Prednisone

The total protein test is a rough measure of all the proteins found in the fluid portion of your blood. Specifically it looks at the total amount of two classes of proteins: albumin and globulin.

Proteins are important parts of all cells and tissues. For example, albumin helps prevent fluid from leaking out of blood vessels. Globulins are an important part of your immune system.

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

The blood sample is placed into a machine called a centrifuge, which spins the blood to separate the the liquid part of the blood (the serum) from the cells. The total protein test is done on serum.

Your health care provider may tell you to stop taking certain drugs that can affect the test.

Drugs that can increase total protein measurements include anabolic steroids, androgens, corticosteroids, dextran, growth hormone, insulin, phenazopyridine, and progesterone.

Drugs that can decrease total protein measurements include ammonium ions, estrogens, hepatotoxic drugs, and oral contraceptives.

This test is often done to diagnose nutritional problems, kidney disease or liver disease. If total protein is abnormal, further tests must be done to identify the specific problem.

The normal range is 6.0 to 8.3 gm/dl (grams per deciliter).

Normal values may vary slightly from laboratory to laboratory.

Higher-than-normal levels may be due to:

• Chronicinflammation or infection, including HIV and hepatitis B or C
• Multiple myeloma
• Waldenstrom's disease

Lower-than-normal levels may be due to:

• Agammaglobulinemia
• Bleeding (hemorrhage)
• Burns(extensive)
• Glomerulonephritis
• Liver disease
• Malabsorption
• Malnutrition
• Nephrotic syndrome
• Protein-losing enteropathy

Additional conditions under which the test may be performed:

• Congenital nephrotic syndrome

Total protein measurement may be increased during pregnancy.

Bazari H. Approach to the patient with renal disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 115.

Klein S. Protein-energy malnutrition. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 234.

Tenosynovitis is inflammation of the lining of the sheath that surrounds a tendon (the cord that joins muscle to bone).

Inflammation of the tendon sheath

The synovium is a lining of the protective sheath that covers tendons. Tenosynovitis is inflammation of this sheath. The cause of the inflammation may be unknown, or it may result from:

• Infection
• Injury
• Overuse
• Strain

The wrists, hands, and feet are commonly affected. However, the condition may occur with any tendon sheath.

Note: An infected cut to the hands or wrists that causes tenosynovitis may be an emergency requiring surgery.

• Difficulty moving a joint
• Joint swellingin the affected area
• Pain and tenderness around a joint, especially the hand, wrist, foot, or ankle
• Pain when moving a joint

Fever, swelling, and redness may indicate an infection, especially if a puncture or cut caused these symptoms.

A physical examination shows swelling over the involved tendon. The health care provider may touch or stretch the tendon, or have you move the muscle where it is attached to see whether you experience pain.

The goal of treatment is to relieve pain and reduce inflammation. Rest or keeping the affected tendons still is essential for recovery.

You may want to use a splint or a removable brace to help immobilize the tendons. Applying heat or cold to the affected area should help reduce the pain and inflammation.

Nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen can relieve pain and reduce inflammation. Local injections of corticosteroids may be useful as well. Some patients need surgery to remove the inflammation surrounding the tendon, but this is not common.

For tenosynovitis caused by infection, your health care provider will prescribe antibiotics. In some severe cases, surgery may be needed to release the pus around the tendon.

After recovery, do strengthening exercises using the muscles around the affected tendon to help prevent the injury from coming back.

Most people fully recover with treatment. However, if the condition is caused by overuse and the activity is not stopped, tenosynovitis is likely to come back. In chronic conditions, the tendon may be damaged and recovery may be slow or incomplete.

If tenosynovitis is not treated, the tendon may become permanently restricted or it may tear (rupture).

Infection in the tendon may spread to other places in the body, which could be serious.

Call for an appointment with your health care provider if you have pain or difficulty straightening a joint or extremity. If you suspect infection, contact your health care provider immediately.

Avoiding repetitive movements and overuse of tendons may help prevent tenosynovitis.

Pneumocystis jiroveci pneumonia is a fungal infection of the lungs. The disease used to be called Pneumocystis carinii.

Pneumocystosis; PCP; Pneumocystis carinii

This type of pneumonia is caused by the fungus Pneumocystis jiroveci. This fungus is common in the environment and does not cause illness in healthy people.

However, it can cause a lung infection in in people with a weakened immune system due to:

• Cancer
• Chronic use of corticosteroids or other medications that weaken the immune system
• HIV/AIDS
• Orrgan or bone marrow transplant

Pneumocystis jiroveci was a relatively rare infection before the AIDS epidemic. Before the use of preventive antibiotics for the condition, most people in the U.S. with advanced AIDS would develop it.

