Lyme Arthritis Essays - Rheumatology, Autoimmune Diseases, RTT

Lyme Arthritis ~~~~~~~~~~~~~~ Lyme disease is a tick-transmitted inflammatory disorder characterized by an early focal skin lesion, and subsequently a growing red area on the skin (erythema chronicum migrans or ECM). The disorder may be followed weeks later by neurological, heart or joint abnormalities. Symptomatology ~~~~~~~~~~~~~~ The first symptom of Lyme disease is a skin lesion. Known as erythema chronicum migrans, or ECM, this usually begins as a red discoloration (macule) or as an elevated round spot (papule). The skin lesion usually appears on an extremity or on the trunk, especially the thigh, buttock or the under arm. This spot expands, often with central clearing, to a diameter as large as 50 cm (c. 12 in.). Approximately 25% of patients with Lyme disease report having been bitten at that site by a tiny tick 3 to 32 days before onset of ECM. The lesion may be warm to touch. Soon after onset nearly half the patients develop multiple smaller lesions without hardened centers. ECM generally lasts for a few weeks. Other types of lesions may subsequently appear during resolution. Former skin lesions may reappear faintly, sometimes before recurrent attacks of arthritis. Lesions of the mucous membranes do not occur in Lyme disease. The most common symptoms accompanying ECM, or preceding it by a few days, may include malaise, fatigue, chills, fever, headache and stiff neck. Less commonly, backache, muscle aches (myalgias), nausea, vomiting, sore throat, swollen lymph glands, and an enlarged spleen may also be present. Most symptoms are characteristically intermittent and changing, but malaise and fatigue may linger for weeks. Arthritis is present in about half of the patients with ECM, occurring within weeks to months following onset and lasting as long as 2 years. Early in the illness, migratory inflammation of many joints (polyarthritis) without joint swelling may occur. Later, longer attacks of swelling and pain in several large joints, especially the knees, typically recur for several years. The knees commonly are much more swollen than painful; they are often hot, but rarely red. Baker's cysts (a cyst in the knee) may form and rupture. Those symptoms accompanying ECM, especially malaise, fatigue and low-grade fever, may also precede or accompany recurrent attacks of arthritis. About 10% of patients develop chronic knee involvement (i.e. unremittent for 6 months or longer). Neurological abnormalities may develop in about 15% of patients with Lyme disease within weeks to months following onset of ECM, often before arthritis occurs. These abnormalities commonly last for months, and usually resolve completely. They include: 1. lymphocytic meningitis or meningoencephalitis 2. jerky involuntary movements (chorea) 3. failure of muscle coordination due to dysfunction of the cerebellum (cerebellar ataxia) 4. cranial neuritis including Bell's palsy (a form of facial paralysis) 5. motor and sensory radiculo-neuritis (symmetric weakness, pain, strange sensations in the extremities, usually occurring first in the legs) 6. injury to single nerves causing diminished nerve response (mononeuritis multiplex) 7. inflammation of the spinal cord (myelitis). Abnormalities in the heart muscle (myocardium) occur in approximately 8% of patients with Lyme disease within weeks of ECM. They may include fluctuating degrees of atrioventricular block and, less commonly, inflammation of the heart sack and heart muscle (myopericarditis) with reduced blood volume ejected from the left ventricle and an enlarged heart (cardiomegaly). When Lyme Disease is contracted during pregnancy, the fetus may or may not be adversely affected, or may contract congenital Lyme Disease. In a study of nineteen pregnant women with Lyme Disease, fourteen had normal pregnancies and normal babies. If Lyme Disease is contracted during pregnancy, possible fetal abnormalities and premature birth can occur. Etiology ~~~~~~~~ Lyme disease is caused by a spirochete bacterium (Borrelia Burgdorferi) transmitted by a small tick called Ixodes dammini. The spirochete is probably injected into the victim's skin or bloodstream at the time of the insect bite. After an incubation period of 3 to 32 days, the organism migrates outward in the skin, is spread through the lymphatic system or is disseminated by the blood to different body organs or other skin sites. Lyme Disease was first described in 1909 in European medical journals. The first outbreak in the United States occurred in the early 1970's in Old lyme, Connecticut. An unusually high incidence of juvenile arthritis in the area led scientists to investigate and identify the disorder. In 1981, Dr. Willy Burgdorfer identified the bacterial spirochete organism (Borrelia Burgdorferi) which causes this disorder. Affected Population ~~~~~~~~~~~~~~~~~~~ Lyme Disease occurs in wooded areas with populations of mice and deer which carry ticks, and can be contracted during any season of the year. Related Disorders ~~~~~~~~~~~~~~~~~ Rheumatoid Arthritis is a disorder similar in appearance to Lyme disease. However, the pain in rheumatoid arthritis is usually more pronounced. Morning stiffness and symmetric joint swelling more commonly occur in rheumatoid arthritis, and knotty lumps

