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STUDENT DIGITAL NEWSLETTER ALAGAPPA INSTITUTIONS |
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Brent Grady, RN, CCRN, CEN
Weed is familiar with the origin of Chiropractic man health women news p90x results buy fincar 5mg on-line, in testimony of which see his letter prostate oncology 21 order fincar 5mg with mastercard, which was quite lengthy; therefore the substance only of special interest was copied androgen hormone structure fincar 5 mg amex. Palmer in 1894 prostate cancer trials cheap 5 mg fincar with visa, after his daughter had been wonderfully cured by magnetic healing by him of a sprained ankle that threatened her life prostate enlarged symptoms 5mg fincar fast delivery. The doctor then relieved him mens health meal plan cheap fincar 5mg without prescription, by magnetic treatment, of splenic trouble which incapacitated him from preaching. Weed and her little daughter took Chiropractic adjustments early in 1896 and were much benefited. About this time I asked him to suggest a name in Greek for the science and art which I had created, one which would mean done by hand. Accidents may eliminate circulation, respiration or innervation either one of the three functions essential to life and no impingement upon nerves. The former occurs, after a length of life recognized as being normal to mankind, from general wearing out of the body and the performance of its functions. By far the larger number of individuals cease to exist as living beings because of conditions we name disease. Nerves may be impinged upon and cause disability or ailments, and yet not cause death. By disease is meant either an increase or decrease of normal functionating or a structural change of any organ or part of the body from the normal state. These two conditions, altho referred to separately, are always associated-either cannot be present without the other. An increase or decrease of tonicity in nerve tissue causes a corresponding change in functions. Organized beings possess life; substances which do not possess organs do not have life. Life is the quality or character which distinguishes an animal or plant from inorganic or dead organic bodies. Every portion of creation that lives performs functions which are necessary for its existence. Life is expressed by the process of metabolism, growth, reproduction and inherent powers of adaptation to environment. Life is the result of vital force, spiritual energy, expressed in organic creation. After the composition of this material is suitably changed it is deposited thruout the body as needed. The substances of their bodies are constantly undergoing a change, old material being decomposed and passed off, and new material taken in to replace that which has served its usefulness. Organized beings are constantly undergoing a change of material, yet remain practically the same. Repair is accomplished by the assimilation of new material which has been taken in and digested. For a normal existence, it is necessary that each and every function should be performed in a natural manner. When, by any means, the organization becomes injured or deranged, the texture too soft or too hard so that its organs can no longer carry impulses and enact them into functions, life ceases. Life is the result of the combination of intellectual spirit and unintelligible matter. Chiropractors should become acquainted with that which constitutes functions-the expressions of life-and know whether they are physiological or pathological. When Chiropractic methods are understood by veterinarians they will cease their cruel treatment. When poultry raisers learn to adjust the backbones of their fowls for diseases they will quit using remedies. This machine, like all others, is run by power, called mental impulses, made in the brain and connected with the body by a system of nerves thru which this force passes in currents, inducing the highest exemplification of the intellectual power. Functions are names given to these actions, any interference to the passage of these vitalizing currents produces abnormal functions-disease. Spirit directs matter, man, beast, bird, fish and plants; it creates law, is not a law itself. Chemical pertains to the changes made by chemical analysis and the compounding of elements. It deals with the quantitative relations of force and matter, as distinguished from those which are mental, vital and chemical. It is impossible to unite an individualized portion of the Allwise with two laws which have no affinity for, or relation with, each other. The living body is subject to vital force, the expenditure of which is known as energy. It is not feasible to unite a spiritual entity to chemical action; the laws of chemistry and kinematics are incongruous. Man is not a machine-he is not subject to the laws which govern inanimate matter. The laws of mechanics are distinguished from those which are mental, vital and chemical. To entertain a thot of uniting spirit and mechanical and chemical entities shows a lack of comprehension of terms. It is impossible to make a union of a spiritual being, a mechanical machine and a chemical laboratory. Whenever a Chiropractor states that he instantly locates where the cause of a certain disease is, you may put him down as an incompetent Chiropractor-that he is a grafter, getting money by false pretenses. While I am writing this article a Chiropractor from Davenport, called and said, "I can tell what ails anyone as far away as San Francisco, without asking a question. A machine is designed to operate upon material, to change it in some preconceived and definite manner, to lift or transport loads, etc. Spinal nerves arise from the spinal cord and emerge thru the intervertebral foramina of the vertebral column. Electricity is an inanimate force; it is an agency to whose action are due numerous phenomena in physics-the science of matter and motion. When applied to the human body, it shocks-is death dealing-does not give vitality or life. A mental impulse is an incitement of the mind by Innate or spirit, in the form of an abrupt and vivid suggestion, prompting some unpremeditated action or leading to unforeseen knowledge or insight. Energy is manifested in various forms, as mechanical, electrical, chemical and thermal. Functional energy is due to thermal force-the amount of heat determines the quantity and quality of action. An element is one of the simple substances of which the physical universe is composed, as earth, air, fire and water-none of these keep the body in health; are not interfered with by pressure upon nerves. The larger share of diseases are the result of too much vital force; consequently, energy is not hindered, kept back, prevented, obstructed or shut off, but accelerated, hastened, quickened, urged, hurried, the volume and force is augmented. I have never seen a cut showing how nerves are pinched between the occiput and atlas, betwixt the atlas and axis, or between the joints of the feet. Why not have cuts of these showing how the first and second pairs of cervical nerves are pinched, also those of other joints than those of the vertebral column? There is a vast