Pneumocystis pneumonia in those with AIDS usually develops slowly over days to weeks or even months, and is less severe. People with Pneumocystis pneumonia who do not have AIDS usually get sick faster and are more acutely ill.

Symptoms include:

• Cough -- often mild and dry
• Fever
• Rapid breathing
• Shortness of breath -- especially with activity (exertion)

• Blood gases
• Bronchoscopy(with lavage)
• Lung biopsy
• X-ray of the chest
• Sputum exam to check for fungus that causes the infection

Antibiotics can be given by mouth (orally) or through a vein (intravenously), depending on the severity of the illness.

People with low oxygen levels and moderate to severe disease are often prescribed corticosteroids as well.

Pneumocystis pneumonia can be life threatening, causing respiratory failure that can lead to death. People with this condition need early and effective treatment. For moderate to severe Pneumocystis pneumonia in people with AIDS, the short term use of corticosteroids has decreased death.

• Pleural effusion (extremely rare)
• Pneumothorax(collapsed lung)
• Respiratoryfailure (may require breathing support)

If you have a weakened immune system due to AIDS, cancer, transplantation, or corticosteroid use, call your doctor if you develop a cough, fever, or shortness of breath.

Many infections can lead to similar symptoms Your health care provider can help rule out opportunistic infections such as pneumocystis.

Preventive therapy is recommended for:

• Patients with AIDS who have CD4 counts below 200
• Bone marrow transplant recipients
• Organ transplant recipients
• People who take long-term, high-dose corticosteroids
• People who have had previous episodes of this infection

Feinberg JE. Pneumocystis pneumonia. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 362.

No the first and most important thing you can do is replace the cam and heads. Everything else is junk. get competition headers from hooker since they are just about the only headers you will find for that car. Then just get some Jegs aluminum heads and a cam with .45 lift max unless you want to get really into it and a cam with a duration of 201 intake and 204 exhaust 105.3 lobe center angle and 105.5 intake centerline. Then get a 390 to 450 cfm Holley carb unless you have one tuned for a 305 and I suggest Holey because they are 10 times better than any universal carb you can find. Dual plane manifolds are highly overrated I suggest a Torker 2 manifold it work great I have it on my 76 nova 305. Your compression ratio will likely drop with the new heads because most smog 305s have dish pistons meaning you have small combustion chambers, which is why a set of 350 heads meant for flat top pistons don't work. Also get MSD it'll be about $500 for the whole setup but its worth it. Go to Summit racing for the cam because you can order a custom grind cam from them with lifters and all for really cheap. But make sure your tranny can handle this because 4th gen novas like that come with the THM-250 instead of the THM-350 for weight savings if you have to get a street-fighter transmission and components from TCI it'll be about $1000 for the whole tranny setup with torque converter. Keep stock gears unless you want your highway driving to suffer. If you want disc brakes in the rear get a second gen camaro or firebird/trans-am with disc brakes and posi. Now you need to get wider tires then those 215s you have and swap out for some 245s or 255s.

If you have the stock Q jet- you are limited. If you have an aftermarket carb, your power potential is greater.

-1.6 rockers- makes the engine *think* it has a bigger cam. I use and recommend aluminum roller rockers.

-Headers- no larger than 1 3/4, 1 1/2 will make the best torque.

-New free flowing exhaust- 3" if you are running a Y pipe, 2.5" if you are running duals. Good mufflers (I prefer Flowmaster for sound).

-New intake manifold (Edlebrock Performer/ Performer RPM).

-New carb- your choice of brand, no larger than 625 CFM.

-Add an electric fan- get rid of the clutch/water pump driven fan.

-Underdrive pulley's.

-New gears (make you 'scoot' quicker).

-Remove your emissions junk if you can- it's ugly and heavy. Did I mention it's ugly?

If you really want to get down and dirty, get a new cam and 416 heads- 416 heads have 58cc combustion chambers, and will probably increase your CR. Never use 350 heads on a 305- it will only cause problems. If going with a new cam, ALWAYS use new valve springs and hardware. I'd recommend a cam with around 212-218* duration at .050 on the intake side.

keep in mind that a 305 has a small bore size and a "good set of cylinder heads" will not work because of engine block interference with larger valves. It is difficult to make allot of power because of this problem. A 305 shares a crank shaft with the 350 ci. It has a much smaller bore size to reduce the engine size. Its not a good design. It was done to increase fuel mileage in the 80s. Kind of a band aid fix. If you like the small ci Chevys use a 327, 302, these are high revving engines with a 4" bore and have allot of potential for power gains