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Short-Term Fourier Transform" analysis was applied to RR time series to compute usual HRV components vs. power stages. For all subjects, visual examination of both ventilatory equivalents and instantaneous high-frequency HF ; energy multiplied by the instantaneous frequency of the HF peak HF. fHF , HF: 0.15fmax Hz ; vs. time linked to power stages ; has shown two synchronous abrupt increases, at the same power level, giving the first ventilatory threshold VT1 ; associated with the first HF threshold HFT1 ; , and the second ventilatory threshold VT2 ; associated with the second HF threshold HFT2 ; . When expressed as a function of power, HFT1 and HFT2 were not respectively different from VT1 and VT2 in C and T. In addition, HFT1 and HFT2 were respectively strongly correlated to VT1 C: r2 0.97, T: r2 0.96, P 0.001 ; and VT2 C: r2 0.94, T: r2 0.97, P 0.001 ; . The subject characteristics and physiological performance levels of the two groups in absolute terms were all significantly different. However, when the performance values were normalised, no significant difference was found between cyclists and triathletes. This study shows that ventilatory threshold assessment is possible from cardiac RR time series using HRV time-frequency analysis in healthy well-trained athletes. Does the meconial aspiration syndrome affect long term pulmonary function? N. Djemal, K. Masmoudi, H. Ben Amar, N. Zouari Functional Exploration Department, Bourguiba University Hospital, 3029 Sfax, Tunisia ; . Acute pulmonary consequences of the meconium aspiration syndrome MAS ; are well described. However, few studies of the long term pulmonary sequelae in MAS have been made. In order to evaluate long term pulmonary function in MAS survivors, we studied 14 children aged 4 to 11 years, an average of 7.41 2.27 years after injury. Our sample had a mean weight of 24.6 7.35 kg and a mean height of 124.5 cm 10.64. At birth, the mean Apgar scores respectively at 1 and 5 min were 5.3 2.28 and 7.23 1.74. All 14 children required oxygen for a mean period of 6.35 days 4.95. In the current study, the.

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Furberg, C. D., et al. "Clinical Epidemiology: The Conceptual Basis for Interpreting Risk Factors." Journal of the American College of Cardiology 98, no. 7 1996: 9769781047. Ignatavicius, Donna D., and Marilyn Varner Bayne. Medical-Surgical Nursing. Philadelphia: W.B. Saunders Co., Harcourt Brace Jovanovich, Inc., 1991. Ishizaki, T., et al. "Pharmacokinetics and Pharmacodynamics in Young Normal and Elderly Hypertensive Subjects: A Study Using Sotalol as a Model Drug." Journal of Pharmacology and Experimental Therapeutics 212, no. 16 1980: 173181. Jansen, R. W., and J. H. Gurwitz. "Controversies Surrounding the Use of BBlockers in Older Patients with Cardiovascular Disease." Drugs and Aging 4, no. 11: 1994: 175183. Kostis, J. B., et al. "Prevention of Heart Failure by Antihypertensive Drug Treatment in Older Persons with Isolated Systolic Hypertension." Journal of the American Medical Association 278, no. 2: 1997: 212216. Krumholz, H. M., Radford, M. J., Wang, Y. et al. "National use and effectiveness for the treatment of elderly patients after acute myocardial infarction." National Cooperative Cardiovascular Project. JAMA 280, 1998: 62329. Leighton, C. "Body-Mind-Spirit: A Change of Heart." American Journal of Nursing 98, no. 10: 1998: 3337. McGovern, M., and J. K. Kuhn. "Cardiac Assessment of the Elderly Client." Journal of Geriontology Nurses 18, no. 8 1992: 4044. Nettina, Sandra M. The Lippincott Manual of Nursing Practice, 7th Ed. Philadelphia: Lippincott, Williams and Wilkins, 2001. Nolan, P. E., Jr., and F. I. Marcus. "Pharmacologic Treatment of Cardiac Disease in the Elderly." Pharmacy Practice News July 1998: 2428. Nolan, P. E., and M. D. Otto. "Lidocaine." In Clinical Pharmacokinetics. Pocket Reference. Edited by J. E. Murphy. Bethesda, MD: American Society of Hospital Pharmacists, 1993: 115-144. Nolan, P. E., and M. D. Otto. "Quinidine." Clinical Pharmacokinetics. Pocket Reference. Edited by J. E. Murphy. Bethesda, MD: American Society of Hospital Pharmacists, 1993: 225253 and reboxetine. Diabetespas.be page?page articles&orl 539&ssn <r &are 783&mi 515&mi 814 : diabetespas.be page?page articles&orl 539&ssn <r &are 285&mi 515&mi 529 Steward M. Brown JB, Weston WW, McWhinney IR, McWilliam CL, Freeman TR. Patient-Centered Medicine. Transforming the Clinical Method. Oxon: Radcliffe Medical press Ltd, 2003. Patients with chronic conditions, such as diabetes patients, make treatment choices