongly encourage you to start screening/monitoring for it when your dog reaches 4-5 years for at risk breeds. Breeding animals should be screened before being bred and then yearly thereafter. If you are unsure whether your breed is considered at risk, you can check the recommended tests for your breed on the OFA website. If you adopt a pup from a rescue or shelter with an unknown genetic background, I would strongly encourage you to ask your vet to properly auscultate during your yearly vet visits and physical exams, and I would request a referral to a cardiologist (if required in your area, our cardiology department doesn't per se require a referral anyone can call and book) even if your dog only has a Grade I-II murmur.