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M.Torabi Nami MD, PhDc Department of Neuroscience Institute for Cognitive Science Studies (ICSS), Tehran 15948 Iran Torabi_m@iricss.org Abstract Sleepiness, tiredness and fatigue are complaints which must be thoroughly analyzed to eliminate blur and ambiguity. Physiological sleepiness (“sleep pressure”) increases while being awake and additionally underlies the circadian rhythm with a lower threshold to fall asleep during night time. Excessive daytime sleepiness (EDS) is considered normal only after sleep deprivation. Clinically, EDS manifests by frequents daytime napping and/or reduced alertness with automatic behavior or - in its extreme form - in recurrent attacks of sudden, uncontrollable compulsion to sleep also in inappropriate situations (= “sleep attacks”). EDS is “objectively” addressed by measuring the mean sleep latency to four to five nap opportunities throughout the day using the multiple sleep latency test (MSLT) or the maintenance of wakefulness test (MWT). EDS denotes both, a ready entrance into sleep as well as difficulty in staying awake during daytime or accordingly in inappropriate situations. These two partially independent aspects of EDS are separately assessed by the “passive” MSLT and the “active” MWT respectively. For that reason the MSLT and MWT only weakly correlate with each other when tested over a broad range of patients with EDS. It is important to keep in mind, that these tests are importantly influenced by a great variety of factors such as mood, anxiety, and motivation. “Vigilance” comprises wakefulness, alertness and attention and therefore is more than just the reciprocal to sleepiness. Cognitive performance tasks such as Steer Clear Reaction Time Test (SCRTT) or driving simulators require the complete integrity of vigilance to achieve normal results. Hypersomnia is usually broadly defined as the combination of abnormally prolonged night-time sleep (regularly >10 h) with EDS during ≥1 months. On the other hand, the term hypersomnia has also been used in a narrower scene for the isolated abnormality of a prolonged night-time sleep need (>10 h). “Tiredness”, also in colloquial language often used for sleepiness, in a broader sense also describes the feeling of lack of energy, motivation and initiative. These patients seek rest rather than sleep. They often cannot fall asleep when given the opportunity in spite of feeling tired, and hence, in an MSLT, do not show an abnormally short sleep latency. Furthermore, tiredness (and fatigue) as opposed to sleepiness has a mental (“central”) and physiological (bodily or “peripheral”) component, which the patients can readily distinguish. Patients with insomnia, mild sleep apnea syndrome, or depression rather suffer from mental tiredness than sleepiness during the day. The simple subjective self-assessment using the Epworth Sleepiness Scale (ESS) quite reliably differentiates between sleepiness and mental tiredness (without sleepiness), which makes it a widely used test. The term “fatigue” is also heterogeneously used. In physiology the “fatigue” implied a “time on task performance decrement” to describe decreasing muscle force during a sustained physical effort. In clinical medicine one distinguishes physical (“peripheral”) from mental (“central”) fatigue and the term usually denotes a chronic and more abnormal situation than tiredness. In a broad sense “fatigue” implies a deficiency in coping satisfactorily with mental and physical work load. The chronic fatigue syndrome entails both mental as well as a physical fatigue (so called “leaden paralysis” of limbs). Depressive states are often associated with insomnia and fatigue, but there are also cases with hypersomnia rather than insomnia ( non organic hypersomnia , “atypical depression” or “hypersom

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A heart attack occurs when blood flow to a part of your heart is blocked for a long enough time that part of the heart muscle is damaged or dies. The medical term for this is myocardial infarction.

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Tracheotomy is a surgical procedure which consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea (windpipe). The resulting stoma (hole), or tracheostomy, can serve independently as an airway or as a site for a tracheostomy tube to be inserted; this tube allows a person to breathe without the use of his or her nose or mouth. Both surgical and percutaneous techniques are widely used in current surgical practice. It is among the oldest described procedures.

The hip joint is formed between the 'ball' of the femoral head and the 'socket' of the acetabulum and a cartilaginous labrum. Strong supporting muscles, the fibrous joint capsule and ischiofemoral ligament make this a stable joint. Hip dislocations are either congenital or traumatic. Congenital dislocation of the hip is caused by dysplasia of the femoral head or acetabulum and is covered in the separate article Developmental Dysplasia of the Hip. This remainder of this article deals with traumatic dislocation. Traumatic hip dislocation is an orthopaedic emergency. Large forces are required to cause hip dislocation (except in prosthetic hips) and this means that such injury may be associated with other life-threatening injuries and other fractures. The condition is extremely painful. Accurate and swift diagnosis means appropriate management can reduce morbidity.

Cardiac catheterization (kath-uh-tur-ih-ZAY-shun) is a procedure used to diagnose and treat cardiovascular conditions. During cardiac catheterization, a long thin tube called a catheter is inserted in an artery or vein in your groin, neck or arm and threaded through your blood vessels to your heart. Using this catheter, doctors can then do diagnostic tests as part of a cardiac catheterization. Some heart disease treatments, such as coronary angioplasty, also are done using cardiac catheterization. Usually, you'll be awake during cardiac catheterization, but given medications to help you relax. Recovery time for a cardiac catheterization is quick, and there's a low risk of complications.

Como Engravidar De Menino, Engravidar De Uma Menina, Como Faço Para Engravidar De Menina. Revelado: Maneira Incomum para Engravidar de uma MENINA! Fiquei impressionada pela grande quantidade de mulheres que possuem uma preferência para o sexo do seu bebê, e portanto vou falar hoje de como aumentar as suas chances de conceber uma menininha! Para aumentar as chances de engravidar de uma menina, devem-se considerar as características dos espermatozoides que carregam o gene X (que irá gerar uma menina) e dos que carregam o gene Y (que gerará um menino). Os espermatozoides femininos são mais lentos, porém mais resistentes que os espermatozoides masculinos. E como mencionei lá em cima a duração é diferente: os espermatozoides que carregam o gene X duram, em média, 72 horas, já os que carregam o gene Y duram menos, cerca de 24 horas. Com essas informações, a dica é ter relações sexuais dois ou três dias antes do período fértil, visto que os espermatozoides femininos são mais resistentes e conseguem “sobreviver” no corpo da mulher até que ela esteja ovulando. Para calcular o período fértil, deve-se considerar o dia da ovulação (em média, 14 dias após o primeiro dia da menstruação) e deixar uma margem de três dias antes e três dias depois da ovulação. Para saber o dia da ovulação, existem testes vendidos em farmácias, que funcionam como os testes de gravidez. Outra dica é observar o muco cervical, que fica com aspecto de clara de ovo no período fértil. Outra recomendação é adotar posições em que a penetração não seja tão profunda. É importante ainda que a mulher tenha orgasmo depois do homem, porque a secreção que ela libera quando atinge o clímax deixa a vagina menos ácida, facilitando a movimentação dos espermatozoides que carregam o gene Y (que irá gerar um menino). No caso da alimentação deve alterar o cardápio algumas semanas antes da ovulação, dando preferência para alimentos com muito cálcio e em magnésio como leite e derivados, frutas, verduras verde-escuras, como espinafre, couve e rúcula. Além disso, é necessário evitar comidas com muito sódio e potássio e reduzir o consumo de carne. Para mais dicas de como engravidar e uma menina acesse o link abaixo Dicas de como engravidar de uma MENINA Vídeo + Informações http://escolher-sexo-bebe.info-pro.co