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As the condition progresses the supply may not be sufficient even at rest. Cardiac failure can result if the myocardium is damaged by ischaemia, if the heart is inefficient due to valve disease or because of excessive peripheral vascular resistance and hypertension.

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What could the skin condition be. Would it be safe to give this patient intravenous iodine contrast agent.

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. Ultraviolet A requires more specialized equipment and prior administration of an oral or topical photosensitizing drug called psoralen, in which case the treatment is known as cialis pharmacy cialis. The combination of psoralen with UVA is known as PUVA. After absorption, psoralen is distributed throughout the body and is activated in the skin by absorbing the energy of UVA radiation. Activated psoralen probably acts by locating between base pairs in the DNA helix and thereby inhibiting replication.

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Osteoarthritis is primarily a degenerative disease of cartilage. With breakdown of cartilage inflammation of the synovium can occur. This is followed by more cartilage destruction and bone remodelling as an attempt at repair. Unlike rheumatoid arthritis, there is no systemic disease associated with osteoarthritis. Treatment of osteoarthritis is with NSAIDs for their analgesic and anti-inflammatory effects. Corticosteroids are not recommended and disease-modifying drugs are not effective in osteoarthritis.


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Sometimes psoriasis can occur in response to drugs such as lithium, chloroquine and NSAIDs, beta-blockers and ACE inhibitors. There is no cure for psoriasis but there are many therapies and treatment depends on the extent and severity of the disease.

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