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Patients with opioid use disorder survive longer and reach higher ages due to harm reduction and maintenance programs. Therefor and because of concomitant comorbidities there is an increased incidence of life-limiting diseases. Thus, increasing numbers of patients with opioid use disorder or in maintenance programs will require palliative care. However, both inpatient and outpatient service providers are uncertain about providing palliative care for these patients. Home-care teams and inpatient hospices have been known to refuse admission for patients with opioid use disorder. Providing medical care to patients receiving substitution therapy can be challenging because maintenance programs require strict compliance with their rules and regulations; however, an individualized approach with knowledge of basic legal requirements enables good palliative care. In this manner, it is possible to ensure healthcare for these aging patients.

Patients with opioid use disorder survive longer and reach higher ages due to harm reduction and maintenance programs. Therefor and because of concomitant comorbidities there is an increased incidence of life-limiting diseases. Thus, increasing numbers of patients with opioid use disorder or in maintenance programs will require palliative care. However, both inpatient and outpatient service providers are uncertain about providing palliative care for these patients. Home-care teams and inpatient hospices have been known to refuse admission for patients with opioid use disorder. Providing medical care to patients receiving substitution therapy can be challenging because maintenance programs require strict compliance with their rules and regulations; however, an individualized approach with knowledge of basic legal requirements enables good palliative care. In this manner, it is possible to ensure healthcare for these aging patients.

Upon peripheral immunization with myelin epitopes, susceptible rats and mice develop T cell-mediated demyelination similar to that observed in the human autoimmune disease multiple sclerosis (MS). In the same animals, brain injury does not induce autoimmune encephalomyelitis despite massive release of myelin antigens and early expansion of myelin specific T cells in local lymph nodes, indicating that the self-specific T cell clones are kept under control. Using entorhinal cortex lesion (ECL) to induce axonal degeneration in the hippocampus, we identified possible mechanisms of immune tolerance after brain trauma. Following ECL, astrocytes upregulate the death ligand CD95L, allowing apoptotic elimination of infiltrating activated T cells. Myelin-phagocytosing microglia express MHC-II and the costimulatory molecule CD86, but lack CD80, which is found only on activated antigen presenting cells (APCs). Restimulation of invading T cells by such immature APCs (e.g. CD80 negative microglia) may lead to T cell anergy and/or differentiation of regulatory/Th3-like cells due to insufficient costimulation and presence of high levels of TGF-β and IL-10 in the CNS. Thus, T cell -apoptosis, -anergy, and -suppression apparently maintain immune tolerance after initial expansion of myelin-specific T lymphocytes following brain injury. This view is supported by a previous metastatistical analysis which rejected the hypothesis that brain trauma is causative of MS (Goddin et al., 1999). However, concomitant trauma-independent proinflammatory signals, e.g., those evoked by clinically quiescent infections, may trigger maturation of APCs, thus shifting a delicate balance from immune tolerance and protective immune responses to destructive autoimmunity.

The authors discuss issues to be considered in developing planning strategies for the 1991 census of Canada. Aspects considered include funding, respondents' willingness to cooperate, public distrust, quality maintenance, international cooperation, census content, and dissemination and research plans.

Orthophosphorsaure-hemihydrat, 2H3PO4 · H2O, kristallisiert monoklin in der Raumgruppe P 21/c mit vier Formeleinheiten in der Elementarzelle (a = 7,387, b = 12,915, c = 7,850 A; β = 109,8°). Die Kristallstruktur wurde mit dreidimensionalen photographischen Rontgen-Intensitatendaten bestimmt. Der abschliesende R-Faktor fur 832 beobachtete unabhangige Reflexe betragt 8,4%. Die Wasserstoffatome konnten nicht voraussetzungsfrei lokalisiert werden. Die Entscheidung zwischen einem Oxoniumsalz, H3PO+H2PO · H3PO4, und einem echten Saurehydrat, 2H3PO4 · H2, kann dennoch getroffen werden, und zwar auf Grund der beobachteten Abstufung der PO-Bindungslangen und OPO-Bindungswinkel, die fur die zweite Moglichkeit spricht. Orthophosphoric acid hemihydrate, 2H3PO4 · H2O, forms monoclinic crystals with space group P21/c and four formula units in the unit cell (a = 7,387, b = 12.915, c = 7,850 A; β = 109.8°). the crystal structure has been determined using three-dimensional photographic X-ray intensity data. The final R-factor for 832 observed independent reflections is 8.4%. The hydrogen atoms could not be located independently. Nevertheless it is possible to decide between an oxonium salt, H3O+H2PO · H3PO4, and a true acid hydrate, 2H3PO4 · H2O, from the observed pattern of PO bond lenghts and OPO bond angles, which favours the second possibility.

This article discusses the revival of interest in research on cyclical behavior in the socialist countries, and the resulting shifting requirements placed upon the national income accounts. The first section discusses the economic experience and the institutional factors leading to this shift in emphasis. The second section deals with the use of national accounts in cyclical analysis, with particular reference to the Czechoslovak experience. The third section extends the discussion to the use of national accounts data for economic forecasting. The final section discusses the theory of economic fluctuations under socialism, and compares it with cyclical behavior in capitalist economies.

1. Bei der Anwendung verschiedener Farbungsmethoden mit Sudan (ubliche Losung von Sudan III, gekochte Sudanlosung und Sudan-α-Naphthol) beziehen sich die Unterschiede bei der Darstellung der Lipoide nicht lediglich auf „integrale Lipoide” (lipoide Granula der Leukocyten, im Chondriom u. a.), sondern auch auf Lipoide von infiltrativem Charakter (Ablagerung von Lipoiden in den Gefasen, sudanophiles Plasma, Ablagerungen der Lipoide in hyalinisierten Geweben usw.). 2. Die Unterschiede der Ergebnisse bei verschiedenen Farbungsmethoden mit Sudan hangen zum Teil davon ab, das die Lipoide nicht frei, sondern an Eiweis gebunden vorkommen. 3. Auf Grund der verschiedenen Farbungsmethoden mit Sudan kann man dem Verstandnis der Eiweisstrukturen, mit welchen die lipoiden Substanzen verbunden sind, nahertreten. Bei Anwendung verschiedener Sudanlosungen ist man imstande, aus dem Grad und der Art der Lipoidfarbung auf die Veranderungen des Eiweislipoidkomplexes bei pathologischen Zustanden zu schliesen. 4. Bei der histologischen Untersuchung kann als Zeichen einer vollstandigen Lipoidfarbung die positive Farbung der lipoiden Kornelung in den Leukocyten der myeloischen Reihe dienen.

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In the period between 1956-1974 twelve cases of occupational vitiligo due to para-tertiary butylphenol were observed. In addition another 12 cases of vitiligo of other etiology occurred. Occupational vitiligo cannot be distinguished from ordinary vitiligo. 21 patients had, aside from their leukodermia a normal thyroid function, and 18 patients showed symptoms of chronic liver damage. The trias of vitiligo, hepatic disease and struma euthyreotica was noticeable. Autoimmunisation tests were positive in cases of vitiligo of unknown etiology. The localization of vitiligo may be compared to viscero-cutaneous reflexes.

Medical science has evolved tremendously from the days when local cauterization was used to treat victims of rabies exposure. Indeed, with appropriate wound care and vaccination procedures, human rabies is a preventable disease. Despite these advances, physicians treating the uncommon but very dramatic cases of human rabies have not been so successful. As research in this field continues, our hope must be that not only will rabies be preventable and curable but that other mystifying central nervous system disorders will become better understood as well.

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