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Kidney Function Restoration Program Review

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Penis Enlargement Holy Grail Review

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Foxbrim Naturals Plant Based Skin Care

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Cheryl Farley Combat Diabetes In 10 Days Or Less Review

Cheryl Farley Combat Diabetes In 10 Days Or Less Review

Roadmap To Genius Skyrockets Your IQ to 180+

Roadmap To Genius Skyrockets Your IQ to 180+

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Get Your Health Back Review

Penis Enlargement Bible Review

Penis Enlargement Bible Review

The Peripheral Neuropathy Solution Review

The Peripheral Neuropathy Solution Review

Eat Sleep Burn by Todd Lamb Complete Review

Eat Sleep Burn by Todd Lamb Complete Review

Articles

Calculation of Dialysis Clearance

Currently, the efficiency of hemodialysis is expressed in terms of dialysis clearance. Dialysis clearance (CLd) is usually estimated from the Fick equation as follows where A is the solute concentration entering (arterial) and V is the solute concentration leaving (venous) the dialyzer. The terms in brackets collectively describe what is termed the extraction ratio (E). As a general principle, clearance from an eliminating organ can be thought of as the product of organ blood flow and...

Multidisciplinary Team MDT Advantages and Disadvantages

In the Introduction to NHS Cancer Plan, Three Year Progress Report - Maintaining the Momentum the National Cancer Director, Professor Mike Richards, said that the establishment of specialist cancer teams across the country has been one of the most important developments in recent years. These multidis-ciplinary teams bringing together surgeons, radiologists, pathologists, oncologists, palliative care specialists and other professionals are now helping to ensure that patients receive appropriate...

Factors Affecting The Rate Of Healing Of A Fracture

Cancellous bone spongy bone Healing in cancellous bone is generally well advanced 6 weeks from he time of the injury, and protection of the fracture can almost invariably be abandoned by that time. This applies to fractures of bones which are composed principally of cancellous issue, and also to fractures involving the cancellous bone to be found at the ends of long bones. This rule is illustrated in the following examples 1. Weight bearing after a fracture of the calcaneus may be permitted...

Section of the lateral pedicles

The periprostatic fascia has two layers the outer layer, called levator fascia, and an inner layer, called prostatic fascia. The neurovascular bundles run between these two layers (Fig. 38.5). At this point they are in proximity with the Denonvillier's fascia. If nerve-sparing is to be undertaken, the two layers of Fig. 38.5. Nerve sparing. After incision of the levator fascia, the neurovascular bundle is released of the prostate. Fig. 38.5. Nerve sparing. After incision of the levator fascia,...

Viscoelastic Behavior

When a force is applied to a viscous fluid, it will start to deform and this deformation is proportional with the magnitude of force applied. It deforms continuously until the force is removed so that it cannot return to its original position. Viscous fluids generally exhibit viscosity while solids exhibit elasticity. Some foods show both viscous and elastic properties which are known as viscoelastic materials. The typical food example for viscoelastic fluids is wheat flour dough. Dairy cream,...

Reasons for Using Animal Subjects

Psychologists study animals for a variety of reasons. Sometimes they study the behavior of a particular animal in order to solve a specific problem. They may study dogs, for example, to learn how best to train them as watchdogs, chickens to learn how to prevent them from fighting one another in henhouses, and wildlife to learn how to regulate populations in parks, refuges, or urban areas. These are all examples of what is called applied research. Most psychologists, though, are more interested...

Positioning techniques depending on various surgical indications

Penis e.g. penis deviation (Nesbit), hypospadia correction, epispadia correction. Testicles e.g. vasectomy, varicocele ligature, vasovasostomy and epididy-movasostomy, microepididymal and testicular sperm extraction (MESA and TESE), spermatocelectomy, epididymectomy. Abdominal operations e.g. suprapubic cystostomy, retroperitoneal lymph-adenectomy, transperitoneal nephrectomy possibly with cavotomy and tumour thrombectomy, intraperitonealisation of the ureters, augmentation of the bladder,...

Gynecological Causes of Acute Abdominal Pain

The main gynecological conditions causing acute abdominal pain are functional ovarian cysts, ovarian torsion, and hydrometrocolpos. Transabdominal US will commonly show the lesion. Transvaginal US should not be routinely done as a primary investigation in adolescent girls, but may supplement the abdominal examination in sexually active patients. Ovarian cysts usually result from failure of involution during the normal menstrual cycle. They may cause acute lower abdominal or pelvic pain in...

Isoniazid And Iproniazid

Isoniazid and iproniazid are chemically similar drugs having different pharmacological effects they may both cause liver damage after therapeutic doses are given. Isoniazid is still widely used for the treatment of tuberculosis, but iproniazid is now rarely used as an antidepressant. The major routes of metabolism for isoniazid are acetylation to give acetylisoniazid, followed by hydrolysis to yield isonicotinic acid FIGURE 7.15 Metabolism of isoniazid. The acetylhydrazine released by the...

Fanconi anaemia Clinical features

Since the first description by Fanconi in 1927, FA has become to be recognized as an autosomal recessive disorder in which there is progressive BM failure and an increased predisposition Table 12.2 Characteristics ofthe bone marrow failure syndromes. SCN IAA Inheritance pattern AR XLR, AR, AD AR AD and AR AR AD, AR Bone marrow failure AA (> 90 ) AA ( 80 ) AA (20 ) RCA Megs Neutropenia Yes (100 ) Chromosome Number of genes At least 7 At least 3 1 At least three Genes AA, aplastic anaemia AD,...