difference between nerves being impinged upon-a pressure on or against one side, and being pinched between two hard substances. I very much desire to know how the 24 cranial and the nerves of the sympathetic nervous system can be adjusted, acted upon by the hands. These fibers become impinged upon or pressed against by the displacement of bones. The nerves are channels for motor impulses outward only, and sensations inward; neither circulate, move in a circle. Any vital action, or the temporary activity of nerves, or the irritation of muscles, would be a stimulus. We would not use such terms as stimulus, electricity or magnetism as synonymous for vital force. We consider all these modes of drugless healing are an evolution from medicine to Chiropractic. We have studied and practiced, with success, all these methods of relief, but, we have left them all, knowing that Chiropractic is the climax. Chiropractic was not evolved from medicine or any other method, except that of magnetic. For nine years previous to the discovery of adjusting vertebrae, I was practicing magnetic healing. During that time I had developed much which afterwards became a part of the science of Chiropractic. For example, I treated (as I supposed) the spleen for cancer of the breast, effecting a cure. While Chiropractic is an outgrowth of magnetic healing, it is not magnetic healing advanced, is not the climax of magnetism or any other method. Chemistry is a science which treats of the elements, the atomic relations of matter and of the various compounds which are formed by elementary substances. The science (knowledge) of chemistry consists in reducing a compound body to its elements and the uniting of elements to make a compound. For example, lye and grease are elements, which, when united, form a compound known as soap. Soap is produced by combining fats or oils with alkalies or alkaline earths, usually by boiling. A chemist knows, when a man talks about a manufactured chemical or a natural chemical, that he is not acquainted with chemistry; that he is using terms which do not apply to the science of chemistry. One may know where to find what he has displaced, but he cannot find what he has misplaced; Vertebrae are displaced, not misplaced. Instead, Chiropractors replace the parts which are not in apposition into their normal relative position. He today holds that same honored position, envied by a few of his students, who advertise themselves as fountain heads and developers of the science. There is but one fountain head and developer, there never can be but one, and that one is D. There are those who try to ape that "peculiar sort of a crank," but they only succeed in making a ludicrous show of themselves; better try "to reach his intellectual level" rather than to falsify and slander their superior, hoping thereby to lower his standard so that they may then be able to attain his level of intellectuality. While others said "Honesty is the best policy" he thought that honesty did not need policy, that in proportion as we use policy, we covered up honesty with deceit; therefore, his stick-to-itiveness to principle and honor made him some enemies, who could but "respect and reverence" him for being truthful and upright. Palmer has been the means of restoring health to thousands; placing hundreds on the "road to wealth, a very few for avaricious greed and mercenary gain, have, childlike, tried to undermine his honor "These would-be fountain heads and developers "are cowards and kleptomaniacs, failing at every turn of the road. When John Robinson, pastor of the flock that came to our shore in the Mayflower, landed at Plymouth, the day of rest was as severe, austere and solemn an occasion as a funeral. Grant, of New York, who would open theaters, parks and seashore places for the work-worried on their day off. Grant may be haunted by the menacing spirit of John Robinson, but he declares that the day will never come when everybody will go to church; hence, for those who will not go, other forms of entertainment must be provided so that they will not engage in other and worse pursuits because of idleness. It seems to be a growing sentiment, that the day of rest should be one of recreation, a change of action and scenery; that the man or woman who is busy six days of a week should enjoy for one day the good things which those of us, who are not so busy, enjoy on week-days. It is in a strange contrast to that made by anatomists and Chiropractors who follow nerves in every conceivable zigzag direction. I only wish to add, that his ideas are not Chiropractic as taught by the originator and developer of this science and art. Poisons are substances which, when introduced into the body, either impair the function of one or more of its organs or destroy life. All poisons lead to a disturbance of the nervous system, no matter by what avenue it is introduced. In others the place of entrace is not affected, the pathological manifestations being due to nervous disturbance. The effect of a poison depends upon the nature of the substance, the amount and the individual. It is not by fear, punishment or threats that the sick are made whole; it is not by cruelty that the bad are made good. When a member of society has fallen, send for an educator to enlighten and remove the stumbling block, so that others may not fall. Philosophy is the knowledge of phenomena as explained by, and resolved into, causes, reasons, powers and laws. Philosophy is the science of things divine and human, and the causes in which they are contained; the science of effects by their causes; the science of sufficient reasons; the science of things possible, inasmuch as they are possible; the science of things evidently deduced from first principles; the science of truths sensible and extract; the application of reason to its legitimate objects; the science of the relations of all knowledge to the necessary ends of human reason. It does not remedy, it adjusts causes, so that Innate may correct abnormal functions and change morbid into normal structures. To relieve an impingement in acute diseases by one adjustment in less than a minute, so Innate can transmit functions in a normal amount, is not an auxiliary to any method, neither does Chiropractic need any method as an auxiliary. Those who expect to put in a life-time combating disease, fighting the entrance of disease, as tho it was an enemy with hostile intent, should not learn Chiropractic. He tells us that, approximation (coming together) of the vertebrae narrows the intervertebral foramina, thereby impinging upon nerves. Now take your spinal column in hand as the developer of Chiropractic has done a thousand times. Observe that there are two articulations between the occiput and the atlas and two corresponding articulations between the atlas and axis. There is no intervertebral cartilage between them, as we find between vertebrae farther down the column. These articulations are covered with thin, hyaline (glass) cartilage which cannot pathologically be made any thinner, consequently, they cannot unduly approximate each other, narrowing the clefts or grooves between the occiput and atlas and the atlas and axis.
