Y. Zakosh. Georgia Southern University.

Gg gallium scan A test to detect sites in the body where cells are multiplying rapidly buy 1.5mg haldol with mastercard medicine wheel native american, such as tumors or areas of inflammation cheap haldol 5mg amex treatment variance. A small amount of radioactive gallium is injected into a vein, and the element is taken up by cells that are rapidly divid- G In genetics, guanine, one member of the G-C ing. There can be just one enzyme that red blood cells rely heavily on because large stone, hundreds of tiny stones, or any combi- it protects the cells against oxidative stresses. If a gallstone provide early diagnostic clues for a number of dis- blocks the opening to the pancreatic duct, which orders, including cerebral palsy, Parkinson’s dis- opens into the common bile duct, digestive enzymes ease, and Rett syndrome. Gallstones may not cause symptoms or may disaccharide that is made up of two sugars, galac- lead to pain for up to several hours in the upper tose and glucose, that are bound together. Gallstones are most common in damage to the liver, brain, kidneys, and other among women, Native Americans, Mexican organs in infants due to the accumulation of galac- Americans, and people who are overweight. Individuals with galac- Laparoscopic surgery to remove the gallbladder is tosemia cannot tolerate any amount of human or the most common treatment. Dry gangrene is the death of tissue due to vascular insufficiency without bacte- gastric cancer See cancer, gastric. For a gastric emptying study, a patient eats a meal in grene occurs when body tissue is invaded by bacte- which the food or beverage is mixed with a small ria that thrive in areas of low oxygen content. A scanner that acts bacteria are called anaerobic bacteria and include like a Geiger counter is placed over the stomach to the Clostridium family of bacteria. The bacteria gen- monitor the amount of radioactivity in the stomach erate gas and pus; the tissues swells and can for several hours after the test meal. Wet gangrene requires urgent antibiotic treatment and sometimes surgical abnormal emptying of the stomach, the food and radioactive material stay in the stomach longer than drainage. Gastroenteritis has numer- gastrectomy Surgery to remove part or all of the ous causes, including infections (viruses, bacteria, stomach. Gastric atro- phy may result in a lack of digestive juices due to gastroesophageal reflux disease A condition in accompanying shrinkage of the digestive glands. The operation is sometimes called gastric increases the risk of cancer of the esophagus. Treatment may involve the use of antacids or just after birth to a form so mild that it may not be medications to decrease acid production or acceler- diagnosed until old age. Changes in the gene are likely gastroparesis A disease of the muscles of the to be lethal. Gastroparesis may be associated gene, zygotic lethal A gene that is fatal for the with paralysis of the small intestine and colon. The zygote, the cell formed by the union of a sperm and most common underlying cause is diabetes mellitus. The zygote would normally develop into an Gastroparesis is diagnosed via gastric emptying embryo, as instructed by the genetic material within study. A zygotic lethal gene is a mutated version of a normal gene gastroscope A flexible, lighted instrument that is that is essential to the survival of the zygote. Tissue from the stomach can be removed gene deletion The total loss or absence of a through a gastroscope. A gastrostomy may be used for feeding, usually gene duplication An extra copy of a gene. Expressed endoscope is passed through the mouth, throat, and genes include genes that are transcribed into mes- esophagus to the stomach. The genes in a gene due to deficient activity of the enzyme glucocere- family are descended from an ancestral gene. For brosidase, which leads to accumulation of gluco- example, the hemoglobin genes belong to one gene cerebroside in tissues of the body. The five types of family that was created by gene duplication and Gaucher disease encompass a continuum of clinical divergence. They must be near enough to the genital herpes An infection by human herpes target gene to be genetically linked to it and to be virus that is transmitted through intimate contact inherited, usually together with that gene, and with the moist mucous linings of the genitals. When an infected person has a herpes product is a measure of the degree of gene activity. Also known general paresis Progressive dementia and gen- as condyloma acuminatum, condylomata, and vene- eralized paralysis due to chronic inflammation of the real warts. General paresis is a part of late (tertiary) genitalia The male or female reproductive syphilis and is very rare today. The female internal genitalia are the ovaries, Fallopian tubes, uterus, cervix, and vagina. The male internal genitalia are the testes, epididymis, and vas genetic code See code, genetic. Humans and many other higher animals actually have two genetic infantile agranulocytosis See severe genomes—a chromosomal genome and a mito- congenital neutropenia.

