HISTORY OF PRESENT ILLNESS  Date of birth  10  4  88 . This patient is a 5 year old white female with a history of type I renal tubular acidosis on nephrocalcinosis who was admitted to Noughwell Entanbon Health of Washington on 9  5  93 at 2116 hours with a 2-3 day history of chills   fevers   cough   vomiting and weakness  unable to walk  . At Noughwell Entanbon Health   her temperature was 101   pulse 135   blood pressure 94  74   respiratory rate 20 . Positive findings of physical examination include chicken pox lesions on thorax   sunken eyes   thick nasal discharge   dry lips   tongue and mucous membranes   red tonsils . The remainder of the physical examination was considered within normal limits . Admission diagnosis at Ni Hospital &aposs  vomiting and dehydration   hypokalemia   hyponatremia   tonsillitis . A peripheral intravenous line was started on Labor Day in the a.m. No respiratory distress was noted . Oral cyanosis and shallow respirations were noted on 9  7  93 at 245 a.m. Therefore the patient was intubated at 345 a.m. on 9  7  93 . Chest x-ray was unremarkable . Cardiovascular stable   significant hypertension was noted on 9  7  93 at 510 a.m. and therefore 10 cc&aposs per kilo albumin was given . The patient was admitted was started on clear fluids   tolerated   with D5 normal saline plus 40 mEq per liter of KCL at a rate of 50 cc &aposs per hour for 9 hours .  100 cc&aposs per kilo  . Sodium and potassium at this time were 128  1.5 . At Labor Day   930 a.m.   the fluids were increased to 100 cc&aposs per hour  200 cc&aposs per kilo for 5 hours  . Electrolytes at this point were sodium 132   potassium 1.8 . At 9  6  93   230 p.m.   fluids were decreased to 75 cc&aposs per hour   150 cc&aposs per kilo   40 mEq of K phosphate added to the intravenous fluids . Electrolytes at this point were a sodium of 143 and potassium 1.7 . On 9  6  93   2200   fluids were changed to D5 normal saline plus 40 KCL and 40 K phosphate at 75 cc &aposs per hour . This rate was maintained for 11 hours . Electrolytes at this time were a sodium of 148   potassium 1.7 . At 9  7  93   100 a.m.   intravenous fluids rate was decreased to 50 cc&aposs per hour   total fluids given during the first 24 hours were 140 to 150 cc&aposs per kilo per day . At this time   sodium was 147   potassium 2.6   total sodium given during the first 24 hours 20 mEq per kilo per day . On 9  7  93 at 400 a.m.   albumin bolus 5 10 cc&aposs per kilo was given   a total of 120 cc&aposs   electrolytes were sodium 155   potassium 3.1 . At 9  7  93 at 500 a.m.   sodium bicarbonate given 60 mEq   calcium bolus 10 cc&aposs given . On 9  7   530 a.m.   D5 quarter normal saline   and 40 of K phosphate at 100 cc&aposs per hour was given . The patient was taking PO initially until 9  6  93 at 1745 . There were no abnormal findings in abdominal exam . On 9  5  93   hematocrit 48   white blood count 11.2   neutrophiles 67   bands 14   lymphs 11   monos 6   meta 2   platelets 220 000 . Copious urine output   BUN 1.0   creatinine .8 . Normal neurologic exam on admission   then lethargic on 9  6  93 at 1745   then patient became unresponsive   areflexic and limp at 9  6  93   at 1745 to 2200 . Patient was having seizures   twitching of face and rapid movements of eyes . Pupils dilated and sluggish . Valium was given at 9  7  93   0002 . IV ampicillin   chloramphenicol   ceftriaxone   and culture were sent . Finally   Fairm of Ijordcompmac Hospital transport team was called and transport team arrived on 9  7  93   630 a.m.   and on arrival patient was seizing with rhythmic eye movement to left . The patient was unresponsive   poor perfusion . Temperature was 101.8 . A second intravenous was started and given normal saline bolus   change in intravenous fluids to D5 water with 80 mEq of bicarbonate   plus 40 mEq of KCL at 45 cc&aposs per hour   bicarbonate given 2 mEq per kilo   attempted to start dopa for poor perfusion but worsening perfusion . Therefore   dopa was stopped . Total volume given as bolus 50 cc&aposs per kilo   sodium bicarbonate at 2 mEq per kilo was given . Last ABG there was 6.98   31   171   bicarbonate of 7 . Phenobarbital and Dilantin given for seizure control . Electrolytes before departure for Fairm of Ijordcompmac Hospital was a sodium of 176   potassium 2.5   chloride 140   bicarbonate 14   calcium 7.2   magnesium 2.7 . Admission to the Pediatric Intensive Care Unit at Fairm of Ijordcompmac Hospital was 9  7  93   1115 a.m. Lines placed were a right femoral triple lumen   endotracheal tube 4.0   arterial line   right radial line   Foley placed   peripheral intravenous line   nasogastric tube . On admission to Fairm of Ijordcompmac Hospital   temperature 100.2   pulse 149   respiratory rate 50   blood pressure 98  66   mean arterial pressure of 73   weight 12 kilos .


Prednisone 60 mg daily for 4 days . Continue inhalers as prescribed . Disposition   Follow up and Instructions to Patient  Call Dr. Linketerf tomorrow and make an appointment for follow-up on the lung nodule . THIS IS VERY IMPORTANT .


Cardiac arrest  His arrest was of unknown etiology at the time of admission . No further history was ever gained about his cardiac arrest throughout his hospitalization . CT angiogram had been negative for pulmonary embolism . The patient had an echocardiogram on 2013-04-26   which showed a normal ejection fraction and trivial mitral regurgitation  otherwise no obvious abnormalities were seen . Given the patient had an out of hospital arrest   remained unresponsive despite hemodynamic stability   he was treated with induced hypothermia and with cold packs and a cooling blanket were placed with goals of reducing his core body temperature to 32 degrees Celsius for a period of twelve hours at which point he would be rewarmed over the subsequent six hours . This was done   however   as in problem number two below   we were not successful in any neurologic recovery . Neurology  The patient remained unresponsive after the induced hypothermia   the patient was noticed to develop myoclonic jerks and occasional fluttering of his eyelids . Electroencephalogram revealed the patient was experiencing persistent seizure activity . Neurology was consulted and the patient was treated very aggressively   loaded with multiple drugs   including Ativan and Propofol drips . The patient continued to demonstrate seizure activity despite this . He was loaded with Dilantin and ultimately was treated with a Pentobarb coma . After multiple attempts of weaning the Pentobarb   the patient was continually reverting to status epilepticus which was never able to be suppressed . Infectious disease  Over the course of his hospital stay   the patient s white blood cell count rose to a peak of 17 . Multiple cultures were done and the patient was ultimately found to have methicillin resistant Staphylococcus aureus bacteremia   pneumonia   and urinary tract infection . For all these infections   the patient was treated with Vancomycin and he was also on Levofloxacin and Flagyl for presumed aspiration pneumonia at the time of his admission . Blood cultures cleared by 2013-05-03 . Sputum culture as late as 2013-05-10   however was still positive for coagulase positive Staphylococcus which was methicillin resistant Staphylococcus aureus . The patient remained gravely ill throughout his hospital stay and had multiple meetings were held with his family with his son being his next of kin . Ultimately it was decided that the patient s wishes would be to not be maintained in a vegetative state and given his poor prognosis ultimately the decision was made to pursue comfort measures only . With these goals of care   the patient expired on 2013-05-11 . The family did consent to a postmortem examination . DISCHARGE DIAGNOSES  Cardiac arrest . Anoxic brain injury Status epilepticus Methicillin resistant Staphylococcus aureus pneumonia . MRSA urinary tract infection . MRSA Bacteremia . Steven Welch   Montana 61528 Dictated By  Julie DD George   M.D. MEDQUIST36 D  2013-12-24 135505 T  2013-12-24 204707 Job  52892 Signed electronically by  DR. Patricia Henley on  Maxine 2014-01-02 1045 AM


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'Seamless care that revolves around you: more than 4,700 physicians and scientists collaborate across Mayo Clinic campuses in <TARGET_REGION>, Florida and Minnesota. U.S. News & World Report ranks Mayo Clinic as the #1 hospital overall and #1 in more specialties tha'


Input: [Problem] Respiratory illness [Signs] Sneezing, coughing, gasping, swollen face [Common Cause] Mycoplasmosis (MG), infectious coryza, infectious bronchitis [Possible Actions]

Output: Isolate sick birds from the rest of the flock

Causes of Common Problems of Hens - For Dummies


Input: [Problem] Feather loss [Signs] All over [Common Cause] Normal molt or louse infestation [Possible Actions]

Output: Examine feather shafts for lice

Causes of Common Problems of Hens - For Dummies


Input: [Signs] Head, neck, and shoulders [Common Cause] Feather pecking from flock mates, poking head through wire fence [Possible Actions]

Output: Observe flock for signs of feather pecking behavior

Causes of Common Problems of Hens - For Dummies


Input: [Signs] Vent area [Common Cause] Feather pecking from flock mates [Possible Actions]

Output: Provide toys and veggie scraps to keep the flock busy

Causes of Common Problems of Hens - For Dummies


Input: [Problem] Strange eggs [Signs] Thin shells [Common Cause] Old hen, hot weather, or lack of calcium in diet [Possible Actions]

Output: Keep hens cool, provide oyster shell for the hens to eat

Causes of Common Problems of Hens - For Dummies


Input: [Signs] Soft or no shells [Common Cause] A scare or a stressful event, or an infection of the oviduct [Possible Actions]

Output: Handle hens quietly and gently. Make their living quarters safe from predators.

Causes of Common Problems of Hens - For Dummies


Input: [Signs] Blood-stained shells [Common Cause] Young hen, underweight hen, or vent pecking by flock mates [Possible Actions]

Output: Feed good quality layer diet. Place nest boxes no more than 18 inches off the ground.

Causes of Common Problems of Hens - For Dummies


Input: [Signs] Weird-shaped shells: ridges, chalky coating, lumps, and so on [Common Cause] Stress, rough handling, too few nest boxes, or oviduct infection [Possible Actions]

Output: Provide more nest boxes. Handle hens quietly and gently.

Causes of Common Problems of Hens - For Dummies


Input: [0] acted [1] edited [2]

Output: proofread

Selling Yourself in a Resume with Action Words - For Dummies


The American who inspires terror from Paris to the U.S.

Senior White House officials began debating whether they should target him for death.

['Senior', 'White', 'House', 'officials', 'began', 'debating', 'whether', 'they', 'should', 'target', 'him', 'for', 'death.']


Justice Antonin Scalia Dies at Age 79 - Breitbart

In 1992 he wrote that Roe v.


