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It was in the face of such chemical and device-caused abortions that Christian leaders in the first few centuries consistently denounced all abortions. For instance, in about AD 200, Minucius Felix wrote in Octavius, "There are women who swallow drugs to stifle in their own womb the beginnings of a man to be--committing infanticide before they even give birth to the infant." In the fourth century Basil the Great wrote, "Those who give abortifacients for the destruction of a child conceived in the womb are murderers themselves, along with those receiving the poisons." See Appendix C, Abortion: Perspectives of the Early Church Leaders. ; In fact, a strong case can be made for understanding the Greek word translated "sorcery" in Galatians 5: 20 as reference to administering drugs to commit abortions. This word is "pharmakeia, " from which we get our word "pharmaceuticals, " or drugs. The administering of drugs and potions was common in sorcery, and hence the word sometimes took on that secondary connotation. But it is also used in the Greek literature of the day with its original primary meaning of drugs, chemicals or medications. The most prevalent social example of the evil use of chemicals was administering them to induce abortions. Early in the second century, the physician Soranos of Ephesus, in his book Gynecology, used pharmakeia referring specifically to drugs that cause abortions. Galatians 5: 20 lists pharmakeia, translated "witchcraft" in the NIV, as one of the "acts of the sinful nature." It precedes it with listing sexual immorality, impurity, debauchery and idolatry. All of these relate to the sexually immoral practices that led to many unwanted children and therefore many abortions, giving further credence to the idea that pharmakeia may in fact refer to, or at least include, using chemicals to kill unborn children. The same word is used three times in Revelation. In Revelation 9: 21 it says: "Nor did they repent of their murders, their pharmakeus, their sexual immorality or their thefts." In 21: 8 it states: "But the cowardly, the unbelieving, the vile, the murderers, the sexually immoral, the pharmakeus, the idolaters and all liars--their place will be in the fiery lake of burning sulfur." In Revelation 22: 15 it says, "Outside are the dogs, the pharmakeus, the sexually immoral, the murderers, the idolaters and everyone who loves and practices falsehood." Even if these Scriptural passages do not refer to chemical abortions--we cannot be certain one way or the other--everything else we know of Scripture and church history tells us we should oppose all forms of abortion with vigor and consistency and lamivudine.
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It is a conundrum--how can the cause of right heart failure be left heart failure if there is no left heart failure? My impression is that there is a percentage of the population with hyperreactive pulmonary vasculature.When stressed with hypoxia COPD ; or hemodynamic overload left side CHF ; , these patients develop pulmonary hypertension. Because the PA clamps down, the left heart is protected, and the clinical picture is isolated right heart CHF. Clinical and laboratory findings--The syndrome is right heart failure--peripheral edema--in a patient with lung disease.The chest x-ray shows no pulmonary congestion, and the echocardiogram confirms normal LV function. Dyspnea is usual but is caused by the lung disease. Palpitations and atrial arrhythmias are common, especially atrial flutter and multifocal atrial tachycardia Figure 8.1 ; . Other cardiac findings of right heart failure are subtle, and may be hard to detect when the chest exam is grossly abnormal. P2 is accentuated with pulmonary hypertension. There may be a right ventricular RV ; lift and a right-side S3 gallop audible during inspiration ; . Jugular venous distension is a prominent finding. If there is also a V wave, consider tricuspid regurgitation see Chapter 7 ; . With RV failure, there may be an inspiratory increase in jugular venous pressure Kussmaul's sign ; and pulsus paradoxus. Although the chest examination is abnormal with lung disease, a normal exam does not exclude cor pulmonale. Other causes such as sleep apnea, PPH, and recurrent pulmonary embolus may not affect the chest examination. The chest x-ray findings of PPH and cor pulmonale are enlargement of the RV and central pulmonary arteries. Decreased vessel markings at the periphery in contrast to the large central vessels produce a pruned tree appearance. The ECG is a nonspecific test. There may be RV hypertrophy and P pulmonale Table 8.5, Figure 8.2 ; , but their absence does not exclude cor pulmonale.
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Offering whole-body MRI as an elective procedure poses a number of legal questions. Most of these, such as the permissibility of advertising, and issues of employment, medical and commercial law, change from country to country. However, the question of liability plays a central and consistent role. As with any medical procedure, liability means explaining to the subject in advance, in understandable terms, any risks or contraindications, possibilities and limitations of the examination. In the case of an elective scan, it also means making sure the subject understands the possibility that something may be found, which could range from a negligible and easily treated illness to serious or untreatable conditions. Such a briefing should also stress the necessity for further, regular testing and the necessity to consult a doctor with any future symptoms to prevent the subject developing any false confidence if nothing is found ; . As in other clinical applications, whole-body MRI should only be used in elective procedures to investigate those illnesses for which it is appropriate.
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In Panama, the statistics that supply the main subsystems or components of the HIS are produced by a number of institutions that complete the entire statistical cycle. Chief among these are the Office of the Comptroller General of the Republic, the Electoral Tribunal, the Ministry of Health and the Social Security Fund The subsystems in question are mainly vital statistics, morbidity and health resources and services see Figure 5 ; . Figure 5. Main health information subsystems in Panama, 2006 Coordinating institution Office of the Comptroller General of the Republic CGR ; and Electoral Tribunal TE ; VITAL STATISTICS 1. Births: a. Variables: Birth weight, mother's age and schooling 2. Deaths: a. General b. Infant c. Perinatal d. Maternal Ministry of Health MINSA ; and Social Security Fund CSS ; Ministry of Health MINSA ; , Social Security Fund CSS ; and CGR.
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Figure 3. Use of antidepressants in the 0-19 year old age group by county council and gender 1999.Which pharmaceutical preparations are increasing most?.
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