Rabu, 20 Februari 2008

koLitis ULseratif....

Gangguan saluran cerna adalah salah satu masalah yang sering kita dijumpai dimasyarakat. Diantaranya banyaknya penyakit tersebut gejala keluarnya feses berdarah, berlendir dan bernanah juga sering didapat

jika hal tersebut terjadi mungkin yang dialami adalah kolitis ulseratif.

mungkin info dibawah ini dapat sedikit menjelaskannya..

apa sih kolitis ulseratif itu ?

Kolitis Ulserativa merupakan suatu penyakit menahun, dimana usus besar mengalami peradangan dan luka, yang menyebabkan diare berdarah, berlendir, bernanah, kram perut dan demam. Colitis ulseratif biasa menyerang pada usia 15-35 tahun, tetapi dapat juga menyerang usia diatas 50 tahun


Penyebab nya apa aja ya?

Penyebab penyakit ini tidak diketahui, namun faktor keturunan dan respon sistem kekebalan tubuh yang terlalu aktif di usus, diduga berperan dalam terjadinya kolitis ulserativa. Selain itu ada juga beberapa fakor yang dicurigai menjadi penyebab terjadinya colitis ulseratif diantaranya adalah : hipersensitifitas terhadap factor lingkungan dan makanan, interaksi imun tubuh dan bakteri yang tidak berhasil (awal dari terbentuknya ulkus), pernah mengalami perbaikan pembuluh darah, dan stress.


Patofisiologis

Pada kondisi yang fisiologis system imun pada kolon melindungi mukosa kolon dari gesekan dengan feses saat akan defekasi, tetapi karena aktifitas imun yang berlebihan pada colitis maka system imunnya malah menyerang sel-sel dikolon sehingga menyebabkan terjadi ulkus

Ulkus terjadi di sepanjang permukaan dalam (mukosa) kolon atau rectum yang menyebabkan darah keluar bersama feses. Darah yang keluar biasanya bewarna merah, karena darah ini tidak masuk dalam proses pencernaan tetapi darah yang berasal dari pembuluh darah didaerah kolon yang rusak akibat ulkus. Selain itu ulkus yang lama ini kemudian akan menyebabkan peradangan menahun sehingga terbentuk pula nanah (pus).

Ulkus dapat terjadi pada semua bagian kolon baik, pada sekum, kolon ascenden, kolon transversum maupun kolon sigmoid.

A ulkus pada cekum C uklus pada kolon transversum

B ulkus pada kolon ascenden D ulkus pada kolon sigoid


Berdasarkan daerah yang terinfeksi kolitis ulseratif dapat dibagi menjadi beberapa tipe, yaitu :

Area yang terinfeksi

Name

Rectum

Ulcerative proctitis

Left side of the colon

Limited, or distal, colitis

Entire colon

Universal, or Pancolitis

Akibat ulkus yang menahun maka terjadilah perubahan bentuk pada kolon baik secara mikroskopik ataupun makroskopik,

Gejala yang sering timbul pada penyakit colitis ulseratif ini adalah :

  1. Nyeri perut

  2. Diare berdarah,berlendir dan bernanah

  1. Anemia

  2. Turunnya berat badan

Gejala yang timbul ini hampir sama dengan penyakit Chron karena itu sering sekali orang mengira penyakit ini adalah penyakit chron, tetapi jika kita lebih teliti maka banyak perbedaan yang terlihat, seperti yang tercantum pada tabel



Symptoms of Inflammatory Bowel Disease

Gejala

Ulcerative Colitis (UC)

Crohn's Disease (CD)

Diarrhea

Diare yang rekuren sangat sering dan selalu disertai mukus

Diare rekuren jarang dijumpai

Rectal bleeding

Darah juga selalu ada dalam feses

Kadang-kadag ada darah dalam feses.

Constipation

Jarang terjadi

Selalu terjadi konstipasi.

Fever

Bias terjadi apabila sudah parah.

Selalu tejadi walapun kenaikan suhu tidak terlalu tinggi, tetapi jika sudah mengalammi komlikasi maka akan lebih meninggi

Loss of appetite, weight loss,

Terjadi jika pnyakit sudah memasui tahap yang parah

Umum dijumpi penurunan sekitar 10-20% dari berat normal.

Abnormal defecation: Increased frequency, a feeling of incomplete evacuation, and tenesmus .

Gejala pada tahap mild or severe.

Terjadi disetiap tahap

Anal ulcers and fistulas: (channels that can burrow between organs, loops of the intestine, or between the intestines and skin).

Hamper tidak pernah ditemukan

Merupakan gejala awal


Diagnosanya ...

Untuk mengetahui pasti diagnose penyakit ini adalah dengan cara melakukan beberapa test.

  • Tes pertama yang dilakukan adalah anamnesis dan pemeriksaaan fisik tentunya, pada pemeriksaan fisik , periksalah kekauan dari otot-otot abdominal kemudian perhatikan

Apakah pasien demam dan dehirasi jika ya, kemungkinan pasien mengalami gejala awal ulkus

  • Pemeriksaan feses (berdarah, lender dan nanah)

  • Pada pemeriksaan laboratorium terlihat anemic dan malnutrisi

  • Sigmoidoskopi, cara yang paling baik yaitu dengan cara memasukan kamera kedalam saluran cerna, dan tampaklah bagian mana yang telah menganai ulkus

Pengobatan yang bisa dilakukan

Pengobatan ditujukan untuk mengendalikan peradangan, mengurangi gejala dan mengganti cairan dan zat gizi yang hilang.Penderita sebaiknya menghindari buah dan sayuran mentah untuk mengurangi cedera fisik pada lapisan usus besar yang meradang. Diet bebas susu bisa mengurangi gejala. Penambahan zat besi bisa menyembuhkan anemia yang disebabkan oleh hilangnya darah dalam tinja.

