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Physical agents these include trauma heart attack demi lovato lyrics cheap 40mg sotalol with mastercard, radiation blood pressure chart what is high generic 40mg sotalol with mastercard, extremes of temperature blood pressure medication options sotalol 40mg lowest price, and electric power. Chemicals With the use of an ever-increasing number of chemical agents such as drugs, in industrial processes, and at home, chemically induced injury has become very common. Their effects vary: · · Some act in a general manner, for example cyanide is toxic to all cells. Others act locally at the site of application, for example strong acids and caustics. Many toxic chemicals are metabolized in liver and excreted in kidney, as a result, these organs are susceptible to chemical injury. Nutritional deficiencies and excesses Nutritional deficiencies may arise as a result of poor supply, interference with absorption, inefficient transport within the body, or defective utilization. It may take the form of deficiency either of major classes of food, usually protein and energy, or vitamins or elements essential for specific metabolic processes. On the other hand, dietary excess plays an important role in diseases in Western countries. Obesity has become increasingly common, with its attendant dangers of type 2 diabetes, high blood pressure and heart disease. Infections and infestations Viruses, bacteria, fungi, protozoa, and metazoa all cause diseases. They may do so by causing cell destruction directly as in virus infections (for example poliomyelitis) or protozoal infections (for example malaria). However, in others the damage is done by toxins elaborated by the infecting agent as in diphtheria and tetanus. Like chemicals, they may have a general effect or they may show a predilection for certain tissues. Immunological factors the immune process is essential for protection against micro-organisms and parasites. For example, bronchial asthma can occur due to exaggerated immune response to the harmless pollen. Immunodeficiency this is due to deficiency of a component of the immune system which leads to increased susceptibility to different diseases. Autoimmunity this is an abnormal (exaggerated) immune reaction against the self antigens of the host. For example, type 1 diabetes mellitus is caused by autoimmune destruction of the beta cells of the islets of Langerhans of the pancreas. Psychogenic factors the mental stresses imposed by conditions of life, particularly in technologically advanced communities, are probably contributory factors in some groups of diseases. Genetic Factors these are hereditary factors that are inherited genetically from parents. Course of disease the course of disease is shown with a simplified diagram as follows. Exposure Biological onset Clinical onset Permanent damage Death Latency period the course of a disease in the absence of any intervention is called the natural history of the disease. The different stages in the natural history of disease include: a) Exposure to various risk factors (causative agents) b) Latency, period between exposure and biological onset of disease c) Biological onset of disease; this marks the initiation of the disease process, however, without any sign or symptom. Following biological onset of disease, it may remain asymptomatic or subclinical. The expression of the disease may be variable in severity or in terms of range of manifestations. Outcome and consequences of disease Following clinical onset, disease may follow any of the following trends: a) Resolution can occur leaving no sequelae, b) the disease can settle down, but sequelae are left, or c) It may result in death. Clinical & biologic death Clinical death Clinical death is the reversible transmission between life and biologic death. Clinical death is defined as the period of respiratory, circulatory and brain arrest during which initiation of resuscitation can lead to recovery. Clinical death begins with either the last agonal inhalation or the last cardiac contraction. Signs indicating clinical death are · · · the patient is without pulse or blood pressure and is completely unresponsive to the most painful stimulus. The pupils are widely dilated Some reflex reactions to external stimulation are preserved. For example, during intubations, respiration may be restored in response to stimulation of the receptors of the superior laryngeal nerve, the nucleus of which is located in the medulla oblongata near the respiratory center. It manifests with irreversible cessation of circulatory and respiratory functions, or irreversible cessation of all functions of the entire brain, including brain stem. However, one should notice that there are internationally accepted criteria to diagnose biological death. Farber, Essential Pathology, Philadelphia, 1990 William Boyd; Textbook of Pathology, structure and Function in disease, Philadelphia, 8th edition, 1987 3. S Israel; General Pathology, Churchill Livingston Edinburgh and London, 4th edition, 1974 5. Macfarlane, Reid, callander, Illustrated Pathology, Churchill Livingstone, 5th edition, 2000. Define hyperplasia, hypertrophy, atrophy, & Metaplasia & list some of their causes. Which of these outcomes occur depends on both the injurious agent & on cellular factors. In other words, the result depends on the type, severity, & duration of the injury & on the type of the cell. This chapter covers the types of cellular adaptation, reversible cell injury, & cell death in that order. Types of cellular adaptation the types of cellular adaptation include hypertrophy, atrophy, hyperplasia, & metaplasia. Increased workload leads to increased protein synthesis & increased size & number of intracellular organelles which, in turn, leads to increased cell size. Examples: the enlargement of the left ventricle in hypertensive heart disease & the increase in skeletal muscle during sternous exercise. It can be physiological as in enlargement of the breast during pregnancy or it can pathological as in endometrial hyperplasia. The atrophic cell shows autophagic vacuoles which contain cellular debris from degraded organelles. Metaplasia Metaplasia is the replacement of one differentiated tissue by another differentiated tissue. Squamous metaplasia this is replacement of another type of epithelium by squamous epithelium. For example, the columnar epithelium of the bronchus can be replaced by squamous epithelium in cigarette smokers 2. Osseous metaplasia this replacement of a connective tissue by bone, for example at sites of injury. Reversible cellular changes & accumulations Even though there are many different kinds of reversible cellular changes & accumulations, here we will only mention fatty change & accumulation of pigments. Fatty liver may be caused by alcohol, diabetes mellitus, malnutrition, obesity, & poisonings.
- Coughing or shortness of breath if the cancer affects the thymus gland or lymph nodes in the chest, putting pressure on the windpipe (trachea) or other airways
- Medicines that block platelet formation
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- Autoimmune diseases, like rheumatoid arthritis and sarcoidosis
- Long-term use of a Foley catheter
- Step reflex (stepping motions when sole of foot touches hard surface).
