วันอาทิตย์ที่ 30 ตุลาคม พ.ศ. 2554
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Pai, você está certo. Linski. Que era o seu nome. Linski.
Richard? Harry sugeriu.
Exatamente, pai. Richard Linski.
Mas ele não era bom, Harry disse a parede passado ombro esquerdo de Ben. Então, nós temos o tutor segundo, e depois notas Michael melhorou. Ele era um bom menino.
Uma vez, ele foi, papai. E você sabe, eu onde comprar Cialis não o culpo por tudo isso. Muita culpa para nós a participar dele.
Ben sentiu sua tristeza estranha chupar-lo tão seguramente como se tivesse sido apanhado em um redemoinho em um mar escuro.
Glenda disse: Você pode feitiço que o sobrenome para mim.
L-i-n-s-k-i, disse Lora.
Richard Linski.
Michael não gostava dele, Lora disse.
Michael era um bom menino, mãe. Harry tinha lágrimas em seus olhos.
Vendo condição de seu marido, Lora disse Karnes, não vamos culpar o rapaz muito, papai. Eu concordo. Ele não era mau.
Não pode culpar uma criança por todos os seus defeitos, mãe.
Você tem que voltar para os pais, pai. Se Michael não era tão perfeito, então é porque não estávamos nos aperfeiçoar.
Como se falar com o evangelista silenciado na televisão, Harry Karnes, disse, Você não pode criar um filho piedoso quando você fez coisas más a si mesmo.
Medo de que o casal estava prestes a Comprar cialis generico descer em uma série de confissões teary que faria sentido não mais do que as palavras na samplers needlepoint, Ben abruptamente se levantou e pegou a mão de Glenda como ela se levantou ao lado dele. Desculpe ter trazido tudo isso para trás em sua mente de novo.
Não em todos, Lora disse Karnes. Castiga memória.
Uma das citações na parede chamou a atenção de Ben:
Mrs. Karnes, disse Ben, você fez a si mesmo samplers?
Sim. Needlepoint ajuda a manter as minhas mãos para a obra do Senhor.
Eles são adoráveis. Mas eu queria saber ... o que é que um significa exatamente?
Sete trovões de uma só vez, ela disse calmamente, sem fervor, na verdade, com uma autoridade irritantemente calma que fez parecer como se o que ela disse com certeza deve fazer sentido. É assim que será. E depois vamos saber por que tem sempre que fazer o nosso melhor. Então nós desejamos que nós tínhamos feito melhor, muito melhor, quando os sete trovões rolar tudo de uma vez.
Na porta da frente, como Ben e Glenda estavam saindo, a Sra. Karnes, disse, Deus opera através de você, Sr. Chase?
Ele não trabalhar com todos nós? Ben perguntou.
Não. Alguns não são suficientemente fortes. Mas você, é você Sua mão, o Sr. Chase?
Ele não tinha comprar cialis barato idéia do que ela queria responder. Eu não penso assim, a Sra. Karnes.
Ela seguiu-los para o andar da frente. Eu acho que você é.
Então, Deus trabalha de maneira ainda mais misterioso do que alguém já sabia antes.
Acho que você está a mão de Deus.
O escaldante, o sol de fim de tarde era opressiva, mas Lora ainda refrigerados Karnes Ben. Ele virou-se ela sem outra palavra.
A mulher ainda estava de pé na porta, olhando, como se afastavam no Mustang agredidas.
วันเสาร์ที่ 19 มีนาคม พ.ศ. 2554
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วันพุธที่ 26 มกราคม พ.ศ. 2554
Fungal infections
Most often mycotic process is due to fungi Candida spp., Which accounted for 80% of all nosocomial fungal infections.
Epidemiology of invasive candidiasis. Of the yeasts most frequent pathogens are Candida albicans. However, there is a tendency to decrease the frequency of their isolation from 80-90% (70-80 years) to 40-60% (90 years). Starting with the 90-ies increases the allocation of Candida non-albicans: C. tropicalis, C. krusei, C. glabrata, C. kefyr, C. parapsilosis and others [1]. The share of infections caused by C. glabrata, has from 5 to 35%, C. tropicalis - from 8 to 43%. C. lusitaniae, C. dubliniensis, C. guilliermondii are rare pathogens.
