By J. Uruk. Willamette University.

This causes swelling of the hair shaft allowing easier penetration of the dye purchase 100mg cefpodoxime visa, known as a toner (57) order cefpodoxime 200 mg without prescription. The toner must be used since hair completely stripped of color has an undesirable grayish appearance order cefpodoxime 200mg mastercard. Specically, permanent hair curling is used to make straight hair wavy, curly, or kinky. The chemistry of the permanent wav- ing process is based on the 16% cystine incorporated into disulde linkages between polypeptide chains in the hair keratin lament. These disulde linkages are responsible for hair elasticity and can be reformed to change the conguration of the hair shaft. Permanent waving utilizes three processes: chemical softening, rearranging, and xing of the disulde bonds (58). The basic chem- istry involves the reduction of the disulde hair shaft bonds with mercaptans (59,60). The standard permanent waving procedure involves initial shampooing of the hair to remove dirt and sebum. This wetting process with water is the rst step in preparing the hair for chemical treatment, since the water enters the hair s hydrogen bonds and allows increased exibility. The hair is then sectioned into 30 to 50 areas, depending on the length and thickness of the hair, and wound on mandrels or rods with holes to allow the permanent waving solution to contact all surfaces of the hair shaft. The size of the rod determines the diameter of the curl with smaller rods producing tighter curls and larger rods producing looser curls. The hair must be wound on the curling rod with sufcient tension to provide the stress required for bond breaking. After the hair has been completely wrapped on the curling rods, the waving lotion and the activator are mixed (Table 6). The activated waving lotion is applied and left in contact with the hair for 5 to 20 minutes, depending on the condition of the hair. Once the hair has been thoroughly saturated with the waving lotion, the hair is placed under a plastic shower cap. The cap traps the heat of the body, which is used to increase the activity of the permanent wave solution. The cap also traps the smell of sulfur, which is produced as sulfur escapes from the hair when the disulde bonds are broken. Once the desired amount of curl has been achieved, the hair disulde bonds are reformed with the hair in the new curled conformation around the curling rods. The neutralizer functions to reform the bro- ken disulde bonds and restores the hair to its original condition (61). Curl relaxation occurs with time as the hair returns to its original conformation. There are several types of permanent waves depending on the chemistry of the solution employed. The differences between the various types of permanent waves are due to the unique attributes of the waving lotions (Table 8) (62 64). The pH of the waving lotion is adjusted to 9 10 since the thioglycolates are not effective at an acidic pH. Alkaline permanent waves produce tight, long-lasting curls very rapidly, but can be damaging to the hair shafts. This has led to the development of buffered alkaline permanent waves, which utilize ammonium bicarbonate as a buffering agent to reduce the pH to 7 8. Another variation on the permanent wave, known as an exothermic permanent, is designed to increase patient comfort by reducing the chill from the cold waving solution. The heat is produced as a by-product of the chemical reaction when the oxidizing agent, such as hydrogen peroxide, is mixed with the thioglycolate-based waving lotion immedi- ately prior to scalp application. Permanent waves are also available in a self-regulated form, designed to reach a chemical equilibrium such that the disulde bond breakage is stopped at a predetermined time. This is accomplished by adding dithioglycolic acid to the thiogly- colate-based waving lotion. The advantage is that the hair does not need to be immediately neutralized allowing the beauty operator more leeway in getting the permanent wave solu- tion out of the scalp. There are two other types of permanent waves, known as acid permanent waves and sulte permanent waves. Sulte permanent waves are mainly marketed for home use and have not found popularity among salons in the United States. These products differ in that the reducing agent is a sulte or bisulte, instead of a mercaptan. Versatility in straightening techniques allows multiple styling options: completely straightened, minimally straightened, texturized, or straightened and recurled. Chemical relaxing can be accomplished with lye-based, lye-free, ammonium thioglycolate, or bisulte creams (67).