- How closely they follow a protein-restricted diet
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For the first time heart attack enzyme test buy sotalol 40mg without prescription, therefore blood pressure quick fix purchase sotalol 40mg online, it is possible to prehypertension at 20 buy sotalol uk begin to look at all aspects of plant biology on a global scale. This includes aspects that are of particular interest in agriculture, such as growth and development, tolerance or resistance to stress and disease, and metabolic activity. Traditionally, there have been two approaches to improving the quality of cultivated plants. The first is by conventional breeding, which involves exploiting varietal or specific differences and using crosses and tissue-culture-based techniques to concentrate favourable traits in particular plant lines. One problem with this approach is that many of the most valued traits in agriculture disease resistance, stress resistance, increased yield etc. The alternative is genetic engineering, because single genes from other species can often confer desirable traits on plants. Although this approach to agricultural improvement is comparatively rapid, the behaviour of the transgenes is unpredictable and there is much public concern about the long-term effects of such plants on health and the environment. The technology and application of genetic engineering in plants is discussed in detail in our sister text, Principles of Gene Manipulation (Primrose et al. Some of the issues of public concern over the use of transgenic plants and food products derived therefrom have been discussed (Firn & Jones 1999; Malik & Saroha 1999; Smith et al. Genomic resources now provide an additional route to the improvement of plants, through the rapid identification of genes and pathways controlling important plant traits. This brings tremendous advantages to agriculture because it provides a holistic view of plant development and how plants respond to abiotic and biotic stresses in the environment, and thus allows the functional annotation and exploitation of desirable genes (Richmond & Somerville 2000; Schaffer et al. Global expression profiling in agriculture Initial studies of global gene expression in plants were small in scale. Interestingly, the first plant microarray experiment with direct agricultural implications involved not Arabidopsis but strawberry, where 200 genes were shown to undergo changes in expression during ripening (Lemieux et al. Over the last 2 years, an increasing number of expression profiling experiments have been carried out to investigate gene expression changes associated with traits of agricultural value. Large-scale microarray-based screening projects have been undertaken to identify drought stress-related genes in Arabidopsis, rice and M. Microarrays have also been used to study the response of the plant to biotic stresses. They found that over 700 transcripts showed significantly increased or reduced expression levels, some of which were specific to particular treatments. These data suggested that there was considerable cross-talk between different defence signalling pathways. The phenomenon of cross-talk may represent a problem when devising strategies to combat disease, because artificially modifying the response to one stimulus could alter the response to several others in an undesirable way. However, as well as identifying common themes in transcriptional profiles, microarray analysis can also separate individual responses. They found that mechanical wounding induced a number of genes also known to be involved in the response to water stress, while such genes were only minimally affected by insect feeding. Thus, strategies to counteract the effects of insect feeding could be targeted to a specific subset of genes so as not to interfere with water stress tolerance. As well as local defence responses, the transcriptional changes accompanying systemic acquired resistance have also been monitored at the global level in Arabidopsis (Maleck et al. The technique has also been used to characterize proteins that are involved in stress response pathways. Such differences have allowed unambiguous genotyping in many plant species, including rice (Abe et al. Secondly presence/absence polymorphisms (P/A), where a protein is present in one sample but absent in another. The first two types of polymorphism are generally Mendelian characters and represent useful genetic markers (de Vienne et al. Theme 6: Developmental genomics Introduction to theme 6 Developmental biology is the area of research which seeks to determine the molecular and cellular mechanisms involved in the coordination of growth, cell division, cell differentiation, pattern formation and morphogenesis, i. An understanding of development is becoming increasingly important in fields such as medicine, biotechnology and agriculture. Many human diseases can be traced back to faults in development, and gene products expressed in development could represent valuable therapeutic agents or potential drug targets. In agriculture, it is clear that many valuable traits are essentially developmental phenotypes. For example, grain yield in cereal plants is a consequence of seed endosperm development, and meat quality in cows, pigs, sheep and chickens is related to muscle development. First, an important theme in developmental biology is the study of gene expression patterns. In particular, the comparison of expression patterns in normal development and when the process is perturbed, either experimentally or by mutation, can be very informative as this can lead to the elucidation of regulatory hierarchies and signalling pathways. As in other fields, developmental gene expression has traditionally been investigated on a gene-by-gene basis but the advent of high-throughput expression profiling now allows the analysis of large numbers of genes simultaneously. Secondly, developmental biology has traditionally relied heavily on the study of mutants, and large-scale mutagenesis screens have had a critical role in the elucidation of developmental processes (Jurgens et al. Comprehensive mutagenesis projects are now in progress for a number of species (Chapter 10), which should facilitate the production of a full catalogue of developmental mutants. Thirdly, one of the most remarkable discoveries to come from the study of development is the close conservation in developmental gene function across diverse species. This, together with the availability of complete genome sequences for a number of lower eukaryotes, means that model organisms can be used as a valuable resource for functionally annotating the human genome and testing the effects of drugs. Benefits of global expression profiling in development Transcriptional profiling using microarrays and direct sequence sampling are being used increasingly to study changes in gene expression during development. The advantage of such multiplex analysis is that catalogues of differentially expressed genes can be identified in one series of ·· 226 Chapter 12 experiments. This can lead to the rapid elucidation of regulatory pathways, hierarchies and networks, and can also help to functionally annotate anonymous genes on the basis of co-expression or co-regulation. This is particularly the case in the study of mammalian development where it is difficult to obtain large numbers of embryos. Despite these difficulties, expression profiling remains an extremely valuable tool in developmental biology. One application is the elucidation of regulatory networks by identifying genes lying downstream of a particular master regulator. This can be achieved by comparing the transcriptional profiles of normal embryos with those in which the master regulator gene is either knocked out (loss of function mutation) or overexpressed (gain of function mutation). Another application of global expression profiling is the characterization of groups of functionally related genes. A frustrating phenomenon often seen in vertebrate development is genetic redundancy, where one gene compensates fully or partially for the function of another, so that gene knockout strategies do not reveal an informative phenotype. The myoD gene, when expressed in transfected fibroblasts, causes differentiation into muscle cells. However, myoD knockout mice showed no phenotype, indicating that myoD is not necessary for the development of a viable animal (Rudnicki et al. The basis of this result is that loss of myoD results in upregulation of a related gene, myf-5, which is sufficient for normal muscle development.