Obat-obatan seperti :

  • dosis kecil loperamide atau difenoksilat, diberikan pada diare yang relatif ringan.

  • Untuk diare yang lebih berat, mungkin dibutuhkan dosis yang lebih besar dari difenoksilat atau opium yang dilarutkan dalam alkohol, loperamide atau codein.

  • Pada kasus-kasus yang berat, pemberian obat-obat anti-diare ini harus diawasi secara ketat, untuk menghindari terjadinya megakolon toksik.

  • Sulfasalazine, olsalazine atau mesalamine sering digunakan untuk mengurangi peradangan pada kolitis ulserativa dan untuk mencegah timbulnya gejala.

Obat-obatan ini biasanya diminum namun bisa juga diberikan sebagai enema (cairan yang disuntikkan ke dalam usus) atau supositoria (obat yang dimasukkan melalui dubur).

Penderita dengan kolitis berat menengah yang tidak menjalani perawatan rumah sakit, biasanya mendapatkan kortikosteroid per-oral (melalui mulut), seperti prednisone.
Prednisone dosis tinggi sering memicu proses penyembuhan. Setelah prednisone mengendalikan peradangannya, sering diberikan sulfasalazine, olsalazine atau mesalamine.
Secara bertahap dosis prednisone diturunkan dan akhirnya dihentikan. Pemberian kortikosteroid jangka panjang menimbulkan efek samping, meskipun kebanyakan akan menghilang jika pengobatan dihentikan.

Bila kolitis ulserativa yang ringan atau sedang terbatas pada sisi kiri usus besar (kolon desendens) dan di rektum, bisa diberikan enema dengan kortikosteroid atau mesalamine.
Bila penyakitnya menjadi berat, penderita harus dirawat di rumah sakit dan diberikan kortikosteroid intravena (melalui pembuluh darah).

Penderita dengan perdarahan rektum yang berat mungkin memerlukan transfusi darah dan cairan intravena.Untuk mempertahankan fase penyembuhan, diberikan azathioprine dan merkaptopurin.Siklosporin diberikan kepada penderita yang mendapat serangan berat dan tidak memberikan respon terhadap kortikosteroid. Tetapi sekitar 50% dari penderita ini, akhirnya memerlukan terapi pembedahan.


Pembedahan

Kolitis toksik merupakan suatu keadaan gawat darurat. Segera setelah terditeksi atau bila terjadi ancaman megakolon toksik, semua obat anti-diare dihentikan, penderita dipuasakan, selang dimasukan ke dalam lambung atau usus kecil dan semua cairan, makanan dan obat-obatan diberikan melalui pembuluh darah.

Pasien diawasi dengan ketat untuk menghindari adanya peritonitis atau perforasi.
Bila tindakan ini tidak berhasil memperbaiki kondisi pasien dalam 24-48 jam, segera dilakukan pembedahan, dimana semua atau hampir sebagian besar usus besar diangkat.

Jika didiagnosis kanker atau adanya perubahan pre-kanker pada usus besar, maka pembedahan dilakukan bukan berdasarkan kedaruratan.Pembedahan non-darurat juga dilakukan karena adanya penyempitan dari usus besar atau adanya gangguan pertumbuhan pada anak-anak.

Alasan paling umum dari pembedahan adalah penyakit menahun yang tidak sembuh-sembuh, sehingga membuat penderita tergantung kepada kortikosteroid dosis tinggi.
Pengangkatan seluruh usus besar dan rektum, secara permanen akan menyembuhkan kolitis ulserativa.

Penderita hidup dengan ileostomi (hubungan antara bagian terendah usus kecil dengan lubang di dinding perut) dan kantong ileostomi. Prosedur pilihan lainnya adalah anastomosa ileo-anal, dimana usus besar dan sebagian besar rektum diangkat, dan sebuah reservoir dibuat dari usus kecil dan ditempatkan pada rektum yang tersisa, tepat diatas anus.


sumber info diatas fika ambil dari :

Sylvia A.price Lorraine M. Wilson . Patofisilogi Konsep Klinis Proses-Proses Penyakit Vol.1. Edisi 6 .EGC; Jakarta. 2006

http://digestive.niddk.nih.gov/ddiseases/pubs/colitis/

www.manukahoneyusa.com/ulcerative-colitis.htm

www.pentasausa.com/what.asp

http://www.indonesiaindonesia.com/f/10717-kolitis-ulserativa/

mungkin info ini kurang lengkap ya?! jadi kalo ada yang mau nambah ato komen fika seneng banget...










50 komentar:

Evan mengatakan...

halo Fika,

Saya dulu juga menderita UC.

tapi skr alhamdulillah sudah sembuh.

Pengalaman saya ada disini:

http://evangeminika.blogdetik.com/2008/12/16/obati-sakit-perut-anda-dengan-tepung-sagu-atau-kanji/

mudah2an bermanfaat,

Evan
www.posvideo.net

Evan Geminika mengatakan...

halo Fika,

seperti yang saya sudah jelaskan sebelumnya.

Ulcerative Colitis sudah ada obat nya dan tidak perlu pembedahan.

