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If we know that data form a normal distribution and that order paxil 20 mg 4 medications list at walmart, for example order paxil with a visa medications known to cause pill-induced esophagitis, the mean is 50 best 30mg paxil medications causing dry mouth, then we know where the center of the distribution is and what the typi- cal score is order genuine paxil on line medicine vs surgery. This indicates that participants who did not score 50 missed it by an “aver- age” of 4 and that most (68%) of the scores fall in the relatively narrow range between 46 150 2 42 and 54 150 1 42. Therefore, you should envision something like Distribu- tion A:The high-frequency raw scores are bunched close to the mean, and the middle 68% of the curve is the narrow slice between 46 and 54. The percent- 16% 16% ages are the approximate 68% percentages of the scores falling into each portion of the distribution. Therefore, envision Distribution C: Scores frequently occur that are way above or below 50, so the middle 68% of the distribution is relatively wide and spread out between 38 and 62. X X ■ The standard deviation is interpreted as the average Sample A is ____ (more/less) variable and most amount that scores deviate from the mean. If X 5 10 and S 5 2, then 68% of the scores fall X For the the scores 5, 6, 7, 8, 9, the X 5 7. However, by reworking them, we have less obvious but faster com- putational formulas. Computing the Sample Variance The computational formula for the sample variance is derived from its previous defini- tional formula: we’ve replaced the symbol for the mean with its formula and then re- duced the components. First, X X variability cannot be a negative number because you are measuring the distance scores are from the mean, and the formulas involve squaring each deviation. Then the largest deviation is about 25, so the “average” de- viation will be much less than 25. Strange answers may be correct for strange distributions, but always check whether they seem sensible. A rule of thumb is For any roughly normal distribution, the standard deviation should equal about one-sixth of the range. To find the standard deviation, perform the above 900 166 – steps and then find the square root, so 6 3. The answer depends on whether we add (subtracting is adding a negative number) or multiply (dividing is multiplying by a fraction). Adding a constant to all scores merely shifts the entire distribution to higher or lower scores. We do not alter the relative position of any score, so we do not alter the spread in the data. In the transformed data, the score is now 14, but it is still 2 points away from the new mean of 16. In the same way, each score’s distance from the mean is unchanged, so the standard deviation is unchanged. Multiplying by a constant, however, does alter the relative positions of scores and therefore changes the variability. If we multiply the scores 4, 5, 6, 7, and 8 by 10, they become 40, 50, 60, 70, and 80. The original scores that were 1 and 2 points from the mean of 6 are now 10 and 20 points from the new mean of 60. Each transformed score produces a deviation that is 10 times the original deviation, so the new standard devia- tion is also 10 times greater. The symbol for the known and true population standard deviation is σX (the σ is the lowercase Greek letter s, called sigma). Because the squared standard deviation is the variance, the symbol for the true population variance is σ2. Otherwise the population standard deviation and variance tell us ex- actly the same things about the population that we saw previously for a sample: Both are ways of measuring how much, “on average,” the scores differ from , indicating how much the scores are spread out in the population. And again, 34% of the popula- tion will have scores between and the score that is 11σX above , and another 34% will have scores between and the score that is –1σX below , for a total of 68% falling between these two scores. X X We won’t bother with their computing formulas, because these symbols will appear for you only as a given, when much previous research allows us to know their values. Estimating the Population Variance and Population Standard Deviation We use the variability in a sample to estimate the variability that we would find if we could measure the population. However, we do not use the previous formulas for the sample variance and standard deviation as the basis for this estimate. These statistics (and the symbols S and S2) are used only to describe the variability in a sample. To understand why this is true, say that we measure an entire population of scores and compute its true variance. We then draw many samples from the population and compute the sample variance of each. Sometimes a sample will not perfectly represent the population