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The effect of chemotherapy on the ovaries may induce a premature menopause and acute menopausal symptoms prostate cancer education cheap rogaine 2 60 ml with amex. There are prostate examination buy rogaine 2 60 ml lowest price, however mens health protein discount rogaine 2 60 ml line, encouraging data showing a significant reduction in the incidence of breast cancer in raloxifene users compared to controls14. Bisphosphonates are another option for the treatment or prevention of osteoporosis (Section 5. Given the availability of these long-term alternatives to estrogen treatment, the management of acute menopausal symptoms, and especially the hot flushes associated with tamoxifen, becomes the main problem. Non-systemic vaginal estrogen preparations can treat urogenital symptoms, and progestogens (norethisterone 5 mg or megestrol acetate 60 mg daily) have been shown to alleviate hot flushes and sweats15, 16. Some women find natural therapies and dietary approaches to be helpful (see Chapter 9). This does not matter and indicates that the endometrium has lost the ability to respond. Logically, if estrogen were to cause an increase in weight, then menopausal women should lose weight as their estrogen levels decline. Women tend both to put on weight and to find it more difficult to lose it, for two reasons. The energy intake recommended for women over 50 is 1900 kcal, compared with 2200 kcal in younger women. If a 50+ woman continues to eat this extra 300 kcal per day, she can put on about 30 lbs in weight in a year! Second, older women are often less active than before, so consuming fewer calories. Fluid retention has been discounted and one theory is that estrogen stimulates the appetite in such women. If some of the clot breaks off, it may travel to the heart and thence to the lung causing a pulmonary embolus, which can be fatal. This translates to an extra two affected women per 10 000 per year, or one per 5000 per year. A non-oral route carries less risk as it bypasses the liver and avoids the negative effects on clotting mechanisms seen with oral treatment (Section 6. These included cardiovascular disease, diabetes, endometriosis, liver diseases and hormone-dependent tumors. No increase in risk of recurrence except possibly for the rare endometrioid ovarian cancer there is no increased risk of cervical cancer, nor is there any evidence that progression from premalignant to malignant disease is hastened. Transdermal administration produces more stable circulating levels and may be less likely to provoke or exacerbate migraine. Patterns of use of hormone replacement therapy in one million women in Britain, 1996­2002. Arch Intern Med 1989;149:2445­8 the Collaborative Group on Hormonal Factors in Breast Cancer. Effects of tibolone and continuous combined hormone replacement therapy on mammographic dsnsity. A randomised double blind cross over trial into the effect of norethisterone on climacteric symptoms and biochemical profiles. The role of megestrol acetate as an alternative to conventional hormone replacement therapy. The endometrial response to long term continuous combined oestrogenprogestogen replacement therapy: a follow-up study. Differential association of oral and transdermal oestrogenreplacement therapy with venous thromboembolism risk. Numerous surveys have shown that, among those who try it, the discontinuation rate is high, varying between 20 and 60%, depending on the country and study. There are several reasons for this ­ they do not feel better, concerns about safety and side-effects, fear of cancer, the feeling that it is not natural, a belief that it will cause weight gain, and the continuation or re-establishment of bleeding. Two examples of media representation are: Banner headlines (such as those in Figure 9. Forced by vigorous protestations from medical experts to take back her statement, she published a retraction in a small corner of an inside page of the newspaper.