that best fit in with their own expectations and personal circumstances. They can therefore have distinctly personal reasons for not always following a strict treatment regimen. Vermeire E, Van Royen P, Coenen S, et al. The adherence of type 2 diabetes patients to their therapeutic regimens: patients' perspective. A qualitative study. Pract Diabetes Int 2003; 20: 209-14. Vermeire E, Van Royen P, Coenen S, et al. Therapietrouw bij diabetes type 2-patinten vanuit het standpunt van de patint. Huisarts Nu. 2005; 34: 118-25. Rather than blaming the patient if the goals are not achieved, the doctor should investigate why this is so. Donovan JL. Patient decision making. The missing ingredient in complex research. Int J Technological assessment in Health Care 1995; 11: 443-55. If the desired goal is that patients should optimally comply with their treatment plan, then this rests on a responsibility shared between doctor and patient, with personally achievable goals being explicitly addressed. Exploring the patient's expectations in regard to his her disease and treatment, and translating these individual expectations into achievable and realistic goals for the patient and together with the patient is an important communication job for the GP. Wens J, Vermeire E, Van Royen P, et al. GPs perspectives of type 2 diabetes patients' adherence to treatment . A qualitative analysis of barriers and solutions. Wens J, Vermeire E, Van Royen P, et al. GPs' perspectives of type 2 diabetes patients' adherence to treatment. A qualitative analysis of barriers and solutions. BMC Family Practice 2005; 6: 20. There is now sufficiently strong evidence that, for care providers, certain instruction interventions result in more patient-oriented consultation management.
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1. Energy calories ; 25-30 cal kg IBW - reduce in obese and increase in underweight 2. Protein0.8 g kg body weight. Supplement for pregnancy, lactation and growth. Include a small quota of animal proteins - fish, chicken, milk and yoghurt. Avoid cattle meat and eggs 3. Fats 20-25% of total calories Saturated: 6-7% of total calories PUFA: 6-7% of total calories MUFA: 6-7% of total calories N6 N3 ratio: 4: 1 Cooking oil: 0.5 kg month person * Total fat intake in the form of cholesterol per day 300 mg. Note : When prescribing fat in the diet one should take into account the invisible fat in the diet which nearly contributes to 50% of the required fat.None of the available oils are ideal.26a The choice of cooking oil should be as follows. a ; Use an oil which has a moderate quantity of linoleic acid like ground nut oil, rice bran or sesame. b ; Use an oil which has high amounts of linoleic acid safflower oil, sunflower oil, cotton seed, corn oil ; along with an oil which has relatively low levels of linoleic acid like palm oil. mix equal quantity or use equal quantity ; . or c ; Use any of the above oils with alpha linoleic acid certaining oil like mustard and soya bean oil. * See Appendix 3-5 for content of saturated and unsaturated fatty acids, omega 3: 6 content in oils and spices ; . 4. Carbohydrates 55-60% of total calories. Encourage complex carbohydrates i.e. mainly grains, cereals, pulses. * Beans, vegetables and salads. Avoid simple and refined carbohydrates like sugar, honey and jaggery. Avoid bakery products or deep fried items. 5. Fruits Fresh fruits up to 400 g day. Avoid juices. Ideal fruits are citrus fruits, orange, sweet lime, guava, apple, papaya and watermelon. They provide vitamins, fibre. One portion contains about 40-50 calories. Dry fruits to be avoided. 6. Dietary fibers 30-40 g day preferably from natural sources. Avoid loss from refining and processing. Indian diet is rich in fiber and generally does not require addition of fiber supplements. See Appendix 6 ; . 7a. Common Salt Up to 6 day. Reduce intake to 4 g day in the presence of hypertension, renal failure and heart problems. 7b. Condiments and spices Include in diet plan. Provide antioxidants, trace elements, minerals and n-3 fatty acids. See Appendix 5 ; . 7b. Fenugreek 8. Artificial sweeteners Use of aspartame, sucralose, etc in limited quantity is acceptable. The maximum permitted consumption range from 2-4 mg kg day. Avoid in pregnancy and lactation. 9. Alcohol Avoid if possible. If not, drastically reduced. It is utilized as carbohydrates. 1 gm of alcohol provides empty calories. Alcohol may exacerbate neuropathy, dyslipidemia, obesity and may worsen the control of diabetes and cause hyperglycemia. 10. Tobacco Avoid smoking and use of tobacco in any form. l, for example, rifampin.

