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October marks the beginning of Breast Awareness month, an annual campaign that aims to increase knowledge and awareness of the disease.

Breast Cancer Awareness Month (BCAM), also referred to in America as National Breast Cancer Awareness Month (NBCAM), is an annual international health campaign organized by major breast cancer charities every October to increase awareness of the disease and to raise funds for research into its cause, prevention, diagnosis, treatment and cure. The campaign also offers information and support to those affected by breast cancer.

NBCAM was founded in 1985 as a partnership between the American Cancer Society and the pharmaceutical division of Imperial Chemical Industries (now part of AstraZeneca, producer of several anti-breast cancer drugs). The aim of the NBCAM from the start has been to promote mammography as the most effective weapon in the fight against breast cancer.

In 1993 Evelyn Lauder, Senior Corporate Vice President of the Estee Lauder Companies founded The Breast Cancer Research Foundation and established the pink ribbon as its symbol, though this was not the first time the ribbon was used to symbolize breast cancer. In the fall of 1991, the Susan G. Komen Foundation had handed out pink ribbons to participants in its New York City race for breast cancer survivors.

A variety of events around the world are organized in October, including walks and runs, and the pink illumination of landmark buildings. In the United States, the National Football League promotes breast cancer awareness by incorporating pink on and off the field, and comic strip artists use pink on one day in October.

In October 1983 the Race for the Cure was held for the first time in Dallas, Texas, where 800 people participated. According to the organizers, by 2002 the number of participants reached 1.3 million and the event was held in over 100 US cities. The event is also being organized in several other parts of the World.

There are various two-day-long walks to raise money for breast cancer research institutes. Avon sponsors a 39-mile (60 km) walk. A walk in Atlanta offers varying lengths of up to 30 miles. Canada’s large “Weekend to End Breast Cancer” features a 60 km walk. St. Louis, MO offers a one-day-long breast cancer walk. This walk consists of three miles.

For the entire month of October Great Architect is sponsoring a Breast Cancer Awareness campaign. They are encouraging all members of their guild and in their games to wear pink for the entire month. You can visit their site and related thread for ways to support Breast Cancer Awareness.

Male breast cancer, which is rare, is generally overlooked. In 2009 the male breast cancer advocacy groups Out of the Shadow of Pink, A Man’s Pink, and the Brandon Greening Foundation for Breast Cancer in Men joined together to globally establish the third week of October as “Male Breast Cancer Awareness Week”.

Inspiration for the foundation of NBCAM came from Zeneca Inc. in 1989 when they began a breast cancer screening program within their company. In 1996, with the screening program and study complete, Zeneca Inc. analyzed the total monetary amounts lost due to the increase in health care provided compared with the total monetary amounts lost if the company was to scrap the program were compared. The total costs to the company of running the early detection program were estimated to be $400,000. Total costs to the company if they chose not to run the program were estimated to be around $1.5 million.

Critics have said that “the BCAM idea ‘was conceived and paid for by a British chemical company that both profits from this epidemic and may be contributing to its cause'”.  Sometimes referred to as National Breast Cancer Industry Month, critics of NBCAM point to a conflict of interest between corporations sponsoring breast cancer awareness while profiting from diagnosis and treatment.  The breast cancer advocacy organization, Breast Cancer Action, has said repeatedly in newsletters and other information sources that October has become a public relations campaign that avoids discussion of the causes and prevention of breast cancer and instead focuses on “awareness” as a way to encourage women to get their mammograms. The term pink-washing has been used by Breast Cancer Action to describe the actions of companies which manufacture and use chemicals which show a link with breast cancer and at the same time publicly support charities focused on curing the disease. Other criticisms center on the marketing of “pink products” and tie ins, citing that more money is spent marketing these campaigns than is donated to the cause<

A closer look at the staggering stats about breast cancer reveal why this is an important cause to so many people.  According to the American Cancer Society, every 2 minutes a woman in the United States is diagnosed with breast cancer — that’s everything from “stage zero” cancer (which some doctors believe shouldn’t even be called cancer) to the deadliest form: invasive breast cancer.

The cancer organization also estimates that 231,840 new cases of invasive breast cancer will be diagnosed in women in the United States this year. And an estimated 2,350 new cases will be diagnosed in men.

The International Agency for Research on Cancer, a part of the World Health Organization, estimated that in 2012, around 1.7 million new cases of breast cancer in women occurred worldwide.

These numbers have influenced the need for early detection and screenings. According to the Food and Drug Administration, more than 39 million mammograms are performed each year in the United States.

And those mammograms may have had an impact. The American Cancer Society reports that the breast cancer death rate is down 34% since 1990. As of Jan. 1, 2014, there were more than 3.1 million breast cancer survivors in the U.S.

The World Cancer Research Fund International reports that there are more than 6 million breast cancer survivors worldwide, giving many survivors a reason to celebrate this month

Breast Cancer Awareness Month, marked in countries across the world every October, helps to increase attention and support for the awareness, early detection and treatment as well as palliative care of this disease.

There are about 1.38 million new cases and 458 000 deaths from breast cancer each year. Breast cancer is by far the most common cancer in women worldwide, both in the developed and developing countries. In low- and middle-income countries the incidence has been rising up steadily in the last years due to increase in life expectancy, increase urbanization and adoption of western lifestyles.

Currently there is not sufficient knowledge on the causes of breast cancer; therefore, early detection of the disease remains the cornerstone of breast cancer control. When breast cancer is detected early, and if adequate diagnosis and treatment are available, there is a good chance that breast cancer can be cured. If detected late, however, curative treatment is often no longer an option. In such cases, palliative care to relief the suffering of patients and their families is needed.

The majority of deaths occur in low- and middle-income countries, where most women with breast cancer are diagnosed in late stages due mainly to lack of awareness on early detection and barriers to health services. A situation that can be reverted if adequate public health programmes are put in place.

WHO promotes comprehensive breast cancer control programmes as part of national cancer control plans. The recommended early detection strategies for low- and middle-income countries are awareness of early signs and symptoms and screening by clinical breast examination in demonstration areas. Mammography screening is very costly and is feasible only in countries with good health infrastructure that can afford a long-term programme.

Kathy Kiefer



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What is the practice of Ananda Yoga like?   What type of exercises does it include? Is it spiritual in nature? Are there required positions to practice Ananda Yoga?