Coronary Artery Anatomy

Right coronary artery RCA, proximal segment 2. Right coronary artery RCA, middle segment 3. Right coronary artery RCA, distal segment 4. Posterior interventricular branch of right coronary artery 5. Left coronary artery main stem 6. Anterior interventricular branch of left coronary artery LAD RIVA, proximal segment 7. Anterior interventricular branch of left coronary artery LAD RIVA, middle segment 8. Anterior interventricular branch of left coronary artery LAD RIVA, distal segment 11....

Coracohumeral Ligament

The coracohumeral ligament (CHL) is a trapezoidal ligament located in the superior part of the shoulder capsule (on its nonarticulating surface) and runs parallel to and is closely overlaid by the CAL. It is present in fetal development by 14-wk gestation as a small band of tissue between the CHL and the CAL. The origin of the CHL is at the most posterior point on the lateral aspect of the coracoid process base (deep relative to the origin of the CAL). It appears as a broad band (2.5 cm wide)...

Interaction of Photons with Matter

High-energy photons interact with matter by three main mechanisms, depending on the energy of the electromagnetic radiation. These are (i) the photoelectric effect, (ii) the Compton effect, and (iii) pair production. In addition, there are other mechanisms such as coherent (Rayleigh) scattering, an interaction between a photon and a whole atom which predominates at energies less than 50 keV triplet production and photonuclear reactions, where high energy gamma rays induce decay in the nucleus,...

Dacryocystorhinostomy indications

Dacryocystorhinostomy DCR involves removal of the bone lying between the lacrimal sac and the nose, with anastomosis between the lacrimal sac and nasal mucosa the lacrimal sac, with the internal opening of the common canaliculus, is incorporated into the lateral wall of the nose and provides a direct route for tears to reach the nose. The usual indication for DCR is complete or partial obstruction of the nasolacrimal duct such obstruction can cause skin excoriation, visual impairment, social...

Success Characteristics Of Highperforming Microsystems

Batalden, Thomas P. Huber, Julie K. Johnson, Marjorie M. Godfrey, Linda A. Headrick, John H. Wasson Background. Clinical microsystems are the small, functional frontline units that provide most health care to most people. They are the essential building blocks of larger organizations and of the health system. They are the place where patients, families, and careteams meet. The quality and value of care produced by a large health system can be no better than the...

Examples of the Prodrug Approach

There have been numerous examples of the application of the prodrug approach to improve the oral bioavailability of drugs subject to extensive presystemic metabolism, with varying degrees of success. Some selected examples of prodrugs and the results observed are summarized in Table 1 and are discussed below. Also included in Table 1 are some examples of peptides for which the prodrug approach was utilized to potentially improve oral or transmucosal delivery by reducing metabolic degradation....

The Humanistic Approach to Motivation

Abraham Maslow (1908-1970) devised a useful though controversial hierarchy of needs required to satisfy human potential. These needs proceed from low-level physiological needs such as hunger, thirst, sex, and comfort, through such other needs as safety, love, and esteem, finally reaching the highest level, self-actualization. According to Maslow, human beings progress sequentially through this hierarchy as they develop. Each category of needs proceeds from the preceding category, and no...

Calculation of reabsorption and secretion rates

- The reabsorption or secretion rate is the difference between the amount filtered across the glomerular capillaries and the amount excreted in urine. It is calculated with the following equations Filtered load GFR x plasma Excretion rate V x urine Reabsorption rate Filtered load - Excretion rate Secretion rate Excretion rate - Filtered load - If the filtered load is greater than the excretion rate, then net reabsorption of the substance has occurred. If the filtered load is less than the...

The mean values for arterial Po2 and Pco2 do not change during exercise

- Arterial pH does not change during moderate exercise, although it may decrease during strenuous exercise because of lactic acidosis. 3. On the other hand, venous Pco2 increases during exercise because the excess C02 produced by the exercising muscle is carried to the lungs in venous blood. Table 4-7. Summary of Respiratory Responses to Exercise 02 consumption C02 production Ventilation rate T (matches 02 consumption C02 production) No change No change in moderate exercise 4- in strenuous...

Plants Can Be Classified by Their Photoperiodic Responses

Numerous plant species flower during the long days of summer, and for many years plant physiologists believed that the correlation between long days and flowering was a consequence of the accumulation of photosynthetic products synthesized during long days. This hypothesis was shown to be incorrect by the work of Wightman Garner and Henry Allard, conducted in the 1920s at the U.S. Department of Agriculture laboratories in Beltsville, Maryland. They found that a mutant variety of tobacco,...

Differential Diagnosis of Dysthymic Disorder

Dysthymia leads to chronic less severe depressive symptoms compared to Major Depression which usually has one of more discrete episodes. B. Substance-Induced Mood Disorder. Alcohol, benzodiazepines and other sedative-hypnotics can mimic dysthymia symptoms, as can chronic use of amphetamines or cocaine. Anabolic steroids, oral contraceptives, methyldopa, beta adrenergic blockers and isotretinoin (Accutane) have also been linked to depressive symptoms. Rule out with...

Absorption Of Drugs Across The Oral Mucosa

The oral cavity is the point of entry for oral drug formulations but usually their contact with the oral mucosa is brief. In order to take advantage of some of the properties of the oral mucosa or to locally treat the mucosa, delivery systems have been designed to prolong residence in this area. The total surface area available for drug absorption is quite limited, being only approximately 100 cm2. Absorption of drugs through the buccal mucosa was first described by Sobrero in 1847 who noted...

Disorders of the glycolytic pathway

Mutations of most of the enzymes in the glycolytic pathway have been described in association with congenital non-spherocytic haemolytic anaemia (CNSHA). However, deficiency of pyruvate kinase (PK) is far and away the most common defect. The haemolysis is the result of a failure to produce sufficient ATP. PK catalyses the final steps of the glycolytic pathway with the conversion of phosphoenolpyruvate (PEP) to pyruvate, with the concomitant phosphorylation of ADP to ATP, leading to overall net...

