Introduction.to.Epidemiology.Seventh[taliem.ir]

Epidemiology

Public health is concerned with threats to the population’s health. Important subfields of public health include epidemiology, biostatistics, and health services. Epidemiology is commonly referred to as the foundation of public health because it is a study that aids our understanding of the nature, extent, and cause of public health problems and provides important information for improving the health and social conditions of people. Epidemiology has a population focus in that epidemiologic investigations are concerned with the collective health of a group of individuals who share one or more observable personal or observational characteristic. Geographic, social, family (marriage, divorce), work and labor, and economic factors may characterize populations .In contrast, a clinician is concerned for the health of an individual. The clinician focuses ontreating and caring for the patient, whereas the epidemiologist focuses on identifying the source or exposure of disease, disability or death, the number of persons exposed, and the potential for further spread. The clinician treats the patient based on scientific knowledge, experience, and clinical judgment, whereas the epidemiologist uses descriptive and analytical epidemiologic methods to provide information that will ultimately help determine the appropriate public health action to control and prevent the health problem .
Immunohistochemistry.in.Tumor.Diagnostics.[taliem.ir]

Immunohistochemistry in Tumor Diagnostics

The following chapters provide an overview of the most common immunohistochemical markers used for tumor diagnosis in addition to the immunoprofle of the most common tumors. The expression pattern of targeted antigens is also listed as an important factor to consider in the interpretation of the immunohistochemical stains and includes the following expression (stain) patterns: 1. Nuclear staining pattern: characteristic for antigens expressed in cellular nuclei or on the nuclear membrane. Good examples for this expression pattern are transcription factors and steroid hormone receptors. 2. Cytoplasmic staining pattern: characteristic for antigens located in the cytoplasm. Common examples are the cellular skeletal proteins such as vimentin, actin, desmin, and cytokeratins. Some antigens display a further restricted cytoplasmic staining pattern and stain-specifc organelles, as, e.g., mitochondria (leading to a granular cytoplasmic staining) or the Golgi apparatus (unilateral perinuclear pattern). 3. Membrane staining pattern: characteristic for antigens located within the cell membrane, typical examples are the majority of CD antigens. 4. Extracellular staining pattern: this pattern is characteristic for extracellular and tissue matrix antigens in addition to the cell secretion products such as collagens and CEA.
Hemodialysis.Access.Fundamentals.[taliem.ir]

Hemodialysis Access

Nearly two centuries ago in 1836, Dr. Richard Bright describes a composite clinical course of end-stage renal disease : The patient awakes in the morning with his face swollen, or his ankles puffy, or his hands edematous … already his urine contains a notable quantity of albumin, his pulse is full and hard, his skin dry, he often has headaches, and sometimes a sense of weight or pain across the loins. Under treatment more or less active, or sometimes without treatment, the more obvious and distressing of the symptoms disappear… absolutely forgotten. Nevertheless, from time to time, the countenance becomes bloated; the skin is dry; headaches occur with unusual frequency; or the calls to micturition disturb the nitrous by the repose. After a time the healthy color of the countenance fades; a sense of weakness or pain in the lines increases; headaches often accompanied by vomiting, add greatly to the general want of comfort; and a sense of lassitude, or weariness and of depression, gradually steal over the body and mental frame. Again the patient is resorted to tolerable health; again he enters is activeduty; or he is perhaps less fortunate; the swelling increases, the urine become scanty, the powers of life seem to yield, the lungs become edematous, and in a state of asphyxia or coma, he sinks into the grave; or a sudden effusion of serum into the glottis closes the passages of air, and brings on a more sudden dissolution.
Handbook.of.Gynecology.[taliem.ir]

Diagnosis and Management of Epithelial Ovarian Cancer

Ovarian cancer is the fifth most common cancer among women after breast, bowel, lung, and endometrial and remains the leading cause of death due to gynecological malignancy (Cancer.org 2016). Epithelial ovarian cancer accounts for the vast majority of ovarian malignancies with figures of around 85 %. Due to its insidious nature of presentation, it is often not diagnosed until the later stages leading to a high mortality rate. Five-year survival is very much influenced by stage at diagnosis. Over the last 20 years, incidence and mortality have remained fairly static, and much research is being undertaken looking for aids to diagnosis, possible screening methods, and improvement in treatment options, both surgical and medical. In this chapter we will discuss presentation, diagnostic tools, and possible management regimes for patients with epithelial ovarian cancer.
Global.Surgery.The.Essentials.[taliem.ir]