Free Essays on Hunger For Memory

, free and clear from the humiliation of the outside world in openly revealing their speech deficiencies. He remembers the first day of catholic school being introduced by a nun as Richard. Rodriguez states â€Å"This was the first time I had heard anyone name me in English† (393). This was the beginning of the end of his Hispanic heritage. In school he felt isolated from the rest of the students and at this point he realized he must now embrace his American identity. Frightening as it may have been. Because of his fear of accepting and learning the public language, it would change the comfort of his family life. He would often hesitate when interacting with his fellow students. Several months later his teacher had noticed his lack of participation i... Free Essays on Hunger For Memory Free Essays on Hunger For Memory Journal Response â€Å"Hunger for Memory† Richard Rodriguez in his book â€Å"Hunger of Memory† writes about the psychological impact of lack of heritage in his adulthood for trying to blend both heritages, American and Hispanic in his childhood. His experience as a second-generation Mexican immigrant, growing up in middle class, predominantly white neighborhood where he felt the discrimination and his struggle with the English language. He also tells us about how uncomfortable it was for him to see his parents trying to speak English. He describes to us the two worlds, â€Å"The Spanish world at his house and the gringos, American world† that he lived for a period of his life in his childhood. Rodriguez says that he felt very comfortable at home where everyone spoke Spanish. Rodriguez states, â€Å"My parents would say something to me and I would feel embraced by the sounds of their words.† (396) It was his language, and the only one that made sense to him. Rodriguez points out how the languag e barrier both excludes the Hispanic and isolates them from the predominant society. He recalls sitting at the dinner table, joining his parents in mocking the pronunciation of English words, free and clear from the humiliation of the outside world in openly revealing their speech deficiencies. He remembers the first day of catholic school being introduced by a nun as Richard. Rodriguez states â€Å"This was the first time I had heard anyone name me in English† (393). This was the beginning of the end of his Hispanic heritage. In school he felt isolated from the rest of the students and at this point he realized he must now embrace his American identity. Frightening as it may have been. Because of his fear of accepting and learning the public language, it would change the comfort of his family life. He would often hesitate when interacting with his fellow students. Several months later his teacher had noticed his lack of participation i...

3 Tricks to Figure out the Authors Tone

3 Tricks to Figure out the Author's Tone Authors tone is simply an authors expressed attitude toward a particular written subject. It may not be his or her actual attitude as authors can certainly express an attitude other than their own. Its very different from the  authors purpose! The tone of the article, essay, story, poem, novel, screenplay, or any other written work can be described in many ways. The authors tone can be witty, dreary, warm, playful, outraged, neutral, polished, wistful, reserved, and on and on. Basically, if theres an attitude out there, an author can write with it. To better understand tone, you should practice. So, now that you know what it is, how can you determine the authors tone when you get to a reading comprehension test? Here are a few tricks to help you nail it every time. Read the Introductory Info On most major reading comprehension tests, the test makers will give you a little snippet of information along with the authors name prior to the text itself. Take these two examples from the ACT Reading test: Passage 1: This passage is adapted from the chapter â€Å"Personality Disorders† in  Introduction to Psychology, edited by Rita L. Atkinson and Richard C. Atkinson ( ©1981 by Harcourt Brace Jovanovich, Inc.). Passage 2: This passage is adapted from the novel The Men of Brewster Place  by Gloria Naylor ( ©1998 by Gloria Naylor). Without reading any portion of the text itself, you can already determine that the first text will have a more serious tone. The author writes in a scientific journal, so the tone will have to be more reserved. The second text could be anything at all, so when youre reading, youll need to use another trick to determine the authors tone. Watch Word Choice Word choice plays a major part in the tone of a piece. If you look at the examples given in the What is Authors Tone article, youll see how very different an identical situation can be by just the words an author chooses to use. Look at the following words and see how they reflect a different feeling, even though the words are similar in meaning. Sit in the sunshine and smile. Bask in the brilliant rays. Discover your giggle.Sit in the hot sun and smirk. Recline in the glaring rays. Hunt for that snicker.  Sit in the warm sun and grin. Relax in the warm rays. Look for a chuckle. Even though all three sentences are written almost identically, the tones are very different. One is more relaxing- you can picture a lazy afternoon by the pool. The other is more joyful- maybe playing in the park on a sunny day. The other is definitely more sarcastic and negative, even though its written about sitting in the sun. Go With Your Gut Often, a tone is tough to describe, but you know what it is. You get a particular feeling from the text- an urgency or a certain amount of sadness. You feel angry after reading it and can sense the author is angry, too. Or you find yourself chuckling throughout the text even though nothing comes right out and screams funny! So, on these kinds of texts, and the corresponding authors tone questions, trust your gut. And on the authors tone questions, hide the answers and make yourself come up with a guess before looking. Take this question for example: The author of the article would most likely describe ballet as... Before you get to the answer choices, try to finish the sentence. Put an adjective in there based on what youve read. Amusing? Essential? Cut-throat? Joyous? Then, when youve answered the question with a gut reaction, read the answer choices to see if your choice, or something similar, is there. More often than not, your brain knows the answer even if you doubt it!