598403789 DH 8993683 816711 963035 02/25/2001 12:00:00 AM ED Discharge Summary Unsigned DIS Report Status : Unsigned ED DISCHARGE NOTIFICATION GLYN , AEA MRN : 8993683 Age : 67y REGISTRATION DATE : 02/25/2001 12:20 PM PRELIMINARY REPORT This is to notify you that your patient , GLYN , AEA arrived in the Emergency Department at Daughtersvillshamen's Hospital on 02/25/2001 12:20 PM . The patient presented with a chief complaint of HEMATURIA . Following evaluation and treatment , the patient 's disposition at the end of the visit was ADMITTED AS AN INPATIENT TO DAUGHTERSVILLSHAMEN'S HOSPITAL . The patient 's preliminary admitting physician is LINKETHORE , HANSVERLLEN G and the preliminary diagnosis is HEMATURIA . Please note this information may have been updated on the inpatient unit . If you need additional information please call 613-870-0699 . PCP Name : SWANKEMANDESSKIAIS , SANTCINET E Provider Number : 42283


920798564 CTMC 70160673 840502 3/3/1999 12:00:00 AM PROSTATE CANCER AND RENAL FAILURE Signed DIS Admission Date : 03/03/1999 Report Status : Signed Discharge Date : 03/08/1999 PRINCIPAL DIAGNOSIS : ACUTE RENAL FAILURE . SIGNIFICANT PROBLEMS : 1. METASTATIC PROSTATE CA . 2. OBSTRUCTIVE UROPATHY , STATUS POST LEFT NEPHROSTOMY . 3. HYPERTENSION . 4. ANEMIA . 5. GASTROESOPHAGEAL REFLUX DISEASE . CHIEF COMPLAINT : This 88-year-old male with history of prostate CA was admitted from an outside hospital secondary to persistent hematuria status post nephrostomy tube placement transferred to Retelk County Medical Center for further management . HISTORY OF PRESENT ILLNESS : Mr. Prehekote is an 88-year-old Portuguese speaking only male who was diagnosed with adenocarcinoma of the prostate in 1998 . He received transurethral resection of the prostate one year ago because of persistent urinary retention . After that , he was on Lupron and Nilandron hormone therapy . The patient was admitted on February 23 , 1999 to Eifro Medical Center because of failure to thrive and decreased hematocrit . He was noted to have elevated BUN and creatinine . BUN was 34 and creatinine was 2.6 , up from his baseline of 1.0 . Prostate specific antigen increased from 77.9 to 88 , and the patient also had urinary incontinence and body weight loss . Further evaluation of his renal failure showed that the patient has bilateral hydronephrosis , most likely obstructive uropathy due to prostate CA in the pelvic area . Because of the increasing creatinine to 8.0 on February 28 , 1999 , a left nephrostomy tube was placed . However after the procedure , the patient 's hematocrit dropped to 24 and he was transfused two units of packed red blood cells . His hematocrit increased to about 30 , but he continued to have hematuria and his renal function only improved very slowly . He also received Kayexalate for hyperkalemia . Due to the persistent blood in the urine , he was transferred from Eifro Medical Center to the Retelk County Medical Center for angiographic studies to rule out any vascular injuries . The patient was transferred to Genearocktemp Ry Health on March 3 , 1999 . REVIEW OF SYSTEMS : The patient had constipation with dysuria , but no fever or chills . No cough . No chest pain . No palpitations , history of epigastric pain and body weight loss . No headache . No bone pain . PAST MEDICAL HISTORY : 1) Hypertension . 2) Gastroesophageal reflux disease . 3) Anemia . 4) Prostate CA . ALLERGIES : No known drug allergies . MEDICATIONS : Clonidine 2.5 milligrams topical q. week , Nitropaste 2 inches q.4h. , Nilandron 50 milligrams p.o. q.d. , Lupron , Dulcolax p.r.n. , Colace 100 milligrams p.o. b.i.d. , Ferrous sulfate 300 milligrams p.o. b.i.d. , Lansopiacole 15 milligrams p.o. q.d. , bethanechol 25 milligrams p.o. t.i.d. SOCIAL HISTORY : The patient has been living in the Kansas for more than 20 years . He was originally from Wark and he speaks Portuguese only . He is now living with his son and daughter , and five other children . PHYSICAL EXAMINATION : On admission , the patient was a frail looking elderly male lying in bed in no acute distress . Temperature 95.4 , pulse 120 , blood pressure 150/80 , respiratory rate 24 , 95% on room air . Conjunctiva were not pale . Sclera nonicteric . Pupils : Isocoric cataract bilaterally . Mouth : Mucous membranes slightly dry . No oral ulcers . Neck : Supple . Jugular vein not engorged . Carotid pulses bounding very strongly . No thyromegaly . Chest examination showed some basilar crackles at the right lung base . Heart initially tachycardia , grade II / VI systolic ejection murmur at the left sternal border . Abdomen : Soft . Liver and spleen were not palpable . Bowel sounds normoactive . Extremities : Traced pitting edema . No cyanosis and no clubbing . Peripheral pulses were very strong and bounding . No calf tenderness . Homan 's sign negative . Neurologic : Examination was limited because the patient speaks only Portuguese . LABORATORY DATA : On admission the patient 's biochemistry showed sodium of 140 , potassium 4.0 , chloride 107 , bicarb 14 , BUN 63 , creatinine 5.8 , blood sugar 133 . Liver function test showed AST 21 , alkaline phosphatase 70 , total bilirubin 0.3 , total protein 6.5 , albumin 3.9 , globulin 2.6 . CBC : WBC 8.4 , hematocrit 32.6 , platelet count 194,000 . PT 11.9 , INR 1.0 , PTT 28.4 . Chest x-ray showed no evidence of cardiomegaly . No lung infiltrate . CT scan of the renal area showed right hydronephrosis which extends to an asymmetrically thickened urinary bladder wall . A mass like thickening of the urinary bladder suggestive of either detrusor hypertrophy or possibly tumor . The CT scan showed a cavitary lung lesion in the right lower lobe compatible with metastatic or septic embolus . EKG showed atrial fibrillation , left axis deviation , LVH , nonspecific ST-T changes either due to digitalis affect . CK enzymes 146 . Repeated three times and remained flat . Troponin I on the second day of admission was 1.18 . HOSPITAL COURSE : After admission , urology , nephrology as well as interventional radiology was consulted about the management of this patient . The specialist concluded that because the patient 's hematuria seemed to be stable and hematocrit to maintain at about 29-30 , there is no urgent need to do an arteriogram which may cause further damage to the patient 's kidney . Urology consultation thinks that cystoscopy would not add any benefit to the management and only would consider a right nephrostomy if renal function failed to improve . After admission , the patient was treated conservatively to correct his electrolyte and metabolic acidosis . He was given blood transfusion , two units when his hematocrit dropped to 29.4 . After transfusion , the patient 's hematocrit rose to 37.7 on the day of discharge . The patient was also given sodium bicarbonate to correct his metabolic acidosis . He continued to pass about 1500-2000 cc of urine a day and his renal function improved slowly with creatinine decreased to 4.2 on the day of discharge . During this admission , the patient also developed atrial fibrillation with ventricular rate of about 70-80 . CPK was tracked , but was totally normal . No beta blockers were given . A long discussion amongst the specialist , nephrology , urology , interventional radiology , primary oncology as well with the family lead to the conclusion that conservative management may give the patient more comfort than crisis treatment in this well advanced prostate CA . Dr. Lucreamull discussed the patient 's clinical status and overall situation with the patient 's family and the family decided that Mr. Prehekote could return home with hospice . The patient 's primary care physician , Dr. Tomedankell Flowayles will manage the hospice issues . The patient was discharged to home for hospice on March 8 , 1999 . DISCHARGE MEDICATIONS : Bethanechol 25 milligrams p.o. t.i.d. , Clonidine 2.5 milligrams topical q. week , apply every Sunday , Colace 100 milligrams p.o. b.i.d. , Haldol 0.5-1 milligrams p.o. q.6-8h. p.r.n. agitation , Niferex 150 milligrams p.o. b.i.d. , nitroglycerin paste 2% , 2 inches topical q.8h. , Prilosec 20 milligrams p.o. q.d. , Senna tablets 2 tablets b.i.d. , sodium bicarbonate 650 milligrams p.o. t.i.d. for five days , Proscar 5 milligrams p.o. q.d. , Casodex 50 milligrams p.o. q.d. , Nephrocaps 1 tablets p.o. q.d. COMPLICATIONS : None . CONDITION ON DISCHARGE : Fair . DISPOSITION : Home with hospice . Dictated By : KYMBELL SPARDJEB , M.D. BJ43 Attending : LAGEORG LUCREAMULL , M.D. MR28 PN199/1242 Batch : 14667 Index No. UDFTTQ73N9 D : 03/08/99 T : 03/09/99


130959255 FIH 1431063 10119/hy66 738478 6/15/1994 12:00:00 AM RIGHT OCCIPITAL HEMORRHAGIC STROKE . Unsigned DIS Report Status : Unsigned ADMISSION DATE : 6-15-94 DISCHARGE DATE : 6-26-94 PRINCIPAL DIAGNOSIS : Right occipital hemorrhagic stroke . HISTORY OF PRESENT ILLNESS : Ms. Tlandkotesmitskote is a patient who came complaining of feeling dizzy and bumping into objects on her left side . She is a seventy-one year old female with a history of hypertension who is in otherwise good health . This morning while on a cruise ship , she was eating breakfast when she suddenly noticed she could not see a roll on her plate although she knew that it was there . She also felt dizzy and the room was spinning . While walking , she kept bumping into object on her left side . She also complained of a dull , right sided headache over the right eyebrow . Symptoms lasted about five hours and then gradually resolved except for the change in vision . She denied having any weakness , numbness , or pain . She also denies having hoarseness , difficulties in finding words , speaking , hiccups , or diplopia . PAST MEDICAL HISTORY : The past medical history is significant for hypertension . The past surgical history is negative . MEDICATIONS ON ADMISSION : Atenolol , 25 mg PO qd . ALLERGIES : The patient has no known drug allergies . REVIEW OF SYSTEMS : On review of systems , the patient denied any history of transient ischemic attacks . FAMILY HISTORY : Father and mother died in their eighties of heart disease . SOCIAL HISTORY : The patient denied using tobacco . PHYSICAL EXAMINATION : On physical examination , she was a very pleasant , moderately obese female in no apparent distress . She was afebrile and her vital signs were stable . The head was normocephalic and atraumatic . The pupils were equal , round , reactive to light . The tympanic membranes were gray . The fundi were sharp . The neck was supple with full range of movement . The lungs were clear to auscultation bilaterally , without rales or wheezes . The heart had a recovery regular rate and rhythm . The abdomen was soft , nontender , nondistended . Extremities revealed 2+ pitting edema in the knees bilaterally . The neurological examination revealed that the patient was awake , alert and oriented to person , place and time . She was able to subtract serial sevens , remember three out of three objects after five minutes , and there was notable aphasia or word finding difficulty . The cranial nerves showed pupils were bilaterally active from 3 to 2 mm . There was a dense hemianopsia on the left side . The extra ocular muscles were intact bilaterally . Corneals were present bilaterally . Sensation was intact to light touch and pin prick bilaterally . Face was symmetric . Eye closing was tight . Hearing was intact bilaterally . Palate was midline . Gag was intact . The sternocleidomastoid and trapezius had good strength . Tongue was midline . Strength was 5/5 in bilateral upper extremities and bilateral lower extremities in detail . There was no pronator drift . Sensation was intact to light touch , pin prick , and proprioception . Cerebellar examination revealed in intention tremor on the right side . The patient had considerable difficulty with left finger-to-nose movement , most likely secondary to hemianopsia . There was no nystagmus , except for some fine fast beat nystagmus bilateral extremes of abduction . Reflexes were symmetric and 2+ bilaterally at the biceps tendon , 2+ bilaterally at brachial radialis , 2+ bilaterally at the patellar tendon , 1+ bilaterally Achilles tendon . The toes were downgoing bilaterally . Gait : patient had difficulty with tandem gait and fell forward while standing on his his toes . Otherwise , the gait was normal . LABORATORY DATA : Laboratory studies on admission demonstrated a sodium of 144 , potassium 4.1 , chloride 106 , bicarbonate 20.0 , BUN and creatinine 12/0.7 , glucose 99 , white blood count of 5.7 , hematocrit of 40.6 , platelet count of 226 , prothrombin time was 9.4 , partial thromboplastin time was 29 . The computerized tomography scan was performed and showed a right occipital hemorrhage . SUMMARY : The patient is a seventy-one year old female with a history of hypertension who now presents with a right occipital hemorrhagic stroke . HOSPITAL COURSE : The patient was admitted to the hospital for further evaluation and work up . The patient was admitted to the Intermediate Care Unit in the Neurology Intensive Care Unit . However , she was soon moved out of there as her examination appeared to be stable . A Neurosurgery Service consultation was obtained and they felt that no surgical intervention was required . The patient underwent a number of tests . She had a magnetic resonance imaging study and magnetic resonance imaging angiogram performed which showed a large hemorrhagic lesion on the occipital lobe . There was no clear enhancing mass , but follow up was suggested . So an magnetic resonance imaging angiogram was obtained and showed the right parietal occipital hemorrhage . The MRA showed mild narrowing of the left ICA just distal to the bifurcation . There was also scattered T2 hyperintense foci within the periventricular and left frontal white matter consistent with small vessel disease , gliosis or demyelination . A Holter monitor was obtained and showed that the patient was in normal sinus rhythm . The heart rate was 53 to 106 . There were some very rare atrial premature contractions . There were no ventricular premature contractions . An echocardiogram was obtained and showed that the ejection fraction was 60% and there was no thrombus . It was felt to be within normal limits . Over the ensuing days , the patient had several episodes of confusion at night . However , these gradually resolved . She also developed what appeared to be urinary tract infection and was placed on PO Bactrim . By 6-26-94 , the patient was felt to be ready for discharge . At that time , she was afebrile and her vital signs were stable . She was tolerating a regular diet . She was awake , alert and oriented to person , place , and time . She continued to have a dense left hemianopsia , but otherwise was neurologically intact . The patient was discharged home with Santea Gehawhi General Hospital care and instructed to follow up . MEDICATIONS ON DISCHARGE : The patient was discharged on Tenormin , 25 mg PO qd ; Bactrim DS , one PO bid x5 days . TATAJO SEE , M.D. TR : ba / bmot DD : 8-4-94 TD : 08/06/94 CC :


