chapter 8  canvas games part i

... Associated with Other Medical Disorders A number of medical conditions are associated with disruptions of sleep The association is frequently nonspecific, e.g., sleep disruption due to chronic pain ... prominent daily variation in airway resistance that results in marked increases in asthmatic symptoms at night, especially during sleep In addition, treatment of asthma with theophylline-based ... Chronic obstructive pulmonary disease is also associated with sleep disruption, as is cystic fibrosis, menopause, hyperthyroidism, gastroesophageal reflux, chronic renal failure, and liver failure.[newpage]...

Ngày tải lên: 06/07/2014, 13:20

... Behavioral modification and nonpharmacologic therapies should be a first step Patient and partner counseling may improve communication and relationship strains Lifestyle changes involving known risk ... discouraged pending proof that it is effective Clitoral Vacuum Device In patients with arousal and orgasmic difficulties, the option of using a clitoral vacuum device may be explored This handheld ... can be an important part of the treatment process Emphasis on maximizing physical health and avoiding lifestyles (e.g., smoking, alcohol abuse) and medications likely to produce FSD is important...

Ngày tải lên: 06/07/2014, 15:21

... in maternal meiosis I owing to the protracted time to completion (often ≥40 years) in females, and recent studies suggest that it may be associated with alterations in meiotic crossing-over In ... abnormalities, unlike numerical abnormalities, can be present in "balanced" form in clinically normal individuals but transmitted in "unbalanced" form to progeny, thereby resulting in a hereditary ... Because most reciprocal translocations involve unique sets of breakpoints, it is difficult to predict the phenotypic consequences in any one situation In general, severity is determined by the amount...

Ngày tải lên: 07/07/2014, 01:20

... abnormality detected in human malignancy was the Philadelphia chromosome detected in CML This cytogenetic abnormality is generated by reciprocal translocation involving the ABL oncogene, a tyrosine ... blocks the activity of BCR-ABL has shown remarkable efficacy with little toxicity in patients with CML Knowledge of genetic alterations in cancer can lead to mechanism-based design and development ... of expression of the BCR-ABL gene product is the activation of signal transduction pathways leading to cell growth independent of normal external signals Imatinib, a drug that specifically blocks...

Ngày tải lên: 07/07/2014, 01:20

... Postmenopa usal Positi ve Negativ Any e Multidrug chemotherapy + trastuzumab in HER2/neu positive tumors Postmenopa usal Positi ve Positive Any Aromatase inhibitors and tamoxifen with or without chemotherapy ... used as a single agent Large clinical trials have shown superiority for aromatase inhibitors over tamoxifen alone in the adjuvant setting Unfortunately the optimal plan is unclear Tamoxifen for ... trastuzumab in HER2/neu positive tumors Postmenopa usal Negat Positive ive >2 Aromatase cm, or 1–2 inhibitors cm and with tamoxifen + other poor trastuzumab in HERprognostic 2/neu variables Postmenopa...

Ngày tải lên: 07/07/2014, 02:20

... assessed in phase II trials of HCC and has encouraging survival effects with minimal toxicities Randomized trials have yet to be performed Vitamin K has been assessed in clinical trials at high dosage ... HCC, including external beam and conformal radiation therapy Radiation hepatitis remains a significant dose-limiting problem The pure beta emitter 90 yttrium attached to either glass or resin microspheres ... 1995 Cisplatin, doxorubicin Same + No + No + No + ethiodol embo Uchino 1993 Cisplatin, Same doxorubicin + oral tamoxifen FU Lin 1988 Embo Embo IV FU Yoshikaw 1994 a Epirubicin + Epirubici No None...

Ngày tải lên: 07/07/2014, 02:20

... I disease, results appear equivalent for either radical hysterectomy or radiation therapy Patients with disease stages II–IV are primarily managed with external beam irradiation and intracavitary ... extracervical extension Stage is carcinoma in situ, stage I is disease confined to the cervix, stage II disease invades beyond the cervix but not to the pelvic wall or lower third of the vagina, ... a risk factor for hydatidiform mole as is a prior history of molar pregnancy Choriocarcinoma occurs in ~1 in 25,000 pregnancies or in 20,000 live births Prior history of hydatidiform mole is...

Ngày tải lên: 07/07/2014, 02:20

... with pride in his face, and his hair in wild disorder, intoxicated by all the darkness, cried out,-"We are free!" "Free, free, free," echoed the fugitives, and the band, seizing hold of the rigging, ... crackles, shot with grape No thunderstrokes: the lightning of boreal storms is silent What is sometimes said of the cat, "it swears," may be applied to this lightning It is a menace proceeding from ... This phase of grumbling is a perilous diminution of uproar Nothing is so terrifying as this monologue of the storm This gloomy recitative appears to serve as a moment of rest to the mysterious...

Ngày tải lên: 07/07/2014, 03:20

... Deficiencies of cobalamin, folate, protein, ?riboflavin, ?nicotinic acid Therapy with colchicine, para-aminosalicylate, neomycin, slow-release potassium chloride, anticonvulsant drugs, metformin, ... chance in close relatives and in persons with other organspecific autoimmune diseases, e.g., thyroid diseases, vitiligo, hypoparathyroidism, and Addison's disease It is also associated with hypogammaglobulinemia, ... infection is infrequent in PA, but it has been suggested that H pylori gastritis occurs at an early phase of atrophic gastritis and presents in younger patients as iron deficiency anemia but in...

