Hypothyroidism and its Relationship to Heart Disease and Cardiac Problems Essay Example for Free

Hypothyroidism and its Relationship to Heart Disease and Cardiac Problems Essay Hershman describes hypothyroidism as a disorder which results from a deficit of the action of thyroid hormone (2009, p. 435). This condition affects the development and function of all tissues of the body, an important example of which is the heart. The thyroid hormone is responsible for the crucial regulation of calcium flux into the sarcomeres of myocytes (Rao, 2007, p. 202). The most common effect of deficient thyroid-hormone action on any tissue is well known; a decrease in the basal metabolic rate. For the heart, this decrease most commonly causes a decrease in heart rate. Other manifestations may include decreased cardiac output, flabby myocardium, pericardial effusion and impaired endothelial function (Hershman, 2009, p. 435). However, for the profoundly hypothyroid patient, the most frequent cause of cardiac anomalies is impaired diastolic relaxation (Klein, 2005, p. 777). Although the fall in rate of metabolism is ubiquitous in hypothyroidism, the heart experiences a disproportionate change in demand and supply of oxygen, the supply drops faster than the demand. On the other hand, patients of coronary heart disease who have later developed hypothyroidism have been given either low doses of T4, or no medication at all by some practitioners (Klein, 2005, p. 777); the lowered cardiac load associated with hypothyroidism helps in lowering the stress on the heart. Nonetheless, the adverse effects of hypothyroidism on the heart and on metabolism generally far outweigh this small concession (Klein, 2005, p. 777). Another complication associated with hypothyroidism is hypertension. The main feature of pathophysiology that results in this manifestation is the increased vascular resistance due to absence of the vasodilating action of T3 (Klein, 2005, p. 776). This brand of hypertension shows decreased sensitivity to salt intake as compared to other forms of hypertension (Klein, 2005, p. 776). Hypertension in a profoundly hypothyroid patient is especially ominous. The increase serum levels of cholesterol and lipoprotein (a), associated with the low metabolic rate, combined with the increased vascular resistance may lead to coronary heart disease (Klein, 2005, p. 77). However, it’s the subclinical counterpart of hypothyroidism that represents a major challenge; the lack of clear cut symptoms makes the diagnosis of this latent condition difficult. In a recent study, subclinical hypothyroidism was claimed to be an independent risk factor for heart disease in women in their 60s and 70s (Hak et al. , 2000). The main pathophysiological feature is the delayed relaxation of the left ventricle after contractions, exacerbated by endothelial dysfunction and a stiffness of the arteries (Biondi, 2009, p. 24). Serum thyroid stimulating hormone, TSH, and serum free T4 are an appropriate starting point in acquiring a diagnosis of hypothyroidism (Hershman, 2009, p. 436). Myoglobin levels in blood and urine are also excellent indicators of injury to cardiac tissue (Klein, 2005, p. 777). Serum creatine kinase levels may also be increased, but troponin levels remain normal (Rao, 2007, p. 202). In subclinical hypothyroidism, TSH levels are moderately increased while T4 levels remain normal. ECG shows a general decrease in amplitude and the T wave may be inverted (Rao, 2007, p. 202). The treatment of both the latent and overt forms of hypothyroidism, in relation to the heart, involves the maintenance of steady thyroid hormone levels. Levothyroxine is the drug of choice; in patients with a known heart condition, the dosage of the drug should be given incrementally to reach a stable normal level (Rao, 2007, p. 202). In elderly patients, some degree of cardiac ischemia is assumed present and the dosage is always increased gradually (Hershman, 2009, p. 438). Beta-blockers can be administered to counter the deleterious effect hormone therapy on cardiac ischemia, unless counter-indicated (Rao, 2007, p. 203).

The Impact of the Electric Guitar on Music Essay -- Exploratory Essays

The Impact of the Electric Guitar on Music Everyone has moments when they feel as if they have found the wrong place. Now, it was time for one young gentleman to partake in one of these moments. A salesman had an appointment for a meeting with a wealthy man, yet he found himself wondering if he had arrived at the correct office. This was supposed to be a millionaire’s office, yet as he looked around the room, he saw no leather couches or expensive desks. In fact, the room was sparsely furnished, and had no carpeting. There was a desk, a rather common one that was too cluttered with blueprints and assorted papers to recognize, anyway. Also cluttered, a metal bookcase was in the corner, covered with speaker parts and catalogues. This enormously wealthy man even saved a disposable Styrofoam cup, which was sitting on his desk with his name labeled on it. Still hoping to find the owner, the salesman peeked in a back room, where he found nothing but dust, drills and punch presses. The man exclaimed, â₠¬Å"Maybe it was the room down the hall† as he turned around. With this turn he bumped into the father of the solid-body electric guitar and the man he had been looking for. Mr. Fender then responded with a whole-hearted, â€Å"Can I help you?† (Wheeler, 1982, pp. 42-43). The sought after executive was a man named Clarence Leo Fender, who was responsible for the first successful mass marketing of the solid-body electric guitar. However, it was an innovation that came after people were already using the electric guitar. For years before Fender’s success began in 1948, hollow-body electric guitars had been produced and used by top names in the guitar business, such as Lonnie Johnson, Eddie Lang, and Blind L... ... in American life. Smithsonian Productions. Retrieved December 21, 2001, from http://www.si.edu/sp/onair/guitar1.htm. Mongan, N. (1983). The history of the guitar in jazz. New York: Oak. Pareles, J. (2000, November 12). The humble instrument that conquered the world. New York Times, p. 1, sec. 2. Romana, H., Gustafson, G., Purse, B., & Daft, M. (1998, March). Guitar: Past, present and future. Music Educators Journal, 5, 84. Retrieved December 18, 2001 from EBSCOhost Database. Thompson, A., Levy, A., Ellis, A., & Fox, D. (1998, December). Legends of the Paul. Guitar Player, 32, 106-123. Retrieved January 4, 2002, from Proquest Database. Waksman, S. (n.d.). Instruments of desire: The electric guitar and the shaping of musical experience. Cambridge: Harvard. Wheeler, T. (1982). American guitars: An illustrated history. New York: Harper.