Pembedahan hanya akan membahayakan pasien.

terapi untuk Ulcerative Colitis dapat di lihat di blog saya:

Terapi Ulcerative Colitis

atau bisa kirim email ke saya, evan.geminika@gmail.com

Sekali lagi saya ingatkan, sebaiknya jangan melakukan tindakan pembedahan, coba dulu terapi yg ada di blog saya di atas.

salam,
Evan
www.posvideo.net

Anonim mengatakan...

I want not concur on it. I regard as warm-hearted post. Expressly the title-deed attracted me to read the unscathed story.

Anonim mengatakan...

Nice post and this mail helped me alot in my college assignement. Say thank you you for your information.

Anonim mengatakan...

seniors dating on line [url=http://loveepicentre.com/]thirtyplussingles[/url] farmer singles in england http://loveepicentre.com/ nzdating

Anonim mengatakan...

notebook batteries [url=http://www.hqlaptopbatteries.com/-r10-s820-laptopbatterymodel2010.html]Apple Laptop[/url] laptop brands http://www.hqlaptopbatteries.com/battery-5005wlmi-batterytype1.html laptop batteries reviews
Fujitsu laptop battery [url=http://www.hqlaptopbatteries.com/-nc6115-laptopbatterymodel523.html]Find a Dell Laptop Battery[/url] sony laptop http://www.hqlaptopbatteries.com/battery-a150-1890-batterytype1.html dell laptop
Laptop Batteries Wholesale [url=http://www.hqlaptopbatteries.com/-223-laptopbatterymodel1189.html]buy laptops[/url] Discount notebook batteries http://www.hqlaptopbatteries.com/battery-1692-batterytype1.html Laptop Batteries Wholesale

Anonim mengatakan...

cody benston bodybuilding [url=http://usadrugstoretoday.com/categories/hypnotherapy.htm]hypnotherapy[/url] keychain pill holder http://usadrugstoretoday.com/categories/miglioramento-femminile.htm natural fast weight loss http://usadrugstoretoday.com/products/epivir.htm
vicodin pill identifier [url=http://usadrugstoretoday.com/products/citalopram.htm]citalopram[/url] pills for penis growth [url=http://usadrugstoretoday.com/products/ed-discount-pack-3.htm]how to gain muscle for hard gainer[/url]

Anonim mengatakan...

medical penis vacuum pump [url=http://usadrugstoretoday.com/categories/de-la-salud-de-la-mujer.htm]de la salud de la mujer[/url] extreme fatigue vitamin overdose http://usadrugstoretoday.com/categories/la-salute-delle-donne.htm physical exams chaperones medical assistant http://usadrugstoretoday.com/products/dulcolax.htm
cast iron tea kettle made in usa [url=http://usadrugstoretoday.com/categories/la-sante-des-os.htm]la sante des os[/url] calcium hydroxide price [url=http://usadrugstoretoday.com/categories/anti-diabetic.htm]health effects of caffein[/url]

Anonim mengatakan...

indiana and bulletin and dependent and accident and dental [url=http://usadrugstoretoday.com/products/strattera.htm]strattera[/url] matt daniels bone marrow cancer endowment for medical research http://usadrugstoretoday.com/products/fml-forte.htm exercises for a medicine ball http://usadrugstoretoday.com/products/prazosin.htm
redhead twin orgasm [url=http://usadrugstoretoday.com/products/pro-erex.htm]pro erex[/url] can blood test tell if theres a present std [url=http://usadrugstoretoday.com/categories/anti-allergic-asthma.htm]how tor read blood work results[/url]

Anonim mengatakan...

http://healthboard.in/cozaar/cozaar-cod
[url=http://healthboard.in/conjugated-linoleic-acid/c9-t11-conjugated-linoleic-acid-sources-australia-blackmore]drug master file[/url] drugs that make women horney [url=http://healthboard.in/decadron/administration-of-decadron]administration of decadron[/url]
drug seisure auction cigarett boat http://healthboard.in/coreg/coreg-effects
[url=http://healthboard.in/depakote/who-makes-depakote]acpe iv certified pharmacy technician[/url] what are recreational drugs [url=http://healthboard.in/buspar/buspar-ingrediants]buspar ingrediants[/url]
drugs for obsseive compulsive disorder http://healthboard.in/bisoprolol/bisoprolol-for-heart-reshaping
[url=http://healthboard.in/dexamethasone/dexamethasone-used-with-photophoresis]premarin drug[/url] how to stop drug abuse [url=http://healthboard.in/cytotec/anencephaly-cytotec-induction-survival-rate]anencephaly cytotec induction survival rate[/url] drugs increase rem sleep [url=http://healthboard.in/cytotec/purchase-cytotec-online-without-a-prescription]purchase cytotec online without a prescription[/url]

Anonim mengatakan...

http://webhealthcentre.in/cyclophosphamide/cyclophosphamide-prescribed-1-gram-and-100-mg
[url=http://webhealthcentre.in/health-magazine/non-profit-health]good drug movies[/url] how to cheat on a drug test [url=http://webhealthcentre.in/cymbalta/cymbalta-australia]cymbalta australia[/url]
where can i buy drugs online http://webhealthcentre.in/primidone/side-effects-of-primidone
[url=http://webhealthcentre.in/health-care/golden-state-health-centers]buy cheap viagra online next day delivery[/url] drugs affecting pt [url=http://webhealthcentre.in/promethazine/lawsuits-inramuscular-injection-phenergan-promethazine]lawsuits inramuscular injection phenergan promethazine[/url]
science and medicine in ancient athens http://webhealthcentre.in/cyclophosphamide/cyclophosphamide-mutagen
[url=http://webhealthcentre.in/cyproheptadine/cyproheptadine-for-felines]a list of all illegal drugs[/url] mcsweeeney gorup sell pharmacys [url=http://webhealthcentre.in/amlodipine/amlodipine-besylate-mylan-gas]amlodipine besylate mylan gas[/url] presciption drug facts [url=http://webhealthcentre.in/tramadol/tramadol-imitrex]tramadol imitrex[/url]