Microangiopathic and other hemolytic anemias that result from trauma to red cells show many erythrocytic abnormalities (helmet and burr cells prostate 91 generic fincar 5mg free shipping, triangle cells prostate cancer 5k harrisburg pa order fincar 5mg otc, and schistocytes) in the peripheral smear prostate help order fincar 5 mg mastercard. Weakness man health about generic 5 mg fincar with visa, weight loss prostate and bladder fincar 5mg with visa, recurrent infections prostate infection treatment buy fincar 5 mg online, proteinuria, anemia, and abnormal proliferation of plasma cells in the bone marrow are findings that highly suggest the presence of multiple myeloma, a plasma cell dyscrasia. The more definitive diagnostic criteria are findings of M component in the results of serum electrophoresis and plasma cell levels of above 20% in the bone marrow. Multiple myeloma, which occurs more commonly in males than in females, shows an increasing incidence with increasing age, and most patients are in their seventies. Myeloma is a monoclonal malignancy of the B lymphocyte system, with bone pain the most common symptom. Myeloma is not associated with lymphadenopathy, but recurrent infections are frequent because of the severe suppression of normal immunoglobulins. In fact, infection is the most common cause of death in these patients and is usually due to encapsulated bacteria. There is no increase in viral infections in these patients because their cell-mediated immunity is normal. As with myeloma, there is a monoclonal production of immunoglobulin (IgM) that produces an M spike. Unlike the case with myeloma, however, there are no lytic bone lesions and no hypercalcemia, and the bone marrow shows proliferation of plasma cells, lymphocytes, and plasmacytoid lymphocytes. Note that M proteins are found in 1 to 3% of asymptomatic persons over the age of 50. Heavy chain disease refers to types of plasma cell dyscrasia that are associated with the monoclonal production of immunoglobulin heavy chains only (not light chains). It is characterized by numerous plasma cells infiltrating the lamina propria of the small intestines. These cells contain distinctive granules, seen by electron microscopy, that are rod-shaped organelles resembling tennis rackets. Acute disseminated Langerhans cell histiocytosis (Letterer-Siwe disease) affects children before the age of 3 years. These children have cutaneous lesions that resemble seborrhea, hepatosplenomegaly, and lymphadenopathy. The Langerhans cells infiltrate the marrow, which leads to anemia, thrombocytopenia, and recurrent infections. The clinical course is usually rapidly fatal; however, with inten- Hematology Answers 263 sive chemotherapy 50% of patients may survive 5 years. The characteristic triad consists of bone lesions, particularly in the calvarium and the base of the skull; diabetes insipidus; and exophthalmos. Unifocal Langerhans cell histiocytosis (eosinophilic granuloma), seen in older patients, is usually a unifocal disease, most often affecting the skeletal system. The lesions are granulomas that contain a mixture of lipid-laden Langerhans cells, macrophages, lymphocytes, and eosinophils. In contrast, sarcoidosis is characterized by a proliferation of activated macrophages that form granulomas. Dermatopathic lymphadenitis refers to a chronic lymphadenitis that affects the lymph nodes draining the sites of chronic dermatologic diseases. The lymph nodes undergo hyperplasia of the germinal follicles and accumulation of melanin and hemosiderin pigment by the phagocytic cells. It typically occurs in young adults and presents with systemic symptoms, lymphadenopathy, and pharyngitis. Peripheral blood shows an absolute lymphocytosis, and many lymphocytes are atypical with irregular nuclei and abundant basophilic vacuolated cytoplasm. These atypical lymphocytes are usually adequate for diagnosis, along with a positive heterophil or monospot test (increased sheep red cell agglutinin). Administration of ampicillin for a mistaken diagnosis of streptococcal pharyngitis results in a rash in many patients. Histologic sections (routine H&E stain) of lung reveal the alveoli to be filled with pale, nongranular pink fluid. Bacterial pneumonia Congestive heart failure Lymphatic obstruction by tumor Pulmonary embolus Viral pneumonia 235. A 7-year-old boy accidentally inhales a small peanut, which lodges in one of his bronchi. A chest x-ray reveals the mediastinum to be shifted toward the side of the obstruction. Absorptive atelectasis Compression atelectasis Contraction atelectasis Patchy atelectasis Hyaline membrane disease 236. Angioinvasive infiltrates of pleomorphic lymphoid cells Deposits of needle-like crystals from the membranes of eosinophils Infiltrating groups of malignant cells having intercellular bridges Irregular membranes composed of edema, fibrin, and dead cells lining alveoli Plexiform lesions within pulmonary arterioles 265 Copyright 2002 the McGraw-Hill Companies. While recovering in bed 1 week after an abdominal hysterectomy, a 42-year-old female develops acute shortness of breath with hemoptysis. Physical examination finds the patient to be afebrile with moderate respiratory distress, calf tenderness, and a widely split S2. Atelectasis Bacterial pneumonia Pulmonary embolus Pulmonary hypertension Viral pneumonia 238. A specimen from a lung biopsy reveals occasional plexiform lesions within pulmonary arterioles. A 19-year-old female presents with urticaria that developed after she took aspirin for a headache. She has a history of chronic rhinitis, and physical examination reveals the presence of nasal polyps. This patient is at an increased risk of developing which one of the following pulmonary diseases following the ingestion of aspirin? Asthma Chronic bronchitis Emphysema Interstitial fibrosis Pulmonary hypertension 240. Which one of the following is a correct association concerning the pathogenesis of smoking-induced emphysema? Destruction of distal acinus = centrilobular emphysema Destruction of distal acinus = paraseptal emphysema Destruction of entire acinus = panlobular emphysema Destruction of proximal acinus = centrilobular emphysema Destruction of proximal acinus = paraseptal emphysema Respiratory System 267 241. Histologic examination of lung tissue reveals multiple suppurative, neutrophil-rich exudates that fill the bronchi and bronchioles and spill over into the adjacent alveolar spaces only. Bronchiectasis Bronchopneumonia Lobar pneumonia Interstitial pneumonitis Pulmonary abscess 243. A 44-year-old male alcoholic presents with fever and a productive cough with copious amounts of foul-smelling purulent sputum. Physical examination finds that changing the position of this individual produces paroxysms of coughing. Esophageal cancer Esophageal reflux Myocardial infarction Pulmonary abscess Pulmonary infarction 268 Pathology 244. A 25-year-old female presents with fever, malaise, headaches, and muscle pain (myalgia). You draw a tube of blood from the patient (the tube contains anticoagulant) and place the tube in a cup of ice. After the blood has cooled, you notice that the red cells have