Risk factors in the development of invasive candidiasis. Factors determining the occurrence of invasive candidiasis in surgical patients are different from the factors that induce fungal infections in patients that category. The main factors include abdominal surgery, especially repeated, which accounted for 75% of all cases of fungal infections. Another no less important a factor is age (approximately 50% of fungal infections in surgical practice recorded in patients over 60 years). The likelihood of developing candidemia was significantly higher if the treatment of infectious complications using three or more antibiotics [4]. In the multivariate analysis showed that colonization of Candida spp. many loci (eg, oral cavity, intestines, vagina), prior hemodialysis, parenteral nutrition, presence of central venous catheters, especially the three-way, are also significant factors influencing the occurrence of invasive candidiasis [5]. Invasive candidiasis is most often detected in patients with extensive burns, with urinary catheter receiving antacids, H2-blockers or other means to suppress gastric acidity, glucocorticoid drugs for a long time applying antimicrobials.
Pathogenesis. Candidiasis is primarily an endogenous infection. Candida brand viagra may colonize the skin, mucous oropharynx, intestine, and their translocation occurs through the intestinal epithelium [6]. In such an embodiment, dissemination, through the bowel, Candida infestation occurs, primarily the liver, spleen, and lungs. Other entrance gate for Candida - venous catheters [6]. Injection catheters happens to the skin or the patient through the hands of medical staff. In this way dissemination of mushroom bodies, are particular targets, usually the kidneys, heart and lungs. Candida in the blood circulation is a short time, then, damaging the endothelium, they are introduced to the bodies, leading to the formation of small abscesses.
Invasive candidiasis
Candidemia - a selection of fungi Candida spp. at least one blood culture is always taken into consideration and is the basis (if any symptoms of infection) to conduct an adequate antimycotic therapy. It should be noted that some patients detect Candida spp. in the blood can not clinically manifested. A similar course of infection occurs in patients with uremia, in the treatment of glucocorticoid agents.
Acute disseminated candidiasis - Candida infestation is one or more bodies hematogenous route. The defeat of the yeast may be any organ, but most often involved in the process of liver, kidney, spleen, heart, the eyes, lungs, brain, skin and subcutaneous tissue. In these cases, the fungi can be detected only by culturing and / or histological examination of biopsy specimens organs.
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วันพฤหัสบดีที่ 20 มกราคม พ.ศ. 2554
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The drug is based on an extract of red brand viagra online vine leaves has a complex effect and combines endotelioprotektivny, anti-inflammatory, anti effect. Due to this, a normalization of the structure and function of the venous wall. Therapeutic effect of the drug on the basis of an extract of red vine leaves appears, usually within 2-3 weeks after starting. Maximum same therapeutic effect is achieved after 4-6 weeks of continuous administration. This is an important argument when dealing with the objections of buyers about the price. Therefore, the client can explain that if you divide the cost of packing on the duration of treatment, you get not a very large sum.
It happens that the buyer is absolutely satisfied with everything in the proposed medicinal product, but it still fluctuates. Give the last argument: once more point to what he loses by not buying the product. In this case - the opportunity to protect themselves (in the case of prevention) or to get rid of chronic venous insufficiency - the pain and heaviness in the legs, swelling.
Expert opinion
Rostislav SINITSYN, doctor of the highest category of the Department of Surgery NMHTS them. Pirogov
Chronic venous insufficiency - a violation of the outflow of blood from the legs, which leads to serious disturbances in their trophic.
What are the causes of chronic venous insufficiency? It is believed that the main reason - bipedalism. Ever since man stood up on its hind limbs, the load on the leg veins are greatly increased. Hence, we are all brand name levitra sooner or later doomed to a certain extent on the development of CVI. In fact, venous insufficiency - is a collective term that combines several different diseases. In addition, this term describes a set of symptoms that develop as a result of impaired blood flow in the veins. Such symptoms are pain in the legs, swelling of feet and leg disorders of the skin (trophic disorders). These symptoms may be expressed to a greater or lesser degree. Sometimes the disease begins with thrombophlebitis of the veins, which later joins the expansion of the surface veins. Sometimes, chronic venous insufficiency is a consequence of phlebothrombosis.
