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The Stop Snoring Exercises Program Review

The Stop Snoring Exercises Program Review

The Psoriasis Strategy Review

The Psoriasis Strategy Review

Skinny Fat Shred Review

Skinny Fat Shred Review

Stop Narcissists from messing up your life

Stop Narcissists from messing up your life

Eczema Vanished Review

Eczema Vanished Review

Eye Floaters No More Review

Eye Floaters No More Review

Bad Breath Free Forever Review

Bad Breath Free Forever Review

Hack Your Carbs Review

Hack Your Carbs Review

Paleo Based Meal Planning Guide Review

Paleo Based Meal Planning Guide Review

Cold Sore Treatment Reviews

Cold Sore Treatment Reviews

Power Of Hormones Review

Power Of Hormones Review

Genius Brain Power Review

Genius Brain Power Review

Articles

Capsular and joint architecture

The ilium, ischium, and pubic bones unite at the acetabulum, forming the innominate bone. During childhood, these bones are separated within the ac-etabulum by the triradiate cartilage, which fuses at skeletal maturity. The acetabulum has an inclined abduction angle of approximately 35 degrees from the horizontal and a forward flexed position of approximately 20 degrees Figure 6.8A,C . The articular surface of the acetabulum has a horseshoe or lunate shape Figure 6.9 . The central inferior...

Noninfectious Conjunctivitis

Table 4.4 provides an overview of pathogens, symptoms, and treatments of noninfectious conjunctivitis. Acute conjunctivitis is frequently attributable to a series of external irritants or to dry eyes conjunctivitis sicca . The disorder is unpleasant but benign. Primary symptoms include foreign-body sensation, reddening of the eyes of varying severity, and epiphora. Therapy should focus on eliminating the primary irritant and treating the symptoms. Acute conjunctivitis should be distinguished...

The Sadistic Personality

When most of us think of sadism, we think of either the violent psychopath or the use of dominance and pain to accentuate sexual pleasure. But there is a difference between sadistic behavior and a sadistic personality. Although psychopaths can be instrumen-tally aggressive and hostile to the point of murder, only when the knowledge that others are suffering gives the individual pleasure does behavior become sadistic. And only when the inflicting of psychological or physical pain becomes the...

Sadistic Personality Disorder Dsmiiir Appendix A

People with Sadistic Personality Disorder are pervasively cruel, demeaning, and verbally and physically aggressive in most of their relationships. The sadistic behavior is typically more evident when the sadistic individual is in a position of power, as in the role of a father, mother, or uncle, or in occupational settings as a boss or in any position where there are subordinates. In contrast, individuals with Sadistic Personality Disorder often manage to contain their behavior when they are in...

Chylomicron metabolism the exogenous pathway

The metabolism of chylomicrons is often called the exogenous pathway of lipoprotein metabolism. Exogenous means 'from outside the body', since this is the pathway for transporting fat from outside the body - in fact, fat which has been eaten. The pathway is summarised in Fig. 9.2. We have already seen how triacylglycerol and cholesterol are absorbed and re-esterified in the cells of the intestinal wall, and secreted as chylomicron particles, via the lymphatics, into the circulation Section...

Effects Produced By The Parasympathetic Nervous System

The parasympathetic physiological activity on the organs is generally the opposite of the sympathetic with a few exceptions. The effect of the parasympathetic nervous system effects on some areas of the body are listed below a. Eye (Pupil). Contraction of the pupil (miosis) is produced by parasympathetic stimulation. b. Heart. The parasympathetic nervous system produces a decrease in heart rate and a slight decrease in the contraction strength of the heart. c. Bronchi. The bronchi are...

Hyperopia Farsightedness Definition

In hyperopia, there is a discrepancy between the refractive power and axial length of the eye such that parallel incident light rays converge at a focal point posterior to the retina (Fig. 16.10a). Epidemiology Approximately 20 of persons between the ages of 20 and 30 have refraction exceeding +1 diopters. Most newborns exhibit slight hyperLang, Ophthalmology 2000 Thieme All rights reserved. Usage subject to terms and conditions of license. Fig. 16.10 a The focal point of parallel light rays...

The impact of genetic engineering on vaccine technology

The advent of recombinant DNA technology has rendered possible the large-scale production of polypeptides normally present on the surface of virtually any pathogen. These polypeptides, when purified from the producer organism (e.g. E. coli, Saccharomyces cerevisiae) can then be used as 'subunit' vaccines. This method of vaccine production exhibits several advantages over conventional vaccine production methodologies. These include Production of a clinically safe product the pathogen-derived...

Variations of the Schizotypal Personality

The evolutionary model (Millon, 1990) holds that the schizoid and avoidant shade gently into the schizotypal thus, these personalities naturally form structural subtypes for this pattern (see Figure 12.1). Actual cases may or may not fall into one of these combinations. The insipid schizotypals represent a structural exaggeration of the passive-detached pattern. Like the schizoid, they are notably insensitive to feelings, seem indifferent to the external world, and appear drab, unmotivated,...

Medicare Reimbursement Basics

Reimbursement for chronic hemodialysis and kidney transplantation was scarce until the mid-1960s and haphazard until 1972, when Congress amended the Social Security Act to include coverage for end-stage renal disease for qualified patients. Because the amendment made Medicare the primary kidney transplantation insurer for more than 90 of the United States population, it was Congress and the U.S. Department of Health and Human Services, rather than the commercial health insurance industry, that...

Hypointense Seminal Vesicle

Figure 8 Utricle in a 70-year-old man. (A) Axial and (B) coronal T2-weighted images demonstrate a midline, benign utricular cyst of high signal intensity (white arrow). Figure 8 Utricle in a 70-year-old man. (A) Axial and (B) coronal T2-weighted images demonstrate a midline, benign utricular cyst of high signal intensity (white arrow). diagnosed in childhood because of its association with hypospadias, cryptorchidism, and ipsilateral renal agenesis (69-71). Mullerian duct cysts arise from the...

