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Sample analysis of the muscle fibers indicated that the ratio of myosin and actin proteins in the muscle fibers was not affected by longduration space flight. Although exercise slowed the onset of atrophy and loss of strength in muscle fibers, a significant amount of muscle volume and strength loss still occurred on long-duration missions. Of the exercise countermeasures that are currently being employed, treadmill exercise appeared the most effective in protecting the calf muscles from loss of strength and atrophy. Microgravity, exercise countermeasures, and human single muscle fiber function (Abstract). Human muscle volume and performance: the effect of 6-mo of microgravity (Abstract). Samples of muscles fibers will be extracted and tested as part of the Biopsy experiment. Expedition 4 Research Area Physiological Studies: Bone and Muscle Osteoporosis is a debilitating disease that causes a reduction in bone mineral density that leads to weakened bones. Bone changes that were observed in older mice closely reflect the bone changes that are observed in older humans. Mice that were exposed to microgravity exhibited a 15% to 20% decline in femur elastic strength and a 40% to 60% decrease in bone formation when compared to the controls. Fluorescent image of femur diaphysis from space flight the femur elastic strength decline was caused by three mechplacebo-treated mouse, indicating greatly decreased bone anisms: reduced bone formation, increased bone resorption, formation (calcein label indicates where bone was forming and inhibition of mineralization. In addition to this detailed analysis of skeletal properties, a secondary analysis of calf muscles from placebo-treated specimens Fluorescent image of femur diaphysis from ground control was performed to collect baseline data to validate spaceplacebo-treated mouse, indicating greatly decreased bone flown mice as an appropriate model for sarcopenia (ageformation (calcein label indicates where bone was forming at the time of launch, which allows quantification of bone related muscle loss). Data obtained from the mice following return to Earth also indicated some alternations in immune functions. Analysis of the spleenocytes (immune cells produced by the spleen) indicated an increase in B-cell (a white blood cell that matures in the bone marrow and, when stimulated by an antigen, differentiates into plasma cells) production compared to T-cells (white blood cells that complete maturation in the thymus and have various roles in the immune system). A slightly lower white blood-cell count in the flight animals compared to the controls was not statistically significant. Results also indicate that flight mice weighed 10% to 12% less than ground controls (Pecaut et al. Platelets (a constituent of blood that promotes clotting at the site of injury) are the primary cells involved in the wound healing process. The animals that were studied had significantly higher platelet levels but low volume compared to the controls. This indicates that the lack of platelets in the wound healing process is not a problem, but that platelets formed in microgravity have a decreased functionality in the wound-healing process. Data indicate that a short stay in microgravity can induce significant changes in immune defense mechanisms, hematopoiesis (blood cell formation), and other aspects of health (Gridley et al. Expedition 15 Research Area Physiological Studies: Bone and Muscle Currently, no pharmaceutical countermeasures for muscle loss that are designed for use in crewmembers during space flight have been approved. These regimes also do not completely alleviate the muscle loss that occurs as a result of extended stays in space. Developing and approving a pharmaceutical countermeasure to this condition could be instrumental to long-duration human exploration missions. This was the first time that an experimental therapeutic for muscle loss was investigated in space; an important and significant step in developing a more effective countermeasure to microgravity induced muscle changes. Physical deficits from muscle atrophy also affect millions of Americans and result in significant health care expenditures. This research is also expected to contribute data to the current body of research on microgravity effects on the skeletal, cardiovascular, and immune systems in addition to liver and kidney function as well as other physiological systems through a tissue-sharing program. Every effort will be made to harvest as many different samples and types of tissue from the mice as possible for other mission-specific biomedical research. Positive results from this research may advance our understanding of the mechanistic changes that occur in various physiological systems after exposure to microgravity and support overall efforts to reduce health risks to crewmembers. Once returned to Earth, their T-lymphocytes were analyzed and compared with ground control mice. New findings report that the immune system of mice are highly sensitive to space-flight-induced stresses. Certain Tand B-cell counts from the spleens of the flight animals were also low, and the natural killer cells were increased.

