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These controls were significantly revised and extended with the Animals (Scientific Procedures) Act 1986 buy 100 mg penegra with mastercard prostate cancer ku medical center. Setting standards The Act requires that before a researcher can use animals he or she must have a series of special licences generic penegra 100 mg without a prescription prostate milking procedure by urologist. Such licences are only granted if: the potential results of the research are important enough to justify the use of animals;the research cannot be done using non-animal methods;and the minimum number of animals will be used order 100 mg penegra prostate oncology york. The law also says that dogs, cats and primates are only to be used when smaller, less advanced,animals could not provide the information. Discomfort or pain should be minimised by the appropriate use of anaesthetics or painkillers, although in most cases the majority of procedures are too minor to require this. It is further laid down that the researchers must have the necessary skill, training and experience with laboratory animals, and the research laboratory has the necessary facilities to care for the animals properly. Three different licences must be granted by the Government,and these are legally binding documents. This is given to a laboratory or research institute which has a properly built and run animal house. The certificate holder has responsibility for making sure there are systems and procedures to manage standards and training of staff. To obtain this, the researchers must go on a training course to familiarise themselves with the law and ethics of animal research,the basics of caring for animals and handling them in experiments, and ways of recognising symptoms of illness or suffering. The licence specifies which procedures the person has sufficient knowledge and experience to conduct on which types of animals. It contains a complete description of the research programme explaining why the animals are needed,what experiments will be done,why the information could not be obtained through other means, why the research is important and what steps have been taken to reduce numbers and care for animals. When new results lead to a significant change of plan,scientists must request an official modification to their licence before doing more experiments. The law says that animals must be examined every day, and a vet must be on call at all times. Any animal judged to be in pain which cannot be relieved must be immediately given pain relief or painlessly killed, regardless of whether or not the purpose of the research has been achieved. These advise on whether licences should be granted,and also carry out spot checks on laboratories. Inspectors carry out about 2,500 visits a year and can turn up at any time,unannounced. There are 12 members, at least two- thirds of whom must be doctors or veterinary surgeons. Animal welfare groups are represented,and at least half the members will be people who have not done animal experiments, or have not done so for six years. Most scientists care about animals and work to longstanding principles of care generally known as the 3Rs. The approach was first outlined in 1959 by researchers William Russell and Rex Burch. The 3Rs call for the replacement of animals by non-animal methods where possible;the reduction of numbers to the minimum necessary to obtain valid results where replacement is not possible, and refinement of all procedures to minimise adverse effects. Refinement means modifying procedures to minimise stress, boredom or suffering experienced by an animal,and enhance its well-being. Improving bedding, cage space and providing more varied food and making environments more interesting could come under this heading. In other cases the use of more sophisticated diagnostic tests can be employed to detect a disease early, to allow an experiment to end before an animal suffers. Where procedures are likely to be painful, anaesthetics or pain relief is provided. Where animals have to be killed,they are killed humanely, following strict regulations and standards. Reduction covers any strategy that will result in fewer animals being used to obtain the same information. As well as the law, and the voluntary 3Rs approach,the Government recently laid down that from April 1999 a local ethical review process is required in all establishments using animals. For instance any new procedure which reduces the numbers of animals needed,or the severity of procedures, should be communicated to other researchers. Published papers should include information which would be likely to help others conducting similar experiments. Some large institutions have full-time vets and smaller ones use local vets with a contract. We are interested in the well-being of individual animals, and if they get sick we do something about it,but we also have to be concerned for the well-being of the whole herd or colony. You look at what is being done and weigh whether the benefit for mankind outweighs the cost to the animals. Sometimes things don t work as you hoped equally you get astonishing discoveries when you least expect. It has now been found that these work in every stage of development of the embryo. Cell lines and organ baths are tremendous, but there comes a point where you need to put this information in a living system to see how it works. But he points out that the similarities with human conditions in some animals are very close. You can do a lot of work in insects but there comes a time when you need to bring it into a mammalian system. The Boyd Group is a forum for open exchange of views on the use of animals in science. It has a broad membership which aims to recommend practical steps to achieving common goals. Besides answering innumerable questions about our molecular selves, a deep- er understanding of the fundamental mechanisms of life promises to lead to an era of molecular medicine, with precise new ways to pre- vent, diagnose and treat disease. They completed a working draft covering 90 percent of the genome in 2000, and by 2003, they will finish the sequence with an accuracy greater than 99. That information fuels today s heady pace of discoveries into the genetic basis of a wide range of disor- ders. These include diseases caused by changes in single genes to more common diseases like cancer, Alzheimer disease, diabetes, and heart disease where several genes in interaction with environmental factors influence who develops a disease and when. Human Genome Project 1 Goals of the Map and sequence the human genome Human Genome Project Build genetic and physical maps spanning the human genome. Map and sequence the genomes of important model organisms (The approximate number of letters, or base pairs, in each species genome is given in parentheses. Study the ethical, legal, and social implications of genetic research Train researchers Develop technologies Make large-scale sequencing faster and cheaper.

