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In a multivariate model with these determinants and duration of recovery and age and gender, duration of recovery ( = 0. Social functioning at T2 was significantly associated with social functioning at T1 ( = 0. Contrary to the clinical experiences, we did not find an association between duration of depression and functional disability in depressed individuals. In a subsequent analysis, severity of depression and comorbid anxiety were found as the strongest contributors to dysfunctioning in depressed individuals, as was found earlier (Ormel et al, 1993, Spijker et al, 2001). Functioning in daily activities improved with a longer duration of recovery but social functioning did not. This suggests a differential effect of duration of recovery on different domains of functioning. Our findings support the notion of synchrony of change: worse functioning was found in actually depressed individuals and functioning improved after recovery of depression. This was demonstrated earlier in older populations (Prince et al, 1998) indicating bidirectional effects of depression and functioning (Ormel & Von Korff, 2001). Furthermore, residual effects on functioning after recovery could be demonstrated, as was found earlier in the general population (Bijl et al, 2001; Mojtabai, 2001). Our results suggest that functional disability is relatively stable and 107 chronic. Disability increases during a depressive episode and, after symptomatic recovery, returns to an (already impaired) premorbid level. Sickness absence was substantial in both still depressed and recovered individuals. However, no significant associations between duration of depression and sickness absence were found. A possible explanation for this finding is that our estimation of sickness absence of longer duration might be inaccurate as a sick leave exceeding 12 months is usually grounds for medical retirement in the Netherlands. The non-association between duration of depression and dysfunctioning we found may be the result of a methodological shortcoming of the study. A repeated assessment of disability during the depressive episode would probably have given a better impression of changes in functioning. We consider as major strengths of our study that we included individuals with newly originated depressive episodes, which enabled us to assess baseline functioning before the depressive episode. Furthermore, duration of depression and duration of recovery were carefully assessed with a life chart method. There is some evidence that a duration of depression, exceeding the two years, leads to more functional disability (Hays et al, 1995).

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Naegeli Jadassohn Franschetti Ichthyosis-Deafness syndrome, hidrotic ectodermal dys C. Proteus syndrome What additional screening test would capture a finding allelic to any of these conditions Pachyonychia congenita syndrome featuring extensive nevus sebaceus with potential concomitant skeletal, neurologic, and oph 10. Epidermolysis Bullosa: cutaneous features, Birth hogg Dube is associated with clinical epidermiologic, and laboratory advances, and the findings renal cancer, Cowden syndrome with breast and thyroid of the National Epidermolysis Bullosa Registry. Baltimore: Johns malignancy and Muir-Torre with sebaceous and gastro Hopkins University Press; 1999, 206-204. Di Cataldo A, Haupt R, Fabietti P, Schiliro G: Is intensive follow-up Denayer E, Chmara M, Legius E et al. Hum Mutat Andiran N, Sarikayalar F, Saraclar M, Caglar M: Autosomal recessive 2002;20(3):234. Ehlers-Danlos syndromes: revised nosology, lap with localized autosomal recessive hypotrichosis Journal of Villefranche, 1997.

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Plus supportive therapies such as: section note above High fibre diet and eating a healthy diet. Common risk factors which trigger the acute episode are presence of gallstones and alcohol intake. Pharmacological Treatment Principles of management include supportive therapies. Common risk factors which trigger the acute episode are presence of gallstones hyperglycaemia. Treatment Pharmacological Treatment Depends on severity of the disease Principles of management include supportive therapies. Pharmacological Treatment: Refer unstable cases to next level of care with adequate expertise and facility. Diagnostic Criteria Severe sharp pain during and after defecation with/out bright red bleeding. Diagnostic Criteria Fever, anorexia, malaise, jaundice and abdominal pain Enlarged and tender liver Altered consciousness, coma (hepatic encephalopathy), and bleeding stigmata (in fulminant cases). Young and middle aged adults most Fulminant cases may require specific antiviral medications commonly affected. Passage of hard stools is a common predisposition to primary expertise and facility for proper management and disposal. Chronic viral Hepatitis Diagnostic Criteria this is a chronic inflammatory reaction that on going beyond 6months from the acute Severe sharp pain during and after defecation with/out bright red bleeding. Non-Pharmacological Treatment Diagnostic Criteria Ensure high fluid intake Usually asymptomatic Use non stimulant osmotic laxatives Right upper quadrant abdominal pains. This is high blood pressure in the hepatic portal system which includes the portal veins and its branches which drains from most of the intestines to the liver. It is indicated when the hepatic venous pressure gradient exceeds 7mmHg, while liver cirrhosis remains the Standard Treatment GuidelinesStandard Treatment Guidelines 119119 most common cause which in our local setting is commonly caused by chronic viral hepatitis followed by heavy alcohol intake. Cholestasis is a pathologic state of reduced bile formation or flow which can be hepatocellular (Intrahepatic), where an impairment of bile formation occurs or ductular Pharmacological Treatment (extra hepatic), where impedance to bile flow occurs after it is formed. Extrahepatic causes include resolves choledocholithiasis, carcinoma, and ascariasis of the biliary tree. S: Inj sclerotherapy (Histo Acryl Glue Inj 5%; Ethanolamine oleate 5%); given 2mls 5mls per varix up to 20mls per session. Bleeding can sometimes be a sign of something serious, therefore it is important to know the possible causes and take adequate measures.