By P. Grimboll. Columbia University. 2018.
Filtration is the physical removal of bacteria from a One approach that has been known for decades still fluid by the passage of the fluid through the filter purchase topamax 100mg free shipping. The filter yields useful information concerning bacterial ultrastructure buy topamax 100mg line. If the diameter is less than This is the substitution of the metals present in the cell wall the smallest dimension of a bacterium purchase 200mg topamax visa, the bacterium will be with other metals buy topamax 200 mg cheap. Metals act like glue to hold various wall retained on the surface of the filter it contacts. Filtration is indirectly metallic species include calcium and magnesium. Out-com- bactericidal since the bacteria that are retained on the filter peting these species by supplying large concentrations of will, for a time, be alive. However, because they are also another metal, the influence of the normal metallic species can removed from their source of nutrients, the bacteria will even- be assessed. The energy membrane, where the underlying attachment to the rigid pep- of the radiation severs the strands of deoxyribonucleic acid in tidoglycan layer is disrupted. With only The use of specific antibodies to determine the molecu- one exception, the damage is so severe that repair is impossi- lar arrangement of ultrastructural constituent targets greatly ble. The exception is the radiation resistant bacterial genus enhances the effectiveness of agents to be used in drug therapy. This genus has the ability to piece together the fragments of DNA in their original order and enzy- See also Atomic force microscope; Bacterial appendages; matic stitch the pieces into a functional whole. Bacterial surface layers; Caulobacter; Electron microscope, Exposure to chemicals can be bacteriocidal. For exam- transmission and scanning; Electron microscopic examination ple, the gas ethylene oxide can sterilize objects. Solutions con- of microorganisms; Sheathed bacteria taining alcohol can also kill bacteria by dissolving the membrane(s) that surround the contents of the cell. Laboratory benches are routinely “swabbed” with an ethanol solution to BACTERIOCHLOROPHYLL • see PHOTOSYNTHESIS kill bacteria that might be adhering to the bench top. Care must be taken to ensure that the alcohol is left in contact with the bacteria for a suitable time (e. Otherwise, bac- BBacteriocidal, bacteriostaticACTERIOCIDAL, BACTERIOSTATIC teria might survive and can even develop resistance to the bac- tericidal agent. Other chemical means of achieving bacterial Bacteriocidal is a term that refers to the treatment of a bac- death involve the alteration of the pH, salt or sugar concentra- terium such that the organism is killed. Penicillin A bacteriocidal treatment is always lethal and is also referred and its derivatives are bactericidal because they act on the pep- 54 WORLD OF MICROBIOLOGY AND IMMUNOLOGY Bacteriophage and bacteriophage typing tidoglycan layer of Gram-positive and Gram-negative bacte- rial cell, and the host cell commences to transcribe and trans- ria. By preventing the assembly of the peptidoglycan, peni- late the viral genes. One of the first genes that it translates cillin antibiotics destroy the ability of the peptidoglycan to encodes an enzyme that chops up the E. At the end of the lytic because they prevent the manufacture of DNA or protein. The resistance by clinically important bacteria is a major problem destroyed or lysed cell releases up to 200 phage particles ready in hospitals. On the other hand, the lysogenic cycle Bacteriostatic agents prevent the growth of bacteria. Instead, the phage DNA is Refrigeration can be bacteriostatic for those bacteria that can- incorporated into the host cell’s chromosome where it is then not reproduce at such low temperatures. Every time the host cell divides, it repli- riostatic state is advantageous as it allows for the long-term cates the prophage DNA along with its own. Ultra-low temperature freezing and two daughter cells each contain a copy of the prophage, and lyophilization (the controlled removal of water from a sample) the virus has reproduced without harming the host cell. Another bacteriocidal tech- certain conditions, however, the prophage can give rise to nique is the storage of bacteria in a solution that lacks nutri- active phages that bring about the lytic cycle.