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Nutritionists sugresponse and creating immunity but not of causing gest that the best way to ensure appropriate doses of illness. These foods offer many benefits that visceral pericardium the inner layer of the vitamin supplements cannot, including fiber, and pericardium. Others are fat-soluble and may build up in voluntary Done in accordance with the conthe body, potentially reaching dangerous concentrascious will of the individual. The terms voluntary and and over-the-counter drugs, making them more or involuntary apply to the human nervous system and less potent. The nervous system is consult a physician before adding vitamin suppledivided into two parts: somatic and autonomic. The autonomic (automatic, or visceral) nervous system vitamin P See bioflavinoid. For example, opening the mouth is voluntary, vitamin therapy the use of vitamins to prevent and blushing and the beating of the heart are involor cure disease, often as a complementary therapy untary. One variant on this theme, megavitamin therapy, is still volvulus Abnormal twisting of a portion of the rather controversial. It is important to consult a gastrointestinal tract, usually the intestine, which physician before adding vitamin supplements to a can impair blood flow. The stomach, small intestine, cecum, and sigmoid colon are all vitiligo A condition in which the skin turns white subject to volvulus. Malrotation of the bowel during due to the loss of pigment from the melanocytes, fetal development can predispose one to a volvulus, cells that produce the pigment melanin that gives which often has a sudden onset. In vitiligo, the melanocytes are signs of a volvulus may include abdominal pain, destroyed, leaving depigmented patches of skin. The treathair that grows in areas affected by vitiligo may also ment is surgery to free the obstruction and ensure turn white. Volvulus is a surgiPeople with vitiligo must protect their skin from cal emergency. When vomit is vitreous humor A clear, jelly-like substance that reddish or coffee-ground colored, it indicates serifills the middle of the eye. When a pervomiting in pregnancy, excess See hyperemeson breathes, the vocal cords relax, and air moves sis gravidarum. When a person talks or sings, the vocal vomiting of pregnancy, pernicious See hypercords tighten up and move closer together. The term void is also sometimes (renal cell carcinoma); pheochromocytomas used to indicate the elimination of solid waste (benign tumors of adrenal-like tissue); and (defecation). The hemangioblastomas in els of von Willebrand factor, which reduces the tenthe retina can cause vision loss and may be the inidency toward bleeding. Several types of von vulvodynia Chronic pain in the area of the Willebrand disease have been described. The main symptom is pain, usually a burning irritation or rawness of the genitals. Symptoms can pain may be constant or intermittent, localized or include easy bruising, nosebleeds, bleeding from diffuse. It can last for months or longer, and it can the gums after a dental procedure, heavy menstrual vanish as suddenly as it started. The cause of vulvobleeding in women, blood in the stool and urine, dynia is unknown. Many women with vulvodynia and excessive bleeding after a cut or other accident or after surgery. Von Willebrand disease is usually have a history of treatment for recurrent vaginal funmild and often does not require treatment. Treatments can include the use of Treatment may be needed only after surgery, a tooth drugs, use of nerve blocks to numb the vulvar nerves, and biofeedback therapy to relax pelvic extraction, or an accident. Plantar warts may attack blood vessels deep in the skin, and they can be quite painful. Waardenburg syndrome A genetic syndrome Avoidance and prompt treatment are essential. In that features varying degrees of hearing loss and some cases, allergy injection therapy is highly effecpigmentation changes in the skin and hair.

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Podophyllin by cytologic changes indicating dysplasia/carcinoma among resin is applied and removed by washing a few hours later; adolescents difers slightly from that for adults. Injectable greater is found on repeat cytology, referral to colposcopy is therapy. Secondary infectherapy, laser therapy, cone biopsy, and a loop electrosurgical tions are not uncommon if ulcerations occur. For persistent or recurrent warts because each treatment has associated toxicity and recurgenital warts, retreatment with any of the modalities previously rences are common after treatment. Patients can be monitored described should be considered, preferably with an alternative by physical examination for evidence of recurrence. Genital warts toxicity of podophyllotoxin and topical podophyllin resin is often require more than one course of treatment. Also, if podophyllin is applied to a large warts should be managed by experienced clinicians and referred treatment area, systemic absorption can cause nausea, vomiting, for excisional therapy. The major side efects of surgical treatment for Prevention of Recurrence genital warts are local pain, bleeding, and secondary infection. No recommendations exist for preventing recurrence of The major adverse events associated with acid cauterization external genital warts. Patients should be monitored with cytoare local pain and irritation or ulceration of adjacent normal logic screening according to published guidelines and, when skin. In one study, use of low-dose intravaginal furouracil aise, depression, and other infuenza-like symptoms. Efudex should not Scarring can occur with any of the above treatment modalibe used in pregnant women. Topical cidofovir may result in systemic absorption and Discontinuing Secondary Prophylaxis be associated with renal toxicity (914). It is caused by primary infection or reactivation of Jamestown lesions in the brain. Postcontrast enhancement is unusual and, when and serious and life-threatening disease. In others might become neurologically stable; however, reports the prevaccine era, approximately 4 million cases of varicella have documented worsening neurologic manifestations after occurred annually in the United States. The incidence of zoster also Management of Treatment Failure increased with age, particularly in persons aged >50 years. Clinical Manifestations this syndrome is not seen among women who develop herpes zoster during pregnancy. In prosyndrome is characterized by cicatricial skin scarring, limb hypfoundly immunocompromised hosts, vesicles can persist for oplasia, and neurologic. Diagnostic laboralation; confrmation by staining with virus-specifc antiserum tory studies are useful if children or adolescents present with is then needed. Shell vial cultures combine centrifugation and unusual clinical manifestations suspected to be caused by zoster. Standard culture usually is necessary when testing the infected patients that occurs in children and adolescents (973). Data are not available on safety, immunogenicity, or efcacy of the combination measlesVol. Previously this was persons aged >8 years who have similar levels of immune funcperformed by administering varicella-zoster immune globution. The majority Treatment Recommendations of varicella cases in vaccinated children are modifed, with fewer lesions (commonly <50), fever, and a shorter duration Treatment of Disease of illness (32,951). Being immunocompromised is a vir should be initiated as soon as possible after initial lesions contraindication for its use. For children aged <1 year, the of acyclovir with improved bioavailability that is rapidly condose of acyclovir is 10 mg/kg/dose administered intravenously verted to acyclovir after absorption and is approved for treating every 8 hours as a 1-hour infusion.