With a clinic evaluation required every year. Annual mammograms and breast exams were required as well. Electrocardiograms were done at baseline and year 3 and 6. Some flexibility with doses of the estrogen and progestin was allowed to control vaginal bleeding and breast tenderness. The study drug was stopped in women who developed breast cancer , deep vein thrombosis DVT ; , pulmonary embolism PE ; , malignant melanoma, meningioma, trigylceride level 1000 mg dl or any prescribed hormone therapy by primary physician. Cardiovascular disease was defined as an acute MI that required an overnight hospital stay, silent MI determined by serial EKG changes or CHD death. 98% of breast, colorectal, and endometrial cancer and 92 % of all other cancers were verified by pathology reports. Hip, vertebral and all fractures reported were verified by radiographic evidence. Monitoring of the study began in 1997. In 1999 the data and safety monitoring board DSMD ; noticed early adverse events in cardiovascular disease. Again in the spring of 2000 and 2001 the data was reviewed by the DSMB. The participants were given notices of increases in MI, stroke and PE DVT by recommenda, tion of the DSMB in 2001, but the trial would continue. In the spring of 2002 the DSMB found events of cardiovascular disease continued even though the risks were within the selected boundaries. Conversely the risk of breast cancer had crossed the boundaries set and was supportive of overall harm within the global index. The DSMB discontinued the trial at this time due to these results and some confirmation of increase in CHD stroke and PE. The risks , outweighed the potential benefit of a decrease in fractures and colorectal cancer over the 5.2-year average follow-up time period that had been completed. Cardiovascular disease, mostly nonfatal MI, was increased by 29% in and stavudine. The pharmacokinetic parameters obtained were similar for both groups, for instance, ethambutol.

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Jain, A.K. and Dubes, R. C. 1988 ; . Algorithms for Clustering Data. Prentice Hall, Englewood Cliff, New Jersey. Li, C. and Biswas, G. 2002 ; . Unsupervised Learning with Mixed Numeric and Nominal Data. IEEE Transactions on Knowledge and Data Engineering, vol. 14, no. 4, pp. 673-690. C. Arima and T. Hanai, 2003 ; "Gene Expression Analysis Using Fuzzy K-Means Clustering", Genome Informatics 14: 334. 335 ; Dembele, D. and Kastner, P., Fuzzy C-means method for clustering microarray data, Bioinformatics, 19: 973 980, S. Chu, J risi, M.Eisen, J.Mulholland, D. Botstein, P.O. Brown, and I. Herskowitz, 1998 ; "The transcriptional program of sporulation in budding yeast", Science, 282: 699705, 1998. W.H.Wolberg and O.L.Mangasarian, 1990 ; , "Multisurface method of pattern separation for medical diagnosis applied to breast cytology", Proceedings of the National Academy of Sciences, U.S.A., Volume 87, pp 9193-9196. Huang, Z. 1997 ; . Clustering Large Data sets with Mixed Numeric and Categorical Values, In Proceedings of The First Pacific-Asia Conference on Knowledge Discovery and Data Mining. Singapore. World Scientific. Table 10.1 Causes of jaundice Pre-hepatic Haemolytic anaemia Hepatic Abnormal bilirubin metabolism Viral hepatitis Drugs hepatitis or cholestasis Malignancy Chronic liver disease 226 Post-hepatic Cholangiocarcinoma Pancreatic carcinoma Sclerosing cholangitis Gallstones and ticlopidine and rifater, for instance, tuberculosis.

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