212512774 WGH 6218589 29021 9923207 10/31/2004 12:00:00 AM OB Discharge Summary Signed DIS Report Status : Signed OB EMR L and D DISCHARGE SUMMARY NAME : RIASHWAN BERLNI VALLEY UNIT NUMBER : 130-93-91 ADMISSION DATE : 20041031 DISCHARGE DATE : 20041103 PRINCIPAL DISCHARGE DIAGNOSIS : Vaginal Delivery With Second Degree Laceration ASSOCIATED DIAGNOSES : Abnormal Laboratory Result ; Abnormal Pap Test ; Monilial Vaginitis PRINCIPAL PROCEDURE OR OPERATION : Spontaneous Vertex Vaginal Delivery ASSOCIATED PROCEDURES OR OPERATIONS : POSTPARTUM DIAGNOSTIC PROCEDURES : None POSTPARTUM THERAPEUTIC PROCEDURES : None OTHER POSTPARTUM THERAPIES : Routine Post Partum Care HISTORY AND REASON FOR HOSPITALIZATION : Premature Rupture Of Membranes PHYSICAL EXAMINATION : HEIGHT 63 HEENT NORMAL MOUTH NORMAL NECK NORMAL BREASTS NORMAL No masses NIPPLES NORMAL CHEST NORMAL CTA bilat , neg wheezing COR NORMAL NSR , no murmur ABDOMEN Gravid , vtx . EFW = 7# . FHTs 140s w/ reactivity . Mild irreg. ctx . EXTREM NORMAL SKIN NORMAL NODES NORMAL VULVA NORMAL VAGINA Leaking copious amounts clear fluid . Fluid amnioswab and fern positive . SSE and digital exam deferred CERVIX digital exam deferred at time of admission OS NORMAL see above ADNEXAE NORMAL non-palp d / t advanced gest UTERUS Gravid , vtx . EFW = 7# . FHTs 140s w/ reactivity . Ctx q 6 ' . UTERINE SIZE IN WEEKS 38 HOSPITAL COURSE ( include complications if any ) : This 27 year old Gravida 1 Para 0000 was admitted to the Life Valley Medical Center Obstetrical service on 10/31/2004 at 08:45 pm for the indication ( s ) : premature rupture of membranes . She delivered a 3235 gram male infant on 11/01/2004 at 09:31 am with apgar scores of 9 and 9 at one and five minutes respectively at 39.0 weeks gestation via spontaneous vertex vaginal delivery . During her labor she encountered the following complication ( s ) : none . During her delivery she encountered the following complication ( s ) : none . Postpartum she encountered the following complication ( s ) : none . She was discharged on 11/03/2004 at 11:18 am in good condition . DISCHARGE ORDERS ( medications instructions to patient , follow-up care ) : DISCHARGE ACTIVITY : No Restrictions DISCHARGE DIET : No Restrictions POSTPARTUM DISPOSITION : Home With Self-Care ( Routine Discharge ) POSTPARTUM CARE SITE : La Community Hospital POSTPARTUM RETURN APPOINTMENT ( DAYS ) : 42 BREAST FEEDING AT DISCHARGE : Yes POSTPARTUM RH IMMUNE GLOBULIN : Not Indicated POSTPARTUM MEASLES / MUMPS / RUBELLA VACCINE : Not Indicated MEDICATION ( S ) ON DISCHARGE : Multivitamins And Folate Electronically Signed : Fyfe , Lan S 11/03/2004 11:19:27 AM


959086752 PUOMC 6824024 094907 812890 2/1/2000 12:00:00 AM Discharge Summary Signed DIS Report Status : Signed DISCHARGE SUMMARY NAME : RATHELIFE , TIEANAKI B UNIT NUMBER : 342-07-28 ADMISSION DATE : 02/01/2000 DISCHARGE DATE : 02/08/2000 PRINCIPAL DIAGNOSIS : Non-healing ulcer on the right leg . PRINCIPAL PROCEDURE : Right fem to below knee pop bypass graft . HISTORY OF PRESENT ILLNESS : This patient is an seventy eight year old female with history of peripheral vascular disease who is status post above knee to fem pop bypass graft with 6 millimeter PTFE . This operation was performed for two months of increased rest pain . Her pain resolved after surgery and she has been doing well since , although at baseline now she is minimally ambulatory from bed to commode . For the past couple of months the patient has had a non-healing right dorsal foot ulcer which has been increasing in size and started as a pin hole and she does not recollect any trauma , as similar small ulcers developed on the left foot as well around the same time , but that has subsequently healed . The ulcer was managed conservatively at Har Hospital by Dr. Holes with Silvadene b.i.d. lower extremity non-invasive study obtained at that time showed poor distal right extremity perfusion . The patient was referred back to Dr. Pop for the possibility of a revascularization procedure . She is status post angiography today . She has just finished a ten day course of Ciprofloxacin . She denies any fevers or chills . She does have rest pain in the right foot and ankle . PAST MEDICAL HISTORY : Significant for Guillain-Barr syndrome , Lupus , status post multiple decubiti , peripheral vascular disease , status post right total knee replacement and status post cholecystectomy , status post hysterectomy , status post goiter and left lung fibrosis , status post methicillin resistant Staphylococcus aureus pneumonia . MEDICATIONS ON ADMISSION : Prednisone 5 every other day , alternating with ten every other day . Trental 400 milligrams t.i.d. , Cytotec 100 milligrams t.i.d. , Ativan 2 milligrams q.h.s. Darvon 65 milligrams two q.i.d , Relafen 500 milligrams b.i.d , Vitamin E , Prilosec 20 milligrams once a day , Zantac 150 milligrams b.i.d , Lasix 120 milligrams every other day PRN edema . Didronel 1 q day which has been on hold . Proventil inhaler via nebulizers 0.5 milligrams with Atrovent . ALLERGIES : The patient is allergic Ampicillin , Tylenol , Clinoril , Biaxin , Codeine , Sulfa and Aminophylline . PHYSICAL EXAMINATION : She is afebrile , her vital signs are stable . Her pupils equal round reactive to light and accomodation , normocephalic , atraumatic , extraocular muscles intact . Neck , she has II+ bilateral carotids , no bruits , no jugular venous distention . Lungs decreased breath sounds at bilateral bases with minimal expiratory crackles on the right . Abdomen , soft , non-tender , non-distended , normal active bowel sounds . Extremities on the right , she has a II+ femoral , no distal pulses beyond that . On the left she has a II+ femoral and II+ popliteal , no distal pulses beyond that . She has on her right ankle anteriorly a four centimeter ulcer with necrotic base . Minimal surrounding erythema . She is able to wiggle her toes bilaterally . Sensation is intact bilaterally . Her legs are tender to touch bilaterally . Her angiography showed a right proximal popliteal occlusion , anterior tibial dominant foot vessel . Small posterior tibial occlusion on the distal calf and a small peroneal goes down to the ankle . On a rectal examination she is guaiac negative , no masses and no gluteal ulcers or decubiti . HOSPITAL COURSE AND TREATMENT : The patient was admitted and taken to the operating room on the following day and she underwent a right fem to below knee popliteal bypass graft using a six millimeter ring PTFE . She had a strong popliteal doppler pulse intraoperatively and good PVR on the right postoperatively . The patient did well in the postoperative period . She was afebrile , her vital signs were stable . She was making adequate urine output anywhere between 20 to 50 ccs an hour . Her hematocrit was 26.8 and she was transfused 1 unit of packed red blood cells . Her diet was advanced from clears to a diet as tolerated . On postoperative day two the patient was noted to have some swelling in her left lower extremity and this was felt to be a hematoma secondary to her PVR cuff . There is mild amount of surrounding erythema and the patient was started on Ancef at that time . The patient was seen by physical therapy . The area of erythema on her left leg enlarged slightly and the patient was placed on Vancomycin for several days after which time her erythema again began to decrease . Her right foot remained warm . She had wounds which were clean , dry and intact and the patient was stable from a respiratory standpoint using her respirator at night . The patient required an additional blood transfusion during her hospital stay as her hematocrit had decreased to 27 on postoperative day three . The patient while in bed had her legs elevated . The patient was tolerating a general diet , she was voiding on her own and the patient was discharged to home as her daughter is a nurse . She was discharged with PO Keflex that she was to take for the next ten days . The patient is to follow up with Dr. Pop in one week and the patient was afebrile with stable vital signs at the time of discharge . LAYMIE ASLINKE , M.D. DICTATING FOR : Electronically Signed EDRY R YELLOW , M.D. 03/16/2000 13:21 _____________________________ EDRY YELLOW , M.D. TR : nw DD : 02/09/2000 TD : 02/12/2000 1:41 P cc : EDRY R YELLOW , M.D.