agglutinated (not clotted). Influenza A virus Mycoplasma pneumoniae Streptococcus pneumoniae Pneumocystis pneumoniae Mycobacterium tuberculosis Respiratory System 269 245. Pseudomonas pneumonia Aspergillus pneumonia Pneumocystis carinii pneumonia Cytomegalovirus pneumonia Influenza pneumonia 270 Pathology 246. A routine chest x-ray performed on an asymptomatic adult male patient who works at sandblasting reveals a fine nodularity in the upper zones of the lungs and "eggshell" calcification of the hilar lymph nodes. Schaumann bodies Ferruginous bodies Cholesterol crystals Candida species Silica particles Respiratory System 271 248. A 24-year-old African American female presents with nonspecific symptoms including fever and malaise. A chest x-ray reveals enlarged hilar lymph nodes ("potato nodes"), while her serum calcium level is found to be elevated. A chest x-ray reveals a diffuse pulmonary infiltrate, while a transbronchial biopsy reveals fibrosis of the walls of the alveoli, many of which contain sheets of "desquamated" cells. Atypical lymphocytes invading blood vessels Granulomatous inflammation of blood vessels with numerous eosinophils Granulomatous inflammation of bronchi with Aspergillus Large, serpiginous necrosis with peripheral, palisading macrophages Necrotizing hemorrhagic interstitial pneumonitis 272 Pathology 251. A 45-year-old man presents with shortness of breath, cough with mucoid sputum, and some weight loss, and has diffuse, bilateral alveolar infiltrates on chest x-ray. Pneumocystis carinii pneumonia Diffuse alveolar damage Pulmonary edema Pulmonary alveolar proteinosis Lipid pneumonia 252. Asteroid bodies in giant cells within bronchioles Loose fibrous tissue within bronchioles and alveoli Multiple rheumatoid nodules within the interstitial tissue Numerous eosinophils within the walls of the alveoli Numerous lymphocytes within the walls of the alveoli Respiratory System 273 253. A 54-year-old male presents with several problems involving his face and pain in his shoulder. Physical examination reveals ptosis of his left upper eyelid, constriction of his left pupil, and lack of sweating (anhidrosis) on the left side of his face. A bronchioloalveolar carcinoma involving the left upper lobe A small cell carcinoma involving the hilum of his left lung A squamous cell carcinoma involving the left mainstem bronchus An adenocarcinoma involving the apex of his left lung An endobronchial carcinoid tumor involving the right mainstem bronchus 254. Several sputum samples sent for cytology are unremarkable, and a bronchoscopic examination is also unremarkable. Histologic examination reveals lobules of connective tissue that contain mature hyaline cartilage. Adenocarcinoma Bronchioloalveolar carcinoma Carcinoid Fibroma Hamartoma 274 Pathology 255. A 67-year-old male long-term smoker presents with weight loss, a persistent cough, fever, chest pain, and hemoptysis. Physical examination reveals a cachectic male with clubbing of his fingers and dullness to percussion over his right lower lobe. Histologic examination of a transbronchial biopsy specimen reveals infiltrating groups of cells with scant cytoplasm. The nuclei of these cells are about twice the size of normal lymphocytes and do not appear to have nucleoli. Adenocarcinoma Hamartoma Large cell undifferentiated carcinoma Small cell undifferentiated carcinoma Squamous cell carcinoma 256. Bronchioloalveolar carcinoma Carcinoid Large cell carcinoma Small cell carcinoma Squamous cell carcinoma Respiratory System 275 257. Which one of the listed abnormalities is an example of a type of pleural effusion that is better classified as an exudate (inflammatory edema) rather than a transudate? A 19-year-old female presents with sudden, severe right-sided chest pain that developed shortly after she had been placing heavy boxes on shelves in her garage. Breath sounds are markedly decreased on the right, and the right lung is hyperresonant to percussion. Pneumoconiosis Pneumocystis infection Bacterial pneumonia Viral pneumonia Pneumothorax 276 Pathology 259. A 57-year-old male presents with a lesion similar to that seen in this gross photograph of a sagittal section of the lung. Which one of the listed characteristics, if present in this lesion, would favor the diagnosis of mesothelioma? Pulmonary edema can be classified based on the etiology into cardiogenic pulmonary edema and noncardiogenic pulmonary edema. Cardiogenic pulmonary edema results from abnormalities of hemodynamic (Starling) forces, while noncardiogenic pulmonary edema results from cellular injury. Causes of cardiogenic pulmonary edema include increased hydrostatic forces, as seen with congestive heart failure (the most common cause of pulmonary edema); decreased oncotic pressure, such as resulting from decreased albumin levels; and lymphatic obstruction. Noncardiogenic edema may be the result of either endothelial injury (infections, disseminated intravascular coagulopathy, or trauma) or alveolar injury (from inhaled toxins, aspiration, drowning, or near drowning). Microscopically, pulmonary edema reveals the alveoli to be filled with pale pink fluid. Cardiogenic edema may lead to alveolar hemorrhages and hemosiderin-laden macrophages (heart failure cells). Where cardiogenic edema is present, chest x-rays show an increase in the caliber of the blood vessels in the upper lobes, perivascular and peribronchial fluid ("cuffing"), and Kerley B lines (fluid in the interlobular septa). Absorptive (obstructive) atelectasis results from airway obstruction, such as occurs with mucus, tumors, or foreign bodies. The air within the lungs distal to the obstruction is absorbed, the lung collapses, and the mediastinum then shifts toward the collapsed lung. In contraction, atelectasis fibrosis causes collapse 277 278 Pathology of lung tissue. Patchy atelectasis may result from loss of pulmonary surfactant, which is seen in hyaline membrane disease of the newborn. In the acute edematous stage, the lungs are congested (pulmonary congestion) and show pulmonary edema with interstitial inflammation. In contrast, angioinvasive infiltrates of pleomorphic lymphoid cells are seen with lymphomatoid granulomatosis, a disease of middle-aged individuals that is characterized by an angiocentric and angioinvasive infiltrate of atypical lymphoid cells. Deposits of needle-like crystals from the membranes of eosinophils, called Charcot-Leyden crystals, can be seen in patients with asthma, while infiltrating groups of malignant cells having intercellular bridges characterize squamous cell carcinoma. Plexiform lesions within pulmonary arterioles are diagnostic of pulmonary hypertension. Pulmonary emboli are common and are found in about 10 to 20% of hospital autopsies. Typical settings for the development of deep vein thrombosis include increased venous stasis and hypercoagulable states, such as after surgery. Pulmonary emboli may produce other clinical Respiratory System Answers 279 symptoms, such as anxiety, pleuritic chest pain, dyspnea, fever, cough, hemoptysis, or sudden death. Hypoxemia results from increased A-a gradients, the result of increased alveolar dead space.