However several of the isolates used in this study were isolated from the soil and it is not possible to draw any conclusion discount 100 mg cefpodoxime with visa. In addition cefpodoxime 100mg lowest price, the skin temperature on cattle uctuates during the day (Polar et al buy cefpodoxime 200 mg visa. Fortunately, these authors demonstrated that isolates which are more thermotolerant are more likely to exhibit high level of pathogenicity under conditions reecting the thermal characteristics of the cattle coat. Thus the next step should consist of an in vivo bioassay to verify that the isolates able to grow in vitro at temperatures ranging from 30 to 35 C are able to germinate, infect the mites and sporulate on the body surface of cattle in presence of diurnal temperature uctuations. A saprophytic microora can in fact be present on the tegument of the arthropods or on the hair of the host and stimulate or suppress the germination of the conidia in vivo (Schabel 1978; Fargues 1981; Polar et al. High relative humidity is generally con- sidered to be necessary for conidial germination but contradictory data can be found concerning this parameter (Lord 2005). In the case of cattle psoroptic mange, the relative humidity at the skin surface is high. Furthermore, it is likely that the conidia formulation would play a crucial role in the infection process by maintaining a high humidity level 102 J. In the case the conidia would still be present when the cows are turned out, the solar radi- ations could inactivate them which could prelude the dissemination of the fungus to non- target organisms. From the present study, two isolates could be considered as potential control agents for psoroptic mange: M. Because of the availability of mass production procedures for the former (no commercial biopesticide based on the use of P. Acknowledgements This study was supported by the convention S-6145 from the Ministere` de la Sante, Belgium. Ann N Y Acad Sci 916:172 178 Samish M, Gindin G, Alekseev E, Glazer I (2001) Pathogenicity of entomopathogenic fungi to different developmental stages of Rhipicephalus sanguineus (Acari: Ixodidae). Meikle Guy Mercadier Niels Holst Vincent Girod Originally published in the journal Experimental and Applied Acarology, Volume 46, Nos 1 4, 105 117. Objectives were to evaluate treatment effect on colony weight, adult bee mass, capped brood, and on Varroa fall onto sticky boards. Treatments included conidia for- mulated with either carnauba or candelilla wax powder, candelilla wax powder alone, or control; in two treatment groups formulation was applied a second time after one week. Colonies treated twice with Bb05002 conidia and carnauba wax powder had signicantly higher mite fall compared to colonies treated with blank candelilla wax powder. The proportion of fallen mites that were infected in both conidia treatments was higher than controls for 18 days after the second treatment. The number of fungal propagules on the bees themselves remained elevated for about 14 days after the second treatment. These results were compared to published results from previous experiments with regard to infection duration. Keywords Apis mellifera Varroa destructor Beauveria bassiana Biopesticide Formulation W. Varroa infestations have been largely responsible for the almost complete elimination of feral colonies in the U. The use of entomopathogenic fungi has been considered a promising alter- native to chemical miticides (Chandler et al. Collecting fungal isolates from either the target environment and/or even the target pests themselves is intended to increase the probability of nding the best adapted isolates. The high temperatures and humidities of beehives, among other factors, can present similar challenges to entomo- pathogenic fungi. Beauveria bassiana is known to have a broad host range (Tanada and Kaya 1993) and Meikle et al. Formulation with carnauba wax has been tested in previous studies and no negative effects have been observed with respect to honeybee colony health (Meikle et al. Treating hives with a powder, such as powdered sugar or pollen, is known to provoke mite fall (Fakhimzadeh 2001; Macedo et al. Diseases of Mites and Ticks 107 The main objective in this study was to evaluate the impact of two successive appli- cations of conidia of entomopathogenic fungi on colony health and on Varroa mite fall. Two kinds of wax powder were also compared as formulation ingredients: car- nauba wax, as used in previous experiments, and candelilla wax, which is obtained from Euphorbia antisyphilitica and Pedilanthus pavonis and is also safe as a human food ingredient (U. Here we measured colony growth rates per week, total adult bee weight and the amounts of sealed brood and honey. The use of growth rates, which are independent of colony size, was intended to facilitate comparison of these results with other studies. Varroa mite fall and the proportion infected mites were measured as in Meikle et al. Conidia were har- vested by scraping the surface of the cultures onto glass petri dishes with a metal spatula, and placing the petri dishes in a crystallizing dish containing silica gel for 20 24 h at room temperature for drying.