so that the sample variance will be either smaller or larger than the pop- ulation variance. The problem is that, over many samples, more often than not the sam- ple variance will underestimate the population variance. In statistical terminology, the formulas for S2 and S are called the biased estima- X X tors: They are biased toward underestimating the true population parameters. This is a problem because, as we saw in the previous chapter, if we cannot be accurate, we at least want our under- and overestimates to cancel out over the long run. The Population Variance and the Population Standard Deviation 97 The sample variance 1S2 2 and the sample standard deviation 1S 2 are perfectly ac- X X curate for describing a sample, but their formulas are not designed for estimating the population. To accurately estimate a population, we should have a sample of ran- dom scores, so here we need a sample of random deviations. Yet, when we measure the variability of a sample, we use the mean as our reference point, so we encounter the restriction that the sum of the deviations must equal zero. Because of this, not all deviations in the sample are “free” to be random and to reflect the variability found in the population. For example, say that the mean of five scores is 6 and that four of the scores are 1, 5, 7, and 9. Therefore, the final score must be 8, because it must have a deviation of 2 so that the sum of all deviations is zero. Thus, the deviation for this score is determined by the other scores and is not a random deviation that reflects the variability found in the population. Instead, only the deviations produced by the four scores of 1, 5, 7, and 9 reflect the variability found in the population. Thus, in general, out of the N scores in a sample, only N 1 of them (the N of the sample minus 1) actually reflect the vari- ability in the population. The problem with the biased estimators (S and S2) is that these formulas divide by X X N. By doing so, we compute the unbiased estimators of the population variance and standard deviation. The definitional formulas for the unbiased estimators of the population variance and standard deviation are Estimated Population Variance Estimated Population Standard Deviation Σ1X – X22 2 Σ1X – X2 s2 5 s 5 X N – 1 X B N – 1 Notice we can call them the estimated population standard deviation and the esti- mated population variance. These formulas are almost the same as the previous defining formulas that we used with samples: The standard deviation is again the square root of the variance, and in both the core computation is to determine the amount each score deviates from the mean and then compute something like an “aver- age” deviation. The only novelty here is that, when calculating the estimated popula- tion standard deviation or variance, the final division involves N – 1.

He is now seen by the onboard phy- (D) Famotidine sician with complaints of blurred vision order paxil overnight delivery medications j tube, (E) Nizatidine confusion order 20 mg paxil fast delivery treatment definition statistics, constipation paxil 20 mg low price medicine zetia, and urinary retention purchase paxil 20 mg with amex medications known to cause pancreatitis. A 34-year-old man is seen over multiple visits Which of the following did the primary care for complaints of ‘‘ulcers,’’ despite the use of ra- physician likely prescribe? Further studies, finding elevated levels (A) Scopolamine of gastrin and evidence of ulcers involving the (B) Metoclopramide jejunum, suggest a diagnosis of Zollinger-Elli- (C) Haloperidol son syndrome. Which of the following agents (D) Dronabinol would be most useful in the management of this (E) Ondansetron patient? A 63-year-old man with long-standing, (D) Tegaserod poorly controlled diabetes is admitted for yet (E) Orlistat another episode of ketoacidosis. Now that he is 202 Chapter 8 Drugs Acting on the Gastrointestinal Tract 203 out of the intensive care unit and beginning to vacationing in Mexico next month. However, he eat, he complains of regurgitation of food fol- is afraid of developing traveler’s diarrhea. You suspect the devel- recommend that he take which of the following opment of diabetic gastropathy, a consequence drugs for prophylaxis? A 72-year-old man with a 150-pack/year history of cigarette smoking presents for further 9. A 78-year-old woman sees her primary care work-up of a large mass seen on a recent chest physician with complaints of ‘‘heartburn. She lives on weight loss over the last 3 months and a poor a fixed income and has no prescription cover- appetite. Her doctor recommends over-the-counter apy, the oncologist decides to add which agent antacids to be used regularly. A 65-year-old man presents to his family only because of her hypertension physician with a 3-month history of watery diar- (D) A