Similar signals may initiate sporulation in species capable of this process (see Chapter 12) man health store generic 5 mg fincar mastercard. During the logarithmic (log) or exponential phase prostate cancer 5k pittsburgh discount 5 mg fincar overnight delivery, the bacteria will grow and divide with a doubling time characteristic of the strain and determined by the conditions mens health 12 week workout order fincar 5mg with visa. The number of bacteria will increase to 2n prostate use discount fincar 5mg with mastercard, in which n is the number of generations (doublings) prostate 56 cheap fincar 5 mg without a prescription. The culture eventually runs out of metabolites prostate cancer wiki generic 5mg fincar otc, or a toxic substance builds up in the medium; the bacteria then stop growing and enter the stationary phase, followed by the death phase. During the death phase, some bacteria stop dividing but remain viable and are often insensitive to antibiotics. Bacterial membrane, peptidoglycan synthesis, and cell division are linked together such that inhibition of peptidoglycan synthesis will also inhibit cell division. Commencement of chromosome replication also initiates the process of cell division, which can be visualized by the start of septum formation between the two daughter cells (Figure 13-8; see also Chapter 12). New initiation events may occur even before completion of chromosome replication and cell division. Toxin and protease are produced to kill host cells and supply the colony with food, and the colony produces a biofilm for protection. Cell wall thickness and adhesion factors are less important within the colony and are repressed. Multiple growing forks may be initiated in a cell before complete septum formation and cell division. Most of these mutations have little effect on the bacteria or are detrimental, but some mutations may provide a selective advantage for survival of the bacteria when challenged by the environment, the host, or antibiotic therapy. A single base change can result in a transition in which one purine is replaced by another purine or in which a pyrimidine is replaced by another pyrimidine. A transversion in which, for example, a purine is replaced by a pyrimidine and vice versa may also result. This type of mutation occurs because more than one codon may encode an amino acid. A missense mutation results in a different amino acid being inserted in the protein, but this may be a conservative mutation if the new amino acid has similar properties. Conditional mutations, such as temperature-sensitive mutations, may result from a conservative mutation that changes the structure or function of an important protein at elevated temperatures. A small deletion or insertion that is not in multiples of three produces a frameshift mutation. This results in a change in the reading frame, usually leading to a useless peptide and premature truncation of the protein. Null mutations, which completely destroy gene function, arise when there is an extensive insertion, deletion, or gross rearrangement of the chromosome structure. Replication requires extension of the cell wall and replication of the chromosome and septum formation. Frameshift mutagens, such as polycyclic flat molecules like ethidium bromide or acridine derivatives, insert (or intercalate) between the bases as they stack with each other in the double helix. However, Borrelia burgdorferi, the causative agent of Lyme disease, and the related Borrelia hermsii are unique among all eubacteria because they possess linear genomes and plasmids. Plasmids carry genetic information that may not be essential but can provide a selective advantage to the bacteria. For example, plasmids may encode the production of antibiotic resistance mechanisms, bacteriocins, toxins, virulence determinants, and other genes that may provide the bacteria with a unique growth advantage over other microbes or within the host (Figure 13-10). The number of copies of plasmid produced by a cell is determined by the particular plasmid. Plasmids are small genetic elements that replicate independently of the bacterial chromosome. This plasmid encodes resistance to ampicillin (Amp) and tetracycline (Tet) and an origin of replication (ori). This may be as few as one in the case of large plasmids or as many as 50 in smaller plasmids. Other plasmids can be transferred into a bacterial cell by means other than conjugation, such as transformation or transduction. These extrachromosomal genetic elements can survive outside of a host cell and be transmitted from one cell to another. Bacteriophages infect bacterial cells and either replicate to large numbers and cause the cell to lyse (lytic infection) or, in some cases, integrate into the host genome without killing the host (the lysogenic state), such as the E. Bacteriophage lambda remains lysogenic as long as a repressor protein is synthesized and prevents the phage genome from becoming unintegrated in order to replicate and exit the cell. The simplest transposons are called insertion sequences and range in length from 150 to 1500 base pairs, with inverted repeats of 15 to 40 base pairs at their ends and the minimal genetic information necessary for their own transfer. Complex transposons carry other genes, such as genes that provide resistance against antibiotics. If insertion and inactivation occur in a gene that encodes an essential protein, the cell dies. Some pathogenic bacteria use a transposon-like mechanism to coordinate expression of a system of virulence factors. The genes for the activity may be grouped together in a pathogenicity or virulence island surrounded by transposon-like mobile elements, allowing them to move within the chromosome and to other bacteria. A, the insertion sequences code only for a transposase (tnp) and possess inverted repeats (15 to 40 base pairs) at each end. The central region encodes three genes-a transposase (tnpA), a resolvase (tnpR), and a -lactamase-conferring resistance to ampicillin. A resolution site (Res site) is used during the replicative transposition process. Several of these mechanisms contributed to the generation of vancomycin-resistant Staphylococcus aureus (Figure 13-13 and Box 13-2). Transformation was the first mechanism of genetic transfer to be discovered in bacteria. In 1928, Griffith observed that pneumococcal virulence was related to the presence of a polysaccharide capsule and that extracts of encapsulated bacteria producing smooth colonies could transmit this trait to nonencapsulated bacteria, normally appearing as rough colonies. Conjugation occurs with most, if not all, eubacteria, usually between members of the same or related species, but it has also been demonstrated to occur between prokaryotes and cells from plants, animals, and fungi. The mating type (sex) of the cell depends on the