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Ophthalmological examinations revealed eye changes for several dogs in each group cheap starlix 120mg without a prescription. Compound related gross lesions consisting of alopecia and enlarged and/or cystic uteri were observed in a number of dogs at terminal sacrifice buy discount starlix 120mg on-line. Organ weight effects were limited to purchase 120 mg starlix overnight delivery increase in uterine weights of individuals in most experimental groups 120 mg starlix otc. The occurrence of benign tumors in vaginas and uteri of several dogs in the high dose group was considered drug related. Hyperplastic nodules and benign tumors occurred in mammary glands of dogs both in control and treated groups, but the incidence at the high-dose level was somewhat greater. Monkeys A combination of 50 parts of norethindrone acetate to one part ethinyl estradiol was administered orally to mature female rhesus monkeys in a long-term study for a period of 10 years at dosage levels of 0. The dosing regimen consisted of consecutive cycles of 21 days of drug administration followed by 7 days of drug withdrawal. Sixteen monkeys were assigned to each treatment group; while an additional 16 animals received the food vehicle only. Daily observations of general health revealed no evidence of overt effects of drug treatment or significant changes in behaviour. The percent body weight gain of surviving animals was comparable, although the body weights of the treated groups were less than controls at some intervals. Red vaginal discharge occurred with greater frequency in control and low-dose groups and was usually observed in the withdrawal phase of the mid-and high-dose groups, reflecting the pharmacologic action of the drug combination. No drug related alterations were noted in vaginal cytology or mammary development. A retinal macular granularity, with and without foci of altered reflectivity, was noted in both control and treated animals beginning at 6 years. Although the incidence and severity of these alterations appeared to be greater in treated animals, no definite relationship to drug administration was considered to have been established. Reduced total platelet count and increased fibrinogen concentrations were noted more frequently for treated monkeys during the initial 90 months and 48 months of study, respectively. An occasional animal showed an elevated postprandial glucose concentration, but no treatment or dosage relationship was apparent. Small nodules were palpable in or near the mammary tissue of five, four, three, and two monkeys in the control, 0. Detailed physical examinations also revealed an abdominal mass in 2 control monkeys, slight curvature of the spine in 2 low-dose animals, and a pulsating saphenous vein in a high-dose animal. A frequent cause of death in this study, which is a common occurrence in non-human primates, was acute gastric dilatation. The lesions observed at necropsy appeared spontaneous and unrelated to drug administration. Microscopically, drug related lesions included uterine atrophy, slightly increased incidence of occurrence of mucus and inflammatory cells in the cervical canal, and dilatation of acini and ducts in mammary glands of monkeys from the high-dose group, were considered to be related to the pharmacologic effect of the test combination. A total of 6 neoplastic microscopic lesions were noted during this entire study; an adenoma (pancreatic duct origin) in a low-dose animal; a granulosa cell carcinoma (ovary) in a control animal with metastasis to liver, lymph node, and lung; and a leiomyoma (uterus) and 2 papillomas (skin) in high-dose animals. With the exception of the granulosa cell carcinoma, no malignant neoplasms were identified. Royal College of General Practioners: Oral Contraception and Thromboembolic Disease. Investigation of Deaths from Pulmonary, Coronary and Cerebral Thrombosis and Embolism in Women in Child-Bearing Age. Investigation of Relation Between Use of Oral Contraceptives and Thromboembolic Disease. Pituitary Gonadotrophic Inhibitory Activity of Various Steroids in Ovariectomized Intact Female Rats in Parabiosis. Comparison of the Antifertility and Sex Hormonal Activities of Sex Hormones and Their Derivatives. Report on Oral Contraceptives 1985, by the Special Advisory Committee on Reproductive Physiology to the Health Protection Branch Health and Welfare Canada. Serious Warnings and Precautions Smoking Cigarette smoking increases the risk of serious heart and blood vessel problems. It becomes important in women older than 35 years of age, who use hormonal birth control. It has been shown to be highly effective in preventing pregnancy when taken as prescribed by your healthcare professional. Pregnancy is always more risky than taking birth control pills, except in smokers over 35. This slows the movement of the sperm through the mucus and through the uterus (womb). Other ways to prevent pregnancy Other methods of birth control are available to you. When used properly, however, other methods of birth control are effective enough for many women. The following table gives reported pregnancy rates for various forms of birth control, including no birth control. The reported rates represent the number of women out of 100 who would become pregnant in one year. Non-Contraceptive Benefits of Combined Birth Controls Pills Several health advantages have been linked to the use of hormonal birth control. Talk about any health conditions or problems you may have, including if you: • smoke • have a history of breast disease. Your visits may include a blood pressure check, a breast exam and a pelvic exam, including a Pap smear.