combined agent to balance the constipa- rhea. Which agent would associated with magnesium hydroxide and be best to treat the patient’s symptoms? An otherwise healthy 33-year-old man sees (D) Bismuth subsalicylate his physician for a routine physical. The patient (E) Sulfasalazine has no complaints and is planning on Answers and Explanations 1. Both meclizine and prome- thazine are antagonists of H1-receptors used in the treatment of motion sickness, true vertigo, and pregnancy-associated nausea. Aprepitant is the first available substance P antagonist used for the prevention of both sudden and delayed chemotherapy-induced nausea and vomiting. Scopolamine is a cholinergic antagonist that is likely associated with all the patient’s new symptoms. Dronabinol can cause sedation, dry mouth, psychotic effects, and orthostatic hypotension. The other agents, sibutr- amine, phentermine, and dextroamphetamine, are used to aid in weight loss. Cimetidine is a competitive inhibitor of the P-450 system, which thereby increases the half-life of warfarin. The other H2-blockers, including ranitidine, famotidine, and nizatidine, are not metabolized by the P-450 system. Propantheline is a choliner- gic agent used in conjunction with other agents, and rarely alone. Poor gastric emptying is a manifestation of the neuropathy that accompanies long-standing diabetes. Metoclopramide is a prokinetic agent used in the treatment of diabetic gastroparesis. Pepto Bis- mol is added in the case of peptic ulcers due to Helicobacter pylori (H. Bismuth subsalicylate is effective for both the treatment and prophylaxis of traveler’s diarrhea, most often due to Escherichia coli (E. Loperamide and diphenoxylate are good to treat diarrhea, but generally are not used for prophylaxis. Megestrol acetate is used as an appetite stimulant and results in weight gain in some patients with cancer. Aprepitant, lorazepam, and ondansetron, while having different mechanisms, are all used for nausea and vomiting, which he may experience eventually with his chemotherapy. Bismuth subsalicylate is used to treat traveler’s diarrhea, and sulfasalazine is used treat such inflammatory bowel disease, such as Crohn disease. The goal of therapy is to decrease airway resistance by increasing the diameter of the bronchi and decreasing mucus secretion or stagnation in the airways. Asthma is characterized by acute episodes of bronchoconstriction caused by underlying air- way inflammation. A hallmark of asthma is bronchial hyperreactivity to numerous kinds of en- dogenous or exogenous stimuli. In asthmatic patients, the response to various stimuli is amplified by persistent inflammation. Antigenic stimuli trigger the release of mediators (leukotrienes, histamine, and many others) that cause a bronchospastic response, with smooth muscle contraction, mucus secretion, and recruit- ment ofinflammatory cells such as eosinophils,basophils, and macrophages (early-phase response). Late-phase response (which may occur in hours or days) is an inflammatory response; levels of histamine and other mediators released from inflammatory cells rise again and may induce bronchospasm. Nonantigenic stimuli (cool air, exercise, nonoxidizing pollutants) can trigger nonspecific bron- choconstriction after early-phase sensitization. Chronic bronchitis is characterized by pulmonary obstruction caused by excessive production of mucus due to hyperplasia and hyperfunctioning of mucus-secreting goblet cells. Rhinitis is a decrease in nasal airways due to thickening of the mucosa and increased mucus secretion. Rhinitis may be caused by allergy, viruses, vasomotor abnormalities, or rhinitis medicamentosa. Adrenergic agonists stimulate b2-adrenoceptors, resulting in relaxation of bronchial smooth muscle. These agentsalso inhibit the releaseof mediatorsand stimulate mucociliaryclearance. Adrenergic agonists are useful for the treatment of the acute bronchoconstriction (exacerba- tions) of asthma. Depending on biologic half-life of the drug, these agents are used both for quick relief and for long-term control. The use of short-acting, inhaled b2-adrenoceptor agonists on a daily basis, with increasing necessity of use, indicates the need for additional long-term pharmacotherapy. Albuterol, levalbuterol, pirbuterol, metaproterenol (1) These agents have enhanced b2-receptor selectivity. Nonselective agents (1) Isoproterenol is a relatively nonselective b-receptor agonist and a potent bronchodila- tor. Isoproterenol is most effective in asthmatic patients when administered as an inhal- ant. During an acute attack, dosing every 1–2 hours is typically required; oral preparations are administered 4 times daily (qid). Epinephrine can be administered as an inhalant or subcutane- ously (in emergency circumstances); onset of action occurs within 5–10 minutes, and duration is 60–90 minutes.

