chapter 20 iterations and comprehensions part 2
Chapter 20 Patterns and UML pot
... (class member functions) Copyright © 20 06 Pearson Addison- 20 -27 Class Diagrams Example: Display 20 .6 A UML Class Diagram Copyright © 20 06 Pearson Addison- 20 -28 Class Diagrams Example Notes ♦ Data ... produce standard for all object-oriented design Copyright © 20 06 Pearson Addison- 20 -25 UML Lately ♦ Since 1996: ♦ Developed and revised with feedback from OOP community ♦ Today: ♦ UML standard ... Quicksort: ♦ Worst case: O(N2) (if split uneven) ♦ Average case: O(N log N) ♦ In practice, one of best sort algorithms Copyright © 20 06 Pearson Addison- 20 -21 Pragmatics and Patterns ♦ Patterns are...
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Chapter 017. Fever and Hyperthermia (Part 1) docx
... temperature is 36.8° ± 0.4°C (98 .2 ± 0.7°F), with low levels at A.M and higher levels at 4–6 P.M The maximum normal oral temperature is 37 .2 C (98.9°F) at A.M and 37.7°C (99.9°F) at P.M.; these ... infections and rapid breathing Lower-esophageal temperatures closely reflect core temperature Tympanic membrane (TM) thermometers measure radiant heat from the tympanic membrane and nearby ear canal and ... then rises by ~0.6°C (1°F) with ovulation and remains at that level until menses occur Body temperature can be elevated in the postprandial state Pregnancy and endocrinologic dysfunction also affect...
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Chapter 017. Fever and Hyperthermia (Part 2) docx
... prescription psychotropic drugs and illicit drugs Drug-induced hyperthermia may be caused by monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and amphetamines and by the illicit use of ... typically occurs in either very young or elderly individuals, particularly during heat waves According to the Centers for Disease Control and Prevention, there were 7000 deaths attributed to heat ... bedridden, persons taking anticholinergic or antiparkinsonian drugs or diuretics, and individuals confined to poorly ventilated and non-air-conditioned environments are most susceptible.Drug-induced hyperthermia...
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Chapter 017. Fever and Hyperthermia (Part 3) pot
... the Hypothalamic Set Point by Cytokines During fever, levels of prostaglandin E2 (PGE2) are elevated in hypothalamic tissue and the third cerebral ventricle The concentrations of PGE are highest ... induce PGE2 in peripheral tissues The increase in PGE2 in the periphery accounts for the nonspecific myalgias and arthralgias that often accompany fever It is thought that some systemic PGE2 escapes ... a dose of 2 3 ng/kg produces fever, leukocytosis, acute-phase proteins, and generalized symptoms of malaise Pyrogenic Cytokines Cytokines are small proteins (molecular mass, 10,000 20 ,000 Da)...
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Chapter 017. Fever and Hyperthermia (Part 4) potx
... receptors are called Toll-like receptors and are similar in many ways to IL-1 receptors The direct activation of Toll-like receptors also results in PGE2 production and fever Production of Cytokines ... levels and peak febrile elevations, the most valuable measurements in patients with fever are C-reactive protein level and erythrocyte sedimentation rate These markers of pathologic processes are particularly ... OR HYPERTHERMIA Physical Examination Attention must be paid to the chronology of events and to other signs and symptoms preceding the fever The temperature may be taken orally or rectally, but...
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Chapter 017. Fever and Hyperthermia (Part 5) pdf
... every 21 days and accompany the neutropenia There is no periodicity of fever in patients with familial Mediterranean fever Recurrent fever is documented at some point in most autoimmune diseases and ... CNS.Oral aspirin and acetaminophen are equally effective in reducing fever in humans Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and specific inhibitors of COX -2 are also excellent ... pyrogenic cytokines Limited experimental evidence indicates that ibuprofen and COX -2 inhibitors reduce IL-1-induced IL-6 production and may contribute to the antipyretic activity of NSAIDs ...
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Chapter 017. Fever and Hyperthermia (Part 6) doc
... and thalidomide in Schnitzler's syndrome Ann Rheum Dis 65:5 42, 20 06 Dinarello CA: Infection, fever, and exogenous and endogenous pyrogens: Some concepts have changed J Endotoxin Res 10 :20 2, 20 04 ... expression Proc Natl Acad Sci USA 99:13 926 , 20 02 [PMID: 122 423 29] Dinarello CA: Differences between anti-tumor necrosis factor-alpha monoclonal antibodies and soluble TNF receptors in host defense ... Med 346:1978, 20 02 [PMID: 120 75060] Chandrasekharan NV et al: COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: Cloning, structure, and expression...
