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In some cases clarinex 5 mg lowest price, how- ever, pressure from pus or exudate in the middle ear can be relieved only by cutting the tympanic membrane, a pro- cedure called a myringotomy (mir-in- GOT-o-me). Surgical removal of the Infection and inflammation of the middle ear cavity, otitis diseased stapes and its replacement with an artificial de- media (o-TI-tis ME-de-ah), is relatively common. Box 11-2 • Health Professions AudiologistsAudiologists udiologists specialize in preventing, diagnosing, and treat- levels and teach the public how to prevent hearing loss. Sense of Taste The sense of taste, or gustation (gus- TA-shun), involves receptors in the tongue and two different nerves that carry taste impulses to the brain (Fig. It may result from prolonged exposure to recently, researchers have identified some other tastes be- loud noises, from the use of certain drugs for long peri- sides these basic four: water, alkaline (basic), and metal- ods, or from exposure to various infections and toxins. The affected person may experience lower frontal cortex of the brain, although there may be a sense of isolation and depression, and psychological no sharply separate gustatory center. Papillae Tongue with A taste receptors The General Senses Unlike the special sensory receptors, which are localized within specific TASTE ZONES: sense organs, limited to a relatively small area, the general sensory recep- Sweet Salty Sour Bitter tors are scattered throughout the body. The lips and the tip of the tongue also contain detect gases and other harmful substances in the environ- many of these receptors and are very sensitive to touch. Because these receptors are high Even when the skin is anesthetized, it can still respond to in the nasal cavity, one must “sniff” to bring odors up- pressure stimuli. Thus, a single strong stimulus produces the immediate sharp pain, followed in a The temperature receptors are free nerve endings, receptors second or so by the slow, diffuse, burning pain that in- that are not enclosed in capsules, but are merely branchings creases in severity with the passage of time. Some pain relief methods that have been found which help to adjust body temperature according to the tem- to be effective include: perature of the circulating blood. Exam- as proprioceptors (pro-pre-o-SEP-tors), are aided in this ples are ibuprofen (i-bu-PRO-fen) and naproxen (na- function by the equilibrium receptors of the internal ear. Information received by these receptors is needed for Narcotics act on the CNS to alter the perception and the coordination of muscles and is important in such ac- response to pain. Effective for severe pain, narcotics 240 CHAPTER ELEVEN Box 11-3 Clinical Perspectives Referred Pain: More Than Skin DeepReferred Pain: More Than Skin Deep eferred pain is pain that is felt in an outer part of the twofold duty of conducting impulses from visceral pain re- Rbody, particularly the skin, but actually originates in an ceptors in the chest and abdomen and from somatic pain re- internal organ located nearby. The brain cannot differentiate between these two possi- Spasm of the coronary arteries that supply the heart may ble sources, but because most pain sensations originate in the cause pain in the left shoulder and arm. Infection of the ap- skin, the brain automatically assigns the pain to this more pendix is felt as pain of the skin covering the lower right ab- likely place of origin.

Stallings brought urine clarinex 5 mg mastercard, causing a severe metabolic disorder that may lead her son, Ryan, to the emergency room in St. Treatment consists chiefly of diet modification because he was very ill, and Ryan was noted to have high and the administration of several medications that may levels of acid in his bloodstream. Stallings Description was sentenced to life in prison in January 1991, for the Proteins are important building blocks of the body, crime of murder by poisoning. They provide the struc- the woman gave birth to a second son, who was diag- ture of muscles, tissues, and organs, and regulate many nosed with the condition, methylmalonicacidemia. Stallings were be broken down into its individual amino acid compo- dropped, and she was released from prison in September nents. This is a dramatic illustration of the critical impor- cose or directly enter metabolic pathways that supply the tance of proper diagnosis of complicated and rare body with energy. Each of the approximately 20 amino acids that are used to make human proteins are metabolized by specific biochemical reactions. Several of these amino acids Genetic profile (isoleucine, valine, threonine, methionine), as well as MCM deficiency is a genetic condition and can be cholesterol and some fatty acids, share a common bio- inherited or passed on in a family. The genetic defect for chemical reaction in the pathway to conversion to usable the disorder is inherited as an autosomal recessive trait, energy. Each of these substances is converted to methyl- meaning that two abnormal genes are needed to display malonic acid (also known as methylmalonic CoA), an the disease. A person who carries one abnormal gene intermediate product on the pathway leading to the pro- does not display the disease and is called a carrier. In order for MCM to function properly, At least two forms of MCM deficiency have been it also requires a vitamin B12-derivative called adenosyl- identified. The disease genes are called, mut0, in which cobalamin (when an enzyme requires another substance there is no detectable enzyme activity, and mut-, in which in order to perform its job, the helping substance is there is some, but greatly reduced, enzyme activity pres- known as a coenzyme or cofactor). The gene for MCM is located on chromosome 6 When there is a defect or deficiency of MCM, (locus 6p21), and about 30 different mutations in the methylmalonic acid cannot be converted into succinic gene have been reported.

GALE ENCYCLOPEDIA OF GENETIC DISORDERS 47 Description of alcohol abuse and dependence among children under 12 years of age generic clarinex 5 mg without prescription. It often involves the criminal justice system as well as medicine and other helping professions. It has been known since the 1960s that alco- Moreover, persons diagnosed with alcoholism may holism has a genetic component. A family history of demonstrate considerable variety in their drinking pat- alcoholism is presently considered the strongest risk fac- terns, age at onset of the disorder, and the speed of its tor for developing alcoholism. Some psychiatrists the sons and 5% of the daughters of alcoholic parents differentiate between so-called primary alcoholism, in develop the disorder, compared to 5% of men and 1% of which the patient has no other major psychiatric diagno- women in the general North American population. The Collaborative Study on the Genetics of depression, schizophrenia, post-traumatic stress disor- Alcoholism (COGA) has pinpointed several areas in the der, or one of the dissociative disorders. Begun in branches of medicine tend to emphasize patterns of and 1989, COGA has compiled a database from over 300 attitudes toward drinking in order to distinguish between alcoholic families at six research sites (SUNY- nonproblematic use of alcohol and alcohol abuse or Downstate, University of Connecticut, Indiana Univer- dependence. Classification is typically based on the fol- sity, Washington University, University of Iowa, and lowing five categories: University of California at San Diego). Individuals who use alcohol in minimal mapping of the human genome is also expected to help to moderate amounts to enhance meals or other social researchers identify the specific genes that affect an indi- activities. These people rarely or never drink Recent COGA findings suggest that a gene or genes except during periods of stress. They are far more likely on human chromosome 1 may influence vulnerability to to drink alone than social drinkers. These individuals drink heavily, even diagnosed with depression as well as alcoholism had a when they are not under overwhelming stress. Their higher prevalence of both disorders than relatives of sub- drinking causes some problems in their lives (e. This type of drinker uses alcohol in an MULTIGENERATIONAL STUDIES The first studies of out-of-control fashion at regular intervals.