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The spots look like tiny grains of streaky red or gray hair in dark-skinned children) purchase paxil 30mg fast delivery symptoms 3 days dpo, white sand purchase cheap paxil medicine x protein powder, each surrounded by a red ring purchase paxil medicine 013. They are and abnormal skin that darkens in irritated but not often found on the inside of the cheek discount 20 mg paxil mastercard medications just for anxiety, opposite the sun-exposed areas. Kwashiorkor disables the immune system, rendering the affected individual susceptible Kostmann disease See severe congenital to a host of infectious diseases. During the first few months of life, means “to repair the bending of the spine to curve they seem normal, but before 6 months of age, the outward from the body. Other the procedure that can re-establish the height of a forms of Krabbe disease have late infantile, juvenile, compressed vertebra. Surgery for kyphoscol- Krukenberg tumor A tumor of the ovary that is iosis may involve inserting a metal rod in the spine caused by the spread of metastatic cancer of the and restructuring some bones, and it is usually fol- gastrointestinal tract, characteristically from the lowed by wearing a back cast and then a back brace stomach. Treatment includes physical therapy kuru A slowly progressive fatal disease of the and wearing a back brace, and in some cases sur- brain that is due to an infectious agent transmitted gery. Surgery for kyphosis may involve inserting a among people in Papua New Guinea by ritual canni- metal rod in the spine and restructuring some balism. Kuru is an infectious form of subacute bones, and it is usually followed by wearing a back spongiform encephalopathy and is caused by a tiny cast and then a back brace for some time. It appears to be similar to bovine spongiform encephalopathy (“mad kyphosis, fixed Kyphosis caused by collapse of cow disease”) and Creuztfeldt-Jakob disease. Kussmaul breathing Air hunger, or the rapid, kyphosis, juvenile See Scheuermann’s disease. For kyphosis, mobile Kyphosis caused by compen- example, Kussmaul breathing is seen with the aci- sating for muscle weakness or structural abnormal- dosis of diabetes mellitus that is seriously out of ity in another area of the body. During the first stage of labor (which is called dila- tion), the cervix dilates fully to a diameter of about 10 cm (2 inches). The first stage of labor is divided into two phases: the latent phase and the active phase. In the latent phase, contractions become Ll progressively more coordinated and the cervix dilates to 4 cm (approximately 1. The latent phase averages about 8 hours for a nullipara (a woman having her first baby) and 5 hours for a L1 through L5 The five lumbar vertebrae, which multipara (a woman having a subsequent baby). In are situated between the thoracic vertebrae and the the active phase, the cervix becomes fully dilated sacral vertebrae in the spinal column. The active phase averages about 5 La Leche League An organization that helps and hours for a nullipara and 2 hours for a multipara. Expulsion generally lasts 2 hours for a nulli- lab result The result of a test done in a laboratory. The third stage of labor begins with the delivery of the baby and ends lab test A test that is done in the laboratory where when the placenta and membranes are expelled. The labyrinth is labia, vaginal The two pairs of labia (lips)—the the portion of the ear that is responsible for sensing labia majora and labia minor—at the entrance to balance. Bilabial sounds, such as “p,” involve both lips, whereas labiodental sounds, lacrimation Shedding tears, or shedding more such as “v,” involve the upper teeth and lower lip. For example, labile blood pres- sure is blood pressure that abnormally increases lactase The enzyme that breaks down the milk and decreases frequently. Without enough lactase, a person is lactose intoler- labile diabetes See diabetes, labile. The hormone oxytocin is produced in laminectomy A surgical procedure in which the response to the birth of a new baby, and it both stim- posterior arch of a vertebra is removed. For the first few hours of nursing, a special spinal cord or on the nerve roots that emerge from fluid called colostrum is delivered; colostrum is the spinal canal. The procedure may be used to especially high in nutrients, fats, and antibodies, to treat a slipped or herniated disc or to treat spinal protect the newborn from infection. Lancet, The A well-known medical journal pub- lactic acid A simple sugar that is the byproduct of lished in England. When lactic acid accumulates rapidly Landau-Kleffner syndrome A disorder with in the muscle cells during or just after exercise, onset in childhood characterized by the loss of cramping can result. Lactic acidosis can occur with seizures and may develop behaviors similar to intensive exercise or may be related to medical autism. Lactobacillus can Langerhans cell histiocytosis The preferred also live in fermenting products, such as yogurt. Humans appear to have a symbiotic relationship with this bacteria: some types have become an important Langerhans cell histiocytosis refers to several disor- part of food digestion, although Lactobacillus can ders in which histiocytes start to multiply and pro- also contribute to cavities in the teeth if allowed to liferate abnormally. The result can be tissue damage, pain, the development of tumor-like lumps, remain