This test evaluates the number of bacteria in the specimen by looking under the microscope buy 50mg penegra amex mens health yellow sperm. The number of bacteria seen under the microscope generally correlates with the infectiousness of the patient order penegra 50mg without prescription androgen hormone during pregnancy. The diagnosis would also depend on the overall clinical picture order penegra on line man health urban athlon on, clinical judgment and the culture results. Treatment should not be delayed while waiting for confirmation by culture or susceptibility results. Treatment is divided into two phases: the intensive phase and the continuation phase. The length of the continuation phase depends on the therapy prescribed and the susceptibility results. Primary resistance is caused by person-to-person transmission of drug-resistant organisms. The test is read between 48-72 hours by a trained health care worker who will look for swelling and hardness (induration) at the site of the injection and must record the result in millimeters and not simply as positive or negative. At present, the major drawback to this test is that blood samples must be processed within 12 hours of the blood draw. If the second test is negative, the contact would then be considered not infected (unless in severely immunosuppressed patients) due to the exposure. They should also be tested any time after they return to their native country or after a prolonged (more than one month) stay abroad. In medicine, a false positive test is when the patient has a positive test result for a medical condition, but in reality does not have the condition. A false negative test is when the patient has a medical condition but the test for the condition is negative. If a skin test is needed, and was not given at the same time of the vaccination, it is recommended to wait four to six weeks before administering it. An impaired immune response is directly related to medical conditions that affect the cellular immunity. Individuals who mount a response to any antigen are considered to have relatively intact cellular immunity, whereas those who cannot mount any response are considered anergic. However, if they are retested within the next year, they may have a positive reaction. Consequently, an infection acquired years ago may be interpreted as a recent infection. Individuals who will be tuberculin skin tested repeatedly as part of routine periodic evaluations should undergo two-step testing the first time they are tested. This would include health care workers and employees or residents of congregate settings. In these persons, a positive reaction to any subsequent test is likely to represent new infection with M. The clinical evaluation should include a medical history, physical examination, chest x-ray, and sputum smear and culture if indicated. If sputum bacteriologic results are negative, but the activity or etiology of a radiographic abnormality remains questionable, further diagnostic evaluation (i. This will avoid possible adverse effects of the medications on the developing fetus. Patients also need to be educated about the signs and symptoms of adverse drug reactions and the need for prompt cessation of treatment and clinical evaluation should symptoms occur. In addition, laboratory testing should be used to evaluate specific adverse events that may occur during treatment. If indicated, other possible risk factors for hepatotoxicity should be identified. Despite the advances made over the years, there is a continued need to develop new diagnostic tools and therapies to combat this complex disease. Isoniazid-related hepatitis: a United States Public Health Service Cooperative Surveillance Study. Each year, there are nearly 500,000 hospitalizations and close to two million visits to the Emergency Department. Nearly one quarter of adults with asthma missed work during the prior year due to asthma and over one third of parents of asthmatics missed work in the prior year. The annual direct and indirect health cost is estimated at over 16 billion dollars. Fortunately the overall mortality of asthma in the United States appears to be decreasing. Some studies have shown a more than 25% chance of having a child with asthma if one of the parents has asthma. Numerous studies have also linked asthma to allergic diseases which occur in families with a genetic predisposition towards the development of a hypersensitivity reaction to environmental allergens. There have been many reports describing the identification of potential asthma-susceptibility genes, and such research and genetic findings will lead to better disease classification and treatment. Environmental risk factors include exposure to maternal smoking during pregnancy, chemical sensitizers, air pollutants, allergens and infections of the respiratory tract. Studies have shown a two-fold risk of a child developing asthma if the mother smokes while pregnant. Environmental tobacco smoke may also be linked to adverse asthma-related outcomes. Interestingly, it has also been shown that exposure to cat or dog allergen early in life may actually be protective against later development of asthma. Certain bacterial infections including Chlamydia pneumoniae and Mycoplasma pneumoniae, as well as a number of viral infections, can stimulate local inflammatory reactions, and may be associated with asthma. Low or high birth weight, prematurity, and obesity have been shown to increase the risk of asthma. Just as with coronary artery disease, consumption of oily fish (salmon, tuna, shark) rich in omega-3 fats may be protective. Occupational asthma is airflow limitation and/or airway hyperresponsiveness caused by exposure to a specific agent or conditions in a particular work environment. Several cohort studies have suggested that work-related exposure to machining fluid, chemicals, laboratory animals, flour and latex may be associated with new-onset asthma. In contrast to work-related asthma, work- aggravated asthma is defined by preexisting asthma that is made worse or exacerbated by the work environment. All of these illnesses have in common provocability (reaction to airborne irritants, allergens, temperature/humidity and exercise), at least partially reversible airways obstruction in response to asthma medications (see below) and may rarely progress to irreversible lower airways obstructive disease (airway remodeling). Microscopically, there is a patchy loss of the epithelium or cellular layer covering the airway, leaving airway nerves exposed. There is accumulation of inflammatory cells, including eosinophils, which can release their contents and cause further inflammation.