The Log Cell Kill Hypothesis

Cytotoxic drugs act by first-order kinetics that is, at a given dose, they kill a constant fraction of the tumor cells rather than a fixed number of cells. For example, a drug dose that would result in a three-log cell kill (i.e., 99.9 cytotoxicity) would reduce the tumor burden of an animal that has 108 leukemic cells to 105 cells. This killing of a fraction of cells rather than an absolute number per dose is called the log cell kill hypothesis. The earliest detectable human cancers usually...

Restrictive Lung Disease

Restrictive lung disease is another category of pulmonary disorders that may require nocturnal PAP therapy. Lung restriction is most commonly seen in obesity, kypho-scoliosis, neuromuscular disease, interstitial lung disease, and pregnancy. PAP therapy should be used unequivocally in these patients if they have coexisting OSA. However, in the absence of OSA, PAP therapy must be considered on a case-by-case manner, depending upon the disease process being considered. Obese patients without OSA...

Schneiderian Papilloma Exophytic

Fig. 1.29 Inverted papilloma A Low magnification showing hyperplastic aggregates of well-demarcated squamous and respiratory epithelium extending throughout the stroma. Note the absence of mucoserous glands. B Papilloma composed partially of hyperplastic, ciliated respiratory epithelium. Note the epithelial transmigration of neutrophils and the delicate basement membrane. C HPV nuclear and cytoplasmic reactivity can be seen in some inverted papillomas, usually in the same nuclei which exhibit...

Variations of the Histrionic Personality

The norm is to receive more than one personality disorder diagnosis. Combinations with secondary patterns lead to colorations of the primary pattern, though occasionally subtypes appear merely as a combination of the major traits. Frequently seen subtypes of the histrionic personality are described in the following sections and summarized in Figure 9.1. Actual cases may or may not fall into one of these combinations. FIGURE 9.1 Variants of the Histrionic Personality. FIGURE 9.1 Variants of the...

Papillary Lesions Of Thyroid

Hyperplastic nodules and adenomas with papillary architecture The papillary hyperplastic nodule of the thyroid is usually identified in girls, usually teenagers in and around the age of menarche. These present as solitary nodules and it is unusual for them to be associated with clinical hyperfunction, although that might occur. These lesion are distinguished from papillary carcinoma in that they are totally encapsulated, often show central cystic change, have subfollicle formation in the...

Importance Of Structure And Function

An ideal reconstruction of the oral cavity is one that very closely resembles the original structures in both form and function. To approach this ideal, the interactions between structures both within and beyond the oral cavity must be considered Fig. 1 . Furthermore, advanced reconstructive techniques typically require utilizing or transversing structures adjacent to the oral cavity. Thus, a detailed understanding of both the structures within the oral cavity, and those related to it, is...

Examination of the Conjunctiva

The conjunctiva is examined by direct inspection. The bulbar conjunctiva is directly visible between the eyelids the palpebral conjunctiva can only be examined by everting the upper or lower eyelid. The normal conjunctiva is smooth, shiny, and moist. The examiner should be alert to any reddening, secretion, thickening, scars, or foreign bodies. Eversion of the lower eyelid. The patient looks up while the examiner pulls the eyelid downward close to the anterior margin (Fig. 1.7). This exposes...

Factors affecting the threshold for excitation

As seen, for example, in Fig. 2.7, excitation of a nerve fibre involves the rapid depolarization of the membrane to a critical level normally about 15 mV less negative than the resting potential. The critical level for excitation is the membrane potential at which the net rate of entry of Na+ ions becomes exactly equal to the net rate of exit of K+ ions plus a small contribution from an entry of Cl- ions. Greater depolarization than this tips the balance in favour of Na+, and the regenerative...

The EPOR modela human sexual response cycle model

The most successful model was that formulated by Masters and Johnson. 20 In the laboratory, they observed the changes that took place in the male and female body and especially the genitals during sexual arousal to orgasm either by masturbation or by natural or artificial coitus with a plastic penis that allowed internal filming of the female genitalia. After studying approximately 7500 female and 2500 male arousals to orgasm in some 382 female and 312 male volunteers over 11 years they...

Retrochiasmal Lesions

Etiology Retrochiasmal lesions may result from a wide variety of neurologic disorders such as tumors, vascular insults, basal meningitis, aneurysms of the posterior communicating artery, abscesses, injuries (such as a contrecoup injury to the occipital lobe), and vasospasms (in an ocular migraine). Symptoms, diagnostic considerations, and clinical picture Visual field testing in particular will provide information on the location of the lesion. Perimetry is therefore a crucial diagnostic study....

International Personality Disorder Examination

The International Personality Disorder Examination (IPDE Loranger, 1999) is an extensive-semi-structured diagnostic interview to evaluate personality disorders according to both the DSM-IV and International Classification of Diseases, 10th edition (ICD-10) classification systems. Impetus for the creation of the IPDE came from the World Health Organization and the U.S. Alcohol, Drug Abuse, and Mental Health Administration in their joint effort aimed at producing a standardized assessment...

Antisocial Personality Disorder

As the term antisocial implies, individuals with this disorder are against society. Indeed, the hallmark feature is a pervasive pattern of disregard for, and failure to comply with, societal norms. Among people with Antisocial Personality Disorder, the rights of others are never a consideration, and when individuals with this disorder hurt, deceive, manipulate, abuse, or victimize others, they fail to experience remorse, guilt, or shame. When caught, antisocial types may weep crocodile tears...