Anonim mengatakan...

auto repair ford moonroof http://automotoportal.in/volvo/volvo-1800es-wiring-harness automobile booster seat
[url=http://automotoportal.in/royce/rolls-royce-naval-marine-inc]texas automobile bill of sale[/url] how to install clutch on a 2002 dodge 3500 [url=http://automotoportal.in/saturn/saturn-dimensions-sl2]saturn dimensions sl2[/url]
what does a speedometer cable for a 1991 dodge 3500 look like http://automotoportal.in/lincolns/lincoln-centennial-medal
[url=http://automotoportal.in/lexus/lexus-marketing-to-baby-boomers]baxter auto c plasmapheresis[/url] plans to build a racing lawn mower [url=http://automotoportal.in/motor/motor-vehicle-in-nj]motor vehicle in nj[/url]
automobile powertrain http://automotoportal.in/rover/land-rover-for-sale-by-tayside-land-rover
[url=http://automotoportal.in/racing/horse-racing-greyhound-racing-stream-video]mckenna volkswagen[/url] automobile rental westover airport [url=http://automotoportal.in/mini-car/mini-dachsunds-for-sale]mini dachsunds for sale[/url]

Anonim mengatakan...

mp3 tag auto lookup http://autoexpress.in/plymouth/new/plymouth/to/australia/1910 performance volkswagen parts
[url=http://autoexpress.in/saab/saab/france]volkswagen nardo w12 show car 2008[/url] napa auto parts store web site [url=http://autoexpress.in/mercedes]mercedes[/url]
horse racing philadelphia http://autoexpress.in/buell/buell/choppers
[url=http://autoexpress.in/scion/scion/window/motors]automobile depreciation concern[/url] automobile loans [url=http://autoexpress.in/saturn/what/would/life/be/on/saturn]what would life be on saturn[/url]
leather seats dodge charger http://autoexpress.in/radiator/radiator/treatment
[url=http://autoexpress.in/bugatti/bugatti/type/55/kit/car]integrity auto repair eugene[/url] mercedes slr meclaren [url=http://autoexpress.in/mazda/seacost/mazda]seacost mazda[/url]

Anonim mengatakan...

joseph bank clothes http://topcitystyle.com/purple-multicolored-color89.html yogi casual clothes [url=http://topcitystyle.com/miu-miu-leather-bag-for-women-black-item2074.html]mens calvin klein underwear[/url] lauren jackson alpha
http://topcitystyle.com/black-outwear-color2.html lightning bolt clothes [url=http://topcitystyle.com/xl-sweater-size6.html]ralph lauren jeans womens[/url]

Anonim mengatakan...

dildo porn vid http://pornrapidshare.in/teen-city/teen-murder-mystery-games
[url=http://pornrapidshare.in/vibrators/vibrator-on-penis]hot lesbian dildo sex[/url] dildo titties [url=http://pornrapidshare.in/vagina/virgin-vagina-pictures]virgin vagina pictures[/url]
amateur female orgasmic clips http://pornrapidshare.in/xxx-girls/free-xxx-video-sharing
[url=http://pornrapidshare.in/vibrators/machine-fucking-vibrator]anal farm tgp[/url] huge penetration hentai [url=http://pornrapidshare.in/teens/spanish-teens-free-xxx-movie]spanish teens free xxx movie[/url]
boob natural amateur blog http://pornrapidshare.in/pissing/stories-pissing-in-strange-place
[url=http://pornrapidshare.in/best-xxx/free-xxx-latina-video]sexy asses videos[/url] ashly blue porn [url=http://pornrapidshare.in/teens-top/body-piercing-and-teens]body piercing and teens[/url]
gay greek xxx http://pornrapidshare.in/pre-teen/free-diet-plans-for-teen-to-loose-20-pounds-in-4-days
[url=http://pornrapidshare.in/free-xxx/xxx-teen-porn]morning after adult[/url] nick sexy [url=http://pornrapidshare.in/teens-top/bedroom-themes-for-teens]bedroom themes for teens[/url]

Anonim mengatakan...

toomey equipment kubota mobile http://www.orderphonetoday.com/jc68-quad-band-dual-cards-dual-standby-with--item65.html get html email windows mobile 5 [url=http://www.orderphonetoday.com/mind-blowing-quad-band-single-card-with-camera--item73.html]physicians in mobile alabama at providence hospital[/url] how to get t mobile web free

Anonim mengatakan...

april vegas travel deals from nashville http://xwa.in/travel/travel-data-slo family travel to europe
[url=http://xwa.in/tourism/berea-kentucky-tourism]names of home travel businesses[/url] travel to tortuga [url=http://xwa.in/airline/low-cost-airline-hong-kong]low cost airline hong kong[/url]
vacation travel insurance htm http://xwa.in/plane-tickets/cheap-plane-tickets-to-australia
[url=http://xwa.in/map/map-of-proposed-hwy-74-bypass-monroe-nc]hotel car rental airline cheap flights rooms tickets travel[/url] world travel boat cruise [url=http://xwa.in/tour/free-streaming-video-hot-thailand-tour-ladyboys]free streaming video hot thailand tour ladyboys[/url]
travel lodge tifton georiga http://xwa.in/travel/western-canada-travel-tips travel agency delaware [url=http://xwa.in/tours/touch-down-tours]touch down tours[/url]

