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Unfortunately purchase 200 mg prometrium free shipping, currently generic 100 mg prometrium visa, clinically useful predictive drug sensitivity assays against tumours do • Drugs are used in combination to increase efficacy, to inhibit not exist. Chemotherapeutic drugs vary in adverse effects and there is • Treatment may be prolonged (for six months or longer) considerable inter-patient variation in susceptibility. The most and subsequent cycles of consolidation or for relapsed frequent adverse effects of cytotoxic chemotherapy are sum- disease may be needed. The • Cancer chemotherapy slows progression through the mechanisms of chemotherapy-induced vomiting include cell cycle. Reduced intracellular drug Doxorubicin Lomustine, carmustine Bleomycin concentration Cyclophosphamide Mitomycin C Cytarabine (i) increased drug efflux Anthracyclines (e. Increased detoxification 6-Mercaptopurine, alkylating lored to the emetogenic potential of the chemotherapy to be administered. It may also be necessary to give the patient a of drug agents supply of as-needed medication for the days after chemother- 4. No prophylactic anti-emetic treatment is 100% effective, target enzyme especially for cisplatin-induced vomiting. Decreased number of Hormones, lar catheters for intravenous cytotoxic drug administration is receptors for drug glucocorticosteroids mandatory. Agent-specific organ toxicity products (red cells and platelet concentrates) and early antibi- 3. The peripheral neuropathy with availability and use of recombinant haematopoietic growth vinca alkaloids, taxanes) factors (erythropoietin (Epo), granulocyte colony-stimulating 4. Infertility/teratogenicity caused by various chemotherapeutic regimens is a clear-cut 6. Second malignancy advance in supportive care for patients undergoing cancer chemotherapy. It is often enhance the ability to minimize cytotoxic induced bone mar- routine to use two- or three-drug combinations as prophyl- row suppression. However, many resume normal menstru- ation when treatment is stopped and pregnancy is then pos- 1000 sible, especially in younger women who are treated with lower 500 Secondary fall total doses of cytotoxic drugs. Sperm storage before chemotherapy can be considered for 100 03 9 15 21 03 9 15 21 27 33 39 45 51 57 males who wish to have children in the future. Reproductively active men and women must be advised to use appropriate Therapy Therapy contraceptive measures during chemotherapy, as a reduction in Figure 48. This malignancy is also approxi- Infection is a common and life-threatening complication of mately 20 times more likely to develop in patients with chemotherapy. It is often acquired from the patient’s own gas- ovarian carcinoma treated with alkylating agents with or tro-intestinal tract flora. This delayed treatment complication is pose-built laminar-airflow units, but this does not solve the likely to increase in prevalence as the number of patients who problem of the patient’s own bacterial flora. Broad-spectrum antibiotic treatment must be started empirically in febrile neutropenic patients before the Adverse effects of cytotoxic chemotherapy results of blood and other cultures are available. Combination • Immediate effects: therapy with an aminoglycoside active against Pseudomonas – nausea and vomiting (e. Therapeutic decisions need to be guided by knowledge of – drug-specific organ toxicities (e. Pneumocystis carinii) can occur; • Late effects: details of the treatment for such infections are to be found in – gonadal failure/dysfunction; Chapters 43, 45 and 46. This may be ameliorated in the case of doxorubicin by cooling the scalp with, for example, ice-cooled 1. It is an inactive prodrug given Alkylating agents are particularly effective when cells are orally or intravenously. If a tumour is sensitive to one alkylating agent, it is usually sensitive to another, but cross-resistance does not necessarily occur. For example, although most alkylating agents diffuse passively T A A T into cells, mustine is actively transported by some cells. Alopecia (10–20%) Chemical cystitis (reduced by mesna) Mucosal ulceration Impaired water excretion Interstitial pulmonary fibrosis Ifosfamide i. These include the following: Cyclophosphamide is highly effective in treating various lymphomas, leukaemias and myeloma, but also has some use • dose-related haematopoietic suppression, leukopenia and in other solid tumours. It is an effective immunosuppressant thrombocytopenia at 10–14 days after treatment; (Chapter 50). It is converted to active metabolites in Pharmacokinetics the liver (see above); these are excreted by the kidneys. Absorption son see disulfiram, Chapter 53) and consequently causes from the gastro-intestinal tract is excellent (essentially 100% flushing and tachycardia if ethanol is taken concomitantly. Cyclophosphamide and its metabolites are is also a weak monoamine oxidase inhibitor and may precipi- excreted in the urine.

