By I. Jorn. Northern Illinois University.

Flying Publisher texts exist 1) in book form and 2) simultaneously as a free internet site buy generic strattera 18mg medicine vile. So a Flying Publisher text has two physical conditions buy strattera 25 mg without prescription treatment wax, a fee-based form (book) and a free-of-charge form (internet). In an instant, we would have an extensive virtual library with all the relevant information needed for day-to-day use. Change of generations Sceptics express concern that doctors already have enough work to do and thus can’t cope with being writers and publishers of free internet textbooks at the same time. Secondly, the sceptics – especially if they are not doctors themselves – are not quite in step with the times. In the last five years, the internet has drastically reduced costs and time involved in the production and marketing of information of every kind. Until recently, those who published textbooks – mostly 45 and older – were too old to understand the internet. Those, on the other hand, who had some idea of the possibilities offered by the internet were too young and inexperienced, and therefore not ready to write textbooks yet. But, as time passes, people get older and the old ones, too old for the internet, take their leave and the young ones, young enough for the internet, get older and reach the age at which they can write textbooks. In the following chapters, we will work our way step by step through the process of how an idea becomes a text and how we get this text to our readers. The individual stages of this adventure are: 8 Communication Selecting and narrowing down a theme, structuring the material and putting together a team of authors (Page 2) Writing the text and guiding the authors (Page 37) Preparations behind the scenes, while the authors are writing (Page 45) Talks with sponsors (Page 54) Refining and polishing work on the chapters until we have a version ready for press Advance publication of the texts on the internet Advertising and marketing Advertising and marketing Copyright clearance for translation into other languages Before describing these points in detail, we have to go back to basics. Does it make more sense nowadays to publish a text in a traditional publishing house or as my own publisher? Communication Communication is the transportation of thoughts, ideas, wishes, images or visions from one brain to another. When you stand up in front of a group of students in a lecture theatre, some things are only in your head, but not in the heads of the students. In the course of history, people have invented cuneiform writing tablets, papyrus, manuscript, books, radio, television and the internet. The first three media are no longer modern, and radio and television are generally not available to us. This leaves us with books and the internet for the communication of our knowledge. The number of people interested can range from 6 thousand million (Message: „the 10-kilometre meteorite is expected to hit three days before Christmas”) to a few hundred (Message: “total mesorectal excision and urogenital dysfunctions”). Flying Publisher how many people are interested in a subject, the following rule applies: if I write and spend days and even weeks formulating a text, I want as many people as possible from the group theoretically interested in my text to read what I have written. Books and the internet are the forms of communication media available to us doctors (Table 1 and 2). The most important difference is that we pay for books, but not for internet sites, and, in addition: Readability: books are easier to read and more versatile in their application Number of readers: for 1000 book-readers there are 10,000 and more internet readers How up-to-date are they? A text which is produced as a combination of “book + internet” leaves little to be desired. A book on its own is immobile – it takes internet sites to set the text in motion. Only then is it to be found standing on every street corner of the internet, calling “Please take me with you!

Evidence for quality of life outcomes at 2 weeks is insufficient to support one treatment over 62 cheap strattera 10 mg with mastercard medications 44 175, 98 the other cheap strattera 18mg line 911 treatment for hair. Adjusted mean differences reported by Carr, 2012, mean differences calculated by authors with available data (Hampel, 2010). Trial size ranged from 102 to 898 patients randomized to treatment groups of interest. In all five trials, the nasal antihistamine was azelastine, and the intranasal corticosteroid was fluticasone propionate. Three 115 trials from the same article used a newly approved combination product comprising both 117, 121 drugs, and two trials used a separate nasal inhaler for each drug in the combination. Of two 117, 121 121 trials that reported the proportions of other races, one included approximately 20 percent Hispanic patients. Individual nasal symptoms (congestion, rhinorrhea, sneezing, and itching) and eye symptoms (itching, tearing, and redness) were rated on a scale from 0 (no symptoms) to 3 (severe symptoms). Morning and evening scores were summed to give a maximum score of 6 for each individual