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You will also learn about the health education messages that you need to communicate to members of your community order 100mg penegra mastercard mens health blog, so they can reduce their exposure to the vectors of these diseases and apply appropriate prevention measures cheap 50 mg penegra visa prostate cancer nhs. As you will see in this study session order penegra 50mg prostate cancer 1 in 7, prevention of all of these diseases includes controlling the vectors with chemicals and/or environmental management, using personal protective clothing or bed nets to reduce exposure to the vectors, and rapid case detection and referral for treatment. Early treatment prevents serious complications and can save lives, and it also reduces the reservoir of infectious agents in the human population. Learning Outcomes for Study Session 37 When you have studied this session, you should be able to: 37. In some described as chronic because the symptoms develop gradually, places, the disease is known by its alternative name bilharzia. Approximately 200,000 people die every year in Africa as a result of the complications caused by these parasites. Rural communities living near water bodies such as rivers, lakes and dams may be highly affected by the disease, because the worms have a complex lifecycle in which they spend part of their development living in freshwater snails. First, as a Health Extension Practitioner, you need to know where the disease is common in Ethiopia. Schistosoma mansoni is widespread in several parts of Ethiopia, usually at an altitude of between 1,200 to 2,000 metres above sea level. In many of these locations, more than 60% of schoolchildren are infected with Schistosoma mansoni. A high burden of the disease in children has severe adverse effects on their growth and performance at school. Washing, swimming or standing in infected water exposes people to the risk of infection with Schistosoma parasites. The major reservoirs of Schistosoma parasites are infected humans (the primary hosts) and freshwater snails (the intermediate hosts). The eggs pass out into the water in either the faeces or urine, to continue the infection cycle. The immune reaction causes an acute inammation around the eggs, which can lead to chronic symptoms (see Box 37. Note that the clinical manifestations of schistosomiasis are mainly related to the immune response against the eggs in the intestine or bladder the symptoms are not due to the worms themselves. The adults can survive in the person s body for up to 20 years, releasing around 300 eggs every day. The main symptoms of Schistosoma mansoni infection of the intestines are abdominal pain and bloody diarrhoea. A blood test usually reveals signs of anaemia and the abdomen may be swollen due to enlargement of the liver. If the infection remains untreated it can lead to permanent liver damage in advanced cases. The main symptoms of Schistosoma haematobium infection of the bladder are pain during urination, frequent need to urinate, and blood in the urine. If the infection remains untreated it can lead to chronic bladder diseases, including cancer, and permanent kidney damage. It may also lead to infertility in men, and pain during sexual intercourse and vaginal bleeding in women. The clinical manifestations (described above) should lead you to suspect cases of schistosomiasis. Asking children if they have seen any blood in their urine is an important way of detecting whether Schistosoma haematobium is common in the area. You have an important role as a Health Extension and control categories again Practitioner to teach community members in affected areas how to apply the when we discuss the other vector-borne diseases later in major prevention and control measures, which can be described in ve general this study session. Rapid case detection and referral to the nearest health centre for effective treatment; the drug used to treat schistosomiasis is called praziquantel, which is administered orally at a dosage of 40 60 mg per kg of body weight, given in two or three doses over a single day. You are not expected to prescribe praziquantel, which must be given at the health centre. Education in the community about the causes and modes of transmission of schistosomiasis. Also they should wear protective clothing when standing in infected water, and seek early diagnosis and treatment for any suspected cases. Visceral is visceral leishmaniasis (also known as kala-azar), which affects the internal pronounced viss-urr-al and organs such as the liver and spleen, and cutaneous leishmaniasis,which cutaneous is pronounced kute- affects the skin. Leishmania aethiopica, Leishmania major and Leishmania tropica,allof which cause cutaneous leishmaniasis. During your work in the community, you should know the common places where leishmaniasis is present. Visceral leishmaniasis affecting the internal abdominal organs such as the liver and spleen is widely distributed in the lowlands of Ethiopia. Important endemic locations include Konso woredas (Lake Abaya and Segen Valleys), the Lower Omo plains, the Metama and Humera plains and Adiss Zemen. Cutaneous leishmaniasis occurs in Meta-Abo, Sebeta, Kutaber in Wello, and in some places in South West Ethiopia such as Jimma Zone. Phlebotomine means blood-sucking and phlebotomine sandytakinga is pronounced eb-otto-meen. There