Global Surgery

Five billion humans worldwide do not have access to safe, timely, and affordable surgical care. Nearly one- third of the global burden of disease can be attributed to conditions treatable by surgery . Not surprisingly, low- and middle-income countries (LMICs) bear the majority of this burden. Less than 6% of surgical operations performed worldwide occur in these countries, and an estimated 143 million additional surgical procedures per year would be necessary to reverse this inequity . Historically, major global public health initiatives have focused on infectious and communicable diseases as the major medical contributors to global morbidity and mortality. HIV/AIDS, tuberculosis, and malaria have stood at the forefront of global attention for decades, and signifcant progress has been made to eliminate widespread burden secondary to these diseases. But recently, comprehensive surgical care––which includes not only surgery but also obstetric, trauma, and anesthesia care––has surfaced to join communicable diseases for center stage in the global development agenda.
Endocrinology.of.the.Testis.[taliem.ir]

Control of GnRH Secretion

Human reproduction and fertility are completely dependent upon neuroendocrine control of the hypothalamus-pituitary-gonadal (HPG) axis and its hierarchy of secreted hormones. The human reproductive system is controlled by the hypothalamus through the decapeptide gonadotropin-releasing hormone (GnRH), which displays a remarkable conservation over millions of years of evolution in the different species. The neurosecretion of GnRH depends on less than 4,000 GnRH-secreting neurons, which have an extracranial origin and finally migrate into the hypothalamic preoptic area. They secrete GnRH starting from the tenth week of gestation till the first 4–6 months of life, when GnRH secretion is “switched-off” until puberty. At puberty, the GnHR secretion is switched back “on” with a characteristic pulsatile manner that is maintained during adulthood. Regulation of GnRH-secreting neuron activity through the lifespan is not completely understood, but is clearly the result of a sophisticated network of stimulatory and inhibitory inputs, that include centrally different subgroups of neurons afferent to the GnRH-secreting neurons and peripherally the gonadal steroid feedback. The present chapter of the Textbook will focus on the ontogeny of the GnRH-secreting neurons and the mechanisms so far known to be implicated in regulating their neurosecretory activity.
Building.Bones.Bone.Formation..[taliem.ir]

Building Bones

Bone is the tissue most frequently recovered archaeologically and is the material most commonly studied by biological anthropologists, who are interested in how skeletons change shape during growth and across evolutionary time. This volume brings together a range of contemporary studies of bone growth and development o highlight how cross-disciplinary research and new methods can enhance our anthropological understanding of skeletal variation. The novel use of imaging techniques from developmental biology, advanced sequencing methods from genetics, and perspectives from evolutionary developmental biology improve our ability to understand the bases of modern human and primate variation. Animal models can also be used to provide a broad biological perspective to the systematic study of humans. This volume is a testament to the drive of anthropologists to understand biological and evolutionary processes that underlie changes in bone morphology and illustrates the continued value of incorporating multiple perspectives within anthropological inquiry.
Acute.Ischemic.Stroke.Medical.Endovascular.[taliem.ir]

Acute Ischemic Stroke

Here, the classifcation and pathophysiology of ischemic stroke will be discussed in detail. Ischemic stroke is often classifed for academic purposes, but there is actually a very practical reason for its classifcation. Ischemic stroke is a clinical syndrome, which develops not with a single cause but with multiple causes. Ischemic stroke with a different cause would have a different clinical developmental pattern, and more decisively, the medicine and therapy for treatment and prevention vary. Thus, its proper confrmation would great influence the patient’s prognosis. In this chapter, the classifcation of ischemic stroke and the latest knowledge on the pathophysiology related to it will be presented.
Abdominal.Neuroendocrine.Tumors.[taliem.ir]