CPAP and intracranial pressure regulation

Some concern may arise when CPAP is delivered to patients with increased intracranial pressure. Positive intrathoracic pressure may indeed decrease venous return and act as a resistive component to venous return from the head, thus increasing intracranial venous pressure and eventually parenchymal intracranial pressure. Decreased systemic venous return may also decrease cardiac output and blood pressure which will decrease oxygen delivery and perfusion to the already jeopardized cerebral...

Variations of the Narcissistic Personality

Few individuals in real life exist as the incarnation of an abstract psychological ideal. Instead, most persons combine aspects of two or more personality styles, though some combinations are more common than others. Whereas the previous section sharpened the contrast between various prototypes for explanatory purposes, in this section we portray narcissistic variants that are found as the disorder begins to shade toward other personalities (see Figure 10.2 for a summary). Actual cases may or...

The Self Defeating Masochistic Personality

Life is tough enough without making things even more difficult. Some people, however, deliberately put obstacles in their own way, seem to court suffering, and need to fail. Such individuals are called masochistic personalities, though they were termed self-defeating personalities in the DSM-III-R. Cursed with an uncanny sense for defeating themselves, they routinely set sail for stormy weather and call down setback, loss, frustration, and grief on themselves. When they do experience good...

Lateral Uncovering Of The Femoral Head

AP radiograph of the right hip of a 50-year-old woman, demonstrating classic characteristics of acetabular dysplasia. FIGURE 3.28. AP radiograph of the right hip of a 50-year-old woman, demonstrating classic characteristics of acetabular dysplasia. FIGURE 3.29. AP radiograph of the right hip of a 24-year-old woman with mechanical catching, suggestive of labral pathology. Signs of mild dysplasia include a slight valgus position of the femoral neck and slight lateral uncovering of...

Well Circumscribed Cystic Lesions

The most common clinical differential diagnosis of cystic orbital lesions includes dermoid cyst, colobo-matous cyst, teratoma, meningoencephalocele, lymphangioma, acquired inclusion cyst, chronic hematic cyst (cholesterol granuloma), mucocele, subperiosteal hematoma, and parasitic cyst.25 On MRI these lesions appear as well-defined, round to oval lesions with variable signal intensity depending on the composition of their content (Table 10.4).1,2,5,31 Dermoid cyst may have an homogeneous or...

Tendons adnexa and ligaments

Tendons are critical biomechanical units in the musculoskeletal system, the function of which is to transmit the muscular tension to mobile skeletal segments. They are extremely resistant to traction, almost like bone. A tendon with a 10 mm2 transverse section can bear a maximum of 600-1000 kg. On the other hand, tendons are not very elastic, and can only tolerate a maximum elongation of 6 before being damaged. Tendons have very slow metabolism, even during action. This can be significantly...

Lymph Node Metastases

Since lymphatic tumour spread is common in pelvic malignancy, it is important to identify the anatomical location of all the pelvic nodal groups and to be aware of the usual pathway of lymphatic drainage for each organ involved. There are perivisceral nodes in the meso-rectal fat, parametrium, and paravesical fat. While meso-rectal lymph node metastases are often identified in rectal cancer, the other perivisceral nodes are only rarely seen. Nodal metastases are most frequently identified in...

Focal Thickening Of Postero Lateral Bladder Wall

Figure 10 Caliceal diverticulum. (A) Excretory-phase axial image demonstrates a urine-contrast level in a mass in the upper pole of the right kidney (arrow). This mass had uniform water attenuation on the precontrast images. Based upon these findings, a diagnosis of caliceal diverticulum can be made. (B) This large caliceal diverticulum is also easily seen on the coronal volume-rendered 3-D reconstruction (arrow). Bladder cancers may also produce small mural nodules. These can be detected by...

Non Venereal Genital System Diseases

The genital tract is the portal of entry for numerous infectious diseases, both venereal and non-venereal (venereal, from Venus, the goddess of love non-venereal means not transmitted by making love). This section discusses some examples of non-venereal genital diseases. The term venereal disease (VD), formerly meaning disease transmitted almost exclusively by sexual intercourse, is now often used interchangeably with sexually transmitted disease (STD), which includes all diseases spread by...

Variations of the Paranoid Personality

Although the paranoid personality is a tightly knit syndrome, its features nevertheless combine with those of several other personalities, producing variations of the core prototype, described in the following paragraphs and summarized in Figure 13.1. Actual cases may or may not fall into one of these combinations. FIGURE 13.1 Variants of the Paranoid Personality. FIGURE 13.1 Variants of the Paranoid Personality. The fanatic paranoid pattern often resembles its less troubled cousin, the...

Horneys Description of Types

Compliant Type (Moving toward People) Compliant types have a strong and compulsive need for affection, approval, belonging, and human intimacy. They need a partner on whom they can regularly rely for help, protection, and guidance. Their urge to satisfy these compulsions is so strong that they often forget what their own real feelings are because they become so sensitive to their partner's feelings. They become so unselfish and self-sacrificing that they have a warped view of their own needs...

Structure and Function of Hepatic Sinusoids

The sinusoids are unique exchange vessels composed of specialized nonparenchymal cells that exhibit structural and functional heterogeneity. The structure of the sinusoid is illustrated in Figure 3. The endothelial cells are highly fenestrated and lack a supporting basal lamina. The fenestrae are organized in clusters known as sieve plates. As a result, there is continuity between the plasma in the sinusoid lumen and the perisinu-soidal space (of Disse). The sinusoidal endothelial cells contain...

Inadequate Personality Disorder

The Inadequate Personality Disorder description in DSM-II included ineffectual responses to any physical, intellectual, social, or emotional demands placed on the individual. Despite the lack of any real physical or intellectual deficits, these patients appear poorly adapted to their environment, are inept, have poor judgment, are socially unstable, lack physical and emotional stamina, and chronically cannot cope with everyday stress and strain. Detailed, behaviorally specific criteria were not...

