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By K. Leon. Concordia College, Austin Texas. 2018.

Other advan- elderly persons who have diffculty walking long distances because tages of ultrasound include: low running costs order lithium 300mg online, needing short ex- of pain buy 150 mg lithium mastercard. After the protocol an immediate effect was seen even on a amination time and consents a multiregional assessment and a good level surface lithium 300mg lowest price, and continuing to exercise on the anti-gravity tread- guide in local injection of joint and periarticular tissues. Herein, mill can be expected to have a positive impact on sustaining and we want to empasize that ultrasonography is quick, successful, and improving amounts of physical activity, and even improve social economical option that can use diagnosis, treatment and follow-up functioning as well. Jie habilitation, Ankara, Turkey Department of Rehabilitation Medicine, Xuzhou Central Hospital, Introduction/Background: Peritendinous adhesions after repair of Xuzhou, Jiangsu Province, China an injury to the digital fexor tendons are a major problem in hand Objective: To study the effect of intensive rehabilitation training surgery and can prevent healing. Detection of this type of inju- on ankle proprioception dysfunction and infuence of Charcot-Ma- ries in time is of paramount importance. Group 2 patients were given conventional comprehensive re- don was resulted from an injury caused by glass cut 45 days ago. Results: limitation on the right 1st metacarpophalangeal and interphalan- Before treatment, the patients in the control group and the obser- geal joints. After treatment, before treatment 2 groups was developed on the distal interphalangeal joint. Conclusion: Tendon adhesion might be an obstacle on the rehabilitation of the tendon injury and ultrasound may be helpful for diagnosis. It results in restoration of prehensile functions of study is to assess whether immobilization after femur fracture sur- thumb. Material and Methods: Case report of 16-year-old male, resi- gery leads to atherosclerotic change in popliteal artery. Material and dent of Karachi Pakistan, had a foot ball hit on left thumb, while play- Methods: Fourteen patients who admitted for rehabilitation after ing, resulting in injury to the thumb. It presented with pain swelling surgical treatment of femur fracture (8 males and 6 females; mean and loss of movement of thumb. He was clinically examined and valgus stress testing of the left was measured by duplex ultrasound. Patient was followed up after 4 weeks of highly related to progression of atherosclerotic plaque formation. There was no pain,swelling or functional losses in activities with left 385 hand and thumb. Miyano een patients that underwent surgery for distal radius fracture were 1 prescribed hand therapy postoperatively according to the following Tokyo General Hospital, Department of Rehabilitation Medicine- protocol. On postoperative day 1, a cock-up splint was applied and Department of Orthopedics Surgery, Nakano-ku, Japan instructions given regarding active fnger motion. From week 1 to 3, Introduction/Background: The purpose of the present study was to active hand motion was allowed for washing hands or bathing. Muscle strengthening exer- with proximal femoral fracture at the rehabilitation wards. Hand function was lon- and Methods: The subjects were 40 patients (Mean age; 84yo) with gitudinally examined according to six items: wrist range of motion postoperative proximal femoral fracture. The results of the subjects on admission and at similar to the hand function before the fracture. That of dementia group increased to 79 points 386 at discharge from 70 points on admission. It is a rare congenital disorder which the central ray of the hand/ pattern and contracture of hands and fngers secondary tospasticity foot is affected. Material and and Methods: A 21-old man was admitted to our rehabilitation centre Methods: In this report we presented a 25 year old man with dys- with bilateral cleft foot and hands. Inability to hold things properly in kinetic cerebral palsy complains about left shoulder pain due to su- the hands and diffculty in walking were the main complaints of the praspinatus muscle tearing andadezive capsulitis occurred because patient. On the right hand, there was a cleft with absence of second, of his hopeless dyskinetic shoulder movements. On the left hand, there was a cleft with ab- pain while resting or activity and increase byshoulder movements. Wrists, forearms, elbows, In examination, range of motion of his left shoulder was limitedand ankles and knees were normal. He was taken 3 miligrams of clonaz- he born of a non-consanguineous marriage full-term by normal vagi- epam daily because of his involuntarymotions when