26 septembre 2025

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La société civile a pris acte de l’arrestation du chef de gand Arnel Joseph et demande aux autorités policières et judiciaires de le garder en vie , car certaines informations doivent dévoiler ; les noms des hommes d’État , comme le sénateur Gracia Delva et autres doivent être connu de tout le monde . Société civile. Une justice forte. Blaise Robelto Flanky

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6 ans ago BLAISE Robelto Flanky

La société civile a pris acte de l’arrestation du chef de gand Arnel Joseph et demande aux autorités policières et judiciaires de le garder en vie , car certaines informations doivent dévoiler ; les noms des hommes d’État , comme le sénateur Gracia Delva et autres doivent être connu de tout le monde .

Société civile.

Une justice forte.

Blaise Robelto Flanky

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2 min read 44

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59 thoughts on “La société civile a pris acte de l’arrestation du chef de gand Arnel Joseph et demande aux autorités policières et judiciaires de le garder en vie , car certaines informations doivent dévoiler ; les noms des hommes d’État , comme le sénateur Gracia Delva et autres doivent être connu de tout le monde . Société civile. Une justice forte. Blaise Robelto Flanky”

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    —

    ## 1. What do the clinical studies say?

    | Study / Trial | Population (Key Inclusion) | Intervention | Control | Primary
    Outcome | Result |
    |—————|—————————-|————–|———|—————–|——–|
    | **PREDIMED‑Plus** (2018) | >50 y, overweight/obese, high cardiovascular risk | Mediterranean diet +
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    Same diet, less fish | 10‑year composite CV events | No significant difference; ~1% absolute
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    | **GISSI‑Prevenzione** (2005) | Post‑MI patients | Added omega‑3 fatty acids (2 g/day) vs.

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    | **DASH‑HF** (2019) | HF patients | DASH diet + regular
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    | **Meta‑analysis of RCTs (2018)** | 42 trials, >30 k participants | Fish or omega‑3 supplements vs.
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    **Key observations**

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    • Distribute protein evenly across meals (≈20–30 g per meal for most
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    | **Optimize nutrient profile** | • Add a handful of nuts or seeds each day for
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    • Consider fortified foods or supplements if vitamin B12, D,
    iron, or omega‑3 intake is low (especially in strict plant‑based diets).

    |

    —

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    – **Quality vs quantity:** While high‑quality animal proteins deliver all
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  59. What Are The Side Effects Of Metandienone?

    ### 1 – Overview of Anabolic‑Steroid Use in Athletes
    | **Aspect** | **Key Points** |
    |————|—————-|
    | **Indications** | Performance‑enhancing muscle hypertrophy, increased
    strength, reduced recovery time. |
    | **Common Regimens** | « Stacking » of testosterone analogues (e.g., nandrolone, oxandrolone) with aromatase inhibitors or
    selective estrogen receptor modulators to control estrogenic side effects.
    Cycles typically last 6–12 weeks, followed by post‑cycle therapy (PCT).
    |
    | **Detection** | Urine and blood screening
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    |

    ### 2.2 Potential Complications in a Male
    Athlete

    | System | Key Complications | Mechanisms | Clinical Indicators |
    |——–|——————-|————|———————|
    | **Endocrine** | – Hypogonadotropic hypogonadism
    – Gynecomastia (estrogenic effect)
    – Hypertriglyceridemia | Exogenous steroids suppress LH/FSH → ↓ testicular
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    |
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    – Atherosclerosis risk | Steroids alter lipid metabolism;
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    |
    | **Metabolic** | – Insulin resistance
    – Type 2 diabetes onset | Steroids impair insulin signaling
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    |
    | **Renal** | – Proteinuria (early sign)
    – Chronic kidney disease progression | Steroid-induced glomerular hyperfiltration and damage.

    | Urinalysis shows albumin excretion rate >30 mg/day.
    |

    —

    ### 4. **Key Clinical Indicators & Monitoring**

    | Parameter | Typical Thresholds | Frequency |
    |———–|——————-|———–|
    | Blood Pressure | ≥140/90 mmHg | Every visit (≥3× per year)
    |
    | Serum Creatinine / eGFR | eGFR 15% decline | Every 6–12
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    | Urine Albumin-to-Creatinine Ratio (UACR) | ≥30 mg/g | Annually (or more
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    | Lipid Profile | LDL ≥130 mg/dL, TG ≥150 mg/dL | Annually |
    | HbA1c (if diabetic) | >7% | Every 3–6 months |

    ### 2.5 Medication Management

    – **ACEI/ARB**: Initiate at low dose; titrate to max
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    – **Statin**: High-intensity if LDL ≥190 mg/dL or
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    – **Antihypertensive**: Prefer thiazide diuretics, calcium
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    – **Diabetes**: Metformin first-line; consider SGLT2 inhibitors for CKD if tolerated.

    —

    ## 3. Risk Prediction Model (Risk Score)

    A simplified risk score based on the above predictors can be implemented in a clinical decision support tool.

    | Variable | Points |
    |———-|——–|
    | Age ≥60 | +1 |
    | Male sex | +1 |
    | Diabetes mellitus | +2 |
    | Hypertension | +2 |
    | History of CVD (HF, CAD) | +3 |
    | Baseline eGFR 0.5 g/day | +4 |

    **Total score interpretation:**

    – 0–3 points: Low risk (~15% progression).
    – 4–7 points: Moderate risk (~30% progression).

    – ≥8 points: High risk (>45% progression).

    —

    ### 3. Clinical Recommendations for Risk Mitigation

    | **Intervention** | **Targeted Population** | **Evidence/Guideline Basis** |
    |——————|————————-|—————————–|
    | **Optimal Glycemic Control (HbA1c 20% increase** over baseline |
    | Time from abnormal result to nephrology referral |

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