Harvesting a Bone Graft from the Iliac Crest

Autogenous bone is needed for the reconstruction of defects or to correct cosmetic deformities. Along with the tibia, fibula, scapula, and ribs, the iliac crest is among the most common donor sites for autogenous bone. It can furnish extremely large grafts, which are usually taken in the form of compound or composite flaps that include soft-tissue elements see Fig. 14.2 . Indications Cancellous bone chips are used as filling material for mandibular reconstructions and bone cysts, and composite...

Retinal Detachment Repair Outlook for the Future

Due to the pioneering work of many ophthalmologists, including Gonin, Lincoff, and others, the basic pathophysiology of rhegma-togenous retinal detachment has been established. A retinal tear is caused by a vitreous detachment and traction on the retinal tear, and peripheral retina is responsible for fluid currents, which go through the break and detach the retina. More fundamental questions remain to be answered and will have important implications for our ability to detect, prevent, and treat...

Unconscious Proprioception

Understood by realizing that the first half of a pathway name commonly refers to where the pathway originates and the latter half refers to where the pathway terminates. E.g. the spinothalamic tract originates in the spinal cord and ends in the thalamus. As may be seen in the figure, a lesion injury of the pain-temperature pathway spinothalamic tract , whether within the brain stem or spinal cord, results in loss of pain-temperature sensation contralaterally i.e. on the opposite side of the...

Benign lacrimal gland disease

The lacrimal gland is liable to inflammation, cysts and benign tumours, but these conditions can present in a similar fashion to malignancy and this complicates the clinical management of these patients. Inappropriate management of benign conditions can lead to serious consequences - as with, for example, malignant recurrence after biopsy of a benign pleomorphic adenoma. Dacryocoele is a retention cyst of a gland ductule and often presents in young adults, with a variable swelling in the...

Psychological Moratorium

An integral part of the identity crisis is the psychological moratorium, a time during which society permits the individual to work on crisis resolution. During this moratorium, the adolescent young adult has the opportunity to examine societal roles, career possibilities, and values, free from the expectation of commitments and long-term responsibilities. Although some individuals choose to remain in a moratorium indefinitely, Erikson contends that there is an absolute end to the recognizable...

Sternocleidomastoid Dissection

6.2.1 The neck is extended and rotated as far as possible in the opposite direction to the operator. If still present, the platysma is now completely resected, leaving the superficial cervical fascia in place. On the surface of the sternocleidomastoid muscle, under the superficial cervical fascia, three structures can clearly be seen which cross the muscle (1) the Fig. 6.2 Superficial cervical fascia plane Fig. 6.2 Superficial cervical fascia plane 4 superficial cervical fascia great auricular...

The Dimensions Of Public Health

It would be useful to explore the concepts contained in the four terms that are commonly used to describe different aspects of public health (Fig. 1.1) Prevention is better than cure is one of the prime messages of public health. It differentiates public health from the clinical disciplines that are primarily involved with the care of the sick, whilst public health emphasizes the avoidance of illness. Prevention was initially construed narrowly in terms of protective measures like vaccination...

Cells Fate Is Determined by Its Position

In both the root and shoot meristem, a small number of stem cells are the ultimate source of any particular tissue, and most of the cells in a given tissue are clonal, having arisen 2. The binding of the CLV3 multimer to the extracellular domain of the CLV1 CLV2 heterodimer induces autophosphorylation of the cytoplasmic domain of CLV1. 3. Phosphorylated CLV1 binds to the downstream effector molecules kinase-associated protein phosphatase KAPP and rho-GTPase ROP . 1. WUS gene expression promotes...

Total Lower Lid Reconstruction

The entire lower lid can be reconstructed with a transposition flap (Fig. 9.11a, b) or a bipedicle flap (myocutaneous flap, Fig. 9.12a, b) from the upper eyelid (Tripier flap). As in other methods, a chon-dromucosal graft from the nasal septum can be used for lining (see Figs. 9.6 and 9.7). The lateral and medial pedicles are divided and inset in a later sitting. Fig. 9.7 Lower lid reconstruction using the rotation-advancement technique of Mustarde (1980). a The mucosal defect is reconstructed...

Benign cystic anomalies of the orbit

Orbital cysts generally arise from epithelium sequestered within the orbit during embryological development, by implantation after trauma or due to expansion of epithelial-lined sinus lesions into the orbit. These lesions arise from surface epithelium implanted at sites of embryological folding and, if situated anteriorly within the orbit, are commonly noted soon after birth. Due to the accumulation of epithelial debris and sebaceous oil in the lumen of the cyst, the cysts slowly enlarge and...

Psychological Models of Abnormality

The psychological model of abnormality also stems from ancient Greece. In the second century c.e., the Greek physician Galen described a patient whose symptoms were caused either by an inflammation of the uterus or by something about which she was troubled but which she was not willing to discuss. He tested these two hypotheses and concluded that the patient's problem was psychological in origin. The psychological model gained support when French physician JeanMartin Charcot (1825-1893) used...

Turnover Flap and Composite Graft

Lexer 1931, modified by Kastenbauer 1977 A bipedicled turnover flap is used for intranasal lining Fig. 5.39a, b , similar to the technique just described. Then a two-layer composite graft is used to reconstruct the alar rim. The skin of the composite Fig. 5.36 Modification of the anteriorly based alar rotation. a An incision is made around the ala, and two adjacent flaps are outlined. b The ala is brought down to the desired position, and the flaps are transposed. c Appearance after the...

Limitations of behavioral therapy

Behavioral therapy is a natural extension and application of many of Skinner's views focusing on observable behavior. The first criticism pertains to the lack of attention that behavior therapy gives to emotion. Behavioral practitioners hold that empirical evidence has not shown that feelings must be changed first in order to achieve measurable progress. In general, behavioral practitioners do not encourage their clients to experience their emotion, although some will work with aspects of...