he referred our nal delivery. The other medical and parental history was a day and gave 75 mg of pregabalin twice aday. Conclusion: Ectrodactyly is a rare syndrome with treatments, his complaint was remained unchanged. Hence we ap- congenital hand and foot abnormalities in which the central bony ele- plied suprascapular nerve block and injected botulinum toxin-a to ments are absent. We present this interesting case to call physicians’ his left brachialis, pronator teres, fexör carpi radialis, fexör digito- attentions towards this syndrome. Material and Methods: In this pa- Turkey per we report an incidentally case in a patient with Poland syndrome. Introduction/Background: Necrotizing fasciitis is defned as a rare, Results: A 23-year-old man was admitted to our outpatient clinic with life threatening soft tissue infection characterized by rapidly devel- complaints of diffculty in using the right shoulder. Material and Methods: A 22-year-old 4/5 in the shoulder fexors and adductors according to manual muscle man patient was admitted to our clinic with complaint of decreased testing. Muscle strength of elbow, wrist and fnger muscles were in range of motion and pain caused by joint movement on his left knee. No lymph node was to his medical history necrotizing fasciitis was diagnosed on his left palpable. Blood biochemistry and complete blood counts were with- lower extremity (affecting the anterolateral face of left thigh, about in normal ranges. Conclusion: Clinicians should keep Poland syndrome degrees on prone position and extension was measured 110 degrees in mind in the differential diagnosis of shoulder complaints. Flexion was increased up to 115 degrees and extension was limited minimally (about 5 de- 390 grees). Turkey There was, likewise, a decrease in abrasion ratings (improvement) for both experimental and control groups but were not signifcant. Conclusion: Intake of collagen hydrolysate com- mon, idiopathic entity characterized by diffuse fascial infammation bined with standard of care can signifcantly increase femoral articu- of extremities, peripheral eosinophilia and elevated acute phase reac- lar cartilage thickness in more areas compared to control. On physical examination, abduction and fexion was decreased 1Faculty of Medicine Siriraj Hospital, Rehabilitation Medicine, minimally on the left shoulder. The passive range of motion of the Bangkok, Thailand left elbow was 110 degrees in fexion and –40 degrees in extension. Additionally, left Introduction/Background: Pes planus or fatfoot is the common foot 3–5. Search for an adjunct manage- ment has lead to studies on the potential benefts of nutraceuticals F. This study aims to determine the ef- Aranez2 fect of collagen hydrolysate as an adjunct treatment for patients 1Cebu City, Philippines, 2Southwestern university, College of Reha- with knee osteoarthritis based on pain scale and articular cartilage bilitative Sciences, Cebu City, Philippines thickness, clarity and abrasion using musculoskeletal ultrasound.

Flowable composites can be used to fill these cavity preparations cheap lithium 150mg visa, and better materials will become available x Stimulate growth of new or reparative dentin generic 150mg lithium. There exists and use of magnification during endodontic therapy some controversy regarding the extent to which dem- will improve the effectiveness of treatment 300mg lithium otc. The use of ineralized tissues can be remineralized and the means lasers in endodontic therapy, including indirect and by which demineralization should be diagnosed in the direct pulp capping, vital pulp amputation and prepa- clinic (Thylstrup and Fejerskov, 1994). The future will polishing of the partially dissolved external surface also see new emphasis on treatment of disease process- of an active lesion. However, several studies have es that affect the periradicular tissues, including persist- demonstrated an increase in hardness and mineral ent apical disease, tooth perforations and fractures, and content and reduced subsequent demineralization at internal and external resorption. Definition of the the surface of tooth tissues that were remineralized importance of growth factors in pulpal repair will like- (Shannon and Edmonds, 1978; Retief et al, 1983; ly be an important area of future research, with a focus Vissink et al, 1985; Larsen and Fejerskov, 1987; on clinical application (Roberts-Clark and Smith, White, 1988; and Linton, 1996). Concern has been raised, however, about deliv- Restorative materials are continually being im- ery of these agents to injured pulp tissue (Tziafas et al, proved. The potential impact of untreated endodontic disease as a risk factor to certain systemic diseases needs x Release antibacterial agents or fluoride on de- to be explored (Grau et al, 1997). Improved