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The vast majority of glucocorticoid activity in most mammals is from cortisol, also known as hydrocortisone. Corticosterone, the major glucocorticoid in rodents, is another glucocorticoid. Cortisol binds to the glucocorticoid receptor in the cytoplasm and the hormone-receptor complex is then translocated into the nucleus, where it binds to its DNA response element and modulates transcription from a battery of genes, leading to changes in the cell's phenotype. Only about 10% of circulating cortisol is free. The remaining majority circulates bound to plasma proteins, particularly corticosteroid-binding globulin (transcortin). This protein binding likely decreases the metabolic clearance rate of glucocorticoids and, because the bound steroid is not biologically active, tends to act as a buffer and blunt wild fluctuations in cortisol concentration.
Methotrexate anti-tumor activity is a result of the inhibition of folic acid reductase, leading to inhibition of DNA synthesis and inhibition of cellular replication. The mechanism involved in its activity against rheumatoid arthritis is not known.
Visualization of the larynx by direct or indirect means is referred to as laryngoscopy and is the principal aim during airway management for passage of a tracheal tube. This paper presents a brief background regarding the development and practice of laryngoscopy and examines the equipment and techniques for both direct and indirect methods. Patient evaluation during the airway examination is discussed, as are predictors for difficult intubation. Laryngoscope blade design, newer intubating techniques, and a variety of indirect laryngoscopic technologies are reviewed, as is the learning curve for these techniques and devices.
The lungs and respiratory system allow oxygen in the air to be taken into the body, while also enabling the body to get rid of carbon dioxide in the air breathed out. Respiration is the term for the exchange of oxygen from the environment for carbon dioxide from the body's cells.
The superior sagittal sinus (also known as the superior longitudinal sinus), within the human head, is an unpaired area along the attached margin of falx cerebri. It allows blood to drain from the lateral aspects of anterior cerebral hemispheres to the confluence of sinuses.
-Korsakoff's syndrome is a common and preventable sequel of Wernicke's encephalopathy. Thiamine, if given during the stage of Wernicke's encephalopathy, can prevent the onset of Korsakoff's psychosis. The administration of glucose prior to thiamine can precipitate Korsakoff's syndrome, as seen in this case. In such patients, brain MRI frequently shows abnormal enhancement of the mammillary bodies & thallamus
Cerebral palsy refers to brain damage that occurs before a child is five years old. Therefore, adults cannot develop cerebral palsy. However, cerebral palsy does not get better or worse with age, so when a child has the condition, he or she will continue to have the condition into adulthood.
Indwelling urinary catheters are commonly used in hospitals and can lead to preventable catheter-associated UTI. How can rates of catheter-associated UTI be reduced in hospitals? New research findings are summarized in a new NEJM Quick Take. Learn more at http://nej.md/1WoeHdF SHOW MORE
Encopresis is a problem that children age four or older can develop due to chronic (long-term) constipation. With constipation, children have fewer bowel movements than normal, and the bowel movements they do have can be hard, dry, and difficult to pass. The child may avoid using the bathroom to avoid discomfort.
Cervical cerclage can be placed via transvaginal, open transabdominal, or laparoscopic transabdominal approach, preferably before pregnancy. Recurrent late miscarriages may be due to a weak (sometimes called an incompetent) cervix that shortens or opens too early in pregnancy. Cervical cerclage involves placing a stitch around the upper part of the cervix to keep it closed; the operation may be carried out through the vagina, or through the abdomen, as an open or laparoscopic ('keyhole') procedure.
Definition. The principal signs of cerebellar dysfunction are the following: Ataxia: unsteadiness or incoordination of limbs, posture, and gait. A disorder of the control of force and timing of movements leading to abnormalities of speed, range, rhythm, starting, and stopping.