Neuroimaging Diagnosis for Alzheimer’s Disease and Other Dementias
اطلاع رسانیThe survey of early-onset dementia was done in fve prefectures and two cities in all parts of Japan from 2006 to 2008. The estimated number of patients per 100,000 in the 18–64-year-old population was 47.6 (95% confdence interval (CI): 45.5–49.7). The estimated patient number in all of Japan was calculated to be 37,800 (95% CI: 36,100–39,400). As a result, we found that vascular dementia (VaD) was the most common illness causing dementia, followed by Alzheimer’s disease (AD), posttraumatic syndrome, and then frontotemporal degeneration. The prevalence of late-onset dementia was surveyed with in ten areas in all parts of Japan from 2009 to 2012. From the results, the estimated national prevalence was 15%, with a standard error of 0.0136 and 95% CI of 0.12, 0.17. The number of people with dementia in all of Japan was estimated to be about 4.62 million out of a population of 30.79 million people (defnite value) aged 65 years and older as of October 1, 2012. The number had probably reached 50 million by the end of 2014. For the immediate future, both the prevalence and the total number of dementia patients are expected to rise steadily with the increase in the mean life expectancy.
Anesthesia and Perioperative Care for Organ Transplantation
اطلاع رسانیDespite extensive surgical training, many transplant team members including surgeons may feel ill prepared in the area of medical ethics. The breadth of transplant surgery ,including the need to balance the needs of multiple patients, and the frequent interaction with issues surrounding death, expose the transplant team members to a variety of ethical concerns. The practicing transplant team members should be prepared to deal with the ethical issues that are integral to this broad spectrum of clinical encounters. Certainly no text or course of study could prepare one for each possible clinical scenario and its associated ethical concerns. This chapter will provide a framework for understanding and addressing the ethical issues that arise daily with patients and families. It is anticipated that this discussion will include some familiar as well as new perspectives on medical decision-making. As transplant team members considering ethical issues in organ donation it may help to adopt the understanding that donation may best be viewed as a voluntary act that has the potential to morally elevate mankind, rather than seeing the human body as a repository of parts.
Te ESC Textbook of Vascular Biology
اطلاع رسانیA healthy heart pumps about 6,000–8,000 litres of blood around the body each day. Blood is carried through the body via blood vessels. Te blood vessels form a closed system that begins and ends at the heart. In mammals, blood circulates through two separate circuits: the pulmonary circuit and the systemic circuit (% Fig. 1.1). ◆ Pulmonary circuit: the right ventricle of the heart pumps blood into the lungs, where waste gases are exchanged for oxygen, afer which the blood is transported back to the lef atrium of the heart. ◆ Systemic circuit: the lef ventricle pumps oxygenated blood to all tissues and organs of the body via the aorta, afer which deoxygenated blood is transported back to the right atrium of the heart. % Figure 1.1 gives a simplifed overview of the blood flow through the body, where deoxygenated blood is depicted in blue and oxygenated blood is depicted in red. Note that somewhat counter-intuitively, deoxygenated blood does not refer to blood without oxygen. Rather, it refers to a lower oxygenation grade than that of oxygenated blood because a certain amount of oxygen has been delivered to tissues. As a result, deoxygenated blood still contains about 75% of oxygencompared to oxygenated blood. A well-functioning cardiovascular system is essential for all vertebrates. Te blood vessels are a conduit for a variety of molecules, such as nutrients, oxygen, and waste products, to and from all parts of the body. Blood vessels have several main functions: 1. Distribution of blood containing nutrients (e.g. glucose and amino acids), oxygen (O2), water, and hormones to all the tissues and organs of the body. 2. Removal of metabolic waste products and carbon dioxide (CO2) from the tissues to the excretory organs and the lungs, respectively. 3. Regulation of blood pressure. 4. Maintenance of constant body temperature (thermoregulation). released to the surroundings. In contrast, blood vessels near the skin’s surface can constrict, reducing heat loss through the skin when needed under cold circumstances.