understanding of wound healing associated with implant placement, with x Be readily placed in very small conservative cav-ity a particular emphasis on the implant-bone interface, preparations. Relying on both met- individuals at a high risk of caries, "actively smart mate- allurgical and biological science, these studies will lead rials" similar to glass ionomer, but with greater fracture to improved implant surface coatings. The challenge for the technology also provides a route to structures made future is to reduce the cost of this treatment so more of gradient materials, i. In underway, targeting decreased polymerization addition, it is likely that algorithms will be devel- shrinkage. Decreased polymerization shrinkage is oped to identify patients at risk for implant failure. Ring-opening monomers and certain epoxy systems that can Research of importance to the practicing dentist expand during polymerization are being developed necessarily includes topics associated with dental or investigated for dental use (Guggenberger et al, biomaterials. Improved filler forming methods have already been introduced into phases, bonding agents and toughened polymer both clinical and dental laboratory settings. It is matrixes are being investigated to improve wear and anticipated that advanced process development will structural behavior and add remineralizing capabil- continue. Much focus will remain on the optimiza- ity (Antonucci et al, 1991; Stansbury and Anto- tion of current materials, minimizing contraindica- nucci, 1992; Skrtic et al, 1996; Schumacher et al, tions and broadening use of esthetic materials for 1997; Stansbury and Antonucci, 1999; and Xu et al, posterior restorations. Novel posterior restorative materials are are under development that combines diagnostic, being developed, including mercury-free, condensa- restorative and therapeutic (controlled release) ble silver fillings and esthetic interpenetrating-phase capability. Work continues on improving adhesive composites (non-shrinking), based on the resin infil- chemistries and on mercury-free restorative materi- tration of porous, three-dimensional ceramic skele- als. Increased focus is being given to the develop- tons (Dariel et al, 1995; Eichmiller et al, 1996; ment of laboratory tests that validly reproduce clin- Giordano et al, 1997; Kelly and Antonucci, 1997; ical behavior. Biomimetic approaches are becomes available regarding intraoral damage mech- being investigated, as are tissue engineering con- anisms and microstructure-property relationships. Surface chemistries ening the use of titanium in fixed prosthodontics, par- and topologies of implantable materials are being ticularly with respect to improving the interface with studied to enhance cellular interactions. Advanced forming systems, almost all involving Many academicians recognize the need for a more some computer control, will (1) broaden the range robust evidence base to guide clinical decisions of currently available materials that can be used in involving comparisons among materials and the dental practice, (2) improve the precision and auto- rational development of clinical indications for new mate dental laboratory fabrication, (3) foster devel- materials (Laskin, 2000). Investigations are being opment of novel prostheses and craniofacial called for to identify the relative technique sensitivi- implants, and (4) provide routes to novel materials. Research is anticipated in the development involves three-dimensional printing of powder/ of in vitro test methodologies predictive of clinical binder combinations followed by sintering to form behavior to evaluate dental biomaterials and assist solid objects from ceramics or alloys (Cima, 1996). Future analysis) of too large a percentage of published den- research will form an improved definition of genet- tal clinical trials (Kelly, 1999; and Palmer and Sendi, ic, environmental, and microbial risk factors for 1999). Rather than focusing on component materi- periodontitis that will lead to development of a pro- al properties, dental prostheses are being evaluated file for patients at risk for advanced disease. It can be antici- and cellular processes with implanted materials pated that subtraction radiography will be intro- remains a research focus to both enhance the clini- duced as part of patient management, but may be cal application of titanium dental implants and to limited to specialized treatment centers. The development possible that this area of investigation will see and microstructure of tissues continues to be studied renewed interest because of the growing body of evi- with the hope that biological processes can be mim- dence linking periodontal diseases and various sys- icked in the fabrication of biomimetic prosthetic temic diseases. These tests will