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Insulin sensitivity in women at risk of coronary heart disease and the effect of a low glycemic diet blood pressure natural remedy cheap sotalol 40mg online. Effect of insulin administration on cardiac glycogen synthase and synthase phosphatase activity in rats fed diets high in protein heart attack history sotalol 40 mg visa, fat or carbohydrate arteria 7ch sotalol 40 mg low cost. The effect of fat and carbohydrate on plasma glucose, insulin, C-peptide, and triglycerides in normal male subjects. Consumption and sources of sugars in the diets of British schoolchildren: Are high-sugar diets nutritionally inferior? Comparison of the effects of preexercise feeding of glucose, glycerol and placebo on endurance and fuel homeostasis in man. Longitudinal assessment of energy expenditure in pregnancy by the doubly labeled water method. Differential effect of protein and fat ingestion on blood glucose responses to high- and low-glycemic-index carbohydrates in noninsulin-dependent diabetic subjects. Effects of glucose and fructose solutions on food intake and gastric emptying in nonobese women. Hyperinsulinemia, upper body adiposity, and cardiovascular risk factors in non-diabetics. Blood lipid distribution of hyperinsulinemic men consuming three levels of fructose. Correlation between ketone body and free fatty acid concentrations in the plasma during early starvation in man. Triglyceride integrated concentrations: Effect of variation of source and amount of dietary carbohydrate. Longitudinal study of caries, cariogenic bacteria and diet in children just before and after starting school. Increased insulin responses to ingested foods are associated with lessened satiety. An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods. The influence of food structure on postprandial metabolism in patients with non-insulin-dependent diabetes mellitus. Improved glycemic control and lipid profile and normalized fibrinolytic activity on a low-glycemic index diet in type 2 diabetic patients. Fiber and physiological and potentially therapeutic effects of slowing carbohydrate absorption. Obesity, body fat distribution, insulin sensitivity and islet `-cell function as explanations for metabolic diversity. Role of glucose in the regulation of endogenous glucose production in the human newborn. Consumption of energy-dense, nutrient-poor foods by adult Americans: Nutritional and health implications. Effect of fructose, glucose, sucrose and starch on serum lipids in carbohydrate induced hypertriglyceridemia and in normal subjects. An adaptation of the nitrous oxide method to the study of the cerebral circulation in children: Normal values for cerebral blood flow and cerebral metabolic rate in childhood. Types of carbohydrate in an ordinary diet affect insulin action and muscle substrates in humans. Two phases of adipose tissue metabolism in pregnancy: Maternal adaptations for fetal growth. The effect of protein ingestion on the metabolic response to oral glucose in normal individuals. Comparison of predictive capabilities of diabetic exchange lists and glycemic index of foods. Effect of the glycemic index and content of indigestible carbohydrates of cereal-based breakfast meals on glucose tolerance at lunch in healthy subjects. Dietary glycemic load assessed by food-frequency questionnaire in relation to plasma high-density-lipoprotein cholesterol and fasting plasma triacylglycerols in postmenopausal women. Relation between consumption of sugar-sweetened drinks and childhood obesity: A prospective, observational analysis. Effects of isocaloric exchange of dietary sucrose and starch on fasting serum lipids, postprandial insulin secretion and alimentary lipaemia in human subjects. Effects on serum lipids of different dietary fats associated with a high sucrose diet. Role of glucose and insulin resistance in development of type 2 diabetes mellitus: Results of a 25-year follow-up study. Dietary compensation by humans for supplemental energy provided as ethanol or carbohydrate in fluids. Plasma insulin response to oral carbohydrate in patients with glucose and lactose malabsorption. Food items and food groups as risk factors in a case-control study of diet and colorectal cancer. Physical exercise as a modulator of adaptation to low and high carbohydrate and low and high fat intakes. Nutritional quality of a high carbohydrate diet as consumed by children: the Bogalusa Heart Study. Effect of protein ingestion on the glucose and insulin response to a standardized oral glucose load. Protein, fat, and carbohydrate requirements during starvation: Anaplerosis and cataplerosis. Carbohydrate-induced hypertriacylglycerolemia: Historical perspective and review of biological mechanisms. Glycerol metabolism and triglyceride-fatty acid cycling in the human newborn: Effect of maternal diabetes and intrauterine growth retardation. The metabolism of ketone bodies in developing human brain: Development of ketone-body-utilizing enzymes and ketone bodies as precursors for lipid synthesis. Diurnal profiles of plasma glucose, insulin, free fatty acids, triglycerides, cholesterol, and individual amino acids in late normal pregnancy. A tracer investigation of obligatory oxidative amino acid losses in healthy, young adults. Effect of a high sugar intake on some metabolic and regulatory indicators in young men. Effect on fasting blood insulin, glucose, and glucagon and on insulin and glucose response to a sucrose load. Blood lipids, lipoproteins, apoproteins, and uric acid in men fed diets containing fructose or high-amylose cornstarch.
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Whiting holds membership in several other professional organizations as well arteria rectal superior discount 40 mg sotalol with mastercard, including Dietitians of Canada and the American Society for Bone and Mineral Research blood pressure up and down discount sotalol 40mg with visa. She served as a reviewer of the Dietary Reference Intakes for Calcium arrhythmia life threatening buy sotalol 40 mg line, Phosphorus, Magnesium, Vitamin D, and Fluoride report and as a member of the Committee on the Use of Dietary Reference Intakes in Nutrition Labeling. She is a former faculty member at the Tufts University Friedman School of Nutrition Science and Policy, where she taught a writing course for graduate students in nutrition and medicine. Prior to serving as study director for this project, she worked for over seven years at the Institute of Medicine as communications director, communications officer, and communications specialist. Otten was an assistant account executive in the food and nutrition division of Porter Novelli. Otten is a member of the American Dietetic Association, Dietitians in Business and Communications, and the Society for Behavioral Medicine. She has also served as the deputy director and a senior program officer for the Board. She provides editorial services for clients who publish in the fields of science, medicine, and technology, including the New England Journal of Medicine. Prior to beginning her freelance career, she served as developmental editor at the National Academies Press, where her focus was on creating print- and Web-based publications that communicated the findings and recommendations of National Academies reports to the broader public. While at the Academies, she received a distinguished service award for creating and distributing more than 400,000 copies of a studies-based booklet and poster on childhood development aimed at child-care professionals. Kalamaras served as senior editor at Discovery Channel Publishing, where she developed and managed book projects covering topics in science, technology, history, and travel. Kalamaras began her publishing career in New York City, as an editor at Stewart, Tabori & Chang, an award-winning publisher of nonfiction illustrated books. Included as well are discussions of methodological problems in assessing requirements and estimating intakes from dietary survey data. Observational studies include single-case and case-series reports and crosssectional, cohort, and case-control studies. Experimental studies include randomized and nonrandomized prevention trials and controlled doseresponse, balance, turnover, and depletionrepletion physiological studies. In addition, dose levels and routes of administration that are practical in animal experiments may differ greatly from those relevant to humans. Much of the understanding of human nutrient requirements to prevent deficiencies is based on studies of this type. Studies in which the subjects are confined allow for close control of both intake and activities. Complete collections of nutrient losses through urine and feces are possible, as are recurring sampling of biological materials such as blood. Depletionrepletion studies, by contrast, measure nutrient status while subjects are maintained on diets containing marginally low or deficient levels of a nutrient; then the deficit is corrected with measured amounts of that nutrient. Typically they are limited in time to a few days or weeks, and so longer-term outcomes cannot be measured with the same level of accuracy. In addition, subjects may be confined, and findings are therefore not always generalizable to free-living individuals. Finally, the time and expense involved in such studies usually limit the number of subjects and the number of doses or intake levels that can be tested. In spite of these limitations, feeding studies play an important role in understanding nutrient needs and metabolism. Hence they are useful in establishing evidence of an association between the consumption of a nutrient and disease risk but are limited in their ability to ascribe a causal relationship. A judgment of causality may be supported by a consistency of association among studies in diverse populations, and it may be strengthened by the use of laboratory-based tools to measure exposures and confounding factors, such as personal interviews, rather than other means of data collection. In recent years, rapid advances in laboratory technology have made possible the increased use of biomarkers of exposure, susceptibility, and disease outcome in molecular epidemiological research. For example, one area of great potential in advancing current knowledge of the effects of diet on health is the study of genetic markers of disease susceptibility (especially polymorphisms in genes encoding metabolizing enzymes) in relation to dietary exposures. This development is expected to provide more accurate assessments of the risk associated with different levels of intake of both nutrients and nonnutritive food constituents. While analytic epidemiological studies (studies that relate exposure to disease outcomes in individuals) have provided convincing evidence of an associative relationship between selected nondietary exposures and disease risk, there Copyright © National Academy of Sciences. First, the