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Pharmacology Classification Word Parts Action Examples bone reabsorption Conditions that result in weak alendronate best 120 mg starlix, Fosamax; inhibitors and fragile bones buy starlix 120 mg mastercard, such as ibandronate buy starlix 120 mg without prescription, Boniva osteoporosis and Paget’s disease 120 mg starlix with visa, are improved by medications that reduce the reabsorption of bones. Organs Here is the primary structure that comprises the muscular system: muscles Word Parts Here are the most common word parts (with their meanings) used to build muscular system terms. Combining Forms duct/o to bring myos/o muscle extens/o to stretch out plant/o sole of foot fasci/o fibrous band rotat/o to revolve fibr/o fibers ten/o tendon flex/o to bend tend/o tendon kinesi/o movement tendin/o tendon muscul/o muscle vers/o to turn my/o muscle Suffixes Prefixes -asthenia weakness ab away from -ion action ad toward -kinesia movement circum around -tonia tone e outward -trophic pertaining to development 114 Musculoskeletal System 115 Muscular System Illustrated Frontalis Orbicularis oris Sternocleidomastoid Trapezius Deltoid Pectoralis Biceps brachii Rectus abdominis Brachioradialis External oblique Sartorius Rectus femoris Vastus medialis Tibialis anterior Gastrocnemius 115 116 Chapter 4 Skeletal Muscle Anatomy and Physiology of the Muscular System muscle tissue fibers muscles Med Term Tip the term muscle is the diminu Muscles are bundles of parallel muscle tissue fibers. As these fibers contract (shorten tive form of the Latin word mus in length) they produce movement of or within the body. Types of Muscles cardiac muscle smooth muscle involuntary muscles voluntary muscles skeletal muscle What’s In A Name The three types of muscle tissue are skeletal muscle, smooth muscle, and cardiac muscle Look for these word parts: (see Figure 4. Voluntary cardi/o = heart muscles are those muscles for which a person consciously chooses to contract and -ac = pertaining to in = not for how long and how hard to contract them. Involuntary muscles are the muscles under the control of the subconscious regions of the brain. The smooth muscles found in internal organs and cardiac muscles are examples of involuntary muscle tissue. It is also referred to as a striated muscle because the human body has more than 400 skeletal muscles, which of its striped appearance under the microscope (see Figure 4. Each muscle account for almost 50% of the is wrapped in layers of fibrous connective tissue called fascia. The tendon then inserts into the periosteum covering a bone to anchor the muscle to the bone. The point at which the motor nerve contacts a muscle fiber is called the myoneural junction. The name smooth muscle refers to the Look for these word parts: in = not muscle’s microscopic appearance; it lacks the striations of skeletal muscle (see cardi/o = heart my/o = muscle again Figure 4. Smooth muscle is found in the walls of the hollow organs, neur/o = nerve such as the stomach, tube-shaped organs, such as the respiratory airways, and viscer/o = internal organ blood vessels. It is responsible for the involuntary muscle action associated with -al = pertaining to movement of the internal organs, such as churning food, constricting a blood vessel, and uterine contractions. With each involuntary contraction the heart squeezes to pump blood out of its chambers and through the blood vessels. Visceral Skeletal Cardiac (smooth) (striated) No striations Striations Striations Central nucleus Peripheral Central nuclei nuclei Contracts Slowly Rapidly Rapidly Found Viscera, blood vessels Trunk, extremities, Heart Figure 4. . Skeletal Muscle Actions action insertion antagonistic pairs origin Skeletal muscles are attached to two different bones and overlap a joint. The less movable of the two bones is considered to be the starting point of the muscle and is called the origin. The more movable bone is considered to be where the Musculoskeletal System 119 muscle ends and is called the insertion (see Figure 4. Muscles are often arranged around joints in antagonistic pairs, meaning that they produce opposite actions. For example, one muscle will bend a joint while its antagonist is responsible for straighten ing the joint. Signs and Symptoms adhesion Scar tissue forming in the fascia surrounding a muscle, making it difficult to stretch the muscle. The high degree of flexibility at the shoulder joint puts the rotator cuff at risk for strain and tearing. Blood levels become elevated in disorders such as heart attack, muscular dystrophy, and other skeletal muscle pathologies. Therapeutic