likely be formatted materials (Marshall et al, 2001; White et al, 2001; in a user-friendly style, utilizing saliva or blood to Kamat et al, 2000; and Kirkham et al, 2000). Research in this area will be tissue engineering research as initial carriers of cells, linked to studies of the relationship of periodontal growth factors and molecular species designed to diseases and cardiovascular disease, cerebrovascular direct and enhance defect repair, especially in bone disease, pre-term low birth weight babies, and dia- (Ma and Choi, 2001; Loty et al, 2000; Reddi, 2000; betes mellitus. Tissue engineering as a means of reducing the risk for these medical dis- approaches may also provide clinicians with the orders will also be explored. As an example, a specific mutation on chromosome Periodontal Disease Risk Assessment and 11q14 associated with the gene encoding of the Diagnosis enzyme cathepsin C was detected in a consanguineous family with prepubertal periodontitis (Hart et al, The diagnosis of periodontal disease will continue 2000). Clinicians will begin of periodontal disease research, in tandem with the to identify individuals who are at risk for active peri- general emphasis on using information about varia- odontal diseases using genetic tests and biologic tests tions in the human genome, and the protein products that identify specific microorganisms in subgingival of those genes, to explain human diseases. In addition, digital radiography Periodontal Disease Management will be used more in periodontal diagnosis, and prac- tical systems will be introduced to perform subtrac- The improved understanding of the pathogenesis of tion radiography in the dental office. The use of systemic antibiotics to general health as other risk factors, such as smok- will be reserved for the most aggressive forms of dis- ing or high cholesterol levels. Considerable research expected to be active participants in the management effort has focused on the use of newer anti-inflamma- of patients with certain systemic diseases, and to tory agents for treatment of periodontitis. While sys- broadly consider how medical management of patients temically delivered agents have been used in both ani- will influence dental health and dental care. For exam- mal and human studies, topical delivery of these agents ple, longitudinal medical studies have demonstrated (mouth rinses, toothpastes) seems the most logical that good glycemic control limits the onset and preva- approach for the future. When indicated, dentists be employed as anti-inflammatory agents (Graves et al, should be checking hemoglobin A1c. Periodontal dis- 1998), and, in the case of diabetes-associated periodon- eases are the sixth complication of diabetes mellitus. Advances in treatment of periodontitis will focus If, in the near future, multicentered, randomized, on procedures to induce regeneration of lost peri- controlled clinical trials confirm that periodontal odontal tissues. Among the specific mediators being disease causes systemic conditions, several issues studied for application in periodontal therapy are will confront the dental profession: recombinant bone morphogenetic proteins and combinations of growth factors. The success of x Studies will need to be conducted to determine these therapies will depend on the identification of the effectiveness of screening patients in the dental the appropriate biological mediator and the appro- office for certain diseases with obvious ramifications priate delivery system. If effective, these pro- grams will enhance the oral health and general Although there are a few negative findings (Hujoel health status of patients. Oral infections are suspected to be a risk lic and physicians that dentistry can no longer be factor for certain systemic diseases (that is, cardiovas- considered solely a luxury, elective health care. Increased x The recognition of the medical necessity for peri- communication by dentists with other health care odontal care will increase the perceived impor- professionals can be expected. Thus, the larger problems are strating a systemic therapeutic benefit from peri- the perception among health care professionals, the odontal therapy, there is no concrete evidence to jus- nature and system by which health care is delivered, tify a change in oral health care policy or current and access and utilization. Future research in humans should more demiological, basic science, social science and clinical thoroughly evaluate the maternal genotype in addition to trial research will enable them to participate more that of the fetus in determining risk of this birth defect. Current research efforts are point- ing the way to promising directions, especially in the x Continued efforts should target the identification areas of etiology/prevention and outcomes.

