Treatment options include certain medications to treat diarrhea or constipation anxiety symptoms full list 25 mg phenergan otc, stress management anxiety symptoms eye twitching order cheapest phenergan, regular physical activity anxiety symptoms in 11 year old boy buy 25 mg phenergan free shipping, eating smaller meals anxiety symptoms gagging generic phenergan 25mg with visa, avoiding foods that exacerbate symptoms, eating a higher-fiber diet, and drinking at least six to eight glasses of water each day. RecaP Diarrhea is the frequent passage of loose or watery stools, whereas constipation is failure to have a bowel movement for two or more days or within a time period that is normal for the individual. In this chapter, you learned the differences between appetite and hunger, as well as the influence of learning on food choices. So now you might be curious to investigate your own reasons for eating what and when you do. Are you eating in response to internal sensations telling you that your body needs food, or in response to your emotions, situation, or a prescribed diet? Keeping a "cues" log for 1 full week would give you the most accurate picture of your eating habits, but even logging 2 days of meals and snacks should increase your cue awareness. Each day, every time you eat a meal, snack, or beverage other than water, make a quick note of: When you eat. At home at the dining room table, watching television, driving in the car, and so on. Some people eat excessively when they are anxious, depressed, bored, or frustrated. Are you eating because you walked past the kitchen and spied that batch of homemade cookies, or smelled coffee roasting? Are you choosing a particular food because it is allowed on your current diet plan? Or are you hungry, but drinking a diet soda to stay within a certain allowance of calories? Are you restricting yourself continued 104 Chapter Review because you feel guilty about having eaten too much at another time? For example, maybe you notice that you often eat when you are not actu- ally hungry but are worried about homework or personal relationships. This self-awareness may prompt you to take positive steps to change those patterns. For instance, instead of stifling your worries with food, sit down with a pen and paper and write down exactly what you are worried about, including steps you can take to address your concerns. And the next time you approach the snack bar, before going in, check with your gut: are you truly hungry? If so, then purchase a healthful snack, maybe a yogurt, a piece of fruit, or a bag of peanuts. Chapter Review Test Yourself Answers 1 2 3 T Sometimes you may have an appetite even though you are not hungry. These feelings are referred to as "cravings" and are associated with physical or emotional cues. Your brain, not your stomach, is the primary organ responsible for telling you when you are hungry. Even extreme food restriction, such as near-starvation, does not cause the stomach to permanently shrink. The folds in the wall of the stomach flatten as it expands to accommodate a large meal, but they reform over the next few hours as the food empties into the small intestine. Only after gastric surgery, when a very small stomach "pouch" remains, can stomach tissue stretch permanently. Although there are individual variations in how we respond to food, the entire process of digestion and absorption of one meal usually takes about 24 hours. Appetite is a psychological desire to consume specific foods; this desire is influenced by sensory data, social and cultural cues, and learning. In response to signals from the gastrointestinal tract and from hormones, the hypothalamus causes us to feel hungry or satiated. Foods that contain fiber, water, and large amounts of protein have the highest satiety value. Digestion is the process of breaking down foods into molecules small enough to be transported into enterocytes, absorption is the process of taking molecules of food out of the gastrointestinal tract and into the circulation, and elimination is the process of removing undigested food and waste products from the body.
In Vitro Biological Methods Many drugs will not perform only according to physicochemical rules anxiety tattoos effective phenergan 25 mg, and their absorption cannot be predicted properly using biophysical methods anxiety symptoms for hiv generic phenergan 25mg with visa. These are the drugs that are susceptible to any of the carrier-mediated processes (both in absorptive and secretory directions) or the molecules that are degraded during transport anxiety 5 months postpartum 25mg phenergan amex. The transport processes used by these drugs must be studied by biological methods anxiety jacket for dogs order 25mg phenergan amex, and information is also needed regarding cofactors and scaling factors to predict the fraction absorbed in humans. Biological methods are therefore used when the mechanisms of absorption (paracellular, transcellular, or carrier mediated) and the enzymatic degradation or regional difference in permeability are to be evaluated. A short description of the best-known biological in vitro methods follows, and more detailed information on each of the methods can be found in, for 150 Ungell and Abrahamsson example, Ungell (1997), Stewart et al. Methods Describing Drug Uptake Membrane Vesicles and Intestinal Rings As a group of methods, membrane vesicles and intestinal rings are technically quick and easy to use, even for persons not very skilled in using biological material. These two methods are mainly used for evaluation of mechanisms of absorption and are not so frequently used in the industry to delineate drug absorption in general. The method can frequently be used for isolated studies of the brushborder membrane transport characteristics without any basolateral membrane influence. It has been used for studies concerning the intestinal peptide carrier system (Yuasa et al. Membrane vesicles have been isolated from numerous animals, including human (Hillgren et al. After correction for unspecific binding to the tissue, the permeability values were found to show a good correlation to the in vivo human fraction absorbed. Generally, membrane vesicles used today are vesicles obtained from cells transfected with a certain transporter protein. Vesicles represent a method of lipid membrane extraction and can be used in drug absorption studies for evaluation of a biological log D value (see the above section on nonbiological methods). This was actually first used for measurements