Chronic venous insufficiency may be due to a congenital abnormality or pathology of the venous system, as well as injuries veins. Other causes of CVI are very rare.
All negative factors contribute to the development of venous insufficiency:
• cardiovascular disease;
• bad heredity: the presence of relatives with diseases of the veins;
• gender: women - the most frequent patients Phlebology. By the development of disorders cause high levels of estrogen, pregnancy, childbirth;
• hormonal preparations;
• Age: the age increases the risk of CVD;
• lack of exercise (low mobility);
• overweight and obesity;
• frequent heavy lifting;
• long-term static load: sedentary or standing work, travel, travel in public transport;
• addiction to prolonged exposure to heat or direct sunlight;
• Chronic constipation;
• Foot injury;
• have already migrated thrombosis or thrombophlebitis.
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วันอาทิตย์ที่ 9 มกราคม พ.ศ. 2554
Helium-neon laser
Describing the importance of lymph nodes in the body can distinguish the following important functions: haematopoietic, immunological, exchange and storage tanks. Functional status of the lymph nodes have a decisive influence on the course of the inflammatory response, the spread of infection the formation of new metastatic lesions of purulent-inflammatory process.
According to the theory of segmental structure of the lymphatic system, there is a certain limforazdel abdominal organs. So from the top floor of the abdomen most of the lymph flows away to the lymph nodes of lesser omentum. From the bodies of the middle and lower floors of the abdominal cavity preferential lymph drainage is carried out in mesenteric lymph nodes. Based on these data, it becomes clear need for therapeutic effect on a particular group of lymph nodes, depending on the localization of pathology and surgical intervention in the abdominal cavity.
Known a lot of literature about the successful use of laser surgery. A positive effect of laser on the immune system, microcirculation, recovery, etc. However, until recently, no attempts were made to the impact of the laser to the lymph nodes.
Materials and methods:
Given the above conditions of laser irradiation of lymph nodes of the abdominal cavity for prevention and treatment of inflammatory complications, we propose a method of segmental laser irradiation of the lymph nodes of the abdomen in the postoperative period (patent number 4989).
The essence of this method is that introoperatsionno a small gland or the mesentery brand viagra and large intestine depending on the region of operation through which the catheter is installed in the postoperative period through the optical fiber produced helium-neon irradiation of different groups of lymph nodes. Irradiation produced a helium-neon laser ILGN-104, power 20 mW, a wavelength of 0.63 microns.
Before the widespread use of the method in patients, we carried out experimental and clinical oprabatsiya laser lymphatic therapy.
The experiments were performed on 30 Wistar rats with tsekotomnoy linear scar. All the animals were divided into two groups: control 18 animals, 12 animals and a major.
The rats in the core group used laser irradiation of the right colonic mesenteric lymph nodes in the postoperative period, through a thin PVC catheter.
The research results were evaluated using scanning electron and transmission microscopy of lymph nodes and intestinal wall.
The clinic employed a method in 120 patients (with resection of the stomach, cholecystectomy operations in the small intestine and large intestine) with identical operations of 115 patients in the control group.
Results of experimental studies have shown that the operation leads to swelling and increase the size of mesenteric lymph nodes, decreased clearance of sines with content in them a large number of tissue detritus, microbes and edema fluid.
Study of the cellular composition of lymph nodes revealed the predominance of macrophages and leukocytes with relatively low content of lymphocytes, especially at 3 and 6 days after surgery. These studies have shown that surgical trauma is accompanied by microbial contamination leads to an overload of the regional viagra the disease and its treatment lymph nodes associated with the massive arrival of edema fluid, microbes and products dismetabolizma of an inflammatory focus in the wall of the cecum.
The morphology of the intestinal wall also revealed a pronounced inflammatory infiltration of intercellular spaces in the zone of injury, edema, hyperemia of blood and lymphatic capillaries.