too long within the mouth. Treatment includes radiation and lactose intolerance The inability to digest lac- chemotherapy; although for reasons unknown, tose, a component of milk and some other dairy some cases of histiocytosis go into remission with- products. This disease includes the conditions lack of an enzyme called lactase in the small intes- known as eosinophilic granuloma, Letterer Siwe tine. The most common symptoms of lactose intol- disease, and Hand-Schuller-Christian disease. The diagnosis may be made via a trial of a lactose-free Langerhans, islet of See islet of Langerhans. Treatment involves avoid- lanugo Downy hair on the body of a fetus or new- ance of products that contain lactose or use of lac- tase enzyme supplements before eating. Lanugo is the first hair to be produced by the fetal hair follicles, and it usually appears on the deficiency, lactase. Although example, a lacunar infarct in the brain is an area lanugo is normally shed before birth, around 7 or 8 where a stroke has left a tiny pit in the brain. This is not a cause for concern: Lanugo disappears lamella A thin leaf, plate, disk, or wafer, such as of its own accord within a few days or weeks. For example, the lamina incisions are made in the abdominal wall through arcus vertebrae are plates of bone within each ver- which a laparoscope and other instruments can be tebral body. A variety of probes or other instru- laryngectomee A person who has had his or her ments can also be pushed through these small inci- larynx (voice box) removed. In this way, a number of surgical procedures can be performed without the need for laryngectomy Surgery to remove part or all of a large surgical incision. The surgeon performs a tracheostomy, creating an opening in the front of the neck laparotomy An operation to open the abdomen. Air enters and leaves the trachea and lungs For example, laparotomy is used to remove cancer through the stoma. The surgeon removes only part of cers, for example lung cancers, in which the abnor- the larynx (voice box)—just one vocal cord, just mal cells are particularly large. After a brief recovery period, the tracheostomy tube is removed, and the stoma closes up. In some cases, however, the voice may be hoarse or laryngeal Having to do with the larynx (voice box). It is said to be recurrent because it returns in its course to laryngitis An inflammation of the larynx.

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Tooth fractures are usually develops from embryonic tissue that forms part of caused by chewing or biting hard objects buy 30mg paxil otc treatment yeast infection home remedies, such as the pituitary gland discount paxil 10 mg without a prescription medications zithromax. Treatment usu- by the tumor reduces the availability of the hormone ally involves protecting the tooth with a crown paxil 40 mg generic treatment urinary tract infection. A craniopharyngioma usually includes hard order cheap paxil line medications jaundice, symptoms, root canal surgery may be necessary. There Sclerodactyly (localized thickening and tightness of is little scientific evidence at this time for the value the skin of the fingers or toes), and Telangiectasias of craniosacral therapy. Premature closure of all the sutures can cause growth retardation, developmental delay, and other microcephaly (an abnormally small head), which abnormal features. Cretinism can be due to defi- prevents the normal growth of the brain and results ciency of iodine in the mother’s diet during preg- in mental retardation. Creutzfeldt-Jakob disease A degenerative dis- craniotomy A surgical operation in which an ease of the brain that causes dementia and, eventu- opening is made in the skull. It is believed to be caused by an unconventional microbe called a prion, rather than cranium The top portion of the skull, which pro- by bacteria or a virus. Also known as Creutzfeldt-Jakob syndrome, burns, inflammatory conditions, and advanced can- Jakob-Creutzfeldt disease, and spastic cer. The term has been replaced cream in that it has an oil base, as opposed to being by handicapped. See also Crohn’s dis- Crepitus in a joint can indicate cartilage wear in the ease. Crohn’s disease can be a chronic, the formation of scar tissue (fibrosis) in the skin recurrent condition, or it can cause minimal symp- and sometimes also in other organs of the body. In more serious cases, deeper and larger Raynaud’s phenomenon (spasm of the tiny artery ulcers can develop, causing scarring, stiffness, and http://www. It is the bowel wall, leading to infection in the abdomi- usually caused by viruses but sometimes by bacte- nal cavity (peritonitis) and in adjacent organs. Symptoms include a cough that sounds like a Abdominal pain, diarrhea, vomiting, fever, and seal’s bark and a harsh crowing sound during weight loss can be symptoms. Treatments concern with croup is difficulty breathing as the air include medications that reduce inflammation, sup- passages narrow. Dietary tration of moist air (as from a humidifier), saltwa- changes can reduce symptoms. Also known as regional suppressants, pain medication, fluids, and, if the enteritis. Crouzon syndrome A hereditary craniofacial Crohn’s ileitis Inflammation of the ileum (the disorder characterized by craniosynostosis, small lowest part of the small intestine) due to Crohn’s eye sockets that cause the eyes to protrude, a large disease. Some people with Crouzon syndrome also Crohn’s ileocolitis Crohn’s disease