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Osteodystrophy osteochondritis dissecans A condition in which can require treatment with vitamin D order zithromax 100mg otc. See also a fragment of bone in a joint is deprived of blood and osteodystrophy cheap zithromax 500mg on line, renal purchase zithromax 100 mg line. Osteo- teens or 20s and is found most frequently in the dystrophy can require treatment with vitamin D generic zithromax 500 mg without a prescription. Most cases do not require invasive treatment order 100 mg zithromax overnight delivery, but just the use of osteogenesis The production of bone. Osteomalacia connective tissue diseases, all of which result from may be caused by poor diet, lack of vitamin D, or mutations that affect collagen in connective tissue in inadequate absorption of calcium and other minerals the body, and all of which result in fragile bones. Osteomyelitis is sometimes a com- osteogenesis imperfecta tarda See osteogene- plication of surgery or injury, although infection can sis imperfecta type I. Both the bone and the bone marrow may be osteogenesis imperfecta type I A type of osteo- infected. Symptoms include deep pain and muscle genesis imperfecta that features bone fragility spasms in the area of inflammation, as well as fever. Treatment includes bed rest, use of antibiotics, and Osteogenesis imperfecta type I is the classic, mild sometimes surgery to remove dead bone tissue. They may ture of the spine (scoliosis and kyphosis), umbilical prescribe medication and perform surgery, and they and inguinal hernias, and mild mitral valve prolapse. Also known as osteogenesis imper- osteopathy A system of therapy founded in the fecta tarda and Lobstein disease. The disease is approach to medical care, it also embraces modern characterized by short-limb dwarfism, thin skin, a medical knowledge, including use of medication, soft skull, unusually large fontanels (soft spots), surgery, radiation, and chemotherapy when war- blue sclerae (bluish whites of the eyes), small nose, ranted. Osteopathy is particularly concerned with low nasal bridge, inguinal hernia, and numerous maintaining correct relationships between bones, bone fractures at birth. Also known as osteogenesis imper- practice in which the bones and tissues of the head fecta congenita and Vrolik disease. It is most common in older adults, particu- larly postmenopausal women, and in patients who otology The study and medical care of the ear. Unchecked osteo- porosis can lead to changes in posture, physical otopharyngeal tube See Eustachian tube. An ostomy may be used to permit drainage of feces (colostomy) or ovarian cyst See cyst, ovarian. Totipotential cells can give rise to all orders of cells that are necessary to form ovulation The release of the ripe egg (ovum) mature tissues and often recognizable structures, from the ovary. The egg is released when the cavity such as hair, bone, and sebaceous (oily) material, surrounding it (the follicle) breaks open in neural tissue, and teeth. Such cysts may occur around 14 or 15 days from the first day of the at any age, but the prime age of detection is in the woman’s last menstrual cycle. Treatment involves surgical occurs, the ovum moves into the Fallopian tube and removal, which can be done via laparotomy (open becomes available for fertilization. Also known as dermoid cyst of the ovary or simply der- ovum An egg within the ovary of the female. The ovaries are located in oxygenation in arterial blood, an important meas- the pelvis, one on each side of the uterus. Each ovary ure of whether the heart and lungs are working is about the size and shape of an almond. Oximetry may be done continuously dur- ovaries produce eggs (ova) and female hormones. Oxygen may be given acteristics, such as the breasts, body shape, and in a medical setting, either to reduce the volume of body hair. They also regulate the menstrual cycle and other gases in the blood or as a vehicle for deliver- pregnancy. It can be delivered via ovary, dermoid cyst of the See ovarian nasal tubes, an oxygen mask, or an oxygen tent. Patients with lung disease or damage may need to use portable oxygen devices on a temporary or per- ovary cyst, follicular See cyst of the ovary, manent basis. Excessive growth of specific oxygen tent A tent-like device that is used in a body parts is also a feature of a number of disor- medical setting to deliver high levels of oxygen to a ders, such as Beckwith-Wiedemann syndrome, in bedridden patient. The tent covers the entire head which there is macroglossia (a large tongue due to and upper body, and oxygen is pumped in from a overgrowth of the tongue).