variation in nutrient intake may be rather limited in populations selected for study. This feature alone may yield modest relative risk trends across intake categories in the population, even if the nutrient is an important factor in explaining large disease rate variations among populations. Third, many cohort and casecontrol studies have relied on self-reports of diet, typically food records, 24hour recalls, or diet history questionnaires. Repeated application of such instruments to the same individuals shows considerable variation in nutrient consumption estimates from one time period to another with correlations often in the 0. In addition, there may be systematic bias in nutrient consumption estimates from self-reports as the reporting of food intakes and portion sizes may depend on individual characteristics such as body mass, ethnicity, and age. For example, total energy consumption may tend to be substantially underreported (30 to 50 percent) among obese persons, with little or no underreporting among lean persons. Such systematic bias, in conjunction with random measurement error and limited intake range, has the potential to greatly impact analytic epidemiological studies based on self-reported dietary habits. Note that cohort studies using objective (biomarker) measures of nutrient intake may have an important advantage in the avoidance of systematic bias, though important sources of bias. The unique strength of randomized trials is that if the sample is large enough, the study groups will be similar with respect not only to those confounding variables known to the investigators, but also to any unknown factors that might be related to risk of the disease. Thus, randomized trials achieve a degree of control of confounding that is simply not possible with any observational design strategy, and thus they allow for the testing of small effects that are beyond the ability of observational studies to detect reliably. Although randomized controlled trials represent the accepted standard for studies of nutrient consumption in relation to human health, they too possess important limitations. Specifically, persons agreeing to be part of a randomized trial may be a select subset of the population of interest, thus limiting the generalization of trial results. For practical reasons, only a small number of nutri- Copyright © National Academy of Sciences. In addition, the follow-up period will typically be short relative to the preceding time period of nutrient consumption that may be relevant to the health outcomes under study, particularly if chronic disease endpoints are sought. Also, dietary intervention or supplementation trials tend to be costly and logistically difficult, and the maintenance of intervention adherence can be a particular challenge. Because of the many complexities in conducting studies among free-living human populations and the attendant potential for bias and confounding, it is the totality of the evidence from both observational and intervention studies, appropriately weighted, that must form the basis for conclusions about causal relationships between particular exposures and disease outcomes. However, studies published in other scientific journals or readily available reports were considered if they appeared to provide important information not documented elsewhere. On the basis of a thorough review of the scientific literature, clinical, functional, and biochemical indicators of nutritional adequacy and excess were evaluated for each nutrient. The characteristics examined included the study design and the representativeness of the study population; the validity, reliability, and precision of the methods used for measuring intake and indicators of adequacy or excess; the control of biases and confounding factors; and the power of the study to demonstrate a given difference or correlation. The assessment acknowledged the inherent reliability of each type of study design as described above, and it applied standard criteria from Hill concerning the strength, doseresponse, and temporal pattern of estimated nutrientdisease or adverse effect associations, the consistency of associations among studies of various types, and the specificity and biological plausibility of the suggested relationships.
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Ordinary physical activity does not cause undue dyspnea or fatigue blood pressure 210 over 110 buy discount sotalol on-line, chest pain or near syncope heart attack now love buy 40 mg sotalol fast delivery. Ordinary physical activity causes undue dyspnea or fatigue arrhythmia or dysrhythmia discount 40 mg sotalol fast delivery, chest pain or near syncope. Less than ordinary activity causes undue dyspnea or fatigue, chest pain or near syncope. Authorization of 24 months may be granted for treatment of moderate to severe plaque psoriasis for members who are 18 years of age or older when all of the following criteria are met: 1. Member has a clinical reason to avoid pharmacologic treatment with methotrexate, cyclosporine or acitretin (see Appendix). Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians; American Thoracic Society, Inc. Tysabri is indicated as monotherapy for the treatment of relapsing forms of multiple sclerosis, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. Pediatric pulmonary hypertension: guidelines from the American Heart Association and American Thoracic Society. Moderately to severely active ulcerative colitis All other indications are considered experimental/investigational and are not a covered benefit. Authorization of 24 months may be granted for treatment of active PsA when all of the following criteria are met: i. Xeloda is indicated as first-line treatment in patients with metastatic colorectal carcinoma when treatment with fluoropyrimidine therapy alone is preferred. Xeloda in combination with docetaxel is indicated for the treatment of patients with metastatic breast cancer after failure of prior anthracycline-containing chemotherapy. Xeloda monotherapy is also indicated for the treatment of patients with metastatic breast cancer resistant to both paclitaxel and an anthracycline-containing chemotherapy regimen or resistant to paclitaxel and for whom further anthracycline therapy is not indicated, for example, patients who have received cumulative doses of 400 mg/m2 of doxorubicin or doxorubicin equivalents. Hepatobiliary cancers (extra-/intra-hepatic cholangiocarcinoma and gallbladder cancer) 9. Ovarian cancer (Epithelial ovarian cancer/fallopian tube cancer/primary peritoneal cancer/mucinous cancer) 11. Neuroendocrine and adrenal tumors All other indications are considered experimental/investigational and are not a covered benefit. Breast Cancer Authorization of 12 months may be granted for the treatment of recurrent or metastatic breast cancer. Neuroendocrine and Adrenal Tumors Authorization of 12 months may be granted for the treatment of neuroendocrine and adrenal tumors. Pancreatic Adenocarcinoma Authorization of 12 months may be granted for the treatment of pancreatic adenocarcinoma. Esophageal and Esophagogastric Junction Cancers Authorization of 12 months may be granted for the treatment of esophageal and esophagogastric junction cancers. Gastric Cancer Authorization of 12 months may be granted for the treatment of gastric cancer. Extrahepatic and Intrahepatic Cholangiocarcinoma and Gallbladder Cancer Authorization of 12 months may be granted for the treatment of extrahepatic and intrahepatic cholangiocarcinoma and gallbladder cancer. Head and Neck Cancer Authorization of 12 months may be granted for the treatment of head and neck cancer. Occult Primary Tumors (cancer of unknown primary) Authorization of 12 months may be granted for the treatment of occult primary tumors. Penile Cancer Authorization of 12 months may be granted for the treatment of penile cancer. Anal Cancer Authorization of 12 months may be granted for the treatment of anal cancer. Hairy cell leukemia Authorization of 12 months may be granted for treatment of hairy cell leukemia. Consensus guidelines for the diagnosis and clinical management of Erdheim-Chester disease. Indicated in combination with prednisone for the treatment of patients with metastatic castration-resistant prostate cancer. Indicated in combination with prednisone for the treatment of patients with metastatic high-risk castrationsensitive prostate cancer. Compendial Uses Node-positive (N1), non-metastatic (M0) prostate cancer All other indications are considered experimental/investigational and not medically necessary. No evidence of disease progression for members who have been receiving Bosulif for > 12 months 3. Coverage for targeted products is provided based on clinical circumstances that would exclude the use of the preferred product and may be based on previous use of a product. The coverage review process will ascertain situations where a clinical exception can be made. This program applies to adult members requesting treatment with a targeted product. For inflammatory joint or bowel disease indications, coverage for the targeted product will continue in situations where the member is currently receiving treatment. Coverage for a targeted product is provided when any of the following criteria is met: A. Member has a documented inadequate response or intolerable adverse event with all of the preferred products (Cosentyx, Enbrel, and Humira) 2. The requested product is Cimzia and member is currently pregnant or breastfeeding B. Member has a documented inadequate response or intolerable adverse event with the primary preferred product (Humira) and with the secondary preferred product (Stelara), unless there is a documented clinical reason to avoid Humira (see Appendix) 2. The requested product is Cimzia and member is currently pregnant or breastfeeding Psoriatic arthritis 1. Member has a documented inadequate response or intolerable adverse event with at least three of the preferred products (Cosentyx, Enbrel, Humira, and Otezla); unless there is a documented clinical reason to avoid Enbrel and Humira (see Appendix) 2. The requested product is Cimzia and member is currently pregnant or breastfeeding Plaque psoriasis 1. Member has a documented inadequate response or intolerable adverse event with all of the preferred products (Humira, Otezla, Skyrizi, Stelara, Taltz); unless there is a documented clinical reason to avoid Humira (see Appendix) 2. The requested product is Cimzia and member is currently pregnant or breastfeeding Rheumatoid arthritis 1. The requested product is Cimzia and member is currently pregnant or breastfeeding Ulcerative colitis 1. Member has had a documented inadequate response or intolerable adverse event with at least one of the preferred products (Humira, Simponi), unless there is a documented clinical reason to avoid Humira and Simponi (see Appendix) 2. In combination with irinotecan in patients who are refractory to irinotecan-based chemotherapy, c.
