Cisco Self-Defending Network: This topic describes the Cisco Self-Defending Network strategy. The Cisco Self-Defending Network strategy describes the Cisco vision for security systems, and helps customers more effectively manage and mitigate risks posed to their networked business systems and applications. Cisco Self-Defending Network is the Cisco response to the increasing challenge of new threats and vulnerabilities that result from constantly evolving technologies and system developments. It provides a comprehensive approach to secure enterprise networks. The Cisco Self-Defending Network strategy consists of three systems, or pillars, each with a specific purpose. By using Cisco integrated security solutions, customers can leverage their existing infrastructure to address potential threats to their network. While security risks are inherent in any network, customers can reduce their exposure and minimize these risks by deploying three categories of overlapping and complementary security solutions: „ Secure connectivity: Provides secure and scalable network connectivity, incorporating multiple types of traffic. „ Threat defense: Prevents and responds to network attacks and threats using network services. „ Trust and identity: Allows the network to intelligently protect endpoints using technologies such as authentication, authorization, and accounting (AAA), Cisco Secure Access Control Server (ACS), Network Admission Control (NAC), identity services, and 802.1x. The Cisco Self-Defending Network is based on a foundation of security integrated throughout the network, with constant innovations in products and technologies and crafted into systemlevel solutions. Such solutions incorporate all aspects of the network as well as the sophisticated services needed to make it work. In addition, Cisco is working with major industry partners to ensure the completeness of the strategy.

The purpose of this book is to explore the origins, pathophysiology, and diagnostic accuracy of many of the physical signs currently used in adult patients. We have a wonderfully rich tradition of physical diagnosis, and my hope is that this book will help to square this tradition, now almost two centuries old, with the realities of modern diagnosis, which often rely more on technologic tests, such as clinical imaging and laboratory testing. The tension between physical diagnosis and technologic tests has never been greater. Having taught physical diagnosis for 20 years, I frequently observe medical students purchasing textbooks of physical diagnosis during their preclinical years, to study and master traditional physical signs, but then neglecting or even discarding this knowledge during their clinical years, after observing that modern diagnosis often takes place at a distance from the bedside. One can hardly fault a student who, caring for a patient with pneumonia, does not talk seriously about crackles and diminished breath sounds when all of his teachers are focused on the subtleties of the patient’s chest radiograph. Disregard for physical diagnosis also pervades our residency programs, most of which have formal x-ray rounds, pathology rounds, microbiology rounds, and clinical conferences addressing the nuances of laboratory tests. Very few have formal physical diagnosis rounds.

The topic of bowels and bowel control remain a taboo subject for many. From the time we become continent it becomes a largely controlled activity that many of us take for granted and do not discuss in any detail, and yet we are beginning to understand the prevalence of bowel problems. A functional bowel disorder was frst defned as a bowel problem which does not have a structural or biological cause . We would like expand upon this defnition because some of the conditions we will discuss in this book do have a structural cause, as with evacuatory dysfunction secondary to a rectocele, or incontinence secondary to a sphincter defect. We will therefore defne functional bowel disorders and bowel dysfunction as the subset of troubling symptoms, which may or may not have a structural or biological cause, but which mean the bowel, and or anorectum and/or pelvic floor do not function at an optimum.