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Efficacy and Effectiveness Outcomes Copyright ©2010 American Urological Association Education and Research prostate laser treatment 60 ml rogaine 2 sale, Inc prostate cancer 2016 buy rogaine 2 60 ml on line. The two largest trials of saw palmetto-containing herbal combinations showed significant improvements in the active-treatment arms compared to prostate cancer ketogenic diet generic 60 ml rogaine 2 amex the placebo arms;147, 150 the two smaller trials found no significant differences but may have been hindered by insufficient statistical power149, 151 (the first of these was a mechanistic study and was not intended to be fully powered for symptom outcomes). The same study reported no effect of either the saw palmetto-Urtica blend or the alpha-blocker on indices of sexual or erectile functioning over the course of the trial. Marks et al (2000) reported that participants treated with a saw palmetto blend had a greater reduction in% epithelium and an increase in the percent of atrophic glands in biopsy specimens. Peak urine flow outcomes were not reported for either of the activecomparator trials. Among the four placebo-controlled trials of saw palmetto-containing compounds, three found no significant difference between treatment groups while one reported a small but significant difference between groups. Prostate volume was measured in two placebo-controlled studies of saw palmetto-containing combination products. In both of these trials, there was little change in overall prostate size and no significant differences between groups in observed changes in the prostate volume. The lumen of the prostatic urethra is directly visualized with an endoscope and two needles are inserted from the prostatic lumen laterally into the prostatic adenoma. A double needled is inserted on both the right and left sides (some have likened the appearance to the antennae of a butterfly). Each needle simultaneously emits radiofrequency energy sufficient to heat the prostate to a temperature exceeding that necessary to cause prostatic tissue necrosis in an oval-shaped lesion around the needle tips. Four areas of necrosis result from each round of treatment, which lasts several minutes. Depending on prostatic size and length, multiple dual insertions at different levels along the length of the prostate may be utilized. The concept is to heat the transition zone of the prostate while sparing the urethral mucosa; preserving the mucosa reduce pain and improve patient tolerance. The conclusion now is that the reduction in prostatic volume is less than initially anticipated. Concepts such as prostatic muscle dysfunction, alpha adrenergic nerve dysfunction and other concepts were proposed; however, no clear conclusion has been reached. Short-term complications, including the need for transfusion, are uncommon or nonexistent. These cohort studies are often retrospective and occasionally stated to include consecutive patients. These studies confirm that symptom scores, QoL and Qmax improve in a fashion very similar to that reported in the randomized trials and will not be detailed again here. Likewise these cohorts confirm that retrograde ejaculation is very rare to nonexistent. But these studies, which range in follow-up from two years to as long as 10 years, provide additional information on perioperative bleeding, patient selection, and need for retreatment. Significant procedure-related bleeding, which was not encountered in the randomized trails, did occur in two of 30 patients and required catheter balloon traction to control bleeding. In the cohort studies, rates of urinary retention and the need for catheterization varied greatly but were common. Rosario et al (2007) noted that only one of their first nine patients voided after the procedure so they adopted routine postprocedure catheterization for all patients for seven days. In a group of 41 patients, prostate volume and prostate transition zone volume decreased significantly at three months and the difference was not significant at 12 months; when patients were evaluated for differences in baseline prostate volume and transition zone, no differences were found between responders and those patients who fared less well. They were more likely at baseline to be over the age of 70, have a higher detrusor pressure, a greater residual volume and a worse QoL score. There are only three prospective randomized trials (one trial is reported at two time points) and all reports taken together lack sufficient detail on the comorbidity of subjects. These systems were responsible for the term "hyperthermia" that evolved to describe their mechanism of action. Hyperthermia techniques failed, however, since early devices were unable to generate temperatures sufficient to ablate prostatic tissue and to adequately target the transition zone transrectally.

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Farrar who later becam e a psy chiatrist mens health report discount 60 ml rogaine 2, noted: `Osier was instinctively practising psychotherapy without ever having studied it androgen hormonal acne buy rogaine 2 60 ml line. Such symptoms constituted - and constitute today - a huge am ount of what was seen in primary care: a third or more of all patients mens health yoga get started guide order rogaine 2 60 ml free shipping. As Francis Weld Peabody, the professor of internal m edicine at Harvard University, volunteered in 1927, `The successful diagnosis and treatm ent of these patients. Among other things, `He heard their stories out w ithout interruption, taking notes of all their observations, of all their questions, of all their wishes. Hermann Nothnagel was probably wrong that to be successful in medicine a physician had to be a good person. Dr Black and countless other physicians doubtlessly used the show o f concern as a m arketing tactic in primary care. The rise of specialism at the end of the nineteenth century was in part pushed by public demand, in part pulled by medical supply. To specialists even more than to general practitioners clung the m antle o f science, a powerful attraction for a public with im plicit confidence in the wonders of progress. With the public a physician who can treat the liver is not good for the stom ach, certainly not for the kidneys. The heart has no connexion