By V. Denpok. Simpson College, Indianola Iowa. 2018.
The relative risk for colon cancer if the ﬁrst-degree relative had an adenoma- tous polyp was 1 buy tetracycline 250mg without a prescription antibiotic before dental work. People with a ﬁrst-degree relative (parent cheap 250 mg tetracycline otc virus zapping robot, sibling, or child) with colon cancer or adenomatous polyps diagnosed at age >60 years or two ﬁrst-degree relatives diagnosed with CRC at any age are rec- ommended to have screening colonoscopy starting at age 40 years or 10 years younger than the earliest diagnosis in their family, whichever comes ﬁrst, and repeated every 5 years (52). People with a ﬁrst-degree relative with colon cancer or adenomatous polyp diagnosed at age ≥60 years or two second-degree relatives (grandparent, aunt, or uncle) with CRC are recommended to undergo screening as average risk persons, but beginning at age 40 years. People with one second-degree relative or third-degree relative (great-grandparent or cousin) with CRC should be screened as average risk persons. History of Adenomatous Polyps: Several studies have demonstrated that colonoscopic polypectomy and surveillance reduces subsequent CRC inci- dence (9,31). The rate of developing advanced adenomas after polypec- tomy is low after several years of follow-up, suggesting that the initial colonoscopy and polypectomy offers the major beneﬁt and that surveil- lance may only beneﬁt those at highest risk. The National Polyp Study (53) found that the rate of adenoma detection 3 years after the initial adenoma resection was 32% to 42%. Recurrent adenomas were mostly small, tubular adenomas with low-grade dysplasia and therefore were of negligible immediate clinical signiﬁcance. Another long-term follow-up study (4) of 1618 postpolypectomy patients also found no increased risk for cancer in patients undergoing resection of single small (<1cm) tubular adenomas, but an increased risk of 3. In patients found to have a colorectal adenoma, the prevalence of synchro- nous polyps is 30% to 50% (54–56). Some of these polyps, especially those measuring <1cm in diameter, will be missed on the initial colonoscopy (57,58). Metachronous adenomas are reported in 20% to 50% of patients, depending on the follow-up surveillance interval used (59–63). Second, the patient’s tendency to form new adenomas with advanced pathology can be assessed. In the National Polyp Study, colonoscopy performed 3 years after initial colonoscopic removal of adenomatous polyps detected advanced adeno- mas as effectively as follow-up colonoscopy performed after both 1 and 3 years. On this basis, an interval of at least 3 years before follow-up colonoscopy after resection of newly diagnosed adenomatous polyps was recommended. Patients with a relatively high risk of developing advanced adenomas during follow-up include those with multiple adenomas (more than two), large adenomas (≥1cm), or a ﬁrst-degree relative with CRC. Patients with a low risk of metachronous advanced adenomas include those with only one or two small adenomas (<1cm) and no family history of colorectal cancer. Surveillance should be of greatest intensity in those most likely to beneﬁt and reduced in those least likely to beneﬁt so as to avoid compli- cations associated with unnecessary removal of small polyps. History of Colorectal Cancer: Aside from recurrence of the original cancer, the incidence of CRC is increased after the ﬁrst occurrence (66). Although colonoscopy can detect recurrent colon cancer, anastomotic recurrences occur in only about 2% of colon cancers and are generally accompanied by surgically incurable disease (67). In an RCT performed in 325 patients with curative resections of colorectal cancer (68), the value of colonoscopy was conﬁned to detection of metachronous adenomas and not recurrent intra- luminal cancer (moderate evidence). Patients with a colon cancer that has been resected with curative intent should have a complete structural colon examination around the time of initial diagnosis to rule out synchronous neoplasms. This exam can be performed by either colonoscopy or CTC; CTC has proven especially effective in the setting of a colorectal mass that prevents passage of the colonoscope, as only air insufﬂation is required for evaluation (69). It offers the advantage that extracolonic structures can be assessed simultaneously. If this does not reveal synchronous lesions, sub- sequent surveillance by colonoscopy or CTC should be offered after 3 years, and then, if normal, every 5 years. Inﬂammatory Bowel Disease: There is extensive experience with DCBE for evaluation of inﬂammatory bowel disease and its complications, including CRC (70,71). Pseudopolyposis is seen when extensive ulceration of the mucosa down to the submucosa results in scattered circumscribed islands of relatively normal mucosal remnants. Postinﬂammatory polyps reﬂect a nonspeciﬁc healing of undermined mucosal and submucosal rem- nants and ulcers, and are mostly multiple. Patients with extensive long-standing ulcerative colitis or Crohn’s disease have an increased risk for the development of CRC (72). Impor- tantly, cancers that develop in patients with inﬂammatory bowel disease differ from more typical colorectal cancers in that they generally develop not from adenomatous polyps but rather from areas of high-grade dys- plasia (73). Dysplasia is a precancerous histologic ﬁnding, and the risk of colon cancer increases with the degree of mucosal dysplasia. Dysplasia may be found in a radiographically normal-appearing mucosa, or it may be accompanied by a slightly raised mucosal lesion, a so-called dys- plasia-associated lesion or mass and as a consequence radiographically detectable.