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Visualization of the two-dimensional gel at different wavelengths enables the intensities of equivalent spots to blood pressure medication kidney stones order 40mg sotalol with amex be judged more easily than is possible when two separate gels are obtained hypertension kidney specialist buy sotalol with amex. These markers can be obtained in two forms heart attack stop pretending purchase 40 mg sotalol with visa, one containing normal hydrogen atoms and the other containing deuterium, the heavy isotope of hydrogen. Instead, proteins interact with one another in biochemical pathways and in multiprotein complexes. Two important techniques, phage display and the yeast two hybrid system, enable these proteinprotein interactions to be examined. Phage display this technique is called phage display because it involves the "display" of proteins on the surface of a bacteriophage, usually M13 (Figure 12. This is achieved by cloning the gene for the protein in a special type of M13 vector, one that results in the cloned gene becoming fused with a gene for a phage coat protein (Figure 12. With luck this hybrid protein will be inserted into the phage coat so that the product of the cloned gene is now located on the surface of the phage particles. Normally this technique is carried out with a phage display library made up of many recombinant phages, each displaying a different protein. The library consists of phages displaying a range of different proteins and is used to identify those that interact with a test protein. This test protein could be a pure protein or one that is itself displayed on a phage surface. The protein is immobilized in the wells of a microtiter tray or on particles that can be used in an affinity chromatography column, and then mixed with the phage display library (Figure 12. Phages that are retained in the microtiter tray or within the column after a series of washes are ones that display proteins that interact with the immobilized test protein. The yeast two hybrid system the yeast two hybrid system is very different to phage display. In the two hybrid system, a pair of transcription factors responsible for expression of a yeast gene is replaced by hybrid proteins, each one made partly of transcription factor and partly of test protein. The ability of this pair of hybrids to direct expression of the yeast target gene is then tested. Chapter 12 Studying Genomes (a) Protein display on the surface of a phage Displayed proteins 221 (b) Fusion between the cloned gene and a coat protein gene Phage gene Cloned gene Gene expression Phage coat protein Displayed protein (c) Using a phage display library Microtiter well Phage display library Retained phage Washes Test protein Figure 12. The first cloning experiment involves the gene whose protein product is being studied. This gene is ligated to the gene for one of the pair of transcription factors and the construct inserted into a yeast vector. The recombinant yeasts that are produced are not able to express the target gene, because this modified transcription factor cannot interact with its partner (Figure 12. In the second cloning experiment, a hybrid version of the partner is made and cloned into the yeast cells. Restoration of expression of the target gene indicates that the two hybrid transcription factors can interact. The fusions are designed in such a way that this can only happen if the interactions occur between the test protein components of the hybrids, not between the transcription factor segments (Figure 12. The second cloning experiment can involve a library of recombinants representing different proteins, so that one protein can be tested against many others. This is not a new subject, although biotechnology has received far more attention during recent years than it ever has in the past. Biotechnology can be defined as the use of biological processes in industry and technology. According to archaeologists, the British biotechnology industry dates back 4000 years, to the late Neolithic period, when fermentation processes that make use of living yeast cells to produce ale and mead were first introduced into this country. During the 20th century, biotechnology expanded with the development of a variety of industrial uses for microorganisms. The discovery by Alexander Fleming in 1929 that the mould Penicillium synthesizes a potent antibacterial agent led to the use of fungi and bacteria in the large-scale production of antibiotics. At first the microorganisms were grown in large culture vessels from which the antibiotic was purified after the cells had been removed (Figure 13. This type of process is not limited to antibiotic production and has also been used to obtain large amounts of other compounds produced by microorganisms (Table 13. One of the reasons why biotechnology has received so much attention during the past three decades is because of gene cloning. Many important pharmaceuticals, which are produced not by microbes but by higher organisms, could not be obtained in this way. The ability to clone genes means that a gene for an important animal or plant protein can now be taken from its normal host, inserted into a cloning vector, and introduced into a bacterium (Figure 13. If the manipulations are performed correctly the gene will be Chapter 13 Production of Protein from Cloned Genes 227 Animal cell Figure 13. Of course, in practice the production of recombinant protein is not as easy as it sounds. Special types of cloning vector are needed, and satisfactory yields of recombinant protein are often difficult to obtain. In this chapter we will look at cloning vectors for recombinant protein synthesis and examine some of the problems associated with their use. This is because expression is dependent on the gene being surrounded by a collection of signals that can be recognized by the bacterium. These signals, which are short sequences of nucleotides, advertise the presence of the gene and provide instructions for the transcriptional and translational apparatus of the cell. A terminator is usually a nucleotide sequence that can base pair with itself to form a stemloop structure. The initiation codon of the gene is always a few nucleotides downstream of this site. The genes of higher organisms are also surrounded by expression signals, but their nucleotide sequences are not the same as the E. A solution to this problem would be to insert the foreign gene into the vector in such a way that it is placed under control of a set of E. If this can be achieved, then the gene should be transcribed and translated (Figure 13. Cloning vectors that provide these signals, and can therefore be used in the production of recombinant protein, are called expression vectors. The amount of recombinant protein obtained therefore depends to a great extent on the nature of the promoter carried by the expression vector. P R T Expression vector Unique restriction site Insert a foreign gene into the unique restriction site P R Foreign gene T Transform E. Strong promoters are those that can sustain a high rate of transcription; strong promoters usually control genes whose translation products are required in large amounts by the cell (Figure 13. In contrast, weak promoters, which are relatively inefficient, direct transcription of genes whose products are needed in only small amounts (Figure 13. Clearly an expression vector should carry a strong promoter, so that the cloned gene is transcribed at the highest possible rate.