433651389 CTMC 81247987 625670 08/16/1998 12:00:00 AM MENTAL STATUS CHANGE , CELLULITIS Signed DIS Admission Date : 08/16/1998 Report Status : Signed Discharge Date : 08/18/1998 PRINCIPAL DIAGNOSIS : MENTAL STATUS CHANGES . OTHER DIAGNOSES : 1) AORTIC STENOSIS . 2) MITRAL REGURGITATION . 3) STATUS POST FALL . 4) HISTORY OF TRANSIENT ISCHEMIC ATTACK / CEREBROVASCULAR ACCIDENT . 5) RIGHT LOWER EXTREMITY WOUND . 6) ATRIAL FIBRILLATION . HISTORY OF PRESENT ILLNESS : The patient is an 88 year-old woman undergoing treatment for a right lower extremity cellulitis who was transferred from Child for worsening cellulitis and new confusion . The patient has a history of severe aortic stenosis and was recently admitted to the Retelk County Medical Center for a Nafcillin sensitive Staphylococcus aureus cellulitis of the right leg treated with a course of Nafcillin and Levofloxacin . There was also a right leg fluid collection that was incised and drained on August 1 , 1998 . The patient was sent to rehabilitation on Levofloxacin orally . Although details were not available at the time of admission , apparently , she had done well until the 24 hours proceeding admission when the cellulitis was felt to be worsening . She had also been noted to be confused and combative during that 24 hour period . As her baseline mental status is completely alert and oriented , this caused concern amongst the staff of the rehabilitation center and the patient was transferred to the Retelk County Medical Center . PAST MEDICAL HISTORY : 1) Aortic stenosis , severe , echocardiogram in July of 1998 with a peak gradient of 6-8 mm of mercury , aortic valve area calculated to be 0.5 cm squared by the continuity equation . The patient has a history of congestive heart failure . Calculated ejection fraction was 45-50% . 2) Mitral regurgitation , 2+ on July of 1998 echocardiogram . 3) History of atrial fibrillation . 4) History of cerebrovascular disease . 5) Hypertension . 6) History of temporal arteritis on chronic steroids . 7) History of colitis . 8) History of vertebral body fractures . MEDICATIONS ON ADMISSION : 1) Digoxin 0.125 mg p.o. q. day . 2) Lasix 80 mg p.o. b.i.d. 3) Aspirin 81 mg p.o. q. day . 4) Coumadin 2 mg p.o. q.h.s. 5) Zaroxolyn 2.5 mg p.o. q. day . 6) Toprol XL 50 mg p.o. q. day . 7) Potassium 20 mEq p.o. q. day . 8) Prednisone 5 mg p.o. q.o.d. 9) Fosamax 10 mg p.o. q. day . 10) Levofloxacin 250 mg p.o. q. day . 11) Axid 150 mg p.o. b.i.d. 12) Buspar 5 mg p.o. t.i.d. 13) Zyrtec 10 mg p.o. q. day . ALLERGIES : The patient had no known drug allergies . SOCIAL HISTORY : The patient is presently staying at the Gangistown Hospital Center . She has a son who is actively involved in her care . PHYSICAL EXAMINATION : Physical examination on admission revealed an elderly woman , sleeping , responsive only to noxious stimuli after having received some sedation in the emergency department . Vital signs : Heart rate 60 , respiratory rate 18 , blood pressure 116/80 , temperature 97.1 degrees , oxygen saturation 93% on room air . Head and neck examination was benign . Skin examination was notable for a leg ulcer and cellulitis to be delineated below . There were no spider angiomata . Neck was supple with no thyromegaly . Lungs were clear to auscultation bilaterally . The heart examination revealed that the patient had a sustained PMI which was located in the left mid clavicular line , S1 , near complete obliteration of the second heart sound by a two out of six high pitched murmur peaking at mid to late systole and heard across the precordium . It radiates to both carotids bilaterally . There was also a blowing holosystolic murmur heard at the patient 's apex to axilla . There was no S3 appreciated . Vascular examination was notable for 1+ carotid impulses which were diminished and delayed and the above mentioned transmitted cardiac murmurs . Abdominal examination revealed that the abdomen was soft , non-tender , non-distended , no organomegaly , no masses , normal active bowel sounds . The patient 's extremity examination was notable for erythema of the right calf with a small ulcer with a relatively clean base . Neurological examination revealed that the patient was quite sedated at this time having received some medications . She was arousable only to painful stimuli . Her pupils were reactive bilaterally . Her face was symmetric . She had an intact gag reflex . She was able to move all four of her extremities in response to pain . Her deep tendon reflexes were slightly diminished at 1+ bilaterally , but symmetric . LABORATORY : The patient 's laboratory data on admission is as follows : Sodium was 142 , potassium 3.3 , chloride 99 , BUN 23 , creatinine 1.1 . AST was 25 , alkaline phosphatase 130 , total bilirubin 3.2 , albumin 3.4 , calcium 8.8 . Digoxin level was 0.8 . Hematocrit was 33.0 , platelet count 627 , white blood cell count 10,000 , MCV 79.8 . Coagulation studies revealed a PT of 17.4 seconds with an INR of 2.1 , PTT 25.5 . The patient 's admission chest x-ray revealed no infiltrate , no congestive heart failure . Head CT scan performed in the emergency department revealed no bleed . Urinalysis revealed trace microscopic hematuria with 47 red blood cells per high powered field , 1+ bacteria . HOSPITAL COURSE : 1) Mental status changes : On admission to the emergency room , the patient was somewhat argumentative and confused as well as uncooperative with procedures . A neurologic work-up was undertaken which included a CT scan of the head which revealed no acute bleed and a lumbar puncture which revealed a glucose of 72 , protein 65 , white blood cell count 19 , red blood cell count 11,500 with no evidence of xanthrochromasia . The Neurology Service evaluated the patient who felt that her agitation was most likely due to infection , her multiple medications , or her metabolic condition . The patient 's mental status slowly began to recover , however on the morning of the first day of admission , August 16 , 1998 , the patient was found after having fallen . A neurological examination was performed which revealed no abnormality and imaging included a head scan which revealed no bleed and a cervical spine series which revealed degenerative joint disease but no obvious fracture . The patient decided not to pursue further testing with a neck CT scan . At the time of discharge , the patient 's mental status is back to its baseline . 2) Right lower extremity cellulitis : The patient was evaluated by the Surgical Service who felt that the wound was clean with some erythema but without evidence of true cellulitis . The patient 's antibiotics were discontinued with the thought that prolonged antibiotics only put her at more risk for infection . 3) Cardiac : The patient has a history of critical aortic stenosis and mitral regurgitation . Fortunately , these issues were not active during the present admission . 4) Status post fall : The patient did fall while inhouse . A head CT scan and cervical spine series were negative . The patient appeared to have no deficits at the time of discharge . 5) Atrial fibrillation : The patient 's Coumadin was continued . 6) Abnormal liver function tests : On admission , the patient was noted to have elevated bilirubins in the 3 range and mildly elevated alkaline phosphatase consistent with a cholestatic picture . These liver function tests will be followed closely as an outpatient . MEDICATIONS ON DISCHARGE : 1) Aspirin 81 mg p.o. q. day . 2) Digoxin 0.125 mg p.o. q. AM . 3) Lasix 40 mg p.o. b.i.d. 4) Zaroxolyn 0.25 mg p.o. q. day . 5) Prednisone 5 mg p.o. q.o.d. 6) Coumadin 2 mg p.o. q.h.s. 7) Kay Ciel 20 mEq p.o. q. day . 8) Fosamax 10 mg p.o. q. day . 9) Amitriptyline 10 mg p.o. q.h.s. 10) Buspar 5 mg p.o. t.i.d. FOLLOW-UP : The patient will be followed at rehabilitation by her primary care physician , Dr. Both . Dictated By : TIA BREUNMULL , M.D. OH29 Attending : RA S. BOTH , M.D. YT79 WH234/2364 Batch : 4025 Index No. FSYAMR79X6 D : 08/18/98 T : 08/18/98


156406283 HLGMC 7213645 64723/51cy 5/28/1993 12:00:00 AM Discharge Summary Unsigned DIS Report Status : Unsigned ADMISSION DATE : 5-28-93 DISCHARGE DATE : 6-4-93 HISTORY OF PRESENT ILLNESS : The patient is a 58 year old right hand dominant white male with a long history of hypertension , changed his medications from Aldomet to Clonidine six weeks ago . The patient has a history of adult onset diabetes mellitus , ankylosing spondylitis , status post myocardial infarction in '96 ( ? ) now with acute onset of left face and arm greater than leg hemiplegia and primary hemisensory loss on the left . Briefly , he was talking to a friend at 5:30 p.m. the day prior to admission , when he had to grab his locker and sit down . His voice became slurred and he had a mild central dull headache . He was unable to move the left side of his body and felt numb on that side . He was taken to Wayskemedcalltown Talmi and transferred to Heaonboburg Linpack Grant Medical Center with a computerized tomography scan showing a 1x2 thalamic capsular hemorrhage without superficial mass effect . His blood pressure was 220/110 there . He denies any visual symptoms or cortical-type symptoms . He is a heavy smoker and drinks 2-3 shots per day at times . MEDICATIONS ON ADMISSION : Vasotec 40 mg q.day , Soma 1 tablet q.day , Demerolprn , Clonidine . ALLERGIES : The patient has no known drug allergies . PAST MEDICAL HISTORY : As described above . FAMILY HISTORY : The family history is positive for diabetes mellitus , positive for cancer . SOCIAL HISTORY : The patient lives with two people in Cinglendda . PHYSICAL EXAMINATION : On physical examination , patient is in no acute distress , afebrile , blood pressure 134/80 , heart rate 80 and regular , no bruits . Cardiovascular exam : regular rate and rhythm with a I/VI systolic ejection murmur . His lungs were clear to auscultation and percussion . The abdomen was soft and non-tender , obese , with normal bowel sounds . Back and neck were stiff and sore , without localizing tenderness . On neurological examination , mental status alert and oriented x three , good memory , fluent speech , good repetition and naming . Able to describe two routes from house to the CMH . The cranial nerves showed full visual fields without extinction , pupils 5 to 3 bilaterally and equal , disks flat , lower left facial decreased sensation to temperature , pin prick on the left V1 through V3 , tongue deviates to the left , good gag , decreased shrug on the left . Motor examination showed full power on the right arm and leg , could barely flex fingers of the left hand , pulls left arm medially only . Left leg could flex 2/5 and wiggle toes . On sensory examination , had decreased pin prick , temperature , vibration in the left side of the body . The finger-to-nose was okay on the right . On reflex examination , 2 on the right upper extremity , 2+ on the left upper extremity , 2 on the right knee , 0 on the right ankle , with down going toe on the right . Three on the left knee , 4 on the left ankle with upgoing toe and clonus on the left . LABORATORY DATA : Electrolytes were within normal limits , glucose 192 , BUN and creatinine 9/0.7 , hematocrit 49.5 , white blood count 7.9 , platelet count 166,000 , 65% polys , 3 bands , 24% lymphs . The electrocardiogram showed normal sinus rhythm with old Q wave inferior myocardial infarction . Head computerized tomography scan showed 1.5 to 2 centimeter bleed in the right thalamus extending to the internal capsule with mild distortion only , no shift . The chest X-ray was clear . HOSPITAL COURSE : The patient was admitted to the floor for observation . The neurological examination on discharge was no movement in the hand on the left or arm . Slight abductive and adductive movement on the left only in the upper extremity . On the lower extremity , could wiggle toes , flexor and plantar , 3+/5 , quadriceps 4/5 on the left . 2. hypertension . The patient was managed with Vasotec , Nifedipine and Clonidine with blood pressure under good control at the time of discharge , average 125 systolic , 70 diastolic , heart rate of 72 . Also managed with Valium 5 mg PO t.i.d. Muscle spasms were managed with Flexeril 10 PO t.i.d. 3. diabetes mellitus . The patient was started on 2.5 of Micronase with resulting sugars as low as 63 , decreased to 1.25 mg q.day . The patient is discharged in fair condition with medical approval to the Pasi . MEDICATIONS ON DISCHARGE : Vasotec 20 mg PO b.i.d. , Clonidine 0.2 mg PO b.i.d. , Nifedipine 20 mg PO t.i.d. , Flexeril 10 mg PO t.i.d. , Valium 5 mg PO t.i.d. , Micronase 1.25 mg q.day . ADVERSE DRUG REACTIONS : The patient was found to be allergic to Percocet and Percodan during his hospital course . DISCHARGE DIAGNOSIS : Right thalamic hemorrhage , hypertension , diabetes mellitus . ROBTHER TIMES , M.D. DICTATING FOR : SHAA LEFT , M.D. TR : nj / bmot DD : 6-4-93 TD : 06/04/93 CC : Dr. Namarce Aldridge Pasi STAT


223159990 PUOMC 3546292 181083 366324 7/31/2000 12:00:00 AM ED Discharge Summary Unsigned DIS Report Status : Unsigned ED DISCHARGE NOTIFICATION AKOTEBONTKAYS , JUANQUINTLEO MRN : 3546292 Age : 37y REGISTRATION DATE : 07/31/2000 07:36 PM PRELIMINARY REPORT This is to notify you that your patient , AKOTEBONTKAYS , JUANQUINTLEO arrived in the Emergency Department at Ph University Of Medical Center on 07/31/2000 07:36 PM . The patient presented with a chief complaint of FEVER . Following evaluation and treatment , the patient 's disposition at the end of the visit was ADMITTED AS AN INPATIENT TO PH UNIVERSITY OF MEDICAL CENTER . Your patient was admitted under the care of ANER , AEA M with a preliminary diagnosis of LINE SEPSIS . If you need additional information please call 639-873-2993 .