Functional Autonomy and Personal Dispositions

Most personality theorists view adulthood as an extension of the basic motives present in childhood. Consistent with his belief that personality is always evolving, Allport believed that the motivations of adulthood are often independent of the motivations of childhood, and he referred to this concept as functional autonomy. For example, a person who plays a musical instrument during childhood years because of parental pressure may play the same instrument for relaxation or enjoyment as an...

Sociocultural Models of Abnormality

A sociocultural model of abnormality emphasizes the social and cultural context, going so far as to suggest that abnormality is a direct function of society's criteria and definitions for appropriate behavior. In this model, abnormality is social, not medical or psychological. For example, early Greeks revered people who heard voices that no one else heard because they interpreted this phenomenon as evidence of divine prophecy. In the Middle Ages, people tortured or killed people who heard...

Scrotum Air Inflation

Ileal atresia is an important cause for low intestinal obstruction. It represents approximately 50 of small bowel atresias and the etiology is similar to that of jejunal atresia. As jejunal atresias, they are believed to result from an intrauterine vascular injury. Approximately 25 have a history of polyhydramnios Sweeney et al. 2001 . Plain film shows numerous dilated loops of bowel occupying the entire abdominal cavity, including the pelvic portion, and multiple air-fluid levels in upright...

Lower eyelid reconstruction

Defects of the lower eyelid can be divided into those that involve the eyelid margin, and those that do not. An eyelid defect of 25 or less may be closed directly. In patients with marked eyelid laxity, even a defect occupying up to 50 of the eyelid may be closed directly. The two edges of the defect should be grasped and pulled together to judge the facility of closure. If there is no excess tension on the lid, the edges may be approximated directly. The lid margin is reapproximated with a...

The twostage model of preeclampsia Figure

The two-stage model of pre-eclampsia, originally proposed more than a decade ago (Redman, 1991) and described elsewhere in this volume, envisages that pre-eclampsia arises in various ways including from placental ischemia secondary to deficient placentation. Whereas some consider abnormal placentation to be the start and invariable cause of pre-eclampsia, it is much more likely that it is a completely separate but predisposing condition (Redman and Sargent, 2000). Placentation is described...

Bilateral Arm Patterns

Bilateral arm work allows you to use irradiation from the patient's strong arm to facilitate weak motions or muscles in the involved arm. You can use any combination of patterns in any position. Work with those that give you and the patient the greatest advantage in strength and control. When you exercise both arms at the same time there is always more demand on the trunk muscles than when only one arm is exercising. You can in crease this demand on the trunk by putting your patient in less...

Application to Functional Groups

There are four functional groups found in drug molecules for which the greatest number of promoieties have been designed, synthesized, characterized (solubility, stability, purity), and evaluated in diffusion cell experiments. These four functional groups are the amide or imide (O C-NH), the thioamide (S C-NH), the hydroxy group (OH) substituted on aliphatic or aromatic carbons, and the carboxylic acid (O C-OH) mentioned above. For each functional group there are two general types of...

Distinction In Stomach

Low intestinal obstruction is defined as one occurring in the distal ileum or colon. The symptoms are vomiting, abdominal distension, and failure to pass meconium. For practical purposes, the differential diagnosis of low intestinal obstruction in the neonate consists of five conditions. Two conditions involve the distal ileum and include ileal atresia and meconium ileus, and three involve the colon, which are colonic atre-sia, Hirschsprung's disease, and functional immaturity of the colon that...

Reproductive Endocrinology Diagnostic Imaging

Fujimoto Introduction The last few decades have witnessed rapid advances in diagnostic and therapeutic options in modern medicine. While the field of reproductive endocrinology has stayed away from many diagnostic modalities using ionizing radiation, the field has benefited from advances in imaging modalities such as ultrasound and magnetic resonance. In this chapter, we will review the general principles of these techniques and offer examples from reproductive...

Other criticisms of Freud and psychoanalysis

As more has been learned about child development since Freud's theories were first launched, there has been an increasing lack of support for some of his assumptions about the human personality. Perhaps none of his ideas have met with as much criticism as his psychosexual stages of development. While many modern-day clinicians still find aspects of his stages helpful, most do not adhere to the presupposition of sexual conflict being the central task of developmental maturity. Thus, concepts...

Present Medical History Is Case Of Fracture

In taking the history of a patient who may have a fracture, the following points may prove to be helpful, especially when there has been a traumatic incident. 1. What activity was being pursued at the time of the incident (e.g. taking part in a sport, driving a car, working at a height, etc.) 2. What was the nature of the incident (e.g. a kick, a fall, a twisting injury, etc.) 3. What was the magnitude of the applied forces For example, if a patient was injured in a fall, it is helpful to know...

Necrotizing Enterocolitis

Necrotizing enterocolitis NEC is the leading gastrointestinal emergency of the premature infant. In many cases, it happens in apparently healthy premature infants who have no other medical problems. Although it affects mostly premature infants, 10 of affected infants are born at term. Its incidence varies between 0.3 and 2.4 infants 1000 births and between 3.9 and 22.4 amongst infants of less than 1500 g. Males and females are equally affected. Most infants develop NEC within the first 2 weeks...

Medical Models of Abnormality

Medical or biological models of abnormality stem back to Greek physician Hippocrates (c. 470-c. 377 b.c.e.), who proposed that psychological disorders are caused by body-fluid imbalances. Greeks believed that the uterus could move around a woman's body, attaching itself at different places and causing the symptoms of hysteria, a disorder in which a person has physical symptoms without the usual organic causes. The medical model gained support when people realized that some bizarre behaviors...