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Authorization of 12 months may be granted for treatment of primary arrhythmia center of connecticut purchase cheap sotalol line, recurrent blood pressure under 50 40 mg sotalol otc, or progressive desmoid tumor/aggressive fibromatosis hypertension workup buy sotalol 40 mg on line. Renal Cell Carcinoma Authorization of 12 months may be granted for treatment of advanced renal cell carcinoma. Differentiated Thyroid Carcinoma Authorization of 12 months may be granted for treatment of progressive and/or symptomatic radioiodine refractory papillary, Hьrthle cell, or follicular thyroid carcinoma. Medullary Thyroid Carcinoma Authorization of 12 months may be granted for treatment of medullary thyroid carcinoma when either of the following criteria are met: 1. Member has disease progression while on vandetanib (Caprelsa) or cabozantinib (Cometriq). Authorization of 12 months may be granted for treatment as second-line therapy for relapsed/refractory or metastatic disease as a single agent for the following types of bone cancer: a. Chordoma Authorization of 12 months may be granted for treatment of recurrent chordoma as a single agent. Epithelial Ovarian Cancer/Fallopian Tube Cancer/Primary Peritoneal Cancer Authorization of 12 months may be granted for treatment of epithelial ovarian, fallopian tube, or primary peritoneal cancer if the disease is platinum-resistant and Nexavar is given in combination with topotecan for persistent disease or recurrence. Neoadjuvant chemotherapy with doxorubicin and cisplatin in malignant fibrous histiocytoma of bone: A European Osteosarcoma Intergroup study. Indicated for the symptomatic treatment of patients with metastatic carcinoid tumors where it suppresses or inhibits the severe diarrhea and flushing episodes associated with the disease. Indicated for long-term maintenance therapy in acromegalic patients who have had an inadequate response to surgery and/or radiotherapy, or for whom surgery and/or radiotherapy is not an option. Indicated for long-term treatment of the severe diarrhea and flushing episodes associated with metastatic carcinoid tumors. Meningiomas Authorization of 24 months may be granted to members for treatment of unresectable meningioma. Thymomas and thymic carcinomas Authorization of 24 months may be granted for treatment of thymomas and thymic carcinomas. All other indications Members (including new members) requesting authorization for continuation of therapy must meet all initial authorization criteria. American Association of Clinical Endocrinologists Acromegaly Guidelines Task Force. Usage Considerations: Patients should be placed on an appropriate lipid-lowering diet before receiving Epanova and should continue this diet during treatment with Epanova. Laboratory studies should be done to ascertain that the triglyceride levels are consistently abnormal before instituting Epanova therapy. Limitations of Use the effect of Epanova on the risk for pancreatitis has not been determined. The effect of Epanova on cardiovascular mortality and morbidity has not been determined. Usage Considerations: Patients should be placed on an appropriate lipid-lowering diet before receiving Lovaza and should continue this diet during treatment with Lovaza. Laboratory studies should be done to ascertain that the lipid levels are consistently abnormal before instituting Lovaza therapy. Every attempt should be made to control serum lipids with appropriate diet, exercise, weight loss in obese patients, and control of any medical problems such as diabetes mellitus and hypothyroidism that are contributing to the lipid abnormalities. Medications known to exacerbate hypertriglyceridemia (such as beta blockers, thiazides, estrogens) should be discontinued or changed if possible prior to consideration of triglyceride-lowering drug therapy. Limitations of Use the effect of Lovaza on the risk for pancreatitis has not been determined. The effect of Lovaza on cardiovascular mortality and morbidity has not been determined. Usage Considerations: Patients should be placed on an appropriate lipid-lowering diet and exercise regimen before receiving Vascepa and should continue this diet and exercise regimen with Vascepa. Attempts should be made to control any medical problems such as diabetes mellitus, hypothyroidism, and alcohol intake that may contribute to lipid abnormalities. Limitations of Use the effect of Vascepa on the risk for pancreatitis in patients with severe hypertriglyceridemia has not been determined. The effect of Vascepa on cardiovascular mortality and morbidity in patients with severe hypertriglyceridemia has not been determined. Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Extranodal natural killer/T-cell lymphoma, nasal type: as a component of multi-agent chemotherapeutic regimen 2. Extranodal Natural Killer/T-cell Lymphoma, nasal type Authorization of 12 months may be granted for the treatment of extranodal natural killer/T-cell lymphoma, nasal type when the requested medication is used in conjunction with multi-agent chemotherapy. Moderately to severely active polyarticular juvenile idiopathic arthritis in patients 2 years of age orolder 3. Active psoriatic arthritis in adults All other indications are considered experimental/investigational and are not a covered benefit. Member has experienced an inadequate response to at least a 3-month trial ofmethotrexate despite adequate dosing. Authorization of 24 months may be granted for members who have previously received Orencia or Actemra. Authorization of 24 months may be granted for treatment of moderate to severe plaque psoriasis when all of the following criteria are met: 1. Appendix A: Examples of Clinical Reasons to Avoid Pharmacologic Treatment with Methotrexate, Cyclosporine or Acitretin. Group for research and assessment of psoriasis and psoriatic arthritis 2015 treatment recommendation for psoriatic arthritis. Psoriasis Otrexup is indicated in adults for the symptomatic control of severe, recalcitrant, disabling psoriasis that is not adequately responsive to other forms of therapy, but only when the diagnosis has been established, as by biopsy and/or after dermatologic consultation. Compendial Uses Myeloproliferative neoplasm (essential thrombocythemia, polycythemia vera, primary myelofibrosis and post-polycythemia vera or post-essential thrombocythemia myelofibrosis) All other indications are considered experimental/investigational and are not a covered benefit. Myeloproliferative neoplasm Authorization of 12 months may be granted for the treatment of myeloproliferative neoplasm (essential thrombocythemia, polycythemia vera, primary myelofibrosis and post-polycythemia vera or post-essential thrombocythemia myelofibrosis). It is indicated in all patients with neonatal-onset deficiency (complete enzymatic deficiency, presenting within the first 28 days of life). It is also indicated in patients with late-onset disease (partial enzymatic deficiency, presenting after the first month of life) who have a history of hyperammonemic encephalopathy. It is important that the diagnosis be made early and treatment initiated immediately to improve survival. Any episode of acute hyperammonemia should be treated as a life-threatening emergency. All other indications are considered experimental/investigational and not medically necessary. Treatment to increase bone mass in men with osteoporosis at high risk for fracture 3. Treatment of men and women with glucocorticoid-induced osteoporosis at high risk for fracture 4.