Ananda Yoga brings yoga back to its original spiritual essence.     Exercise and stress relief are only the beginning; the higher purpose of Ananda Yoga practice is to uplift your consciousness. To accomplish that, you’ll work not only with your body, but also with your prana (subtle energy) and the inner faculties of your mind and heart.

Ananda Yoga includes:  (1) Asana (yoga postures); (2) Pranayama (breathing and energy-control techniques); (3) Yogic meditation techniques; and (4) Applied yoga philosophy.

Ananda Yoga brings the science of hatha yoga back to its original purpose: transcending the limitations of the physical body in order to enter into a higher awareness as it brings the body, mind and spirit into mutual harmony.

We find that the whole system of hatha yoga is a very important tool for reminding us of our inner nature, and for strengthening that nature.   Through increased awareness, we gradually become aware of the body on a spiritual level. Eventually we become aware of spirit without the body.

Yoga is an art as well as a science. It is a science, because it offers practical methods for controlling   body and mind, therefore making deep meditation possible. And it is an art, for unless it is practiced intuitively and sensitively it will yield only superficial results.

Yoga posture practice in Ananda Yoga is gentle for beginning students, becoming more challenging with experience. It is an inwardly directed practice, and is never aggressive or aerobic.

The primary emphases are:

  • Safety and correct alignment
  • Being relaxed at all times, even during the midst of effort
  • Working directly with the body’s subtle energy via the yoga postures
  • Using the postures to raise your consciousness
  • Adaptation – modifying each yoga posture to fit the needs and abilities of the practitioner rather than trying to force the practitioner into some “ideal” position

The Energization Exercises are a series of 39 special energy-control techniques that Yogananda developed in order to help the practitioner increase, focus, and control the life-force.

Each yoga posture is paired with its own affirmation, which one practices silently while in the posture. The affirmation is designed to reinforce the posture’s natural effect on one’s state of consciousness, bringing the mind actively and directly into one’s practice.

Ananda Yoga is as concerned with mental attitude as with physical postures. Physical tension, stiffness, muscle tightness all come from corresponding mental states of stress, inflexibility and intolerance.   Physical ailments are often caused by psychological stats as fear, anxiety, resentment and judgment.

In Ananda Yoga, mental affirmations are combined with each posture.   The affirmation is repeated throughout the posture, like a mantra, enabling the thought-seed to penetrate deeply into the mind. The physical stretch is thus enhanced by an expansion of mental outlook.   The result is a gradual change of mental attitude that makes the physical benefits of yoga more lasting. The body is thus used as an instrument through which we can directly and powerfully influence our mind and our mental habits.

Ananda Yoga, or Ananda Yoga for Higher Awareness is a system of Hatha Yoga established by Kriyananda, a disciple of Paramahansa Yogananda, and is based on his Kriva Yoga teachings. Ananda Yoga emphasizes inner awareness; energy control; and the experience of each asana as a natural expression of a higher state of consciousness, which is enhanced by the use of affirmations.

Ananda Yoga was established from one of the oldest Hatha Yoga systems in the West. Its roots are the 1940s/1950s, when Kriyananda was asked by Yogananda, founder of Self-Realization Fellowship (SRF), to demonstrate the postures for visiting guests, as well as for public events, such as the SRF “Lake Shrine Dedication.” Kriyananda also modeled for photos, for articles on the yoga postures in Yogananda’s “Self-Realization Magazine.” From 1965 he started to teach Ananda Yoga publicly in California. In 1972 his students developed a Yoga Teacher Training Program, which is now taught in America, in Europe, and in India. The director of Ananda Yoga, Gyandev Rich McCord, is a co-founder of Yoga Alliance and a member of its Board of Directors.

Ananda Yoga uses asana and pranayama to awaken, experience, and control the subtle energies (prana) within oneself, especially the energies of the chakras. Its object is to use those energies to harmonize the body, uplift the mind, and above all to attune oneself with higher levels of awareness. One unique feature of this system is the use of silent affirmations while in the asanas, as a means of working more consciously with the subtle energies to achieve this attunement. Ananda Yoga is a relatively inward experience, not an athletic practice. A main goal is to prepare for deep meditation, as Hatha Yoga is considered the physical branch of Raja Yoga. Ananda Yoga also includes Paramahansa Yogananda’s Energization Exercises, which direct cosmic life force (prana) through the medulla oblongata to all parts of the body.

The Hindu word for ‘breath,’ ‘life’ and ‘energy’ is the same: prana.   Prana surrounds us in the air we breathe.   We draw not only air into our body when we breathe, but also vitality, strength and courage.   When we   exhale, we through out of our system, not only carbon dioxide, but also mental and emotional impurities: discouragement, weakness, and despair. But inasmuch as these are mental and emotional tendencies, we must use mental ‘lungs’ to draw them into us or to expel them, even as we must use our physical lungs to inhale and exhale air.   When a deliberate mental effort is made to absorb prana from the air that we breathe, then give us psycho-spiritual benefits as well.

Yoga works primarily with the energy in the body, through the science of pranayama, or energy control.   Yoga teaches how, through breathe-control, to still the mind and attain higher states of awareness.

The “Energization Exercises”, a vital part of Ananda Yoga, are Yogananda’s contribution to the science of yoga. He first developed them in 1916, within his organization then called “Yogoda,” which he changed to Self-Realization Fellowship in the 1930s. He later expanded them into a set of 39 exercises. The goal is to tap into cosmic energy, recharging the whole body. Yogananda explains in his Autobiography of a Yogi: “Realizing that man’s body is like an electric battery, I reasoned that it could be recharged with energy through the direct agency of the human will…. I therefore taught the Ranchi students my simple “Yogoda” techniques by which the life force, centered in man’s medulla oblongata, can be consciously and instantly recharged from the unlimited supply of cosmic energy.”

Kathy Kiefer


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Schermata 2015-09-16 alle 21.19.45



What is Kundalini Yoga?

What creative spirits are involved or energy?

What can be learned from it?


Kundalini Yoga also known as laya yoga, is a school of yoga. Kundalini yoga was influenced by the tantra and Shakta schools of Hinduism.

Kundalini yoga derives its name through a focus on awakening kundalini energy through regular practice of meditation, pranayama, chanting mantra and yoga asana. Called by practitioners “the yoga of awareness”, it aims “to cultivate the creative spiritual potential of a human to uphold values, speak truth, and focus on the compassion and consciousness needed to serve and heal others.”