Neuroma Another TMS tendonalgia attributed to something else is found in the fore part of the bottom of the foot cheap tetracycline 500 mg with mastercard antibiotics sinus infection. Pain is usually in the metatarsal region and is almost always blamed on a neuroma tetracycline 250 mg lowest price 999 bacteria, which is a benign tumor. Plantar Fasciitis The pain in plantar fasciitis is located on the bottom of the foot along the length of the arch. Although they are often vague about cause, doctors may ascribe this pain to inflammation. The area is usually very tender to palpation and seems quite clearly to be a manifestation of TMS. It refers to nerve symptoms that appear to affect many nerves in a random pattern. In my view it is often an example of TMS neuralgia because TMS tends to involve so many different muscles and nerves in the neck, shoulders and back. Temporomandibular Joint Syndrome (TMJ) Temporomandibular joint syndrome is a very common painful condition of the face that has historically been attributed to pathology of the jaw joint (TM joint) and, therefore, has been in the dental domain. I have never treated this disorder specifically but am strongly inclined to think that it is similar in cause to tension headache and TMS. TMS patients who come in for neck and shoulder pain frequently give a history of TMJ, and the jaw muscle is tender to palpation, just like the shoulder, back and buttock muscles. Inflammation Inflammation must be discussed for it is the explanation presented for many cases of upper and lower back pain and is the basis for the prescription of both steroidal (cortisone) and nonsteroidal (such as ibuprofen) anti-inflammatory drugs. Because of the magnitude of the back pain problem, these medications are widely used. Experience with the diagnosis and treatment of TMS makes it clear that the source of the pain is neither spinal structures nor The Traditional (Conventional) Diagnoses 119 inflammation. An inflammatory process is an automatic reaction to disease or injury; it is basically a protective, healing process. It has been suggested in this book that the source of the pain is oxygen deprivation and not inflammation. This idea has at least a modicum of support from the rheumatologic studies on fibromyalgia. Sprain and Strain The term sprain should be restricted to clear-cut instances of minor injury, like turning the ankle. Unfortunately, both of these terms are often used when the symptom is a TMS manifestation. Having briefly reviewed these common traditional diagnoses for back pain, let us now look at the conventional treatments employed. The fact that there are so many different treatments for the common neck, shoulder and back pain syndromes suggests that the diagnosticians are not really sure what the problem is. Of course, the patient is always given a diagnosis, usually a structural one, but subsequent management, including the use of medications, physical therapies of different kinds, manipulation, traction, acupuncture, biofeedback, transcutaneous nerve stimulation and surgery, many of which are symptomatic treatments, suggests that the diagnoses are on shaky grounds. People with TMS need to know about these treatments so they can understand why they did or did not respond to them or why they derived only partial or temporary benefit from them. In thinking about how to review the subject it occurred to me that the best approach might be to consider each treatment modality from the standpoint of its intended purpose. Of course, all treatments are supposed to relieve pain but the important question is how. Before we get into this lets review once more the subject of the placebo effect because 120 The Traditional (Conventional) Treatments 121 of its crucial importance in any discussion of treatment. THE PLACEBO EFFECT A placebo is any treatment that produces a good therapeutic result despite the fact it has no intrinsic therapeutic value. It is clear that the desirable outcome must be attributed to the ability of the mind to manipulate the various organs and systems of the body. In order to do this the mind must believe in the efficacy of the treatment and/or the treater.