Changes in Personality Almost all of the people who spoke with me felt that their use of alternative therapies resulted in changes to one or more aspects of their personalities order topamax 200 mg on line. For instance order 200 mg topamax mastercard, Laura felt she had gained confidence and become a more assertive person through her use of alternative therapies: “At the time I wasn’t a very assertive person cheap topamax 100mg without prescription, I don’t believe that any more about myself purchase 200mg topamax mastercard.... For example, Pam believed that an alternative approach resulted in what she saw as a remarkable change in her daughter’s entire personality: I removed all the wheat that you could just see, the bread, the buns. And within three weeks there was a remarkable change, change in personality, the temper tantrums left, the disorganization left. Hanna also believed that several aspects of her personality had changed and that she had become a calmer, more tolerant, more contented, and a less worried person: I’m a lot more level. When you do yoga for several years you go through different levels of experiences and you learn not to question what’s happening to you.... It means more contentment because you’re not 88 | Using Alternative Therapies: A Qualitative Analysis worried. I feel a lot more self-sufficient, I don’t worry about the future any more. Similarly, Brenda believed she had become a more patient and tolerant person, less argumentative and judgmental, more honest with herself, and, in general, happier: I don’t judge anybody; the other thing is happiness. Also relationships, I was always angry with something, I was never satisfied, everything was wrong. Our lives were just bitching and complaining at each other and now we don’t ever. The changes Betty saw in her personality included becoming more confident and calmer, as well as less fearful and worried. She told me, “Things don’t bother me nearly as deeply or the same as they would have. I have a confidence in myself, in my ability, in my life, that I didn’t used to have. For instance, Hanna said that one of the changes she experienced in her personality was “being just a little bit more psychic. I think once you become spiritually aware or are beyond the two dimensions of body and mind I think you can,... I even said to her [alternative practitioner], ‘How will I know when I’m intuitive? Finally, Jenny pointed out that it was the changes to personality she experienced as a result of her use of alternative therapies that led to physical benefits for her. She said: “It’s given me at certain times a greater composure, ability to survive, openness to others and just a greater sense of well-being which goes through to the way I feel physically. Those who perceived their values to have changed were more likely to espouse non-mainstream religious beliefs. For example, both Hanna, who is a Buddhist, and Lorraine, who follows new age spirituality, felt they had changed in terms of the value they placed on material things. There was a point in my life that I could have never said that, they’re only things, they do not matter. Whether the changes these people perceive occur on the level of value systems, personality, or in the whole person, they are experienced as positive change. According to Lindsay, I got my orthotics and balanced my feet and started having my chiropractic done and balanced my hips. I think it’s important for everybody to find things that help them be the best person they can. That’s why I’m exploring it [alternative therapies], cause I want to be the best possible person I can. Again, it is the ideology contained within their alternative models of health and healing that makes them better people. In Hanna’s words, Yoga philosophy is to be basically a very good person with high moral standards. Love your neighbour as yourself, that type of thing, but a lot 90 | Using Alternative Therapies: A Qualitative Analysis more self-discipline, mental and physical discipline, and to be a nice person, treat other people the best way you can, don’t judge people, and I suppose the philosophy is to improve yourself. HEALING THE SELF McGuire (1987:376) contends that “the very rhetorics of healing in mod- ern Western societies emphasize individual choice and transformation. For instance, Easthope (1993:294) asserts that “The healer’s task is to reconstruct...
Here began what became the most Institute order 200mg topamax fast delivery, he had great influence in bringing the absorbing interest of his career—the study of the problems of these patients to the attention of pathology of bone diseases effective 200mg topamax. He pointed out the to Chicago to resume his teaching position at importance of a holistic approach order topamax 100mg fast delivery, i cheap topamax 100 mg with amex. Phelps’ paper on the classification the Presbyterian Hospital Unit, and at the end of and treatment of cerebral birth injuries, written the war returned to Rush Medical College, where early in his career, is considered by orthopedic he soon became professor of surgery. Bick to be the most important carried on a large private practice, he devoted publication on the subject since the original much time to teaching and laboratory research. Many of his contributions to the knowledge of bone and joint diseases, as well as to the field of general surgery, owe their inception to this period in his life. Phemister’s achievements won him every school at the University of Chicago in 1927, recognition in the medical world. Phemister entered upon the most significant positions of distinction in the surgical societies of work of his career. The university asked him to the United States and in international associa- undertake the task of organizing a department of tions. Many foreign societies conferred honorary surgery, whose members were to devote all their memberships upon him. These honors he received time to teaching and investigation as well as to with characteristic humility and always with a clinical work. His greatest personal full-time medical faculty was an important new satisfaction was to observe the growth and principle, Dr. While awaiting the completion of the buildings On December 28, 1951, the medical world was of the university clinics, he went to Europe for saddened by the death of Dallas B. In London he began his work on operative shock, a subject to which he made contributions of the greatest importance through the subsequent years. With the opening of the University of Chicago School of Medicine, came the most productive years of his career. Not only did he make many contributions to knowledge, but by his example, he stimulated others who came under his influ- ence to do likewise. His research on bone tumors, infections, bone growth and repair, bone trans- plantation and aseptic necrosis of bone radically altered the surgical care of patients with skeletal disorders. Although bone and joint disease remained his primary interest throughout his life, other fields too were affected by his investiga- tions. He was the first successfully to remove the esophagus, in case of carcinoma, with re- establishment of continuity by anastomosis with the stomach. His studies on the formation and constituents of gallstones were fundamental. His early recognition of the need for blood replace- Nikolai Ivanovich PIROGOFF ment in surgical shock helped to revolutionize the surgical management of patients injured or con- 1810–1881 valescent from operation and made possible the greatly expanded surgical treatment that we know Nikolai Ivanovich Pirogoff was one of the great- today. Phemister’s own accomplishments in the well known in the English-speaking world since medical sciences would alone be sufficient to his contributions to the surgical literature were earn him a high place in medical history. He written in Latin, Russian, French, and German was most profoundly influential, however, as a and have not been translated into English. His personal qualities of intellectual eponym is attached to an osteoplastic amputation honesty, tireless energy, generosity, dignity, and of the foot in which the heel pad is affixed to the simplicity deeply affected all who came in contact distal tibia utilizing a portion of the os calcis to with him. In Russia, he had dealing with undergraduate students, residents, an enormous influence on medical practice and or staff doctors. After a private primary education, he To the many scientific societies in which he was admitted to the University of Moscow to took an active part, he brought the same high study medicine. It was during his visualization of anatomic relationships and was student days that Pirogoff developed a progres- widely adopted. The standard of medical edu- participated in the general decline of interest in cation at the University of Moscow at that time gross anatomy on medical school curricula, but was very poor.