What has become known as “Kundalini yoga” in the 20th century, after a technical term peculiar to this tradition, has otherwise been known as laya yoga from the Sanskrit term laya “dissolution, extinction”. The Sanskrit adjective kuṇḍalin means “circular, annular”. It does occur as a noun for “a snake” (in the sense “coiled”, as in “forming ringlets”) in the 12th-century Rajataangini chronicle. Kuṇḍa, a noun with the meaning “bowl, water-pot” is found as the name of a Nagain Mahabharata. The feminine kuṇḍalī has the meaning of “ring, bracelet, coil (of a rope)” in Classical Sanskrit, and is used as the name of a “serpent-like “Shakti in Tantrism as early as c. the 11th century, in the Śaradatilaka.   This concept is adopted as kuṇḍalini as a technical term into Hatha Yoga in the 15th century and becomes widely used in the Yoga Upanishads by the 16th century.

The Yoga-Kundalini Upanishad is listed in the Muktika canon of 108 Upanishads. Since this canon was fixed in the year 1656, it is known that the Yoga-Kundalini Upanishad was compiled in the first half of the 17th century at the latest. The Upanishad more likely dates to the 16th century, as do other Sanskrit texts which treat kundalini as a technical term in tantric yoga, such as the Ṣaṭ-cakra-nirūpana and the Pādukā-pañcaka. These latter texts were translated in 1919 by John Woodroffe as The Serpent Power: The Secrets of Tantric and Shaktic Yoga. In this book, he was the first to identify “Kundalini yoga” as a particular form of Tantric Yoga, also known as Laya Yoga.

The Yoga-Kundalini and the Yogatattva are closely related texts from the school of Hatha yoga. They both draw heavily on the Yoga Yajnavalkya, as does the foundational Hatha Yoga Pradipika. They are part of a tendency of syncretism combining the tradition of yoga with other schools of Hindu philosophy during the 15th and 16th centuries. The Yoga-Kundalini Upanishad itself consists of three short chapters; it begins by stating that Chitta (consciousness) is controlled by Prana, and it’s controlled by moderate food, postures and Shakti-Chala.   Verses I.3-6 explains the concepts of moderate food and concept, and verse I.7 introduces Kundalini as the name of the Shakti under discussion.   The Sakti is only Kundalini. A wise man should take it up from its place to the middle of the eyebrows. This is called Sakti-Chala. In practicing it, two things are necessary, Sarasvati-Chalana and the restraint of Prana (breath). Then through practice, Kundalini (which is spiral) becomes straightened.

Although kundalini developed as a part of tantra side-by-side with hatha yoga through a process of syncretism, Swami Nigamananda (d. 1935) taught a form of laya yoga which he insisted was not part of Hatha yoga.

Swami Sivananda (1935) introduced many readers to “Kundalini yoga” with his book on the subject in 1935. Swami Sivananda’s book combines laya teachings from older sources including the Hathapradipika and Satcakranirupana. Together with other currents of Hindu revivalism and Neo-Hinduism, Kundalini Yoga became popular in 1960s to 1980s western counter-culture.

In 1968, Yogi Bhajan introduced his own brand of kundalini yoga into the United States, “Kundalini Yoga as taught by Yogi Bhajan”. Yogi Bhajan founded the “Happy, Heathy, Holy Organization” (3HO) as a teaching organization. Yogi Bhajan took yogic postures and techniques, attached them to Tantric theories and Sikh mantras, synthesizing a new form of ‘Kundalini’ yoga. “When placed alongside the teachings of Swami Dhirendra Brahmachari and Maharaj Virsa Singh, it becomes strikingly apparent that at least in its earliest years, Yogi Bhajan’s Kundalini yoga was not a distinct practice, but essentially a combination of yogic mechanics learned from the former and the Sikh-derived mantras (Ik Ongkaar, Sat Naam, Sri Waheguru) and chanting from the latter,” Deslippe writes. But Virsa Singh rejected Bhajan’s Kundalini yoga. Yoga was not a part of the Gobind Sadan spiritual path. And a power struggle ensued over who would win control of the new American followers.

Traditional Sikhs use quotations by Bhai Gurdas, whose “Vaaraa,” or “Ballads,” were considered by Guru Arjan as a key to understanding the concepts of the Guru Granth as saying, wherever Guru Nanak went and debated the futility of yoga, the yogis gave up their yogic paths. The yogis of “Gorakhmata,” meaning “Wisdom of Gorakhnatha,” the founder of Hatha yoga, converted to the path of Guru Nanak, and also changed the name of their ancient center to “Nanakmata,” meaning “Wisdom of Guru Nanak,” known today as Gurdwara Sri Nanakmata Sahib. Guru Nanak never practiced yoga, and neither did any of the following Gurus, their Sikhs or the Khalsa. Yoga is unmistakably refuted in the Guru Granth.

Disciples of Harbhajan Singh (Yogi Bhajan) claim that while Yoga practice and philosophy are generally considered a part of Hindu culture, Kundalini Yoga as taught by Yogi Bhajan is founded on the principles of Sikh Dharma. While adhering to the three pillars of Patanjali’s kriya yoga system: discipline (tapaḥ), spiritual study (svādhyāya) and devotion to God (iśvarapraṇidāna), Kundalini Yoga as taught by Yogi Bhajan does not condone extremes of asceticism or renunciation. He encouraged his students to marry, establish businesses, and be fully engaged in society. Rather than worshiping God, Yogi Bhajan’s teachings encourage students to train their mind to experience God. Yogi Bhajan sometimes referred to the Sikh lifestyle as Raja Yoga, the yoga of living detached, yet fully engaged in the world.

Kundalini is the term for “a spiritual energy or life force located at the base of the spine”, conceptualized as a coiled-up serpent. The practice of Kundalini yoga is supposed to arouse the sleeping Kundalini Shakti from its coiled base through the 6 chakras, and penetrate the 7th chakra, or crown. This energy is said to travel along the ida (left), pingala (right) and central, or sushumna nadi – the main channels of pranic energy in the body.

Kundalini energy is technically explained as being sparked during yogic breathing when prana and apana blends at the 3rd chakra (navel center) at which point it initially drops down to the 1st and 2nd chakras before traveling up to the spine to the higher centers of the brain to activate the golden cord – the connection between the pituitary and pineal glands – and penetrate the 7 chakras.