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However haldol 1.5 mg with visa treatment borderline personality disorder, in correlational research buy haldol 1.5mg overnight delivery treatment quadricep strain, we do not always know which factor occurred first. For example, if we simply measure the coffee drink- ing and nervousness of some people after the fact, it may be that participants who were already more nervous then tended to drink more coffee. Therefore, maybe greater nerv- ousness actually caused greater coffee consumption. But, in correlational research, we do little to control or eliminate other potentially causal variables. For exam- ple, in the coffee study, some participants may have had less sleep than others the night before testing. Perhaps the lack of sleep caused those people to be more nervous and to drink more coffee. In experiments we apply the in- dependent variable first, and we control other potential causal variables, so experiments provide better evidence for identifying the causes of a behavior. Unfortunately, this issue is often lost in the popular media, so be skeptical the next time some one uses correlation and cause together. The problem is that people often ignore that a relationship may be a meaningless coincidence. For example, here’s a re- lationship: As the number of toilets in a neighborhood increases, the number of crimes committed in that neighborhood also increases. Crime tends to occur more frequently in the crowded neighborhoods of large cities. Here’s a serious example: A particular neurological disease occurs more often in the colder, northern areas of the United States than in the warmer, southern areas. But, for all the reasons given above, the mere ex- istence of this relationship is not evidence of causality. The north also has fewer sunny days, burns more heating oil, and differs from the south in many other ways. One of these variables might be the cause, while coincidentally, colder temperatures are also present. Instead, correlational research is used to simply describe how nature relates the variables, without identifying the cause. Distinguishing Characteristics of Correlational Analysis There are four major differences between how we handle data in a correlational analy- sis versus in an experiment. First, back in our coffee experiment, we would examine the mean nervousness score (Y) for each condition of the amount of coffee consumed (X). With correlational data, however, we typically have a large range of different X scores: People would probably report many amounts of coffee beyond only 1, 2, or 3 cups. Therefore, in correlational procedures, we do not compute a mean Y score at each X. A second difference is that, because we examine all pairs of X–Y scores, correla- tional procedures involve one sample: In correlational designs, N always stands for the number of pairs of scores in the data. Third, we will not use the terms independent and dependent variable with a correla- tional study (although some researchers argue that these terms are acceptable here). Conversely, if we ask, “For a given nervousness score, what is the amount of coffee consumed? Further, recall that, in a relationship, particular Y scores naturally occur at a particular X. The procedures for doing this are described in the next chapter, where the X variable is called the predictor variable, and the Y variable is called the criterion variable. As you’ll see, researchers used correlational techniques to identify X variables that are “good predictors” of Y scores. Finally, as in the next section, we graph correlational data by creating a scatterplot. Plotting Correlational Data: The Scatterplot A scatterplot is a graph that shows the location of each data point formed by a pair of X–Y scores. It shows that people drinking 1 cup have nervousness scores around 1 or 2, but those drinking 2 cups have higher nervousness scores around 2 or 3, and so on. Thus, we see that one batch of data points (and Y scores) tend to occur with one X, and a different batch of data points (and thus different Y scores) are at a different X. Real research typically involves a larger N and the data points will not form such a clear pattern. A data point that is relatively far from the majority of data points in the scatterplot is referred to as an outlier—it lies out of the general pattern. When you conduct a correlational study, always begin the analysis by creating a scat- terplot. The scatterplot allows you to see the relationship that is present and to map out the best way to summarize it. Instead, from the description provided, you should envision the scatterplot, and then you will understand the relationship formed by the data.