Psychosexual development

Main points Freud's theory of psychosexual development had its origins in, and was a generalization of, Josef Breuer's earlier discovery that traumatic childhood events could have devastating negative effects upon the adult. This view assumed that early childhood sexual experiences were the crucial factors in the determination of the adult personality. Freud's believed that from the moment of birth, the infant is driven in his actions by the desire for bodily sexual pleasure. Initially, infants...

C677T Polymorphism of Methylenetetrahydrofolate Reductase Gene

The MTHFR gene has been mapped to the chromosomal region 1p36.3 and is composed of 11 exons 26 . A common mutation of the MTHFR gene is the C to T transition, located at nucleotide 677 C677T . This results in the amino acid change alanine to valine. This mutation is associated with increased thermolability and reduced specific activity of the enzyme mean activity is 65 in the Ala Val heterozygote and 30 in the Val Val homozygous state, respectively compared to the mean activity in the Ala Ala...

Intraocular Tamponade

Another technique to help appose retina and choroid that could be used in conjunction with other procedures was injection of air into the vitreous cavity. Originally described by Ohm in 1911 and then by Rohmer in 1912, injection of air at the end of the operation was adopted by Arruga in 1935, and to close retinal breaks by Rosengren in 1938 32, 34,139 . Rosengren carefully localized retinal breaks, then placed penetrating diathermy in a pattern covering an area 6-7 mm in diameter with drainage...

Fractures of the orbital floor and medial wall

The indirect, blowout fracture of the orbital floor occurs when a major blunt blow is applied across the anterior orbital entrance, the fracture resulting from hydraulic collapse of the orbital floor and possibly by transmission of energy from a transient deformation of the inferior orbital rim. Typically one edge of the fracture involves the infraorbital nerve canal and a transient neuropraxia of this nerve is extremely common, with hypoaesthesia of the ipsilateral cheek, side of nose and...

Deep System Cervical Lymph Nodes Proper

The deeper fascial structures of the head and neck drain either directly into the deep cervical lymph nodes or through the superficial system first and then into the deep system. These superficial nodes have already been described. The deep cervical lymph nodes proper (Figure 13.1) consist of the junctional nodes, the upper, middle, and lower cervical nodal groups which are situated along the internal jugular vein, the spinal accessory group which accompanies the accessory nerve in the...

Standardization of antihuman globulin reagents

All antiglobulin reagents available at present, monospecific or polyspecific, are standardized by the producer and issued pre-diluted for immediate use or within the gel or bead matrix of a microcolumn. Antiglobulin reagents standardized for use in haemagglutina-tion tests should not agglutinate red cells, regardless of their ABO type, after incubation with compatible serum i.e. they should be free of unwanted antibodies, especially anti-species . The antiglobulin reagent should not agglutinate...

Two Dimensional Clinical Tissue Engineering

The earliest clinical applications of tissue engineering revolved around the use of essentially flat materials designed to stimulate wound care. Tissue-engineered skin substitutes dominated the market for almost a decade. Another small and slim tissue that found a clinical application was cartilage. Later in the 1990s thin sheets of cells were produced in culture and then applied to patients using a powerful cell-sheet technology. In both the applications, engineered tissue equivalent is...

Scintillation Detectors in PET

As mentioned above, scintillation detectors are the most common and successful mode for detection of 511 keV photons in PET imaging due to their good stopping efficiency and energy resolution. These detectors consist of an appropriate choice of crystal scintil-lator coupled to a photo-detector for detection of the visible light. This process is outlined in further detail in the next two sections. Scintillation Process and Crystals Used in PET The electronic energy states of an isolated atom...

The unscientific nature of Jungs psychology

One of the earliest criticisms of Jung's work is that it is anti-scientific in its intentions as well as its content. This accusation surfaced as early as Jung's break with Freud in 1913. Jung's view of the functions of symbolism in dreams led to his isolation from the mainstream psychiatric community. As he put it, all my friends and acquaintances dropped away. My book was declared to be rubbish I was a mystic, and that settled the matter. The insecure position of the social sciences in the...

Binet compared to Galton and Cattell

The failure of Galton's and Cattell's intelligence tests opened the door for Binet to develop a more practical alternative. He succeeded where they had failed at devising a test that was related to intelligent behavior in real life. Today, most useful intelligence tests for people of all ages are still based on Binet's model. Such tests require people to use several mental abilities to perform a broad range of complex tasks. One factor that may have helped Binet succeed was his choice of study...

Evidence Based Practices

From its earliest beginnings, psychiatric rehabilitation has sought, usually by trial and error, to develop effective services for persons with severe mental illness. This process has led to the existence of a large number of essentially idiosyncratic services, some of which are effective and some not. The adoption of an evidence-based practice approach is addressing this problem. The EBP process employs controlled clinical trials to identify effective services and define the critical elements...

Obsolete Etiological Theories

The scientific community has made real progress in its understanding of the etiology of the major mental illnesses. At the same time, the public is still exposed to a number of discredited or obsolete theories about what causes major mental illness. Most of these obsolete theories center on early childhood psychological trauma or abusive family environments as causal factors. Harding and Zahniser (1994) describe the familial role in etiology as one of the great myths about schizophrenia. While...

Functional Assessment of PTSD

Memory, Attention, and Concentration Memory dysfunction is a common presenting problem from patients with PTSD and can be observed by third parties, such as family members, coworkers, or employers. Patients are told they are forgetting conversations they've had or tasks they were expected to perform. Memory problems can also be observed clinically in patients' inability to recall information from their pasts surrounding the traumatic event, missing appointment times, or forgetting to do...

Paranoid and Depressive Anxieties

The broad variety of clinical psychoanalysis situations includes a range of forms of pathogenic anxiety, reviewed by Gabbard 7 . Freud, Melanie Klein, Winnicott, and Kohut have all dealt with the topic, and this is clearly not the place to attempt a summary. However, while supporters of the conflict theory, including Freud and Klein, have worked to define the intrapsychic facets of anxiety, the deficit theory, upheld by thinkers like Winnicott and Kohut, focuses more on the relational aspect of...