Borrowing and integrating the highest forms from many different approaches, Kundalini Yoga can be understood as a tri-fold approach of Bhakti yoga for devotion, Shakti yoga for power, and Raja yoga for mental power and control. Its purpose through the daily practice of kyiyas and meditation in sadhana are described a practical technology of human consciousness for humans to achieve their total creative potential. With the practice of Kundalini Yoga one is thought able to liberate oneself from one’s Karma and to realize one’s Dharma (Life Purpose).

The practice of kriyas and meditations in Kundalini Yoga are designed to raise complete body awareness to prepare the body, nervous system, and mind to handle the energy of Kundalini rising. The majority of the physical postures focus on navel activity, activity of the spine, and selective pressurization of body points and meridians. Breath work and the application of bandhas aid to release, direct and control the flow of Kundalini energy from the lower centers to the higher energetic centers.

Along with the many kriyas, meditations and practices of Kundalini Yoga, a simple breathing technique of alternate nostril breathing (left nostril, right nostril) is taught as a method to cleanse the nadis, or subtle channels and pathways, to help awaken Kundalini energy.

Kundalini Yoga is a catalyst for psycho-spiritual growth and bodily maturation. According to this interpretation of yoga, the body bows itself into greater maturation […], none of which should be considered mere stretching exercises.   “Kundalini Yoga consists of active and passive asana-based kriyas, pranayama, and meditations which target the whole body system (nervous system, glands, mental faculties, chakras) to develop awareness, consciousness and spiritual strength.” —Yogi Bhajan

One of the best features about New Moons is the feeling having a fresh start with new awareness and new intensions. Kundalini Yoga during a new moon can be a time for new construction and work on the inner self. It can be a time to go within and meditate where you have been and where you want to be. It is an opportunity to go into a state of silence and neutrality to remember what is really important in your life. With the world in fast forward with upheavals and challenges happening every day and everywhere, it is important to pause and set time aside to revitalize and reenergize. Yoga and meditation practiced during a new moon can give you fresh new perspectives and enhanced commitment to a new direction. This class also includes a long gong relaxation.

Kathy Kiefer


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Why is Pharmacogenomics suddenly in the news?

Why haven’t I heard of it before?   What is it about?

Pharmacogenomics (a portmanteau of pharmacology and genomics) is the study of the role of genetics in drug response. It deals with the influence of acquired and inherited genetic variation on drug response in patients by correlating gene expression or single-nucleotide polymorphisms with drug absorption, distribution, metabolism and elimination as well as drug receptor target effects. The term pharmacogenomics is often used interchangeably with pharmacogenetics. Although both terms relate to drug response based on genetic influences, pharmacogenetics focuses on single drug-gene interactions, while pharmacogenomics encompasses a more genome-wide association approach, incorporating genomics and epigenetics while dealing with the effects of multiple genes on drug response.

Pharmacogenomics aims to develop rational means to optimize drug therapy, with respect to the patients’ genotype, to ensure maximum efficacy with minimal adverse effects. Through the utilization of pharmacogenomics, it is hoped that drug treatments can deviate from what is dubbed as the “one-dose-fits-all” approach. It attempts to eliminate the trial-and-error method of prescribing, allowing physicians to take into consideration their patient’s genes, the functionality of these genes, and how this may affect the efficacy of the patient’s current and/or future treatments (and where applicable, provide an explanation for the failure of past treatments).   Such approaches promise the advent of “personalized medicine”; in which drugs and drug combinations are optimized for each individual’s unique genetic makeup. Whether used to explain a patient’s response or lack thereof to a treatment, or act as a predictive tool, it hopes to achieve better treatment outcomes, greater efficacy, minimization of the occurrence of drug toxicities and adverse drug reactions (ADRs). For patients who have lack of therapeutic response to a treatment, alternative therapies can be prescribed that would best suit their requirements. In order to provide pharmacogenomic-based recommendations for a given drug, two possible types of input can be used: genotyping or exome or whole genome sequencing. Sequencing provides many more data points, including detection of mutations that prematurely terminate the synthesized protein (early stop codon).

Pharmacogenomics was first recognized around 510 BC when a connection was made between the dangers of fava bean ingestion with hemolytic anemia and oxidative stress. Interestingly, this identification was later validated and attributed to deficiency of G6PD in the 1950s and called favism. Although the first official publication dates back to 1961, circa 1950s marked the unofficial beginnings of this science. Reports of prolonged paralysis and fatal reactions linked to genetic variants in patients who lacked butyryl-cholinesterase (‘pseudocholinesterase’) following administration of succinylcholine injection during anesthesia were first reported in 1956. The term pharmacogenetic was first coined in 1959 by Friedrich Vogel of Heidelberg, Germany (although some papers suggest it was 1957). In the late 1960s, twin studies supported the inference of genetic involvement in drug metabolism, with identical twins sharing remarkable similarities to drug response compared to fraternity twins. The term pharmacogenomics first began appearing around the 1990s.

There are several known genes which are largely responsible for variances in drug metabolism and response. The focus of this article will remain on the genes that are more widely accepted and utilized clinically for brevity. (a) Cytochrome P450s; (b) VKORC1; and (c) TPMT

The most prevalent drug-metabolizing enzymes (DME) are the Cytochrome P450 (CYP) enzymes. The term Cytochrome P450 was coined by Omura and Sato in 1962 to describe the membrane-bound, heme-containing protein characterized by 450 nm spectral peak when complexed with carbon monoxide. The human CYP family consists of 57 genes, with 18 families and 44 subfamilies. CYP proteins are conveniently arranged into these families and subfamilies on the basis of similarities identified between the amino acid sequences. Enzymes that share 35-40% identity are assigned to the same family by an Arabic numeral, and those that share 55-70% make up a particular subfamily with a designated letter.   For example, CYP2D6 refers to family 2, subfamily D, and gene number 6.