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These both together secure the devices from the unauthorized access / data transmission blood pressure keeps going down cheap 40 mg sotalol otc. Bluetooth secure methods briefly explained below · Authorization Authorization in Bluetooth is the way that describes access control the information in general arterial nosebleed order 40mg sotalol mastercard. For example arrhythmia dysrhythmia discount sotalol 40mg with mastercard, data in a device normally authorized to access other devices information is usually formalized as access control rules in a device system. During operation, the system uses the access control rules to choose whether access requests from authenticated the device user shall be approved or rejected. Resources include individual files and the personal data, provided by applications or device. For that authentication it uses the key that already in the devices so it is no need to generate new key for every new connection with the same device connected already. This permanent key may store in a non-volatile memory, this can be used in the present situation and it will be terminated, but the temporary key is limited by lifetime in the present situation. Encrypted key will be get from the present link key in that encryption is activated. In essence the authentication and encryption security procedures to allow any Bluetooth device to connect to it. Mode 2: A Bluetooth device does not initiate security procedures before connection establishment. Bluetooth chips produce wavelengths that are constraint to frequencies operating within a range specifically set aside for this sort of short-range communication. Other devices you may catch that use this frequency include cordless telephones and baby monitors. Other devices operating at the same, or nearest, frequencies will cause interruptions in the signal. To prevent this from being an issue, the signal is expand over a wider range of frequencies. In order to manage this, the signal hops around the frequency, and in the case of Bluetooth that come into 1600 times per second. The frequent change in wavelength means that even a consistent signal will not interrupt, and will not be interrupted, for longer than 1/1600th of a second. Bluetooth headsets can identify in two different styles, using a full or part duplex connection. A full-duplex signal means that all connected devices are capable to send and receive signals in this case a two-way conversation simultaneously, as opposed to a half-duplex signal, alike a walkie-talkie, where each side can still talk and listen, just not both at the same time and Table I explain about Bluetooth device classes. The concept of a security manager is introduced in this mode to control access to services. The centralized security manager maintains access control policies and is responsible for interfacing with other protocols and device users. Mode 3: A Bluetooth device initiates security procedures before the link set-up is completed. Since this security mode is fixed it is not aware of any application layer security. Authentication and encryption are realized using a shared secret link key that is derived during the pairing process. Bluetooth Security and Vulnerabilities Bluetooth technology is a wireless substitute to data cables by exchanging data using radio -transmissions. Bluetooth technology was created as an open standard to authorize connectivity and collaboration between disparate products and industries. Like any wireless technology, Bluetooth also has a number of security vulnerabilities. These vulnerabilities may comprise the device or the networks that the device connects to. However if the common Bluetooth security features are used properly, it should provide adequate security. Mechanism of Bluetooth Security When devices connect to each other, Bluetooth creates a link which uses optional pre-shared key authentication and algorithms which is considered to be strong when used correctly. The strength of the Bluetooth security mainly relies on the randomness and the length of the passkey used at the time of their first connection. Discoverability and connectability settings also play an important role in determining the security strength. These settings control whether the device can searched by other Bluetooth devices and how it can be connected. Bluetooth has a very complex specification and provides support for a lot of services. Some of these services include input output devices like keyboard and mouse, headphones, speakers, networking, file transfer and printing. In order for these service to work and communicate with devices, designers and programmers implements Bluetooth for a wide variety for operating systems, chipsets and devices. Settings like discoverability, connection preferences and security of the interface are not always the same and depend on the programmer. Some of the known Bluetooth attacks include the following: Identity detection; Location tracking; Denial of service; Unintended control and access of data and voice channels; Unauthorized device control and data access. As an example, researchers have shown that Bluetooth headset use can compromise devices in several ways. On the contrary, the rise usage of Bluetooth devices makes security worries even more disturbing. Hereafter, Bluetooth security architecture needs a constant development to avoid new unidentified threats. Like any further wireless communication system Bluetooth transmission can be deliberately jammed or block. False or modified information can be delivered to the devices by the cyber criminals. Security threats in Bluetooth can be branched into three major categories as follows: · Disclosure threat: the information can flow from the target system to an eavesdropper that is unauthorized to access the information. Bluetooth security is presently a very active research area in both academia and industry. Security threats like disclosure and integrity attacks commonly compromise some sensitive information and therefore, can be very dangerous. On the other hand, DoS attacks commonly disturb Bluetooth network users and are considered to be fewer dangerous. Powerful directional antennas can be used to greatly increase the scanning, eavesdropping and attacking range of almost all kind of Bluetooth device. It is a rifle stock with a dominant directional antenna involved to a small Bluetooth-compatible computer.
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Determination of Follicular Localization in Human Ovarian Cortex for Vitrification hypertension with chronic kidney disease cheap sotalol online amex. Herraiz S arteria labialis superior cheap sotalol online american express, Novella-Maestre E blood pressure average order 40mg sotalol otc, Rodriguez B, Diaz C, Sanchez-Serrano M, Mirabet V, Pellicer A. Improving ovarian tissue cryopreservation for oncologic patients: slow freezing versus vitrification, effect of different procedures and devices. Ovarian tissue cryopreservation: Low usage rates and high live-birth rate after transplantation. Improving fertility preservation in cancer: ovarian tissue cryobanking followed by ovarian stimulation can be efficiently combined. Imbert R, Moffa F, Tsepelidis S, Simon P, Delbaere A, Devreker F, Dechene J, Ferster A, Veys I, Fastrez M et al. Safety and usefulness of cryopreservation of ovarian tissue to preserve fertility: a 12-year retrospective analysis. Efficacy of ovarian tissue cryopreservation for fertility preservation: lessons learned from 545 cases. Bone marrow remission status predicts leukemia contamination in ovarian biopsies collected for fertility preservation. Kikuchi I, Kagawa N, Silber S, Kuwayama M, Takehara Y, Aono F, Kumakiri J, Kato O, Takeda S. Hepatocellular alterations after intraportal transplantation of ovarian tissue in ovariectomized rats. Fertility preservation and refreezing of transplanted ovarian tissue-a potential new way of managing patients with low risk of malignant cell recurrence. Comparison between Slow Freezing and Vitrification for Human Ovarian Tissue Cryopreservation and Xenotransplantation. Ovarian tissue cryopreservation and retransplantation-what do patients think about it? Is transplantation of cryopreserved ovarian tissue from patients with advanced-stage breast cancer safe? Safety of ovarian tissue transplantation in patients with borderline ovarian tumors. Development of sex cord stromal tumors after heterotopic transplantation of cryopreserved ovarian tissue in rats. First pregnancies, live birth, and in vitro fertilization outcomes after transplantation of frozen-banked ovarian tissue with a human extracellular matrix scaffold using robot-assisted minimally invasive surgery. Robot-assisted orthotopic and heterotopic ovarian tissue transplantation techniques: surgical advances since our first success in 2000. Impact of first-line cancer treatment on the follicle quality in cryopreserved ovarian samples from girls and young women. New insights in the selection and management of cancer patients applicants for ovarian tissue cryopreservation. Impact of cancer chemotherapy before ovarian cortex cryopreservation on ovarian tissue transplantation. Development of Ovarian Tissue Autograft to Restore Ovarian Function: Protocol for a French Multicenter Cohort Study. Rahimi G, Isachenko V, Kreienberg R, Sauer H, Todorov P, Tawadros S, Mallmann P, Nawroth F, Isachenko E. Re-vascularisation in human ovarian tissue after conventional freezing or vitrification and xenotransplantation. Rodriguez-Iglesias B, Novella-Maestre E, Herraiz S, Diaz-Garcia C, Pellicer N, Pellicer A. New methods to improve the safety assessment of cryopreserved ovarian tissue for fertility preservation in breast cancer patients. Autotransplantation of cryopreserved ovarian tissue in 12 women with chemotherapy-induced premature ovarian failure: the Danish experience. First delivery in a leukemia survivor after transplantation of