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This type of memory is also termed Explicit memory, and the two terms (declarative and explicit are often used inter changeably). Declarative (or explicit) memory is divided into Episodic memory and Semantic memory (Squire and Zola 1996). This is the memory for what you did yesterday, where you went on your first date, or your first car. Episodic memory is the active recall of the learning event, while semantic memory recall is retrieval of a fact, and does not require one to recall the autobio graphical event when the material was learned. Semantic memory is unable to determine a particular place and time the information was learned. The unique aspects of this remembered material is the conscious effort involved in the learning 184 J. This is the conscious material that can be recalled which is unique to the experiences of the individual. Declarative memory is the type of memory which we most commonly refer to when discussing memory in a clinical setting. And it is episodic memory which is of particular emphasis in neuropsychological assessments. Nondeclarative (Implicit) Memory Nondeclarative memory refers to memory for skills and procedures which are learned and recalled. Evidence for such a memory system is found by the efficiency and skill gains which accumulate for even complex activities. The origins of the learning process are often lost such as learning to speak or riding a bicycle, but the transfer of learning must occur for such behaviors to be demonstrated and recalled. Nondeclarative memory includes a number of acquired motor skills, but also includes a great number of very complex behaviors such as playing a musical instrument or driving a car. The adaptation of humans to perform repetitive skills with precision and very little conscious processing is astounding. The next section provides an overview of common terms used to describe memory problems followed by a brief review of neuroanatomical correlates of memory. Classically, amnesia describes the loss of memory while other neuropsychological functions remain intact.
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A 55-year-old Asian man from Taiwan presents with clearly overweighs any possible benefit to the patient fever, conjunctival and penile erosions, as well as tender, erythematous, purpuric macules coalescing into patches on the torso. Radiation recall is most consistent with stasis dermatitis and you start treatment with triamcinolone 0. Which of the following represents the mechanism follow-up appointment in 6 weeks, his condition is sig of action of vismodegib in the treatment of locally nificantly worse and you are concerned about allergic advanced basal cell carcinoma Binds and inactivates patched resulting in constitutive activation of Gli and downstream Hedgehog target A. Anti-Fas receptor antibodies block Fas ligand/Fas receptor binding and inhibit apoptosis 3. Which of the following drugs, when given downstream Hedgehog target genes concomitantly, may reduce the risk of methemoglobin E. Suppression of antibody production by IgG binding nevirapine-induced hypersensitivity in Tais. Valacyclovir cause radiation recall in which drug administration is associated with the reappearance of previous sunburn or Answers previously irradiated area becomes infamed. Increased risk of bone marrow suppres is associated with the development of fagellate sion may occur with concomitant use of azathioprine hyperpigmentation. This basal cell carcinoma by binding and inactivating smooth creates an excess of toxic purine analogs and results in ened which inhibits the activation of Gli and downstream increased risk for myelosuppression. Most basal cell carcinomas be given to patients taking allopurinol, the dose must be have abnormal Hedgehog signaling. The patch test screening agent for sus hyperpigmentation of the nails, oral mucosa, and skin. Protease inhibitors are associated with the is used to test for contact allergy to Class A corticoste development of lipodystrophy or abnormal fat deposits. Acyclovir, when 17-butyrate is the agent used to screen for allergy to given intravenously, may cause a reversible obstructive Class D2 corticosteroids, such as hydrocortisone valer neuropathy due to crystal deposition. Cutaneous side effects of epidermal growth factor recep is associated with severe, sometimes fatal, cases of tor inhibitors: clinical presentation, pathogenesis, and manage thrombotic thrombocytopenic purpura/hemolytic ure ment. Dermatologic side effects associated with the epi riasis foundation consensus conference. Efficacy and safety of once-daily topical brimoni Clin Pharmacol 2011;71(5):684-700.
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Segundo, las celulas endometriales refluidas se encuentran viables en la cavidad peritoneal. Tercero, el reflujo de celulas endometriales se encuentra en condiciones para adherirse al (8) peritoneo con la subsecuente invasion, implantacion y proliferacion. De acuerdo con esta teoria, la endometriosis surge como resultado de la metaplasia de la serosa peritoneal. Estos cambios metaplasicos se producen como respuesta a procesos inflamatorios o a influencias hormonales. La embriologia demuestra que el peritoneo pelvico, el epitelio germinal del ovario y los conductos mullerianos son derivados de la pared celomica. Existen evidencias que podrian sugerir este mecanismo de diseminacion via linfatica en sitios distantes como pleura, ombligo, espacio retroperitoneal, extremidades inferiores, vagina y cervix, por la comunicacion linfatica entre estas estructuras. Sampson demostro ademas la presencia de tejido endometrial en venas uterinas en mujeres con adenomiosis. Hobbs y Borthnick lograron inducir endometriosis pulmonar en conejos inyectando tejido endometrial via intravenosa. Esta teoria tambien podria explicar los casos raros de endometriosis osea, muscular, en cerebro, parenquima pulmonar, espacio vertebral y extremidades. Se propone que puede activarse la diferenciacion celular de restos de celulas de origen Mulleriano en celulas endometriales, en presencia de estimulos especificos, pudiendo esto tambien explicar la presencia de endometriosis reportada en hombres. Ninguna de estas teorias por si solas podrian explicar todos los tipos de endometriosis, sin embargo la teoria de la menstruacion retrograda es la mas aceptada a nivel mundial, ademas de que esta apoyada por la distribucion de las (1) lesiones en la cavidad abdominal. Es importante recalcar que la menstruacion retrograda ocurre en el 76% y el 90% de las mujeres y por la baja prevalencia de endometriosis seria improbable que la sola presencia de sangre menstrual o de celulas endometriales puedan contribuir a una respuesta antigenica o al desarrollo de endometriosis. Se ha postulado que las pacientes con endometriosis tienen (2,8) mecanismos inmunologicos alterados contra las celulas ectopicas de endometrio. La proimenorrea es factor de riesgo ya que existe una exposicion mas frecuente a la presencia de menstruacion, asi tambien es el caso de la hipermenorrea ya que mas volumen se relaciona con mayor riesgo de reflujo menstrual. No se reporta evidencia consistente de riesgo de endometriosis con presencia de ciclos menstruales irregulares. En el caso de la multiparidad, la exposicion mas reducida a ciclos menstruales debida al embarazo disminuye el riesgo de presentar endometriosis, comparado con las mujeres con proiomenorea. Por ultimo la asociacion de anticonceptivos orales no guarda relacion ya que estos se usan como parte del manejo de endometriosis. Por otro lado la raza blanca parece ser un factor que disminuye el riesgo de endometriosis. No se sabe con certeza el mecanismo por el cual se disminuye el riesgo de endometriosis en mujeres con consumo de alcohol y cafeina. El ejercicio fisico regular ocasiona disminucion de estrogenos asociandose a una reduccion en el riesgo de endometriosis. La exposicion a dioxina se ha visto relacionada con alteraciones en el sistema inmunologico en diversos experimentos con primates favoreciendo esto la presencia de endometriosis.
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