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Samuel buy 100 mg prometrium fast delivery, The Golden U Vilayat Khan prometrium 200mg otc, Pir 67 Seven Plus One 77 ulcers, Chinese herbs for 27 vine 17 The West Point Candidate Book ultrasound, hyperthermia with Viniyoga 171 (Smallwood) xix 61, 62 violet wheat grass 50 Upanishads 165 Fringed 12 White, Ganga 171 Upledger, John E. See World Health 234–235 visualization Organization usnea 7 in guided imagery 50 Wholeness and the Implicate Order Usui, Mikao 137, 159 in Imaginal Therapy 67 (Bohm) 21 vital force 157 Why People Don’t Heal and How vitalism 157 They Can (Myss) 87 vitamin(s) 157–158 Wilde, Stuart, Affirmations 5 V vitamin A 157 wild oat 17 Vacaspati Mishra 164 vitamin B 158 wild rose 17 vaccines vitamin B1 157 willow 17, 148 as homeopathy 56 vitamin C 119, 158 wintergreen oil 118 Law of Similars in 75 vitamin D 158 Wittlinger, H. Donald 168 on homeopathy 57 276 The Encyclopedia of Complementary and Alternative Medicine Worrall, Olga 126 yarrow oil 118 yogi 164 wraps yeast infections 157 yogurt 47 herbal 8, 55, 61 yellow bile 58 You Don’t Have to Die (Hoxsey) in hydrotherapy 60–61 yellow fever 57 58 Wright, Carol 130 yin 163 Wright, Donald F. See also specific Zak, Victor 23–24 X types zanfu zhi qi 173 xenobiotics 161 branches of 168–172 zang 163 xian 161 definition of 164 zang fu 173 xin 161 history of 164–165 zanthoxylum oil 118 X rays, chiropractic 161 important figures in zero balancing 173 xu 161 164–168 zheng qi 133, 173 writings on 164–165 Zikr 173 YogaDance 171–172 zone therapy 173. See also Yoga Makarandam reflexology Y (Krishnamacharya) 167 zong qi 133, 173 Yajur-Veda 165 Yogananda, Paramhansa 167, Zukav, Gary 173 yama 164, 165 168, 169 Zulu culture 141 Yamamoto, Shizuko 79 Yoga-Sutra 164, 165, 166 yang 163 Yoga Zone Studios 169 . No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission of the copyright holder. The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. The right of Steven B Kayne to be identified as the author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act, 1988. Contents Preface vii About the editor ix Contributors x 1 Introduction to traditional medicine 1 Steven Kayne 2 Traditional European folk medicine 25 Owen Davies 3 Aboriginal/traditional medicine in North America: a practical approach for practitioners 44 John K Crellin 4 Traditional medicine used by ethnic groups in the Colombian Amazon tropical forest, South America 65 Blanca Margarita Vargas de Corredor and Ann Mitchell (Simpson) 5 Traditional medical practice in Africa 82 Gillian Scott 6 Traditional Chinese medicine 119 Steven Kayne and Tony Booker 7 Indian ayurvedic medicine 195 Steven Kayne 8 Japanese kampo medicine 225 Haruki Yamada vi | Contents 9 Korean medicine 257 Seon Ho Kim, Bong-Hyun Kim and Il-Moo Chang 10 Traditional medicines in the Pacific 270 Rosemary Beresford 11 Traditional Jewish medicine 293 Kenneth Collins Index 317 Preface My good friend, Dr Gill Scott, and I were sitting in the gardens of the Mount Nelson Hotel (affectionately known as ‘The Nellie’) in Cape Town discussing Traditional African Medicine. We both thought that it would be good to bring descriptions of a representative number of traditional medical systems together in one text, aimed at academics, students and interested members of the public. Over one-third of the population in developing countries lack access to essential medicines. Countries in Africa, Asia and Latin America use tradi- tional medicine to help meet some of their primary health care needs. In Africa, up to 80% of the population uses traditional medicine for primary health care. The provision of safe and effective Traditional Medicine Therapies could become a critical tool to increase access to health care. Migration, both within countries and across continents, means that host communities, in particular health care providers working in multicultural environments, may well come into contact with unfamiliar practices. A compact yet wide ranging source of knowledge such as that provided in this book will help them understand the basics of medical systems that are being used by patients, often concurrently with western medicine. However, health care providers need more than just knowledge, for it is necessary to understand and effectively interact with people across cultures. With this in mind