Variable Loop In Trna Role

FIGURE 14-3 A subset of modifief nucleosides found in tRNA. plays an important role in the process ofcedon recognition by certain tRNAs. tRNAs Share a Common Secondary Structure that Resembles a Clover leaf As we saw in Chapter 6, RNA molecules typically contain regions of self-complementarity that enable them to form limited stretches of double helix that are held together by base pairing. Other regions of RNA molecules have no complement and hence, are single-stranded. tRNA molecules exhibit...

A new look at levodopa based on the Elldopa study

Department of Neurology, Columbia University, New York, NY, USA Summary. Levodopa has been the gold standard for Parkinson's disease (PD) therapy since it was successfully introduced in 1967. But in the years since then, after recognizing that levodopa often leads to the motor complications of wearing-off and dyskinesias, there have been debates among clinicians as to when levodopa therapy should be started. Delaying therapy was advocated for the purpose of delaying the development of these...

Signs and Symptoms of Hypoventilation

The presence of clinical symptoms and or physiologic markers of hypoventilation are useful in identifying clinical severity as it relates to therapeutic decision-making with regard to initiation of nocturnal NIPPV. In the course of a typical progressive disease, two successive steps occur more or less rapidly (i) nocturnal hypoventilation reversible during wake associated with none or a few clinical symptoms and (ii) nocturnal and daylight hypoventilation associated with clinical symptoms,...

Formulation of insulin products

Insulin, whatever its source, may be formulated in a number of ways, generally in order to alter its pharmacokinetic profile. Fast (short)-acting insulins are those preparations that yield an elevated blood insulin concentration relatively quickly after their administration (which is usually by s.c. or, less commonly, by i.m. injection). Slow-acting insulins, on the other hand, enter the circulation Table 11.3 Native and engineered human insulin preparations that have gained approval for...

Mastoidectomy Facial Recess Approach and Cochleostomy Techniques

The important point in considering the mastoidect-omy for placement of a cochlear implant is that this is much smaller than that utilized for chronic ear disease. In contrast to the standard method of saucerizing the mastoid cavity, this is not performed in cochlear implant surgery. There are two areas that need to be skeletonized, and the single most important one of these is the bony external auditory canal. If the bony external auditory canal is not thinned appropriately, then the angle...

The Interpersonal Perspective

The interpersonal perspective is concerned with how human beings interact and how these interactions support, invalidate, and elaborate the self-image. Sullivan is considered the father of this approach, reacting against the classical psychoanalysis of Freud, whereby pathology was always a property of the person. Instead, Sullivan saw psychopathology as emerging from an individual's relationships and patterns of communication. According to Sullivan (1956, p. 145), there are two requirements for...

Direct Vs Indirect Molecular Diagnostic Tests

Genetic testing, through interrogation of DNA, RNA, chromosomes, or proteins, can provide critical information for the detection of heritable disease genotypes for a number of different applications Table 3 15 . Many procedures can be used in either a direct or indirect mutation analysis. Most types Applications of Molecular Genetic Testing Diagnostic testing Testing for a gene mutation in symptomatic individuals as a diagnostic aid. Newborn screening Testing is used to screen populations to...

Nutrition and the metabolic response to injury

Cuthbertson described the metabolic response to injury as consisting of an ebb phase and a flow phase.2526 The ebb phase is the period of traumatic shock or hypometabolism during the first few hours or days after injury. This phase is soon replaced by the flow phase that is a period of hypermetabolism that may last for weeks or months depending on the nature of the injury and obstacles to recovery. In the case of minor injury, such as elective surgery, both of these phases may be relatively...

Vascular Supply To The Femoral Head

Intraarticular isolation of the femoral head and neck makes it highly dependent on its tenuous vascular supply. Its susceptibility to circulatory compromise is an ongoing source of concern to physicians who treat hip pathology. Ischemic insult followed by avascular necrosis AVN of the femoral head, similar to other forms of osteonecrosis, has been clearly linked to certain disease states and types of exposure although it is less clearly associated with others and often purely idiopathic.10 AVN...

Lateral Epicondylitis and Lateral Collateral Ligament Injury

Lateral epicondylitis, also called tennis elbow, is caused by degeneration and tearing of the common extensor ten-don.22 This condition often occurs as a result of repetitive sports-related trauma to the tendon, although it is seen far more commonly in nonathletes.9 In the typical patient, the degenerated extensor carpi radialis brevis tendon is partially avulsed from the lateral epicondyle.22 Scar tissue FIGURE 4.4. Clinically suspected tennis elbow in a patient who did not respond to a local...

Thyroid Follicular Hyperplasia And Neoplasia

Follicular nodules are the most commonly encountered problems in the surgical pathology of the thyroid. These lesions can be classified along the full spectrum of thyroid pathology from hyperplastic nodules to benign follicular adenomas and malignant fol-licular carcinomas. Sporadic nodular goitre is characterised by numerous follicular nodules with heterogeneous architecture and cytology, features that have suggested a hyperplastic rather than neoplastic pathogenesis 7-10 . The gland may be...

Congenital Ocular Melanocytosis

Ocular melanocytosis. a Heterochromia with light brown right iris and dark brown left iris. b Episcleral melanocytosis Fig. 8.11 a, b. Ocular melanocytosis. a Heterochromia with light brown right iris and dark brown left iris. b Episcleral melanocytosis Although it is not strictly in the conjunctiva, congenital ocular melanocytosis is included here because it is an important epibulbar lesion of childhood. It is a congenital diffuse, patchy epibulbar pigmentation that is situated...

Meiosis In Grasshopper Testis

For each pair of terms, explain how the meanings of the terms differ. 2. Explain the relationship between the terms chromosome and homologous chromosomes. 3. Use the following terms in the same sentence mitosis, meiosis, and cytokinesis. 4. Word Roots and Origins The word oogenesis is derived from the Greek oion, which means egg, and geneia, which means birth. Using this information, explain why the term oogenesis is a good name for the biological process it describes. 5. Describe the...

