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This is not surprising because in the stationary case the irregularities of the two surfaces can settle more deeply into each other discount 17mg duetact with amex. The force that must be applied to an object to get it moving is again obtained from Eq buy generic duetact 17mg on line. The magnitude of the frictional force does not depend on the size of the contact area 16 mg duetact with mastercard. If the surface contact area is increased buy generic duetact 16 mg online, the force per unit area (pressure) is decreased, and this reduces the interpenetration of the irregulari- ties. However, at the same time, the number of irregularities is proportionately increased. Coeﬃcients of static and kinetic friction between some surfaces are shown in Table 2. As is evident, the coeﬃcient of static friction for two given surfaces is somewhat larger than the coeﬃcient of kinetic friction. We have illustrated the concept of friction with surfaces sliding along each other, but frictional forces are encountered also in rolling (rolling friction) and in ﬂuid ﬂows (viscous friction). Rolling motion is not encountered in living systems, but viscous friction plays an important role in the ﬂow of blood and other biological ﬂuids. Whereas sliding friction is independent of velocity, ﬂuid friction has a strong velocity dependence. It is both a nuisance and an indispens- able factor in the ability of animals to move. Without friction an object that is pushed into motion would continue to move forever (Newton’s ﬁrst law, Appendix A). It is the frictional force that dissipates kinetic energy into heat and eventually stops the Section 2. Without friction we could not walk; nor could we balance on an inclined plane (see Exercise 2-2). Friction also produces undesirable wear and tear and destructive heating of contact surfaces. Both nature and engineers attempt to maximize friction where it is necessary and minimize it where it is destructive. Friction is greatly reduced by introducing a ﬂuid such as oil at the interface of two surfaces. A natural example of such lubrication occurs in the joints of animals, which are lubricated by a ﬂuid called the synovial ﬂuid. Assume that she is wearing leather-soled shoes and that she is standing in a vertical position as shown in the ﬁgure. The force parallel to the surface Fp, which tends to cause the sliding, is Fp W sin θ (2. When the joints are in motion, these large forces produce frictional wear, Section 2. Frictional wear at the joints is greatly reduced by a smooth cartilage coating at the contact ends of the bone and by synovial ﬂuid which lubricates the contact areas. When a person walks, the full weight of the body rests on one leg through most of each step. Because the center of gravity is not directly above the joint, the force on the joint is greater than the weight. Since the radius of the joint is about 3 cm, the joint slides about 3 cm inside the socket during each step. Furthermore, this work would be dissipated into heat energy, which would destroy the joint. Therefore, the work expended in counteracting friction and the resul- tant heating of the joint are negligible. However, as we age, the joint cartilage begins to wear, eﬃciency of lubrication decreases, and the joints may become seriously damaged. Studies indicate that by the age of 70 about two-thirds of people have knee joint problems and about one-third have hip problems.
However duetact 16mg with amex, if you are measuring someone else 17mg duetact otc, they can simply touch the plate with a finger order 17mg duetact visa. Younger or healthier humans start emitting at a lower fre- quency and sometimes end at a higher frequency discount duetact 16 mg on line. I hope this challenges you to accomplish a health improvement reflected in an even broader bandwidth for yourself. Lesson Twenty Four Purpose: To find the effect of a variety of things on the lower end of your spectrum, such as body temperature, eating, time of day, rainy weather, feeling sick. Notice that you may not change for weeks at a time, then suddenly see a shrinking of your bandwidth. If this is positive go on a mold free diet—watching carefully for mold in your white blood cells. Even after removing the mold from your diet, so that no molds appear in your white blood cells, notice that your bandwidth does not recover. Method: Search for the bottom of the resonant frequency band as in the previous lesson. Note the bandwidth also depends on the accuracy of your particular frequency generator. This lets you determine whether the next illness is new or a recurrence of this one. Any that are back must have come from an internal source not reached by the zapper current, like from the bowel or an abscess. Lesson Twenty Eight Purpose: To observe the action of a positive offset frequency on a very small animal. Method: Place the small animal in a plastic container like a cottage cheese carton. Place them inside the milk glass or cottage cheese carton, across from each other. They should be gone (but the food is not safe to eat due to the metal released from the teaspoons). Per- haps water supplies as well as foods and medicines could be sterilized this way. If you do decide to explore this possibility, remember not to put metals in your mouth or food. Experiment with new combinations to create different flavorful fruit and vegetable juices. Consider the luxury of preparing gourmet juices which satisfy your own individual palate instead of the mass-produced, polluted varieties sold at grocery stores. All honey and maple syrup should have vitamin C added to it as soon as it arrives from the supermarket. Fresh Tomato Juice Simmer for ½ hour: 12 medium-sized raw, ripe tomatoes, ½ cup water, 1 slice onion, 2 ribs celery with leaves, ½ bay leaf, 3 sprigs parsley. Mix the pulp with an equal amount of clover honey and use as topping (kept in freezer) for homemade ice cream (below), pancakes, or yogurt. Maple Milk Shake For each milk shake, blend or shake together: 1 glass of milk and 2 tablespoons maple syrup. C-Milk Milk can absorb a surprising amount of vitamin C powder without curdling or changing its flavor. Many variations are possible: other fruit concentrates, made in the blender, can be used along with some lemon juice; for example, 2 blended whole apples (peeled), blended pineapple, orange or grapefruit. If you have heart disease, high blood pressure, or edema, use potassium bicarbonate instead. Ask your doctor what an ac- ceptable amount of sodium or potassium bicarbonate is. I would suggest limiting yourself to one glass of soda pop a day, even if you do not have heart disease. Another Note: the citric acid kills bacteria, while the car- bonation brings relief. Squeeze 1 slice of lemon and 1 whole orange into an 8 ounce bottle that has a tight lid. Food Recipes Despite the presence of aflatoxins, benzopyrenes, and sol- vents in many foods, it is possible to have a delicious and safe diet.