of the lipid composition (Hillgren et al. The major disadvantage of the method is that these processes represent only a fraction of the complete absorption process into the cell. There may be a day-to-day variation in vesicle preparation and a leakage of drugs from the vesicles during washing and filtration, which can affect the drug concentration (Osiecka et al. However, despite these drawbacks, it can be used for mechanistic studies of the drug absorption process, although there are only data on a direct correlation to human in vivo absorption values. This method for studying drug absorption has been used extensively in the early 90s for kinetic analysis of carriermediated transport of glucose, amino acids, and peptides (Kararli, 1989; Osiecka et al. The method is easy to use; the intestine of the animal is cut into rings or slices of approximately 30 to 50 mg (2 to 5 mm in width), which are put into an incubation medium for a short period of time (often up to one minute) with agitation and oxygenation. Samples of the incubation medium and rings are analyzed for drug content after the incubation. The intestine is sometimes everted on a glass rod before cutting, and different regions of the intestinal tract can be used. Diffusion into the tissue slices takes place on the side of the tissue (not only through the lipid membrane), as the connective tissue and Biopharmaceutical Support in Candidate Drug Selection 151 muscle layers are exposed to the incubation solution. Correction is not always made for the adsorption of a drug on the surface of the tissue, and the slices do not maintain their integrity for more than 20 to 30 minutes (Osiecka et al. Nevertheless, good mechanistic correlation to in vivo measurements has been achieved with the method in kinetic studies of carriermediated mechanisms of peptides (Kim et al. The method was evaluated for the prediction of in vivo absorption potential (Leppert and Fix, 1994), and it was shown that, under appropriate conditions, uptake into everted intestinal rings closely paralleled known in vivo bioavailability. The method has also recently been experimentally improved for better hydrodynamics and a requirement for lower volumes during the incubation period (Uch and Dressman, 1997; Uch et al. When fully differentiated, the cells express the transport characteristics of mature cells. The Caco-2 cell monolayer shows an epithelium membrane barrier function similar to the colon of human (Artursson et al.
The muscularis of the urinary bladder is moderately thick and consists of inner longitudinal anxiety young adults cheap phenergan 25 mg online, middle circular anxiety symptoms of purchase cheap phenergan, and outer longitudinal layers of smooth muscle anxiety symptoms light sensitivity quality 25 mg phenergan. Around the internal urethral orifice anxiety techniques phenergan 25mg visa, the muscle increases in thickness to form the internal sphincter of the urethra. A coat of fibroelastic connective tissue, the adventitia, surrounds the muscularis and attaches the extrarenal passages to surrounding structures. On the superior surface of the bladder the fibroelastic coat is covered by peritoneum. Blood vessels pierce the muscularis, provide it with capillaries, and then form a plexus of small vessels in the lamina propria. Nerve fibers and small ganglia also occur in the adventitia and represent the sympathetic and parasympathetic divisions of the autonomic nervous system. The membranous urethra pierces the skeletal muscle of the urogenital diaphragm immediately before it enters the penis. Skeletal muscle surrounding this part of the urethra forms the external sphincter (sphincter urethrae) of the urethra and is under voluntary control during micturition. The third and longest segment, about 15 cm, is the penile urethra (pars cavernosa), which runs longitudinally through the corpus cavernosa urethrae to end at the tip of the glans penis. The membranous and penile parts of the urethra are lined by stratified or pseudostratified columnar epithelium. Stratified squamous epithelium often occurs in patches of the penile portion and also lines a distal enlargement, the fossa navicularis. The epithelium lining these glands is the same as that found in the intraepithelial nests of clear, mucus-secreting cells within the urethral epithelium. The lamina propria beneath the urethral epithelium is a highly vascular, loose connective tissue rich in elastic fibers. The mucosa is bounded by inner longitudinal and outer circular layers of smooth muscle. Female Urethra the female urethra is shorter than the male (3 to 5 cm long) and is lined by stratified squamous epithelium, although patches of stratified or pseudostratified columnar may be found. As in the male, the lamina propria is a vascular, fibroelastic connective tissue that contains numerous venous sinuses. The surrounding muscularis consists of an inner longitudinal layer of smooth muscle bundles and an outer circular layer. The female urethra is surrounded by skeletal muscle of the urogenital diaphragm that forms the external urethral sphincter near its orifice. The first segment is 3 to 4 cm long and lies within the prostate, an accessory sex gland. This part forms the prostatic urethra (pars prostatica) and is lined by transitional epithelium similar to that of the Organogenesis the urinary and reproductive systems arise in common from mesoderm of the urogenital ridge. A nonfunctional pronephros, a mesonephros functional in the fetus, and a metanephros (the definitive kidney) 218 arise successively each caudal to the last with some overlapping. A functional pronephros occurs only in chordates such as Amphioxus and myxinoid fishes. Except for lacking loops of Henle, pronephric and mesonephric nephrons resemble those of the metanephros. Although the nephron and collecting tubules form continuous structures in the definitive kidney, each has a separate origin, unlike other exocrine glands in which secretory and ductal units arise from the same primordium. Mesonephroi are drained by mesonephric ducts that regress in the female but in the male are incorporated into the reproductive tract. By a series of subdivisions, an outgrowth of the mesonephric duct, the uteric bud, gives rise to ureters, renal pelvis, major and minor calyces, papillary ducts, and collecting tubules. The ureteric bud extends into the metanephric blastema, a mass of mesoderm that gives rise to nephrons. The looser, more external layer of mesoderm forms the interstitial tissue and capsule of the kidney.