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Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis order 150 mg lithium otc. Recurrence of spontaneous bacterial peritonitis in cirrhosis: frequency´ ´ and predictive factors buy discount lithium 300mg line. Trimethoprim-sulfamethoxazole for the prevention of spontaneous bacterial peritonitis in cirrhosis order lithium 300mg without prescription. Norfloxacin prevents spontaneous bacterial peritonitis recurrence´ in cirrhosis: results of a double-blind, placebo-controlled trial. Primary prophylaxis of spontaneous bacterial peritonitis delays hepatorenal syndrome and improves survival in cirrhosis. Ciprofloxacin in primary prophylaxis of spontaneous bacterial peritonitis: a randomized, placebo-controlled study. Epidemiology of severe hospital-acquired infections in patients with liver cirrhosis: effect of long-term administration of norfloxacin. Infections caused by Escherichia coli resistant to norfloxacin in hospitalized cirrhotic patients. Population-based study of the risk and short- term prognosis for bacteremia in patients with liver cirrhosis. Bacteremia and bacterascites after endoscopic sclerotherapy for bleeding esophageal varices and prevention by intravenous cefotaxime: a randomized trial. Infectious sequelae after endoscopic sclerotherapy of oesophageal varices: role of antibioitic prophylaxis. High frequency of bacteremia with endoscopic treatment of esophageal varices in advanced cirrhosis. Oral, nonabsorbable antibiotics prevent infection in cirrhotics with gastrointestinal hemorrhage. Norfloxacin prevents bacterial infection in cirrhotics with gastrointestinal hemorrhage. Systemic antibiotic prophylaxis after gastrointestinal hemorrhage in cirrhotic patients with a high risk of infection. The effect of ciprofloxacin in the prevention of bacterial infection in patients with cirrhosis after upper gastrointestinal bleeding. Pneumococcal bacteremia with especial reference to bacteremic pneumococcal pneumonia. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Guidelines for the management of adults with hospital- acquired, ventilator-associated, and healthcare-associated pneumonia. Vibrio vulnificus infection: clinical manifestions, pathogenesis, and antimicrobial therapy. Streptococcus bovis endocarditis and its association with chronic liver disease: an underestimated risk factor. Ahmed Infectious Diseases Fellow, Southern Illinois University School of Medicine, Springfield, Illinois, U. Nancy Khardori Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois, U. As a part of the immune system, the spleen is involved in production of immune mediators like opsonins. A decrease in the level of factors responsible for opsonization, such as properdin and tuftsin, occurs in splenectomized patients (1,2). Complement levels are generally normal after splenectomy, but defective activation of alternate pathway has been reported. In addition, neutrophil and natural killer cell function and cytokine production are impaired (3). The ability of the spleen to remove encapsulated bacteria is especially significant, because these organisms evade antibody and complement binding (4). The antibody response to capsular polysaccharide (in encapsulated bacteria) in normal adults consists of IgM and IgG2. In patients with asplenia, IgM production is impaired, recognition of carbohydrate antigens and removal of opsonized particles containing encapsulated organisms are defective. There is no compensatory mechanism within the immune system to overcome these defects in patients with asplenia or suboptimal splenic function. Consequently asplenic and hyposplenic patients are susceptible to fulminant infections, e. An extensive review concluded that the incidence of sepsis in adult asplenics is equal to that of the general population, but the mortality rate from sepsis is 58-fold higher (6). A meta- analysis showed that incidence of sepsis after splenectomy done for hematologic disorders, such as thalassemia, hereditary spherocytosis, congenitally acquired anemia, and lymphomas, is as high as 25% (7,8). Most of the infectious complications (50% to 70%) occur within two years of splenectomy (6–10). However the risk of overwhelming infection is lifelong, and postsplenectomy sepsis has been reported more than 40 years after surgery (10–14). In one retrospective review of 5902 postsplenectomy patients studied between 1952 and 1987, the incidence of infection was 4. A Danish study found that the incidence of pneumococcal infection in splenectomized children decreased dramatically following the introduction of the pneumococcal vaccine and the promotion of early penicillin therapy (15). In another study the overall rate of first, second, and third severe infections in postsplenectomy patients were reported as 7, 45, and 109 per 100 person-years respectively. Second (42% to 76%) and third (61% to 84%) episodes of severe infections occurred within 6 months after the first severe infection. Between 50% and 80% of all severe infections or deaths occurred within one to three years after splenectomy; males had a shorter survival compared with females after splenectomy (16). Other reactants in the cascade are arachidonic acid metabolites, prostaglandins, cyclooxygenase lipoxygenase, complement C5a, leukotrienes, bradykinins, and kinins. Later during the course it causes vasodilatation and thrombosis with tissue injury. Waterhouse–Friderichsen syndrome and bilateral adrenal hemorrhage may be found at autopsy (19). The mechanism of sepsis syndrome in asplenic patients is the same as in the general population. Although most severe infections are seen in splenectomized patients, they may also occur in functional hyposplenism as well. Functional hyposplenism is associated with the following: hematologic diseases such as sickle cell hemoglobinopathies, hemophilia; neoplasms such as chronic myeloid leukemia, non-Hodgkin’s lymphoma, and following bone marrow transplantation; gastrointestinal disorders such as Crohn’s disease, ulcerative colitis, and Whipple’s disease, the degree of hyposplenism appears to be less in Crohn’s disease than ulcerative colitis; autoimmune disorders such as chronic active hepatitis, rheumatoid arthritis, Sjogren’s syndrome, and systemic lupus erythematosus; infiltrative diseases such as amyloidosis and sarcoidosis. Epidemiology The significance of postsplenectomy infections is in its excessive morbidity and mortality despite low incidence. The indications for splenectomy have been reevaluated and there is more conservative approach to splenic resection. Overall numbers are decreasing as well as the percentage of cases for particular indications. This has been the case primarily in two areas: splenic trauma and hematologic malignancies.

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With circi- ity in the brain and spinal cord (central nervous sys- nate balanitis generic 150 mg lithium with amex, the skin around the shaft and tip of the tem) buy lithium 150 mg with visa, including many sleeping pills lithium 300mg low price, sedatives, penis can become inflamed and scaly. See also balanitis; addictive, carry a high risk of overdose, and should keratodermia blennorrhagicum; Reiter syndrome. An uncircumcised boy should bariatric surgery Surgery on the stomach be taught to clean his penis with care to prevent and/or intestines to help a person with extreme obe- infection and inflammation of the foreskin and the sity lose weight. Full retraction of the foreskin may between 35 and 40 who have health problems like not be possible until after age 3. There are many types of bald- bariatrician A physician who specializes in ness, each with a different cause. See alopecia; alopecia areata; behavior modification, lifestyle changes, and, when alopecia capitis totalis; alopecia, traumatic; indicated, the prescription of appetite suppressants alopecia universalis. Bariatrics also includes research into overweight, as well as its ball-and-socket joint A joint in which the causes, prevention, and treatment. The barium outlines the colon on the X-ray enlarge a narrowing in a coronary artery. Trench sulfate, which produces a visible image on X-ray fever was first recognized in the trenches of World film. Barium solution outlines organs of the body so War I, and it now occurs among homeless people, they can be seen as images on X-ray film. Also basal cell A small, round cell found in the lower known as upper gastrointestinal series. Basal cell carcinoma often occurs on Barr body A microscopic feature of female cells the face and neck, where the skin is exposed to sun- that is due to the presence of two X chromosomes, light. These tumors are locally invasive and tend to one of which is inactive and crumples up. There is a small nucleus, putamen, and globus pallidus) that are but definite increased risk of cancer of the esopha- responsible for involuntary movements such as gus (adenocarcinoma) in people with Barrett tremors, athetosis, and chorea. The diagnosis of Barrett esophagus is are abnormal in a number of important neurologic made on seeing (through endoscopy) a pink conditions, including Parkinson’s disease and esophageal lining (mucosa) that extends a short Huntington’s disease. The basal meta- bolic rate can offer clues about underlying health barrier method A birth control method that problems. For example, a person with an overly employs a barrier which prevents sperm from active thyroid has an elevated basal metabolic rate. Condoms and diaphragms are examples of a barrier basal temperature 1 Usually, a person’s tem- method. This meas- nearby glands, called the lesser vestibular glands, ure is now superceded by modern thyroid function