Anonim mengatakan...

the brother movie [url=http://full-length-movies.com/dvd-quality-movie-power-rangers-the-movie/878database/]Power Rangers The Movie[/url] watch free movie online class [url=http://full-length-movies.com/dvd-quality-movie-the-black-pimpernel/12800database/]The Black Pimpernel[/url]
werner erhard movie [url=http://full-length-movies.com/dvd-quality-movie-indiana-jones-y-el-reino-de-la-calavera-de-cristal/25017database/]Indiana Jones Y El Reino De La Calavera De Cristal[/url] real d converts movie theaters to 3d [url=http://worldmovs.co.cc/full_version-tmnt/25560database/]TMNT[/url]
movie trailers sex free [url=http://full-length-movies.com/dvd-quality-movie-illuminati-compilation-du/25188database/]Illuminati Compilation Du[/url] movie star news [url=http://full-length-movies.com/dvd-quality-movie-edy/20095database/]Edy[/url]
silent movie score [url=http://worldmovs.co.cc/full_version-fracture/23606database/]Fracture[/url] the movie ice age [url=http://worldmovs.co.cc/full_version-perfect-stranger/21139database/]Perfect Stranger[/url]

Anonim mengatakan...

newborn boys hip hop clothes http://luxefashion.us/?action=products&product_id=1803 lrg fashion [url=http://luxefashion.us/women-jeans-cut-pants-type3.html]gucci handbag[/url] madeline shoes
http://luxefashion.us/-sandals-on-sale-category84.html designer pups [url=http://luxefashion.us/dolce-amp-gabbana-page5.html]replica chanel jewelry[/url]

Anonim mengatakan...

cinch clothes http://luxefashion.us/?action=products&product_id=1945 corporate interior designers [url=http://luxefashion.us/light-green-casual-shirts-color133.html]womens wide wdth shoes[/url] gucci minaudiere
http://luxefashion.us/jackets-amp-sweatshirts-roberto-cavalli-category10.html sofft shoes [url=http://luxefashion.us/29-versace-size16.html]how to get whiteout out of clothes[/url]

Anonim mengatakan...

the health chanel http://www.thefashionhouse.us/?action=products&product_id=2283 tanya stoecklein [url=http://www.thefashionhouse.us/dark-grey-grey-casual-color31.html]nike air max history of shoes converge triax[/url] cathy bell designer
http://www.thefashionhouse.us/roberto-cavalli-tank-top-for-women-leopard-print-item2526.html designer jeans [url=http://www.thefashionhouse.us/white-yellow-women-s-tops-color207.html]hsn and shoes off[/url]

Anonim mengatakan...

sizng chart shoes http://luxefashion.us/dsquared-long-sleeve-tops-brand13.html cheap shoes [url=http://luxefashion.us/gucci-men-brand12.html]womens golf shoes[/url] poems by paul laurence dunbar
http://luxefashion.us/-leather-big-bags-on-sale-category38.html spaghetti sauce out of clothes [url=http://luxefashion.us/anarchy-brand94.html]designer prom dresses[/url]

Anonim mengatakan...

herbal penis enlargements [url=http://usadrugstoretoday.com/products/viagra.htm]viagra[/url] heart shaped hot tubs ma http://usadrugstoretoday.com/products/viagra-professional.htm
blood elf art [url=http://usadrugstoretoday.com/categories/ipnoterapia.htm]ipnoterapia[/url] illinois department of publich health [url=http://usadrugstoretoday.com/products/minocycline.htm ]butt enhancer pills to gain a bigger butt [/url] eye health nutrition ocular
does any other disease mask as diabetes [url=http://usadrugstoretoday.com/products/procalisx.htm]procalisx[/url] drug use in saints row http://usadrugstoretoday.com/products/vitaliq.htm
rsd calcium channel blockers [url=http://usadrugstoretoday.com/products/pletal.htm]pletal[/url] best natural medication to lower blood pressure [url=http://usadrugstoretoday.com/products/celexa.htm ]finding an infertility medicine specialist [/url] lemon juice and pepper diet

Anonim mengatakan...

olympus fashion week http://luxefashion.us/grey-club-wear-color1.html stephon marburry shoes [url=http://luxefashion.us/faith-connection-trendy-t-shirt-for-men--item1299.html]chanel bag[/url] information on being a designer of magazine layouts
http://luxefashion.us/orange-jackets-amp-sweatshirts-color121.html affordable fashion [url=http://luxefashion.us/?action=products&product_id=1358]television chanells in indaina[/url]

Anonim mengatakan...

worker health and safety [url=http://usadrugstoretoday.com/products/propranolol.htm]propranolol[/url] biggest loser million pound weight loss challenge http://usadrugstoretoday.com/categories/arthritis.htm
weight loss expectation on atkins diet [url=http://usadrugstoretoday.com/categories/dysfonction-erectile.htm]dysfonction erectile[/url] braden dental and lake geneva [url=http://usadrugstoretoday.com/products/zelnorm.htm ]bio degradeable gum [/url] free dog health info
beth kelly tarrytown eating disorder [url=http://usadrugstoretoday.com/products/viagra-professional.htm]viagra professional[/url] prescription medication integrative therapy http://usadrugstoretoday.com/products/xtz--energy-booster-.htm
stress release games [url=http://usadrugstoretoday.com/products/horny-goat-weed.htm]horny goat weed[/url] blood pressure edema [url=http://usadrugstoretoday.com/products/hydrochlorothiazide.htm ]advance of antenatal medicine [/url] lock stock smoking barrels soundtrack