Personality Disorders and Dementia

Perhaps the ultimate overarching task in late life is that of life review looking back over one's life, reflecting on it, and making meaning from the journey. Erik Erikson's (1963) influential developmental theory posited a conflict between ego integrity and despair, with the successful outcome being the achievement of wisdom. As clinicians, we recognize that there can be many hurdles along the way. Wisdom might be a possible outcome, but simply becoming old does not guarantee its achievement....

Pitfalls In Image Interpretation

Several problems can be encountered when performing and interpreting CT urograms. Knowledge of these potential pitfalls is important so that studies can be performed with the optimal technique and erroneous interpretations minimized. Figure 13 Tiny bladder cancer. A 3 mm diameter bladder cancer projects into the contrast-containing lumen of the urinary bladder arrow , producing a small filling defect. This could not be seen on any of the 3-D reconstructed images. A variety of criteria must be...

Testicle Shrinkage Treatment

Feel your breast in overlapping areas. Some research suggests that many women do breast self-examinations more thoroughhly when they use a pattern of up-and-down lines or strips. Other women feel more comfortable with another pattern. The important thing is to cover the entire breast and to pay special attention to the area between the breast and the underarm, including the underarm itself. Check the area above the breast, up to the collarbone and all the way over to your shoulder. Feel the...

The Mechanism Of Dna Polymerase

DNA Polymerases Use a Single Active Site to Catalyze DNA Synthesis The synthesis of DNA is catalyzed by an enzyme called DNA polymerase. Unlike most enzymes, which have an active site dedicated to a single reaction, DNA polymerase uses a single active site to catalyze the addition of any of the four deoxynucleosido triphosphates. DNA polymerase accomplishes this catalytic flexibility by exploiting the neatly identical geometry of the A T and G C base pairs remember that the dimensions of the...

The DSM Multiaxial Model

The disorders in the DSM are grouped in terms of a multiaxial model. Multiaxial literally means multiple axes. Each axis represents a different kind or source of information. Later, we concentrate on exactly what these sources are now, we just explain their purpose. The multiaxial model exists because some means is required whereby the various symptoms and personality characteristics of a given patient can be brought together to paint a picture that reflects the functioning of the whole person....

Paranasal Sinuses Sinusitis

Anatomical (compromised patency of ostia causes hypooxygenation and impairment of sinus drainage) Dysfunction of Cilia Motility Change in Quality of Secretions Viral rhinovirus (most common) Bacterial S. pneumoniae (most common bacterial agent), H. influenzae, B. catarrhalis, S. aureus, S. pyogenes Fulminant Fungal Aspergillosis, Phaehyphomycosis, Mucor, Rhizopus Chronic anaerobes, S. aureus, H. influenzae, 1 2 fungal Complicated Sinusitis Cystic Fibrosis P. aeruginosa, S. aureus Nosocomial P....

Vitreous Hemorrhage Definition

Bleeding into the vitreous chamber or a space created by vitreous detachment. Epidemiology The annual incidence of this disorder is seven cases per 100000. Etiology A vitreous hemorrhage may involve one of three possible pathogenetic mechanisms (Fig. 11.5) 1. Bleeding from normal retinal vessels as can occur as a result of mechanical vascular damage in acute vitreous detachment or retinal tear. 2. Bleeding from retinal vessels with abnormal changes as can occur as a result of retinal...

The Psychodynamic Perspective

Although the preceding contributions anticipate the modern view, arguably the most important historical development came in 1895 with the publication by Breuer and Freud on unconscious mechanisms in hysteria, stimulated by the famous case of Anna O. Both were fans of hypnosis, used to gain insight into Anna's unconscious conflicts, including her dislike for her father and her love for Breuer, who then left the case to Freud. Eventually, the two formed the theory that hysterical symptoms...

Occasional Plasmids are Linear or Made of RNA

Although most plasmids are circular molecules of DNA there are occasional exceptions. Linear plasmids of double-stranded DNA have been found in a variety of bacteria and in fungi and higher plants. The best-characterized linear plasmids are found in those few bacteria such as Borrelia and Streptomyces that also contain linear chromosomes (see Ch. 5). Linear DNA replicons in bacteria are not protected by incompatibility The inability of two plasmids of the same family to co-exist in the same...

Nutritional Factors that Influence Microbial Growth

Growth of any bacterium depends not only on a suitable physical environment, but also an available source of chemicals to use as nutrients. From these, the cell must synthesize all of the cell components discussed in chapter 3, including lipid membranes, cell walls, proteins, and nucleic acids. These components are made from building blocks such as fatty acids, sugars, amino Table 4.3 Representative Functions of the Major Elements Component of cellular constituents including amino acids,...

Variations of the Dependent Personality

In addition to the more prototypal cases described in this chapter, there are several variations of the dependent that express its combination with other personalities. Figure 8.1 provides a summary of these subtypes. Actual cases may or may not fall into one of these combinations. A mixture of both the dependent and avoidant patterns, the disquieted dependent is often found in an extreme form in institutional settings that minister to chronic ambulatory patients. Most live a parasitic...

Microscopic Techniques Dyes and Staining

It can be difficult with the bright-field microscope to observe living microorganisms. Most are nearly transparent and often move rapidly about the slide. Consequently, cells are frequently immobilized and stained with dyes. These dyes may be attracted to one or more cellular components. As a result, an entire organism, or its specific parts, can be made to contrast with the unstained background. Many different dyes and staining procedures can be used each has specific applications table 3.2 ....