From a clinical perspective, the most commonly tested CYPs include: CYP2D6, CYP2C19, CYP2C9, CYP3A4 and CYP3A5. These genes account for the metabolism of approximately 80-90% of currently available prescription drugs. Also known as debrisoquine hydroxylase (named after the drug that led to its discovery), CYP2D6 is the most well-known and extensively studied CYP gene. It is a gene of great interest also due to its highly polymorphic nature, and involvement in a high number of medication metabolisms (both as a major and minor pathway). More than 100 CYP2D6 genetic variants have been identified.   Discovered in the early 1980s, CYP2C19 is the second most extensively studied and well understood gene in pharmaco-genomics. Over 28 genetic variants have been identified for CYP2C19, of which affects the metabolism of several classes of drugs, such as antidepressants and protein pump inhibitors.    CYP2C9 constitutes the majority of the CYP2C subfamily, representing approximately 20% of the liver content. It is involved in the metabolism of approximately 10% of all drugs, which include medications with narrow therapeutic windows such as warfarin and tolbutamide. There are approximately 57 genetic variants associated with CYP2C9.   The CYP3A family is the most abundantly found in the liver, with CYP3A4 accounting for 29% of the liver content. These enzymes also cover between 40-50% of the current prescription drugs, with the CYP3A4 accounting for 40-45% of these medications.   The vitamin K epoxide reductase complex subunit 1 (VKPRC1) is responsible for the pharmacodynamics of warfarin.   VKORC1 along with CYP2C9 are useful for identifying the risk of bleeding during warfarin administration. Warfarin works by inhibiting VKOR, which is encoded by the VKORC1 gene. Individuals with polymorphism in this have an affected response to warfarin treatment.

Patient genotypes are usually categorized into the following predicted phenotypes: (1) Ultra-Rapid Metabolizer: Patients with substantially increased metabolic activity; (2) Extensive Metabolizer: Normal metabolic activity; (3) Intermediate Metabolizer: Patients with reduced metabolic activity; and (4) Poor Metabolizer: Patients with little to no functional metabolic activity.

The two extremes of this spectrum are the Poor Metabolizers and Ultra-Rapid Metabolizers. Efficacy of a medication is not only based on the above metabolic statuses, but also the type of drug consumed. Drugs can be classified into two main groups: active drugs and pro-drugs. Active drugs refer to drugs that are inactivated during metabolism, and Pro-Drugs are inactive until they are metabolized.

Each phenotype is based upon the allelic variation within the individual genotype. However, several genetic events can influence a same phenotypic trait, and establishing genotype-to-phenotype relationships can thus be far from consensual with many enzymatic patterns. For instance, the influence of the CYP2D6*1/*4 allelic variant on the clinical outcome in patients treated with Tamoxifen remains debated today. In oncology, genes coding for DPD, UGT1A1, TPMT and CDA are involved in the pharmacokinetics of 5-FU/capecitabine, irinotecam, 6-mercaptopurine and gemcitabine/cytarabine, respectively, have all been described as being highly polymorphic. A strong body of evidence suggests that patients affected by these genetic polymorphisms will experience severe/lethal toxicities upon drug intake, and that pre-therapeutic screening does help to reduce the risk of treatment-related toxicities through adaptive dosing strategies.

The list below provides a few more commonly known applications of pharmacogenomics: (1) Improve drug safety, and reduce ADRs; (2) Tailor treatments to meet patients’ unique genetic pre-disposition, identifying optimal dosing; (3) Improve drug discovery targeted to human disease; and (4) Improve proof of principle for efficacy trials.

Pharmacogenomics may be applied to several areas of medicine, including Pain Management, Cardiology, Oncology and Psychiatry. A place may also exist in Forensic Pathology, in which pharmacogenomics can be used to determine the cause of death in drug-related deaths where no findings emerge using autopsy.

In cancer treatment, pharmacogenomics tests are used to identify which patients are most likely to respond to certain cancer drugs. In behavioral health, pharmacogenomic tests provide tools for physicians and care givers to better manage medication selection and side effect amelioration. Pharmacogenomics is also known as companion diagnostics, meaning tests being bundled with drugs. Beside efficacy, germline pharmacogenetics can help to identify patients likely to undergo severe toxicities when given cytotoxics showing impaired detoxification in relation with genetic polymorphism, such as canonical 5-FU.

A potential role pharmacogenomics may play would be to reduce the occurrence of poly-pharmacy. It is theorized that with tailored drug treatments, patients will not have the need to take several medications that are intended to treat the same condition. In doing so, they could potentially minimize the occurrence of ADRs, have improved treatment outcomes, and can save costs by avoiding purchasing extraneous medications. An example of this can be found in Psychiatry, where patients tend to be receiving more medications then even age-matched non-psychiatric patients. This has been associated with an increased risk of inappropriate prescribing.

The U.S. Food and Drug Administration (FDA) appears to be very invested in the science of pharmacogenomics as is demonstrated through the 120 and more FDA-approved drugs that include pharmacogenomic biomarkers in their labels. On May 22, 2005, the FDA issued its first Guidance for Industry: Pharmacogenomic Data Submissions, which clarified the type of pharmacogenomic data required to be submitted to the FDA and when. Experts recognized the importance of the FDA’s acknowledgement that pharmacogenomics experiments will not bring negative regulatory consequences. The FDA had released its latest guide Clinical Pharmacogenomics (PGx): Premarket Evaluation in Early-Phase Clinical Studies and Recommendations for Labeling in January, 2013. The guide is intended to address the use of genomic information during drug development and regulatory review processes.

Although there appears to be a general acceptance of the basic tenet of pharmacogenomics amongst physicians and healthcare professionals, several challenges exist that slow the uptake, implementation, and standardization of pharmacogenomics. Some of the concerns raised by physicians include:   (1) Limitation on how to apply the test into clinical practices and treatment; (2) A general feeling of lack of availability of the test; (3) The understanding and interpretation of evidence-based research; and (4) Ethical, legal and social issues.

Issues surrounding the availability of the test include: (a) The lack of availability of scientific data: Although there are considerable number of DME involved in the metabolic pathways of drugs, only a fraction have sufficient scientific data to validate their use within a clinical setting; and (b) Demonstrating the cost-effectiveness of pharmacogenomics: Publications for the pharmacoeconomics of pharmacogenomics are scarce, therefore sufficient evidence does not at this time exist to validate the cost-effectiveness and cost-consequences of the test.