symptom. As shown in these tables and noted above, several trials reported on each outcome. Four trials (85 percent of patients reporting this outcome) were included in meta- analyses for each nasal outcome. Variance estimates necessary for pooling were not reported by 117 Hampel (2010), preventing inclusion of this trial in the meta-analyses. All five trials showed greater improvement in congestion with combination therapy than with 117 intranasal corticosteroid monotherapy. In three trials, including Hampel (2010), treatment effects were statistically significant and ranged from 0. For the outcome of congestion, the risk of bias was rated as low based on the quality of the 115, 121 trials. Statistical heterogeneity of a meta-analysis of four trials was low, and the pooled 117 effect was consistent with the effect reported in the one trial not included in the meta-analysis. The body of evidence supporting a conclusion of equivalence of combination therapy and intranasal corticosteroid for this outcome was therefore considered precise. All five trials showed greater improvement in rhinorrhea with combination therapy than with intranasal corticosteroid monotherapy. For the outcome of rhinorrhea, the risk of bias was rated as low based on the quality of the 115, 121 trials. Statistical heterogeneity of a meta-analysis of four trials was low, and the pooled 117 effect was consistent with the effect reported in the one trial not included in the meta-analysis. The body of evidence supporting a conclusion of equivalence of combination therapy and intranasal corticosteroid for this outcome was therefore considered precise. All five trials showed greater improvement in sneezing with combination therapy than with 117 intranasal corticosteroid monotherapy. In four trials, including Hampel (2010), treatment effects were statistically significant and ranged from 0. For the outcome of sneezing, the risk of bias was rated as low based on the quality of the 115, 121 trials. Statistical heterogeneity of a meta-analysis of four trials was low, and the pooled 117 effect was consistent with the effect reported in the one trial not included in the meta-analysis. The body of evidence supporting a conclusion of equivalence of combination therapy and intranasal corticosteroid for this outcome was therefore considered precise. All five trials showed greater improvement in nasal itch with combination therapy than with 117 intranasal corticosteroid monotherapy.

Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality buy generic strattera 18 mg on line symptoms 24 hours before death. Radionuclide bone scintigraphy in patients with biochemical recurrence after radical prostatectomy: when is it indicated? Local recurrence after radical prostatectomy: characteristics in size cheap 10mg strattera with visa symptoms wisdom teeth, location, and relationship to prostate-specific antigen and surgical margins. Radical salvage prostatectomy: Treatment of local recurrence of prostate cancer after radiotherapy. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial. Prostate cancerspecific survival following salvage radiotherapy vs observation in men with biochemical recurrence after radical prostatectomy. Adaptation vs selection as the mechanism responsible for the relapse of prostatic cancer to androgen ablation therapy as studied in the Dunning R- 3327-H adenocarcinoma. Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical Trials Working Group. Prostate-specific antigen as a measure of disease outcome in metastatic hormone-refractory prostate cancer. Change in serum prostate-specific antigen as a marker of response to cytotoxic therapy for hormone-refractory prostate cancer. The use of bisphosphonates for the palliative treatment of painful bone metastasis due to hormone refractory prostate cancer. Prostate specific antigen after gonadal androgen withdrawal deferred flutamide treatment. Chemotherapy with mitoxantrone plus prednisone or prednisone alone for symptomatic hormone-resistant prostate cancer: a Canadian randomized trial with palliative end points. Laplanche A, Beuzeboc P, Lumbroso J, Massard C, Plantade A, Escudier B, Di Palma M, Bouzy J, Haddad V, Fizazi K. Interventions for the treatment of metastatic extradural spinal cord compression in adults. A systematic review of the best available evidence and the strength of that evidence. If necessary relevant focused questions can be framed in order to exactly define the purview of the exercise. The standard treatment guidelines for testicular torsion fail to mention if it is based on based on current literature following a systematic review. If the literature on testicular torsion lacks well designed studies that are amenable to a structured analysis, this should be mentioned. If due to lack of sufficient high quality evidence this document will largely be a consensus document, this should be mentioned. Investigation The diagnosis of testicular torsion is mainly clinical as mentioned. It should be emphasized that by no means should be time between presentation to the surgeon and exploration in strongly suspected cases exceed 1 hour. It is enough to recommend scrotal exploration and fixation of the contralateral testes.