the Bartholin glands act to aid in sexual intercourse. Transmission tary to one another (A and T, or G and C) and join occurs when infected louse feces are rubbed into http://www. It may be caused by incomplete development of bladder control, a basement membrane A thin membrane that is sleep or arousal disorder, bladder or kidney dis- composed of a single layer of cells. About 20 percent of 5- with coarse, bluish-black granules of uniform size year-olds wet the bed at least once a month; sur- within the cytoplasm. A bee sting can trigger an allergic reaction, including life-threatening anaphy- battered child syndrome A condition in which lactic shock. Avoidance and prompt treatment are a person has skeletal fractures, especially multiple essential for those who are allergic to bee stings. Hikers dating the reporting of suspected instances of child should wear long pants and shirts in risk areas. Victims with Mycobacterium bovis that is closely related to more serious symptoms can require intravenous Mycobacterium tuberculosis, the agent responsible fluids, oxygen, cortisone medicine, or epinephrine, for tuberculosis. In selected cases, allergy injection therapy is Beau’s lines Transverse lines or grooves across highly effective for prevention. For those who are the fingernails, or transverse depressions in the nail not allergic, stings are a minor nuisance unless they plate, from temporary disturbance of cell division occur in multiples. The condition may be caused by local disease or injury of the nail fold, or bee sting, Africanized A sting from an Africanized (“killer”) bee, a species of large honey from a generalized condition such as an illness or a drug, for example, chemotherapy. This species of bees has an bedbug A blood-sucking bug in the Cimex family unusual and dangerous natural defense mechanism that lives hidden in bedding or furniture and comes when disturbed. They bedsore A painful, often reddened area of degen- attack in large numbers and for a longer period of erating, ulcerated skin that is caused by pressure time than is typical of the common European honey and lack of movement and is worsened by exposure bee. As a result, Africanized bees inflict more stings, to urine or other irritating substances. Untreated injecting a higher dosage of bee venom into their bedsores can become seriously infected or gan- victims. Beef tapeworm does not invade surrounding tissue or spread to can be contracted from infected beef that is raw or other parts of the body; it is not a cancer. Half of men over age 50 develop symptoms of biofeedback, relaxation training, and hypnosis. Medical therapy includes drugs such behaviorism The science of studying and modi- as finasteride and terazosin. Prostate surgery has fying animal or human behavior, often through traditionally been seen as offering the most bene- behavior modification techniques. Also known as benign pro- Behcet’s syndrome A chronic disease featuring static hypertrophy and nodular hyperplasia of the inflammation of small blood vessels and character- prostate. The cause of Behcet’s syndrome is bereavement The period after a loss during not known. Upper abdominal dis- beriberi Inflammation of multiple nerves comfort associated with excessive swallowed air (polyneuritis), heart disease (cardiopathy), and may extend into the lower chest, producing symp- edema (swelling) due to a deficiency of thiamine toms that suggest heart or lung disease. Bell’s palsy Paralysis of the nerve that supplies Bernard-Soulier syndrome A disorder in the facial muscles on one side of the face (the sev- which the platelets crucial to normal blood clotting enth cranial nerve, or facial nerve). Bell’s palsy lack the ability to adequately stick to injured blood often starts suddenly. Treatment includes protecting the eye on the Bernard-Soulier syndrome usually appears in the affected side from dryness during sleep. Massage of newborn period, infancy, or early childhood, with affected muscles can reduce soreness. Bernard- cortisone medication, such as prednisone, is given Soulier syndrome is an inherited disease, transmit- to reduce inflammation during the first weeks of ill- ted as an autosomal recessive trait. Specific platelet function tests, as well as tests for the glycoproteins common to belly See abdomen. Also beta-adrenergic blocking drug See beta known as esophageal acid infusion test. Bezoars can block the digestive system, espe- beta blocker A class of drugs that block the cially the exit of the stomach. A bezoar composed of effect of beta-adrenergic substances such as adren- hair is called a trichobezoar. A bezoar composed of aline (epinephrine), that play a key role in the sym- vegetable materials is called a phytobezoar. They have also become important bias In a clinical research trial, the effects that drugs in improving survival after a heart attack.