Computational advances in Pharmacogenomics has proven to be a blessing in research. As a simple example, for nearly a decade the ability to store more information on a hard drive has enabled us to investigate a human genome sequence cheaper and in more detail with regards to the effects/risks/safety concerns of drugs and other such substances. Such computational advances are expected to continue in the future. The aim is to use the genome sequence data to effectively make decisions in order to minimize the negative impacts on, say, a patient or the health industry in general. A large amount of research in the biomedical sciences regarding Pharmacogenomics as of late stems from combinatorial chemistry, genomic mining, omic technologies and high throughput screening. In order for the field to grow rich knowledge enterprises and business must work more closely together and adopt simulation strategies. Consequently more importance must be placed on the role of computational biology with regards to safety and risk assessments. Here we can find the growing need and importance of being able to manage large, complex data sets, being able to extract information by integrating disparate data so that developments can be made in improving human health.

 Kathy Kiefer

HERBAL REMEMEDIES: Dry extract of Horsetail + Nettle = Gold for bones, teeth, hair, scars … and not only these…

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                                  Dry extract of Horsetail + Nettle = Gold for bones, teeth, hair, scars … and not only these…

Dry extract of Horsetail contains organic acids, minerals (especially potassium and silicon), glycosides, tannins, flavonoids and isoquercitina. The beneficial effects of this plant have been known since ancient times: the Roman physician Galen recommended it to his patients for its diuretic properties.


Horsetail is primarily used as a diuretic. Its features make it a useful remedy for cellulite, water retention and drainage of the urinary tract. For this reason it is often used as an adjuvant for cystitis and for the health of the prostate.


The high concentration of minerals present in horsetail make it a valid and useful tool for demineralizing, and in the strengthening of nails, hair and bones. That is why natural medicine is recommended for use in case of osteoporosis, and in the case of nails or brittle hair.


Known for its slimming and anti-swelling effects, horsetail also stimulates collagen production, toning of the tissue andurl1 wrinkle-free skin. Diuretic, cleansing and toning, horsetail also helps to eliminate waste and toxins that promote overweight. Here are some guidelines for how to use it.

Effective: The horsetail has a diuretic action, thanks to the presence of flavonoids (isoquercitina, kaemferolo, but fifteen different types have been identified) enhanced in their action by mineral salts, that make the plant particularly suitable in case of swelling due to fluid retention, cellulite and cystitis. In particular, the silicon contributes to eliminate metabolic waste (urea, uric acid, nicotine etc.) with a detoxifying effect. The minerals present in the dry extract also stimulate the production of collagen, the substance that makes tissues; it prevents the formation of wrinkles and improves skin elasticity.


Suitable especially when following a weight loss program and you want to get results quickly and avoid losing tone. Also it has been proven very effective if you suffer from fluid retention, cellulite, as well as swelling of eyes, legs and ankles.


Rich in silicon, magnesium salts etc., horsetail can be used for demineralizing treatments in order to counteract some of the most common problems that are typical of pre-menopausal and menopause, such as osteoporosis, weakening of hair and nails, slowing of metabolism, aging skin, and loss of tone in tissues.


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Nettle dioica-2-Known for its irritant properties, but its extract is a blessing for the well-being of the body,    as well as is highly stimulating, purifying and diuretic. It has properties similar to the saw palmetto which benefits prostate health. It has an interesting property to maintain a good level of free testosterone and activity.

The main effects shown are:

It maintains free testosterone by binding to SHBG
• It inhibits the conversion of testosterone to DHT
• Can prevent benign prostatic hyperplasia
• It can prevent hair loss
• Hypoglycemic Action
• May affect anti rheumatic
• Anti-anemic property
• Diuretic

Constituents of nettle include: acetylcholine, histamine, formic acid and Gallic, carotene, vitamin C, chlorophyll, tannin,infuso-ortica_ng1 potassium, calcium, iron, manganese, silicon.

Has been used successfully in alternative care: for the hair, treatment of diabetes, anemia, edema, sciatica, rheumatism, insect bites, psoriasis, skin care, hives, menopause, bed wetting, and epistaxis.

Preparation: You can mix the decoction or macerated horsetail to macerated nettles for more comprehensive action.

Kathy Kiefer


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The field of complementary and alternative medicine is known as CAM. CAM tries to prevent and treat different conditions with techniques such as: (A) Recommended Related to Mind, Body, Spirit

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Healing touch; (B) Energy; and (c) Herbal medicines. Many CAM therapies have been around for centuries. But do they really work?   Many different fields make up the practice of complementary and alternative medicine (CAM). In addition, many components of one field may overlap with the components of another field (an example is acupuncture, which is also used in conventional medicine).

According to the National Center for Complementary and Alternative Medicine (NCCAM), complementary and alternative medicine therapies can be classified into five broad categories:

Alternative medical systems are built upon complete systems of theory and practice. Often, these systems have evolved apart from and earlier than the conventional medical approach used in the United States.

Mind-body medicine uses a variety of techniques designed to enhance the mind’s capacity to affect bodily function and symptoms. Some techniques that were considered alternative in the past have become mainstream (for example, patient support groups and cognitive-behavioral therapy).

Other mind-body techniques are still considered alternative, including: (1) Art therapy; (2) Biofeedback; (3) Dance therapy; (4) Guided imagery; (5) Humor therapy; (6) Hypnotherapy; (7) Meditation; (8) Music therapy; (9) Prayer therapy; and (10) Yoga.

Biologically based therapies in complementary and alternative medicine use substances found in nature, such as herbs, foods, and vitamins. Some examples include: (a) Diet; (b) Dietary supplements; (c) Herbal products; and (D) Megavitamins.

It also includes the use of other so-called natural but as yet scientifically unproven therapies (for example, using shark cartilage to treat cancer).

Manipulative and body-based methods in complementary and alternative medicine are based on manipulation and/or movement of one or more parts of the body. Some examples include: (1) Acupressure; (2) Alexander Technique; (3) Chiropractic; (4) Feldenkrais Method; (5) Massage Therapy; (6) Osteopathy; (7) Reflexology; (8) Rolfing; (9) Therapeutic Touch; and (10) Trager Approach.

Energy therapies involve the use of energy fields. They are of two types:

Biofield therapies are intended to affect energy fields that purportedly surround and penetrate the human body. The existence of such fields has not yet been scientifically proven. Some forms of energy therapy manipulate biofields by applying pressure and/or manipulating the body by placing the hands in, or through, these fields. Examples include: (a) Qi gong; (b) Reiki; and (c) Therapeutic Touch.

Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields, such as: (1) Pulsed fields; (2) Magnetic fields; and (3) Alternating-current or direct-current .fields

There is research to show that some CAM techniques can help with problems like pain and nausea. But other alternative therapies don’t have enough medical evidence to determine if they are effective.