Cardiac examination is significant for normal S1 and single S2 with an ejection systolic-early diastolic mur- mur over the left upper sternal border with no clicks or gallop buy cheap cefpodoxime 100mg line. Abdominal examina- tion reveals an enlarged liver down to 3 cm below right costal margin purchase cefpodoxime 200mg fast delivery. Investigative studies: A complete blood count is performed with a white blood cell count of 17 cefpodoxime 200 mg on line,400 with 85% segmented neutrophils, Hgb of 11. Differential diagnosis: This case presents a patient with recent valve replacement who subsequently develops a febrile illness with physical examination findings sug- gestive of pulmonary stenosis and insufficiency with evidence of new congestive heart failure. Myocarditis or pericarditis as a cause for fever and new onset congestive heart failure must also be considered. Final diagnosis: Transthoracic echocardiogram shows the presence of a large veg- etation 1 cm in diameter attached to the pulmonary valve with moderate degree of pulmonary stenosis and insufficiency. Two sets of blood cultures are sent and the patient is started on empiric antibiotic therapy with oxacillin and gentamicin. Assessment: This case illustrates the late presentation of prosthetic valve endo- carditis caused by S. These patients frequently require prolonged antibiotic therapy and often surgical intervention for debridement and replacement of the prosthetic valve. These postoperative infections are thought to be caused by organ- isms inoculated at time of surgery. The presentation is usually in the first 2 3 months after surgery, but can occur several months after. She devel- ops evidence of pulmonary embolism which requires surgical therapy with replace- ment of the pulmonary valve. Echocardiography cannot differentiate acute myocarditis from dilated cardiomyopathy. Definition Myocarditis is characterized by an inflammatory infiltrate of the myocardium with necrosis/degeneration of the myocytes. It is estimated that 50 80% of pediatric patients with acute presentation of dilated cardiomyopathy have myocarditis as the underlying cause. Coxsackievirus type B and parvovirus B19 are common viral agents implicated in myocarditis. In South America, Chagas disease caused by Trypanosoma cruzi is the commonest cause. Toxicity to medications such as antimicrobials and chemotherapeutic medications such as anthracyclines has been implicated in the cause of myocarditis. Hypersensitivity reactions to certain medications represent a particular type of cardiomyopathy. Pathology The gold standard for diagnosing myocarditis has been the pathological findings on endomyocardial biopsy. The cellular infiltrate is usually lymphocytic, but can also include eosinophils and plasma cells. There is usually variable and patchy myocyte degeneration and necrosis, which sometimes makes biopsy diagnosis difficult. Recently, immunohistochemical staining of biopsies has allowed the identifica- tion of viral genomes in the affected cardiac tissues. Other more advanced staining has allowed for the characterization of different immune mediated reactions of the involved myocytes to the causative agents. In all stages, direct damage to myocytes and inflammatory reaction leads to loss of myocytes and fibrous tissue formation, thus diminishing the contractility of the myocardium. The onset is usually heralded by a viral prodrome consisting of fever, upper respiratory and gastrointestinal symptoms, thought to coincide with the viremic stage of the disease. Older children and adolescents are more likely to have chest pain, easy fatigue and general malaise, exercise intolerance and abdominal pain, or even arrhythmias and syncope. On physical examination, infants might have pallor and appear dusky in addition to the findings of congestive heart failure signs. Respiratory distress is the next most common finding, fol- lowed by hepatomegaly and abnormal heart sounds or a heart murmur of mitral regurgitation. Jugular venous distension is more likely in older children, as this is an unreliable sign in the younger age group. Chest X-Ray Chest X-ray may show the presence of cardiomegaly and increased pulmo- nary vascular markings or frank pulmonary edema in almost half of patients (Fig. Arrhythmias such as ventricular or supraventricular tachycardia or atrio- ventricular block can also be seen. Echocardiography The typical findings include the presence of a dilated left ventricle with decreased systolic function in most patients (Chap. Echocardiography may also reveal the presence of mitral valve regurgitation and pericardial effusion. Pulmonary vasculature is prominent due to congested pulmonary venous circulation secon- dary to poor ventricular function due to myocarditis Laboratory Investigations The gold standard for the diagnosis of myocarditis historically has been endomyo- cardial biopsy. However, this is not routinely done due to the low sensitivity of the procedure (3 63%) and the often patchy involvement of the myocardium. Elevation of the cardiac enzymes especially involving cardiac troponins is posi- tive in about 1/3 of patients.