presence (male) or absence (female) of a conjugative plasmid, such as the F plasmid of E. When it transfers into the recipient cell, it carries that fragment with it and converts it into an F male. If the F plasmid sequence is integrated into the bacterial chromosome, the cell is designated an Hfr (high-frequency recombination) cell. Mobilization begins when a plasmid-encoded protein makes a singlestranded site-specific cleavage at the oriT. The nick initiates rolling circle replication, and the displaced linear strand is directed to the recipient cell. Because of the fragile connection between the mating pairs, the transfer is usually aborted before being completed, such that only the chromosomal sequences adjacent to the integrated F are transferred. Artificial interruption of a mating between an Hfr and an F- pair has been helpful in constructing a consistent map of the E. Box 13-2 GenerationofVancomycin-Resistant Staphylococcus aureusbyMultipleGeneticManipulations Until recently, vancomycin was the last-resort drug for Staphylococcus aureus strains resistant to -lactam (penicillin-related) antibiotics. The gene for vancomycin resistance was contained within a transposon (Tn1546) on a multiresistance conjugative plasmid. Generalized transducing particles are valuable in the genetic mapping of bacterial chromosomes. This process usually requires specialized (sometimes site-specific) recombination enzymes, such as those produced by many transposons and lysogenic bacteriophages. The use of genetic engineering and "cloning" has revolutionized biology and medicine. Bacteriophages, such as lambda, are used for larger fragments up to 25 kb, and cosmid vectors have combined some of the advantages of plasmids and phages for fragments up to 45 kb. Restriction enzymes recognize a specific palindromic sequence and make a staggered cut that generates sticky ends or a blunt cut that generates blunt ends (see Table 13-1). Genetic engineering has been used to isolate and express the genes for useful proteins such as insulin, interferon, growth hormones, and interleukin in bacteria, yeast, or even insect cells. Similarly, large amounts of pure immunogen for a vaccine can be prepared without the need to work with the intact disease organisms. The hepatitis B surface antigen is produced by the yeast Saccharomyces cerevisiae. Bibliography Alberts B: Molecular biology of the cell, ed 4, New York, 2002, Garland Science. What products of anaerobic fermentation would be detrimental to host (human) tissue. Which mechanisms may be used by a bacterial cell for the exchange of genetic material? Discuss the applications of molecular biotechnology to medicine, including contributions and uses in diagnoses. Anaerobic conditions: Glycolysis occurs in a process called fermentation without respiration. Repression: A repressor protein binds to the promoter sequence and prevents the polymerase from binding. For the lac operon, the repressor prevents expression of the gene unless lactose is present. Attenuation: Translation of a protein can regulate the transcription of the gene because there is no nuclear membrane to separate these processes. These genes have been cloned into plasmids and expressed in large quantities to produce these proteins as drugs. Expression of the gene and its protein in the vaccinated person will lead to the development of an immune response. Bacteria have traits that enable them to enter (invade) the environment, remain in a niche (adhere or colonize), gain access to food sources (degradative enzymes), sequester ions. When sufficient numbers of bacteria are present (quorum), they turn on functions to support the colony, including production of a biofilm. Unfortunately, many of the mechanisms bacteria use to maintain their niche and the byproducts of bacterial growth. Many of these traits are virulence factors that enhance the ability of bacteria to cause disease. Although many bacteria cause disease by directly destroying tissue, some release toxins, which are then disseminated by the blood to cause systemwide pathogenesis (Box 14-1). Production of disease results from the combination of damage caused by the bacteria and the consequences of the innate and immune (inflammation) responses to the infection (Box 14-2). Not all bacteria or bacterial infections cause disease; however, some always cause disease. The human body is colonized with numerous microbes (normal flora), many of which serve important functions for their hosts. The composition of the normal flora can be disrupted by antibiotic treatment, diet, stress, and changes in the host response to the flora. An altered normal flora can lead to inappropriate immune responses, causing inflammatory bowel diseases. Normal flora bacteria cause disease if they enter normally sterile sites of the body. Opportunistic bacteria take advantage of preexisting conditions, such as immunosuppression, to grow and cause serious disease. Disease results from the damage or loss of tissue or organ function due to the infection or the host inflammatory responses. The signs and symptoms of a disease are determined by the change to the affected tissue. Systemic responses are produced by toxins and the cytokines produced in response to the infection. The seriousness of the disease depends on the importance of the affected organ and the extent of the damage caused by the infection. The bacterial strain and inoculum size are also major factors in determining whether disease occurs; however, the threshold for disease production is different for different bacteria. For example, although a million or more Salmonella organisms are necessary for gastroenteritis to become established in a healthy person, only a few thousand organisms are necessary in a person whose gastric pH has been neutralized with antacids or other means. The longer a bacterium remains in the body, the greater its numbers, its ability to spread, and its potential to cause tissue damage and disease, and the larger the host response. Many of the virulence factors consist of complex structures or activities that are only expressed under special conditions (see Figure 13-6). The components for these structures are often encoded together in a pathogenicity island. Pathogenicity islands are large genetic regions in the chromosome or on plasmids that contain sets of genes encoding numerous virulence factors that may require coordinated expression. A pathogenicity island is usually within a transposon and can be transferred as a unit to different sites within a chromosome or to other bacteria. Disease is caused by damage produced by the bacteria plus the consequencesofinnateandimmuneresponsestotheinfection. Thelengthoftheincubationperiodisthetimerequiredforthebacteria and/or the host response to cause sufficient damage to initiate discomfortorinterferewithessentialfunctions.