Anonim mengatakan...

http://xpv.in/doxycycline/over-the-counter-doxycycline
[url=http://xpv.in/ranitidine/nnmethyl-dimer-ranitidine]i take drugs i get drunk[/url] erectile disfunction illinois clinics [url=http://xpv.in/pyridostigmine/distinon-pyridostigmine-bromide]distinon pyridostigmine bromide[/url]
problems drug treatment britain http://xpv.in/pyridostigmine/neostigmine-and-pyridostigmine
[url=http://xpv.in/pyridium/pyridium-and-methemoglobin]osco drug la grange park illinois[/url] cialis viagra on line [url=http://xpv.in/reglan/allergy-to-reglan]allergy to reglan[/url]
cvs pharmacy home page http://xpv.in/doxepin/doxepin-hcl-solubility
[url=http://xpv.in/ceftin/ceftin-dosing]drug cutting agents that leave a residue[/url] aids drug in developing country [url=http://xpv.in/amaryl/amaryl-dose]amaryl dose[/url] abuse of drugs among teen [url=http://xpv.in/amitriptyline/amitriptyline-blood-pressure]amitriptyline blood pressure[/url]

Anonim mengatakan...

massachusetts gambling council http://wqm.in/keno_gambling-online-play-keno-online illinois lottery number
[url=http://wqm.in/baccarat_baccarat-regler]treasure hunt pa lottery game[/url] gambling winnings non taxable [url=http://wqm.in/roulette_roulette-set-game]roulette set game[/url]
hoyle casino 2008 download http://wqm.in/bingo_holiday-bingo-for-kids
[url=http://wqm.in/casino-online_discounts-for-south-point-casino]the colorado investment jackpot[/url] fat jack spread betting [url=http://wqm.in/jokers_drawings-of-evil-jokers]drawings of evil jokers[/url]
australian bingo http://wqm.in/joker_mego-joker-mobile samsung blackjack e mail [url=http://wqm.in/blackjack_current-blackjack-news]current blackjack news[/url]

Anonim mengatakan...

dodge tiger 2 http://xwm.in/dodge/dodge-ram-2500-crash-data-recorder wood brothers racing
[url=http://xwm.in/car-racing/racing-grannies-game]digital automobile gauges[/url] volkswagen dealers morris county [url=http://xwm.in/royce/buy-rolls-royce-corniche]buy rolls royce corniche[/url]
mercedes kdi http://xwm.in/racing/sim-racing-china
[url=http://xwm.in/oldsmobile/restored-classics-oldsmobile]wissota racing[/url] automobile color codes [url=http://xwm.in/car-racing/racing-exhaust]racing exhaust[/url]
ford superduty 4 wd stage 5 auto trans package http://xwm.in/citroen/citroen-club-uk
[url=http://xwm.in/audi/audi-air-bag]recommended automobile tire pressure[/url] cleveland automobile dealers association printing [url=http://xwm.in/nissan/couresy-nissan-tampa]couresy nissan tampa[/url]

Anonim mengatakan...

http://jqz.in/propranolol/propranolol-coq10
[url=http://jqz.in/vpxl/maxim-vpxl]employee killed in pharmacy shootout[/url] interviews in relation to ben cousins drug use [url=http://jqz.in/pharma/pharma-programmer-telecommute]pharma programmer telecommute[/url]
what are side effects of the drug celebrex http://jqz.in/zithromax/zithromax-indications
[url=http://jqz.in/vpxl/viramune]illegal drugstores[/url] review of viswiss erectile dysfunction supplements [url=http://jqz.in/cialis/hong-kong-cialis-hongkong]hong kong cialis hongkong[/url]
flea heartworm medicine combos http://jqz.in/cialis/cialis-mix-viagra
[url=http://jqz.in/tramadol/tramadol-180-tablet]imitrex and citralpaim drug interaction[/url] joe kelley of eli lilly drugs [url=http://jqz.in/paxil/generic-name-for-paxil]generic name for paxil[/url] cialis stories [url=http://jqz.in/paxil/paxil-long-term-effect]paxil long term effect[/url]

Anonim mengatakan...

nevada gambling http://lwv.in/slot casino colombia
[url=http://lwv.in/online-casinos/veges-casinos]atlantic bingo[/url] b 17 blackjack [url=http://lwv.in/lottery/wisconsin-state-lottery]wisconsin state lottery[/url]
conversation heart bingo http://lwv.in/lottery/the-uk-international-lottery
[url=http://lwv.in/bingo/play-bingo-online-no-deposit]bingo phrases[/url] how to win at video gambling [url=http://lwv.in/baccarat/keyword-baccarat]keyword baccarat[/url]
joker tats http://lwv.in/betting/golf-betting-pick blackjack i321 accessories [url=http://lwv.in/online-casinos/black-hawk-colorado-casinos]black hawk colorado casinos[/url]

Anonim mengatakan...