with the lungs, and all the organs of the body are totally indepen dent of one another. But physicians followed the internal logic o f their own interests to specialism, not ju st the fancy of the public. Subjects such as ophthalm ic surgery did indeed possess demanding cores of knowledge that could not be mastered while staying abreast of the inform ation needed for general practice. Then came inventions that called for specialized knowledge, such as the electrocardiograph. New York City had, for example, a dermatological soci ety, an obstetrical society, and a forensic-m edicine society by the 1870s. London saw in the 1880s the form ation of six specialty societies, including dental surgery, ophthamology, dermatology, gynaecology, neurology, and ear-nose-and-throat surgery. International cooperation was, however, dashed by international rivalries, in medicine as in politics, in the era leading up to the First World War. By 1939 there were some 2, 8 0 0 full-tim e consultants and specialists and 18, 000 general practitioners in Britain. By the mid-1920s perhaps a quarter of the population of the largest cities was receiving its medical care in clinics and outpatient depart ments. Daniel Cathell com m ented in 1924: `Today a specialist wisely located in any large city m ust be but an ordinary man, not to get considerable business. W hile a general practitioner in a large city must be an extraordinary man to get m uch or any good, desirable business at all. By 1989, o f 4 6 9, 0 0 0 physicians in active patient care, only 12 per cent were in general and family practice. In no medical specialty were more than 13 per cent of the patients referred (urology), m eaning that these doctors were giving primary care to m ost of their patients. Bernhard Naunyn recalled from the time of his general practice in the late 1860s in Berlin being hauled from bed in the wee hours three nights in a row. Before the late nineteenth century, however, the impor tance of proper sterilization w as not appreciated, and so instrum ent cases could be ver itable deathtraps, harbouring lethal bacteria. In this adver tisem ent from 1 9 1 3, it is still assumed that the doctor will be going around in a horsedraw n carriage. I thought about the sick child, and soon I did get up, and went over there, and I found the child dead. Then there was the sheer exhaustion of being on the road in a horse and buggy or on horseback, and spending the night on top of tables in the waiting rooms of railway stations. The telephone made it possible for the physician to establish w hether an emergency existed before going out. M otor transport, of course, let the doctor get about more easily on house calls but, more important, it permitted the patient to com e to the doctor, or to the hospital emergency depart ment. The first rudimentary telephone exchange on record, built in 1877, con nected the Capital Avenue Drugstore in Hartford, Connecticut, with twenty-one local doctors. Primary Care 149 House calls in w in the r W illiam Macartney, a general practitioner in Fort Covington, New York in the 1890s and after, remembered what it was like to make house calls in the winter.

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The irony of post-m odern m edicine is that prostate-7 confidence inc rogaine 2 60 ml line, although doctors have becom e therapeutically far more awesome than ever before prostate lymph nodes buy rogaine 2 60 ml free shipping, they have ceased giving the patients what they want androgen hormone uterine discount 60 ml rogaine 2 with amex. Effective against disease at an organic level, doctors have often found it no longer necessary to enlist the psy chological benefits o f the doctor-patient relationship in bolstering the patient through an illness. The whole patient-as-a-person m ovem ent fell into desuetude after 1950, replaced by a new generation of physicians filled with an overweening therapeutic self-confidence. It was not that physicians became somehow more inhumane, merely that the previous display of apparent hum anity had now becom e therapeutically unnecessary. Thus post-modern medicine has becom e haunted by a growing dissatisfaction among patients with primary care. The sympathetic old doc, always willing to turn an apparently attentive ear, has becom e a totem ic figure in tirades against the impersonality of the health-care system. Grateful as patients have been for the new drugs, they have becom e increasingly resentful of those who prescribe them, hurling showers o f m alpractice suits against physicians perceived as remote and arrogant. Alternative m edicine, with its confidence in the therapeutic benefits of stroking the soles of the feet or getting those poisons out of there with colonic irri gation, has undergone a rebirth. This failure to supply what is psychologically required to gratify the patient has thus produced a supreme irony. An adversarial note has entered the doctor-patient relationship, and it has becom e, rightly or wrongly, increasingly anachronistic to claim of a post-m odern doctor what the patients of an old family doctor in Chicago once said to him, with a hug about the neck: `Oh, you dear, good man, how we all love you! By the late Middle Ages, however, there was growing dissatisfaction with certain deeply entrenched doctrines, and the new intellectual ferment we call the Renais sance - the quest to purify old doctrines and discover new truths - encouraged fresh biom edical inquiry. During the Renaissance, m edicine was put on a surer footing, particularly once the Scientific Revolution brought glowing success to the m echanical sciences, physics, and chemistry. Doctors in ancient Athens had treated the hum an body as sacred, and honoured it by refraining from cutting up dead bod ies. In spite of their many contributions, therefore, Hippocratic and the later G alenic medicine were anatom ically weak. Analogous views about the sanctity of the body (the belief that it belonged to God n ot m an) later led the Rom an Catholic Church to voice some opposition to dissecting the dead. Grass-roots hostility to dissection made itself felt in Britain even as late as the passing of the Anatomy Act in 1832. In Edinburgh, Burke and Hare murdered the subjects they then sold for research to the medical school. A sound anatomical and physiological basis is to us essential