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Chapter 018. Fever and Rash (Part 2) pot
... subsided It consists of 2- to 3-mm rose-pink macules and papules that rarely coalesce, occur initially on the trunk and sometimes on the extremities (sparing the face), and fade within days Although ... received the killed measles vaccine between 1963 and 1967 in the United States and who were not subsequently protected with the live vaccine Hand-foot -and- mouth disease (Chap 184), most commonly caused ... spread diffusely and involve mucosal surfaces Stevens-Johnson syndrome is considered a maximal form of erythema multiforme and is lifethreatening Lesions may develop on the hands and feet in endocarditis...
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Chapter 018. Fever and Rash (Part 3) potx
... appropriate travel history and a petechial rash Thrombotic thrombocytopenic purpura (Chaps 54, 101, and 109) and hemolytic-uremic syndrome (Chaps 109, 143, and 147) are closely related and are noninfectious ... Elsevier Saunders, 20 06 Schlossberg D: Fever and rash Infect Dis Clin North Am 10:101, 1996 [PMID: 8698985] Weber DJ et al: The acutely ill patient with fever and rash, in Principles and Practice of ... 1, 6th ed, GL Mandell et al (eds) Philadelphia, Elsevier Churchill Livingstone, 20 05, pp 729 –746 Wenner HA: Virus diseases associated with cutaneous eruptions Prog Med Virol 16 :26 9, 1973 [PMID:...
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Chapter 020. Hypothermia and Frostbite (Part 1) potx
... hypothermia Hypothyroidism—particularly when extreme, as in myxedema coma—reduces the metabolic rate and impairs thermogenesis and behavioral responses Adrenal insufficiency and hypopituitarism also ... surface-to-mass ratio and their lack of effective shivering and adaptive behavioral responses In addition, malnutrition can contribute to heat loss because of diminished subcutaneous fat and because of ... loss), reduces thermogenesis and gluconeogenesis, and may impair judgment or lead to obtundation Phenothiazines, barbiturates, benzodiazepines, cyclic antidepressants, and many other medications...
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Chapter 020. Hypothermia and Frostbite (Part 2) pot
... shiverin r oderate with behavio M ism g < 32. 2°C E EG Prog ressive Hypo ventilation; 0% Hyp oreflexia; (90°F)– abnorm decrease in 50% 28 °C alities; pulse ( 82. 4°F progres cardiac carbon blood induced ... Pulm onic D ecrease No 28 °C oss motion; ( 82. 4°F cerebro decrease in congestion ) vascula blood and edema; blood nerve- r pressure, 75% conduction autoreg heart ulation; and cardiac oxygen decreas ... Table Hypothermia 20 -2 Physiologic Changes Associated with Accidental S everity B C Car entral Tempe Nervou r rature s Endocr System ine ild 5°C L inear Tach ycardia, enal Neur and iratory R ody...
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Chapter 020. Hypothermia and Frostbite (Part 3) doc
... be corrected for temperature (Chap 48) An uncorrected pH of 7. 42 and a PCO2 of 40 mmHg reflects appropriate alveolar ventilation and acid-base balance at any core temperature Acid-base imbalances ... CO2 production When the PCO2 decreases 10 mmHg at 28 °C, it doubles the pH increase of 0.08 that occurs at 37°C The severity of anemia may be underestimated because the hematocrit increases 2% ... is temperature-dependent, and platelet function is impaired The administration of platelets and fresh frozen plasma is, therefore, not effective The prothrombin or partial thromboplastin times...
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Chapter 020. Hypothermia and Frostbite (Part 4) pot
... perfusionist/pump/anticoagulation Flow rates 22 5–375 mL/min ROR 3°–4°C/h Cardiopulmonary bypass (CPB) Circuit—full circulatory support with pump and oxygenator Perfusate-temperature gradient (5°–10°C) Flow rates 2 7 L/min (ave ... 150–400 mL/min ROR 2 –3°C/h Hemodialysis Circuit—single or dual vessel cannulation (HD) Stabilizes electrolyte or toxicologic abnormalities Exchange cycle volumes 20 0–500 mL/min ROR 2 –3°C/h Continuous ... active core rewarming, it eliminates respiratory heat loss and adds 1° 2 C to the overall rewarming rate Crystalloids should be heated to 40°– 42 C, but the quantity of heat provided is significant...