Before you try CAM, read this overview. Learn which treatments might actually help you feel better — and which ones may not be worth the money.

Acupuncture.     This traditional Chinese medicine technique uses thin needles to stimulate various points around the body. Each point corresponds to a specific condition. The aim of acupuncture is to restore a balance of energy and good health to the body.

The evidence: More study needs to be done into the benefits of acupuncture. However, evidence suggests that acupuncture holds promise for relieving vomiting caused by cancer chemotherapy. It also may help ease some chronic pain conditions, that include: (a) Headaches; (b) Low back pain; and (c) Osteoarthritis of the knee.

Chiropractic Medicine.  Chiropractors specialize in adjustments — manipulating the spine to put the body into better alignment. People typically visit the chiropractor when they have pain in their lower back, shoulders, and neck. But many chiropractors claim adjustments can also improve overall health.

The evidence: Chiropractic medicine does seem to provide some relief for lower back pain.  But it may not be any better than other back pain treatments. Studies have also found the technique effective for: (1) Migraine and neck-related headaches; (2) Neck pain; (3) Joint conditions; and (4) whiplash.

But there isn’t much data on the effectiveness of chiropractic medicine for some general medical conditions. For example, there’s no solid evidence that it can treat asthma, high blood pressure, menstrual pain, or fibromyalgia. .

Energy therapies use magnets and therapeutic touch to manipulate the body’s energy fields and improve health.

Magnetic Field Therapy   Magnets are thought by some to have healing abilities. Centuries ago, people believed magnets could treat everything from gout to baldness. Today, they’re worn inside bracelets, shoes, and other accessories.

The evidence: There’s no conclusive evidence that magnets are effective pain relievers.

A small study has shown that a magnet therapy called transcranial magnetic stimulation may aid recovery in certain stroke survivors. The results are preliminary. More study is needed to see if the therapy is effective. Repetitive TMS (rTMS) also is a non-experimental, FDA-approved treatment for major       depression.

Magnets are generally safe. But they can disrupt the function of pacemakers, defibrillators, and insulin pumps. That makes them potentially dangerous for anyone who uses these devices.

The premise of Reiki is that it accesses the body’s natural energy to speed healing. The practitioner hovers his or her hands over the patient’s body. Or he or she places them lightly on the person’s skin.

The evidence: There is something to be said for the healing touch when it comes to bringing about a state of calm. One study checked the effect of Reiki on people hospitalized with heart disease. It showed that Reiki was effective in bringing about an increase in: (1) Happiness; (2) Relaxation; and (3) Feeling of calm.

Therapeutic Touch Advocates of this technique suggest that the power of touch may direct energy flow and treat pain and disease.

The evidence: It’s hard to tell for sure whether therapeutic touch works. There have been few good studies done on this technique. Researchers have investigated its effects on wound healing, pain, and anxiety. Studies into its effectiveness have not been conclusive.

Herbal Medicine Plants form the foundation of herbal medicine. They’re taken in several forms, including pills, powders, or extracts to treat a variety of conditions. Herbal medicine can be divided into three types: (a) Ayurvedic; (b) Chinese; and (c) Traditional.

Ayurvedic medicine originated in India more than 2,000 years ago. It focuses on balance of the mind, body, and spirit. Hundreds of different herbs are used to: (1) Protect the body against disease; (2) Relieve pain; and (3) Improve general health.

The evidence: Most studies performed have been small. They cannot provide conclusive evidence that Ayurvedic herbal medicine works.   There’s also a serious caution to using Ayurvedic products. One study found that Ayurvedic herbal medicines from South Asia had dangerously high levels of: (1) Lead; (2) Mercury; and (3) Arsenic.

Chinese herbal medicines include gingko and ginseng. They are not used to treat a specific symptom or disease. Instead they are meant to restore balance to the body as a whole. These medicines can be taken in many forms, including pills, powders, and teas.

The evidence: Chinese herbal remedies have been studied for treating conditions such as cancer, heart disease and diabetes. But the research hasn’t been well-designed enough to draw any conclusions on effectiveness. Regarding safety, there have been reports of heavy metals and other toxins in certain Chinese herbal remedies.

Traditional   A number of different herbs are grown right here in the U.S. or in Europe that are considered “Western” or “traditional” herbal remedies. Most studies on these herbs have been small. So it’s hard to know for sure whether they work. A few herbs that have shown possible benefit include: (a) Chamomile for relieving stomach upset; (b) Cranberry for preventing urinary tract infections; (c) Flaxseed, garlic, and soy for lowering cholesterol; (d) Peppermint oil for preventing heartburn; and (e) St. John’s wort for relieving mild to moderate depression.

Although herbal remedies are considered “natural,” they can cause side effects. They may also interact with drugs you’re taking for other conditions. Talk to your doctor before taking any herbal medicine.

Kathy Kiefer


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Pyrotechnics is the science of using materials capable of undergoing self-contained and self-sustained exothermic chemical reactions for the production of heat, light, gas, smoke and/or sound. Its etymology  stems from the Greek words pyro (“fire”) and tekhnikos (“made by art”). Pyrotechnics include not only the manufacture of fireworks but items such as safety matches, oxygen candles, explosive bolts and fastners, components of the automotive airbag and gas pressure blasting in mining, quarrying and demolition.

Individuals responsible for the safe storage, handling, and functioning of pyrotechnic devices are referred to as pyrotechnicians.

Explosions, flashes, smoke, flames, fireworks or other pyrotechnic driven effects used in the entertainment industry are referred to as theatrical special effects, special effects, or proximate pyrotechnics. Proximate refers to the pyrotechnic device’s location relative to an audience. In the majority of jurisdictions, special training and licensing must be obtained from local authorities to legally prepare and use proximate pyrotechnics.

Many musical groups use pyrotechnics to enhance their live shows. Pink Floyd were without a doubt the innovators of pyrotechnic use in concerts. For instance, at the climax of their song Careful With That Axe.   Bands such as The Who, KISS and Queen, soon followed use of pyrotechnics in their shows. Michael Jackson attempted using pyrotechnics in a 1984 Pepsi advertisement, where a stray spark caused a small fire in his hair. German industrial metal band Rammstein are renowned for their large variety of pyrotechnics, which range from flaming costumes to face-mounted flamethrowers. Night wish, Lordi and Green Day have all become known for their vivid pyrotechnics in concert. Many professional wrestlers have also used pyrotechnics as part of their entrances to the ring.

