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Journal article with a personal author and more than one organization as author 11 generic 40 mg sotalol fast delivery blood pressure healthy value. Journal article authors with compound last names (give as found in the article) 14 sotalol 40mg heart attack is. Journal article author names with particles sotalol 40 mg low cost blood pressure quit drinking, prepostitions, prefixes (give as found in the article) 15. If you abbreviate a word in one reference, abbreviate the same word in all references. Journals 13 Place the affiliation in parentheses Box 13 Names for cities and countries not in English Use the English form for names of cities and countries when possible. Moskva becomes Moscow Wien becomes Vienna Italia becomes Italy Espana becomes Spain Examples for Author Affiliation 17. Box 16 Translated article titles ending in punctuation other than a period Most article titles end in a period. When a translation of an article title is provided, place it in square brackets, with a closing period outside the right bracket. Metodo para el estudio de la funcion pulmonar en los laringectomizados [Method for the study of pulmonary function in laryngectomized patients]. Place the title in square brackets, with a closing period outside the right bracket. Influence of seed extract of Syzygium Cumini (Jamun) on mice exposed to different doses of -radiation. Influence of seed extract of Syzygium Cumini (Jamun) on mice exposed to different doses of gamma-radiation. Box 18 Article titles with headers Journal articles sometimes contain a header (such as news, case report, or clinical study) at the top of the page to indicate a section of the issue. Do not include a header as part of the article title unless the table of contents for the journal issue indicates that it is. Box 19 No article title can be found Occasionally an article does not appear to have any title; the article simply begins with the text. In this circumstance, create a title from the first few words of the text and place it in square brackets. Journal article in a language other than English with optional original language title included Journals 17 20. Journal article title with special characters Article Type for Journal Articles (optional) General Rules for Article Type An article type alerts the user that the reference is to an abstract of an article or a letter to the editor, not a full article. Increased cardiac Connexin45 results in uncoupling and spontaneous ventricular arrhythmias in mice [abstract]. Box 21 Article titles not in English Most journal article titles end in a period. When a translation of a journal article title is used as the title, place it in square brackets. Place (letter) or (abstract) within the square brackets and end title information with a period. Etude de la permeabilite nasale dans les fentes unilaterales operees [Study of nasal permeability in patients with operated unilateral clefts] [letter]. Journal article with type of article indicated Journal Title for Journal Articles (required) General Rules for Journal Title Enter a journal title in the original language Cite the journal name that was used at the time of publication. A list of the abbreviations for common English words used in journal titles is in Appendix A. Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention becomes Inj Prev. This practice is used to show that two or more journal titles with the same name reside in a library collection or database; the name of the city where the journal is published distinguishes the titles. The city is usually shown in abbreviated format following the same rules used for words in journal titles, as Phila for Philadelphia in the example above. If you use a bibliography or database such as PubMed to verify your reference and a place name is included, you may keep it if you wish. If you do, abbreviate the title according to the Abbreviation rules for journal titles and indicate the language of the article after the location (pagination). See Appendix A for a list of commonly abbreviated English words in journal titles. Example: or becomes c Separate the edition from the title proper by a space and place it in parentheses End all journal title information with a period placed outside the closing parenthesis Example: 24 Citing Medicine Pharmakeutikon Deltion. Examples : o becomes o becomes u Separate the edition from the title proper by a space and place it in parentheses End all the title information with a period placed outside the closing parenthesis Example: Fang She Hsueh Shi Jian. If you do, abbreviate them according to the Abbreviation rules for journal titles. Journal article in a microform Date of Publication for Journal Articles (required) General Rules for Date of Publication Include the year, month, and day of publication in that order. However, the month and day of the month or the season must be included when citing a journal that has no volume or issue number. A supplement, part, or special number to a date will occasionally have another subdivision. For example: - date with supplement - with a part 2005;Suppl: 2005;Suppl Pt 1: 2005;Suppl 2: 2005;Suppl 2 Pt A: 2005 Jan;Suppl: 2005 Jan;Suppl Pt 2: - date with part - with a supplement 2004;(Pt 2): 2004;(Pt 2 Suppl): - date with special number - with a part 2003;Spec No: 2003;Spec No Pt 2: Specific Rules for Supplement/Part/Special Number to a Date Non-English names for supplements, parts, etc. Journal article with year with supplement having a further division 30 Citing Medicine 32. Journal article with year having a part Volume Number for Journal Articles (required) General Rules for Volume Number Omit "volume", "vol. Occasionally a journal is published in a series of issues without volumes or is published with a supplement, part, or special number to a date of publication rather than to a volume or issue. Box 40 Non-English names for volume To help locate volumes, see the following list for the words and abbreviations used for volume in a variety of languages: aarg. For example: - volume with supplement - with a part 2005;15 Suppl 1: 2005;15 Suppl 1 Pt A: 2005;45 Suppl A: 2005;45 Suppl A Pt 2: 2005 Mar;87 Suppl 1: 2005 Mar;87 Suppl 1 Pt 1: - volume with part - with a supplement 2004;66(Pt 2): 2004;66(Pt 2 Suppl): 2004 Dec;124(Pt A): 2004 Dec;124(Pt A Suppl) - volume with special number - with a part 2003;6 Spec No: 2003;6 Spec No Pt 2: Specific Rules for Supplement/Part/Special Number to a Volume Further subdivisions to supplements, parts, etc. Journal article volume with special number Issue Number for Journal Articles (required) General Rules for Issue Number Omit "number", "no. For example: - issue with supplement with a part 2005;15(1 Suppl): 2005;15(1 Suppl Pt A): 2005;(12 Suppl A): 2005;(12 Suppl A Pt 2): 2005 Mar;87(3 Suppl): 2005 Mar;87(3 Suppl Pt B): - issue with part with a supplement 2004;66(1 Pt 2): 2004;66(Pt 2 Suppl): 2004 Dec;124(Pt A): 2004 Dec;124(Pt A Suppl) - issue with special number with a part 2003;6(2 Spec No): 2003;6(2 Spec No Pt 2): Specific Rules for Issue Number Non-English names for issue No volume number present No issue number present Options for issues Box 45 Non-English names for issue To help locate issues in languages other than English, see the following list of words and abbreviations used for issue (usually variations on the word number) in a variety of languages: s. Box 47 No issue number present If no issue number is found, follow the volume number with a colon and the location (pagination) Prokai-Tatrai K, Prokai L. Journal article issue with special number Location (Pagination) for Journal Articles (required) General Rules for Location (Pagination) Give the inclusive page numbers on which the article appears Do not repeat page numbers unless they are followed by a letter. Box 54 Text such as a discussion, quiz, or author reply to a letter follows the article Begin with the location (pagination) of the article Follow it by a semicolon and a space Add the name of the additional material and its location (pagination) End with a period :145-54; discussion 155-6. Box 55 No numbers appear on the pages of the article Occasionally, a journal article will have no page numbers. Journal article with roman numerals for page numbers (upper or lower case as found) 61. Journal article with no page number provided Journals 39 Physical Description for Journal Articles (optional) General Rules for Physical Description Give information on the location of an article and its physical characteristics when the journal appears in a microform (microfilm, microfiche, etc. For example, if the volume or issue consists of 5 microfiche and the particular article being cited is on the third fiche, cite it as "microfiche 3 of 5 microfiche.
At the other end of the scale order sotalol 40mg without a prescription hypertension and stroke, much remains to be done for adults and elderly people generic sotalol 40mg line arteria temporalis media. Improving the dialogue between public and private sectors should be an important approach to emphasize in every country purchase sotalol with visa hypertension with pregnancy. Efforts remain to be made for a comprehensive salt iodization as recommended by international organizations. This implicates obligatory reinforcement of policies for legislation, standards, application and control. Regulations on the advertising of beers, wines, other alcoholic drinks and tobacco must be reinforced, especially during sports and cultural events. Nigerian President Olusegun Obasanjo has lent his support to the goal of reducing death from chronic dis- ease: Governments have a responsibility to support their citizens in their pursuit of a healthy, long life. It is not enough to say: we have told them not to smoke, we have told them to eat fruit and vegetables, we have told them to take regular exercise. We must create communities, schools, workplaces and markets that make these healthy choices possible. Lessons learnt from other integrated programmes (for both noncommunicable and communicable diseases) could serve as a model for neurological disorders associated with malnutrition. It is essential to set up a multidisciplinary task force surrounding neurologists and nutritionists. This team should be supplemented by clinicians who are concerned with the secondary causes of neurological diseases related to nutrition, i. Social scientists would also have an important role, for a better understanding of knowledge, attitudes and practices. Specialists in communication would be involved in the initiative, so as to reach, educate and sensitize the population. Other sectors such as education, private and public sectors, civil society, community leaders and nongovernmental organizations will all have a part to play to contribute to the concretization and reinforcement of the strategies and interventions. Schools constitute a favourable environment because they provide access to teachers and pupils who can carry the message home at household level. The capacities of nongovernmental organizations, community organizations and the education sector must be reinforced and developed so as to target the prevention of nutritional problems. Nutritional supplementation, psychosocial stimulation, and mental development of stunted children: the Jamaican study. Management of severe malnutrition: a manual for physicians and other senior health workers. Cuban epidemic neuropathy, 1991 to 1994: history repeats itself a century after the amblyopia of the blockade. Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects. Recommendations for accelerating global action to prevent folic acid-preventable birth defects and other folate-deciency diseases: meeting of experts on preventing folic acid-preventable neural tube defects. Scientic evidence supporting folic acid fortication of our in Australia and New Zealand. The effect of folate fortication of cereal-grain products on blood folate status, dietary folate intake, and dietary folate sources among adult non-supplement users in the United States. Functional correlates of nutritional anemias in infancy and childhood child development and behavior. Iron and zinc supplementation promote motor development and exploratory behavior among Bangladeshi infants. Residual neuropathological changes in Canadians held prisoners of war by the Japanese (Strachan s disease). Global and regional burden of disease attributable to selected major risk factors. Pain acute and chronic is a 136 Training major public health problem that poses signicant chal- 137 Conclusions and recommendations lenges to health professionals involved in its treatment. Chronic pain may persist long after initial tissue damage has healed: in such cases, it becomes a specic health-care problem and a recog- nized disease. Adequate pain treatment is a human right, and it is the duty of any health-care system to provide it. This denition was qualied by the Taxonomy Task Force of the association in 1994 (2): Pain is always subjective. Each individual learns the applications of the word through experiences relating to injuries in early life. The physiological effect of pain is to warn of tissue damage and so to protect life. Pain is classied as nociceptive if it is caused by the activation of nociceptors (primary sensory neurons for pain). Nociceptive pain can be somatic (pain originating from the skin or musculoskeletal system) or visceral (pain originating from visceral organs). The sensory system itself can be dam- aged and become the source of continuous pain. Chronic neuropathic pain has no physical protective role as it continues without obvious ongoing tissue damage. Pain without any recognizable tissue or nerve damage has its cause classied as idiopathic pain. A clinician s duty is to diagnose, treat and support pain patients, which means the identication of pain type(s) and their causative disease(s). It is also to provide adequate treatment aimed at the cause of the pain and symptomatic relief which should include psychosocial support. As the denition of pain reveals, pain has both a physical and a psychological element. The latter plays an important part in chronic pain disorders and their management. Adequate pain treatment is a human right and organization of it involving all its dimensions is the ethical and legal duty of society, health-care professionals and health-care policy-makers. Pain can also be an indirect conse- quence of a nervous disease when it causes secondary activation of pain pathways. Examples of these types of pain include musculoskeletal pain in extrapyramidal diseases such as Parkinson s disease, or deformity of joints and limbs due to neuropathies or infections. Pain begins frequently as an acute experience but, for a variety of reasons some physical and often some psychological it becomes a long-term or chronic problem. Pain directly caused by diseases or abnormalities of the nervous system Neuropathic pain In contrast to nociceptive pain which is the result of stimulation of primary sensory nerves for pain, neuropathic pain results when a lesion or disruption of function occurs in the nervous system. Neuropathic pain is often associated with marked emotional changes, especially depression, and disability in activities of daily life.
The abdomen should be exam- awoman sotalol 40mg mastercard pulse pressure range normal, which is in the same distribution as in males buy 40mg sotalol with mastercard arrhythmia yawning. Paraneoplastic syndrome Clinical features Impetigo appears as erythematous erosions with a char- Investigations acteristic golden brown crusting buy sotalol 40mg without prescription arrhythmia junctional. There may be associ- Dependent on the level of virilisation and menstrual ated localised lymphadenopathy. Bullous impetigo de- anomaliesfound;hormoneproleandabdominalimag- scribes punched-out blistering lesions with crusting due ing may be required. Management Management r Any underlying cause for excess androgen production Swabs should be taken. Of- r Physical methods of hair removal include shaving, ten the condition requires treatment with oral penicillin chemical depilatories, bleaching, electrolysis and laser (Streptococcus) and ucloxacillin (Staphylococcus). Cellulitis Hypertrichosis Denition Denition Cellulitis is an acute diffuse spreading infection of the Hypertrichosis is excessive hair in a non-androgenic dis- skin extending into the soft tissues. Clinical features Aetiology/pathophysiology Patients present with ne terminal hair diffusely on the The main causative organisms are -haemolytic Strep- face, limbs and trunk. The mechanisms of infection are not clearly understood but may involve bacterial exotox- Infections of the skin and ins and cytokine release. There is warmth Impetigo andtendernesstotouch,oftenwithlocallymphadenopa- Denition thy. If untreated, there is spreading of the erythema, Impetigo is a contagious supercial skin infection oc- abscess formation and secondary septicaemia. Management Management Prevention of clostridial infections involves adequate Initial