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The energy produced by fats is 9 calories per feces the excrement discharged from the gram. These fats are greasy, solid materials found in animal tissues and in some plants. This principle is the basis for the practice of biofeedfatty acid, trans See trans fatty acid. The pelvic basin of the female is presence of an enlarged spleen (splenomegaly) and more spacious and less funnel-shaped than the an abnormally low white blood cell count. From a purely anatomic viewpoint, the may have an increased susceptibility to infection. The a particular physical appearance, chromosome urethra in a female is shorter than the urethra in the constitution, or gender identification. A minority of females have other iliac artery after it passes under the inguinal ligachromosome complements, such as 45, X (45 chroment. The femoral vein is a continuation of the popliteal vein, and it carries female genital mutilation See circumcision, blood back to the heart from the lower extremities. The blood ferritin level serves as an indicafemale organs of reproduction the ovaries, tor of the amount of iron stored in the body, and it which produce eggs (ova) and female hormones; can become elevated due to the presence of condithe Fallopian tubes, which transport the egg from tions featuring significant inflammation. The term fetal and there is a history of alcohol exposure before distress is commonly used to describe fetal hypoxia birth. No amount of alcohol has been proven safe of fetoscopes: A fiberoptic scope for looking directly during pregnancy. At least two of the following groups fetus An unborn offspring, from the embryo stage of signs must be present: small head size (micro(the end of the eighth week after conception, when cephaly); small eyes (microphthalmia) and/or the major structures have formed) until birth. For that fever, remittent A type of fever that gradually reason, low fevers should normally go untreated, decreases in intensity over time. Home treatment possibilities include the use of aspirin or, fever, spotted See Rocky Mountain spotted in children, nonaspirin pain killers such as acetafever. Fever therapy was done in the past but is rarely, if fever, Lassa An acute viral infection found in the ever, used today. Person-to-person transmission also tion; it helps the body move food through the occurs via direct contact, contamination of skin digestive tract, reduces serum cholesterol, and conbreaks with infected blood, and aerosol spreads tributes to disease protection. The antiviral drug ribavirin is used for fiber, cholesterol and Cholesterol blood levels treatment along with supportive care. Soluble fiber substances are effective in helping reduce the level fever, Mediterranean See familial of blood cholesterol. Insoluble fiber retains water in the colon, resulting in softer and larger. Fiber is used effectively in treating constipanormal rhythm, and prevention of blood clots. Soluble fibers found in oat bran, fibrillation, ventricular An abnormal and apples, citrus fruits, pears, peas and beans, psylirregular heart rhythm in which there are rapid lium, and other foods slow down the digestion of uncoordinated fluttering contractions of the lower carbohydrates (sugars), which results in improved chambers (ventricles) of the heart. A diet high in cereal fiber has rillation disrupts the synchrony between the heartbeen linked to a decreased risk for developing type beat and the pulse beat. Insoluble fiber is found in wheat bran, cabbage, peas and beans, and other foods. Both are fibrin the protein that is formed during normal important diet components for optimal health. Soluble fiber is found in oat bran, apples, citrus, pears, peas and beans, psylfibroadenoma the most common benign tumor lium, and other foods. Both soluble and insoluble of the breast and the most common breast tumor in fiber are important diet components for optimal women under 30 years of age. The most common signs of fibroadefibrates Cholesterol-lowering drugs that are noma are a painless, rubbery or firm, moveable effective in lowering triglycerides and, to a lesser mass of the breast. Treatment may involve surgical Gemfibrozil (brand name: Lopid), the fibrate most removal. Fibrates are generally sue throughout the body that produces collagen and well tolerated by most patients.

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