last waltz movie [url=http://moviestrawberry.com/films/film_popeye_the_sailor_meets_sinbad_the_sailor/]popeye the sailor meets sinbad the sailor[/url] movie gedbaw http://moviestrawberry.com/films/film_george_carlin_it_s_bad_for_ya/ gladiator movie clips
movie down to you [url=http://moviestrawberry.com/films/film_a_sense_of_freedom/]a sense of freedom[/url] guido from movie cars http://moviestrawberry.com/films/film_red_river/ quick change movie
the movie physco [url=http://moviestrawberry.com/films/film_horsey/]horsey[/url] drug dealer in movie
video clips movie [url=http://moviestrawberry.com/films/film_puma_lion_of_the_andes/]puma lion of the andes[/url] quotes from the movie never been kissed http://moviestrawberry.com/films/film_dont_look_back/ compleat movie list
amateur movie clip [url=http://moviestrawberry.com/films/film_animal_house/]animal house[/url] the gamers movie http://moviestrawberry.com/films/film_lady_godiva/ halloween movie poster

Anonim mengatakan...

transformer movie decepticon mobile metallic sticker [url=http://moviestrawberry.com/films/film_in_like_flint/]in like flint[/url] elf movie with will ferrell http://moviestrawberry.com/films/film_the_money_pit/ movie ralphie parker wants a red ryder bb gun
watch disturbia movie online for free [url=http://moviestrawberry.com/films/film_kurenai_no_buta/]kurenai no buta[/url] hot sexy movie http://moviestrawberry.com/films/film_freedom_writers/ the rock movie
blod diamond movie clothing for actors [url=http://moviestrawberry.com/films/film_second_chances/]second chances[/url] the dash movie
limewire movie downloads [url=http://moviestrawberry.com/films/film_this_above_all/]this above all[/url] reactiion of movie tajing lives http://moviestrawberry.com/films/film_kiss_them_for_me/ interracial teen sex movie
movie previes [url=http://moviestrawberry.com/films/film_snow_falling_on_cedars/]snow falling on cedars[/url] will hay movie list http://moviestrawberry.com/films/film_don_donald/ canvas movie

Anonim mengatakan...

ben stillers new movie in theatres [url=http://moviestrawberry.com/films/film_altered_states/]altered states[/url] characters in lion king movie http://moviestrawberry.com/films/film_dragonball_evolution/ celebrity movie arhives
passion of christ movie [url=http://moviestrawberry.com/films/film_september_dawn/]september dawn[/url] movie theaters in downtown denver co http://moviestrawberry.com/films/film_the_untouchables/ cast list for the movie ice princess
the stranger 1946 movie [url=http://moviestrawberry.com/films/film_jackass_3/]jackass 3[/url] daily movie sex movie clips
guido from movie cars [url=http://moviestrawberry.com/films/film_the_student_prince/]the student prince[/url] parenthood movie and lyrics to song diarrhea http://moviestrawberry.com/films/film_close_encounters_of_the_third_kind/ movie man who lived forever
view latest movie trailers [url=http://moviestrawberry.com/films/film_backdraft/]backdraft[/url] blockbuster movie store http://moviestrawberry.com/countries/?page=36 movie censor removal

Anonim mengatakan...

disney all star movie hotel [url=http://moviestrawberry.com/films/film_a_walk_to_remember/]a walk to remember[/url] whole movie http://moviestrawberry.com/films/film_far_from_heaven/ new movie releases fantasy
sally fields and farrah fawcet tmade for tv movie [url=http://moviestrawberry.com/films/film_otto_or_up_with_dead_people/]otto or up with dead people[/url] movie review deja vu http://moviestrawberry.com/films/film_charlie_bubbles/ best movie shareware sites
babylon 5 movie list [url=http://moviestrawberry.com/films/film_tommy_and_the_cool_mule/]tommy and the cool mule[/url] the mummy patricia velasquez movie photo from
cisco kid movie [url=http://moviestrawberry.com/films/film_shrooms/]shrooms[/url] movie indexes http://moviestrawberry.com/films/film_marley_me/ watch transformers the movie online
movie subtitle database [url=http://moviestrawberry.com/films/film_battle_of_the_sexes_in_the_animal_world_1999/]battle of the sexes in the animal world 1999[/url] free grannie movie galleries http://moviestrawberry.com/films/film_the_skulls/ movie reviews by guys

Anonim mengatakan...

malcolm x movie sounds [url=http://moviestrawberry.com/films/film_28_days_later_/]28 days later [/url] flash the movie http://moviestrawberry.com/films/film_the_hive/ cunnilingus movie
horror movie icons [url=http://moviestrawberry.com/films/film_crash_2008/]crash 2008[/url] bad boys movie online download http://moviestrawberry.com/films/film_the_devil_s_rejects/ redline 2007 movie website
animal farm movie review [url=http://moviestrawberry.com/films/film_2_days_in_paris/]2 days in paris[/url] gen 13 movie
die hard movie [url=http://moviestrawberry.com/films/film_courage_under_fire/]courage under fire[/url] what makes the film the diary of a mad black woman a good movie http://moviestrawberry.com/films/film_racing_daylight/ movie love song
funeral of luciano pavarotti movie [url=http://moviestrawberry.com/films/film_wasabi/]wasabi[/url] jesse james movie http://moviestrawberry.com/films/film_basket_case_3_the_progeny/ barath latest movie

Anonim mengatakan...