are about 30 species of sandies that blood meal from a person s can transmit Leishmania parasites to humans found throughout the tropical arm. The protozoa develop inside the sandyandarepassedonwhenthesandy takes a blood meal from a healthy person. The enlarged abdomen of the sick person on the left indicates visceral leishmaniasis affecting the internal organs. The disease can produce a large number of ulcers sometimes up to 200 which may result in physical disability (e. The visible ulcers are a source of social stigma, which can leave the patient suffering mental distress and rejection in their community. For this reason, visceral leishmaniasis is said to have a high case-fatality rate. The general principles will already be familiar to you from the earlier discussion of schistosomiasis. Rapid case detection and referral to the nearest health centre or hospital prevents the transmission of the parasite to others. Cases of leishmaniasis will be treated using intravenous or intramuscular drugs such as pentostam or amphotericin B. Investigate and control epidemics in epidemic-prone areas:early identication and management of epidemics of leishmaniasis helps to control the disease from spreading to the wider population. Education in the community about the causes and modes of transmission of leishmaniasis. Onchocerciasis is found in the western part of Ethiopia, where there are many rapidly owing rivers and streams, with vegetation along the banks that provide good habitats for the blackies that transmit the parasite. Unlike mosquitoes and sandies, they bite during the day when people are active in the area.

Parts of Books Sample Citation and Introduction Citation Rules with Examples Examples D purchase penegra 50mg without a prescription prostate lesion. Sample Citation and Introduction to Citing Entire Books The general format for a reference to a book order penegra line prostate oncology letters, including punctuation: 98 Citing Medicine Examples of Citations to Entire Books A book is a publication that is complete in one volume or a limited number of volumes; books are therefore often called monographs purchase genuine penegra online prostate 2. Because technical reports and other specific types of monographs have additional special features, they are treated in their own chapters. References to books in print or in microform (microfilm, microfiche) are included in this chapter. The back of the title page, called the verso or copyright page, and the cover of the book are additional sources of authoritative information not found on the title page. Note that the rules for creating references to books are not the same as the rules for cataloging books. Citation Rules with Examples for Entire Books Components/elements are listed in the order they should appear in a reference. Author/Editor (R) | Author Affiliation (O) | Title (R) | Content Type (O) | Type of Medium (R) | Edition (R) | Editor and other Secondary Authors (O) | Place of Publication (R) | Publisher (R) | Date of Publication (R) | Pagination (O) | Physical Description (O) | Series (O) | Language (R) | Notes (O) Author/Editor for Entire Books (required) General Rules for Author/Editor List names in the order they appear in the text Enter surname (family or last name) first for each author/editor Books 99 Capitalize surnames and enter spaces within surnames as they appear in the document cited on the assumption that the author approved the form used. Books 103 American College of Surgeons, Committee on Trauma, Ad Hoc Subcommittee on Outcomes, Working Group. Follow the same rules as used for author names, but end the list of names with a comma and the specific role, that is, editor or translator. Separate the surname from the given name or initials by a comma; follow initials with a period; separate successive names by a semicolon and a space. Book with organization as author and subsidiary department/division named Books 105 13. Box 14 Names for cities and countries not in English Use the English form for names of cities and countries if possible. Moskva becomes Moscow Wien becomes Vienna Italia becomes Italy Espana becomes Spain Examples for Author Affiliation 18. Diagnostika i kompleksnoe lechenie osnovnykh gastroenterologicheskikh zabolevanii: klinicheskie ocherki. Base molecular de la expresion del mensaje genetico [Molecular basis of gene expression]. Diagnostika i kompleksnoe lechenie osnovnykh gastroenterologicheskikh zabolevanii: klinicheskie ocherki [Diagnosis and complex treatment of basic gastrointestinal diseases: clinical studies]. Le genome: avancees scientifiques et therapeutiques et consequences sociales = The genome: scientific and therapeutic developments and social consequences. Box 18 Titles ending in punctuation other than a period Most titles end in a period. When a translation of a book title is provided, place it in square brackets after the original language or romanized title. Box 19 No title can be found Occasionally a publication does not appear to have any title; the book or other short document simply begins with the text. In this circumstance: Construct a title from the first few words of the text Use enough words to make the constructed title meaningful Place the constructed title in square brackets Examples for Title 19. Musical pathology in the nineteenth century: Richard Wagner and degeneration [dissertation]. Box 21 Titles not in