By O. Domenik. Southern Illinois University at Carbondale. 2017.

Surgical techniques are times 100mg dilantin with visa, irritants such as wind and excessive glare cause an now available to correct some visual defects and eliminate inflammation buy dilantin 100 mg with amex, which may in turn lead to susceptibility to the need for eyeglasses or contact lenses. In underdevel- THE SENSORY SYSTEM 231 oped countries where this infection appears in chronic Glaucoma Glaucoma is a condition characterized by form, it is known as trachoma (trah-KO-mah). Interfer- prevent reinfection has reduced the incidence of blind- ence with the normal reentry of this fluid to the blood- ness from this disorder in many parts of the world. An acute infection of the eye of the newborn, caused The most common type of glaucoma usually pro- by organisms acquired during passage through the birth gresses rather slowly, with vague visual disturbances canal, is called ophthalmia neonatorum (of-THAL-me-ah being the only symptom. Preventive doses of an appropriate antiseptic or antibiotic Many cases of glaucoma are diagnosed by the measure- solution are routinely administered into the conjunctiva ment of pressure in the eye, which should be part of a of newborns just after birth. They may follow a sinus infection, tonsillitis, conjunc- Disorders Involving the Retina Diabetes as a cause 11 tivitis, or other disorder in which the infecting agent can of blindness is increasing in the United States. Other disorders of the eye directly related to diabetes in- Injuries The most common eye injury is a laceration or clude optic atrophy, in which the optic nerve fibers die; scratch of the cornea caused by a foreign body. Injuries cataracts, which occur earlier and with greater frequency caused by foreign objects or by infection may result in among diabetics than among nondiabetics; and retinal de- scar formation in the cornea, leaving an area of opacity tachment. If such an injury In cases of retinal detachment, the retina separates involves the central area anterior to the pupil, blindness from the underlying layer of the eye as a result of trauma may result. In such cases, an operation to remove the eyeball, Macular degeneration is another leading cause of a procedure called enucleation (e-nu-kle-A-shun), is per- blindness. Factors con- tributing to macular degeneration are smoking, exposure Cataract A cataract is an opacity (cloudiness) of the to sunlight, and a high cholesterol diet. Diseases such as diabetes, as well as certain medications, are The ear is the sense organ for both hearing and equilib- known to accelerate the development of cataracts. It is divided into three main sections: 232 CHAPTER ELEVEN Box 11-1 Hot Topics Eye Surgery: A Glimpse of the Cutting EdgeEye Surgery: A Glimpse of the Cutting Edge ataracts, glaucoma, and refractive errors are the most Laser trabeculoplasty to treat glaucoma. During this procedure, a laser reshapes the cornea to long) is made through the sclera near the outer edge of the allow light to refract directly on the retina, rather than in cornea. The procedure is typically painless al- minutes and patients recover their vision quickly and usu- though the patient may feel some discomfort for 1 to 2 days ally with little postoperative pain.

Usually dilantin 100 mg on line, results are given as pO2 and oxy- gen saturation (See Table 8–1 for normal values in page 162) 100 mg dilantin amex. Oxygen saturation at any given pO2 is influenced by temperature, pH, and the level of 2,3-DPG as shown in Figure 8–4. Pneumothorax O2 dissociation curve of blood at 37°C 100 90 80 70 60 O2 affinity O2 affinity 50 (shift to right) (shift to left) 40 acidosis alkalosis hypoxemia hypothermia 30 fever banked blood increased decreased 20 2,3 DGP 2,3 DGP 10 0 0 10 20 30 40 50 60 70 80 90 100 110 120 Blood oxygen tension (pO2) FIGURE 8–4 Oxyhemoglobin dissociation curve. Congenital heart disease: Tetralogy of Fallot, transposition, etc 8 SAMPLE ACID–BASE PROBLEMS In each of the following examples, use the technique for blood gas interpretation on page 163 in this chapter to identify the acid–base disorder. Step 3: pCO > 44 and [HCO −] is not < 22, so it represents a respiratory acidosis. This patient has a chronic res- 3 piratory acidosis due to hypoventilation (simple acid–base disorder). Step 3: [HCO −] is < 22 mEq/L and pCO is not > 44, so this is a metabolic acidosis. This patient has a lactic acidosis following a car- diopulmonary arrest (simple acid–base disorder). This patient had a metabolic acidosis due to dia- betic ketoacidosis and a concomitant respiratory alkalosis due to early sepsis and fever (mixed acid–base disorder). Step 3: pCO < 36 and the [HCO −] is not >26, thus a respiratory alkalosis is present. This patient has a respiratory acidosis due to pregnancy and a relative secondary meta- bolic alkalosis due to vomiting. Because the actual bicarbonate was higher than expected, this must be a mixed metabolic gap acidosis and metabolic alkalosis. The patient has a metabolic gap acidosis from DKA and a metabolic alkalosis from the vomiting. Step 1: 17 mmol/L actual gap −10 mmol/L normal gap 7 mmol/L expected change in [HCO –] from normal 3 Step 2: 24 mmol/L normal [HCO–] 3 −7 mmol/L expected change in [HCO –] 3 17 mmol/L expected change in [HCO –] 3 Actual bicarbonate is 10 mmol/L and not the expected 17 mmol/L if there was a pure metabolic gap acidosis.