Inoculum Expansion and Production Steps

Very limited information is available in the public domain regarding the general design and sizing of an upstream processing line for pilot- or large-scale production. Chu and Robinson (2001) present an overview of the technologies (bioreactor type and mode, medium type) for the various commercial products recently approved (recombinant proteins, vaccines, diagnostics and tissue culture), but few details on the scale of the cultivation vessels are actually available. In the following, typical...

Exponential Phase Log Phase

During the exponential or log phase, cells divide at a constant rate and their numbers increase by the same percentage during each time interval. The generation time is measured during this period of active multiplication. Because bacteria are most susceptible to antibiotics and other chemicals during this time, the log phase is important medically. During the initial phase of exponential growth, all the cells' activities are directed toward increasing cell mass. Cells produce compounds such as...

Fermentation Processes

Fermentation is the term used by microbiologists to describe any process for the production of a product by means of the mass culture of a microorganism 1 . The product can either be i The cell itself referred to as biomass production. ii A microorganism's own metabolite referred to as a product from a natural or genetically improved strain. iii A microorganism foreign product referred to as a product from recombinant DNA technology or genetically engineered strain. There are three types of...

Bacterial Skin Diseases

Only a few species of bacteria commonly invade the intact skin directly, which is not surprising in view of the anatomical and physiological features discussed earlier. Hair follicle infections exemplify direct invasion. Infections originating in hair follicles commonly clear up without treatment. In some instances, however, they progress into severe or even life-threatening disease. Folliculitis, furuncles, and carbuncles represent different outcomes of hair follicle infections. In...

Slime Molds and Water Molds

The slime molds and water molds used to be considered types of fungus. They are, however, completely unrelated to the true fungi and are good examples of convergent evolution. Convergent evolution occurs when two organisms develop similar characteristics because of adaptations to similar environments and yet are not related on a molecular level figure 12.19 . There are two groups of slime molds, the acellular slime molds and the cellular slime molds. The slime molds are terrestrial organisms...

Structured Clinical Interview for Dsmiv Axis II Personality Disorders

The Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II First, Gibbon, Spitzer, Williams, & Benjamin, 1997) was developed to complement the widely used Axis I version of the SCID (First, Spitzer, Gibbon, & Williams, 1997). The SCID-II has semi-structured format (like the Axis I version) but it covers the 10 standard DSM-IV Axis II personality disorders, as well as Personality Disorder Not Otherwise Specified, and Depressive Personality Disorder and...

Case Study Of Bacillus Anthracis

In this section, we will present some quantitative considerations related to microbial forensics. We will use published research on Bacillus anthracis to illustrate several important issues. We do so because the anthrax terrorist attacks of October 2001 have received considerable attention and, thus, offer concrete data for discussion. However, we will gloss over certain complications of this particular example in order to emphasize more general issues that would probably apply to similar cases...

Vaginitis or Vulvitis

Common cause of vaginitis in prepubertal girls. Presents with serous discharge, marked erythema and irritation of the vulvar area, and discomfort on walking and urination. 2. Candida. Can also cause vaginitis but typically causes intense pruritus. Labia may be pale or erythematous with satellite lesions. Vaginal discharge, if present, is usually thick and adherent, with white curds. 3. Other causes. In sexually active adolescents, the most common causes include bacterial...

Antiparkinsonian Therapy And Hypersexuality

With the advent of antiparkinsonian therapy, reports of increased libido and sexual performance, hypersexual behavior (with or without concomitant hypomania), and rarely paraphilias have appeared in the literature.11-25 Comparisons cannot be made among studies, as different criteria were used to collect data. Due to the small size of the studies, the incidence of increased sexual drive in patients receiving treatment with antiparkinsonian therapy cannot be determined. The data does not provide...

Larynx Cancer Relative Risk Cigarettes

Fig. 3.2 A Diagram of the larynx and pre-epiglottic space. B Diagram and boundaries of the oropharynx and hypopharynx, with relationship to oral cavity and larynx, respectively. conus elasticus inferiorly, the thyroid cartilage laterally, the quadrangular membrane medially and the pyriform sinus posteriorly. The pre-epiglottic space, also filled with adipose and connective tissue, is triangular shaped. It is bounded anteriorly by the thyroid cartilage and thyrohyoid membrane, posteriorly by the...

Alopecia Male Pattern Baldness

Alopecia occurs when the hair shaft is lost and the hair follicle cannot regenerate. This results in permanent hair loss. Alopecia is associated with a familial history and the aging process. Some patients experience alopecia earlier than others. Some medications can cause temporary alopecia. These include anticancer (antineoplastic) agents, gold salts, sulfonamides, anticonvulsants, aminoglyco-sides, and nonsteroideal antiflammatory drugs (NSAIDs) such as indomethacin. Table 20-2. Topical...

The Cognitive Behavioural Model Of Bipolar Disorder

Many authors have argued that there is a marked lack of a coherent psychological model of bipolar disorder (e.g., Jones, 2001 Scott, 2001a). Recent research, however, highlights the role of cognitive and psychosocial factors in the development and course of bipolar disorder, and the first treatment manuals were published in recent years, delineating the application of CBT principles to bipolar disorders (Basco & Rush, 1996 Lam et al., 1999 Newman et al., 2002 Scott, 2001b). A body of...

CT Quantification of Emphysema

University of Michigan Health System, Ann Arbor, Michigan Before the reintroduction of lung volume reduction surgery (LVRS) in the mid-1990s as a surgical treatment for advanced emphysema 1 , the routine clinical use of medical imaging for emphysema was largely limited to the chest radiograph. Emphysema was commonly depicted on computerized tomography (CT) scans of the thorax performed for other reasons, such as lung cancer diagnosis or staging however, there has been little reason to apply...