management with penicillin (Streptococcus) and wound care at the time of original trauma including ex- ucloxacillin(Staphylococcus);erythromycinisusefulfor cision and debridement of necrotic tissue. In vanced or if it fails to respond to oral therapy, parenteral established cases penicillin is the drug of choice. Aggres- penicillin and ucloxacillin are used, and clindamycin, sive surgical intervention with wide excision, opening of if penicillin allergic. It is useful to outline the erythema fascial compartments, and meticulous debridement of to allow the condition to be followed. Clostridial myonecrosis (gas gangrene) Denition Leprosy Gangrenereferstodeathoftissue,andmyonecrosisrefers specically to muscle. Clostridial infection of wounds Denition may result in signicant infection of muscle, which de- Leprosy is a chronic indolent mycobacterial infection velops rapidly and is potentially life-threatening. Com- Geography promise of the blood supply as a result of the traumatic Leprosy is found primarily in Africa and Asia. It is thought that -toxin pro- Leprosy is caused by an intracellular acid-fast bacillus, duced by Clostridium prevents the normal inamma- Mycobacterium leprae. The mode of transmission is un- tory cell inltration and therefore allows the infection certain and the incubation may be many years. Fivepatternsofdiseasearerecognisedthataredependent on the immunological response of the individual (see Clinical features Table 9. Patients develop severe pain due to myonecrosis at a site There are two immunological reactions that may oc- of trauma with induration, blistering and oedema. It is characterised by fever and mul- most individuals are seropositive by adult life. Im- munocompromised patients are at particular risk for recurrent and disseminated infection. Afterprimary infection, the latent non-replicating virus resides within the dorsal root ganglion, shielding the Management virus from the immune system. Symptomatic infection usually manifests as acute gingivostomati- tis with vesicles on the lips and painful ulcers within Viral skin infections the mouth accompanied by fever and malaise. Local herpes inoculation into a site of injury may present Herpes simplex as a herpetic whitlow apainful vesicle or pustule on a digit. Ocular infections and encephalitis (see page Denition 304) may occur with or without kin lesions. Aetiology/pathophysiology Latent infection occurs and recurrence is often her- There are two subtypes: alded by a burning or tingling sensation. Theyheal Patients with atopic eczema may develop eczema her- over 2 3 weeks leaving scars. Corneal ulcers and corneal scarring may result from trigeminal infection with ocular involvement. Topical treat- therpetic neuralgia is found in 5 10% of patients pre- ment at the onset of tingling may prevent a recur- senting as a continued burning pain. As aciclovir works to prevent reactivation it is of limited value in established disease. However, immuno- Investigations suppressed patients should be treated aggressively with The virus can be isolated from vesicular uid and iden- parenteral aciclovir to prevent dissemination. Aciclovir is effective in Denition shortening the duration of pain when started within Herpes zoster or shingles is an acute self-limiting der- 48 hours of the onset of the rash. It should be given matomal vesicular eruption occurring in a dermatomal parenterally in the immunocompromised. Human papillomavirus (viral warts) Incidence Affects 10 20% of the population at some time in their Denition lives. Like other herpes virus infections, it are high-risk subtypes for neoplasia and are associated then remains as a latent infection in the sensory dorsal with cervical and oral cancer. Clinical features 1 Common warts are well-demarcated dome shaped Clinical features papules or nodules with an irregular papilliferous sur- Pain,tendernessorparaesthesiadevelopsinthedistribu- face. Commonly occur on the back of hands, between tion of a single dermatome 3 5 days prior to the onset of ngers and around the nail edge. No treatment is universally successful, and as there is a Patients present with an inamed glans and prepuce. Management Topical antifungals are used in the form of creams, Prognosis lozenges or pessaries. Fungal skin infections Dermatophyte (ring worm) fungi Candida albicans Denition Denition Dermatophytes or ringworm fungi invade keratin and Candida albicans,acommensal yeast of the gastroin- cause skin and nail infections. Aetiology/pathophysiology Lesions are single or multiple erythematous, scaly, Candida is a dimorphic fungus occurring as a yeast on well-demarcated patches on the scalp that gradually mucosal surfaces. Hairs within the patch break off giving a patch infections result from disruption of the normal body of alopecia. It is a form of immune response tend towards more extensive persistent mucous mem- to the fungus. Neutropenic patients are at risk of itraconazole or griseofulvin are effective even in ke- widespread disseminated illness. Patients develop itchy or painful, erythematous scaling lesions between the Clinical features toes. It may be acute self-limiting or a persistent 1 Oral candidiasis is commonly seen in babies and chronic infection. Topical antifungal agents are usu- patients treated with antibiotics or chemotherapy. Patients develop Topical shampoo containing insecticides such as mala- asymmetrical discoloured (white/yellowish black) thion and permethrin may be used, although there thickened nails with crumbling white material un- is some evidence of increasing resistance. Mechanical removal of prolonged course of systemic antifungals as for tinea lice nit combs from wet hair is an alternative strategy.