... in their published work and were not able to overcome the emerging division of labor between religious and theological studies, on the one hand, andthe anthropology of religion, on theother ... from other experiences and tacitly protected from comparison with them Experiences deemed religious are viewed in relation toother experiences and subject to comparison with them sui generis approach ... consider the merits of two basic approaches to “religious experience,” one in which the religiousness of the experience is understood to be inherent (sui generis) in the experience itself andthe other...
... that the erosion is the primary lesion andthe redness and scale are secondary, while the correct interpretation would be that thepatient has a pruritic eczematous dermatitis with erosions caused ... (present in patients with psoriasis or atopic dermatitis) places thepatient in a different diagnostic category than would hemorrhagic papules, which may indicate vasculitis or sepsis (Figs 52-4 and ... instance, the sometimes minor differences in color and shape that distinguish a melanoma (Fig 52-1) from a benign nevomelanocytic nevus (Fig 52-2) can be difficult to recognize To aid in the interpretation...
... epidermal atrophy) Scar: A change in the skin secondary to trauma or inflammation Sites may be erythematous, hypopigmented, or hyperpigmented depending on their age or character Sites on hair-bearing ... Violaceous to purple, polygonal lesions that resemble those seen in lichen planus Milia: Small, firm, white papules filled with keratin Morbilliform: Generalized, small erythematous macules and/ or ... is often the predominant symptom of inflammatory skin diseases (e.g., atopic dermatitis, allergic contact dermatitis); it is also commonly associated with xerosis and aged skin Systemic conditions...
... generalized erythematous exanthem is more likely to have a drug eruption than is a patientwith a similar rash limited tothe sun-exposed portions of the face Once the distribution of the lesions has ... noted and considered during a physical examination: the distribution of the eruption, the types of primary and secondary lesions, the shape of individual lesions, andthe arrangement of the lesions ... patientwith cutaneous small vessel vasculitis (Courtesy of Robert Swerlick, MD; with permission.)[newpage] APPROACHTOTHE PATIENT: SKIN DISORDER In examining the skin it is usually advisable to...
... The distribution of some common dermatologic diseases and lesions Figure 52-7 Psoriasis This papulosquamous skin disease is characterized by small and large erythematous papules and plaques with...
... contrast, lesions with a generalized arrangement are common and suggest a systemic etiology Figure 52-9 Erythema multiforme This eruption is characterized by multiple erythematous plaques with a target ... usually represents a hypersensitivity reaction to drugs (e.g., sulfonylamides) or infections (e.g., HSV) (Courtesy of the Yale Resident's Slide Collection; with permission.) Figure 52-10 ...
... against the surface of the skin and rotated with downward pressure until it penetrates tothe subcutaneous tissueThe circular biopsy is then lifted with forceps, andthe bottom is cut with iris ... utilized to identify hyphae in dermatophyte infections, pseudohyphae and budding yeast in Candida infections (see Fig 196-1), and "spaghetti and meatballs" yeast forms in tinea versicolor The same ... History of allergies Presence of photosensitivity Review of systems Family history (particularly relevant for patients with melanoma, atopy, psoriasis, or acne) 10 Social, sexual, or travel history...
... suspected allergens is applied tothepatient' s back under occlusive dressings and allowed to remain in contact withthe skin for 48 h The dressings are removed, andthe area is examined for evidence ... edematous, erythematous papules and plaques are characteristic of this whealing eruption Wood's Light A Wood's lamp generates 360-nm ultraviolet (or "black") light that can be used to aid the ... reactions (e.g., erythema, edema, or papulovesicles) This test is best performed by physicians with special expertise in patch testing and is often helpful in the evaluation of patients with chronic...
... same as the prognosis of the person with aortic stenosis who develops the first symptoms of congestive heart failure (median survival, ~8 months) However, thepatientwith heart disease ... of cancer cells is that thepatient feels betrayed by his or her body The cancer patient feels that he or she, and not just a body part, is diseased The Magnitude of the Problem No nationwide ... its own; the cancer cell competes to survive using natural mutability and natural selection to seek advantage over normal cells in a recapitulation of evolution One consequence of the traitorous...