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He considers that this starting-point will also be the origin of rational activity (noÓv and boÅleusiv) discount haldol 1.5mg amex medications 1040, and having disposed of ‘chance’ (tÅch) as an evidently unsatisfactory candidate for this function he argues that the starting-point wanted is in fact the starting-point of movement in the soul; then it is clear that this starting-point is God order 1.5 mg haldol with mastercard symptoms wisdom teeth. Thus God is the starting-point of all psychic activity, both of reasoning (no¦sai) and of the irrational impulses (¾rma©) on which eutuchia is based. God is even more powerful than the divine principle in man, the intellect (noÓv), and it is for this reason that people who are devoid of rational activity, too, can make the right choice: they succeed without reasoning because they still have God, although the wise people also have God and use his movement in their calculation of the future, either by experience or by habit: thus there is a more rational form of divination as well. Both irrational and rational divination, then, ‘use’ God (who sees the future as well as the present), but God moves more strongly in those people whose reasoning faculty is disengaged. Thus God’s movement is present both in the irrational people daimonia because it is beyond human control, as is indicated by the use of the word daim»niov in Somn. The individual human nature is further called daimonia because it works more strongly when reason is inactive, and because it plays the part of intermediary between God and man, which Greek tradition assigned to demons. This is an obvious reference to the distribution argument in 1247 a 28–9, where it was stated that it is ‘paradoxical’ that a god or demon should love simple people, not the best and wisest (mŸ t¼n b”ltiston kaª fronimÛtaton); evidently Aristotle remains aware of the distribution argument and anticipates it by means of a careful presentation of his own explanation. For the purpose of clarity I will print first a text and a translation of each section and then add comments on the section in question. The text of the manuscript tradition will be followed as closely as possible; any deviations from it will be accounted for from line to line. It seems to me that the numerousproblemsofinterpretationinthischapteraredueatleastasmuchtoAristotle’sconciseand often frankly clumsy way of writing as to possible corruptions in the text. Therefore the interpreter should maintain a fundamental distinction between hypotheses concerning the original text which Aristotle wrote down, and hypotheses concerning what he intended to say. This distinction seems to have often been ignored, and apparently interpreters have, with an appeal to the abysmal state of the text, proposed many conjectures with a view to making the text comply with interpretations mainly prompted by theological assertions in other Aristotelian writings. The unfortunate consequence of this process is that there is no generally accepted text on which to base a debate concerning the tenability of a particular interpretation: in order to scrutinise it, one has to be willing to accept, for the sake of argument, the readings proposed by the interpreter, while these readings were actually chosen to support the interpretation. This account should be based principally on the immediate context and only secondarily on statements on the subject in other Aristotelian writings. Aristotle on divine movement and human nature 249 23 Œpanta ›staiá £35 ›sti tiv ˆrcŸ ¨v oÉk ›stin Šllh ›xw, aÌth 24 d• di‡ t¼ toiaÅth e²nai toioÓto dÅnatai poie±n;36 t¼ d• 25 zhtoÅmenon toÓtì ›sti, t©v ¡ t¦v kinžsewv ˆrcŸ –n t¦€ yuc¦€; d¦lon 26 dŸ ãsper –n tä€ Âlw€ qe¼v kˆn –ke©nw€. For we did not deliberate at a particular moment concerning a particular thing after having deliberated – no, there is a certain starting-point, nor did we think after having already thought before thinking, and so on to infinity. Intelligence, therefore, is not the starting-point of thinking nor is counsel the starting-point of de- liberation. Or is there some starting-point beyond which there is no other, and is this starting-point such as to be able to produce such an effect? What we are looking for is this: what is the starting-point of the movement in the soul? It is now evident that, as it is a god that moves the universe, so it is in the soul. It is of vital