a method by which orthodox health care providers can approach patients using their traditional practices in a sympathetic manner is introduced in Chapter 3. Although it specifically refers to North American aboriginal medicine it can be adapted to other health care environments. This book covers medical systems practised on five continents, chosen to offer readers an awareness of different approaches to health care around the world. For example, Traditional Chinese Medicine and Ayurvedic medicine, two complete health systems that form the basis of almost all Asian medi- cine, are covered in detail, using material derived from both observation and published literature. Medicine from the Amazonian region of Colombia is presented through a series of fascinating interviews with local healers that viii | Preface emphasises the importance of ritualistic practice. Chapters on Japanese, Korean and Traditional Medicine in the Pacific provide an insight into the way other cultures have contributed to the development of their health care practices. Two chapters on folk medicine are also included: one covers the history and practice of secular and ecclesiastical practices with their origins across the continent of Europe, while the other seeks to demonstrate the wide ranging influence that a global religion can have on the health care of its believers. As well as authoring, editing and contributing chapters to many books, Dr Kayne has written numerous papers and journal articles on a variety of topics associated with health care and has presented at conferences as an invited speaker on four continents. Associate Dean of Graduate Studies in Health Sciences, and finally Associate Dean of phar- macy admissions and undergraduate programmes before retiring in 2008. Dr Beresford’s many academic and other contributions to the pharmacy profession in New Zealand were recognised by her appointment as an honorary member of the Pharmaceutical Society of New Zealand in 2004 and acceptance into the International Academy of History of Pharmacy in 2005. She was created an Officer of the New Zealand Order of Merit ‘for services to medicine’, in 2007. Dr Beresford currently holds honorary appointments as Associate Professor at the Universities of Hong Kong and Auckland. He works as a practitioner in several clinics in Kent and maintains his own Chinese herbal dispensary integrated within an allopathic pharmacy. He has a particular interest in the treatment of debilitating conditions such as multiple sclerosis and rheumatoid arthritis. He is President of the Register of Chinese Herbal Medicine and, since 2005, has sat on the Herbal Medicines Advisory Committee. Professor Chang has written more than 120 research papers, 22 book chapters and monographs, including Treatise on Asian Herbal Medicines (9 volumes, 8804 pages).

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White paper: Criteria for assessing the accuracy generic prometrium 200mg on line, credibility trusted 100mg prometrium, currency, and trust- quality of health information on the Internet (working draft). Nursing decision making and the science of the Bartlett Publishers and National League for Nursing. The Nightingales Florence Nightingale transformed a “calling from were on an extended European tour, begun in 1818 God” and an intense spirituality into a new social shortly after their marriage. A reflection on this statement A legacy of humanism, liberal thinking, and love appears in a well-known quote from Notes on of speculative thought was bequeathed to Nursing (1859/1992): “Nature [i. His views on the educa- tion of God] alone cures … what nursing has to tion of women were far ahead of his time. Florence and her sis- Although Nightingale never defined human care or ter studied music; grammar; composition; modern caring in Notes on Nursing, there is no doubt that languages; Ancient Greek and Latin; constitutional her life in nursing exemplified and personified an history and Roman, Italian, German, and Turkish ethos of caring. It is model is yet to truly come of age in nursing or the Parthenope, the older sister, who clutches her fa- health care system. Justice- making is understood as a manifestation of com- passion and caring,“for it is our actions that brings about justice” (p. This chapter reiterates Nightingale’s life from the years 1820 to 1860, delineating