Chemotherapeutic agents commonly used in MBC

Anthracycline antibiotics (doxorubicin and epirubicin) are among the most active drugs in MBC and cause anti-tumour effects by a variety of mechanisms including generation of oxygen free radicals and impairing DNA replication. Recent studies have conferred that overexpression of topoisomerase II alpha (TOP2A) gene may provide as a rational predictive marker for response to anthracycline therapy. It is often co-amplified in 35 of tumours with HER-2 amplification. But its level of overexpression...

Collagenases and Their Inhibitors

Collagenases are a family of enzymes that digest collagen, the fibrous protein found in connective tissue. Collagen is derived from the Greek words kolla (glue), and gennan (to produce), reflecting its role in gluing cells together. Collagen accounts for approximately 30 percent of the body's total protein store. Each type of collagenase degrades a specific type of collagen. For example, the basement membrane around capillaries contains type IV collagen, and therefore type IV collagenase is a...

Mannitol and hypertonic saline

Intravenous mannitol is invaluable as a first aid measure in a patient with brain herniation as a result of raised ICP. In practice, mannitol tends to be given as an intermittent bolus (2 ml kg of a 20 solution over 15-20 minutes) whenever the individual patient's ICP rises significantly above the threshold of 20-25 mmHg. Effects last for up to four hours. As osmotic diuresis may lead to hypovolaemia it is crucial to avoid dehydration and latent hypotension with careful attention to fluid...

Protein and amino acid metabolism

Posttraumatic hypermetabolism is associated with increased catabolism and loss of lean body mass in proportion to the severity of the injury. It is well established that an increased intake of protein is required for wound healing and achievement of nitrogen balance. Patients with sepsis can lose up to 250 g of lean body mass per day if unfed 87 . Muscle proteolysis, a hallmark of protein metabolism in sepsis and trauma, can result in compromised respiratory function and further...

The Ljubljana Classification and WHO 2005 Classification

Comparing the two classifications, one should be aware that there is no simple relationship and overlapping between the WHO 2005 and the Ljubljana classifications Table 1.1 . The group of the so-called benign lesions, including squamous and basal-parabasal cell abnormal hyperplasia is comparable in both classifications. Disagreement starts with the presumption of the WHO 2005 classification 381 that each grade of the whole series of dyspla-sia is considered to be a precursor or potentially...

Natural Compounds That Stimulate Andor Support The Immune System

A large number of natural compounds can stimulate or support the immune system or do both. A selected list of some of the major compounds is provided in Table 12.1. Note that many other natural compounds discussed in this book (and many not included) could act as immunostimulants or supportive agents. For example, CAPE has been reported to increase the susceptibility of tumor cells to NK cell attack and induce expression of tumor-associated antigens on human melanoma and brain cancer cells...

Employers Liability for Employees Negligence

The application of traditional vicarious liability rules renders employers vicariously liable for the acts of their employees when performed in the scope of their employment (93). Thus, when Norman Munnal killed a woman when he fell asleep at the wheel of a tractor-trailer while driving for his trucking company employer, it was W.L. Logan Trucking Company that faced liability for its driver's acts (94). The trucking company invoked Ohio's version of the sudden blackout doctrine to defend...

Personality Diagnostic Questionnaire Fourth Edition Plus

The Personality Diagnostic Questionnaire has been through several revisions since its inception and the latest edition is called the Personality Diagnostic Questionnaire Fourth Edition Plus (PDQ-4+ Hyler, 1994), which is consistent with the DSM-IV. The PDQ-4+ assesses the 10 standard personality disorders in the DSM-IV and the plus indicates that the measure also assesses Passive-Aggressive Personality Disorder and Depressive Personality Disorder in Appendix B of the DSM-IV. The PDQ-4+ contains...

Microbiology of Solid Waste Treatment

In addition to ridding our environment of wastes in water, we must dispose of the solid wastes that are generated each day. Some of it is inert materials such as glass, metals, and plastics, but a large amount is organic material that is affected by microorganisms. Eliminating waste products from the environment has become an increasingly complex problem. Sanitary Landfills for Solid Waste Disposal Sanitary landfills are widely used to dispose of non-hazardous solid wastes in a manner that...

Characteristics of the Secondary Response

Memory B cells are responsible for the swift and effective reaction of the secondary response, eliminating identical repeat invaders before they cause noticeable harm. Thus, once a person has recovered from a particular disease, he or she generally has long-lasting immunity to that disease. Vaccination exploits this naturally occurring phenomenon. Memory B cells that bind antigen can promptly become activated provided they receive necessary signals from effector T-helper cells. When compared to...

Obligate Intracellular Parasites

Obligate intracellular parasites are unable to reproduce outside a host cell. In general, the term only refers to those that infect eukaryotic cells. By living within eukaryotic cells, these bacteria are supplied with a readily available source of compounds they would otherwise need to synthesize for themselves. As a result, most species of these genera have lost the ability to synthesize substances needed for extracellular growth. Bacterial examples include members of the genera Rickettsia,...

Contraindications and false contraindications

Contraindications to immunization dictate circumstances when vaccines should not be given because the condition in an individual increases the risk for a serious adverse reaction following immunization. The majority of con traindications are temporary, and the vaccine can be given later. However, in many cases immunization is delayed or denied because of conditions falsely believed by the physician or the health worker to constitute a contraindication. The World Health Organization and the...

Mistletoe as a Remedy

The intentions of mistletoe uses were manifold and conflicting in several cases. According to the Greek physician and author Dioskorides (15-85 AC), Hippocrates (460-377 BC) used the mistletoe to treat diseases of the spleen and complaints associated with menstruation. Plinius (23-79 AC) reported mistletoe from oak trees, when applied as a chewed pulp, to be beneficial for epilepsy, infertility, and ulcers (Historia naturalis, liber XXIV, 12). Around 150 AC, the Platonist Celsus reported the...

