Ethical Purchasing And Selling By DCs

Dr Perle's article on ethics in purchasing for chiropractic treatment.http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=5428

Portal vein thrombosis after laparoscopic splenectomy: an ongoing clinical challenge.

ObjectivesPortal vein thrombosis (PVT) following open splenectomy is a potentially lethal complication with an incidence of up to 6%. The objective of this report is to describe our management of a recent laparoscopic case, discuss current therapies, and consider antiplatelet therapy for prophylaxis.MethodsMedical records, laboratory studies, and imaging studies pertaining to a recent case of a laparoscopic splenectomy were examined. Current literature related to this topic was reviewed.ResultsA 16-year-old girl underwent laparoscopic splenectomy for idiopathic thrombocytopenic purpura. Her preoperative platelet count was 96K. She was discharged on postoperative day 1 after an uneventful operation including division of the splenic hilum with an endoscopic linear stapler. On postoperative day 20, she presented with a 5-day history of epigastric pain, nausea, and low-grade fevers without peritoneal signs. Her white blood cell count was 17.3; her platelets were 476K. Computed tomography demonstrated thrombosis of the splenic, superior mesenteric, and portal veins propagating into the liver. Heparinization was begun followed by an unsuccessful attempt at pharmacologic and mechanical thrombolysis by interventional radiology. Over the next 5 days, her pain resolved, she tolerated a full diet, was converted to oral anticoagulation and sent home. Follow-up radiographic studies demonstrated the development of venous collaterals and cavernous transformation of the portal vein.DiscussionNo standard therapy for PVT exists; several approaches have been described. These include systemic anticoagulation, systemic or regional medical thrombolysis, mechanical thrombolysis, and surgical thrombectomy. Unanswered questions exist about the most effective acute therapy, duration of anticoagulation, and the potential efficacy of routine prophylaxis with perioperative antiplatelet agents. PVT following splenectomy occurs with both the open and laparoscopic approach

ZNF804A genotype modulates neural activity during working memory for faces

Copyright © 2013 S. Karger AG, Basel.Peer reviewedPublisher PD

Representations of the Canonical group, (the semi-direct product of the Unitary and Weyl-Heisenberg groups), acting as a dynamical group on noncommuting extended phase space

The unitary irreducible representations of the covering group of the Poincare group P define the framework for much of particle physics on the physical Minkowski space P/L, where L is the Lorentz group. While extraordinarily successful, it does not provide a large enough group of symmetries to encompass observed particles with a SU(3) classification. Born proposed the reciprocity principle that states physics must be invariant under the reciprocity transform that is heuristically {t,e,q,p}->{t,e,p,-q} where {t,e,q,p} are the time, energy, position, and momentum degrees of freedom. This implies that there is reciprocally conjugate relativity principle such that the rates of change of momentum must be bounded by b, where b is a universal constant. The appropriate group of dynamical symmetries that embodies this is the Canonical group C(1,3) = U(1,3) *s H(1,3) and in this theory the non-commuting space Q= C(1,3)/ SU(1,3) is the physical quantum space endowed with a metric that is the second Casimir invariant of the Canonical group, T^2 + E^2 - Q^2/c^2-P^2/b^2 +(2h I/bc)(Y/bc -2) where {T,E,Q,P,I,Y} are the generators of the algebra of Os(1,3). The idea is to study the representations of the Canonical dynamical group using Mackey's theory to determine whether the representations can encompass the spectrum of particle states. The unitary irreducible representations of the Canonical group contain a direct product term that is a representation of U(1,3) that Kalman has studied as a dynamical group for hadrons. The U(1,3) representations contain discrete series that may be decomposed into infinite ladders where the rungs are representations of U(3) (finite dimensional) or C(2) (with degenerate U(1)* SU(2) finite dimensional representations) corresponding to the rest or null frames.Comment: 25 pages; V2.3, PDF (Mathematica 4.1 source removed due to technical problems); Submitted to J.Phys.

Neural hyperactivation in carriers of the Alzheimer's risk variant on the clusterin gene

Copyright © 2011 Elsevier B.V. All rights reserved.Peer reviewedPostprin

Effects of hyperlinks on navigation in virtual environments

Hyperlinks introduce discontinuities of movement to 3-D virtual environments (VEs). Nine independent attributes of hyperlinks are defined and their likely effects on navigation in VEs are discussed. Four experiments are described in which participants repeatedly navigated VEs that were either conventional (i.e. obeyed the laws of Euclidean space), or contained hyperlinks. Participants learned spatial knowledge slowly in both types of environment, echoing the findings of previous studies that used conventional VEs. The detrimental effects on participants' spatial knowledge of using hyperlinks for movement were reduced when a time-delay was introduced, but participants still developed less accurate knowledge than they did in the conventional VEs. Visual continuity had a greater influence on participants' rate of learning than continuity of movement, and participants were able to exploit hyperlinks that connected together disparate regions of a VE to reduce travel time