the formative influences on her thinking and providing historical context for her ideas about nursing as we recall them today. Part of what follows is a well-known tale; yet it remains a tale that is irresistible, casting an age-old spell on the reader, like the flickering shadow of Nightingale and her famous lamp in the dark and dreary halls of the Barrack Hospital, Scutari, on the outskirts of Constantinople, circa 1854 to 1856. Early Life and Education A profession, a trade, a necessary occupation, some- thing to fill and employ all my faculties, I have always felt essential to me, I have always longed for, con- sciouslyornot.... Nightingales and both daughters made an extended —Florence Nightingale, private note, 1850, cited tour of France, Italy, and Switzerland between the in Woodham-Smith (1983, p. From there, Nightingale vis- By all accounts, Nightingale was an intense and ited Germany, making her first acquaintance with serious child, always concerned with the poor and Kaiserswerth, a Protestant religious community the ill, mature far beyond her years. A few months that contained the Institution for the Training of before her seventeenth birthday, Nightingale Deaconesses, with a hospital school, penitentiary, recorded in a personal note dated February 7, 1837, and orphanage. What that Fleidner, and his young wife had established this service was to be was unknown at that point in community in 1836, in part to provide training for time. This was to be the first of four such experi- women deaconesses (Protestant “nuns”) who ences that Nightingale documented. Nightingale was to return there in The fundamental nature of her religious convic- 1851 against much family opposition to stay from tions made her service to God, through service to July through October, participating in a period of “nurses training” (Cook, Vol. What the make it without”(Nightingale, private note, cited in Kaiserswerth training lacked in expertise it made Woodham-Smith, 1983). It would take 16 long and torturous years, from Florence wrote, “The world here fills my life with 1837 to 1853, for Nightingale to actualize her call- interest and strengthens me in body and mind” ing to the role of nurse. Nightingale took two trips to Paris she turned down proposals of marriage, potentially, in 1853, hospital training again was the goal, this in her mother’s view, “brilliant matches,” such as time with the sisters of St. In August 1853, she accepted her need to serve God and to demonstrate her caring first “official” nursing post as superintendent of an through meaningful activity proved stronger. She “Establishment for Gentlewomen in Distressed did not think that she could be married and also do Circumstances during Illness,” located at 1 Harley God’s will. After six months at Harley Street, Calabria and Macrae (1994) note that for Nightingale wrote in a letter to her father: “I am in Nightingale there was no conflict between science the hey-day of my power” (Nightingale, cited in and spirituality; actually, in her view, science is nec- Woodham-Smith, 1983, p. The development of science allows for the concept of one perfect God who regulates the uni- verse through universal laws as opposed to random Spirituality happenings. Nightingale referred to these laws, or the organizing principles of the universe, as Today I am 30—the age Christ began his Mission. As part of Now no more childish things, no more vain things, no God’s plan of evolution, it was the responsibility of more love, no more marriage. A suc- cessful advance of Russia through Turkey could God lays down certain physical laws. Upon his carry- threaten the peace and stability of the European ing out such laws depends our responsibility (that continent. It was written of that battle that it was a “glorious and bloody vic- Influenced by the Unitarian ideas of her father tory. However, the telegraph enabled war truth, studying a variety of religions and reading correspondents to telegraph reports home with widely. The horror of the battlefields was Nightingale wrote: “I believe that there is a Perfect relayed to a concerned citizenry. Descriptions of Being, of whose thought the universe in eternity is wounded men, disease, and illness abounded. The French Dossey (1998) recasts Nightingale in the mode of had the Sisters of Charity to care for their sick “religious mystic.