But why should this be the ultimate target of medical science discount topamax 200mg line, let alone of government policy purchase topamax 200mg line, least of all at a time when the increasing longevity of the population has become a widely acknowledged social problem? A boy born in Britain today can expect to live until he is nearly 75; a girl until over 80 purchase topamax 100mg line. Life expectancy has increased by more than 30 years over the past century and by around a decade since the Second World War purchase 200mg topamax overnight delivery, apparently without the benefit of government-sanctioned measures of health improvement. It is clear that we have not only exceeded the 2 INTRODUCTION biblical lifespan of ‘three score and ten’ but that more and more of us are reaching closer and closer to the biological limit of the human species. There is much scientific debate about whether further increase in life expectancy is possible. For many of my patients, the prospect of prolonging their stay in a world that has little time or respect for them has little appeal. The controversy over euthanasia and the romanticisation of suicide among young men (such as rock stars Kurt Cobain and Michael Hutchence) reflect a deeply pessimistic current in contemporary society. The desire simply to live longer by taking health precautions may be interpreted as another way of responding to the perception that life in modern society lacks meaning and purpose. The promoters of health awareness will object that their emphasis is not so much on ensuring that people live longer as on preventing premature deaths. They will point out that, even though there is an average life expectancy of 75– 80, more than 90,000 people die every year in the UK before the age of 65. Furthermore, some 32,000 of these deaths are from cancer and 25,000 from heart disease and strokes, many of which could have been prevented. In this context, the concept of prevention is abused: death cannot be prevented, only postponed. Unfortunately, given the current state of medical science, death can generally be postponed only for a relatively short time by relatively intensive preventive measures. In the nineteenth century, public health measures to improve sanitation and housing played a decisive role in curtailing the epidemics of infectious diseases that devastated the urban poor. Over the past two decades, proponents of the ‘new public health’ have emphasised the promotion of a healthy lifestyle as the key strategy to combat the modern epidemics of heart disease and cancer. The central weakness of the new public health is the fact that the scope for significant postponement of death from the major causes of premature mortality by preventive measures is limited, though the costs are often substantial. Thus, for example, the increase in average life expectancy to be gained from a 10 per cent reduction in the level of serum cholesterol in the population at large (a much vaunted target of the 1992 Health of the Nation White Paper, though dropped in the 1999 document) is between 2. However, even to achieve this degree of reduction in cholesterol would require either drastic dietary modification or long-term drug treatment (with its attendant side- effects). Now it is true that the fact that old people live longer does not necessarily mean that they suffer worse health. However, it is also true that there is a tendency for the prevalence of common chronic degenerative conditions— heart disease, stroke, cancer, osteoarthritis, diabetes, dementia—to increase with age. What is by no means clear is the contribution of the various preventive measures favoured by the government to improving the quality—as distinct from the duration—of people’s lives. Indeed it may well be the case that an old person’s enjoyment of a cigarette, a cream bun and a bottle of Guinness is more important to them than the extra few weeks they might spend in a life of miserable abstinence. A further aim of government public health policy is to ‘narrow the health gap’ between rich and poor by concentrating its efforts on improving the health of the ‘worst off in society’. Here is another paradox: the government and the medical profession have become more preoccupied with the relationship between inequality and health at a time when social differentials in health are less significant in real terms than ever before. No doubt it is true that people who are better off are healthier and that the poor are sicker. A vast edifice of epidemiological data has been erected in recent years substantiating these differentials in great detail in relation to every disease and health indicator. Yet the simple contrasts between the health gap that exists in Britain today and that between rich and poor in Victorian England, or that which still prevails between Western and Third World countries today, is enough to expose the lack of historical or social perspective of contemporary public health. Take infant mortality, one of the most intensively studied indices of population health. The persistent gap between the rate of infant deaths among rich and poor has been a particular focus of the new public health since the publication of the Black Report in 1980 (Black 1980; Townsend, Davidson 1992). The 1990 figures reveal that the number of babies whose fathers are classified as ‘unskilled workers’ (social class V) who die in the first year of life is 11.