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In essence generic 250 mg zithromax amex, a participant’s “score” on the independent variable is assigned by the experimenter order zithromax 500 mg fast delivery. In our examples discount zithromax 100mg with visa, we cheap zithromax 100 mg with mastercard, the researchers generic 250mg zithromax fast delivery, decided that one group of students will have a score of 1 hour on the variable of study time or that one group of people will have a score of 20 on the variable of age. Conditions of the Independent Variable An independent variable is the overall variable that a researcher examines; it is potentially composed of many different amounts or categories. A condition is a specific amount or category of the independent vari- able that creates the specific situation under which participants are examined. Thus, although our independent variable is amount of study time—which could be any amount—our conditions involve only 1, 2, 3, or 4 hours. Likewise, 20 and 40 are two conditions of the independent variable of age, and male and female are each a condi- tion of the independent variable of gender. A condition is also known as a level or a treatment: By having participants study for 1 hour, we determine the specific “level” of studying that is present, and this is one way we “treat” the participants. The Dependent Variable The dependent variable is used to measure a partici- pant’s behavior under each condition. A participant’s high or low score is supposedly caused or influenced by—depends on—the condition that is present. Thus, in our studying experiment, the number of test errors is the dependent variable because we believe that errors depend on the amount of study. If we manipulate the amount of chocolate people consume and measure their eye blinking, eye blinking is our depend- ent variable. Or, if we studied whether 20- or 40-year-olds are more physically active, then activity level is our dependent variable. The behavior that is to be influenced is measured by the dependent variable, and the amounts of the variable that are present are indicated by the scores. Drawing Conclusions from Experiments The purpose of an experiment is to produce a relationship in which, as we change the conditions of the independent vari- able, participants’ scores on the dependent variable tend to change in a consistent fash- ion. To see the relationship and organize your data, always diagram your study as shown in Table 2. Each column in the table is a condition of the independent variable (here, amount of study time) under which we tested some participants. Each number in a column is a participant’s score on the dependent variable (here, number of test errors). To see the relationship, remember that a condition is a participant’s “score” on the independent variable, so participants in the 1-hour condition all had a score of 1 hour paired with their dependent (error) score of 13, 12, or 11. Likewise, participants in the 2-hour condition scored “2” on the independent variable, while scoring 9, 8, or 7 errors. Now, look for the relationship as we did previously, first looking at the error scores paired with 1 hour, then looking at the error scores paired with 2 hours, and so on. Essentially, as amount of study time increased, participants produced a different, lower batch of error scores. Thus, a relationship is present because, as study time increases, error scores tend to decrease. For help envisioning this relationship, we would graph the data points as we did pre- viously. Notice that in any experiment we are asking, “For a given condition of the in- dependent variable, I wonder what dependent scores occur? Likewise, we always ask, “Are there consistent changes in the dependent variable Diagram of an as a function of changes in the independent variable? Understanding Experiments and Correlational Studies 25 For help summarizing such an experiment, we have specific descriptive procedures for summarizing the scores in each condition and for describing the relationship. For exam- ple, it is simpler if we know the average error score for each hour of study. Notice, how- ever, that we apply descriptive statistics only to the dependent scores. Above, we do not know what error score will be produced in each condition so errors is our “I Wonder” variable that we need help making sense of. We do not compute anything about the con- ditions of the independent variable because we created and controlled them. Then the goal is to infer that we’d see a similar relationship if we tested the entire population in the experiment, and so we have specific inferential procedures for exper- iments to help us make this claim. If the data pass the inferential test, then we use the sample statistics to estimate the corresponding population parameters we would ex- pect to find.

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Of course order zithromax 250mg without prescription, there were exceptions on either side purchase 250mg zithromax mastercard, and the names of such eminent historians of medicine as Karl Sudhoff cheap 500mg zithromax with visa, Henry Sigerist and Owsei Temkin generic zithromax 100 mg, who devoted much attention to anti- quity cheap zithromax 250mg online, could be paralleled by classicists such as Hermann Diels, Ludwig Edelstein, Karl Deichgraber and Hans Diller. But the reason why the latter¨ are well known to most classical scholars is that they published also on mainstream, canonical classical subjects such as Aristophanes, Sophocles, the Presocratics, Plato, Aristotle and Posidonius. And at any rate (with the exception of Edelstein), their approach to ancient medicine had always been rather strictly philological, focusing on the texts of the great masters such as Hippocrates and Galen, but paying little attention to the social, cultural, economic, institutional, geographical and religious environment in which medical writing took place. For the rest, the subject was largely neglected: the majority of classicists considered it too medical and too technical, while the fact that the main texts were in Latin and Greek (and often in a quite technical, austere kind of Latin and Greek at that) did not help to secure the subject a prominent place in the attention of medical historians or members of the medical profession at large. Nothing could be further from my intention than to dismiss the con- tribution of members of the medical profession to the study of ancient medicine – indeed, I myself have often benefited from the collaboration and dialogue with medically trained colleagues when studying ancient Greek medical texts. Still, it is fair to say that, especially in the first half of the twen- tieth