importance to notice that the ‘starting-point’ (ˆrcž) Aristotle is seeking is the starting-point of all movement in the soul, both of ‘thinking’ (no¦sai) and of ‘desiring’ (–piqum¦sai, ¾rma©). Thus God is also the ‘principle of movement’ in the souls of those people who actualise ‘intellect and deliberation’ (noÓv, boÅleusiv). Verdenius (private correspondence) suggested to me as a translation of the whole sentence: ‘It is clear that this starting- point is analogous to the part which God plays in the universe, where he moves everything’ (reading kaª pŽn –ke©nw€ and taking ka© as specifying ãsper –n tä€ Âlw€). However, the connection with the following then becomes difficult, for the ˆrcž sought is not t¼ –n ¡m±n qe±on (which is the noÓv) but ¾ qe»v (who is kre±tton toÓ noÓ). The analogy which Aristotle wants to express is best achieved when we read kˆn –ke©nw€, where –ke©nw€ refers to yucž (as so often in this chapter a neuter pronoun refers to a masculine or feminine noun; for this reason Wood’s conjecture kˆn –ke©nh€ can be left aside). Dirlmeier reads kaª pŽn –ke±no and translates: ‘so bewegt er auch alles jene (in der Seele)’, but this is awkward as Greek. Aristotle anticipates this idea by arguing that, admittedly, this is true in a certain way (pwv), but the intellect itself has got its movement from something which is ‘superior’ (kre±tton,cf. Wagner (1970) 105–8, who wrongly follows Dirlmeier (1962a) 108 in concluding that ‘this divine element moves the processes in the soul’ (‘dieses qe±on bewegt die Vorgange in der Seele’), which is incompatible with Wagner’s¨ own conclusion that t¼ –n ¡m±n qe±on is equivalent to ¾ noÓv which is distinguished from ¾ qe»v:if Wagner reads qeä€ in 1248a 38, how can he conclude that not ¾ qe»v but t¼ qe±on is the ˆrcŸ t¦v kinžsewv –n t¦€ yuc¦€? Woods (1982, 182) and Dirlmeier (1962a, 490) refer to 1246 b 10–12: ˆll‡ mŸn oÉdì ˆretžá cr¦tai g‡r aÉt¦€á ¡ g‡r toÓ Šrcontov ˆretŸ t¦€ toÓ ˆrcom”nou cr¦tai (on which see Moraux (1971) 264–5). Aristotle on divine movement and human nature 251 1248 a 29–34: 29 kaª di‡ toÓto, 30 Á43 o¬ p†lai ›legon, eÉtuce±v kaloÓntai o° ‹n ¾rmžswsi 31 katorqoÓsin44 Šlogoi Àntev, kaª bouleÅesqai oÉ sumf”rei aÉto±v. For they have such a starting-point which is stronger than intelligence and deliberation (others have reasoning; this the lucky people do not possess) and they have divine inspiration,48 but they are not capable of intelligence and deliberation: they hit the mark without reasoning. The adjunct ‘though lacking reasoning’ (Šlogoi Àntev) again stresses what has already been noted in the beginning of the chapter (1247 a 4; 13), that their success is not due to reason or intelligence; the sentence ‘it is not profitable for them to deliberate’ refers to 1247 b 29–37, where Aristotle says that in the case of eutuchia the natural impulse (¾rmž) is contrary to reasoning and that reasoning is idle (¾d• logism¼v §n l©qiov, 35). The anticipation in lines 26–9 now turns out to be very appropriate: having discussed the part played by the intellect (noÓv being on a par in this context with l»gov and boÅleusiv) in human action, Aristotle stipulates that there is a starting-point which is even more powerful than this, and that this starting-point is the cause of the lucky people’s success. But it is improbable that these o° d” should be the subject of ›cousi (‘they have’) and that toÓto (‘this’) should refer to ˆrcž, since it is hardly credible that these people do not have this starting-point (ˆrcž), for this starting-point was said to be the origin of all movement in the soul, including intellect, reason and deliberation. Various solutions to this problem might be suggested: (1) The subject of ›cousi (‘they have’) is not o° d”, but the ‘irrational people’ (the Šlogoi); and toÓto (‘this’) refers to l»gov (‘reason’). It might be objected to this possible solution that the sentence toÓto dì oÉ dÅnatai (‘they are not capable. But this objection can be countered in two ways: either (i) the sentence o° d• t¼n l»goná toÓto dì oÉk –cousi (‘others have reasoning; this the lucky people do not possess’) can be taken as a parenthesis (as does Susemihl, who puts it between brackets): in this case the redun- dancy is not unacceptable; or (ii) there is a new change of subject: the second toÓto (‘this’) refers to –nqousiasm»n (‘divine inspiration’) and the subject of dÅnantai (‘they are capable’) is o° d”, the people with reason (l»gov).