Fragmentation of Monoclonal Antibodies

In certain circumstances, it may be desirable to generate antigen-binding fragments of monoclonal antibodies. For example, when cells with receptors for the Fc portion of IgG are present (e.g. macrophages, monocytes), intact IgG molecules may bind nonspecifically via their Fc portions (see Section 5.3.4). Removal of the Fc will prevent this mode of binding. The production of small fragments of IgM (intact Mr 900000) may aid penetration into the tissues for cytochemical studies. The older...

Acupuncture for Pelvic Floor Dysfunction

Acupuncture is an important mainstay of traditional Chinese medicine (TCM). Empirically derived by thousands of years of observation, Chinese medical doctors recorded their treatments almost 2000 years ago in the then modern text, Yellow Emperor's Book of Internal Medicine. Although the physiologic reasoning may seem bizarre to modern allopathic physicians, accepting and understanding the basic tenets does then provide a logical choice of therapy that has withstood the test of time,longer than...

Diagnosis and differential diagnosis

The main diagnostic challenges are to identify pathological grief, and to identify other mental disorders provoked by bereavement ( Table ). Table 2 Complications of bereavement Pathological grief has different meanings. It can be defined as follows (25) chronic grief the failure to resolve all adverse bereavement-related symptoms within 6 months inhibited grief the absence of expected grief symptoms delayed grief the avoidance of painful symptoms within the first 2 weeks of a loss. An...

Fundamental Advantages of MDCT

The first advantage of MDCT is the ability to scan a lot faster while acquiring a dataset with similar slice thickness and image quality to that of SDCT. Faster table speeds are particularly advantageous in patients with reduced breath-holding capacity since table speeds on the order of 50 to 70 mm per second are achievable. Fast table speeds are often chosen in the setting of trauma, in patients with dyspnea, in young children or in those patients in whom there are communication difficulties...

The Biological Perspective

The history of the schizoid personality begins in early descriptive psychiatry and continues through later temperament and constitutional theorists. Early writers emphasized different characteristics of the modern prototype. For example, Ribot (1890) invented the term anhedonia to describe the diminished ability to experience pleasure, characteristic of the schizoid pattern. Similarly, A. Hoch (1910) described what he called the shut-in personality, using adjectives such as reticent, seclusive,...

Use of Toxicological Data in Evaluating Chemical Safety Gloria Rachamin PhD

5 Characterization of Dose-Response Relationships The quantitative relationships between dose and the incidence of adverse response (see Appendix 1) provide the basis for evaluating chemical hazard and the derivation of exposure limits. The approach used to assess the dose-response relationship depends on whether the chemical produces threshold or nonthreshold end points (19, 20). 5.1 Threshold and Nonthreshold Effects A threshold dose-response relationship is used to evaluate chemicals that...

Fungal Wound Infections

Fungal infections of wounds are unusual in economically developed countries, except that the yeast Candida albicans can be troublesome in severe burns and in those with wounds and underlying diseases such as diabetes and cancer. This yeast, commonly present among the normal flora and kept in check by it, becomes pathogenic when the competing microorganisms are eliminated, as in individuals receiving antibacterial therapy. Other fungal wound infections are much more common in impoverished people...

The Evolutionary Neurodevelopmental Perspective

By definition, perspectives offer only limited insight into any given phenomenon. Because personality refers to the matrix of the total person, a theory adequate to embrace personality must exist at a level of analysis equal to personality itself. Perspectives are only parts, not wholes, and cannot accomplish this goal. According to the biopsychosocial-evolutionary theory (Millon, 1990 Millon & Davis, 1996), the narcissistic personality is passively self-oriented. Such individuals turn...

Epidemiology and presentation of invasive fungal infections in pediatric patients

Candida spp. colonize the vaginal tract of approximately 30 of pregnant women very rarely, they can become the cause of chorioamnionitis and intrauterine infection 29, 30 . Candida rapidly colonizes the mucocutaneous surfaces 31, 32 in healthy infants, this colonization may result in thrush and diaper dermatitis 31 . In hospitalized, ill neonates, however, Candida has evolved as important cause of life-threatening invasive infections, particularly in very low birth weight infants. Candida spp....

Obsessive Compulsive Personality Disorder

This disorder is characterized by a preoccupation with rules, details, organization, orderliness, and internal and external control. People with Obsessive-Compulsive Personality Disorder are highly perfectionistic, and they apply their overly strict standards to their own behavior and that of others. This preoccupation with details, lists, schedules, routines, organization, and perfectionism is so engrossing that the major point of the activity or project often becomes obscured, lost in the...

Passive Aggressive Personality Disorder Dsmivtr Appendix B

The Passive-Aggressive Personality Disorder has been in the DSM since its inception in 1952. Only in 1994 with the advent of DSM-IV was the Passive-Aggressive Personality Disorder removed from Axis II and placed in an appendix. The reasons for its drop in diagnostic status are uncertain however, Appendix B of DSM-IV-TR is intended to foster research that may result in a refinement of the diagnosis and its criteria, so it is possible the type may reappear in revised form in future versions of...

The Case of Doreen Schizotypal Personality Disorder

Doreen G. is a 68-year-old woman who has come to the attention of mental health professionals only twice in her life. The first time was early in high school when the teachers were concerned about the degree of her introversion and lack of connection to her classmates, and about her sometimes bizarre facial expressions, which did not seem to match the events going on around her. She was a bit peculiar and significantly withdrawn and detached. Her parents were called into school to discuss these...

Developing an idiosyncratic model of the patients problem

Assessment ends with the development of an idiosyncratic version of the cognitive model. In particular, therapists aim to show patients how the specific triggers for their anxiety produce negative automatic thoughts relating to feared outcomes and how these are maintained by safety behaviours and other maintenance processes. The model is usually drawn on a whiteboard, so that patient and therapist can look at it and discuss it together. Figure 1 shows an example for a panic disorder patient....