Modern pyrotechnics are, in general, divided into categories based upon the type of effect produced or manufacturing method. The most common categories are: (1) Airburst – Hanging charges designed to burst into spheres of sparks; (2) Binary powders – Kits divided into separate oxidizer and fuel, intended to be mixed on site; (3) Comet (meteor) – Brightly colored burning pellets resembling shooting stars; (4) Mine – Tubes containing a lift charge intended to project stars, sparks, confetti or streamers; (5) Preloaded Smoke Pot – Cartridges designed to release a mushroom cloud of smoke; (6) Concussion (cannon simulator, concussion tube) – Device designed to create a loud report; (7) Falls – Propellant with titanium burning in an open ended tube creating a falling spark effect; (8) Fireballs / Mortar Hits – Short barreled device projecting smoky rolling ball of flame; (9) Flame Projector – Tube containing nitrocellulose granules that burn in pillars of colored flame; (10) Flare (Torch) – Short, high intensity flames or various colours; (11) Flash Cotton (Sparkle String) – Nitrated cotton string(nitrocellulose); (12) Flashpaper – Sheets of nitrated paper (nitrocellulose) resembling tissue paper; (13) Flash Pot – Short metal pot used with binary powders creating flash, smoke or sparks; (14) Flash Tray (split mine) – A long tube slit down one side to project a sheet of flash; (15) Gerb (including fountain, whistle and waterfall) – A fountain of sparks; (16) Lance – Small colored flare tube used in making points of light lance work or pictures in fire;   (17) Line Rockets – Whistling or colored rocket devices that travel along guide cables; (18) Multi-Tube Article (multi-shot plate, multiple shot repeater boards and bombardo boards; designed to function in sequence) – Multiple effects chained together; (19) Pre-Mixed Powder – Powders intended to create various effects. (Concussions, flashes, etc.); (20) Squib – A small electrically initiated device replicating bullet hits; (21) Strobe – A brightly colored magnesium fueled flare blinking with repetitive flashes; and (22) Wheel (Saxon) – Tubes that create a spinning wheel of sparks.

A basic theatrical effect, designed to create a jet or fountain of sparks, is referred to as a gerb. A gerb consists of a sufficiently strong and non-flammable container to hold the pyrotechnic compound. Typical pyrotechnic formulations consist either of flammable materials such as nitrocellulose and/or black powder or a mixture of a fuel and oxidizer blended in situ. A plug placed at one end of the container with a small orifice, called a choke, constricts the expulsion of the ignited pyrotechnic compound, increasing the size and aggressiveness of the jet.

Various ingredients may be added to pyrotechnic devices to provide colour, smoke, noise or sparks. Special additives and construction methods are used to modify the character of the effect produced, either to enhance or subdue the effect; for example, sandwiching layers of pyrotechnic compounds containing potassium perchlorate, sodium salicylate or sodium benzoate with layers that do not creates a fountain of sparks with an undulating whistle.

In general, such pyrotechnic devices are initiated by a remotely controlled electrical signal that causes an electric match, or e-match, to produce ignition. The remote control may be manual, via a switch console, or computer controlled according to a pre-programmed sequence and/or a sequence that tracks the live performance via stage cues.

Display pyrotechnics, also known as commercial fireworks, are pyrotechnic devices intended for use outdoors, where the audience can be further away, and smoke and fallout is less of a concern. Generally the effects, though often similar to proximate pyrotechnics, are of a larger size and more vigorous in nature. It will typically take an entire day to set up a professional fireworks display. The size of these fireworks can range from 50 mm (2″) to over 600 mm (24″) diameter depending on the type of effect and available distance from the audience. In most jurisdictions, special fireworks training and licensing must be obtained from local authorities to legally prepare and use display pyrotechnics.

Consumer pyrotechnics are devices readily available for purchase to the general public with little or no special licensing or training. These items are considered relatively low hazard devices but, like all pyrotechnics, can still be hazardous and should be stored, handled and used appropriately. Some of the most common examples of consumer pyrotechnics encountered include recreational fireworks (including whistling and sparking types), model rocket motors, highway and marine distress flares, sparklers and caps for toy guns. Pyrotechnics are also indirectly involved in other consumer products such as powder actuated nail guns, ammunition for firearms, and modern fireplaces. Some types, including bird scarers, shell crackers, whistle crackers and flares, may be designed to be fired from a 12-gauge pistol or rifle.

Pyrotechnics are dangerous and must be handled and used properly. Recently, several high profile incidents involving pyrotechnics have re-enforced the need to respect these explosives at all times. Proximate pyrotechnics is an area of expertise that requires additional training beyond that of other professional pyrotechnics areas and the use of devices specifically manufactured for indoor, close proximity use.

A common low-budget pyrotechnic flash pot is built using modified screw-in electric fuses in a common light fixture. The fuses are intentionally blown, acting as ignitors for a pyrotechnic material.

Homemade devices may fail to include safety features and can provide numerous hazards, including: (a) A firing circuit using high-power, non-isolated AC line voltage can be a shock hazard to the operator and bystanders; (b) The use of high-current fuses as ignitors can cause main circuit breakers and fuses to trip, due to the sudden inrush of hundreds of amperes through a dead-shorted circuit. Switches used to control ignition may be damaged from the high-current surges; and (c) There may not be indicators or interlocks preventing premature ignition of the pyrotechnic material. Screwing a powder-loaded fuse into an unknowingly powered socket will result in immediate ignition, injuring the operator.

Commercial flash pots include safety features such as warning pilot lamps, pre-ignition grounding, and safing circuits. They also use isolated and low-voltage power sources, and have keyed power connections to help prevent accidental ignition.  Pyrotechnics can be dangerous substances that must always be treated with the utmost respect and with the proper training. Due to the hazardous nature of these materials, precautions must always be taken to ensure the safety of all individuals in the vicinity of pyrotechnics. Despite all precautions, accidents and errors occur from time to time, which may result in property damage, injury and in severe cases loss of life. These incidents may be the result of poorly manufactured product, unexpected or unforeseen events, or in many cases, the result of operator error.

Fireworks/Pyrotechnics, while widely used to celebrate the 4th of July here in the United States, are also used for other celebrations as well such as the Inauguration of a President, concerts and much more.

Kathy Kiefer