to scientific med icine, but it could develop only out o f systematic dissection. From the fourteenth century, however, dissections grew more com m on, especially in Italy, w hich was then the centre of scientific inquiry (see page 7 5). Early anatomical demonstrations were public occasions, alm ost spectacles, for the purpose not of research but instruc tion - they allowed the professor to parade his proficiency. Dressed in long robes he would sit in a high chair reading out relevant passages from the works of Galen, while his assistant pointed to the organs alluded to and a dissector did the knifework. Early in the sixteenth century Leonardo da Vinci produced some 750 anatom ical drawings. These were done in a purely private capacity, perhaps in secret, and made no im pact at all on medical progress. The apparent visual crudity of this and similar late-medieval anatomical images is not due to the absence of artists skilled in representing reality. Squatting figures, depicted frontally and with legs astride, were used to show disease, wounds, and the influence of the zodiac on parts of the body. Realism was irrelevant: the aim w as to reinforce the verbal message, to indicate the standard con clusions of learned physic. These images were evidently successful for they survived into the age of print, woundm en in particular being used in books of sixteenth-century surgery. They presented the body as a teaching-aid, neatly labelled and connected to the macrocosm. In 1543, he published his masterw ork, De Humani C orporis F abrica (O n the Structure of the Human Body).

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Four themes demonstrate how media reflect and promote traditional arrangements between the sexes mens health 012014 rogaine 2 60 ml otc. I gives up her identity as a mermaid in order to androgen hormone zanane rogaine 2 60 ml overnight delivery become acceptable to mens health 8 pack rogaine 2 60 ml lowest price her human lover. Even the Smurfs, formless little beings who have no obvious sex, reflect the male-female, dominant-submissive roles. The female smurf, unlike her male companions who have names, is called only Smurfette, making her sole identity a diminutive relation to male smurfs. The male dominance/female subservience pattern that permeates mediated representations of relationships is no accident. In rap music videos, where African-American men and women star men dominate women, whose primary role is as objects of male desires (Pareles, 1990; Texier, 1990). News programs that have male and female hosts routinely cast the female as deferential to her male colleague (Craft, 1988; Sanders & Rock, 1988). Commercials, too, manifest power cues that echo the male dominance/female subservience pattern. For instance, men are usually shown positioned above women, and women are more frequently pictured in varying degrees of undress (Masse & Rosenblum 1988; N&o, Hill, Gelbein, & Clark, 1988). Such nonverl bal cues represent women as vulnerable and more submissive while men stay in control. In a brief departure from this pattern, films and television beginning in the 1970s responded to the second wave of feminism by showing women who were independent without being hard, embittered, or without close relationships. During this period, television followed suit, offering viewers prime-time fare such as "Maude" and "The Mary Tyler Moore Show, " which starred women who were able and achieving in their own rights. By the 198Os, however, traditionally gendered arrangements resurged as the backlash movement against feminism was embraced by media (Haskell, 1988; Maslin 1990). Crossing Delancey showed successful careerist Amy Irving talked into believing she needs a man to be complete, a theme reprised by Cher in Moonstruck. When I get on his case, he reminds me of what happened when the father on some show had to take over housework and practically demolished the kitchen. Gendered Medi wrong; rather, it is that media virtually require this of women in order to present them positively Media define a very narrow range for womanhood. Her mission: create a more meaningful life for herself and her family She is the New Traditionalist-a contemporary woman who finds her fulfillment in traditional values. With only rare exceptions, women are still portrayed as dependent on men and subservient to them. A second recurrent theme in media representations of relationships is that men are the competent authorities who save women from their incompetence. One of the most pervasive ways in which media define males as authorities is in commercials. Women are routinely shown anguishing over dirty floors and bathroom fixtures only to be relieved of their distress when Mr. Television further communicates the message that men are authorities and women are not. In addition, the dominance of men as news anchors who inform us of happenings in the world underlines their authority ("Study Reports Sex Bias, " 1989). Prime-time television contributes to this image by showing women who need to be rescued by men and by presenting women as incompetent more than twice as often as men (Bayer, 1986; Lichter et al. Consider the characters in "The Jetsons, " an animate, television series set in the future. The Rescuers, a popular animated video of the 199Os, features Miss Bianca (whose voice is that of Zs: Zsa Gabon fittingly enough), who splits her time evenl) between being in trouble and being grateful to mah characters for rescuing her. These stereotypical repre sentations of males and females reinforce a number o; harmful beliefs. Third, these stereotypes underline the requiremen; that men must perform, succeed, and conquer in order to be worthy Women as primary caregiverslmen as breadwinners. A third perennial theme in media is that women are caregivers and men are providers. Since the backlash of the 198Os, in fact, this gendered arrangement has been promulgated with renewed vigor. Once again, as in the 195Os, we see women devoting themselves to getting rings off of collars, gray out of their hair, and meats on the table. Horovitz (1989), for instance, reports that in commercials men are regularly the butt of jokes for their ignorance about nutrition, child care, and housework When media portray women who work outside of the home, their career lives typicallyFreceive little or no attention.