Muscle Injuries in Sport Athletes
اطلاع رسانیSkeletal muscle exhibits plasticity in response to physical training. The functional consequences of these adaptations are determined by training volume, intensity and frequency. One could oppose the practice of endurance sports to sports involving strength and speed. Endurance exercise leads to physiological and biochemical adaptations in skeletal muscle which sustain aerobic metabolism capacity such as mitochondrial biogenesis, angiogenesis, and fiber type transformation. Strength training stimulates synthesis of contractile proteins that are responsible for muscle hypertrophy and increased maximal contractile force output. The increase in muscle mass observed in response to strength training is related to hypertrophy of cellular components, with an increase in their number referred to as hyperplasia. These adaptive changes are responsible for the improvement of physical performance. This review focuses on the mechanisms involved in these adaptations. Modifications of muscle typology under the effect of training result from three main factors: nerve stimulation, mechanical stress resulting from the type of physical activity, and the metabolic response to effort. Beside these main factors of muscle adaptation, hormonal response and nutrition can modulate their expression. Recent findings have revealed some of the mechanisms of various signal transduction pathways and gene expression programs in exercise-induced skeletal muscle adaptations. It is now possible to study the effects of various training interventions on a variety of signaling proteins and early-response genes in skeletal muscle.
Muscle and Tendon Injuries
اطلاع رسانیMuscle is one of the four principal tissue types; it produces movement by pulling on the dense connective tissue which forms the tendons and periosteum. In the human body there are four different types of muscle:
1. Smooth muscle, also known as involuntary, or nonstriated muscle, is responsible for the generation of the tunica muscularis, or muscle coat, of the internal organs and blood vessels and makes up the stroma of several visceral organs. The contraction of smooth muscle cells is involuntary, as opposed to the contraction of striated muscle; it is slower and requires less energy but can be maintained for longer periods of time. The sarcoplasm (cytoplasm of muscle cells) of smooth muscle cells is rich in myofbrils, which are not arranged in sarcomeres as in striated muscle types. 2. Cardiac muscle, also called myocardium, makes up the walls of the heart and is responsible for the pumping of blood. Cardiac muscle contraction is involuntary, unlike skeletal muscle, although it is characterised by striations similar to those in skeletal muscle which are due to the organised distribution of myofbrils within the cell sarcomere. 3. Skeletal muscle, also known as striated or voluntary muscle, is connected to the skeleton and is responsible for generating movement. Contraction is under voluntary control, and as a result the skeletal muscle is highly innervated by motoneurons: every muscle fbre is contacted by a motoneuron at the neuromuscular junction, which transmits the signal to contract.
Mycobacterial Skin Infections
اطلاع رسانیAs compared to other Schizomycetes, mycobacteria (from the Greek muxes:mycetes and bacterion: rod) present some atypical characteristics that cause them to resemble mycetes. Nevertheless, there is no doubt as to their status as bacteria: they belong to the order of the Actinomycetaceae, and the family of Mycobacteriaceae. This family includes only the Mycobacterium genus, that accounts for more than 170 species, many of which are of no clinical interest . Despite a few peculiar differences observed in some species, the morphology of mycobacteria tends to be homogeneous. They are long, slender bacilli ranging from 1 to 5 μm in length and 0.2–0.6 μm in diameter. Coccobacillary forms, although rarely found in pathological samples, are common in colony-forming preparations. Mycobacteria have no locomotor organules and are strictly aerobic or microaerophylic, as well as being Gram-positive and pleomorphic. Their pleomorphism is due to the fact that they normally grow in flaments, sometimes branched (hence the name of this genus, to indicate their resemblance to mycetes, that being moulds, have a flament-like branched morphology), that fragment into bacilli or coccobacilli. Mycobacteria are not mobile nor sporogenic, and except for a few species, show fairly slow reproductive rhythms. In fact, while mean duplication time is about 20 min in Enterobacteriaceae, in the case of mycobacteria it exceeds 15 h. Except for M. leprae, all the species can be cultured, even if most of them require very complex culture media. The colonies show morphological differences among the species but generally feature a rough surface.