405868244 YC 70449076 5586564 11/16/2005 12:00:00 AM POSTPARTUM DIS Admission Date : 11/16/2005 Report Status : Discharge Date : 11/19/2005 ****** FINAL DISCHARGE ORDERS ****** WARESIN , SAGAY 702-84-43-7 L06 Room : DBM62-8758 Service : OBS DISCHARGE PATIENT ON : 11/18/05 AT 02:00 PM CONTINGENT UPON cnm evaluation WILL D / C ORDER BE USED AS THE D / C SUMMARY : YES Attending : OBSTETRICS SERVICE , YC , M.D. DISPOSITION : Home DISCHARGE MEDICATIONS : DOCUSATE SODIUM 100 MG PO BID PRN Constipation IBUPROFEN 400-600 MG PO Q6H PRN Pain Food / Drug Interaction Instruction Take with food PRENATAL MULTIVITAMINS ( STUARTNATAL ) 1 TAB PO QD MAALOX-TABLETS QUICK DISSOLVE / CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach DIET : No Restrictions ACTIVITY : Resume regular exercise FOLLOW UP APPOINTMENT ( S ) : BROOKSIDE 2 wks , ALLERGY : NKA ADMIT DIAGNOSIS : pregnancy , term PRINCIPAL DISCHARGE DIAGNOSIS ; Responsible After Study for Causing Admission ) POSTPARTUM OTHER DIAGNOSIS ; Conditions , Infections , Complications , affecting Treatment / Stay postpartum OPERATIONS AND PROCEDURES : Vaginal delivery : Spontaneous Laceration : Perineal , 1st degree Placenta : Delivery : Spontaneous Condition : Normal Certified Nurse Midwife : NEAD , MANERTNY , CNM OTHER TREATMENTS / PROCEDURES ( NOT IN O.R. ) repair of first degree perineal laceration BRIEF RESUME OF HOSPITAL COURSE : G2 T1 P0 A0 L1 Estimated EDC : 12/02/05 Maternal transfer : No Initial newborn exam : No observed abnormalities Baby 1 MRN : 26793023 Delivery date : 11/16/05 02:21 PM Apgars 9,9 Weight : 7lb 4.8 oz 3311 grams Sex : Female ADDITIONAL COMMENTS : DISCHARGE CONDITION : Stable TO DO / PLAN : No dictated summary ENTERED BY : JESCCOT , LA P. , C.N.M ( YW8 ) 11/17/05 08:24 AM ****** END OF DISCHARGE ORDERS ******


693008750 HLGMC 6001356 014235 9/18/2001 12:00:00 AM ED Discharge Summary Unsigned DIS Report Status : Unsigned ED DISCHARGE NOTIFICATION HUHTLAND , CIE MRN : 6001356 Age : 82y REGISTRATION DATE : 09/18/2001 10:52 AM PRELIMINARY REPORT This is to notify you that your patient , HUHTLAND , CIE arrived in the Emergency Department at Heaonboburg Linpack Grant Medical Center on 09/18/2001 10:52 AM . The patient presented with a chief complaint of WHEEZES . Following evaluation and treatment , the patient 's disposition at the end of the visit was ADMITTED AS AN INPATIENT TO HEAONBOBURG LINPACK GRANT MEDICAL CENTER . Your patient was admitted under the care of SAPSCLYSS , LEO R with a preliminary diagnosis of PNEUMONIA , . If you need additional information please call 605-304-8547 . PCP Name : SC , JUSONKIM N Provider Number : 96078


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A Porthcawl RNLI crew with a medic and the coastguard search and rescue helicopter were sent to Sker Beach, near Kenfig Nature Reserve, at 12:50 GMT on Sunday.
Crewman Chris Page said the rider had head injuries and was very cold from lying unconscious on wet sand.
She was treated before being flown to Cardiff's University Hospital of Wales.

A woman has been airlifted to hospital after falling from a horse on a Bridgend county beach.


Verheydt, who had been with Maastricht since 2015, has signed a three-year contract with Harry Kewell's side.
The 25-year-old scored 13 goals in 43 appearances in all competitions last season.
Meanwhile, Watford winger Dennon Lewis, 20, has joined the Reds on a loan deal until 31 December.
Lewis, who made 29 National League appearances on loan at Woking last season, played under Kewell when the Australian was coach of Watford's under-23 team.
Find all the latest football transfers on our dedicated page.

League Two side Crawley Town have signed striker Thomas Verheydt from Dutch second-tier side MVV Maastricht for an undisclosed fee.


The 32-year-old had been playing in the Isthmian Premier Division with Leatherhead following his release by Newport at the end of last season.
Pidgeley has made 260 appearances in spells with nine clubs, including Chelsea, Watford and Millwall.
Forest Green are currently second in the National League table, one point behind leaders Cheltenham Town.
Pidgeley could make his Rovers debut when they host Aldershot on Friday.

National League side Forest Green Rovers have signed goalkeeper Lenny Pidgeley until the end of the season.


The suspected green mamba was found on a ship that had docked in Aberdeen from west Africa last month.
The snake died after it was placed in a freezer by the animal charity after attempts to rehome it with specialist reptile keepers failed.
The snake was later identified as a harmless green tree snake.
Police Scotland said a complaint was under consideration.
Scottish SPCA Ch Supt Mike Flynn said: "We were called out after a green snake arrived in Aberdeen on a boat from Africa.
"The snake was thought to be a green mamba, one of the deadliest snakes in the world. The snake was taken by police escort to our Aberdeenshire animal rescue and rehoming centre.
"Sadly the snake, which staff genuinely believed to be a green mamba, had to be put to sleep after our attempts to rehome it to specialist reptile keepers were unsuccessful."
He added: "We could not keep the snake in our centre due to severe health and safety concerns, as the closest anti-venom is held in Bedford. Green mambas also require a Dangerous Wild Animal Licence which the society does not have.
"The safety of our staff and the public is paramount and as such the snake was placed in a freezer where it passed away.
"The Scottish SPCA is proud of its policy not put healthy animals to sleep. Animals are only put to sleep on veterinary advice if they are too ill or too aggressive to be rehomed, or where we are legally required to do so.
"The decision to euthanise the snake was not taken lightly. Unfortunately, the snake has since been identified as a harmless green tree snake. This has been an honest mistake on the society's part as we genuinely believed this was an extremely deadly snake."
The western green mamba feeds on small animals and rodents and is mainly found in the coastal tropical rainforests of western Africa.
Experts say its bite can be fatal in as little as 30 minutes.

A complaint about the Scottish SPCA putting what was thought to be one of the world's most deadly snakes to sleep is being investigated by police.


The all-rounder has been included in the T20 squad to face Sri Lanka on 5 July at the Ageas Bowl, having been part of the World T20 squad in March.
"It's nice to be involved again," the 26-year-old slow left-armer and right-handed batsman told BBC Radio Solent.
"I wasn't expecting to be as I thought Moeen Ali would, but him being rested hands me another opportunity."
Dawson failed to make an appearance during England's run to the World T20 final in India this year, but his limited-overs performances for Hampshire this season have kept him in contention.
"I'm not sure what team they'll go with," he said.
"I've had some good performances for Hampshire in one-day and T20 cricket and if I keep going with that, hopefully I might get a chance."

Hampshire's Liam Dawson says it would be "amazing" to make his England Twenty20 debut on his home ground.


The Egypt-backed plan had envisaged a regional forum which analysts say might have forced Israel to reveal whether or not it has nuclear weapons.
The proposal was blocked by the US, the UK and Canada. The next review is set for  2020.
Israel neither confirms nor denies it has a stockpile of nuclear weapons.
Speaking after four weeks of negotiations, US Under-Secretary of State Rose Gottemoeller accused Egypt and other Arab countries of "not willing to let go of these unrealistic and unworkable conditions" for future talks.
She also said some participants tried to "cynically manipulate" the whole process.
But Egypt warned that the failure to reach a deal "will have consequences in front of the Arab world and public opinion", the Associated Press news agency reports.
Last month, Egypt had proposed to stage a regional conference - with or without Israel's participation and without an agreed agenda.
Some analysts suggested that this move might have forced Israel - which is not a party to the Treaty on the Non-Proliferation of Nuclear Weapons (NPT) - to publicly clarify its position on nuclear weapons.
Decisions at NPT review conferences - held every five years - are made by consensus.
The failure of the current talks means the next gathering could only be held in 2020 at the earliest.

A UN conference aimed at preventing the proliferation of nuclear weapons has ended in failure after a row over a nuclear-free Middle East proposal.


Mothers-to-be are more likely to get malaria as their immunity is lowered, says the Royal College of Obstetricians and Gynaecologists (RCOG).
Malaria carries serious risks for mother and baby including miscarriage, stillbirth and premature labour.
The tropical disease is transmitted by mosquitoes and causes a fever, flu-like symptoms, vomiting and diarrhoea.
There have been no malaria-related deaths in pregnant or recently pregnant women in the UK in the past decade but the RCOG says it has been receiving inquires from worried women.
In the UK, about 1,500 cases of malaria are reported each year and about 10 people will die, said the RCOG.
It says all non-essential trips to areas with a high risk of malaria should be avoided.
Risk areas include large areas of Africa, Asia including China and India, Central and South America, parts of the Middle East and some Pacific Islands.
If the trip is unavoidable, the college advises women to seek advice from a centre with expertise in malaria which will provide information on ways to reduce the risk of infection.
Women should make sure they are aware of the risk, take out measures such as mosquito nets for bite prevention and take anti-malarial medication.
Philippa Marsden, who chairs the RCOG's patient information committee, said although the risks were still relatively small it was important that women were well-informed.
Cath Broderick of the RCOG women's network said: "If women are worried about symptoms after returning from a high-risk country and think they may have malaria, they should see a doctor immediately and inform them of their recent travels."
Symptoms can take a week or more to develop after being bitten.

Pregnant women should visit countries with a risk of malaria only if their trip is essential, experts are warning.