What Are Some Different Types of Brainstorming

There are several ways to conduct brainstorming sessions. This section describes three of them. First, there is group interactive brainstorming. This approach can be loud and expressive. When group members think out loud, that stimulates ideas that build on each other, resulting in a list of many ideas. Ideas can be posted on a large flipchart as individuals call them out. It is important for the recorder to capture each individual's idea by writing his or her exact words on the flipchart and...

Benign vascular anomalies of the orbit

Many vascular anomalies, such as varices, lymphangiomas and cavernous haemangiomas, are probably present from birth but may only become manifest in early adulthood. Capillary haemangiomas occur in 1-2 of infants and are more common in females and children of low birth weight most appear soon after birth, can enlarge dramatically and then undergo a spontaneous involution - with 75 resolving within five years. Involvement is usually unilateral and the intradermal eyelid lesions are bright red and...

Horneys disagreement with Freuds penis envy theory

When Freud disciple Karl Abraham in 1920 posited that women, because of penis envy, actually wanted to be men, he went on to state that he believed that this desire to be men led to lesbianism, women with masculine ambition, and feminists. Horney, who was from all reports not a lesbian, and did not consider herself a feminist (but may have possessed what Abraham called masculine ambition), was offended. Horney, who had already witnessed decades of male sexism, was put off by this theory not...

Critiques of Kohlbergs stage theory

Many of Kohlberg's critics have pointed to what they regard as weaknesses in his stage theory of moral development. Some of these concern the number of stages. As was noted earlier, the existence of Kohlberg's sixth stage was questioned by researchers who could not find subjects who seemed to have attained it. In addition, Kohlberg's eventual hypothesis of a seventh stage of moral development, which he called a soft stage, represented a later modification of his original position. Other critics...

Gambar Psterior Axillaris Line

Not pertaining to the center. 37 Radial. Radialis. Pertaining to or located at the radius. B 38 Ulnar. Ulnaris. Pertaining to or located at the ulna. B 39 Fibular. Fibularis. Pertaining to the fibula or located on the fibular part of the leg. B 40 Tibial. Tibialis. Pertaining to the tibia or locted on the tibial part of the leg. B 41 Palmar. Palmaris. Pertaining to or located on the plam. B 42 Volar. Volaris. Same as palmar. B 43 Plantar. Plantaris. Pertaining to or...

Corpus Trapezoideum Pons

Nucleus motorius nervi trigeminalis nucleus motorius trigeminalis . It is located near the exit of the trigeminal nerve. A B 2 Nucleus of abducens nerve. Nucleus nervi ab-ducentis nucleus abducens . It is found beneath the facial colliculus. A B 3 Nucleus of facial nerve. Nucleus nervi facialis nucleus facialis . This motor nucleus lies laterally below the nucleus of the abducens. A B 4 Genu of facial nerve. Genu nervi facialis. Arch formed by fibers of...

What Exactly Is a Traumatic Stressor

The truth is that even though we are all exposed to high levels of stress, including some of us who have been exposed to war, combat, and related stressors that would be defined as traumatic stressors, research has continued to show that most individuals exposed to stressors that would meet the definition of a traumatic stressor fail to develop PTSD, much like the citizens of Israel and Palestine. According to Breslau, Andreski, Federman, and Anthony (1998) only 9 percent of those exposed to...

Some Ineffective Treatments

In the past, some treatments deservedly received a bad name for their ineffectiveness or actual harm in helping people with serious and persistent mental illness. There were efforts to treat people with schizophrenia without antipsychotic medication (available since the 1950s) and with only psychotherapies, such as traditional insight-oriented individual and group therapy. These resulted in very poor outcomes for the treatment recipients (Hogarty, 1993 Lehman & Steinwachs, 1998)....

Wound Management and Scar Revision

It is a general rule in facial plastic surgery to sacrifice as little skin as possible. Small wounds that extend obliquely into the tissue should be straightened whenever the surrounding tissue can be mobilized and the wound edges coapted without tension. A subcutaneous suture with a buried knot should always be placed to allow tension-free approximation of the wound margins (see Fig. 2.1). Because the subcutaneous tissue, epidermis, and dermis take different lengths of time to achieve adequate...

The Goals of Psychiatric Rehabilitation

As we stated above, the goals of PsyR represent the objectives of PsyR services. These are what all PsyR services strive to achieve for their clients. In that sense, goals are guidelines for service and go hand in hand with PsyR values. The combination of goals and values helps determine the guiding principles. Our review of several efforts to identify these ideas Anthony et al., 2002 Anthony amp Nemec, 1983 Cnaan, Blankertz, Messinger, amp Gardner, 1988, 1989, 1990 International Association of...

Three Aspects of the Proprium

Allport referred to the unifying core of personality, or those aspects of the self that a person considers central to self-identity, as the proprium. During the first three to four years of life, three aspects of the proprium emerge. The sense of a bodily self involves awareness of body sensations. Self-identity represents the child's knowledge of an inner sameness or continuity over time, and self-esteem reflects personal efforts to maintain pride and avoid embarrassment. Self-extension...

Guiding Principles of Psychiatric Rehabilitation

The guiding principles of psychiatric rehabilitation comprise a set of rules that can be applied to specific situations in order to achieve the goals and reflect the values of the field. In a sense, they constitute rules of thumb that PsyR practitioners can refer to when faced with important decisions. The principles are important tools for providing day-today guidance in clinical situations and for systematizing the practice of PsyR. Although the higher order values and goals are widely shared...