Then buy tetracycline 250mg overnight delivery virus infection, we typically try to rigidify the case definition by establishing ironclad inclusion criteria tetracycline 500 mg line antibiotics for sinus infection nausea. Here the major goal is to assist in communication so that everyone concerned is using terms in the same way, as noted in Chapter Two. But then the pendulum swings back because there are always borderline cases which ought to be thought of like the central cases for certain purposes, and mild or subclinical cases are found having the same etiology as the originally identified overt cases. Authorities pronounce, fashion sways, and the latest article prevails only to be dethroned the next year, all of which fails to enlighten us about what is really at stake in deciding inclusion criteria. Dewey, confronted with these two tendencies and traditions, was one of the first to notice that in fact there are hardly any true semantic interpretations (empirical instantiations) of formal systems other than in mathematics and the basic sciences. The relations among formal conceptual structures, called by Dewey "universal 88 CHAPTER 3 propositions," are rarely helpful guides for understanding experiences. In addition, generalizations from prior experience, which he called "generic propositions" are useful only to the degree to which (never 100%) present situations duplicate preceding ones. The interactive experience of living in an environment decides for Dewey what forms of inference (broadened to "involvement") are valid. He could not have been farther from the position of those who, in his day and after, posited as real only those entities and relations which could fit (exemplify) those of a formal system. Reflection, which is well epitomized by the phrase "looking before (and while) you leap" appears to have four main aspects in Dewey’s work. First, there is considering and evaluating the claims of all the impulses; second, there is review of all the consequences ("imaginative rehearsal") of alternate actions; third, there is thoughtful assessment of the relevance and applicability of established habits; and finally, there is creative engagement in action, which involves imagination, new discovery and the renewal of previous valuations. But a recent writer, Rignano, working from a biological basis, has summed up his conclusions as follows: ‘The analysis of reasoning, the highest of our mental faculties, has led us to the view that it is constituted entirely by the reciprocal play of the two fundamental and primordial activities of our psyche, the intellectual and the affective. The incidents in which emotion leads to misinterpretation and misunderstanding are the exception, not the rule. We could not possibly navigate the world without love, fear, suspicion, trepidation, gratitude, relief, shame, hope and trust to name just a few. Sometimes these emotions are misplaced, usually because of a misunderstanding of facts. But just as illusions do not invalidate the great preponderance of sensory experience, occasional examples of misplaced emotion do not invalidate its overarching role in connecting us to people, things and events. So full-bodied reasoning not only makes use of the typically special image schemas discussed in Chapter I, but also of the full spectrum of emotion. And especially, this spectrum of reasoning is needed to cope with the non-absolutes of medical care. JOHN DEWEY’S PERSPECTIVES ON MEANS AND ENDS 89 For all these reasons, "intelligence" replaces "reason" in Dewey’s philosophy, " the marks of ‘reason’ in its traditional sense are necessity, universality, superi- ority to change, domination of the occurrence and the understanding of change. Far from the empyrean realm where "reason" dealt with the immutable, abstract, universal, certain and necessary, "intelligence" delves into the messy practical world of the evolving, concrete, particular, uncertain (the "merely probable") and contingent. THE IMPORTANCE OF CONTEXT Dewey addresses the importance of context repeatedly, but gives it the central place in the essay "Context and Thought" (1931) and in the section of his Logic entitled "Judgment as Spatial-Temporal Determination: Narration-Description. Context is first the relatively stable background of interest, belief and knowledge which forms the setting for narration and description. This provides the physical, cultural and historical locus of activity and concern. Stories, the temporal accounts of events and acts, as well as descriptions, which are primarily spatial accounts, are the "ground" of propositions, whereas propositions themselves tend to be about central foci of concern. Background is relatively "stable," "settled," "assumed" and "inexplicit" whereas the most salient elements in means/ends problems, those "in play," are changing, "unsettled," and attended to explicitly. However, the great point that Dewey makes is just how the meaning of foreground action is context- dependent. Acts and events relate to specific beginnings and ends, and cannot be understood or evaluated apart from the contexts in which they occur. Context itself, while mainly assumed, can also be a matter of selective interest, particularly when there is the leisure to reflect. Otherwise, resolution of any dispute or deliberation needed for action cannot occur, and paralysis ensues. There is always that which continues to be taken for granted, which is tacit, being ‘understood. In a medical emergency, for example, decisions open for reflection must be very few, else the outcome will be decided by default.
