h4. Introduction Physicians are at the center of the health care process. In this central role, they use their knowledge, skills, and defined processes to provide or coordinate health care for patients. The success of the patient-physician relationship is determined by the way this relationship is valued, developed, nurtured, and maintained. Changes in the health care process bring changes in stakeholders, ...

h4. Introduction Erectile Dysfunction (ED) is defined as the consistent inability to achieve and maintain an erection of the penis sufficient to permit satisfactory sexual intercourse. The word "consistent" is included in the definition because an occasional episode of ED occurs in many men as a normal phenomenon. Additionally, the use of "impotence" as a synonym for ED has been virtually ...

h4. Introduction Cystic fibrosis (CF) is a systemic, recessively inherited disease affecting the glands that produce mucus, tears, sweat, saliva and digestive juices. Normally, these secretions are thin and slippery. But in CF, a defective gene causes the body's secretions to become thick and sticky. Instead of acting as a lubricant, the secretions may plug up tubes, ducts and passageways — ...

h4. Introduction Many drugs undergo oxidative biotransformation in order to be transformed from lipophilic to hydrophilic compounds so that they may be more readily eliminated from the body. The cytochrome P450 enzyme system is the major catalyst of oxidative biotransformation reactions involved in drug metabolism. The nomenclature of the cytochrome P450 enzyme system involves grouping the enzymes into families and subfamilies. ...

h4. Introduction Today's clinicians are busier than ever. The managed care revolution, reimbursement, loss of autonomy, and the Internet have all affected today's physician. The generalist is being asked to do more each day with less, and seems to be losing the war over billing, paperwork, independence, and turf. Because traditional CME frequently has been shown to be of limited value ...

The Problem: "It's my grandmother," explained the scared blond ten-year old. "She's sick again." With the help of some neighbors, Amra Omerovic's resourceful young grandson had brought her to the emergency room. This lovely silver-haired lady was in shock; her blood sugar levels were dangerously high. The doctor was baffled. If this 58-year-old Bosnian grandmother was taking her insulin "just like ...

h4. Introduction Low back pain is a universal phenomenon. The economic cost in the United States, in terms of lost time and medical expense, amounts to 1.9 billion dollars annually. Over 200,000 patients have surgery for ruptured lumbar discs yearly in the United States. While laminectomy for disc removal is the standard, it is not without its' well-known morbidity. Because of ...

h4. Introduction h4. Historical Development The complications associated with the administration of anesthetic agents were recognized almost immediately after the introduction of inhalation anesthesia in the mid 19th century. John Snow, the first recognized physician anesthesthetists in the Western World, and the author of what is probably the first major textbook on anesthesia, devoted one third of his text to the ...

h4. Introduction This course covers the history, required skills, and proper techniques of accessing and maintaining an implantable port in a clinical setting. The pros and cons of implantable ports versus other central lines are described and troubleshooting techniques are detailed. The importance of patient education is emphasized. The course work is intended for nurses, medical technicians, and physician assistants who ...

h4. General Principles Of Contact Dermatitis Introduction Why are we interested in the skin's reaction to foreign chemicals? Perhaps because many of us have had blisters from poison ivy, rashes from nickel in metal items like earrings or necklaces, or eczematous reactions to other everyday objects. A friend comes to visit one evening with a red rash around her eyes; she ...

h4. Chapter 2: Integumentary System The skin is the largest organ in the body. The normal adult has over 20 square feet of skin so it is easy to understand how something can go wrong with this much area to cover. As a membranous barrier between a person's outer and inner surroundings, the skin responds to external changes and also reflects ...

h4. Introduction Performing an accurate physical assessment and being able to differentiate normal from abnormal findings is one of the most important roles for today's health care practitioner. If an accurate physical assessment cannot be performed, whether for baseline data or when the patient's condition changes, then the patient is not receiving the level of competent care that should be given. ...

Psychosocial assessments are often overlooked as a portion of the physical examination. However, a person's psychological well-being has much to do with physical health. The following guide to psychosocial assessment can be remembered by the acronym "SELF PACING". The findings from this assessment in addition to the physical findings will provide a comprehensive view of the patient's status. S - Self-Esteem: ...

h4. Background h4. Overview Altered states of consciousness include a spectrum of conditions of a normal, paranormal or abnormal nature. This course will present information on the alterations in levels of consciousness that are produced as a result of definitive and usually demonstrable structural abnormalities of the brain. Normal alterations in consciousness such as sleep and dreams will not be discussed ...

h4. Introduction There are the traditional forms of management, which most of us grew to hate as we endured our supervisors and their enlightened whims. We all can relate to the plight of Dilbert, the cartoon engineer, who constantly fights a losing battle with his thickheaded boss. For most of us, there has been an occasional good manager who helped us ...

h4. Introduction According to a report in the New York Times (June 6th two years of war have resulted in the deaths of more than 1.7 million people in the eastern Congo. The report, based on a study released by the International Rescue Committee in New York, indicates that about four times as many people have died in the area since ...

h4. CRYPTOSPORIDIOSIS h4. Introduction Cryptosporidium parvum (C. parvum), a coccidian protozoan, has been recognized as a human pathogen only since 1976. It received widespread recognition as a disease-producing agent in 1993, when over 400,000 people in Milwaukee Wisconsin developed diarrhea after drinking water contaminated with C. parvum1. Similar, but less spectacular, outbreaks have been reported since then and C. parvum has ...

h4. Introduction Deep vein thrombosis (DVT) is the primary cause of fatal and nonfatal pulmonary embolism (PE). Most thrombi form in the deep calf veins - in the valve sinuses of the soleal veins or behind the valve cusps in the posterior and anterior tibial veins. However, 20% or more develop in the popliteal vein, femoral vein, and iliac branches, and ...

h4. Chapter 7: Endocrine System The endocrine system is composed of glands that both produce and secrete hormones. The pituitary gland secretes ACTH (adrenocorticotropic hormone) and TSH (thyroid stimulating hormone). These hormones stimulate the adrenal cortex and thyroid gland to do their jobs. The adrenal gland produces epinephrine, norepinephrine, and mineralcorticoids, glucocorticoids, and androgens. These hormones prepare people for emergency situations ...

h4. Chapter 8: Neurological System The nervous system consists of the central nervous system (CNS), the peripheral nervous system, and the autonomic nervous system. Together these three components integrate all physical, emotional, and intellectual activities. The CNS includes the brain and spinal cord. These two structures collect and interpret voluntary and involuntary sensory and motor signals. A brief overview of the ...