Feneis Pocket Atlas of Human Anatomy 2000 Thieme

13 M. longissimus cervicis. o Transverse processes T1-6. i Transverse processes of vertebrae C2-7. It lies between the iliocostalis cervicis and longissimus capitis muscles. C 14 M. longissimus capitis. o Transverse processes of vertebrae C3-T3. i Mastoid process. It lies between the longissimus cervi-cis and semispinalis capitis muscles. A Lateral and backward flexion of the head. It rotates the face toward the ipsilateral side. C 15 M. iliocostalis. Iliocostal muscle, which consists of the...

Factors Influencing Nerve Regeneration

Six groups of factors, which influence nerve regeneration, and consequently, the final result of a nerve repair may be distinguished, i.e., general factors, type and site of the lesion, timing, coaptation technique, biomolecular factors. In this group we include such parameters as the patient's age and general health. The age of the patient is a very important prognostic factor. It is well known that children generally have better functional recovery than do adults. This is due, in part, to a...

Posttraumatic Stress Disorder and Neurochemical Processes

As was mentioned earlier, what lies at the root of brain alterations in PTSD are alterations in neurochemicals such as neurotransmitters, hormones, and neuro-peptides. These alterations ultimately lead to changes at the synaptic level, which lead to changes in circuitry and connectivity and the way different brain areas interact with and influence each other. These neural changes occur within the larger behavioral and neurobiological context of the stress response and the fear response and its...

Surgical Treatment of Female Infertility

Mohammed Al-Sunaidi and Togas Tulandi Introduction Due to widespread availability of assisted reproductive technologies, the need for reproductive surgery in infertile women has declined in recent decades. However, surgery still has a place in the management of infertile women. For example, young women with pelvic adhesions or blocked fallopian tubes that impair their fertility may benefit from early surgical intervention. On the other hand, women over the age of 35 with a long history of...

Santorini Venous Plexus

Internal iliac artery and vein 15. Insertion of gluteus minimus and medius muscle (greater trochanter) 40. Internal pudendal artery and vein 46. Lateral vesical lymph nodes 4. Interosseous sacroiliac ligaments 18. External anal sphincter muscle 24. Inferior articular process (zygapo-physis) 28. Internal iliac artery and vein 5. Superior gluteal artery and vein 20. Inferior articular process (zygapophysis, L4) 25. Internal iliac artery and vein 29. External anal...

Flexion Adduction External Rotation d

Muscles principal components Kendall and McCreary 1993 Flexion, adduction, External rotation Psoas major, iliacus, adductor muscles, sartorius, pectineus, rectus femoris Extensor hallucis, extensor digitorum Your left hand grips the patient's foot with the fingers on the medial border and the thumb giving counter-pressure on the lateral border. Hold the sides of the foot but do not put any contact on the plantar surface. To avoid blocking toe motion, keep your grip proximal to the...

Abdominal Muscles Musculi abdominis

2 M. rectus abdominis. o Costal cartilages 5-7. i Pubis and symphysis. A Forward flexion of trunk, lowering of thorax, elevation of pelvis. I Intercostal nerves 7-12. AE 3 Tendinous intersections. Intersectiones ten-dineae.The 3-4 intermediate tendons of the rectus abdominis muscle. They fuse with the anterior wall of the rectus sheath. A 4 Rectus sheath. Vagina m. recti abdominis. Covering of the rectus abdominis muscle formed by the aponeuroses of the flat abdominal muscles. A 6 Posterior...

Effects Of Renal Disease On Drug Distribution

Impaired renal function is associated with important changes in the binding of some drugs to plasma proteins. In some cases the tissue binding of drugs is also affected. albumin binding sites by organic molecules that accumulate in uremia. As described in Chapter 3, reductions in the protein binding of acidic drugs result in increases in their distribution volume. In addition, the elimination clearance of restrictively eliminated drugs is increased. However, protein binding changes do not...

The History of Retinal Detachment Surgery

The history of retinal detachment surgery is one of the great success stories in the history of medicine. The first descriptions of retinal detachment were by Ware in 1805, Wardrop in 1818, and Panizza in 1826 1-3 . These descriptions relied mainly on pathological observations. The introduction of the ophthalmoscope by Fig. 1.1. Jules Gonin. (Reproduced with permission Wilkinson CP, Rice TA (1997) Michels retinal detachment, 2nd edn. Mosby St. Louis MO. pp 241-333 10 ) Fig. 1.1. Jules Gonin....

The Stress VulnerabilityCoping Competence Model

The stress vulnerability coping competence model was proposed by two individuals who are well known in the field of psychiatric rehabilitation, William A. Anthony and Robert Paul Liberman (1986). An elaboration of the diathesis stress model described earlier, the stress vulnerability coping competence model provides both a theory about the cause of severe mental illness and an explanatory framework for the impact that psychiatric rehabilitation and treatment interventions can have on the...

The History of the Self Help Movement

Self-help and mutual support among persons coping with severe mental illnesses has been an important part of psychiatric rehabilitation since the field's beginning. In fact, there are some peer support initiatives that predate the establishment of PsyR as a distinct practice. For example, the group of ex-psychiatric patients described in Chapter 6, who dubbed themselves WANA (We Are Not Alone) in the 1940s, and then went on to establish Fountain House, began as a self-help group. Alcoholics...

Anterior Elevation and Posterior Depression O Fig 64 ac

The therapist stands behind the patient, facing up toward the patient's head. Anterior Elevation (O Fig. 6.4 b, 6.5) Grip. Place one hand on the anterior aspect of the glenohumeral joint and the acromion with your fingers cupped. The other hand covers and supports the first. Contact is with the fingers and not the palm of the hand. D Fig. 6.3a,b. The direction of the resistance is an arc (posterior depression of the scapula) Levator scapulae, rhomboids, serratus anterior Serratus anterior...

