By M. Grubuz. University of Kansas Medical Center.
According to Roman law discount strattera 10mg online, for exam- ple discount strattera 25 mg mastercard, no deceased pregnant woman could be buried without prior removal of the fetus from the womb so that it could be baptized. The scientific documents that have been preserved from the Roman Empire are mostly compilations of information ob- FIGURE 1. New anatomical information was scant, and for the most part was derived from dissections of animals other than human. Through vivisections and dissections of human cadavers, he pro- Most of what is currently known about the Alexandrian school vided excellent descriptions of the skull, eye, various visceral or- of medicine is based on the writings of the Roman encyclopedist gans and organ relationships, and the functional relationship of Cornelius Celsus (30 B. Two monumental works by tion into an eight-volume workcalled De re medicina. He re- only limited influence in his own time, however, probably be- garded the brain as the seat of intelligence and described many of cause of his use of Latin rather than Greek. It was not until the its structures, such as the meninges, cerebrum, cerebellum, and Renaissance that the enormous value of his contribution was fourth ventricle. A Greek living under Roman domination, he tions than structure and is frequently referred to as the father of was certainly the most influential writer of all times on medical physiology. For nearly 1,500 years, the writings of Galen repre- servations on the heart, vessels, brain, and cranial nerves. Erasis- sented the ultimate authority on anatomy and medical treat- tratus noted the toxic effects of snake venom on various visceral ment. Galen probably dissected no more than two or three organs and described changes in the liver resulting from various human cadavers during his career, of necessity limiting his diseases. Although some of his writings were scientifically accu- anatomical descriptions to nonhuman animal dissections. History of Anatomy © The McGraw−Hill Anatomy, Sixth Edition Companies, 2001 12 Unit 1 Historical Perspective Middle Ages The Middle Ages, frequently referred to as the Dark Ages, began with the fall of Rome to the Goths in A.
This information may be important for subgroup analyses in case of heterogeneity strattera 10 mg generic. All evidence available should be reviewed discount strattera 18 mg without prescription, regardless of the language of publication. It is not easy to identify non-English publications, as they are often not indexed in computerised databases. In the field of intervention research there is some evidence of bias when excluding non-English publications. Methodological quality The methodological quality of each selected paper should be assessed independently by at least two reviewers. Chance-adjusted agreement should be reported, and disagreements solved by consensus or arbitration. To improve agreement, reviewers should pilot their quality assessment tools in a subset of included studies or studies evaluating a different diagnostic test. Validity criteria for diagnostic research have been published by the Cochrane Methods Group on Screening and Diagnostic Tests32 (http://www. The internal validity criteria refer to study characteristics that safeguard against the intrusion of systematic error or bias. External validity criteria provide insight into the generalisability of the study and judge whether the test under evaluation was performed according to accepted standards. Internal and external validity criteria, describing participants, diagnostic test and target disease of interest, and study methods may be used in meta-analysis to assess the overall “level of evidence” and in sensitivity and subgroup analyses (see Data extraction and Data analysis sections). It is important to remember that studies may appear to be of poor methodological quality because they were either poorly conducted or poorly reported. Methodological appraisal of the primary studies is frequently hindered by lack of information. In these instances reviewers may choose to contact the studies’ authors, or to score items as “don’t know” or “unclear”. Example A urine dipstick is usually read before the material is cultured.
This is hyperbolic but is transformed to a sigmoid shape generic strattera 40 mg with mastercard, which is linear over a large dose range purchase strattera 25 mg visa, when the dose is plotted on a log scale (Fig. Comparison of the con- centrations of two or more drugs required to produce the same response is a measure of their relative potency. Often the potency of a drug is defined as the dose or concentration of drug required to produce 50% of the maximal response, i. It obviously has agonist activity but since it cannot produce a maximal response it is known as a partial agonist. While such a property may seem unwanted the drug could still produce an adequate effect and avoid the danger of that becoming too great with increasing dose. There are some points about the dose±response curve that justify consideration. When a drug is administered to either humans or animals we obviously know the dose but not the concentration at its site of action. In this instance the relationship between the amount of drug and its effect really is a dose±response curve. If a drug is added to an in vitro system in an organ or tissue bath then, provided the volume of the bathing solution is known, the concentration of drug can be calculated. Concentration is also known if a tissue is superfused with a prepared drug solution. Even then, the actual con- centration of drug at the receptor site is not really known, since there can be a steep gradient between the concentration of drug in the medium and that at the actual receptor, especially if the drug is only in contact with the tissue for a short time. A proportion of most NTs is likely to be metabolised in, or taken up by, the tissue before reaching the receptor, although this is less likely with synthetic drugs. It could be that they are achieving the same response by acting through different receptors and that those targeted by A are either more numerous or better equipped to initiate the response. If they are both acting on the same receptor then obviously A has a more appropriate chemical structure to fit that receptor than B, but whether this has conferred on it a greater ability to combine with the receptor (affinity) or to activate it (efficacy) is unclear. It certainly should not be assumed that the EC50 is a measure of the affinity of the drug for the receptor. All responses are the result of a series of PHARMACOLOGY AND DRUG EFFECTS 107 Figure 5.
Contraction of the dome-shaped diaphragm causes it Inspiration (inhaling) and expiration (exhaling) are accom- to flatten order strattera 18mg on-line, lowering its dome purchase strattera 25mg free shipping. This increases the vertical dimen- plished by alternately increasing and decreasing the volume of the thoracic cavity (fig. Breathing in takes place when the air pressure within the lungs is lower than the atmospheric pressure; breathing out takes place when the air pressure within the lungs is greater than the atmospheric pressure. Respiratory System © The McGraw−Hill Anatomy, Sixth Edition Body Companies, 2001 Chapter 17 Respiratory System 619 At rest Inspiration Expiration FIGURE 17. At rest (a),the atmospheric pressure at sea level and within the plural cavities is 760 mmHg. During inspiration (b),the diaphragm contracts,causing a decrease in intrapleural pressure and consequent inflation of the lungs. During expiration (c),the diaphragm recoils,causing an increase in intrapleural pressure and consequent deflation of the lungs. A simultaneous contraction of the external intercostal muscles and interchondral portion of the in- ternal intercostal muscles increases the diameter of the thorax. The scalenes and sternocleidomastoid muscles are involved in deep inspiration or forced breathing. At the same time, the upper rib cage is stabilized so that the external intercostal muscles become more effective. The expanded thoracic cavity decreases the air pressure within the pleural cavities to below that of the atmosphere. It is (a) (b) this pressure difference that causes the lungs to become inflated. The increase in Expiration lung volume during full inspiration is shown by comparison with the lung volume in full expiration (dashed lines). For the most part, expiration is a passive process that occurs as the muscles of inspiration are relaxed and the rib cage returns to its original position. The lungs recoil during expiration as elastic fibers within the lung tissue shorten and the pulmonary alveoli draw to- gether. Lowering of the surface tension in the pulmonary alveoli, Van De Graaff: Human VI.