Syndromes
Study shows dissociation between objective and subjective responses to homoeopathy in allergic rhinitis prostate cancer younger men discount fincar 5mg visa. Effects of homeopathic medications Eupatorium perfoliatum and Arsenicum album on parasitemia of Plas-modium berghei-infected mice man health check purchase fincar 5mg without prescription. Liu G androgen hormone 0 purchase fincar 5mg mastercard, Zhang D androgen hormone vertigo discount fincar 5mg online, Jiao Y man health online cheap fincar 5 mg on line, Zheng D prostate 64 liquid protein generic fincar 5 mg overnight delivery, Liu Y, Duan C, Jia L, Zhang Q, Lou H: Comparison of different methods for preparation of a stable riccardin D formulation via nanotechnology. Single and repeated dose toxicity of mesoporous hollow silica nanoparticles in intravenously exposed mice. Potential health impact on mice after nasal instillation of nano-sized copper particles and their translocation in mice. Silica nanoparticles as promising drug/gene delivery carriers and fluorescent nano-probes: recent advances. Predictors of complementary and alternative medicine use among older Mexican Americans Complement Ther Clin Pract. A Review of Complementary and Alternative Treatments for Autism Spectrum Disorders Autism Res Treat. Evidence of the differential biotransformation and genotoxicity of ZnO and CeO2 nanoparticles on soybean (Glycine max) plants. Use of alternative therapies by patients presenting to a pediatric emergency department, the Journal of Emergency Medicine, Volume 28, Issue 3, April 2005, Pages 267-271Loudon I. Complementary and Alternative Drugs Use among Preoperative Patients: A CrossSectional Study in Italy Evid Based Complement Alternat Med. Confessions of a researcher: Are we guilty of reviewing homeopathy to the point of irrelevance? Complementary Therapies in Medicine, Volume 15, Issue 3, September 2007, Pages 155-156 Ludtke, R. The conclusions on the effectiveness of homeopathy highly depend on the set of analyzed trials. Rainbow Plasmonic Nanobubbles: Synergistic Activation of Gold Nanoparticle Clusters J Nanomed Nanotechnol. Even if homoeopathy is no better than placebo, could it not form a valuable treatment for illness with a strong psychosomatic component? Effect of Traumeel S, a homeopathic formulation, on blood-induced inflammation in rats. Homoeopathy and scientific rationality, British Homoeopathic journal, Volume 84, Issue 4, October 1995, Pages 203-206 Lynch I (2007) Are there generic mechanisms governing interactions between nanoparticles and cells? An evolutionary stress-response hypothesis for chronic widespread pain (fibromyalgia syndrome). Ulcerative Colitis treated with Homoeopathy British Homoeopathic Journal, July 1993, 82, 179-185. Long-term follow-up of breast cancer survivors with post-mastectomy pain syndrome Br J Cancer. Is metabolic dysregulation associated with antidepressant response in depressed women in climacteric treated with individualized homeopathic medicines or fluoxetine? Complementary Therapies in Nursing and Midwifery, Volume 1, Issue 6, December 1995, Page 178 Mackinnon, E. Effects of homeopathic preparations on human prostate cancer growth in cellular and animal models. European Journal of Integrative Medicine Volume 4, Supplement 1, Page 69, September 2012. Amorphous calcium phosphate is a major component of the forming fin bones of zebrafish: Indications for an amorphous precursor phase. Mapping amorphous calcium phosphate transformation into crystalline mineral from the cell to the bone in zebrafish fin rays. Bone mineralization proceeds through intracellular calcium phosphate loaded vesicles: a cryo-electron microscopy study. The efficacy of homoeopathic simillimum in the treatment of chronic primary insomnia. Dielectric dispersion studies of some potentised homeopathic medicines reveal structured vehicle. Structural Model Explains High Potency Homoeopathic Medicines and Leads to a Generalized Understanding of Medicines Int J Complement Alt Med 2015, 1(2) Mahesh S, Gopal A, Thirumalai R, Ajayaghosh A: Light-induced Ostwald ripening of organic nanodots to rods. Mesoporous Silica Nanoparticles Act as a SelfAdjuvant for Ovalbumin Model Antigen in Mice. The effect of homeopathic treatment in controlling aggressiveness in patients with cerebral palsy. Calcium phosphate nanoparticles: second-generation nonviral vectors in gene therapy. Use of homeopathic preparations in experimental studies with healthy plants, Homeopathy, Volume 98, Issue 4, October 2009, Pages 228-243 Majewsky V, Scherr C et al. Reproducibility of effects of homeopathically potentised gibberellic acid on the growth of Lemna gibba L. A Novel Technique for Name Identification from Homeopathy Diagnosis Discussion Forum Procedia Technology, Volume 6, 2012, Pages 379-386 Makich, L. Influence of very low doses of mediators on fungal laccase activity-nonlinearity beyond imagination. Malarczyk E, Pazdzioch-Czochra M, et al: Nonlinear changes in the activity of the oxygen-dependent demethylase system in Rhodococcus erythropolis cells in the presence of low and very low doses of formaldehyde. Ameliorating effect of microdoses of a potentized homeopathic drug, Arsenicum Album, on arsenic-induced toxicity in mice. Training nurses working in the Ontario Canadian Health Care System: homeopathy and homotoxicology, British Homoeopathic journal, Volume 89, Supplement 1, July 2000, Page S69 Malloy, A. A randomised, double blind, placebo-controlled, multi-centric parallel arm trial to assess the effects of homeopathic medicines on chronic rhinosinusitis. Complementary and Alternative Medicine Use among Cancer Survivors: a PopulationBased Study J Cancer Surviv. Veterinary homeopathy, health and ethics in the prison island of Gorgona (Tuscany, Italy) European Journal of Integrative Medicine, Volume 4, Supplement 1, September 2012,Pages 164-165 Marcus, D. Poetry and homeopathy: an exploration Homeopathy, Volume 95, Issue 1, January 2006, Pages 2027 *Curated by Iris Bell M. Anthroposophical injectable Arnica montana extract in acute low back pain: A prospective study. Non-linear effects of cycloheximide in glutamate-treated cultured rat