Procedures Term Word Parts Definition Surgical Procedures carpal tunnel release carp/o = wrist Surgical cutting of the ligament in the wrist -al = pertaining to to relieve nerve pressure caused by carpal tunnel syndrome, which can result from repetitive motion such as typing. He reports he has experienced occasional knee pain and swelling Illness: since he injured his knees playing football in high school. These symptoms became worse while he was in his 50s and working on a concrete surface. He saw his orthopedic surgeon six months ago because of constant knee pain and swelling severe enough to interfere with sleep and all activities. He was able to transfer himself out of bed by the third post-op day and was able to ambulate 150 ft with a walker and dress himself on the fifth post-op day. Pearson General Hospital Emergency Room Record Task Edit View Time Scale Options Help Download Archive Date: 17 May 2015 Current Complaint: An 82-year-old female was transported to the Emergency Room via ambulance with severe left hip pain following a fall on the ice. Past History: Patient suffered a broken wrist bone 1 2 years earlier that required immobilization by solid material. She held her hip in a bent position 7 and could not tolerate movement toward a straight position. Use your text, a medical dictionary, or any other reference material you choose to answer these questions. Mary Pearl, age 60, has come into the physician’s office complaining of swelling, stiffness, and arthralgia, especially in her elbows, wrists, and hands. A bone scan revealed acute inflammation in multiple joints with damaged articular cartilage and an erythrocyte sedimentation rate blood test indicated a significant level of acute inflammation in the body. The physician ordered nonsteroidal anti-inflammatory medication and physi cal therapy. Look this condition up in a reference source and include a short description of it.

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In addition starlix 120mg free shipping, the accumulation of potassium outside the muscle cell can cause pain generic starlix 120 mg with visa. There is very little published information on how to discount starlix 120 mg on-line treat contractures once they have occurred cheap starlix 120mg mastercard. McArdle people have anecdotally reported the following home treatments; use of cool/ice packs, heat packs, strong painkillers, massage. There is no published information on any of these home treatments, and some of these treatments (like massage) could lead to further damage to the muscles. Pain can serve as a warning to protect the muscle from further damage, and the use of strong painkillers could lead to the muscle being used, which could cause further damage. Further reading: Serious training for endurance athletes by Rob Sleamaker, Ray Browning, 1996 (Information about different types of exercise. Evers, Lisa Starr (An easier explanation of the role of the calcium, sodium and potassium pumps, see page 85. Byrne (A more complicated explanation of the role of the calcium, sodium and potassium pumps. Jon Russell, 2001 56 5 Muscle damage (rhabdomyolysis) can lead to raised creatine kinase levels in the blood, myoglobinuria, and kidney failure 5. Muscle cells are like a balloon which is filled with water and lots of little components, including creatine kinase and myoglobin. The broken parts of the muscle cells and the components go into the bloodstream, and then pass through the kidneys. The smaller bits, like myoglobin, pass out in the urine – producing dark red/brown coloured urine known as myoglobinuria. The kidneys also play an important role in keeping the correct concentration of several compounds including potassium, sodium and calcium (called “electrolytes”) in the bloodstream. If kidney failure occurs, the kidneys are no longer able to maintain the correct concentrations of electrolytes. It is likely that these may also increase the chance of rhabdomyolysis in McArdle people, and would be best avoided. Surgery: if a surgical procedure is performed in an improper position or a tourniquet is used for a long period of time. Extreme physical exertion, especially in conditions of high temperature and humidity. Hypokalemia (when potassium levels in the blood are lower than they should be) increases the risk of rhabdomyolysis during strenuous exercise. Diuretics are drugs which increase the rate of urine production and can lead to depletion of electrolytes such as potassium. Abuse of diuretics may lower potassium levels, making athletes more likely to develop rhabdomyolysis during strenuous exercise. Any condition which produces major electrolyte losses