Researchers at the University of Sheffield said the tumours were effectively "fertilising" the bone to help themselves grow.
The study, in the journal Nature, said it may be possible to protect bone from a tumour's nefarious influence and consequently stop the cancer's spread.
Cancer charities said this opened up "a whole new avenue for research".
Around 85% of breast cancers that spread around the body end up in bone, at which point the cancer is difficult to treat and more deadly.
The scientists, in Sheffield and the University of Copenhagen, discovered patients with secondary cancers had higher levels of an enzyme called LOX being produced by their tumours and released into the blood.
Bone is constantly being broken down and rebuilt. But in a series of experiments on mice, the research team showed LOX was disrupting the process and leaving lesions and holes in the bone.
Using drugs to block LOX prevented the cancer from spreading.
Dr Alison Gartland, a reader in bone and cancer biology at the university, told the BBC News website: "We think it's a significant breakthrough in trying to prevent metastases (secondary tumours) in breast cancer.
"The cancer cells in the primary tumour are actually fertilising the soil for the future growth of itself, LOX is changing the environment in bone to make it better to grow."
The animal tests also showed that a set of osteoporosis drugs called bisphosphonates could prevent the spread of cancer.
Bisphosphonates also interfere with the way bone is recycled in order to strengthen it.
They are already given to some cancer patients, but the Sheffield team believe they could have a much larger role.
The effect was discovered only in oestrogen-negative breast cancers. They account for around a third of cases, but are far more deadly.
Katherine Woods, from Breast Cancer Campaign and Breakthrough Breast Cancer, said: "By unveiling the role that the protein LOX is playing, these results open up a whole new avenue for research and treatments that could stop breast cancer spreading to the bone.
"The research also adds weight to the growing body of evidence supporting the role of bisphosphonates in stopping secondary breast cancer in its tracks.
"The reality of living with secondary breast cancer in the bone is a stark one, which leaves many women with bone pain and fractures that need extensive surgery just when they need to be making the most of the time they have left with friends and family."
The findings may also apply in colon cancer.

Breast cancers can manipulate the structure of bone to make it easier to spread there, a study has found.


Field of the Invention
The present invention relates to a valve timing control system for an internal combustion engine, equipped with a hydraulic actuation type variable valve timing mechanism.

14 schematically shows a construction of a conventional valve timing control system for use in an internal combustion engine.

14 shows, the conventional valve timing control system is made up of an oil pump 1 for supplying a lubricating oil under pressure to a valve timing control system, a cam shaft 2 for opening and closing intake valves and exhaust valves in the internal combustion engine, a VVT (Variable Valve Timing) actuator 3 for varying the rotational phase of the cam shaft 2 with respect to a crank shaft (not shown), an oil control valve 4 for adjusting the quantity of the lubricating oil to be supplied to the VVT actuator 3, a crank shaft rotational-phase detecting means 5 for detecting a rotational phase of the crank shaft, a cam shaft rotational-phase detecting means 6 for detecting a rotational phase of the cam shaft 2, an operational-state detecting means 7 for detecting an operational state of the internal combustion engine, an oil control valve drive circuit 8 for driving the oil control valve 4 electrically, and an ECU 9 for issuing a command to the oil control valve drive circuit 8.

In this construction, the VVT actuator 3 is composed of a cam pulley 2a rotating in synchronism with the crank shaft (the speed of rotation is 1/2 of that of the crankshaft), and an advance (spark-advance) chamber 3a, a retardation (spark-retardation) chamber 3b and a rotor 3c for rotationally shifting the cam shaft 2 to the advancing side or the retarding side.

Secondly, a description will be given hereinbelow of an operation of the conventional valve timing control system for use in the internal combustion engine.

On the basis of the operational state (engine speed, throttle opening degree, charging efficiency, cooling water temperature and others) of the internal combustion engine the operational-state detecting means 7 detects, the ECU 9 is made to determined the optimal valve timing.

Additionally, as a function of the phases of the crank shaft and the cam shaft 2 the crank shaft rotational-phase detecting means 5 and the cam shaft rotational-phase detecting means 6 detect respectively, the ECU 9 calculates the present valve timing.

The ECU 9 calculates a controlled variable (actuation) for the oil control valve 4 so that the deviation between the optimal valve timing and the present valve timing decreases, with this controlled variable being forwarded to the oil control valve drive circuit 8.

The oil control valve drive circuit 8 adjusts the voltage or the current to be supplied to the oil control valve 4 on the basis of a command from the ECU 9 so that the controlled variable commanded by the ECU 9 corresponds to an electrical behavior of the oil control valve 4.

The lubricating oil fed under pressure from the oil pump 1 to the oil control valve 4 is distributed to an advance side oil passage 3d or a retardation side oil passage 3e, communicating with the advance chamber 3a or the retardation chamber 3b, in the oil control valve 4, thereby entering the advance chamber 3a or the retardation chamber 3b.

For the advance of the valve timing, the lubricating oil is supplied into the advance chamber 3a while the lubricating oil in the interior of the retardation chamber 3b is returned through a drain of the oil control valve 4 to an oil pan.

Since the cam shaft 2 is connected coaxially with the rotor 3c in the VVT actuator 3, the rotor 3c is rotated by the oil pressure to the advance side with respect to the cam pulley 2a so that the rotational phase of the cam shaft 2 advances relative to the rotational phase of the crank shaft.

On the other hand, for the retardation of the valve timing, the lubricating oil is given to the retardation chamber 3b while the lubricating oil in the interior of the advance chamber 3a is returned through the drain of the oil control valve 4 to the oil pan.

This operation reverse to the advancing operation causes the retardation of the valve timing.

The driving force of the VVT actuator 3 is determined from an operational torque of the cam shaft and a pressure of the lubricating oil supplied from the oil pump 1, while the conventional valve timing control system has been designed such that the pressure of the lubricating oil and the operational torque of the cam shaft 2 have been estimated from a detection signal (for example, engine speed or cooling water temperature) of the operational-state detecting means 7.

However, the pressure of the lubricating oil not only depends on the characteristic of the lubricating oil, the variation of the oil temperature and the degree of the deterioration thereof, but also varies, for example, due to the variation of the delivery pressure of the oil pump 1 resulting from the bias of the lubricating oil in the oil pan or the like at the decrease in the oil quantity, at the acceleration/deceleration or at the high-speed turning or due to the increase in the pressure loss stemming from the accumulation of foreign matters in the oil supply passages, even if the internal combustion engine takes the same operating conditions.

In addition, the operational torque of the cam shaft varies with the engine speed and the viscosity of the lubricating oil.

For this reason, there is a problem which arises with the conventional control method of determining the controlled variable by estimating the driving force of the VVT actuator 3 on the basis of only the operational state, however, in that the controllability of the valve timing becomes variable.

Additionally, as the case in which the pressure of the supply oil by the VVT actuator 3 drops significantly, there may be an extremely high oil temperature plus a low engine speed, or the accumulation of foreign matters in the oil supply passages.

In these cases, the driving force of the VVT actuator 3 falls, which creates a problem in control of the valve timing to a desired value.

Still additionally, the combustion state of the internal combustion engine becomes unstable.


Q:

Saving and loading dictionary into python

I have the code below to save a dictionary to csv in python.

There are a few answers on here, but none seem to be working
file='Location'
with open(file, 'w') as f:  # Just use 'w' mode in 3.x
    w = csv.

DictWriter(f, mydic.keys())
    w.writeheader()
    w.writerow(mydic)

A:

I would suggest to save a dictionary as json file.

import json

with open('data.json', 'w') as fp:
    json.dump(mydic, fp)

To load the json file:
with open('data.json', 'r') as fp:
    mydic = json.load(fp)


Q:

Using a coordinate pair as a key in a Lua table

As the title says, I'm trying to use a coordinate pair (x, y) as a key for a table.

 Here is what I have done so far
local test = {_props = {}}
local mt = {}
local xMax = 5
local yMax = 5

local function coord2index(x, y)
    return ((x-1) * xMax) + y
end

mt.__index = function(s, k)
    if s._props[coord2index(k[1], k[2])] ~= nil then
        return s._props[coord2index(k[1], k[2])]
    end
end

mt.__newindex = function(s, k, v)
   s._props[coord2index(k[1], k[2])] = v
end
mt.__call = function (t, k)
    if type(k) == "table" then print "Table" end
end

setmetatable(test, mt)

test[{1,2}] = 5
print( test[{1,2}])

This is actually working as expected.

What I'm really wondering if there is a way to reduce this even more, something like test[1,2] = 5 and print(test[1,1]).

There is no technical need for this, it's purely for my further edification into Lua.

You can also use strings instead of numbers and do something like return x..';'..y in your coord2index function.


[Primary hepatic lymphoma: an infrequent cause of focal hepatic lesion].

Primary hepatic lymphoma (PHL) is confined to the liver with no evidence of extrahepatic lymphomatosis.

Histopathologically, the PHL belongs to the group of non-Hodgkin's lymphomas and the most common subtype is the diffise large B-cell lymphoma.

We present a 72-year-old woman, with no relevant antecedents and the following symptoms: early satiety, abdominal discomfort and rapid weight loss.

Liver function tests are normal, erythrocyte sedimentation rate is accelerated and LDH progressively increases during the hospitalization.

Imaging studies (ultrasound, CT scan, nuclear magnetic resonance) show a multilobued mass of around 12 cm of diameter in the right hepatic lobe.

Tumoral and virological markers are negative.

The pathology of an echo-guided biopsy informs a massive infiltration by a diffuse large B-cell lymphoma.

The immunohistochemical study shows CD20+, CD45+ and negative CD3, CKAE1, AE3, Hepatocyte and HMB45.

The citology of pleural liquid is negative for atypia, peripheral blood smear shows no signs of leukemia, bone marrow biopsy is negative for lymphomatous infiltration, and gallium scintigraphy and body CT scan do not reveal extrahepatic lesions.

The patient starts chemotherapy with cyclophosphamide and methylprednisolone but worsens and dies two weeks after beginning treatment.

We conclude that our patient had a rare disease with an unresectable lesion, poor prognostic factors and high recurrence risk.

Chemotherapy is the treatment of choice in these cases.


<meaning-changed>  We obtain four such theorems by considering a financial market both with and without a riskless asset and by considering both constant and random consumption.

We obtain two such theorems by considering a financial market both with and without a riskless asset and by considering both constant and random consumption.


We obtain four such theorems by considering a financial market both with and without a riskless asset for random consumption. The striking result is that we obtain two-fund theorems despite the additional source of randomness from consumption.


<clarity>  The efficiencies of the mechanisms and the nature of the induced, time-dependent flow fields are found to differ widely among swimmers .

The swimming efficiency and the nature of the induced, time-dependent flow fields are found to differ widely among swimmers .


The efficiencies of the mechanisms and the nature of the induced, time-dependent flow fields are found to differ widely among body designs and propulsion mechanisms .


<clarity> We employ perturbation analysis technique to study trading strategies for multi-asset portfolio  and obtain optimal trading methods for wealth maximization under arbitrary utility functions .

We employ perturbation analysis technique to study multi-asset portfolio and obtain optimal trading methods for wealth maximization under arbitrary utility functions .


<meaning-changed> We employ perturbation analysis technique to study trading strategies for multi-asset portfolio  and obtain optimal trading methods for wealth maximization under arbitrary utility functions .

We employ perturbation analysis technique to study trading strategies for multi-asset portfolio optimisation with transaction cost. We allow for correlations in risky assets and obtain optimal trading methods for wealth maximization under arbitrary utility functions .


We employ perturbation analysis technique to study trading strategies for multi-asset portfolio and obtain optimal trading methods for general utility functions. Our analytical results are supported by numerical simulations in the context of the Long Term Growth Model .


<fluency>  Simple sufficient conditions are given for the problem to be well-posed, in the sense that optimal wealths and marginal utility-based prices are continuous functionals of the inputs .