The underlying abnor- mality is loss of the intramural neurons that control the inhibitory neurotransmitters cheap 5 mg haldol amex symptoms yeast infection men. Other diseases that can cause secondary achalasia through destruction of these neurons include Chagas’ disease discount 10 mg haldol with mastercard treatment magazine, malignancy, and viral infections. Typical clinical symptoms of achalasia include dysphagia with both solids and liquids equally and worsening of symp- toms with emotional stressors and rapid eating. The presence of esophageal reflux symptoms is inconsistent with the diagnosis of achalasia. The course is usually progressive, with weight loss occurring over several months. Nitrates and calcium channel blockers offer short-term benefits for relief of symp- toms but lose efficacy over time. Endoscopic injections of botulinum toxin are also effective for short periods but may lead to fibrosis with repeated injections. Balloon dila- tation is effective in approximately 85% of patients with the side effect of perforation or bleeding. Finally, some patients ultimately require surgical intervention with myotomy, which has equal success compared to balloon dilatation. Ery- thema nodosum and venous thromboembolism also generally correlate with intestinal disease activity. The progressive and gradual nature of the process is evident in worsen- ing tolerance for solid foods over the course of months. The patient’s prior partial gastrectomy predisposes him to gastric outlet obstruction as a result of stricture at the previous anastomosis. Although the patient has no current symptoms of peptic ulcer disease, underlying malignancy with gastric outlet obstruction must be considered as gastric ulcers may de- velop into cancerous lesions if left untreated. Other factors that support the diagnosis of gastric outlet obstruction are the abdominal x-ray findings of dilated gastric bubble and the lack of air in the small bowel. Small bowel obstruction presents acutely with abdomi- nal distention, pain, and vomiting. Gastroparesis is common in poorly controlled diabetic patients, symptomatically affecting approximately 10% of those patients. Finally, cholelithiasis is most often asymptomatic but can present as biliary colic. There should be associated pain in the right upper quad- rant and epigastrium with eating. Again, the abdominal radiogram is normal in this con- dition with the possible exception of stones seen within the gallbladder. Gastric adenocarcinoma remains a prevalent malig- nancy worldwide despite significant decline in incidence over the last 50 years. A major pathophysiologic risk appears to be related to bacterial conversion of ingested nitrites into carcinogens in the stomach. Risk factors for the development of gastric cancer include long-term ingestion of foods with high concentrations of nitrite (dried, smoked, salted foods) and conditions that promote bacterial colonization/infection in the stomach, such as Helicobacter infection, chronic gastritis, and achlorhydria. The disorder is notable for both endocrine and exo- crine dysfunction of the pancreas. Often diabetes ensues as a result of loss of islet cell function; though insulin-dependent, it is generally not as prone to diabetic ketoacidosis or coma as are other forms of diabetes mellitus. As pancreatic enzymes are essential to fat digestion, their absence leads to fat malabsorption and steatorrhea. Replacement of pancre- atic enzymes orally with meals will correct the vitamin deficiencies and steatorrhea. The incidence of pancreatic adenocarcinoma is increased in patients with chronic pancreati- tis, with a 20-year cumulative incidence of 4%. Chronic abdominal pain is nearly ubiqui- tous in this disorder, and narcotic dependence is common. Niacin is a water-soluble vitamin, and absorption is not affected by pancreatic exocrine dysfunction. Fat malabsorption syndromes classically lead to weight loss and many vitamin deficiencies, including iron, vitamin B12, vitamin D, and vitamin K. Pancreatic insufficiency must be considered in cases of malabsorption, but destruction of the organ must be near total for this to occur, usually in the setting of long-standing alcohol abuse. Celiac disease affects 1% of Americans, often presents with symptoms similar to those of irritable bowel syndrome, and requires an endoscopy with biopsy to confirm the diagnosis. Other causes of steatorrhea include bacterial overgrowth, bariatric surgery, liver disease, and Whipple’s disease. A 24-h stool collection is a formal way to confirm steatorrhea, though a consistent patient history may be adequate to begin evaluation. Small-intestinal disease typically will result in fecal fat of ~15–25 g/day, and pancreatic exocrine insufficiency may result in >30 g/day. Chronic pancreatitis can develop in individuals who consume as little as 50 g of alcohol daily (equivalent to ~30–40 ounces of beer).

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