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By R. Jesper. University of Texas of the Permian Basin.

Consumed at a more rapid rate purchase 20 mg levitra amex, alcohol enters the ture) developed a pyramid to represent the quantities of bloodstream and affects many cells discount levitra 20 mg on-line, notably in the brain levitra 10mg line. When deliv- sion order 10mg levitra with mastercard, and some suggested improvements include: ered in excess to the liver, alcohol can lead to the accu- mulation of fat as well as inflammation and scarring of liver ◗ Distinguish between unrefined and refined carbohy- tissue. Alcohol ◗ Distinguish between healthful unsaturated fats, which metabolism ties up enzymes needed for oxidation of nu- can be eaten in moderation, and less healthful saturated trients and also results in byproducts that acidify body flu- and processed (trans-) fats, which should be restricted. Fats, oils, sweets Although alcohol consumption is compatible with good health and may even have a beneficial effect on the Use sparingly cardiovascular system, alcohol should be consumed only Meat, poultry, in moderation. Milk, yogurt fish, dry beans, and cheese eggs, and nuts Checkpoint 20-7 What are typical recommendations for the rel- ative amounts of carbohydrates, fats, and proteins in the diet? Common food allergens are METABOLISM, NUTRITION, AND BODY TEMPERATURE ✦ 415 wheat, nuts, milk, shellfish, and eggs, but almost any food Calculation of body mass index (BMI) might cause an allergic reaction in a given individual. A low pro- nate method is to divide weight in pounds by the square of tein level in the blood plasma interferes with fluid return height in inches and multiply by 703. It is Underweight common knowledge that overweight and obesity have in- People who are underweight have as much difficulty creased in the past several decades in many countries. It is asso- shortens the life span and is associated with cardiovascular ciated with low reserves of energy, reproductive distur- disease, diabetes, some cancers, and other diseases. Scientists are studying the nervous and hormonal ◗ Nutrition and Aging controls over weight, but so far they have not found any effective and safe drugs for weight control. Because metabo- orous exercise at least four times a week is recommended lism generally slows, and less food is required to meet en- for health and weight control. Exercise helps to boost appetite and 416 ✦ CHAPTER TWENTY Box 20-3 • Health Professions Dietitians and NutritionistsDietitians and Nutritionists ietitians and nutritionists specialize in planning and su- anatomy and physiology. Most dietitians and nutritionists in Dpervising food programs for institutions such as hospi- the United States receive their training from a college or uni- tals, schools, and nursing care facilities. Dietitians and nutritionists also work in community the American population continues to age, the need for nutri- settings, educating the public about disease prevention tional planning in hospital and nursing care settings is ex- through healthy eating. In addition, many people now place an empha- food and nutrition has also led to new opportunities in the sis on healthy eating and may consult nutritionists privately. To perform their duties, dieti- For more information about this career, contact the American tians and nutritionists need a thorough understanding of Dietetic Association. These responses do ◗ Body Temperature not account for all the increase, however, nor do they ac- count for the much greater increase in metabolism after a Heat is an important byproduct of the many chemical ac- meal containing a large amount of protein. Under normal conditions, a number of regulatory devices keep body temperature constant within quite narrow lim- Checkpoint 20-8 What are some factors that affect heat pro- its. Factors Affecting Heat Production The rate at To illustrate evaporation, rub some alcohol on your which heat is produced is affected by a number of factors, skin; it evaporates rapidly, using so much heat from the including exercise, hormone production, food intake, and skin that your arm feels cold. The rate of heat loss and epinephrine (adrenaline) from the adrenal medulla, through evaporation depends on the humidity of the sur- increase the rate of heat production. When it exceeds 60% or so, perspiration METABOLISM, NUTRITION, AND BODY TEMPERATURE ✦ 417 does not evaporate so readily, making one feel generally lation because variations in the activity of these large tis- miserable unless some other means of heat loss is avail- sue masses can readily increase or decrease heat genera- able, such as convection caused by a fan. Because muscles form roughly one-third of the body, either an involuntary or an intentional increase in Prevention of Heat Loss Factors that play a part in their activity can form enough heat to offset a consider- heat loss through the skin include the volume of tissue able decrease in the temperature of the environment. Age Factors Very young and very old people are lim- If the temperature of the surrounding air is lower than ited in their ability to regulate body temperature when ex- that of the body, excessive heat loss is prevented by both posed to environmental extremes. Normal Body Temperature The normal tempera- Temperature Regulation ture range obtained by either a mercury or an electronic Given that body temperature remains almost constant de- thermometer may extend from 36. Temperature tends to be higher in the The Role of the Hypothalamus Many areas of the late afternoon and evening because of physical activity body take part in heat regulation, but the most important and consumption of food. Skin temperature obtained in the axilla 20 pothalamus control heat production in body tissues, (armpit) is lower than mouth temperature, and mouth whereas another group of cells controls heat loss. It is believed that, if it were possible to place a ther- through the brain and also on input from temperature re- mometer inside the liver, it would register a degree or ceptors in the skin. Other impulses are sent to the muscles the ice point is at 0 and the normal boiling point of water to cause shivering, a rhythmic contraction of many mus- is at 100, the interval between these two points being di- cles, which results in increased heat production. Usually, the presence of fever With further heat retention and more fluid loss, heat is due to an infection, but there can be many other causes, exhaustion occurs. Curiously enough, fever usually is preceded by a Heat stroke (also called sunstroke) is a medical emer- chill—that is, a violent attack of shivering and a sensation gency. Heat stroke can be recognized by a body temperature of cold that blankets and heating pads seem unable to re- of up to 41 C (105 F); hot, dry skin; and CNS symptoms, in- lieve.