Simple sufficient conditions are given for the problem to be well-posed, in the sense the optimal wealth and the marginal utility-based prices are continuous functionals of the inputs .


<meaning-changed>  Simple sufficient conditions are given for the problem to be well-posed, in the sense that optimal wealths and marginal utility-based prices are continuous functionals of the inputs .

Simple sufficient conditions are given for the problem to be well-posed, in the sense that optimal wealths and marginal utility-based prices are continuous functionals of preferences and probabilistic views .


<coherence> The utilization of multiple post translational modifications (PTMs) in regulating a biological response is ubiquitous in cell signaling. If each PTM contributes an additional, equivalent binding site, then one consequence of an increase in the number of PTMs may be to increase the probability that, upon disassociation, a ligand immediately rebinds to its receptor. How such effects may influence cell signaling systems has been less studied. Here, a self-consistent integral equation formalism for ligand rebinding in conjunction with Monte Carlo simulations are employed to further investigate the effects of multiple, equivalent binding sites on shaping biological responses. Multiple regimes that characterize qualitatively different physics due to the differential prevalence of rebinding effects and their relation to systems-level properties are predicted and studied. Calculations suggest that when ligand rebinding contributes significantly to the dose response, a purely allovalent model can influence the binding curves nonlinearly but other mechanistic ingredients are required to achieve high degrees of biochemical cooperativity. It is our hope that these calculations motivate experiments that can further unravel the many functional consequences of multi-site phosphorylation.


People start their own businesses for many reasons .


But a chance to fill out sales - tax records is rarely one of them .


Red tape is the bugaboo of small business .


Ironically , the person who wants to run his or her own business is probably the active , results - oriented sort most likely to hate meeting the rules and record - keeping demands of federal , state and local regulators .


Yet every business owner has to face the mound of forms and regulations -- and often is the only one available to tackle it .


Last week , Sen. Malcolm Wallop -LRB- R. , Wyo . -RRB- held hearings on a bill to strengthen an existing law designed to reduce regulatory hassles for small businesses .


`` A great many federal regulations are meant for larger entities and do n't really apply to small businesses , '' says Marian Jacob , a legislative aide to Sen. Wallop .


Other lawmakers are busy trying to revive the recently lapsed Paperwork Reduction Act , which many feel benefited small enterprises .


Thus , optimistic entrepreneurs await a promised land of less red tape -- just as soon as Uncle Sam gets around to arranging it .


He is the recipient of multiple accolades, including a Golden Globe Award and a Screen Actors Guild Award, in addition to nominations for three Academy Awards and two BAFTAs.

Academy Awards
Golden Globe Award
Screen Actors Guild Award


In the 1990s, Depp acted mostly in independent films, often playing eccentric characters.


These included What's Eating Gilbert Grape (1993), Benny and Joon (1993), Dead Man (1995), Donnie Brasco (1997), and Fear and Loathing in Las Vegas (1998).

Dead Man
Donnie Brasco
Benny and Joon
What's Eating Gilbert Grape
Fear and Loathing in Las Vegas


Depp also began collaborating with director Tim Burton, starring in Edward Scissorhands (1990), Ed Wood (1994), and Sleepy Hollow (1999).

Ed Wood
Tim Burton
Sleepy Hollow
Edward Scissorhands


He received critical praise for Finding Neverland (2004), and continued his commercially successful collaboration with Tim Burton with the films Charlie and the Chocolate Factory (2005), where he portrayed Willy Wonka, Corpse Bride (2005), Sweeney Todd: The Demon Barber of Fleet Street (2007), and Alice in Wonderland (2010).


During the 2010s Depp began producing films through his company, Infinitum Nihil, and formed the rock supergroup Hollywood Vampires with Alice Cooper and Joe Perry, before starring as Gellert Grindelwald in the Warner Bros. Wizarding World films Fantastic Beasts and Where to Find Them (2016) and Fantastic Beasts: The Crimes of Grindelwald (2018).


Yeah
One two, one two, one two

Came from the mud and the trenches
Runnin and hoppin the fences
Packing the pen like a weapon
Fresh out the pen like a sentence
Hush all the noise and the tensions
Glad that I got your attention
Cut out the brother youre friends with
They only come holler for guest lists
Please see the exit
I done lost too many brothers this year
To worry about new invitations
Still think about you like Neo
Howd I get stuck in the matrix?
Countin the one and the zeros
Sorry but this aint the movies
You do not end up the hero
Your face do not make the papers
Maybe a couple a shirts
Flowers on top of your hearse
Questioning, what was it worth?
Hop in the van and we skrrt
Hope police get to you first, yeah
We do not need to converse, yeah
Save the forgiveness for church
Well, if them boy bad, not bad after we
Nah, cant lay a hand on none of my Gs
Well, if them boy bad, not bad after we
Them man not gang, no, not on my team
Well, if them boy bad, not bad after we
Nah, cant lay a hand on none of my Gs
Well, if them boy bad, not bad after we
Them man not gang, no, not on my team
Came from the bottom of the swamp
Never forgotten where Im from
Robbin what I want
Am I wrong? Am I wrong? Am I wrong?
Malcolm X by any means
You coulda found me dead by 23
You hear the sound of skengs, you better leave
Where you gone? Where you gone? Where you gone?
Woo-ha
D-D-D, shooter
Brrr, Luger
Head tumor
.45 sittin in the waist
Manll send a missile in the place
Lick him in his face
I got off for killin with the bass
Fell that in your chest, Timberland
Still caps in your ead, diss the man
Real family and friends on Instagram
And it began
Well, if them boy bad, not bad after we
Nah, cant lay a hand on none of my Gs
Well, if them boy bad, not bad after we
Them man not gang, no, not on my team
Well, if them boy bad, not bad after we
Nah, cant lay a hand on none of my Gs
Well, if them boy bad, not bad after we
Them man not gang, no, not on my team


Ill be so glad when the sun goes down, uh huh
Ill be so glad when the sun goes down, uh huh
Ill be so glad when the sun goes down, uh huh
Ill be so glad when the sun goes down, uh huh
These times they aint moving fast enough
Every time Im looking up
I dont get no answer I dont get no love
Every day I play the game, knowing I wont win again
They say times are changing now
Well, Ill be so glad when the sun goes down
Well Ill be so glad when the sun goes down
Well Ill be so glad when the sun goes down
Well Ill be so glad when the sun goes down
The last thing you ever promised was tomorrow
All the irony convinced a pessimist could see shallow waters as twice as deep
Well timed silence, twice as powerful as mindless speech
Eyes wide shut, fortnight sleep, that be twice as weak
But like a mortal man leaving troubles in other mortal hands
I buried my mistakes, mistaking hope should maybe understand
Ive never had the answers
Fuck, I barely had a mattress
Paranoia, common practice
Promised the rest when I meet my casket
Throw my ashes to the atlas
Let them travel round its axis
Use my soul to pay my taxes
Make my music off my sadness
Oh Ill be so glad so glad, so glad when the sun goes down
Well Ill be so glad when the sun goes down
Well Ill be so glad when the sun goes down
Well Ill be so glad
When the sun goes down
Will you meet me
This time around?
Well Ill be so glad
When the sun goes down
Will you meet me
This time around?
Well Ill be so glad when the sun goes down
Well Ill be so glad when the sun goes down
Well Ill be so glad when the sun goes down
Well Ill be so glad when the sun goes down
Well Ill be so glad when the sun goes down
Well Ill be so glad when the sun goes down
Well Ill be so glad when the sun goes down
Well Ill be so glad when the sun goes down


You know what would really help though?
Just when you thought we were done
Get away clean, Master P in 91
If only you knew, what we done overcome
Over-stand, that this aint what you want
Im bout it, bout it, like its 1997
If all young kings get beheaded
Expect royalty in heaven
Me and my Gs big bands, looking like One Direction
Start by getting the facts straight
Some learn better the hard way
Whole lotta stress in the book bag
Young boy carry the hard weight
As long as the family eat first
Ive got a reason to say grace
Sipping the holiest agua
Wishing I wash all my sins away
Way, way, down, down, in a dark place I sunken
Rat race, money chase, Im lost in
John Q with a hostage, might meet my prophet
That broke life too costly and it dont fly like Ostrich
Young, dumb, so reckless
AP with a death wish
Jealousy on entrance
No, I need no guestlist
See the thriller in the mirror
Halo, matching with the leather
We gone done em on arrival
Bad, bad no Michael
Bad, bad like I still a legend when I die
Mamma said it wasnt easy
Win, win and repeat
Pappa said it wasnt easy
Win, win and repeat
Win, win, win again
Just when you thought we were done
Get away clean, Master P in 91
If only you knew, what we done overcome
Over-stand, that this aint what you want
Im bout it, bout it, like its 1997
If all young kings get beheaded
Expect royalty in heaven
Me and my Gs big bands, looking like one direction
We pull strings like triggers, bet I never missed that shot
Bet I never missed that calling, when she want me on top
She thats G O D you gotta earn that spot
Good things dont come cheap
All my mistakes cost
Fragrance Hugo Boss, cant smell fear on man
You can never tell man shhh, shhh
Them man know my voice
All I smoke is noise, hope God bless my plug
Hope, God, god got my dons
H we soon link up
Bad, bad like I still a legend when I die
Mamma said it wasnt easy
Win, win and repeat
Pappa said it wasnt easy
Win, win and feed me
Win, win, win again
Just when you thought we were done
Get away clean Master P in 91
If only you knew, what we done overcome
Over-stand, that this aint what you want
Im bout it, bout it, like its 1997
If all young kings get beheaded
Expect royalty in heaven
Me and my Gs big bands, looking like one direction


Company Info:
William M. Cobb & Associates, Inc.
12770 Coit Road, Suite 907
Dallas, TX  75251
972-385-0354 (phone)
972-788-5165 (fax)

Contact:
Randal M. Brush
Senior Vice President

If you need any other info just let me know.


chelsea sweet - i am a horny hot blond chick, so come over and let's just fuckSex Category: Babes

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Dani Wild - Party girl with natural boobs and bubble butt!

I am the real thing and love to raise a little hell and have some fun.

I am spunky and outgoing, and yes - I am exhibitionist.

Come to see me play!Sex Category: Babes

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I am very sexual and love trying new things!

I can be your escort to fulfilling your ultimate sex dream desire!Sex Category: Babes


Q:

classic asp multiple button click

I have 2 asp pages.

Feedback_Administration_Update.asp
Feedback_Administration.asp

My HTML form:
<form ACTION="Feedback_Administration_Update.asp" METHOD=POST NAME="form">
  <input type="button" value="Submit" onclick="javascript:Checkit();" name="btnSubmit">
  <input type="reset" value="Reset" onclick="javascript:document.location=location">
  <input type="button" value="Send Response to Requester" name="btnSubmit" onclick="javascript:Checkit();"/>
</form>

Code in Feedback_Administration_Update.asp file:
dim buttonPressed
buttonPressed=Request.

Form("btnSubmit")
select case buttonPressed
    case "Submit"
        'update database code
        Response.

Redirect "feedback_administration.asp?ID=" & regEx.

Replace((request.form("ID")), "''") & "&lstPages=" & Trim(Request("lstPages")) & "&view=" & Request("view")& "&strSuccess1=" &"Success"
    case "Send Response to Requester"
        'mail  task code
End Select

I am not sure why they are not working on clicking any button.

When I click on submit the page, it should update the code, when I click on submit Send Response to Requester, it should send email.

A:

The value of button inputs is not sent to the server.