African American philosophy Essay Example | Topics and Well Written Essays - 2250 words

African American philosophy - Essay Example Philosophy is a detailed system of ideas about human beings and the nature of the human existence and truth.Actually it is a complete guide for living. It deals in issues which are fundamental and consider the steps we take in life for progress. It also deals with our attitude and treatment of other people. The main branches of Philosophy are: Metaphysics, which deals with reality, Epistemology, which deals with knowledge, Ethics, which considers moral values, Politics, which accounts for legal rights and governments, and Aesthetics, which looks in to nature of art.While we start to think of African American Philosophy, the first point going to pop up is the attitude of the citizens in developed countries towards the men in Africa. When compared citizens of United States and Africa, we understand that the Blacks are considered to be second-class citizens in the United States. In fact they are not considered human beings at all. In the past, they were treated as slaves. They were made to work day and night, beaten with sticks and transported along with asses and horses. They were not given proper food. When they were sick, they were not given medical treatment. They lived miserably. They had no hope of future. Things have not changed much, according to Charles Mills. At least a section of the U.S. citizens still see the Africans as somebody who maintains lower standards of life. Even though slavery has been abolished that sort of mindset still continues.Law was enacted to strengthen the concept that Blacks are sub-persons. The pity is that not even an apology was given by the authorities for the misdeeds and torture towards the Blacks for centuries. In fact, many Americans feel that it is time to stop the little benefits given to the Blacks and to cancel the measures which objected to ill treatment of the Afro-Americans. They think that enough is enough and it is time to stop the concessions. They fear that it would amount to create discrimination against Whites . When we approach the problem from the side of African citizens, it is clear that an inferiority complex remains in their brains and minds. They themselves keep the wrong feeling that Blacks are second-class citizens. They have no hope of a happy future. They still live in poverty. The wages are comparatively much lower. Job opportunities also remain lesser. They are not likely to get good education or medical treatment. Just through an example, the consideration being given to Whites and Blacks could be compared. For the same crime the Blacks black may be sent to jail, whereas the Whites may be let free. In every respect the Blacks are treated harsh. In other words, their condition has not improved at all even before law. In fact, it has deteriorated, feels Charles Mills. Time has changed. But not much has changed for the Blacks. Their problems have not been addressed seriously. It has been wrongly said that the Blacks are not taking enough interest in the country, nor in their future and that they do not bother to be a part of the society. It is said that they do not try to come out of the negative situation they are in and for that they only need to be blamed. That is not a valid statement. It is nothing more than an excuse. It is absurd to think that they want to remain where they are. Do not forget, the part they played in nation building. Many numbers of roads, buildings and similar structures are there because of the manpower and work skills of the Blacks. It is silly to think that they are lazy. The Blacks think that they are not given justice. They only want their genuine rights. They are not expecting charity. They want the discrimination is buried for ever. The country belongs to them as much as it is for the Whites. The issues which have put them down should be modified to uplift them. But for the sweat of the blacks, The United States of America would have been nowhere. They have done enough to convert the country into a large nation. They have done much more than the Whites. They must be allowed to reap the harvest now.