This adher- ence to respectful practice invites generative conversations and shapes the lens that others use in viewing couples tetracycline 500 mg overnight delivery antibiotic bone cement. If you’re looking for Re- sourcefulness in couples discount tetracycline 250 mg on-line virus 300 fine remove, you’re more likely to find it. DISCOURSE AND DECONSTRUCTION Until lions have their own historians, tales of hunting will always glorify the hunter. Understanding Michel Foucault’s concept of modern power opens up new understandings of how oppressive practices and self-subjugation operate. Power is distributed unequally among members in the culture, privileging the voices of some while marginalizing the voices of others (Foucault, 1979, 1980). White and Epston (1990) describe how Foucault used the prison ar- chitectural structure designed by Jeremy Bentham in the eighteenth cen- tury as a metaphor to speak about the operation of modern power in our cultural and historical landscape. The Panopticon was a structure designed to house prisoners that made it possible to achieve the greatest degree of social control. A round building surrounding a courtyard housed prisoners in individual cells, isolating them from their fellow inmates. A tall tower stood in the middle of the courtyard, from which guards could see into every cell. In exploring the effects of this over time, Foucault describes how the gaze of the guards would recruit the pris- oners into modifying or policing their own behaviors, acting as if they were always being watched. In the context of social or relational isolation, part- ners practice self-surveillance and self-regulation based on socially con- structed norms. When this form of power remains invisible to couples, its effects can be insidious (Foucault, 1979; White, 1991). Narrative therapists listen for oppressive (often invisible) discourses that influence a couple’s relationship. Once identified, therapeutic inquiry de- constructs the assumptions and beliefs that support the taken-for-granted Narrative Therapy with Couples: Promoting Liberation 173 status of the discourse. When an oppressive discourse is made visible, cou- ples are invited to renegotiate their position within that discourse or to choose an alternate discourse that is less restrictive. By refusing to comply with a marginalizing discourse, couples are challenging the status quo and promoting social justice in the larger community. Anorexia had successfully recruited Suzanne into self-subjugating practices of self-starvation, excessive exercise, rigid rules regarding eating, and continual practices of measuring up. The meaning she has constructed of the events in her life is that she is a "mess," unable to handle the stres- sors in her life and "codependent. By unveiling the tricks Anorexia uses and the cultural discourses that keep it alive, Suzanne and Pete are able to join forces in reclaiming their relationship from the problem’s grip. Suzanne enlists Pete’s support in resisting Anorexia’s attempts to under- mine her efforts, and as a result, she is no longer silenced by Secrecy and Shame. In the following, Pete and Suzanne are invited to consider the socio- cultural influences that have supported Anorexia: "Suzanne, how do you think Anorexia gets women to participate in self- shrinkage and diminishment? How do we challenge practices that position us as "agents of social control" (Foucault, 1979)? Narrative thera- pists turn a critical eye on practices that might inadvertently maintain dominant ideologies by supporting certain groups over others (Freed- man & Combs, 1996; Madigan, 1993). Although it is not possible to com- pletely flatten the hierarchy inherent in the therapeutic relationship, we remain vigilant about using our power in support of client agency and empowerment. Whether we are talking about a couple, two religious groups, or two nations, narrative practice is inter- ested in how people handle the process of differing. Do conversations around difference create space for many perspectives, or do they quiet the voices that stand outside the dominant view? How do cultural discourses influence the ways in which a couple handles day-to-day dilemmas? Western society privileges productivity and gives power to individuals and groups based on binary positions; educated/uneducated, rich/poor, white/person of color, heterosexual/gay, thin/large, young/old, able- bodied/disabled (Cushman, 1995). Dominant and privileged groups de- velop exaggerated entitlements that lead to abuses of power and the ongo- ing oppression of less-dominant groups (Winslade & Monk, 2001). Narrative therapists challenge discourses related to race, class, gender, sexual orientation, age, and mental and physical ability. The following ex- amples illustrate the deconstruction of any oppressive discourse. GENDER A culture that gives men resources to succeed in a capitalist society may have the effect of objectifying women in relationships.