The neurons of the the shortest and borders the anterior chamber sensory retina differentiate from the inner layer angle; it gives origin to the iris generic 100 mg cefpodoxime free shipping. Optic Nerve The optic nerve meets the posterior part of the Blood Supply globe slightly nasal to the posterior pole and slightly above the horizontal meridian buy cheap cefpodoxime 100 mg on-line. Inside The blood supply of the globe is derived from the eye this point is seen as the optic disc quality 100mg cefpodoxime. There three sources: the central retinal artery, the are no light-sensitive cells on the optic disc anterior ciliary arteries and the posterior ciliary and hence the blind spot that anyone can nd in arteries. The optic nerve contains mic artery, which is a branch of the internal about one million nerve bres, each of which carotid. Nerve bres sweep its branches spread out over the inner surface of across the innermost part of the retina to reach the retina supplying its inner half. The anterior ciliary arteries emerge from the insertion of the recti muscles and perforate the globe near the Optic disc Macula iris root to join an arterial circle in the ciliary body. The posterior ciliary arteries are the ne branches of the ophthalmic artery, which pene- trate the posterior pole of the eye. Some of these supply the choroid and two or more larger vessels run anteriorly to reach the arterial circle in the ciliary body. The larger vessels are known as the long posterior ciliary arteries, and those supplying the choroid are known as the short posterior ciliary arteries. The branches of the central retinal artery are accompanied by an equivalent vein, but the choroid, ciliary body and iris are drained by approximately four vortex veins. The retina: Apart from the optic nerve,the posterior pole of the globe is also perforated by several long and rods and cones short ciliary nerves. These contain parasympa- bipolar cells thetic, sympathetic and sensory bres, which ganglion cells. Axons of the ganglion cells visual and sphincter) and ciliary body (ciliary muscles). Subcortical centres and relays: superior colliculus reex control of eye movements pretectal nuclei pupillary reexes lateral geniculate body cortical relay. Cortical connections: optic radiations visual cortex (area 17) vision and reex eye movements association areas (areas 18 and 19) frontal eye eld voluntary eye movements. By the same token, the retinal ganglion cells can be compared to the second-order sensory neurons, whose cell bodies lie within the spinal cord or medulla. The background is darker in the African owing to sebaceous glands) open behind the grey line. The The meibomian glands are long and slender, nerve fibre layer is noticeable,especially along the superior and and run parallel to each other, perpendicular to inferior temporal arcades. The Extraocular Muscles There are six extraocular muscles that help to move the eyeball in different directions: the superior, inferior, medial and lateral recti, and the superior and inferior obliques. All these muscles are supplied by the third cranial nerve except the lateral rectus (supplied by the sixth nerve) and superior oblique (fourth nerve). All the extraocular muscles except the Levator inferior oblique originate from a brous ring expansion around the optic nerve (annulus of Zinn) at the orbital apex. All the recti oculi muscles attach to the eyeball anterior to the equator while the oblique muscles attach behind the equator. The tarsal plate gives stiff- that surrounds the eye and is continuous with ness to the eyelids and helps maintain its the fascial covering of the muscles. The lower tarsus measures about 5mm in height, while the upper tarsus measures about 10 12mm. The orbicularis oculi muscle lies between the skin and the tarsus and serves to close the Levator palpebrae superioris eyelids. Superior rectus The Lacrimal Apparatus Optic nerve Medial Inferior rectus rectus The major lacrimal gland occupies the superior temporal anterior portion of the orbit. It has ducts that open into the palpebral conjunctiva above the upper border of the upper tarsus. Tears collect at the medial part of the palp- ebral ssure and pass through the puncta and the canaliculi into the lacrimal sac, which term- inates in the nasolacrimal duct inferiorly. Basic Anatomy and Physiology of the Eye 13 Physiology of the Eye The Cornea The primary function of the cornea is refrac- The primary function of the eye is to form a clear tion. These cornea requires the following: images are transmitted to the brain through the optic nerve and the posterior visual pathways. The Eyelids Corneal transparency is contributed to by Functions include: (1) protection of the eye anatomical and physiological factors: from mechanical trauma, extremes of temp- 1. Anatomical: erature and bright light, and (2) maintenance absence of keratinisation of epithelium of the normal precorneal tear lm, which is important for maintenance of corneal health tight packing of epithelial cells and clarity. Regularity produces a diffraction grating The Tear Film paucity of corneal stromal cells, which The tear lm consists of three layers: the are attened within lamellae mucoid, aqueous and oily layers. It improves the wetting properties of active dehydration of the cornea the tears.