cryopreserved ovarian tissue, evaluated for leukemia cells contamination. Vitrification versus slow freezing for human ovarian tissue cryopreservation: a systematic review and meta-anlaysis. First reported clinical pregnancy following heterotopic grafting of cryopreserved ovarian tissue in a woman after a bilateral oophorectomy. In vitro development of secondary follicles from cryopreserved rhesus macaque ovarian tissue after slow-rate freeze or vitrification. Human single follicle growth in vitro from cryopreserved ovarian tissue after slow freezing or vitrification. Similar results were reported in another study comparing outcomes after oocytes collected in the early follicular, late follicular, and luteal phases. This study reported no statistically significant differences in the number of oocytes collected (8. In view of these differences from conventional oocyte pick-up after ovarian stimulation, clinical and laboratory personnel need specific expertise to optimize oocyte pick-up, recovery and maturation rates. The study further reported a higher number of oocytes (10  versus 5 ) and embryos cryopreserved (5  versus 3 ) (Creux, et al. The number of retrieved oocytes was significantly lower in breast cancer patients (but not the other patient groups) compared to the control group (9[6-16] versus 12[7-20]). The latter study showed oocyte maturation rates in cancer patients ranging from 50 to 61. Regarding the feasibility of the former option, there are limited data on oocyte capability for maturation and survival after vitrification. Until a protocol to protect cumulus-enclosed oocytes for vitrification is developed, the consensus is to vitrify oocytes at the mature state, i. Among those reported births, the largest series of patients (n=20) led to 4 live births (Chian, et al. This strategy can be useful where ovariectomy is part of the treatment of cure. Studies containing at least 25 oncological and non-oncological patients aged from 0 - 44 years old resulted in oocyte recovery from 87% of ovarian tissue specimens, with a range of 0 to 58 oocytes recovered, with mean values 14. Lower oocyte recovery rates were reported in patients who had previously received chemotherapy (7 vs 12), in patients aged 218 years old (Abir, et al. Reported oocyte maturation rates after 24-48h culture vary from 23 to 62% from studies involving more than 25 patients (Fasano, et al. A case involving a mosaic Turner syndrome patient reported the recovery of 11 immature oocytes with 8 (73%) of them becoming matured and were vitrified (Huang, et al. In general, it seems that survival rate and maturation capacity of ex vivo extracted oocytes from ovarian tissue may be lower than that of in vivo aspirated oocytes (Kedem, et al.
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They have to blood pressure chart with age purchase sotalol with amex manage both family commitments and economic activities of the family can high blood pressure medication cause joint pain purchase sotalol 40 mg visa. Women should be the major focus of the society in Sri Lanka because the majority of the people are women hypertension essential buy sotalol 40mg low price. But national income statistics showed that 68% of males have been participated in the workforce while the women participation is limited to 36% (Central Bank Annual Report, 2012). Almost all the countries in the world have some kind of national income accounts measure the economic activities. The national income accounts are based on the idea that the economic activities occurs during the considering period of time, by taking the amount of output produced, the income received by the producers of the output and the amount of spending by the ultimate purchases of output. Women greater majority of unremunerated domestic and community work is not often measured in quantitative terms and it is not valued in national accounts. Various steps have been taken by the successive governments to develop this province. Especially the women in rural areas are needed to develop and to sustain the economy of the country. Problems such as incomplete or misreported data must show reasonable measure about economic activities among the people who live in an economy. So this study will fill the gap of such studies among the women in rural economy and informal activities in Sri Lanka. More over scholars have stated that when an enterprise is established and controlled by women, it is not only boosts economic growth, but also has many desirable outcomes. The most important feature is that when there is poverty, major vulnerable groups among the poor are women. Rural people largely depend on agriculture, fishing, small scale industries and services. Focus of this paper is to identify rural woman contribution to build up the families or society without any/much recognition of the society/economy or country. She participates in the production of goods and services for the market and house hold consumption, in agriculture, food production or engaging in some other economic activity while building up her family. According to the past researchers most of the rural people engage in both tradable, non tradable goods and services. Aikaeli (2010) has said that the quality of human capital is an important factor in explaining rural poverty. Further it says that education adds to the effectiveness of labour through, technical progress and also in general education allows people to adapt more easily to both social and technical changes in the economy and to change in the demand for labour. In a study on the determinants of Soviet household income had found that human capital and demographic factors were the main determinants of the income. Scholars have identified that major factors of women empowerment is defined their decision making capacity, control over resources and their own welfare practices (Sultana et al (1994),Lingman (2011),Riber and Nisha,(2012). Some of the researchers emphasized that empowering the women is a one of the key to human development. Several other researchers have done researches on the determination of the labour force participation of married women. Descriptive statistics was used to determine the labour force participation of married women. Several researchers have found that contribution of women were a function of several socio-economic variables. They are related to socio cultural factors, environmental factors, competencies and to political factors. In Sri Lanka the age distribution of women in the labour force indicates that the highest number of women are in the economically active category between ages 30 and 60 years (Chambers, (1978). Most of the past studies,those who have done their research on this title revealed that many rural women work on their home or any other place, are not covered by labour legislation. And wages are low and link to the targets of productions rather than computation of number of hours worked. Argument here is, with the changes of technology, politics, policies, situation must change. Problem Identification As in the case of many developing countries, in Sri Lanka the contribution of rural women to the economy is ignored. But in Sri Lanka women in the rural areas occupy themselves in considerable amount of economic activities in order to enhance the family budget. Objective of this study Development of rural areas becomes a major factor in many countries. Hence the objective of this study is:to investigate informal activities among rural women in Sri Lanka. Hypothesis Ho:- There is a positive relationship between living standard of the household and the contribution of the rural women. Vs H1:- There is no positive relationship between living standard of the household and the contribution of the rural women. Methodology Study Area Matara district is located on the Southern Coast of Sri Lanka. Matara District contributes a significant amount of national revenue in Sri Lanka by agriculture, agriculture based industries, fisheries industries and other industries. Primary data collected through 120 women those who are engage in the identified informal activities in the areas. Selfadministered structured questionnaire was used to collect the data Sampling Technique Women were selected through stratified random sampling techniques. Because population falls into natural groups and I can be divided into non-overlapping groups, stratified random sampling technique used as the most suitable sampling technique for collecting primary data in this study. Within the strata simple random sample technique was used to select the respondents (R. Questionnaire were distributed among women who were engage in domestic industries such as coir, beeralu, lace making, weaving, fishery and tailoring etc. Scholars have been identified following variables for their research to identify the contribution of business/jobs. Therefore, researcher used following variables as the dependent variable and independent variables. Dependent variable: - Women participation in informal economic activities in Matara District in Sri Lanka Independent Variables:- Family and cultural background, Educational Level, Risk taking and commitment, Environmental factors, Financial barriers, Self Confidence, Recognition by the society. According to the results of the sample survey, at young age labour force participation was low because of family responsibilities or any other reason. But they do child caring or any other house hold work at home without getting any income. But with age, when women get older they are able to spend more time on their income generating activities. In this age women tend to earn more money, in order to facilitate the children education and enhance the house hold welfare. Less contribution is indicated in service type activities like house maids, caring children, caring sick peoples and look after elders etc. Table 3 - Recognition of the employment Recognition by the society Percentage (%) Excellent 00 Good 13.