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Beneficial effects of extendedrelease doxazosin and doxazosin standard on sexual health androgen hormones in females generic 60 ml rogaine 2. Combination of alfuzosin and sildenafil is superior to mens health 7 day workout plan buy discount rogaine 2 60 ml on line monotherapy in treating lower urinary tract symptoms and erectile dysfunction prostate cancer hormone therapy buy 60 ml rogaine 2 overnight delivery. Comparison of the efficacy and safety of finasteride in older versus younger men with benign prostatic hyperplasia. Combination therapy with doxazosin and finasteride for benign prostatic hyperplasia in patients with lower urinary tract symptoms and a baseline total prostate volume of 25 ml or greater. Vasodilatory factors in treatment of older men with symptomatic benign prostatic hyperplasia. Tolterodine and tamsulosin for treatment of men with lower urinary tract symptoms and overactive bladder: a randomized controlled trial. Detrusor contraction duration may predict response to alpha-blocker therapy for lower urinary tract symptoms. Tolterodine extended release attenuates lower urinary tract symptoms in men with benign prostatic hyperplasia. Impact of baseline symptom severity on future risk of benign prostatic hyperplasia-related outcomes and long-term response to finasteride. Modified bulbar urethral sling procedure for the treatment of male sphincteric incontinence. Do prostatic stents solve the problem of retention after transurethral microwave thermotherapy. Diuretic renogram clearance half-times in the diagnosis of obstructive uropathy: effect of age and previous surgery. Comparison of transurethral vaporization using PlasmaKinetic energy and transurethral resection of prostate: 1-year follow-up. Outcome of kidney transplantation from high-risk donors is determined by both structure and function. Effect of beta-sitosterol on transforming growth factor-beta-1 expression and translocation protein kinase C alpha in human prostate stromal cells in vitro. Cooled transurethral microwave thermotherapy for intractable chronic prostatitis-results of a pilot study after 1 year. Metabolic syndrome and lower urinary tract symptoms secondary to benign prostatic hyperplasia. Page 114 100280 117490 120110 122680 120600 160790 133680 128400 102000 109760 103720 130830 165390 112630 121740 104890 123290 September 2010 Appendix 3: Master Bibliography American Urological Association, Inc. A randomized controlled trial of hydrocortisone against hyponatremia in patients with aneurysmal subarachnoid hemorrhage. Expression of tissue factor in prostate cancer correlates with malignant phenotype. The effect of sodium nitroprusside infusion on renal function during reperfusion period in patients undergoing coronary artery bypass grafting: a prospective randomized clinical trial. Clinical predictors in the use of finasteride for control of gross hematuria due to benign prostatic hyperplasia. Sensitivity and specificity of antiproliferative factor, heparin-binding epidermal growth factor-like growth factor, and epidermal growth factor as urine markers for interstitial cystitis. Bladder epithelial cells from patients with interstitial cystitis produce an inhibitor of heparin-binding epidermal growth factor-like growth factor production. In vitro functional responses of isolated normal human prostatic tissue to compounds interacting with the cyclic guanosine monophosphate pathway. Clearance of lower-pole stones following shock wave lithotripsy: effect of the infundibulopelvic angle. Transurethral microwave thermotherapy for treatment of benign prostatic hyperplasia: a preliminary assessment of the Prostalund feedback treatment machine. Renal function and size at young adult age after intrauterine growth restriction and very premature birth. Reduction of human prostate tumor vascularity by the alpha1-adrenoceptor antagonist terazosin. Efficacy of high-energy transurethral microwave thermotherapy in alleviating medically refractory urinary retention due to benign prostatic hyperplasia. Glomerular filtration rate estimation from plasma creatinine after inhibition of tubular secretion: relevance of the creatinine assay.