A type of "vegetarian" diet receiving significant media attention recently is the flexitarian diet: Flexitarians are considered semivegetarians who eat mostly plant foods anxiety oils order line phenergan, eggs anxiety symptoms cures order 25 mg phenergan fast delivery, and dairy but occasionally eat red meat anxiety symptoms for months safe 25mg phenergan, poultry anxiety funny purchase phenergan cheap online, and/or fish. At the extreme, only brown rice and small amounts of water or herbal tea are consumed. Only raw or dried fruit, seeds, nuts, honey, and vegetable oil Comments Typically exclude or limit red meat; may also avoid other meats Pesco means fish, the only animal source of protein in this diet Excludes animal flesh and seafood Relies on milk and cheese for animal sources of protein Excludes dairy, flesh, and seafood products May not provide adequate vitamin B12, zinc, iron, or calcium Taken to the extreme, can cause malnutrition and death Fruitarian Very restrictive diet; deficient in protein, calcium, zinc, iron, vitamin B12, riboflavin, and other nutrients the more restrictive the diet, the more challenging it becomes to achieve an adequate protein intake. When discussing vegetarianism, one of the most often-asked questions is why people would make this food choice. Religious, Ethical, and Food-Safety Reasons Some make the choice for religious or spiritual reasons. Several religions prohibit or restrict the consumption of animal flesh; however, generalizations can be misleading. For example, whereas certain sects within Hinduism forbid the consumption of meat, perusing the menu at any Indian restaurant will reveal that many other Hindus regularly consume small quantities of meat, poultry, and fish. Many Buddhists are vegetarians, as are some Christians, including Seventh Day Adventists. These people feel that it is morally and ethically wrong to consume animals and any products from animals (such as dairy or egg products) because they view the practices in the modern animal industries as inhumane. They may consume milk and eggs but choose to purchase them only from family farms where they feel animals are treated humanely. There is also a great deal of concern about meat-handling practices, because contaminated meat has occasionally made its way into our food supply. For example, in 1982, there was an outbreak of severe bloody diarrhea that was eventually traced to contaminated meat in hamburgers served at a fast-food restaurant. One recent concern surrounding beef that has taken Europe by storm is the epidemic of mad cow disease. See the accompanying Highlight box for a review of mad cow disease and its impact on the United States and other countries. Ecological Benefits Many people choose vegetarianism because of their concerns about the effect of meat industries on the global environment. Due to the high demand for meat in developed nations, meat production has evolved from small family farming operations into the larger system of agribusiness. Critics point to the environmental costs of agribusiness, including massive uses of water and grain to feed animals, methane gases and other wastes produced mad cow disease A fatal brain disorder caused by an abnormal form of protein that causes brain damage. Prions influence other proteins to take on their abnormal shape, and these abnormal proteins cause brain damage. Eventually, the brain can no longer control vital life functions, and the cow literally "goes mad. They think that cattle become infected by eating feed made with the brains and spinal cords of infected cattle. Using neural tissue in animal feed used to be a common practice in many countries. When cattle are slaughtered at an older age, this increases the risk of passing the disease from one animal to another. In the late 20th century, the effect of mad cow disease on the European beef market was staggering, with beef consumption dropping 25% to 70% in certain countries; Great Britain, France, and Germany were particularly affected. Millions of cattle, including many that were only potentially infected, had to be slaughtered. To date, no person eating Canadian beef has developed symptoms suggestive of infection. However, the occurrence of this disease in Canadian cattle has prompted the United States to temporarily ban the import of Canadian beef. In December 2003, the first case of mad cow disease was reported in the United States, shocking those who believed the food supply to be safe from this disease. This discovery prompted many countries to immediately ban importation of American beef.