christian movie list [url=http://moviestrawberry.com/films/film_housefly_an_everyday_monster/]housefly an everyday monster[/url] little cunts movie http://moviestrawberry.com/films/film_harm_s_way/ power rangers generation the movie
movie about american civil war boss spearmen [url=http://moviestrawberry.com/films/film_hellraiser_inferno/]hellraiser inferno[/url] movie scripts online http://moviestrawberry.com/films/film_pluto_s_heart_throb/ movie producing software
sankyo auto 5x movie camera info [url=http://moviestrawberry.com/films/film_confessions_of_an_innocent_man/]confessions of an innocent man[/url] forever together movie songs
movie download p2p applications [url=http://moviestrawberry.com/films/film_harry_and_the_hendersons/]harry and the hendersons[/url] movie gore http://moviestrawberry.com/films/film_animals_are_beautiful_people/ microsoft movie maker download
movie star bondage [url=http://moviestrawberry.com/films/film_warbirds/]warbirds[/url] springfield movie pages http://moviestrawberry.com/films/film_beowulf/ wraith movie car

Anonim mengatakan...

terri movie [url=http://moviestrawberry.com/films/film_villa_rides/]villa rides[/url] james bond films movie villains http://moviestrawberry.com/films/film_krull/ movie dvd source gathering of eagles
brians song the movie [url=http://moviestrawberry.com/films/film_gi_la_testa/]gi la testa[/url] resident evil extinction movie http://moviestrawberry.com/films/film_the_third_wheel/ us marshals the movie
sugar house movie [url=http://moviestrawberry.com/films/film_wraiths_of_roanoke/]wraiths of roanoke[/url] movie the fog
johnny gaddar movie torrent [url=http://moviestrawberry.com/films/film_the_player/]the player[/url] windows movie player http://moviestrawberry.com/films/film_deep_in_the_valley/ movie lesbian double dildo
out of balance movie [url=http://moviestrawberry.com/films/film_evil_under_the_sun/]evil under the sun[/url] the secret movie soundtrack composer http://moviestrawberry.com/hqmoviesbygenres/download-genre_comedy-movies/?page=13 bratz for real the movie

Jubaida Seksi mengatakan...

hay hay,,
infonya keren yah..
thanks..

Rosee mengatakan...

emmm Keren..
bermanfaat ya..
makasi atas infonya

critical illness cover quote mengatakan...

The above statement is seen to be contradictory. The situation is very critical and need an experience complainer to resolve it.

Anonim mengatakan...

oZzy moved away ever before, I miss his cock, and I'm always hungry for sex.
FUCK MY PUSSY!

Also visit my blog - hcg injections

Anonim mengatakan...

Having read this I believed it was really informative.

I appreciate you spending some time and energy to put this informative
article together. I once again find myself spending a
lot of time both reading and commenting. But so what,
it was still worthwhile!

my weblog; ludwikishafen.de

Anonim mengatakan...

Yοuг artiсlе offerѕ vеrified useful tο
myѕelf. Ιt’s extremely informatіve and you arе ceгtaіnly very well-informeԁ in this region.
Υou gеt eхposed my sіght іn order tο varying opiniоn of this kind of
subject along with intriquing, notable anԁ ѕolid writtеn
content.
Here is my homepage - Buy Klonopin

Anonim mengatakan...

Perm pounds 6, 2013 in New York Fashion Design week yesterday. www.kaspersuitsshop.com/ [url=http://kaspersuitsshop.com]kasper suits[/url] The 4 Groups Of societal Fashion Design Startups Enabling DiscoveryInternet entrepreneurs Own for the most part neglected by the make's and then-owner, Prada, Versace, Calvin Klein? Stumbling from memory to computer memory I could Experience caught the attending granted to these media images tap these insecurities of the fashion design industry is lour mastered on your legs more from the F. There are some of the trade name is smart and fashion designable. kasper ladies suits kasper ladies suits Expect to find mild Crack that are not equipped talking to the" fashionista reported. It is a estimable way to ardent up ahead taking his own boutique fashion features an reliable company brute.

Anonim mengatakan...

Wonderful web site. Lots of useful info here. I am sending it to some friends ans
also sharing in delicious. And certainly, thanks for your effort!


My web blog: http://petrock.ru

Anonim mengatakan...

I likе the valuаble infoгmation you providе for уour
articlеs. I'll bookmark your blog and check again here frequently. I'm quite sure
І will leагn many new stuff propeг right heгe!
Best оf luck for the fοllowing!

Here is my site :: hcg diet drops

Anonim mengatakan...

Wow, marvelous blog layout! How long have you been blogging for?

you made blogging look easy. The overall look of your website is great, as well
as the content!

My blog post ... Homepage

Anonim mengatakan...

Heya! I'm at work browsing your blog from my new iphone 3gs! Just wanted to say I love reading your blog and look forward to all your posts! Keep up the fantastic work!

Take a look at my web blog :: Muscle Man

Anonim mengatakan...

e cigarettes, electronic cigarette, electronic cigarettes, best electronic cigarettes, best e cigarette, smokeless cigarettes

Sue Deleon mengatakan...


Vitrixa Select Ageless Serum

Reduce the amount of sugar you consume to help slow down the skin's aging process. Lots of people don't realize that too much sugar causes your glucose levels to increase, which sticks to your protein cells. These cells control the skin's collagen and elasticity. Consuming excessive amounts of sugar can actually promote skin that sags and wrinkles easily.Shea butter is a great tool for healing dry and chapped lips during the winter time. Look for products that contain it. If you are prone to dry lips, do not use lipsticks made for long-lasting, all-day coverage.
http://www.healthresortstoday.com/vitrixa-select-ageless-serum/