You need to use ordinary submit buttons, and to have validation code you can cancel their onclick event:
<input type="submit" value="Submit" onclick="return Checkit();" name="btnSubmit" />
<input type="submit" value="Send Response to Requester" name="btnSubmit" onclick="return Checkit();" />

To make it work, change your JavaScript function in two ways.

First, don't make it submit the form and second have it return true upon successful validation and false otherwise, e.g.:
function Checkit() {
    //validate your stuff..
    if ([all is good]) {
        //don't submit the form here, the submit button will do that.

        return true;
    }

    //indicate that something was wrong, cancel form submission:
    return false;
}

Having this in place will cause Request.

Form("btnSubmit") to hold the desired value.


This invention relates to providing a system for improved risk assessment in market trading.

More particularly, this invention relates to providing a system for risk assessment from multiple independent risk factors across multiple time frames.

In trading any market vehicle, over a period of time, technicians and economists seek to identify risks as early as possible.

However, early pin-point detection, optimal sequencing, categorization, and confirmation of the risks are difficult in real-time (as they happen); this leads to delayed entry and exit in market trades.

Further, multiple confirmations of risks delay entries and exits in market trades even longer.

A system is needed to identify and confirm risks in real-time, as the risks develop.

Further, a system is needed that will identify and confirm risks in user-desired time frames and at any stage of a trend.


Denis Bertolini

Denis Bertolini (born 13 December 1977 in Rovereto) is an Italian former professional road racing cyclist.

Major results
2001
 1st  Road race, Mediterranean Games
2004
 1st Stages 2 & 6 Circuit de Lorraine
 1st Stage 2 Peace Race

References

Category:1977 births
Category:Living people
Category:Italian male cyclists
Category:Mediterranean Games gold medalists for Italy
Category:Mediterranean Games medalists in cycling
Category:Competitors at the 2001 Mediterranean Games


Q:

Value not being returned

being new to this I am probably doing something silly somewhere which is breaking the code.

Have taken a look at some similar posts but found nothing that helps.

So, the issue I am having is when I attempt to print newmarbles at the end it is saying it is not defined.

I assume I am doing something wrong in terms of returning the value?

import random

def playNovice(marbles):
    aimove = random.randint(1, (marbles/2))
    print("AI Move", aimove)
    newmarbles = marbles - aimove
    return newmarbles

def userPlay(marbles):
    usermove = int(input("Enter your move: "))
    while usermove > marbles / 2 or usermove == 0:
        print("Invalid Move")
        usermove = int(input("Enter your move: "))
    else:
        newmarbles = marbles - usermove
        return newmarbles

difficulty = input("Which difficulty?

novice or expert: ")
marbles = 100
playNovice(marbles)
userPlay(marbles)
print(newmarbles)

A:

The scope of newmarbles is local to playNovice().

You should assign the returned value to a variable, which may have the same name:
newmarbles = playNovice(marbles)
userPlay(marbles)
print(newmarbles)


Black Eyed Susan

Context: That fall came and I went back to Michigan and the school year went by and summer came and I never really thought about it. I'm not even sure if I was officially asked, I just wound up heading back to New Jersey when school was out. I think my parents thought it was a good enough deal. They were already having some problems and without Nonna there anymore to take care of me I think my cousin's house on the coast seemed like as good a spot as any to stick me for the summer. It certainly wasn't because of any great love between me and my cousin. We weren't really very good friends at that point. I think she saw me as sort of foisted off on her and getting in the way of her summers. Which was a fair enough judgment. But she could have been nicer. It's pretty amazing that she wound up as my Maid of Honor. Time does strange things. Your lovable jack-ass of a father would mention something about magic in here. You know if you took a group of fifty strangers, had them chat with your father for half an hour then with me for half an hour, then told them that one of us was an English Professor and one of us was head of distribution in the northeast for a large soft drink manufacturing concern, I'm pretty sure all fifty would peg your father as the English Professor and me as the head of distribution. He's honestly so good at what he does that I can almost allow him to claim it's magic except that it'd be nice if he took credit for some of the things he's done with his life. Of course he has this idea that he deserves credit for all sorts of things that he had no control over. Like our first kiss.

Question: Why was this character sent away after each school year?

Answer: not enough information

Answer: to visit family

Answer: parents had problems

Answer: for tutoring


Black Eyed Susan

Question: What is true about the narrator?

Answer: She is old

Answer: She is married

Answer: She is an orphan

Answer: not enough information


Black Eyed Susan

Question: What is obvious about the father's personality?

Answer: not enough information

Answer: he is shy

Answer: he is a little vain

Answer: he is funny


Black Eyed Susan

Question: During what time of the year was this character sent to their cousins house?

Answer: not enough information

Answer: winter

Answer: fall

Answer: summer


Black Eyed Susan

Question: The author believes that the cousin's father:

Answer: is incompetent

Answer: not enough information

Answer: is a liar

Answer: is a jack-ass


Black Eyed Susan

Question: What is probably true about the cousin's father?

Answer: not enough information

Answer: he is a bad father

Answer: he is dumb

Answer: he is extremely smart


Black Eyed Susan

Question: What did the main character do for a living?

Answer: not enough information

Answer: English Professor

Answer: head distributor of softdrink maufacture

Answer: Magician


Black Eyed Susan

Question: Heading back to New Jersey took roughly how long?

Answer: a year

Answer: not enough information

Answer: one week

Answer: a few hours


Black Eyed Susan

Question: Who was the English Professor?

Answer: mother

Answer: not enough information

Answer: immortal light kids

Answer: father


Black Eyed Susan

Question: What is my mom's profession?

Answer: head of distribution

Answer: English professor

Answer: a magician

Answer: not enough information


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/*
 * Some or all of this work - Copyright (c) 2006 - 2020, Intel Corp.
 * All rights reserved.

 *
 * Redistribution and use in source and binary forms, with or without modification,
 * are permitted provided that the following conditions are met:
 *
 * Redistributions of source code must retain the above copyright notice,
 * this list of conditions and the following disclaimer.

 * Redistributions in binary form must reproduce the above copyright notice,
 * this list of conditions and the following disclaimer in the documentation
 * and/or other materials provided with the distribution.

 * Neither the name of Intel Corporation nor the names of its contributors
 * may be used to endorse or promote products derived from this software
 * without specific prior written permission.

 *
 * THIS SOFTWARE IS PROVIDED BY THE COPYRIGHT HOLDERS AND CONTRIBUTORS "AS IS"
 * AND ANY EXPRESS OR IMPLIED WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE
 * IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE
 * ARE DISCLAIMED.

IN NO EVENT SHALL THE COPYRIGHT OWNER OR CONTRIBUTORS BE
 * LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, OR CONSEQUENTIAL
 * DAMAGES (INCLUDING, BUT NOT LIMITED TO, PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES;
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 * THEORY OF LIABILITY, WHETHER IN CONTRACT, STRICT LIABILITY, OR TORT (INCLUDING
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 * EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGE.

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DefinitionBlock(
	"B216.aml", // Output filename
	"DSDT",     // Signature
	0x02,       // DSDT Revision
	"Intel",    // OEMID
	"Many",     // TABLE ID
	0x00000001  // OEM Revision
	) {

	// All declarations
	Include("../../../../../runtime/cntl/DECL_5UP.asl")
	Include("../../../../../runtime/collections/bdemo/ACPICA/0216/DECL.asl")

	Method(MAIN) {

		// Initialization
		STRT(0)

		// Run verification methods
		Include("../../../../../runtime/collections/bdemo/ACPICA/0216/RUN.asl")

		// Final actions
		Store(FNSH(), Local7)

		return (Local7)
	}
}


Field of the Invention
This invention relates to apparatus for cutting stacks of flat workpieces, particularly of making undershirt-shaped bags from stacked tubular film sections made of thermoplastic material and formed with side gussets and with top and bottom end seams welds.

The apparatus includes punch-and-die sets, which are mounted in a machine frame and include punches associated with drive means for moving said punches up and down, and die plates, which are fixed to the machine frame, and also including a conveyor for intermittently feeding the stacks between, and for removing them from, the punches and dies.

Description of the Prior Art
In general apparatus tubular film section cutting as is from Published German Application No.

29 15 689 and from Published German Application No.

33 31 069 (corresponding to U.S. patent application Ser.

4,589,183 ) and is used to make undershirt-shaped bags.

However the punches and dies become dull after a relatively short time so that the dull punches and dies must be reground or replaced after relatively short intervals of time, and the machine is inoperative for relatively long times.


Distribution of ornithine decarboxylase activity induced by 1 alpha,25-dihydroxyvitamin D3 in chick duodenal villus mucosa.

The distribution of enzymes involved in polyamine synthesis and that of the polyamine levels were investigated in the duodenal mucosa of vitamin D-deficient chicks and those supplemented with 1 alpha,25-dihydroxyvitamin D3 [1 alpha,25-(OH)2D3].

Duodenal epithelial cells were isolated sequentially from the villus tip to the crypt region using a nonenzymatic method.

In vitamin D-deficient chicks, the activities of ornithine decarboxylase (ODC) and S-adenosylmethionine decarboxylase were markedly higher in the crypt cells than in the villus cells.

Similar gradients were observed in the distribution of putrescine and spermidine.

Six hours after iv administration of 625 ng 1 alpha,25-(OH)2D3, ODC activity and putrescine levels markedly increased both in the villus and crypt region.

The rate of the increase in ODC activity and putrescine levels, however, was much higher in the villus than in the crypt region.

Neither S-adenosylmethionine decarboxylase activity nor spermidine levels were affected by the treatment with 1 alpha,25-(OH)2D3.

To investigate differential uptake of 1 alpha,25-(OH)2D3 in the duodenal mucosa, 0.1 nmol 1 alpha,25-(OH)2[3H]D3 with or without a 200-fold excess of unlabeled 1 alpha,25-(OH)2D3 was injected into rachitic chicks, and epithelial cells were sequentially isolated 2 h later.

The radioactivity specifically incorporated in the nuclear fraction was distributed uniformly from the villus tip to crypt cells.

The cytoplasmic receptor for 1 alpha,25-(OH)2D3 was similarly distributed in the crypt and villus cells.

These results suggest that 1 alpha,25-(OH)2D3 plays a physiological role in cellular activities not only in the villus but also in the crypt region through polyamine biosynthesis.


Stereoselective synthesis of 1,1'-linked alpha-l-lyxopyranosyl beta-d-glucopyranoside, the proposed biosynthetic precursor of the FG ring system of avilamycins.

The non-reducing disaccharide beta-d-Glcp-(1<-->1)-alpha-L-Lyxp1 had been proposed to be an early intermediate during the biosynthesis of avilamycin A [Boll, R.; Hofmann, C.; Heitmann, B.; Hauser, G.; Glaser, S.; Koslowski, T.; Friedrich, T.; Bechthold, A. J. Biol.

This work describes a comparison of two strategies for the synthesis of 1 and its 2-amino-2-deoxy analog with either the glucose or the lyxose moiety acting as the glycosyl donor.

The best results in terms of stereoselectivity and yield were obtained with 2,3,4-tri-O-acetyl-alpha-L-lyxopyranosyl trichloroacetimidate 13.

Reaction of 13 with 2,3,4,6-tetra-O-acetyl-D-glucopyranose gave the disaccharide as mixture of 1beta,1'alpha and 1beta,1'beta isomers in a ratio of 10:1 and a yield of 50%.

Reaction of 13 and 3,4,6-tri-O-acetyl-2-azido-2-deoxy-D-glucopyranose yielded the desired 1beta,1'alpha disaccharide as a single isomer in 72% yield.

Interestingly, the formation of alpha-glucosides was not observed in any case, regardless of the use of glucose as glycosyl donor or acceptor.