and dehydration, such as severe diarrhoea, vomiting, or bulimia (see cross ref) could lead to rhabdomyolysis. Neuroleptic malignant syndrome is a reaction to antipsychotic drugs like butyrophenones, phenothiazines and thioxanthenes. Hypothermia (being very cold or frozen) can reduce the blood flow to the muscles, reducing the amount of glucose and energy available for movement. Cocaine can cause rhabdomyolysis by having a toxic effect on muscle cells; prolonged use can limit the amount of blood flow to the muscles, and by inducing coma and immobility for a long time. Rhabdomyolysis may be triggered by statins within a short period of taking the drug, or many years later. Statins can also cause inflammation of the muscles (myositis), causing pain, and weakness of the muscles. Excessive amounts of alcohol, either binge drinking or alcohol abuse, can lead to pain and swelling of the muscles. Some drugs have the side effect of rhabdomyolysis in people who are unaffected by McArdle’s, and recently, some of these have been found to also increase the risk of rhabdomyolysis in McArdle people. For example, the cholesterol lowering drugs known as statins have been reported to increase the likelihood of rhabdomyolysis in McArdle people. The early complications include an increased level of potassium in the blood (hyperkalemia), very low levels of calcium in the blood (hypocalcaemia), elevated liver enzymes, cardiac dysrrhythmias and cardiac arrest, while the late complications include acute renal failure and clotting of blood in the blood vessels (called “disseminated intravascular coagulation”). Myoglobinuria (blood in the urine) can cause the urine to be a colour ranging from “pink-tinged, to cola coloured, to dark black” (Huerta-Alardin, 2005). The red-brown colour is usually seen when the myoglobin concentrations in urine are above 300mg/l. The main treatment is aggressive fluid replacement with saline (water containing salts), usually delivered via an intravenous drip. The amount of urine which is passed will probably be measured to determine how much fluid is passing through the kidneys. A catheter may be inserted into the urethra to achieve this, or you may be asked to urinate into a cup/bedpan or other measuring device. Mannitol may reduce the amount of cell injury, may reduce the amount of heme which is left in the tubes of the kidneys (heme deposits are bad for the kidneys), and also may help to keep the tubes of the kidney open (is a renal vasodilator). Sometimes other diuretics such as furosemide are given to try to encourage the flow of liquids through the kidneys. After rhabdomyolysis, a large amount of acidic urine may pass through the kidneys. Bicarbonate would help to neutralise the acidic urine, and could help to reduce the level of damage. However, there is not very much clinical evidence for use of 60 bicarbonate or mannitol, and just the use of saline alone seems to have an equal result (Huerta-Alardin, 2005).

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The and spindle-shaped purchase 120 mg starlix with visa, with a thin buy discount starlix 120 mg on-line, papery buy starlix 120mg with visa, outer review on ginseng uses advises for not using shell and small black seeds order 120mg starlix visa. Elettaria pods are ginseng in pregnant women in the first light green while Amomum pods are larger 27 trimester because of possible birth defects. It should thus not Benefits be used in patients on oral anticoagulant Both forms of cardamom are used as 24 and/or antiplatele therapy. Ginseng has been flavouring agents in both food and drinks, as associated with documented reports of cooking spices and as a medicine. It can cardamomum (the usual type of cardamom) is lower blood concentrations of alcohol and used as a spice, a masticatory, and in warfarin, and can induce mania if used medicine; it is also smoked sometimes. Ginseng and cardamom is broadly used in South Asia to amlodipine may cause an adverse treat infections in teeth and gums, to prevent 28 interaction. Ginseng may exacerbate and treat throat troubles, congestion of the seizures although the evidence for this is lungs and pulmonary tuberculosis, 29 similarly anecdotal and uncertain. Ginseng inflammation of eyelids and also digestive may affect blood glucose levels and should disorders. Ginger may increase used as an antidote for both snake and the risk of bleeding or potentiate the effects of 4 scorpion venom. This study investigated the and as an ingredient in traditional medicine in effect of ginger, a common morning sickness traditional Chinese medicine. Pregnant popular traditional flavouring agent for baked