English If a translation of a title is provided, place it in square brackets following the original language or romanized title Ochoa S. Box 23 Titles ending in punctuation other than a period Most titles of books end in a period. Women and medicine: remedy books, 1533-1865, from the Wellcome Library for the History and Understanding of Medicine, London [microfilm]. Box 24 Titles not in English If a translation of a title is provided, place the translation in square brackets after the original language or romanized title Ochoa S. Etude et traitment de la meningite tuberculeuse [Study and treatment of meningeal tuberculosis] [microfilm]. Book in a microform with type of medium given Books 113 Edition for Entire Books (required) General Rules for Edition Indicate the edition/version being cited after the title (and Content Type or Type of Medium if present) when a book is published in more than one edition or version Abbreviate common words (see Abbreviation rules for editions below) Capitalize only the first word of the edition statement, proper nouns, and proper adjectives Express numbers representing editions in arabic ordinals. Examples: or becomes c Do not convert numbers or words for numbers to arabic ordinals as is the practice for English language publications. Examples: becomes o becomes u Do not convert numbers or words for numbers to arabic ordinals as is the practice for English language publications. Box 27 First editions If a book does not carry any statement of edition, assume it is the first or only edition Use 1st ed. Book with an edition in a language other than English Books 117 Editor and other Secondary Authors for Entire Books (optional) General Rules for Editor and other Secondary Authors A secondary author modifies the work of the author. Books 121 Box 35 No place of publication can be found If no place of publication can be found on the title page or its verso (back), but one can be found elsewhere in the publication or can be reasonably inferred (e. Book with unknown place, publisher, and date of publication Publisher for Entire Books (required) General Rules for Publisher A publisher is defined as the individual or organization issuing the book Record the name of the publisher as it appears in the publication, using whatever capitalization and punctuation is found there Abbreviate well-known publisher names if desired but with caution to avoid confusion. Place all translated publisher names in square brackets unless the translation is given in the publication. Tokyo: Medikaru Rebyusha; Beijing (China): [Chinese Academy of Social Sciences, Population Research Institute]; Taiyuan (China): Shanxi ke xue ji she chu ban she; [Note that the concept of capitalization does not exist in Chinese. Aarhus (Denmark): Aarhus-Universitetsforlag [Aarhus University Press]; As an option, you may translate all publisher names not in English. Designate the agency that issued the publication as the publisher and include distributor information as a note. For those publications with joint or co-publishers, use the name given first as the publisher and include the name of the other(s) as a note if desired. Box 41 No publisher can be found If no publisher can be determined, use the words "publisher unknown" placed in square brackets Sciarra C. Book with unknown place, publisher, and date of publication Date of Publication for Entire Books (required) General Rules for Date of Publication Always give the year of publication Convert roman numerals to arabic numbers. Box 43 Non-English names for months Translate names of months into English Abbreviate them using the first three letters Capitalize them Examples: mayo = May luty = Feb brezen = Mar Box 44 Seasons instead of months Translate names of seasons into English Capitalize them Do not abbreviate them For example: balvan = Summer outomno = Fall 126 Citing Medicine hiver = Winter pomlad = Spring Box 45 Date of publication and date of copyright Some publications have both a date of publication and a date of copyright. A copyright date is identified by the symbol, the letter "c", or the word copyright preceding the date. This convention alerts a user that the information in the publication is older than the date of publication implies. Box 46 No date of publication, but a date of copyright A copyright date is identified by the symbol, the letter "c", or the word copyright preceding the date. If no date of publication can be found, but the publication contains a date of copyright, use the date of copyright preceded by the letter "c"; for example c2005. Box 47 No date of publication or copyright can be found If neither a date of publication nor a date of copyright can be found, but a date can be estimated because of material in the book itself or on accompanying material, insert a question mark after the estimated date and place date information in square brackets Pathak L, editor. Box 50 No numbers appear on the pages of the book Occasionally, a book will have no numbers on its pages. If the entire publication has no page numbers: Count the total number of pages of the text Express the total as leaves, not pages End with a period Examples: Howell E. Book with no numbers on the pages Physical Description for Entire Books (optional) General Rules for Physical Description Give information on the physical characteristics if a book is published in a microform (microfilm, microfiche, etc.