... workers, rehabilitation medicine specialists, and a number of other consulting professionals working closely with each otherandwiththepatientand family ... cancer predisposition and point out the need to begin surveillance or other preventive therapy for unaffected siblings of thepatientThe review of systems may suggest early symptoms of metastatic ... procedure, the diagnosis generally depends on obtaining adequate tissueto permit careful evaluation of the histology of the tumor, its grade, and its invasiveness andto yield further molecular...
... and/ or tissue adjacent tothe tumor, and inspection and biopsy of organs commonly involved in disease spread Pathologic staging includes histologic examination of all tissues removed during the ... Against Cancer andthe American Joint Committee on Cancer (AJCC) The TNM classification is an anatomically based system that categorizes the tumor on the basis of the size of the primary tumor ... disease (M0 and M1 for the absence and presence, respectively, of metastases) The various permutations of T, N, and M scores (sometimes including tumor histologic grade G) are then broken into stages,...
... radiation oncologist, and surgeon is crucial to achieving optimal results Sometimes the chemotherapy and radiation therapy need to be delivered sequentially, andother times concurrently Surgical ... physician also has much to offer thepatient for whom curative therapy is no longer an option Often a combination of guilt and frustration over the inability to cure thepatientandthe pressure of a ... precede or follow other treatment approaches It is best for the treatment plan either to follow a standard protocol precisely or else to be part of an ongoing clinical research protocol evaluating...
... the success of cancer therapy depends on the success of the supportive care Failure to control the symptoms of cancer and its treatment may lead patients to abandon curative therapy Of equal importance, ... should strive to keep communications open and nonjudgmental, so that patients are more likely to discuss withthe physician what they are actually doing The appearance of unexpected toxicity may ... months, then every other month for a year, every months for a year, every months for a year, every months for a year, and then annually At each visit, a battery of laboratory and radiographic and...
... provocative and palliative factors, and intensity (Chap 12); a review of the oncologic history and past medical history as well as personal and social history; and a thorough physical examination Thepatient ... administration of chemotherapy and represents a conditioned response to visual and olfactory stimuli previously associated with chemotherapy delivery Acute emesis is the best understood form Stimuli ... signals in the chemoreceptor trigger zone in the medulla, the cerebral cortex, and peripherally in the intestinal tract lead to stimulation of the vomiting center in the medulla, the motor center...
... affected by the diagnosis and is coping with it is an important goal of patient management It is best to speak frankly withthepatientandthe family regarding the likely course of disease These discussions ... disease, andthe goal of palliative therapy is embraced in the hope of being able to live with disease; finally, at the disclosure of imminent death, another adjustment in outlook takes place Thepatient ... difficult for the physician as well as for thepatientand family The critical features of the interaction are to reassure thepatientand family that everything that can be done to provide comfort...
... expression and function of MMPs There are reports of other staphylococcal virulence factors associated withthe pathogenesis and severity of SA [43-45] Whether these virulence factors are associated with ... anticipated to augment the risk of infection in patients with RA The reasons for the predominance of S aureus in SA andthe mechanisms of pathogenecity are not yet fully understood The synovium of patients ... remains to be seen In addition tothe bone and joint infections, S aureus is also the prime causative agent in many skin andsofttissueinfections (SSTIs), which can be manifested as superficial to...
... related tothe state by equation 1.14 The system matrices A and B relates the current state tothe previous stat end the system inputs while the matrix H relates the measurement tothe state of the ... able to search outside the information within the population In addition the theory is too simplistic to explain the complex operators and real encoding used in the algorithms developed and applied ... as the measurement error covariance R approaches zero, the gain approaches H-1 andthe state estimate (Eq 1.15) is dominated by the measurement On 14 Chapter Introduction theother hand if the...
... will then be possible to identify the appetite or attitude to that type of risk, together withthe capacity of the organisation to withstand that risk Finally, the organisation can determine the ... made to protocols Monitoring activities should provide assurance that there are appropriate controls in place and that the procedures are understood and followed Changes within the organisation and ... sector and those involved in the delivery of services tothe public There are many risk classification systems available andthe one selected will depend on the size, nature and complexity of the...