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Effects of fit and bonding characteristics of femoral stems on adaptive bone remodeling plavix 75 mg discount. The effect of hip stem material modulus on surface strain in human femora. Fluid pressure causes bone resorption in a rabbit model of prosthetic loosening. Schmalzried T P, Kwong L M, Jasty M, Sedlacek R C, Haire T C, O’Connor D O, Bragdon C R, Kabo J M, Malcolm A J, Harris W H. The mechanism of loosening of cemented acetabular components in total hip arthroplasty. Albrektsson T, Branemark˚ P-I, Hansson H-A, Lindstrom¨ J. Re- quirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Introduction to osseointegration, in Tissue Integrated Prosthesis. Branemark˚ P-I, Zarb GA, Albrektsson T, eds: Quintessence: Berlin, 1985: 11–76. Branemark P-I, Hansson B-O, Adell R, Breine U, Lindstrom J, HallenO˚ ¨ ´ ,O¨ hman A. Osseointegrated implants in the treatment of the edentulous jaw. Adell R, Eriksson B, Lekholm U, Branemark P-I, Jemt T. A long-term follow-up study of osseointe-˚ grated implants in the treatment of totally edentulous jaws. Albrektsson T, Dahl E, Enbom L, Engevall S, Engquist B, Eriksson R A, Feldmann G, Freiberg N, Glantz P-I, Kjellman P, KJristersson L, Kvint S, Kondell P-A, Palmquist J,¨ ˚ Werndahl L, Astrand˚ Osseointegration Principles in Orthopedics 237 P. A Swedish multicenter study of 8139 consecutively inserted Nobel- pharma implants. Albrektsson T, Branemark P-I, Jacobsson M, Tjellstrom A.

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E: Liposomal tretinoin for uncomplicated acne Pharm Res 2000 buy plavix 75 mg otc;6:919–931. Lancet 24 Schaller M, Steinle R, Korting HC: Light and pharmacology of topical retinoids. J Am Acad Dermatol 1998; netic model for retinoic acid and its metabo- nereol 1997;77:122–126. J Invest Dermatol 1991;96: of antiproliferative effects of retinoids in Kapo- 6(suppl 1):35–44. Mol Cell Biol 1997;17:4159– 19 Lucky AW, Cullen SI, Jarratt MT, Quigley JW: 26 Franz TJ, Lehmann PA, Franz SF: Topical use 4168. J Invest 10 Nagpal S, Athanikar J, Chandraratna RA: Sep- tretinoin gels: Results from a multicenter dou- Dermatol 1993;100:490A. J Am Acad Dermatol functions of retinoic acid receptor alpha. Topical Treatment in Acne Dermatology 2003;206:29–36 35 27 Latriano L, Tzimas G, Wong F, Wills RJ: The 39 Barua AB, Olson JA: Percutaneous absorption, 50 Eady EA: Bacterial resistence in acne. Derma- percutaneous absorption of topically applied excretion and metabolism of all-trans retinoyl- tology 1998;196:59–66. J Am Acad Der- 40 Fort-Lacoste L, Verscheure Y, Tisne-Versailles thromycin und Benzoylperoxid. J, Navarro R: Comedolytic effect of topical 1982;57:867–878. Der- 52 Bojar RA, Cunliffe WJ, Holland KT: The gland deposition of isotretinoin after topical matology 1999;199(suppl 1):33–35. Br J Dermatol 1995; 29 Vahlquist A, Rollman O, Holland DB, Cunliffe retinaldehyde 0. WJ: Isotretinoin treatment of severe acne af- acne vulgaris. Clin Exp Dermatol 1999;24: 53 Hegemann L, Toso SM, Kitay K, Webster GF: fects the endogenous concentrations of vitamin 354–357.

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Which of the following statements accurately characterizes treatment of these complications of severe dementia? Even though this patient has severe dementia generic plavix 75 mg overnight delivery, it would be unethical to withhold nutrition and hydration ❏ C. A feeding tube will reduce the risk of aspiration pneumonia ❏ D. Prochlorperazine relieves nausea by blocking serotonin at its site of action in the vomiting center of the brain ❏ E. Impaction may explain all the symptoms Key Concept/Objective: To understand the management of nausea and anorexia near the end of life Haloperidol is highly effective against nausea and may be less sedating than many com- monly used agents, such as prochlorperazine. Because of the terminal and irreversible nature of end-stage dementia and the substantial burden that continued life-prolonging care may pose, palliative care focused predominantly on the comfort of the patient is often viewed as preferable to life-prolonging measures by a substantial proportion of nursing home patients and family members. Every physician must make his or her own decision, but it is never unethical to withhold nutrition and hydration if these are not helping the patient. There is no evidence that tube feeding reduces the risk of pneumonia in such patients, and it may even increase it. Dopamine-mediated nausea is probably the most common form of nausea, and it is the form of nausea most frequently targeted for initial symptom management. Bowel impaction could easily explain the gradually worsening anorexia and nausea in a bedrid- den patient. In a palliative care unit, a patient with terminal ovarian cancer became dramatically less responsive sev- eral hours ago. Her breathing pattern has changed, and it appears that she is actively dying. Which of the following statements accurately characterizes appropriate physician management dur- ing the last hours of living? Subcutaneous hydration prevents the discomfort that terminal dehydra- tion causes ❏ B.

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