It puts the responsibility on the industry to ascertain product safety and efﬁcacy (claims justiﬁcation) (2) discount 16 mg duetact free shipping. Natural extracts effective duetact 16 mg, whether from animal purchase duetact 16 mg with mastercard, botanical order duetact 16 mg with amex, or mineral origin, have been used as ‘‘active ingredients’’ of drugs or cosmetics for as long as human history can go. Oils, butter, honey, beeswax, lead, and lemon juice were common ingredients of the beauty recipes from ancient Egypt. Many botanical extracts are used today in traditional medicine and large pharmaceutical companies are rediscovering them. The major differences between the drug and the cosmetic approach rely on the intent (i. In the drug industry, you need to know the chemical structure of the active ingredient within the extract, very often to synthesize it, to purify it, sometimes to discover that isolation and puriﬁcation leads to a loss in the biologi- 97 98 Khaiat cal activity, or to realize that, despite all the skills of organic chemists, nature is not easy to reproduce. There are plant pow- ders for hair coloring (Henne), scrubs (apricot kernel, corn), or masks (oat ﬂour); plant extracts (‘‘as is’’ or puriﬁed); and biotechnology extracts obtained through fermentation, cloning, soilless culture (aquaculture, artiﬁcial media, etc. Therefore, it is usually only one part of the plant that is used: fruit, bark, root, bud, ﬂower, leaves, etc. Depending on the future use of the extract, various extraction processes can be used. As mentioned, it is industry’s responsibility to ensure the absence of toxic substances that could lead to unwanted side effects. The drug approval process allows side effects to be present provided the beneﬁts outweight the dis- advantages, while the cosmetics consumer has the choice of using a product that may have side effects or using another that has none, the product with side effects would not be acceptable. Total Extracts Total extracts are most common in the cosmetics industry, rarely, if ever, used in drugs. Their activity is often empirical and their active ingredients are not al- ways identiﬁed, but their beneﬁts are, very often, without possible doubt. Their mode of preparation can be found in traditional pharmacopeas (China, India, Africa, Europe, America), or from observing shamans or traditional practitioners. Very often, plants are blended in order to better control or synergize their effects, but sometimes also to preserve the secret of the active ingredient. These processes allow for better controls: stability, preservation, manufac- turing reproducibility. The content of the extract is very much a function of the type of solvent, the temperature, the plant:solvent ratio, the time of contact, the part of the plant used and its species. Sometimes it is also dependent of the plant culture conditions and the season of harvest. In the drug industry, especially, the extract must be concentrated and the active material isolated by selective precipitation, chromatography, electrophore- sis, etc. Solvents have to be carefully chosen, not only for their extraction proper- ties, but also for their compatibility with the ﬁnal formulation and their harm- lessness. Selective Extracts Special extraction processes or the use of speciﬁc solvents will lead to the obten- tion of a speciﬁc class of molecules. The fragrance industry has for centuries obtained essential oils or ﬂoral water by water vapor extraction or ‘‘enﬂeurage’’—a process by which the plant ﬂowers are put in contact with solid fats and terpens and sesquiterpens migrate into the oil phase. The use of vegetable oils as solvent allows for the extraction of oil-soluble vitamins or lipids. Puriﬁcation Extract puriﬁcation to separate speciﬁc molecules from others are done following classic physicochemical processes—cryoprecipitation, column chromatography, electrophoresis, use of selective solvents and salts, etc. Biotechnology Extracts Biotechnology can be used to obtain, purify, or transform extracts. One can ﬁnd different enzymes to be used for very speciﬁc reactions in certain conditions. They could become an alternative to chemical reactions as they provide stereospeciﬁcity or eliminate the risk of solvent residues. Today, protein hydrolysates obtained by enzymatic 100 Khaiat reaction are free of the chlorine residues formed when acid hydrolysis is used.