Although processed tomato products are the richest source of lycopene in the diet buy dilantin 100mg mastercard, ingesting tomatoes may Clinton discount dilantin 100 mg online, Steven K. As a result, joint carti- ORGANIZATIONS lage continues to break down and is not replaced by new, American Heart Association, National Center. Building 31, Another indirect precaution is that processed tomato Room 10A03, 31 Center Drive, MSC 2580, Bethesda, products usually contain large amounts of sodium,un- MD 20892. Side effects Genevieve Slomski Teresa Norris Although extensive research has not been conduct- ed, there have been no reported side effects or toxicity associated with lycopene intake. Interactions Lycopodium Research into the interactions of lycopene with food, drugs, or diseases has not been conducted as of the Description year 2000. Lycopodium (Lycopodium clavatum) is a perennial evergreen plant that grows in pastures, woodlands, Resources heaths, and moors of Great Britain, Northern Europe, PERIODICALS and North America. The pale yellow pollen collected from the spores is “Clinical Intervention Trial Finds Benefit of Lycopene. The pollen is odorless, water resistant, and highly GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2 1249 flammable. For this reason, it used to be a component of although they dread the presence of new persons, fireworks. Early physicians used the plant to stimulate the ap- Insecurity and cowardice are general symptoms; petite and to promote urination and the excretion of other lycopodium patients are typically concerned with what body fluids. Lycopodium was also used in the treatment of others think of them and have many fears, particularly flatulence, rheumatism, gout, lung ailments, and diseases of death, the dark, crowds, or new situations. In the 17th century the pollen may try to hide their fears by becoming haughty or was used as an internal remedy for diarrhea, dysentery, domineering. Externally, the pollen was a treatment for Persons who need lycopodium generally have a wounds and diseases of the skin such as eczema.

As the bile for passive intestinal absorption that the compound will flows through the biliary system of ducts buy dilantin 100 mg, its composi- reenter the blood that perfuses the intestine and again tion can be modified in the ductules and ducts by the be carried to the liver 100 mg dilantin otc. Such recycling may continue (en- processes of reabsorption and secretion, especially of terohepatic cycle or circulation) until the drug either un- electrolytes and water. For example, osmotically active dergoes metabolic changes in the liver, is excreted by compounds, including bile acids, transported into the the kidneys, or both. This process permits the conserva- bile promote the passive movement of fluid into the tion of such important endogenous substances as the duct lumen. In the gallbladder, composition of the bile bile acids, vitamins D3 and B12, folic acid, and estrogens is modified further through reabsorptive processes. Hence, drugs with molecular change resins have been used clinically to interrupt en- weights lower than those of most protein molecules terohepatic cycling and trap drugs in the gastrointesti- readily reach the hepatic extracellular fluid from the nal tract. A number of compounds are taken up into the As stated earlier, many foreign compounds are ei- liver by carrier-mediated systems, while more lipophilic ther partially or extensively metabolized in the liver. Finally, the administration of one drug may influ- Adriamycin Methadone ence the rate of biliary excretion of a second coadmin- istered compound. These effects may be brought about Amphetamine Metronidazole Chlordecone Morphine through an alteration in one or more of the following 1,25-Dihydroxyvitamin D3 Phenytoin factors: hepatic blood flow, uptake into hepatocytes, rate Estradiol Polar Glucuronic Acid of biotransformation, transport into bile, or rate of bile Conjugates formation. In addition, antibiotics may alter the intes- Indomethacin Polar Sulfate Conjugates tinal flora in such a manner as to diminish the presence Mestranol Sulindac of sulfatase and glucuronidase-containing bacteria. This would result in a persistence of the conjugated form of the drug and hence a decrease in its enterohepatic re- circulation. Conjugation of a compound or its metabolites is espe- cially important in determining whether the drug will undergo biliary excretion.