Use of laser irradiation of lymph nodes, a very positive influence on the course of the inflammatory response. So after three sessions of laser therapy significantly reduced lymphatic edema of the stroma of lymph nodes, enlarged marginal gaps and central sinuses. Increases of lymphocytes and plasma cells, compared with a control group in the lumen of the sinuses reduces the content of tissue detritus and microbes. A better picture can be seen in the intestinal wall, where there is significant reduction of morphometric stromal edema, narrowing of the lumen of lymphatic capillaries and venules.
Results of clinical studies have shown that the use of laser irradiation of regional lymph nodes can provide a smoother postoperative course. Thus, in the main group of patients rapidly eliminated leukocytosis and elevated ESR. Quickly returned to normal body temperature is restored laxation. All this contributed to a more active management of early postoperative period, with early feeding and standing patient from the bed. Thanks to laser lymphatic therapy could reduce the number of inflammatory complications from 12,2 to 3,1%.
Discussion.
Summarizing the results of experimental and clinical research we can say that the use of helium-neon laser irradiation to regional lymph nodes of the pathological focus is having a very positive impact. Marked improvement in the morphological picture of the regional lymph nodes. This is manifested reduced edema of the stroma of lymph nodes, with the improvement of the capacity of central and morginalnyh sinuses. Through the use of laser marked decrease in the concentration of microbes in the lumen of the sinuses, increasing the number of lymphocytes and plasma cells. Improve drainage and immunological functions of the regional lymph nodes promotes unloading interstitium of the intestinal wall from excess edematous interstitial fluid, it creates the conditions for the strength of the intestinal suture. Around the wound is reduced inflammatory infiltration, more increases of lymphocytes by improving microcirculation. Regional impact of the laser to the lymph nodes of the pathological process is in our opinion one of the pathogenetic methods of prevention and treatment of inflammatory complications. After all, the lymph nodes first to stand in the way of spreading infection. In some cases, infection with virulent and attenuated protective function of the body's own lymph nodes become gathering places, and microbial growth (suppurative lymphadenitis) All this indicates a need influence at the regional lymph nodes in the fight against this pathology. Clinical studies have confirmed the experimental data on the effectiveness of the method. It is important to note that the method is very easy to implement and can be successfully used in surgical units at any level.
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วันอาทิตย์ที่ 2 มกราคม พ.ศ. 2554
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It is impossible not to recognize that cloning has its pros - the artificial cultivation of human organs. This, say doctors (incidentally not all) is even very good purpose and not contrary to the moral and ethical standards. Seemingly simple truth, but behind it is not a correct understanding of medical earthly life, death and eternal life.
Extend the life of man can and with the help of, for example, fetal therapy *. An example of this can serve as a BN Yeltsin, whose bodies are not just rejuvenates with the help of the "treatment". Currently, fetal therapy literally proclaimed panacea for all ills - from endocrine disorders to hematological diseases, immunological and neurological diseases.
Professor AP Akifyev, Head of Laboratory of the mechanisms of mutagenesis of the Institute of Chemical Physics. Semenov Sciences, calls on the leaders of the state - and the theorists and practitioners who are engaged in reforming the society, to take into account the dual, bisotsialnuyu human nature. "All that we are now seeing: the decline of discipline and ethics, laziness, extremely low labor productivity and product quality (99% of which are not competitive on the world market), the desire to do everything and gotten a sense of joy and pride for the perfect fraud or petty theft, unbelievable scale drunkenness, stiffness (example - hazing in the army), the countless, sometimes very cynical violation of doctors of their moral code - the Hippocratic oath, the catastrophic rise in crime, from my point of view, the evidence not only about the evils of the system, but also reflects the signs of genetic degradation of the nation, was a consequence of the rule of totalitarianism. "
Thus good intentions to improve the ailing humanity to be implemented, focusing on the best brand name viagra human qualities. However, one can not but recall that the essence of chelovekobozhiya is principled distinction between natural rights and the separation from the spiritual.
From the Orthodox point of view of human cloning (and not just him) - is a violation of Christian ethics. Some local Orthodox Church has spoken out about the incompatibility of the latest genetic technologies with a Christian worldview and the institution. You can only add to this the fact that in today's cloning so clearly looked through davola smirk, because all the intrigues of the enemy of the human reduced to a blasphemous parody of what God created. Cloning in a literal sense - it's the devil trying to copy a creature and a man who has in his image and likeness of God.