involving the have sleep apnea, hearing loss, and other difficul- ileum (the lowest portion of the small intestine) and ties. Crossing over is cryoglobulinemia The presence in blood of a way to recombine the genetic material so that each abnormal proteins called cryoglobulins that have person (except for identical twins) is genetically the unusual property of precipitating from the blood unique. Cryoglobulins can increase the risk of crossover study A type of clinical trial in which blood clots forming in the brain (stroke), eyes, and the study participants receive each treatment in a heart. With this type of study, every patient blood vessels (vasculitis), which increases the risk serves as his or her own control. Cryoglobulinemia can also are often used when researchers feel it would be accompany another disease, such as multiple difficult to recruit participants willing to risk going myeloma, dermatomyositis, or lymphoma. For example, the culdoscope The viewing tube (endoscope) technology of cooling and storing cells at a temper- introduced through the end of the vagina into the ature below the freezing point (–196° C) permits rectouterine pouch (the pouch of Douglas), an high rates of survivability of the cells upon thawing. Cultural evolution shows a rapid rate of crypt In anatomy, variously a blind alley, a tube change, is usually purposeful and often beneficial, is with no exit, a depression, or a pit in an otherwise widely disseminated by diverse means, is frequently fairly flat surface. For example, the tonsillar crypts transmitted in complex ways, and is enriched by the are little pitlike depressions in the tonsils. Cultural evolution is unique to humans among cryptorchidism A condition in which one or all forms of life. Any body tis- rected in early childhood are at increased risk for sue or fluid can be evaluated in the laboratory by developing cancer of the testicles. Also known as using culture techniques to detect and identify infec- undescended testicles. The word curette comes from French back that allows it to articulate posteriorly with the and means “scraper. It also has a joint in the front that permits it to articulate anteriorly with the Curie A unit of radioactivity. Specifically, a Curie fourth and fifth metatarsals (the bones just behind is the quantity of any radioactive nuclide in which the fourth and fifth toes). The term cul-de-sac is Cushingoid Having the constellation of symptoms used specifically to refer to the rectouterine pouch and signs seen in Cushing’s syndrome, caused by an (the pouch of Douglas), an extension of the peri- excess of cortisol hormone, particularly facial puffi- toneal cavity between the rectum and back wall of ness and unexplained weight gain. This cycle is governed by a complex sequence of hormones that influence fertility and Cushing’s syndrome A constellation of symp- may affect mood and a variety of physical functions. Cushing’s syndrome is a hormonal condition begin on the first day of menstrual bleeding. Cushing’s syndrome are due to the excess produc- tion of cortisol by the adrenal gland. It is important to tion (brand names: Neoral, Sandimmune) that is wash a cut with soap and water, and keep it clean prescribed chiefly for organ transplant recipients and dry, but avoid putting alcohol, hydrogen perox- and people with autoimmune disorders. Delay in getting medical care can increase the rate cyclothymia A form of bipolar disorder in which of wound infection. If a cut results from a puncture the mood swings are less severe than manic depres- wound through a shoe, there is a high risk of infec- sion. Redness, swelling, increased pain, and pus draining from the wound also indicate an infection cyst A closed sac or capsule, usually filled with that requires professional care. Also known as chalazion or cutaneous syndactyly See syndactyly, cuta- tarsal cyst. Still other types of ovarian cysts are called dermoid cysts, or ovarian cyanosis A bluish color of the skin and the teratomas. These bizarre but usually benign tumors mucous membranes due to insufficient oxygen in can contain many different body tissues, such as the blood. When a cyst causes symptoms, pain can be present at birth, as in a “blue baby,” an infant is by far the most common feature. Pain from an with a malformation of the heart that permits into ovarian cyst can be caused by rupture of the cyst, the arterial system blood that is not fully oxygenated. Treatment of ovarian cysts depends on the woman’s age, the size and type of the cyst, and the cycle, cell See cell cycle. If a cyst is causing severe pain, is not resolving, or is suspicious in any cycle, menstrual The monthly progression of way, it can be removed through laparoscopy or, changes in the endometrium (the lining of the if necessary, through an open laparotomy (bikini http://www. When cysticerci are found in the cyst, synovial, of the popliteal space See brain, the condition is called neurocysticercosis. When the tapeworm eggs are inside the stomach, cyst, thyroglossal A fluid-filled sac that is pres- they hatch, penetrate the intestine, travel through ent at birth and located in the midline of the neck. It results from incomplete closure of often in rural, developing countries where hygiene a segment of the thyroglossal duct, a tube-like struc- is poor and pigs are allowed to roam freely and eat ture that normally closes as the embryo develops.

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