The syndrome can occur more frequently and earlier in patients who are “slow acety- lators” of procainamide and is influenced by genetic factors effective duetact 17mg. Sixty to 70% of patients who receive procainamide on a chronic basis develop antinuclear anti- bodies generic duetact 16mg with visa, with clinical symptoms in 20–30% order 17mg duetact visa, but this is reversible when procainamide is stopped order duetact 16 mg overnight delivery. The most common relates to the drug’s potent parasympatholytic properties and includes urinary hesitancy or retention, constipation, blurred vision, closed-angle glaucoma, and dry mouth. Some patients can have “cross- sensitivity” to both quinidine and disopyramide and develop torsades de pointes while receiving either drug. Finally, disopyramide can reduce contractility of the normal ventricle, but the depression of ventricular func- tion is much more pronounced in patients with preexisting ventricular failure. In patients with atrial tachyarrhythmias, ventricular rate acceleration has been noted. This phenomenon is unlikely to be clinically important, for the urine pH is normally acidic, and the amount of drug excreted in the urine unchanged is less than 10 and 30–50%, respectively. However, there remains the potential for patients with disorders of urinary acidification to accumulate either of these drugs to toxic levels. It does not appear that decreased renal function per se importantly influences the kinetics of either of these agents. Aggravation of existing ventricular arrhythmias or onset of new ventricular arrhythmias can occur in 5–30% of patients, the increased per- centage in patients with preexisting sustained ventricular tachycardia, cardiac decom- pensation, and higher doses of the drug. Failure of the flecainide-related arrhythmia to respond to therapy, including electrical cardioversiondefibrillation, may result in a mortality as high as 10% in patients who develop proarrhythmic events. Patients with sinus node dysfunction may experience sinus arrest, and those with pacemakers may develop an increase in pacing threshold. Mortality was highest in those with non-Q-wave infarction, frequent premature ventricular com- plexes, and faster heart rates, raising the possibility of drug interaction with ischemia and electrical instability. Exercise can amplify the conduction slowing in the ventricle produced by flecainide and in some cases can precipitate a proarrhythmic response. Proarrhythmic responses, more often in patients with a history of sustained ventricular tachycardia and decreased ejec- tion fractions, appear less commonly than with flecainide and may be in the range of 5%. Noncardiac adverse effects primarily involve the nervous system and include tremor, mood changes, headache, vertigo, nystagmus, and dizziness. Proarrhythmic effects have been reported in about 3–15% of patients and appear to be more common in patients with severe ven- tricular arrhythmias. Sudden withdrawal of propranolol in patients with angina pectoris can precipitate or worsen angina and cardiac arrhythmias and cause an acute myocardial infarction, possibly owing to heightened sensitivity to b-agonists caused by previous b-blockade (upregulation). Heightened sensitivity may begin several days after cessation of propranolol therapy and may last 5 or 6 d. Other adverse effects of propranolol include worsening of asthma or chronic obstructive pulmonary disease, inter- mittent claudication, Raynaud’s phenomenon, mental depression, increased risk of hypo- glycemia among insulin-dependent diabetic patients, easy fatigability, disturbingly vivid dreams or insomnia, and impaired sexual function. Most adverse effects are reversible with dose reduction or cessation of treatment. Of the noncardiac adverse reac- tions, pulmonary toxicity is the most serious; in one study it occurred between 6 d and 60 mo of treatment in 33 of 573 patients, with three deaths. The mechanism is unclear but may relate to a hypersensitivity reaction and/or widespread phospholipidosis. Dys- pnea, nonproductive cough, and fever are common symptoms, with rales, hypoxia, a positive gallium scan, reduced diffusion capacity, and radiographic evidence of pul- monary infiltrates noted. Steroids can be tried, but no controlled studies have been done to support their use. A 10% mortality in patients with pulmonary inflammatory changes results, often in patients with unrecognized pulmonary involvement that is allowed to progress. Chest roentgenograms at 3-mo intervals for the first year and then twice a year for several years have been recommended. Although asymptomatic elevations of liver enzymes are found in most patients, the drug is not stopped unless values exceed two or three times normal in a patient with initially abnormal values. Neurological dysfunction, photosensitivity (perhaps minimized by sunscreens), bluish skin discolor- ation, corneal microdeposits (in almost 100% of adults receiving the drug more than 6 mo), gastroenterological disturbances, and hyperthyroidism (1–2%) or hypothyroidism (2–4%) can occur.