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Gluten sensitivity is a term that is applied interchangeably with intolerance. However, the term should be used to describe patients who can get a variety of symptoms when they eat gluten and feel better on a gluten-free diet but do not have celiac disease. The biopsy is normal and there is no damage to the intestine. Common symptoms of gluten sensitivity include abdominal pain similar to irritable bowel syndrome, fatigue, headaches and paresthesia tingling of the extremities. There is also a possibility that a subgroup of patients with psychiatric disorders like schizophrenia might be affected by gluten sensitivity.

Heparin works by enhancing the formation of a complex of thrombin and antithrombin III. This effectively prevents thrombin from activating fibrinogen. Heparin has a rapid action of short duration and has to be given by injection. It is used to decrease the risk of deep vein thrombosis after order adipex 37.5 mg and during recovery from heart attack and stroke until warfarin becomes effective. Hirudin is a substance produced by medicinal leeches, which directly inactivates thrombin. Lepirudin is a synthetic version produced by recombinant DNA technology, which has to be given by injection.

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It is particularly useful in treating psychomotor epilepsy. It induces liver enzymes, which reduces its effectiveness and the effectiveness of other drugs such as phenytoin, order adipex 37.5 mg contraceptives, warfarin and corticosteroids. Adverse effects of carbamezepine are similar to those seen with phenytoin. They include the relatively mild drowsiness, dizziness and ataxia, to the more severe mental and motor disturbances. The drug can also cause gastrointestinal disturbances and arrhythmia.

Premedication and adjuncts to general anaesthesia are discussed further on page Induction is most likely to be achieved using an intravenous anaesthetic, which produces unconsciousness within seconds. Maintenance of anaesthesia is then usually by administration of an inhalation anaesthetic in a mixture of air or oxygen. Inhalation anaesthetics are either gases or volatile liquids. Apart from nitrous oxide, which is still widely used, earlier inhalation anaesthetics are no longer used. Ether is not suitable because it is explosive and irritant to the respiratory tract. Chloroform cannot be used because it is toxic to the liver.

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HRT is most effective if started early in the menopause and continued for up to five years (after which osteoporosis will return, possibly at an accelerated rate). Osteomalacia is caused by deficiency of vitamin D. Vitamin D regulates calcium homeostasis in the body by facilitating absorption of calcium from the intestine and, together with PTH, by enhancing calcium mobilization from bone and by reducing excretion of calcium by the kidney. Deficiency of vitamin D leads to inadequate absorption of calcium. Low levels of calcium stimulate the release of PTH, which in turn causes release of calcium from bone and failure to mineralize newly formed bone. Osteomalacia in childhood is known as ricketts and leads to soft bones with characteristic deformities.

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Cancer cells are similar to normal cells and most anticancer drugs show little selective toxicity and therefore produce serious adverse effects. Conventionally, micro-organisms include bacteria, viruses and fungi; protozoa and parasitic worms are parasites. However, bacteria, viruses and fungi are also parasitic, in that they live in or on other living organisms. The term parasite can be applied to any organism that causes disease. A basic knowledge of the characteristics of these organisms is needed in order to understand how they differ from human cells and how these differences can be exploited in chemotherapy. Bacteria are single cell organisms, which can be rod-shaped or spherical.

They are used as a creams, lotions, ointments and bath oils in concentrations from Coal tar orders adipex 37.5 mg are less irritating to normal skin than dithranol, but can cause folliculitis. Keratolytics break down keratin and soften skin, which improves penetration of other treatments. Salicylic acid ointment is most frequently used either on its own or in combination with coal tar or dithranol. Phototherapy is the use of ultraviolet light, which produces improvement in most patients with psoriasis but should only be done under supervision of a dermatologist. UVB is useful if patients have extensive small plaques of psoriasis resistant to topical treatment.

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