Sprague-Dawley rats were administered, from goods and confectionery. No maternal toxicity was Dermatitis from skin exposure to observed, however embryonic loss in the cardamom has been reported. Few papers treatment groups was double that of the reported cases of allergic contact dermatitis to controls (P<0. No gross morphologic cardamom elicited by terpenes present in the malformations were seen in the treated 33-34. Treated foetuses also officinale and it belongs to family had more advanced skeletal development as Zingiberaceae, the ginger family. Ginger is an determined by measurement of sternal and herb; its rhizome (underground stem) is used metacarpal ossification centres. It can be this study suggested that in utero exposure to used fresh, dried and powdered, or as a juice ginger tea results in increased early embryo or oil. Ginger may help to lessen nausea 3 Benefits due to chemotherapy drugs and anaesthesia. Ginger is also sometimes used for Commonly known as Jaiphal, is used chest pain, low back pain, and stomach pain. The spices in their ground form are Risks mainly used in the food processing industry, Heartburn or stomach distress can principally in the seasoning of meat products; occur if taken in large quantities. Ginger they are also used in soups, sauces, baked reinforces warfarin action by heterogeneous goods and spice mixes. These patients on oral anticoagulant and/or products are also used in the perfumes. Hallucinations after or Mulhati is an effective expectorant, and has voluntary ingestion of nutmeg is an been used for this purpose since ancient 36 unrecognized drug abuse. High doses can times, especially in Ayurvedic medicine cause bizarre behaviour and visual, auditory, where it is also used in tooth powders. Liquorice is a vision followed by numbness, double, and popular and well-known remedy for cough, triple vision, headache, and drowsiness. Seeds of nutmeg enters into the composition of cough lozenges are used as spice, but they are also abused and pastilles, with sedatives and expectorants. Nutmeg disguising the taste of nauseous medicines, poisoning is rare but probably underreported having a remarkable power of converting the and should be considered in recreational flavour of acrid or bitter drugs. Licorice is substance users with acute psychotic useful in treating pain due to stomach ulcers, symptoms as well as central nervous system as it soothes the irritation caused by acids. As neuromodulatory signs that may mimic in an anti-hepatotoxic, licorice is effective in the part an anticholinergic hyperstimulation. It is Licorice may increase the risk of found widely distributed in fats throughout bleeding or potentiate the effects of warfarin 4 the plant and animal kingdom, including therapy. Severe hypokalemia may be irritating in pure form to skin and eyes lead to rhabdomyolysis. A diagnosis of excess under exaggerated exposure conditions, but is amount of apparent mineralocorticoid was not known or predicted to induce sensitization attributable to licorice and grapefruit juice responses. Glycyrrhizic acid and available indicate that at the current level of glycyrrhetinic acid, its hydrolytic product, in intake, food flavouring use of myristic acid licorice extracts, and polyphenols, in 39 does not pose a health risk to humans. Heavy licorice (glycyrrhizin) consumption Licorice is Glycyzrrhiza glabra of has been associated with shorter gestation. Heavy glycyrrhizin exposure was associated with preterm delivery and may be a novel 41 marker of this condition. Blumenthal M, Goldberg A & failure or who are taking digitalis, unless Brinckman J, Turmeric should be used 3 directed to do so by their physician. Herbal Medicine: Expanded Commission E Monographs 2000; 379– It is concluded that adverse effects of 384. Bardai S, Lyoussi B, Wibo M & Morel with their side effects at normal and large N,Pharmacological evidence of doses. This paper had highlighted uses and hypotensive activity of Marrubium adverse effects of selected eleven above vulgare and Foeniculum vulgare in mentioned herbal drugs. One should also spontaneously hypertensive rat, Clin Exp consider other herbal products for the possible Hypertens 2001;23 (4): 329–343. Stickel F, Patsenker E & Schppan D, rats, Indian J Physiol Pharmacol1985; Herbal hepatotoxicity, J Hepatol 2005; 29(1):21-26. Murray M, the Pill Book Guide to Characterization of allergens in Natural Medicines: Vitamins, Minerals, Apiaceae spices: anise, fennel, coriander Nutritional Supplements, Herbs, and and cumin, Clin Exp Allergy1997; 27 Other Natural Products, Bantam 2002; (11): 1299-1306.

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