Abdominal Neuroendocrine Tumors

The neuroendocrine system is a network of cells distributed throughout the human body, having structure similar to nerve cells (neurons) and releasing hormones into the bloodstream like endocrine cells. These hormones work like neurotransmitters and are released to transmit signals or impulses to other specialized or nerve cells. The gastrointestinal (GI) tract and pancreatobiliary system contain a variety of endocrine cells that constitute a diffuse endocrine system. This is the largest population of hormone-producing cells in the body . Specialized endodermderived epithelial cells, called enteroendocrine cells (EECs), are widely distributed throughout the GI tract . Intestinal EECs are restricted to the mucosa and represent only a small minority (<1%) of the overall epithelial cell population, often lying isolated from one another and interspersed by non- endocrineepithelial cells. These cells produce and release hormones and play a key role in the control of GI secretion and motility, regulation of food intake, postprandial glucose levels and metabolism. When EECs interact with luminal content, they release signal molecules which can enter the circulation and act as classic hormones on distant targets. They also act locally on neighboring cells and on distinct neuronal pathways including enteric and extrinsic neurons . The normal distribution of the neuroendocrine cells in the GI and pancreatobiliary tracts is reported in Table 1.1.
Kotler-Dar-Modiriate-Bazar-PhilipKotler.[taliem.ir]

كاتلر در مديريت بازار

مردم و كسبوكارها نميدانند كه با ورود به هزاره سوم ميلادي به پيشواز چه چيزي ميروند. نه تنهـا بـا دگرگوني ها، كه با افزايش شتاب آنها هم روبه رو هستيم. شركت ها از اينكه بازارهايشان هر چند سال يك بار دگرگون ميشود غافلند. خوب كه بنگريم، دو دسته شركت در صحنه ميبينيم: آنهـايي كـه دگرگـوني هـا را ميپذيرند و آنهايي كه نابود ميشوند. دو نيروي پر توان چشم انداز اقتصادي امروز را ميسازند. فنآوري و جهـاني شـدن. در كنـار فـنآوري و جهاني شدن، نيروهاي ديگري هم به شكلدهي اقتصاد سرگرمند، مقرراتزدايي يكي از آنهاست. يـك نيـروي تحول آفرين ديگر، خصوصي سازي است. بسياري از شركتها وسازمانهاي وابسته به بخش دولتي و همگاني به اميد برخوردار شدن از مديريت و كارايي بهتر، به بخش خصوصي واگذار ميشوند. از آنجائي كه شتاب دگرگوني ها بسيار زياد است، توان همراه شدن با آن به يك امتياز رقابتي و نقطه قوت تبديل ميگردد. توان " دگرگوني پذيري" به توان " خودآموزي" نياز دارد. جاي شگفتي نيست كه شـركت هـايي همچون كوكاكولا، جنرال الكتريك، در سازمان خود معاون مديرعامل در )دانش، يـادگيري، خردمنـدي( ايجـاد كرده اند. در جدول زير وضعيت شركتها در دوره انتقال ارائه ميگـردد. ايـن جـدول ره يافـته ـايي بـراي كارآمدي و سود بيشتر در دوران كنوني را توضيح ميدهد. در بازاريابي راهكارهاي پيروزمندانه اي را ميشناسيم، كه در موقعيت مديريت بازار، كارسـازند. برخـي از آنها از اين قرار است: پيروزي در سايه كيفيت، خدمات بهتر، قيمتهاي پايين، داشتن سهم بزرگي از بـازار، مناسـب و همخـوان شدن با نيازهاي مشتري، بهسازي ِ مستمر فـرآورده، نـوآوري، ورود بـه بازارهـاي پررشـد و فراتـر رفـتن از انتظارات مشتري و دلشاد كردن وي. بيترديد راه مشخص و يكساني در بازاريابي نداريم. نكته مهم در اينجاست كه تنها انـدكي بهتـر بـودن از رقيبان كفايت نميكند. از ديد مايكل پورتر پروفسور دانشگاه هاروارد شـركتي برخـوردار از يـك اسـتراتژي استوار است كه تفاوت هاي چشمگير با رقيبان داشته باشد. براي ايـن كـار تقليـد و پيـروي از اسـتراتژي هـاي پيروزمندانه به طور كامل، سازنده نيست بايد تنها پارهاي از مفهوم هايي را كه با شركت شما سـازگار اسـت، برگزيد. تقليد كامل از رهبران بازار كاري بسياري پيچيده و پرهزينه است و دست آخر نيز شركت را به يـك پيرو متوسط تبديل ميكند .