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Free text fields in medical records are considered of invaluable importance for medical relevance (Stein cheap 10 mg levitra overnight delivery, Nadkarni order 10mg levitra mastercard, Erdos levitra 10mg lowest price, & Miller generic 10mg levitra with mastercard, 2000). However, many existing informa- tion systems do not yet take advantage of the complex CDA or the even more substantial Reference Information Model—because it is a very time consuming task to transfer documents to the new standards and to fit the enormous mass of model objects to free text data. Nevertheless, these systems store valuable information—just in a format which cannot be directly analyzed by structured methods. In order to provide access by content, the aforementioned Information Retrieval methodologies can significantly contribute to facilitate these tasks: a self-organizing map creates structure and context purely on the statistical word distributions of free text and thus allows a semantic browsing of clinical documents. This in turn offers the possibility to gain a problem orientated perspective on health records stored in information systems, that is, as Lovis et al (2000) have noted: “intelligent browsing of documents, together with natural language emerging tech- niques, are regarded as key points, as it appears to be the only pertinent way to link internal knowledge of the patient to general knowledge in medicine. Currently, many case studies are published which emphasize that data mining techniques provide efficient means to detect significant patterns in medical records. Interactive OLAP tools support best practice and allow for informed real time decision-making and therefore build the solid foundation for further improvements in patient care. The next step to further broaden the knowledge base in healthcare environments will be the integration of unstructured data, predominantly free narrative text documents. The nature of this type of data will demand for new approaches to deal with the inherently vague information contained in these documents. We have shown how artificial neural networks with their ability for self-organization of non-crisp data provide an almost natural link between the hard computational world and the soft-computing of the human brain. We believe that interactive information retrieval methodologies that account for the rich context of natural language will significantly contribute to knowledge acquisition through text analysis. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. Knowledge representation and retrieval using conceptual graphs and free text document self-organisation techniques. Efficient literature searching: A core skill for the practice of evidence-based medicine. Integrating query of relational and textual data in clinical databases: A case study. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. Interactive Information Retrieval Towards Effective Knowledge Management 69 Hearst, M. Proceedings of 19th ACM International Conference on Research and Development in Information Retrieval (pp. Indexing biomedical documents: From thesaural to knowledge- based retrieval systems. Text categorization with support vector machines: Learning with many relevant features. Special Issue on Neural Networks for Data Mining and Knowledge Discovery, 574-585. Proceedings of the 7th World Multiconference on Systemics, Cybernetics and Informatics, July (pp. Annual Conference of the American Medical Informatics Association (AMIA), 445-449. Power of expression in the electronic patient record: Structured data or narrative text? Copying or distributing in print or electronic forms without written permission of Idea Group Inc. Understanding and using the medical subject headings (MeSH) vocabulary to perform literature searches. Towards routine automatic pathway discovery from on-line scientific text abstracts. GeneWays: A system for extracting, analyzing, visualizing, and integrating mo- lecular pathway data.

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Except as permitted under the United States Copyright Act of 1976 levitra 20mg lowest price, no part of this publication may be reproduced or distributed in any form or by any means buy 10mg levitra free shipping, or stored in a database or retrieval system 10mg levitra with mastercard, without the prior written permission of the publisher order 20 mg levitra visa. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps. McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs. For more information, please contact George Hoare, Special Sales, at george_hoare@mcgraw-hill. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if you fail to comply with these terms. McGraw-Hill and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill has no responsibility for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. About twenty symptoms account for most of the reasons people go to health professionals. They also visit health pro- fessionals to learn whether their symptoms indicate an increased risk for serious problems. The most common group of symptoms is caused when a “bug” (bac- teria or virus) has invaded the body. The typical symptoms of a “bug” are cough, fever, chills, runny nose, sneezing, sore throat, earache, nausea, vomiting, and diarrhea. Immu- nizations are given to young children to help speed up this process and eliminate the problems caused when these bugs are able to invade the body. Low back, knee, leg, foot, hand, neck, and shoul- der pains are most often caused by “wear and tear. After these two groupings, there a number of common symptoms with several or less obvious causes: headaches, abdominal (belly) pains, shortness of breath (difficulty breathing), chest pains, red or itching skin, emotional problems, dizziness, tiredness, and fatigue. When Symptoms Limit Daily Activities The more numerous, severe, and persistent our symptoms, the more they limit our ability to perform daily activities. X PREFACE persistent “wear and tear” pains, anxiety or depression, dizziness or fatigue, and trouble sleeping frequently limit activities. There are notable differences in the frequency of several bother- some, persistent symptoms by age and gender. Older people are frequently bothered by problems with urination, consti- pation, and hearing. When Symptoms Might Indicate a Serious Problem The overwhelming majority of symptoms are not a sign of a serious problem. First, while in children and adolescents the “bug-related” symptoms listed above are self-limited almost all of the time, fever and cough in the very old had a potentially serious cause about 5 to 10 times out of 100. The most common serious cause in the studies was an infection of the lung (pneumonia) that might have benefitted from antibiotics. Second, about 5 to 10 out of 100 abdominal and chest pains suffered by adults in the studies were likely to have serious causes; in adoles- cents and children, these problems were very seldom serious.

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