cerebellar neurons. Transcriptome Profiling of Wheat Seedlings following Treatment with Ultrahigh Diluted Arsenic Trioxide. Marschollek B, Nelle M, et al; Effects of exposure to physical factors on homeopathic preparations as determined by ultraviolet light spectroscopy. Hydrodynamic Properties of Magnetic Nanoparticles with Tunable Shape Anisotropy: Prediction and Experimental Verification. Of nanobacteria, nanoparticles, biofilms and their role in health and disease: facts, fancy and future. Comprehensive proteomic analysis of mineral nanoparticles derived from human body fluids and analyzed by liquid chromatography-tandem mass spectrometry. Critical evaluation of gamma-irradiated serum used as feeder in the culture and demonstration of putative nanobacteria and calcifying nanoparticles. Arnica montana Stimulates Extracellular Matrix Gene Expression in a Macrophage Cell Line Differentiated to Wound-Healing Phenotype. Masiello, D and Loike, J Homeopathic Treatment of Infertility: A Medical and Bioethical Perspective MedCrave, Volume 5, Issue 5 2017 Mason S, Tovey P, et al. Cross-sectional survey: Risk-averse French general practitioners are more favorable toward influenza vaccination, Vaccine, Volume 33, Issue 5, 29 January 2015, Pages 610-614 Masson, J. Self-Reported Use of Complementary and Alternative Medicine among the Health Care Consumers at a Tertiary Care Center in Ajman, United Arab Emirates Ann Med Health Sci *Curated by Iris Bell M. Clinical outcomes research: contributions to the evidence base for homeopathy, Homeopathy, Volume 92, Issue 1, January 2003, Pages 56-57 Mathie, R. Homeopathic prescribing for chronic conditions in feline and canine veterinary practice, Homeopathy, Volume 99, Issue 4, October 2010, Pages 243-248 Mathie, R. Veterinary homeopathy: meta-analysis of randomised placebo-controlled trials Homeopathy January 2015 Volume104, Issue 1, Pages 3-8. Clausen "Veterinary homeopathy: systematic review of medical conditions studied by randomised placebo-controlled trials. Outcomes from homeopathic prescribing in dental practice: a prospective, researchtargeted, pilot study, Homeopathy, Volume 96, Issue 2, April 2007, Pages 74-81 Mathie R, Fisher P. Homeopathic Oscillococcinum for preventing and treating influenza and influenza-like illness (Review) Cochrane Database Syst Rev. Homeopathy is safe and does not lack positive evidence in clinical trials Br J Clin Pharmacol. Randomised controlled trials of homeopathy in humans: characterising the research journal literature for systematic review Homeopathy Jan 2013; 102(1): 3-24. Outcomes from homeopathic prescribing in veterinary practice: a prospective, research-targeted, pilot study. Outcomes from homeopathic prescribing in dental practice: a prospective, researchtargeted, pilot study. Homeopathic treatment of patients with influenza-like illness during the 2009 A/H1N1 influenza pandemic in India. Complementary and Alternative Approaches to Biomedicine Evid Based Complement Alternat Med. Drug Nanoparticles by Antisolvent Precipitation: Mixing Energy versus Surfactant Stabilization. Viewpoint: mechanisms of action and therapeutic potential of neurohormetic phytochemicals. The effect of a homoepathic preparation on the clinical condition of patients with corticosteroid dependant bronchial asthma. Wheat growth (7 days) and extremely diluted gibberellic acid (10e-30): Repetitive experiments on a fundamental homoeopathy research model, European Journal of Integrative Medicine, Volume 2, Issue 4, December 2010, Page 245 Maxion-Bergemann, S. Hormesis pervasiveness and its potential implications for pharmaceutical research and development. Understanding Patient Preference for Integrative Medical Care: Results from Patient Focus Groups J Gen Intern Med. Survey of paediatric complementary and alternative medicine use in health and chronic illness Arch Dis Child. An overview of two Cochrane systematic reviews of complementary treatments for chronic asthma: acupuncture and homeopathy Respiratory Medicine, Volume 98, Issue 8, August 2004, Pages 687-696 McCrae, W. Treatment of anxiety with a homoeopathic remedy Journal of Applied Nutrition, 1996, 48, 1& 2, 2-6. Determination of the true size of poly(vinyl chloride) latices by electron microscopy using a vertical shadowing technique. Fostering a Healing Presence and Investigating Its Mediators J Altern Complement Med. Interacting mediators of allostasis and allostatic load: towards an understanding of resilience in aging. The ever-changing brain: cellular and molecular mechanisms for the effects of stressful experiences. The Concordant Clinical Homeopathic Repertory, Homeopathy, Volume 104, Issue 1, January 2015, Page 66 McGuigan, M. The importance of the emotional or psychical nature of people in general in the practice of medicine in its widest sense Can Med Assoc J. Usefulness of homoeopathy in essential hypertension: an exploratory interventional trial Homeopathy, Volume 103, Issue 1, January 2014, Page 88 Mehrotra, R. Epigenetic modulation of human breast cancer by metallofullerenol nanoparticles: in vivo treatment and in vitro analysis. Characterization and pharmacokinetics of coenzyme Q10 nanoparticles prepared by a rapid expansion of supercritical solution process. The importance of empathy in the enablement of patients attending the Glasgow Homoeopathic Hospital. Particle Size Measurements: Fundamental, Practice, Quality; Springer Science and Business Media B. Effects of a homeopathic complex on the performance and cortisol levels in Nile tilapia (Oreochromis niloticus) Homeopathy. Homeopathy Medical Clinics of North America, Volume 86, Issue 1, January 2002, Pages 47-62 Merrills J, Fisher J. Prospective, non-randomised, open-label study of homeopathic Zingiber officinale (ginger) in the treatment of acne vulgaris Focus on Alternative and Complementary Therapies Volume 19 Issue 4, December, 2014 pages 191-197 *Curated by Iris Bell M. Teaching Residents About Complementary and Alternative Medicine in the United States J Gen Intern Med. Homoeopathic Treatment of Alcohol Withdrawal British Homoeopathic Journal, October 1993, 82, 249-251.
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