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Chapter 020. Hypothermia and Frostbite (Part 5) pdf
... most of the symptoms and signs of infection, notably fever and leukocytosis Shaking rigors from infection may be mistaken for shivering Except in mild cases, extensive cultures and repeated physical ... arteriovenous shunting increases tissue pressures, and edema forms Finally, thrombosis, ischemia, and superficial necrosis appear The development of mummification and demarcation may take weeks to months ... First-degree frostbite causes only anesthesia and erythema The appearance of superficial vesiculation surrounded by edema and erythema is considered second degree (Fig 20 -1) Hemorrhagic vesicles reflect...
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Chapter 022. Dizziness and Vertigo (Part 1) doc
... semicircular canals and the otolithic apparatus (utricle and saccule) on each side The canals transduce angular acceleration, while the otoliths transduce linear acceleration and the static gravitational ... cranial nerves III, IV, and VI; spinal cord; cerebral cortex; and cerebellum The vestibuloocular reflex (VOR) serves to maintain visual stability during head movement and depends on direct projections ... the pons and, via the medial longitudinal fasciculus, to the third (oculomotor) and fourth (trochlear) cranial nerve nuclei in the midbrain These connections account for the nystagmus (to -and- fro...
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Chapter 022. Dizziness and Vertigo (Part 2) pps
... the lesion side, and the tendency to fall is toward the side of the lesion, particularly in darkness or with the eyes closed Under normal circumstances, when the head is straight and immobile, the ... central connections The vertigo is associated with jerk nystagmus and is frequently accompanied by nausea, postural unsteadiness, and gait ataxia Since vertigo increases with rapid head movements, ... rate from one and a commensurate decrease from the other This change in neural activity is ultimately projected to the cerebral cortex, where it is summed with inputs from the visual and somatosensory...
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Chapter 022. Dizziness and Vertigo (Part 3) doc
... upright may also be present Table 22 -1 Benign Paroxysmal Positional Vertigo and Central Positional Vertigo Features BPPV Central Latencya 3–40 s None: immediate vertigo and nystagmus Fatigabilityb ... cerebellum can cause acute vertigo, but associated signs and symptoms usually permit distinction from a labyrinthine etiology (Table 22 -2) Occasionally, an acute lesion of the vestibulocerebellum ... present with monosymptomatic vertigo indistinguishable from a labyrinthopathy.Table 22 -2 Features of Peripheral and Central Vertigo Sign or Symptom Peripheral Central (Labyrinth) (Brainstem or Cerebellum)...
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Chapter 022. Dizziness and Vertigo (Part 4) doc
... decreases cerebral blood flow and should reproduce ischemic symptoms Hyperventilation is the cause of dizziness in many anxious individuals; tingling of the hands and face may be absent Forced ... Patients with symptoms of positional vertigo should be appropriately tested (Table 22 -1) A final provocative and diagnostic vestibular test, requiring the use of Frenzel eyeglasses (self-illuminated ... hyperventilation syndrome, hypoglycemia, and the somatic symptoms of a clinical depression; these patients should all have normal neurologic examinations and vestibular function tests Depressed...
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Chapter 022. Dizziness and Vertigo (Part 5) pptx
... Table 22 -3 Treatment of Vertigo Agenta Doseb Antihistamines Meclizine 25 – 50 mg times/day Dimenhydrinate 50 mg 1 2 times/day Promethazinec 25 – 50-mg suppository or IM Benzodiazepines Diazepam 2. 5 ... times/day Clonazepam 0 .25 mg 1–3 times/day Phenothiazines Prochlorperazinec mg IM or 25 mg suppository Anticholinergicd Scopolamine Patch transdermal Sympathomimeticsd Ephedrine 25 mg/d Combination ... neurodiagnostic studies.Vertigo: Treatment Treatment of acute vertigo consists of bed rest (1 2 days maximum) and vestibular suppressant drugs such as antihistaminics (meclizine, dimenhydrinate, promethazine),...
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Chapter 022. Dizziness and Vertigo (Part 6) pot
... BPPV from Italy and Korea Further Readings Dieterich M: Dizziness The Neurologist 10:154, 20 04 [PMID: 1514 027 5] Halmagi GM: Diagnosis and management of vertigo Clin Med 5:159, 20 05 Leigh RJ, Zee ... York, Oxford, 20 06, pp 76–79; 559–597 Strupp M et al: Methylprednisolone, valacyclovir, or the combination for vestibular neuritis N Engl J Med 351:354, 20 04 [PMID: 1 526 9315] ———, Brandt T: Pharmacological ... of neurootological and eye movement disorders Curr Opin Neurol 19:33, 20 06 White J et al: Canalith repositioning for benign paroxysmal positional vertigo Otol Neurotol 26 :704, 20 05 [PMID: 16015173]...
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