Pain Medicine
اطلاع رسانیNociception is the measurable physiological response of specialized sensory receptors (nociceptors) to overt or potential tissue damage and is perceived in the CNS—via the spinothalamic tract, the thalamus, and fnally different areas in the neocortex—as pain. Initially, noxious chemical, mechanical, or thermal stimuli are detected at nerve endings of primary sensory neurons with their soma located in the dorsal root ganglion (DRG) for body sensation, and in the trigeminal ganglion (gasserian ganglion) for face sensation. Specialized receptors (transducers) located at the cell membrane of sensory nerve endings translate the intensity of a given stimulus into action potential frequency, which results in the emission of glutamate and peptides in the respective area in the spinal cord dorsal horn (mostly superfcial laminae I and II with some projections to lamina V). Nociceptors can be divided into different groups by means of their anatomical structure, their characteristic expression of various proteins or the distinct receptors at their terminals, as described below.
Oncologic Imaging: Spine and Spinal Cord Tumors
اطلاع رسانیThe main clues favoring an extradural tumor are extrinsic dural sac compression and tumor extension into the neural foramen. With severe tumor compression of the dural sac, however, it can be diffcult to tell if the dural/cord compression is extrinsic (by an extradural tumor) or due to a space occupying lesion within the dura (by an intradural tumor). The clue that points toward an extradural tumor lies in the appearance of the
subarachnoid space at the margin of the tumor; due to extrinsic compression of the dura, the subarachnoid space between the dura and spinal cord is obliterated at its margin of the tumor. With an intradural tumor, the dura bulges out instead with a convex appearance, while the cord is compressed by the tumor, resulting in widening of the subarachnoid space at the edge of the tumor.
Nutrition and Health in a Developing World
اطلاع رسانیNutrition is a basic need and a key input as well as a desired outcome of economic development. The most important reason for investing in nutrition is to allow individuals to survive and thrive and reach their full potential. Quantifying the economic benefits of nutrition interventions can be a powerful way to advocate for increased resources for nutrition. Economic analysis can also help to decide how best to allocate investments to improve nutrition among competing programs, and how to use public funding most effectively. Undernutrition is associated with 3.1 million child deaths each year (45% of all child deaths in 2011 ). This includes deaths associated with stunting, wasting, suboptimal breastfeeding, fetal growth restriction, and deficiencies of micronutrients including vitamin A and zinc. Estimates of economic losses associated with individual micronutrients can be as large as 1–2% of GDP (Gross Domestic Product, a measure of national income). More recently, studies have attempted to estimate the losses associated with stunting, and these losses can be as large as 8–10% of GDP (see The Costs of Undernutrition section). Stunting is to a large extent a consequence of diets which are chronically inadequate in quantity and quality, and is a good indicator of overall nutritional status. Recent work suggests that breastfeeding has benefits on IQ and income later in life, which is separate from measured nutritional status.
مرغ خودم غازه
اطلاع رسانیدر لابه لای صحبت های دوستانم خیلی شنیده بودم که ماه پایانی کنکور (خردادوتیر) مهمترین برهه کنکوراست؛ بنابراین با تمام عقب ماندگی خود تصمیم گرفتم که اینیک ماه را به طور کامل درس بخوانم به امید آنکه شاید برحسب شانس من نیز کنکور قبول شوم، میدانستم که برای تمرکز بیشتر به یک محیطی آرام و به دوراز هیاهو نیاز دارم، جایی که در آن بتوانم فقط و فقط به مطالعه بپردازم، بنابراین منزل خالهام را که زنی تنها بود برای آنیک ماه انتخاب کردم. یک ماه کامل در منزل خالهام ساکن بودم.