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He Medical Science 161 made remarkable observations on birds in flight prostate cancer recurrence purchase rogaine 2 60 ml, fish swimming man health food purchase 60 ml rogaine 2 amex, m uscular contraction mens health 20 minute workout generic rogaine 2 60 ml on line, the m echanics o f breath ing, and a host of similar subjects, and attempted, more boldly than any before him, to com prehend body functions primarily in terms of the laws of physics. He viewed respiration as a purely m echanical process that drove air through the lungs into the bloodstream. Another innovative attempt to analyse the body in sci entific terms lay in iatrochemistry. W hereas iatrophysics read the hum an frame through the laws of physics, iatrochem ists applied chem ical analysis. Repudiating the hum ours as archaic and fanciful, certain investigators looked back to the chem ical theories of the sixteenth-century Swiss iconoclast, Paracelsus dismissed by some as a quack but respected by many as a m ajor medical reformer. Paracel sus harked back to the sim plicity of Hippocrates, learned from folk m edicine, and believed in the power o f nature to cure the body and heal the mind (see page 2 4 8). Devotees of Paracelsus also drew on the opinions of his Netherlandish fol lower, Johannes (Jean) Baptiste van Helmont. He held all vital processes to be chem ical, each being due to the action of a particular ferm ent or gas. These ferm ents were imperceptible spirits capable o f converting food into living flesh. Transformative processes occurred throughout the body, bu t particularly in the stom ach, liver, and heart. Van Helm ont deemed body heat a by-product of chem ical ferm enta tions, arguing that the whole system was governed by a soul situated in the pit of the stomach. A supporter of W illiam Harvey who taught at Leiden, Sylvius emphasized the salience of blood Seventeenth-century anatom ists treated the body as a m achine, activated by devices such as pulleys and levers, and understandable in term s of geometry, statics, and dynamics. Perhaps the fullest attem pt to give a quan titive description of the body w as made by a disciple of Galileo, Giovanni Alfonso Borelli, who was also an astronom er and m athemati cian. In his De Motu Animalium of 1 6 8 0 - 1, from w hich this dem onstration of the leg joints is taken, he cal culated the force exerted by the pull of different m uscles, and analysed in geometrical term s how human muscles act w hen used in walking and running. Scientific m edicine during the following century fulfilled certain of these goals, but also saw them frustrated. Demonstrating supreme artistic skill and capitalizing on improvements in printing, many splendid anatom ical atlases were published, including folios such as the O steographia (1 7 3 3) of the London surgeon-anatom ist W illiam Cheselden. Anatomists struggled to lay bare the form/function relationship of m inute (som etim es microscopical) structures, in the light o f images of the organism as a system of vessels, tubes, and fluids. The Dutch anatom ist Herman Boerhaave, the greatest medical teacher of his times (see page 12 4), proposed that physical systems operating throughout the body comprised an integrated, balanced whole in w hich pressures and liquid flows were equalized and everything found its own level. Health was explained by the m ovement of fluids in the vascular sys tem; sickness was largely explained in terms o f its obstruction or stagnation. The old hum oral emphasis on balance had thus been preserved but translated into m echanical and hydrostatic terms. Yet the fascination felt by Boerhaave and others in the m echanics of the body does not mean that m edicine had becom e dogmatically reductionist or material ist. The presence of a soul in hum an beings could be taken for granted, but (Boer haave judiciously m aintained) inquiry into the essence o f life or the immaterial soul was irrelevant to the nitty-gritty o f m edicine, whose business lay in the inves tigation of tangible physiological and pathological structures and processes. That meant reopening old debates over historic subjects, such as the doctrine o f the soul. Highly significant was the work of the German chem ist and physician Georg Ernst Stahl. The founder of the distinguished Prussian medical school at the University of Halle in 1693, Stahl advanced classic anti-m ech anistic arguments. Purposive hum an actions could not, he m ain tained, be wholly explained in terms of m echanical chainreactions - like a stack of dominoes toppling over or balls cannoning round a billiard table. Purposive hum an activity presupposed the presence of a soul, understood as a constantly intervening, presiding power, the very quintessence of the organism. For disease, in his view, was a disturbance of vital functions provoked by maladies o f the soul.