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Even if pain impulses were comparable order prometrium 200 mg overnight delivery, pain experiences are unique to each individual necessitating individual assessment buy prometrium 100 mg fast delivery, which should be a nursing priority (Doverty 1994). Assessing pain Pain assessment, together with nursing knowledge and attitudes, is fraught with problems. Compared with patients’ own assessments, nurses consistently underestimate pain (Seers 1987; Ferguson et al. Since it is impossible to judge what others are experiencing, it is better to give too much analgesia rather than too little (McCaffery & Beebe 1994). Verbal assessment may be influenced by a nurse’s choice of words and so ‘hurt’, ‘discomfort’, ‘ache’ and ‘soreness’ may identify discomforts that would be denied as ‘painful’ (McCaffery & Beebe 1994). Pharmacological interventions Although the actions of drugs are often complex, including significant psychological/placebo components, analgesics can be divided between those with peripheral actions (e. Observe for skeletal muscle response (a) body movement immobility purposeless or inaccurate body movements protective movements include withdrawal reflex rhythmic movements (b) facial expression: clenched teeth wrinkled forehead biting of lower lip widely opened or tightly shut eyes 2. Autonomic nervous system response (a) sympathetic nervous system activation: increased pulse increased respiration increased diastolic and systolic blood pressure cold perspiration pallor dilated pupils nausea muscle tension (b) parasympathetic activation in some visceral pain low blood pressure slow pulse 3. Verbal report of pain Pain management 67 Questions to elicit from the patient location of pain intensity of pain (scale 1–10) onset and duration precipatating and aggravating factors nature of pain (i. Questions nurses should ask themselves (a) How long has it been since the fresh postoperative patient was medicated for pain? Most peripheral analgesics are anti-inflammatory, making them effective against musculoskeletal pain. Since prostaglandin inhibition impairs platelet aggregation, coagulopathies may be aggravated. Intensive care nursing 68 Opiates Opiates bind to receptors in the central nervous system; three types of receptors have been identified: mu, kappa and sigma. Since fats and fat soluble molecules readily cross the blood- brain barrier, lipid soluble (lipophilic) analgesics act quickly. Differences between opiates are relatively small and so choice largely depends on the personal preference of prescribers/users (Bergman & Yate 1997). Continuous infusions can cause accumulation if drugs have prolonged action or if renal or hepatic metabolism is impaired (renal failure, hepatic failure). It suppresses impulses from C fibres, but not A-delta fibres, and so relieves dull, prolonged pain. Its poor lipid solubility prolongs its effect and makes it unsuitable for epidural analgesia (McCaffery & Beebe 1994). Adverse effects include: ■ respiratory depression ■ histamine release (causing hypotension) (Viney 1996) ■ nausea (concurrent antiemetics may be needed) ■ euphoria Most other opiates also cause these effects. Morphine can be used with children; by the age of six, clearance and half-life have reached adult levels (Knight 1997). It has few cardiovascular effects, but analgesia remains unpredictable (Viney 1996). Its high lipid solubility makes it useful for epidural infusions (McCaffery & Beebe 1994). Transcutaneous patches are also available, but impaired peripheral perfusion may limit absorption in the critically ill. The metabolite nor-pethidine is a highly toxic central nervous system stimulant, causing twitches, tremors, muscle jerks and fits (McCaffery & Beebe 1994). The half-life of nor- pethidine exceeds fifteen hours (McCaffery &: Beebe 1994); the antagonist for pethidine is naloxone hydrochloride. However, although naloxone eliminates pethidine, it does not eliminate nor-pethidine (McCaffery & Beebe 1994). Success is difficult to predict (Seymour 1995a), and excessive electrical stimulation may cause pain. Placebos As pain perception is influenced by psychology, chemically inactive substances may relieve pain if patients believe they will work. However, if caregivers appear sceptical, patients will probably lose trust in a placebo’s effectiveness, and because the drug is a placebo, this necessitates lying to patients (directly or by implication), which is ethically questionable. Consequentialists might justify such lies by the benefits obtained from pain Intensive care nursing 70 relief, but deontologists are less likely to consider any lie acceptable. Nurses have various roles in pain management, ranging from provision of simple comforts to administering and observing controlled drugs. In all aspects of care, holistic and humanistic approaches can reduce patient suffering. Further reading Classic books on pain management include Melzack and Wall (1988) or McCaffery and Beebe (1994); Hayward’s (1975) classic study on postoperative pain remains valuable. Although Melzack’s own work on the gate control theory is authoritative, Davis (1993) gives a clear summary. In addition to acute postoperative pain, Mr Hunt is known to suffer with chronic back pain from kyphotic scoliosis in his thoracic vertebrae. These should include patient-controlled infusions, epidural and interpleural techniques. Using the literature, your own, colleagues’ and patients’ experiences debate the most effective approach to manage Mr Hunt’s pain.

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