Ngày tải lên: 07/07/2014, 04:20

... DIC High-grade DIC is also associated with levels of antithrombin III or plasminogen activity

Ngày tải lên: 07/07/2014, 04:20

... and vancomycin To kill enterococci requires the synergistic interaction of a cell wall–active antibiotic (penicillin, ampicillin, vancomycin, or teicoplanin) that is effective at achievable serum ... agent cannot participate in the interaction to produce killing High-level resistance to gentamicin predicts that tobramycin, netilmicin, amikacin, and kanamycin also will be ineffective In fact, ... Enterococci Enterococci are resistant to oxacillin, nafcillin, and the cephalosporins and are only inhibited—not killed—by penicillin, ampicillin, teicoplanin (not available in the United States),...

Ngày tải lên: 07/07/2014, 04:20

... utility gentleman, and played, as occasion required, his little parts Often when they appeared side by side on the stage Ursus in his tightlylaced bear's skin, Homo with his wolf's skin fitting ... too-tooing of Fibi and Vinos, gave instructive revelations as to the trumpetings "This symphony is Gregorian," he would exclaim "Citizens and townsmen, the Gregorian form of worship, this great ... progress, is opposed in Italy to the Ambrosial ritual, and in Spain to the Mozarabic ceremonial, and has achieved its triumph over them with difficulty." After which the Green Box drew up in some...

Ngày tải lên: 07/07/2014, 05:20

... Jesuits in his policy The incompatibility is nil In this world everything is a clock To gravitate is to oscillate One pole is attracted to the other Francis I is attracted by Triboulet; Louis XIV is ... noisome fly of the abyss This buzzing commands A reign is a dictation The loud voice is the sovereign; the low voice, sovereignty Those who know how to distinguish, in a reign, this low voice, ... exists a deep affinity between extreme elevation and extreme debasement It is abasement which directs Nothing is easier of comprehension It is he who is below who pulls the strings No position...

Ngày tải lên: 07/07/2014, 05:20

... buried in. I beg to inform your lordships that it does not suit me to allow your insolence in my presence I will chastise you, my lords I take it ill that you should have ridiculed Lord Fermain ... heeding whether it will or will not affect my own affairs, I consider it a beautiful sight to see an insect transformed into an eagle, and Gwynplaine into Lord Clancharlie My lords, I forbid you ... round his wrists and neck, and was feverishly fingering with his left hand the hilt of the sword which from his waistbelt, and on the billets and scabbard of which were embroidered an admiral's...

Ngày tải lên: 07/07/2014, 14:20

... this scenario could account for the increased mortality risk in asymptomatic meningitis In contrast, the receipt of antibiotics before hospital admission has been associated with lower mortality ... vaccine-induced immunity in adults is probably

Ngày tải lên: 08/07/2014, 02:20

... Prophylactic regimens are discussed in the text Hospitalization is indicated if the diagnosis is uncertain, if the patient has frank arthritis with an effusion, or if the patient cannot be relied on ... antimicrobial treatment Treatment for chlamydial infection (as above) should be given if this infection has not been ruled out h Hospitalization is indicated endocarditis to exclude suspected meningitis ... or Ceftizoxime (1 g IV q8h) Patients allergic to β-lactam Spectinomycin (2 g IM q12h) c drugs Continuation therapy Meningitis or endocarditis a Cefixime (400 mg PO bid) See texth True failure...

Ngày tải lên: 08/07/2014, 02:20

... epidemiologic, clinical, and radiologic findings strongly favor another etiology, empirical therapy for pneumonia must include an agent that will be effective against S pneumoniae, which remains ... administration, mandated by the short half-life of penicillin, renders this regimen impractical d Not proven to be effective by the extensive clinical experience that applies to the other regimens ... more expensive Telithromycin is likely to be equally effective Moxifloxacin is also highly likely to be effective in the United States except in patients who come from a closed population where...

Ngày tải lên: 08/07/2014, 02:20

... unusual clinical presentations encountered in patients with community-associated MRSA infections include necrotizing fasciitis, necrotizing pneumonia, and sepsis with Waterhouse-Friderichsen syndrome ... function abnormalities Diagnosis of TSS still depends on a constellation of findings rather than one specific finding (Table 129-2) Part of the case definition is the absence of laboratory evidence ... fulminans These life-threatening infections reflect the increased virulence of MRSA strains Toxin-Mediated Diseases Toxic Shock Syndrome TSS was first recognized as a disease in children in 1978...

Ngày tải lên: 08/07/2014, 02:20

... juncture bumptious explicit kimono cacophonous fabrication laborious candid facetious labyrinth cantankerous facile lackadaisical capricious facsimile lascivious fathom lateral circumspect complacent ... imponderable ire lackadaisical metaphorical nautical presumptuous 10 lenient Bonus: capricious Puzzle #2 levee prohibitive quintessence impel fabrication explicit tedious loathe erroneous 10 diaphanous ... deferential denunciate depravity diaphanous disingenuous gait generate hindrance hodgepodge homogeneity laud lax legitimate lenient pedestrian presumptuous prohibitive quintessence repudiate resonate...

Ngày tải lên: 21/07/2014, 21:21

... of -ir verbs in the imperative Table 8-2 Finir (to finish) in the Imperative Form Present Tense Imperative Form Tu finis Finis! (Finish!) Nous finissons Finissons! (Let’s finish!) Vous finissez ... negative imperatives with direct and indirect object pronouns Parle-lui! (Speak to him/her!), Ne lui parle pas! (Don’t speak to him/her!) Finis-le! (Finish it!), Ne le finis pas! (Don’t finish it!) ... usually follow it with the infinitive This word is a polite way to give commands and is often translated as please, as it is with Veuillez entrer (Please come in) and Veuillez me suivre (Please...

Ngày tải lên: 08/08/2014, 10:22