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Data include only new district court commitments in the Federal Bureau of Prisons whose sentencing year was 1994 or later prostate cancer meaning generic rogaine 2 60 ml with mastercard. This information includes whether the offender has been previously sentenced to mens health lunch box cheap 60 ml rogaine 2 mastercard a term of imprisonment mens health face care order rogaine 2 60 ml visa, the length of each previous sentence imposed, whether the most recent offense was committed soon after a release from incarceration, whether the most recent offense was committed while under criminal justice supervision. Criminal history points are assigned in differing levels for each of these categories, and the points are collapsed into six levels of criminal history-zero points indicates that there is no history in any of the above domains, and higher point totals reflect more extensive criminal histories. Criminal history category may also be adjusted based on other aggravating circumstances, such as being a career offender or a repeat and dangerous sex offender against minors. The proportion of offenders in Category I ranged from 39% for heroin offenders to 49% for powder cocaine offenders. Within each drug type, the majority of offenders in Category I had no criminal history points at the time of sentencing. Across all drug offenders, powder cocaine (41%) and marijuana (36%) offenders were the most likely to have no criminal history points applied at sentencing and be in Category I. About a quarter of federal drug offenders were sentenced for weapons involvement Nearly 1 in 4 (24%) federal drug offenders in prison at yearend 2012 who were sentenced since 1998 were sentenced for having a weapon involved in the instant offense (table 5). To ensure continuity within comparisons of weapons, offenders sentenced prior to 1998 were excluded. A majority of the weaponinvolved offenders received a sentence enhancement, accounting for 18% of the total drug offender population. Another 6% of the drug offender population were convicted of a 924(c) weapon offense. Methamphetamine offenders were the next most likely to have weapon enhancements-more than 25% had some kind of sentencing related to weapons. In comparison, marijuana offenders were the least likely to have these weapon enhancements-3% had a mandatory minimum sentence under 924(c) for gun involvement and 12% had a specific offense characteristic. Table 5 Gun involvement in the instant offense for federally sentenced drug offenders in the Federal Bureau of Prisons at fiscal yearend 2012, by drug type Gun involvement in offense Total No Yes 924(c)d Weapon-specific offense characteristic Both Numbere All drug types 100% 75. To make the percentages consistent, only cases after 1998 are considered in this table. Almost two-thirds (65%) of offenders were sentenced to a term of imprisonment of more than 5 years up to and including 20 years. Thirteen percent of federal drug offenders were sentenced to a term of imprisonment greater than 20 years, while less than 1% were sentenced to a term of 1 year or less (table 6). Marijuana offenders had the shortest prison terms Marijuana offenders had the shortest average term of imprisonment of all drug types. The average sentence was more than 7 years (88 months) and the median was 5 years (60 months). A majority of marijuana offenders received a sentence of more than 1 year up to and including 5 years in prison. In comparison, crack cocaine offenders had the longest average and median prison terms. On average, these offenders were sentenced to more than 14 years (170 months), while the median sentence was more than 12. A majority (62%) of crack cocaine offenders were sentenced to more than 10 years in prison. Table 6 Sentences imposed for federally sentenced drug offenders in the Federal Bureau of Prisons at fiscal yearend 2012, by drug type Sentence length Total 1 year or less 1­5 5­10 10­20 20 or mored Meane Mediane Numberf All drug types 100% 0. Pre-sentencing admissions, offenders sentenced prior to the Sentencing Reform Act of 1984, and others who were not new U. For more information about offenders who were included or excluded for the purposes of linking, see Dataset composition and definition of drug offender below. Probabilistic matching techniques were applied across personally identifiable information such as name, date of birth, and sentencing year to link records between the two different data sources. The two primary technical reasons are (1) a person is in prison for Class B or C misdemeanors not covered by the U. A comparison of linked and unlinked records by primary offense category shows 6For more detailed information about the linking methodology employed, see Kelly, J.


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