century, the interest taken by medical people in Greek and Roman medicine was often motivated, apart from antiquarian intellectual curiosity, by what we could call a positivist, or presentist, attitude. There often was an underlying tendency to look for those respects in which Greek medicine was, as it were, ‘on the right track’, and to measure the extent to which the Greeks ‘already knew’ or ‘did not yet know’ certain things which contempo- rary biomedicine now knows, or claims to know, to be true. In other words, it was inspired by 3 A striking example is the vigorous debate initiated by R. Kapferer in the 1930s on the question whether the Hippocratic writers were familiar with the process of blood circulation; for a review of this debate see Duminil (1998) 169–74. Postmodernism, pluralism, cultural relativism and comparativism, as in so many other areas, have had their impact also on the study of Greek medicine and science. Questions have been asked about the uniqueness of Greek medical thought, and it has been suggested that its debt to earlier, Near Eastern and Egyptian thinking may have been much greater than was commonly assumed. Questions have also been raised about the rationality of Greek medical thought, about the assumption that Greek medicine developed ‘from myth to reason’,4 and Greek medicine has been shown to have been much more open and receptive to superstition, folklore, religion and magic than was generally believed. Furthermore, in the academic study of medical history – and to a certain extent also in the historiography of science – significant changes have oc- curred over the past decades, especially in the area of medical anthropology, the social, cultural and institutional history of medicine and science, the history of medical ethics, deontology and value systems, and the linguistic study and ‘discourse analysis’ of medical texts. There has been an increasing realisation of the social and cultural situatedness of medicine, healthcare and knowledge systems: individuals, groups of individuals and societies at large understand and respond differently to the perennial phenomena of sickness and suffering, health and disease, pain and death; and these reac- tions are reflected in different medical ideas, different ‘healthcare systems’, different value systems, each of which has its own social, economic and cultural ramifications. This appreciation of the variety of healthcare (and knowledge) systems – and indeed of the variety within one system – is no doubt related to the increasing acceptance of ‘alternative’ or ‘comple- mentary’ medicine in the Western world and the corresponding changes in medical practice, doctor–patient relationship and the public perception of the medical profession. And the traditional assumption of a superiority of Western, scientific medicine over non-Western, ‘primitive’, ‘folklore’ or ‘al- ternative’ medicine has virtually reached the state of political incorrectness. This shift in attitude has had rather paradoxical implications for the study of ancient medicine. In short, one could say that attention has widened from texts to contexts, and from ‘intellectual history’ to the history of ‘dis- courses’ – beliefs, attitudes, perceptions, expectations, practices and rituals, their underlying sets of norms and values, and their social and cultural ramifications. At the same time, the need to perceive continuity between 4 For a more extended discussion of this development see the Introduction to Horstmanshoff and Stol (2004). Introduction 5 Greek medicine and our contemporary biomedical paradigm has given way to a more historicising approach that primarily seeks to understand med- ical ideas and practices as products of culture during a particular period in time and place. As a result, there has been a greater appreciation of the diversity of Greek medicine, even within what used to be perceived as ‘Hippocratic medicine’. For example, when it comes to the alleged ‘ratio- nality’ of Greek medicine and its attitude to the supernatural, there has first of all been a greater awareness of the fact that much more went on in Greece under the aegis of ‘healing’ than just the elite intellectualist writing of doctors such as Hippocrates, Diocles and Galen. Thus, as I argue in chapter 1 of this volume, the author of On the Sacred Disease, in his criticism of magic, focuses on a rather narrowly defined group rather than on religious healing as such, and his insistence on what he regards as a truly pious way of approaching the gods suggests that he does not intend to do away with any divine intervention; and the author of the Hippocratic work On Regimen even positively advocates prayer to specific gods in combination with dietetic measures for the prevention of disease. Questions have further been asked about the historical context and representativeness of the Hippocratic Oath and about the extent to which Hippocratic deontology was driven by considerations of status and reputa- tion rather than moral integrity. And the belief in the superiority of Greek medicine, its perceived greater relevance to modern medical science – not to mention its perceived greater efficacy – compared with other traditional healthcare systems such as Chinese or Indian medicine, has come under attack. As a result, at many history of medicine departments in universi- ties in Europe and the United States, it is considered naıve¨ and a relic of old-fashioned Hellenocentrism to start a course in the history of medicine with Hippocrates. This change of attitude could, perhaps with some exaggeration, be described in terms of a move from ‘appropriation’ to ‘alienation’. Greek, in particular Hippocratic medicine, is no longer the reassuring mirror in which we can recognise the principles of our own ideas and experiences of health and sickness and the body: it no longer provides the context with which we can identify ourselves. Nevertheless, this alienation has brought about a very interesting, healthy change in approach to Greek and Roman medicine, a change that has made the subject much more interesting and 5 For an example see the case study into experiences of health and disease by ‘ordinary people’ in second- and third-century ce Lydia and Phrygia by Chaniotis (1995). An almost exclusive focus on medical ideas and theories has given way to a consideration of the relation between medical ‘science’ and its environment – be it social, political, economic, or cultural and religious. Indeed ‘science’ itself is now understood as just one of a variety of human cultural expressions, and the distinction between ‘science’ and ‘pseudo-science’ has been abandoned as historically unfruitful.

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