Week 456 CRJ 330 Essay Example | Topics and Well Written Essays - 250 words

Week 456 CRJ 330 - Essay Example If, for example a one year in jail is increased to five years in prison, they say that it does not reduce crime, but only increase the imprisonment period. Furthermore not all are caught on their first crime. The passing of the three strike law in California saw a 27 years old man imprisoned for 25 years for stealing a pizza. Others, however, argue that if penalties on certain crimes are made harsh, people or in this case criminals will avoid crime due to fear. The American criminal justice officials implemented policies to respond to the crimes of terrorism. To them, the rights of the terrorists should not be violated as well as those of their immediate families. According to them, these criminals should be allowed judicial assistance; they should not be intimidated, and should be provided with medical, social and psychological assistance. They should also be compensated if necessary. The USA has the best police force. Their functions are clearly outlined and they do not cross borders in performing their duties. They are not a source of fear to the community but are a source of assistance. The police force is divided into different departments each performing its designated function. The departments perform their tasks without

Essay on Villains in Much Ado About Nothing and Othello -- comparison

Comparing the Villains in Much Ado About Nothing and Othello    The two villains in Much Ado About Nothing and Othello share much in common, despite their numerous differences. It is evident that Shakespeare framed the second piece of literature to be similar to the first. Although shorter, the plot of   â€Å"Othello† is definitely more complex. The villains play a major part in the novels, and are very much alike in their line of thinking.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The comedy, â€Å"Much Ado About Nothing† depicts the story of a group of high-ranking soldiers who travel through a town called Messina. They had been to the town before, and this time Claudio confesses his love for the governor’s daughter, Hero. Because Leonato is so fond of Claudio, the wedding is set to be a few days away. This gives Don John, Claudio’s bastard brother, a chance to show his true hatred for Claudio. He comes up with a scheme to make Claudio think that Hero is cheating by dressing Margaret in her clothing and perching her near the window with another man. When Claudio sees this, he says that he will humiliate Hero instead of marrying her.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The next day Claudio does exactly as he had said, degrading Hero in front of all her family and friends. Because she did not cheat on him, she did not expect that kind of reaction. She is so dejected that she faints, and everyone assumes she is dead. Eventually Borrachio is overheard talking about Don John’s plan, and Don John is arrested. Later Claudio learns that Hero is not actually dead, and they are finally married.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   â€Å"Othello†Ã¢â‚¬â„¢... ...io merely humiliated Hero. Iago seeks revenge on Othello for two reasons: he suspects Othello slept with Emilia, and he also despises Othello for choosing Cassio as lieutenant instead of him. One final and resounding difference between Don John and Iago has to do with the past of each character. Shakespeare portrays Iago as an intelligent and sometimes caring character until Othello supposedly wrongs him. On the other hand, Don John has more of an evil aura about him, and shows his hatred for Claudio right from the start.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Overall, the characters of Don John and Iago are very similar, although the latter is much more intelligent and complex. These two men are what draw the reader’s attention to the novel, and share so much in common that the two seemingly unrelated works are read in tandem constantly.

Tax Memo

Facts Latrell accumulated frequent flyer miles from his business travel as a CPA in which his employer paid for the business trips, and he was not taxed on the travel reimbursement. He recently used his Delta Skymiles to purchase a free roundtrip airline ticket worth $1,200 to Milan, Italy. Issues Is an employee’s personal use of frequent flyer miles earned as a result of business travel taxable? Authorities IRC Sec. 62(a) IRS Announcement 2002-18 ConclusionNo, an employee’s personal use of frequent flyer miles earned as a result of business travel is not taxable. Because Latrell’s used his frequent flyer miles to purchase an airline ticket instead of redeeming his frequent flyer miles for cash, he does not need to include the value of the airline ticket in gross income. Analysis IRC Sec. 62(a) provides the deductions from gross income that are allowed for computing â€Å"adjusted gross income. † IRC Sec. 2(a)(1) states that gross income includes fringe be nefits such as frequent flyer miles accumulated from business travel. IRC Sec. 62(a)(2)(A) states that the reimbursed expenses of an employee related to his or her performance of services under a reimbursement or other expenses allowance arrangement with the employer are allowable deductions in addition to those allowed by IRC Sec. 161 through IRC Sec. 196. Since under IRC Sec. 62(a) frequent flyer miles are categorized as deductions to gross income, they are not taxable.IRS Announcement 2002-18 also states that frequent flyer miles or other in-kind promotional benefits, such as a free airline ticket, earned by the taxpayer’s business travel will not represent taxable income. However, this ruling applies only to in-kind benefits and not to benefits that have been liquidated or converted to cash. Therefore, since Latrell used his frequent flyer miles to purchase an airline ticket instead of redeeming his frequent flyer miles for cash, he does not need to include the value of t he airline ticket as taxable income.