Type A: Extraarticular Type A1: Extraarticular tetracycline 250mg cheap antibiotics and milk, avulsion Type A2: Extraarticular generic tetracycline 500 mg visa infection toe, coronal Type A3: Extraarticular, multifragmentary Type B: Partial articular, single joint (calcaneocuboid or cubotarsal) Type B1: Partial articular, sagittal Type B2: Partial articular, horizontal Type C: Articular, calcaneocuboid and cubotarsal involvement Type C1: Articular, multifragmentary Type C1. PELVIS AND LOWER LIMB 75 Tarsometatarsal (Lisfranc) Joint Quenu and Kuss Classiﬁcation (Figure 3. Fracture-dislocations of the tarsometatarsal joints: end results correlated with pathology and treatment. Copyright © 1986 by the American Orthopaedic Foot and Ankle Society (AOFAS), originally published in Foot and Ankle Interna- tional, April 1986, Volume 6, Number 5, page 228 and reproduced here with permission. Divergent Partial Total Fractures of the Base of the Fifth Metatarsal Dameron Classiﬁcation (Figures 3. Reprinted from The Journal of the American Academy of Orthopaedic Surgeons, Volume 3 (2), pp. Type II: Transphyseal fracture that exits the metaphysis; the metaphyseal fragment is known as the Thurston- Holland fragment; the periosteal hinge is intact on the side with the metaphyseal fragment; prognosis is excel- lent, although complete or partial growth arrest may occur in displaced fractures. Type III: Transphyseal fracture that exits the epiphysis, causing intraarticular disruption; anatomic reduction and ﬁxation without violating the physis are essential; pro- gnosis is guarded because partial growth arrest and resultant angular deformity are common problems. Type IV: Fracture that traverses the epiphysis and the physis, exiting the metaphysis; anatomic reduction and ﬁxation without violating the physis are essential; pro- gnosis is guarded, because partial growth arrest and resultant angular deformity are common. Type V: Crush injury to the physis; diagnosis is generally made retrospectively; prognosis is poor because growth arrest and partial physeal closure commonly result. It can cause scaring, tethering and arrest of the periphery of the epiphyseal plate, producing angular deformity. SUPRACONDYLAR HUMERUS FRACTURES Classiﬁcation of Extension Type Gartland Classiﬁcation Based on degree of displacement: Type I: Nondisplaced Type II: Displaced with intact posterior cortex; may be slightly angulated or rotated Type III: Complete displacement; Posteromedial or postero- lateral Wilkins Modiﬁcation of Gartland’s Classiﬁcation Type 1: Undisplaced 4. FRACTURES IN CHILDREN 81 Type 2 Type 2A: Intact posterior cortex and angulation only Type 2B: Intact posterior cortex, angulation and rotation Type 3 Type 3A: Completely displaced, no cortical contact, posteromedial Type 3B: Completely displaced, no cortical contact, posterolateral LATERAL CONDYLAR PHYSEAL FRACTURES Milch Classiﬁcation (Figure 4. Type II: Fracture line extends into the apex of the trochlea, rep- resenting a Salter-Harris type II fracture. Group B: Lateral condyle ossiﬁed (7 months to 3 years); Salter- Harris type I or II (ﬂeck of metaphysis). Group C: Large metaphyseal fragment, usually exiting laterally (ages 3 to 7 years). T-CONDYLAR FRACTURES Wilkins and Beaty Classiﬁcation Type I: Nondisplaced or minimally displaced Type II: Displaced, with no metaphyseal comminution Type III: Displaced, with metaphyseal comminution 4. FRACTURES IN CHILDREN 83 RADIAL HEAD AND NECK FRACTURES Wilkins Classiﬁcation (Figure 4. Continued PEDIATRIC FOREARM Descriptive Classiﬁcation Location: Proximal, middle, or distal third Type: Plastic deformation, incomplete ("greenstick"), com- pression ("torus" or "buckle"), or complete displacement angulation Associated physeal injuries: Salter-Harris Types I to V SCAPHOID Classiﬁcation Type A: Fractures of the distal pole Type A1: Extraarticular distal pole fractures Type A2: Intraarticular distal pole fractures Type B: Fractures of the middle third Type C: Fractures of the proximal pole 86 FRACTURE CLASSIFICATIONS IN CLINICAL PRACTICE FIGURE 4. FRACTURES IN CHILDREN 87 TIBIAL SPINE (INTERCONDYLAR EMINENCE) FRACTURES Meyers and McKeever Classiﬁcation (Figure 4. FRACTURES IN CHILDREN 89 CALCANIAL FRACTURES Schmidt and Weiner Classiﬁcation of Calcaneal Fractures Type I: Fracture of the tuberosity of apophyses Type IA: Fracture of the sustentaculum Type IB: Fracture of the anterior process Type IC: Fracture of the anterior inferolateral process Type ID: Avulsion fracture of the body Type II: Fracture of