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Unit11、Somefactorsthatmayleadtothecomplaint:·Neuronoverload·Patients*highexpectations·Mistrustandmisunderstandingbetweenthepatientandthedoctor2、Mrs.Osorio’scondition:·A56-year-oldwoman·Somewhatoverweight·Reasonablywell-controlleddiabetesandhypertension·Cholesterolonthehighsidewithoutanymedicationsforit·Notenoughexercisessheshouldtake·HerbonesalittlethinonherlastDEXAscan3、Goodthings:·Bloodtestsdone·Glucosealittlebetter·HerbloodpressurealittlebetterbutnotsogreatBadthings:·Cholesterolnotsogreat·Herweightalittleup·HerbonesalittlethinonherlastDEXAscan44、Thesituation:·Theauthorwasinamoderatestateofpanic:jugglingsomanythoughtsaboutMrs.Osorio’sconditionsandtryingtoresolvethemallbeforetheclockrandown.·Mrs.Osoriomadeatrivialrequest,notsoimportantascomparedtoherconditions.·Mrs.Osorioseemedtocareonlyabouther“innocent—andcompletelyjustified—request”：theformsignedbyherdoctor.·Thedoctortriedtooratleastpretendedtopayattentiontothepatientwhilecompletingdocumentation.5、Similarities:·Incomputermultitasking,amicroprocessoractuallyperformsonlyonetaskatatime.Likemicroprocessors,wehumanbeingscarftactuallyconcentrateontwothoughtsatthesameexacttime.Multitaskingisjustanillusionbothincomputersandhumanbeings.Differences:·Theconceptofmultitaskingoriginatedincomputerscience.·Atbest,humanbeingscanjuggleonlyahandfulofthoughtsinamultitaskingmanner,butcomputerscandomuchbetter.·Themorethoughtshumanbeingsjuggle,thelesshumanbeingsareabletoattunefullytoanygiventhought,butcomputerscandomuchbetter.6、·7medicalissuestoconsider·5separatethoughts,atleast,foreachissue·7x5=35thoughts·10patientsthatafternoon·35x10=350thoughts·5residentsundertheauthorssupervision·4patientsseenbyeachresident·10thoughts,atleast,generatedfromeachpatient·5x4x10=anther200thoughts·350+200=550thoughtstobehandledintotal·Ifthedoctordoesagoodjobjuggling98%ofthetime,thatstillleavesabout10thoughtsthatmightgetlostintheprocess.7、Possiblesolutions:·Computer-generatedreminders·Casemanagers·Ancillaryservices·Thesimplestsolution:timeUnit21、Theauthorimplies:•Peoplesinadequateconsciousnessabouttheconsequenceofneglectingthere-emerginginfectiousdiseases·Unjustifiabilityofpeoplescomplacencyaboutthepreventionandcontroloftheinfectiousdiseases·Unfinishedwaragainstinfectiousdiseases2、Victorydeclarations:·SurgeonGeneralWilliamStewart'shyperbolicstatementofclosing“thebookoninfectiousdisease”.·Astringofimpressivevictoriesincurredbyantibioticsandvaccines·ThethoughtthatthewaragainstinfectiousdiseaseswasalmostoverWhatfollowedeversince:·AppearanceofnewdiseasessuchasAIDSandEbola·Comebackoftheoldafflictions:»DiphtheriaintheformerSovietUnion»TBinurbancenterslikeNewYorkCity»RisingGroupAstreptococcalconditionslikescarletfever·Thefearofapowerfulnewflustrainsweepingtheworld3、Elaborateonthejoinedbattle:·WHOestablishedanewdivisiondevotedtoworldwidesurveillanceandcontrolofemergingdiseaseinOctober1995.·CDClaunchedapreventionstrategyin1994.·Congressraisedfundfrom$6.7millionin1995to$26millionin1997.4、Thebordersaremeaninglesstopathogenicmicrobes,whichcantravelfromonecountrytoanotherremotecountryinaveryshorttime.5、TB:·PrisonsandhomelesssheltersasidealplacesforTBspread·Emergingofdrug-resistantstrainorevenmulti-drug-resistantstrain·ArideontheHIVw^onbyattackingtheimmunocompromisedGroupAstrep:·Achangeinvirulence·MutationintheexteriorofthebacteriumFlu:Constantchangesinitscoat(surfaceantigens)andresultantchangesinitslevelofvirulence6、Examples:·ExperimentinEnglandisseeingthewaningimmunitybecauseofnovaccination.·Duetopoorvaccinationefforts,thediphtheriasituationintheformerSovietUnionisserious.'•ThevaccinationratesaredroppinginsomeAmericancities,anditwillleadtomorediphtheriaandwhoopingcough.7、Thefourareasoffocus:·Theneedforsurveillance·Updatedsciencecapableofdealingwithdiscoveriesinthefield·Appropriatepreventionandcontrol·Strongpublichealthinfrastructure8、TheinfectiousdiseasessuchasTB,flu,diphtheriaandscarletfeverwillneverreallygoaway,andthewaragainstthemwillneverend.Unit31、Terry'slifebefore·ShelovedpracticingTaeKwonDo·Shelovedthesurgeofadrenalinethatcamewiththecontrolledcombatoftournaments.·Shecompetednationally,evenwonbronzemedalinthetrialsforthePanAmericanGames.·Sheattendedmedicalschool,practicedasaninternalmedicineresident,andbecameanacademicgeneralinternist.·Shegotmarriedandgotasonandadaughter.2、ThesymptomsofMSandautoimmunedisease:·Lossofstaminaandstrength·Problemswithbalance·Boutsofhorrificfacialpain·Dipsinvisualacuity3、Terrydidthefollowingbeforesheself-experimented:·Shestartedinjections.·Sheadoptedmanypharmacotherapies.·Shebeganherownstudyofliterature:»ShereadarticlesonwebsitessuchasPubMed.»ShesearchedforarticlestestingnewMSdrugsinanimalmodels.»Sheturnedtoarticlesconcerningneurodegenerationofalltypes—dementia，Parkinson'sdisease,Huntington'sdisease,andLouGehrig'sdisease.»Sherelearnedbasicsciencessuchascellularphysiology,biochemistry,andneurophysiology.4、ApproachesTerrymainlyused:·Self-experimentationwithvariousnutrientstoslowneurodegenerationbasedonliteraturereportsonanimalmodels·Self-experimentationwithneuromuscularelect