Consequences of Deficit and Excess Energy Intake

Deficit energy intake and negative energy balance can be acute or chronic 9 . Acute energy deficiency results in short-term negative energy balance during which there is a progressive loss of body weight. Chronic energy deficiency reflects long-term inadequate food intake during which a steady state is achieved at a suboptimal nutritional status. Energy deficit in children leads to growth retardation, loss of fat and muscle, delayed motor, cognitive and behavioral development, diminished...

Storage Lipids Are Converted into Carbohydrates in Germinating Seeds

After germinating, oil-containing seeds metabolize stored triacylglycerols by converting lipids to sucrose. Plants are not able to transport fats from the endosperm to the root and shoot tissues of the germinating seedling, so they must convert stored lipids to a more mobile form of carbon, generally sucrose. This process involves several steps that are located in different cellular compartments oleosomes, gly-oxysomes, mitochondria, and cytosol. Overview Lipids to sucrose. The conversion of...

Horneys coping strategies

In the course of Horney's experience in analysis with her patients, she began to see that these neurotic needs correlated with the psychic personality development she had observed and documented earlier. She called meshing of these neurotic personality types, and the needs addressed by each behavior, coping strategies. Her coping strategies are broken down into three types compliance, aggression, and withdrawal. Compliance According to Horney, compliance, or the basic anxiety that overcomes...

Importance to Psychology of Consciousness

As a naturally induced alteration in consciousness that can be studied objectively with electrophysiological recording equipment, sleep has assumed a prominent role in the psychology of consciousness. Electrophysiological recording techniques that were originally developed in sleep research are now widely used to study other aspects of consciousness, such as hemispheric asymmetries, meditation, sensory isolation, biofeedback, dreams, and drug effects on the brain and behavior. In addition,...

Influences on Affiliation

Beyond easing fear and satisfying the need for information or social comparison, mere affiliation with others is not usually a satisfactory form of interaction. Most people form specific attractions for other individuals, rather than being satisfied with belonging to a group. These attractions usually develop into friendship, love, and other forms of intimacy. Interpersonal attraction, the experience of preferring to interact with specific others, is influenced by several factors. An important...

Reinforcers and Punishers

In operant conditioning, there are four basic contingencies that can be used to modify the frequency of occurrence of nonreflexive behavior. A contingency refers to the relation between the situation, a behavior, and the consequence of the behavior. A reinforcer is a consequence that makes a behavior more likely in the future, whereas a punisher is a consequence that makes a behavior less likely in the future. Reinforcers and punishers both come in both positive and negative forms. A positive...

Aging Related Changes in the Retina

The human retina shows considerable age-related structural changes, particularly in its peripheral zones, although the macula and its fovea centralis are not spared. The aged retinal periphery is thinner (10-30 mm), containing a lesser number of rods and other nerve cell types. The aging-related loss of rods appears to be a slow process, beginning in the third and fourth decade, and may be related to accumulated damage due to physiological exposure to light (8-10). With aging rods, outer...

Median Forehead Flap with Soft Tissue Expansion

In this technique the median forehead skin is expanded with a 200-mL envelope for 6-8 weeks, and then a forehead flap is incised to match the nasal defect Fig. 5.53 Siegert et al. 1992, 1994 see also Fig. 5.49 and Fig. 5.16, oblique forehead flap . b The forehead flap is inset into the defect over silicone stents lining see text . Closure of the donor defects is the same as with the Converse scalping flap Figs. 5.50 and 5.51 e, f . Fig. 5.52 Sickle flap of Farrior 1974 . a The lower portion of...

Protocorm formation in orchids

The seeds of orchids (like those of some other saprophytic or semi-parasitic plants) contain a small embryo of only about 0.1 mm diameter, without any associated endosperm storage tissue. Upon germination, the embryo enlarges to form a small, corm-like structure, called a protocorm, which possesses a quiescent shoot and root meristem at opposite poles. In nature, a protocorm becomes green and accumulates carbohydrate reserves through photosynthesis. Only when it has grown and has sufficient...

Therapeutic Response Cumulative Drug Effects And Schedule Dependence

So far we have focused our attention on the time course of drug effect. While the study of these effects can be helpful in understanding the mechanism of drug action and factors affecting efficacy and potency, it usually does not provide information on how drug exposure influences therapeutic response. Clinical response can be defined as the effect of drug treatment on the clinical endpoint of how the patient feels, functions, or survives. Some clinical responses can be described by composite...

Suture Materials and Techniques

We use atraumatic cutting needles for the skin, and we generally use round needles for the mucosa. Our suture material of choice for the face is 6-0 or 7-0 monofilament on a very fine needle. Occasionally we use 5-0 monofilament for areas that are not visible. Prolene , PDS , P1 and P6 5-0 needle with P3 or PS 3 needle. Our subcutaneous sutures are composed of ab-sorbable or fast-dissolving braided or monofilament material. Vicryl or PDS, P1, P3 needle Ethicon, Norderstedt, Germany. A suture or...

Four Principles of Life Span Developmental Psychology

One central idea of life span developmental psychology is that development concerns not only the biologically determined differentiation and growth of psychological factors in children. Development is rather seen as taking place from the very beginning until the end of human life, with any phase having its own specific importance for the entire course of development (e.g., Baltes & Baltes, 1990). For the life span development of prospective memory, this means that we need to describe and...

Symmetrical Reciprocal and Asymmetrical Exercises

In addition to the exercises carried out with one body part in one direction the scapula moving into anterior elevation and in both directions the scapula moving back and forth between anterior elevation and posterior depression , both scapulae or the scapula and pelvis can be exercised simultaneously. Any combination of scapular and pelvic patterns may be used, depending on the goal of the treatment and the abilities of the patient. Here we describe and illustrate two combinations. Use the...