Splenectomy involves: ligature of the splenic pancreatic juice into the pancreatic ducts and best 40mg strattera medications causing hyponatremia, from there purchase strattera 10mg amex symptoms 10dpo, ultimately vessels approaching the hilum (taking care not to injure the tail of the into the duodenum. The secretion is essential for the digestion and pancreas or colon); and dissection of the splenic pediclesbthe gastro- absorption of proteins, fats and carbohydrates. The mechanism by all patients are routinely vaccinated against the capsulated bacteria, which these aetiological factors result in pancreatic injury is unknown; and children, who are the group most at risk of sepsis, are maintained however, they both appear to result in activation of pancreatic exocrine on long-term antibiotic prophylaxis. The pancreas and spleen 47 20 The posterior abdominal wall Inferior phrenic artery Oesophagus Coeliac artery Superior mesenteric artery Transversus Iliohypogastric nerve Quadratus Ilioinguinal nerve lumborum Psoas major Gonadal artery Inferior mesenteric artery Genitofemoral nerve Femoral nerve Lateral cutaneous nerve of thigh Median sacral artery Fig. The small diagram shows how the renal columns represent the cortices of adjacent fused lobes Suprarenal Diaphragm Spleen Outline of pleura Duodenum Stomach 12th rib Pancreas Liver Transversus abdominis Colon Subcostal nerve Colon Ilio-inguinal nerve Small intestine Quadratus lumborum Small Psoas major intestine Fig. The intravesical portion of the ureter is • The lumbar sympathetic trunks and plexuses and the lumbar plexus approximately 2 cm long and its passage through the bladder wall (see p. Each kid- • Blood supply: as the ureter is an abdominal and pelvic structure it ney is approximately 10–12 cm long and consists of an outer cortex, an receives a blood supply from multiple sources: inner medulla and a pelvis. The renal pelvis divides into two or three major calices and these, in turn, divide into minor calices which receive urine from the medullary Ureteric stones pyramids by way of the papillae. Most ureteric calculi arise for unknown reasons, although inadequate • Position: the kidneys lie in the retroperitoneum against the posterior urinary drainage, the presence of infected urine, and hypercalcaemia abdominal wall. Large • Blood supply: the renal arteries arise from the aorta at the level of impacted stones can lead to hydronephrosis and/or infection of the L2. Together, the renal arteries direct 25% of the cardiac output affected kidney and consequently need to be broken up or removed by towards the kidneys. The differential pressures cortex is derived from mesoderm and is responsible for the production between afferent and efferent arterioles lead to the production of an of steroid hormones (glucocorticoids, mineralocorticoids and sex ultrafiltrate which then passes through, and is modified by, the nephron steroids). The right gland lies behind the right The ureter is considered in abdominal, pelvic and intravesical portions. The left • Structure: the ureter is approximately 20–30 cm long and courses adrenal is anteriorly related to the lesser sac and stomach. It has a muscular wall and • Blood supply: the phrenic, renal arteries and aorta all contribute is lined by transitional epithelium. The posterior abdominal wall 49 21 The nerves of the abdomen T12 (subcostal) L1 Nerves L2 Subcostal Iliohypogastric L3 Ilioinguinal L4 Genitofemoral Lateral L5 cutaneous of thigh Femoral Obturator Fig. The upper two ganglia no intercostal space but, instead, runs below the rib in the neurovascu- receive white rami from L1 and L2. The lumbar sympathetic chain, the splanchnic nerves and the vagus • The iliohypogastric nerve is the main trunk of the 1st lumbar nerve. It contribute sympathetic and parasympathetic branches to plexuses supplies the skin of the upper buttock, by way of a lateral cutaneous (coeliac, superior mesenteric, renal and inferior mesenteric) around the branch, and terminates by piercing the external oblique above the abdominal aorta. In addition, other branches continue inferiorly to form superficial inguinal ring where it supplies the overlying skin of the the superior hypogastric plexus (presacral nerves) from where they mons pubis. The ilioinguinal nerve is the collateral branch of the iliohy- branch into right and left inferior hypogastric plexuses. The ilioinguinal runs in the neurovascular plane of the receive a parasympathetic supply from the pelvic splanchnic nerves. The abdominal wall to emerge through the superficial inguinal ring to pro- branches from the inferior hypogastric plexuses are distributed to the vide a cutaneous supply to the skin of the medial thigh, the root of the pelvic viscera along the course and branches of the internal iliac artery. It courses inferiorly and divides into: a genital component ior primary rami of S2,3,4athe pelvic splanchnic nerves. The latter that enters the spermatic cord and supplies the cremaster (in the male), parasympathetic supply reaches proximally as far as the junction and a femoral component that supplies the skin of the thigh overlying between the hindgut and midgut on the transverse colon.