the posterior and/or superior parts of the tuberosity Type III: Fracture of the body not involving the subtalar joint Type IV: Nondisplaced or minimally displaced fracture through the subtalar joint Type V: Displaced fracture through the subtalar joint Type VA: Tongue type Type VB: Joint depression type Type VI: Either unclassiﬁed or serious soft-tissue injury, bone loss, and loss of the insertions of the Achilles tendon Chapter 5 Periprosthetic Fractures PERIPROSTHETIC HIP FRACTURES Vancouver Classiﬁcation (Duncan and Masri) Type A: Involve the trochanteric area (AG involve the greater trochanter, AL involve the lesser trochanter) Type B: Fractures around the stem or extending slightly dis- tal to it (B1 implant well ﬁxed, B2 implant loose, bone stock adequate, B3 implant loose, bone stock inadequate) Type C: Fractures distal to the stem that the presence of the femoral component may be ignored Johansson Classiﬁcation Type I: Fracture proximal to prosthetic tip with the stem remain- ing in the medullary canal Type II: Fracture extending beyond distal stem with dislodge- ment of the stem from the distal canal Type III: Fracture entirely distal to the tip of the prosthesis Cooke And Newman (Modiﬁcation Of Bethea) (Figure 5. Cooke and Newman classiﬁcation of periprosthetic fracture about total hip implants. Reproduced with permission and copyright © of The Journal of Bone and Joint Surgery, Inc. See Spine position of occiput Children, fractures in relation to C1, 1 calcaneal, 89 Atlas fractures, Levine and forearm, 85 Edwards classiﬁcation, 1 hip, 86 lateral condylar physeal, B 81–82 Bado classiﬁcation, medial condylar physeal, 82 Monteggia fracture, radial head and neck, 28–29 83–85 98 INDEX Children, fractures in (cont. See joint, ﬁrst, 78 Tarsometatarsal joint INDEX 101 Lunate fractures, Teisen and Monteggia fracture Hjarkbaek classiﬁcation, Bado classiﬁcation, 28–29 34 Letts classiﬁcation, 84–85 Luxatio erecta, 18 Myerson classiﬁcation, tarsometatarsal joint, 76 M Main and Jowell N classiﬁcation, midtarsal Navicular fractures, 72–74 joint, 71–72 Eichenholtz and Levin Mallet fracture, Wehbe and classiﬁcation, 72 Schnider classiﬁcation, Sangeorzan classiﬁcation, 36 72–74 Mason classiﬁcation, radial Neer classiﬁcation head, 26 knee fractures, McAfee classiﬁcation, periprosthetic, 92–93 thoracolumbar spine proximal humerus, 18–19 fractures, 6 Medial condylar physeal O fractures, 82 Occipital condyle fractures, Metatarophalangeal joint, Anderson and Montisano ﬁrst classiﬁcation, 1 Bowers and Martin Odontoid process fractures, classiﬁcation, 77 Anderson and D’Alonzo Jahss classiﬁcation, 78 classiﬁcation, 2–3 Metatarsal Olecranon, Morrey Bowers and Martin classiﬁcation, 25 classiﬁcation, 77–78 Orthopaedic Trauma dislocation, 78 Association classiﬁcation ﬁfth, Dameron cervical spine injuries, 6 classiﬁcation, 77 cuboid fractures, 74 metatarophalangeal joint, 77–78 P tarsometatarsal joint, 75–77 Patellar fractures, 55–56 Meyers and McKeever descriptive classiﬁcation, 55 classiﬁcation, tibial spine, Saunders classiﬁcation, children, 87 55–56 Midtarsal joint, Main and Pauwels classiﬁcation, Jowell classiﬁcation, femoral neck fractures, 71–72 44 Milch classiﬁcation Pediatric fractures. See condylar fractures, 23 Children, fractures in lateral condylar physeal Pelvis, 37–39 fractures, children, acetabulum, 39 81–82 Tile classiﬁcation, 38–39 102 INDEX Pelvis (cont. All rights reserved, whether the whole or part of the material is concerned, speciﬁcally the rights of translation, reprinting, reuse of illustrations, recitation, broad- casting, reproduction on microﬁlm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September, 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Product liability: The publisher cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Editor: Simon Rallison, Heidelberg Desk editor: Anne Clauss, Heidelberg Production editor: Nadja Kroke, Leipzig Cover design: design&production GmbH, Heidelberg Typesetting: LE-T XJE elonek,Schmidt&VöcklerGbR,Leipzig Printed on acid-free paper SPIN 11533467 27/3150/YL – 5 4 3 2 1 0 Abbreviations IX VMpo Nucleus ventralis medialis, posterior part VPI Nucleus ventralis posterior inferior VPL Nucleus ventralis posterior lateralis VPLc Nucleus ventralis posterior lateralis, caudal part VPLo Nucleus ventralis posterior lateralis, oral part VPM Ventral posteromedial thalamic nucleus VR1,VRL1 Vanilloid receptors 1 and L1 VZV Varicella-zoster virus List of Contents 1 tro uc ti o..............................................