* Fetal therapy - a treatment with drugs made of tissues and organs of embryos of different age groups.
On the negative attitude of the Russian Orthodox Church to the cloning of shows as well and Deacon Andrei Kuraev, which is in one of his books, notes that: "Christians do not set themselves the task of breeding a new race of people through the use of genetic engineering **. neo-paganism, in contrast, is quite ready for the gene - plant breeding with humanity ***. "
It is obvious that humanity can not go this way, because even reaching them recognize that the consequences of scientific discovery can be very unpredictable, and that would be a creature that it will carry in my soul, which distorted the original intent will become, no one knows.
** Genetic engineering - a design of living cells and organisms with foreign genes (taken from other organisms), and therefore the modified hereditary traits.
*** Deacon Andrei Kuraev: "On our defeat." - Svetloyar "Fund" Blagovest "- Petersburg, 1999., P.13.
New reproductive technologies and Orthodoxy.
In the media, and special medical information has been intensively discussed problem of "family planning". Developed the so-called new reproductive technologies (NRT, they are also - assisted reproduction techniques): artificial insemination by husband or donor semen, in vitro fertilization (IVF), the transfer of germ cells before their fusion (gametes) and eggs after fertilization (zygote) in the tube and the uterus , a surrogate - motherhood, fertilization in vitro by mikromanipulyatsionnoy technology (eg, injection of sperm into the egg) and some others.
Advertising substantiation of new reproductive technology looks very attractive. "Methods for HPT developed in response to the acute problem of infertility in marriage." Currently in the world suffer from infertility 15 - 20% of married couples. Childlessness has become not only medical but also social problems which have an extremely negative impact on the institution of the modern family.
Fertilization in vitro can be mothers, even those women whose infertility was absolute - in the absence of the uterus. These states can be congenital or acquired, when a woman is deprived of the uterus in the operative surgery due to an illness.
Development mikromanipulyatsionnoy technology allowed to enter the sperm directly into an egg. To become fathers may now be men, not previously respond to treatment, which, instead of several million active healthy sperm in each milliliter of seminal fluid there are only a few weak and inactive.
Thus, this method can overcome the sterility of almost all married couples. Achieved a breakthrough in the long and severe the problem of infertility. It is reported that in the world with HPT was born around 150 000 children.
To justify experimentation on human beings and the whole system as a whole HPT argue that an embryo becomes a person only with a 14 - day of development. Requested prior to 14 - day called fetus is not an embryo, and preembrionom. In this Viagra two-chamber vessel regard, we discuss the right to use preembrionov human science - for research purposes (certainly for the good of the human race ").
Field of application methods HPT is expanding. Continuing and experiments on humans. The nature of these experiments in the press is not directly reported, but you can make about them representation on the recommendations of a commission of experts, dealing with the ethical issues of IVF:
1 Research on human embryos are necessary, since in animal experiments can not always get answers to questions about the person. Do not use for research purposes of human embryos older than 14 - th day of intrauterine development. A special "products" of embryos for research purposes and their sale is prohibited.
Two embryos, which were what - or manipulation for research purposes, can not be implanted in the uterus.
3 Do not permitted (except for purposes of gene therapy) studies aimed at altering the genetic structure of gametes and human embryos, the formation of chimeras with other cells, the selection of embryos by sex in order to change it.
4 prohibits fertilization of human sperm cells of animals and the transfer of human embryos in the uterus of animals. During fertilization of oocytes animal sperm man is forbidden to continue further development of the zygote of the first cleavage.
5 The duration of cryopreservation of gametes, and their fate is determined only by agreement with their "owners".
The famous Hippocratic Oath shows that even in pagan times people understood the crime of interference in fetal life and the responsibility of a doctor for it. Activities of specialists HPT not only violates the principles of medical practice thousands of years, but also leads them to understand themselves not behave like doctors. Even the word "doctor" is usually replaced by the word "specialist".
The basis of the Christian family is the piety and harmony with God's will, the foundation of the house - a stone of faith and fear of God. HPT as well as all the methods related to genetic or obstetric intervention in the human body, with Orthodoxy has nothing to do but has a rapport with the spirits of wickedness.
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