Management Principles & Practice Essay

A group of twelve lifelong friends put together $1,200,000 of their own funds and built a $6,000,000, 48-lane bowling alley, near Norfolk, Virginia. Two of the investors became employees of the corporation. Ned Flanders works full-time as General Manager and James Ahmad, a licensed CPA, serves as Controller on a part-time basis. The beautiful, modern-day facility features a multilevel spacious interior with three rows of 16 lanes on two separate levels of the building, a full-service bar, a small restaurant, a game room (pool, videogames, pinball),and two locker rooms. The facility sits on a spacious lot with plenty of parking and room to grow. The bowling center is located in the small blue-collar town of Wallingford. There is no direct competition within the town. The surrounding communities include a wide-ranging mix of ethnic groups, professionals, middle- to upper-middle-class private homes, and apartment and condominium complexes ranging from singles to young married couples to senior citizen retirement units. Nearly 200,000 people live within 15 miles of Wallingford. The bowling center is open 24 hours per day and has a staff of 27 part- and full-time employees. After four years of operation, the partners find themselves frustrated with the low profit performance of the business. While sales are covering expenses, the partners are not happy with the end-of-year profit-sharing pool. The bowling center operates at 100 percent capacity on Sunday through Thursday nights from 6:00 P.M. until midnight. Two sets of men’s leagues come and go on each of those nights, occupying each lane with mostly five-person teams. Bowlers from each league consistently spend money at both the bar and restaurant. In fact, the men’s leagues combine to generate about 60 percent of total current sales. The bowling center operates at about 50 percent capacity on Friday and Saturday nights and on Saturday morning. The Friday and Saturday â€Å"open bowling† nights include mostly teenagers, young couples, and league members who come to practice in groups of two or three. The Saturday morning group is a kid’s league, ages 10 through 14. There are four ladies leagues that bowl on Monday and Wednesday afternoons. Business is extremely slow at the bowling center on Monday through Friday and Sunday mornings, and on the afternoons of Tuesday, Thursday, Friday, Saturday, and Sunday. It is not uncommon to have just three or four lanes in operation during those time periods. The owners have taken a close look at the cost side of their business as a way to improve profitability. They concluded that while the total operating expense of $1,466,000 might appear to be high, there was in fact little room for expense cutting. At a recent meeting of the partners, James Ahmad reported on the results of his three-month-long investigation into the operating cost side of other bowling alleys and discovered that the Wallingford Bowling Center was very much in keeping with their industry. James went on to report that bowling alleys were considered to be â€Å"heavy fixed cost operations† and that the key to success and profitability lies in maximizing capacity and sales dollars . QUESTIONS 1. Apply the decision-making process described in the chapter to this case. What is the major problem facing Wallingford? List five specific alternative solutions that could be implemented to solve that major problem. 2. As general manager of this company, how could you utilize and manage the group decision-making process and technique to improve company profits? Which employees would you include in the group?

Drug Testing Essay - 2735 Words

Drug testing is a laboratory procedure that looks for evidence of drug consumption by analyzing urine, blood, and hair samples. If tested, you must provide a sample in front of an observer to make sure that it is not tampered with. Samples are then sent to a laboratory for analysis, after which the employer is notified of the results (Wodell 1). Exactly who should be subject to the new trend of mandatory drug tests, is the big question being raised among businesses, schools, athletes and federal government employees. Businesses feel that random drug testing of their employees will create higher productivity, save on health care costs, improve employee turnover, prevent less accidents, and improve job satisfaction. Schools are beginning to†¦show more content†¦On the contrary, many employees are not very happy about having to take drug tests and they are voicing their opinions. A recent study conducted by the LeMoyne College Institute of Industrial Relations suggests that, mandatory drug testing actually hurts workplace work place productivity and may promote the abuse of cocaine, booze and other drugs. The study also implied that these programs reduce employee productivity by as much as 33%, because it makes workers feel that they are not trusted by their employers. Lastly, the study points out that because drug tes ts tend to zoom in on marijuana (which only stays in the system for six weeks) some are turning to cocaine, and psychedelic mushrooms which leave little residue in the body (Workplace 1). Companies putting these testing policies in place must also consider the legal repercussions involved if they are not careful. Many firms have found themselves in violation of our Fourth Amendment protection against unlawful search and seizure, better known as a violation of privacy. Opponents claim that the tests are too costly, ineffective, and prone to abuse. Random testing is a risk in many states, but if the employee is in a position in which drug use could result in the death of an employee or the death of others, random testing is usually OK. Another way employers are evaluating the need for a test is byShow MoreRelatedDrug Testing : A Drug Test1221 Words   |  5 PagesDrug testing in the workplace started happening in 1988 and till this day is still continuing. Not until 1991 did they sta rt drug testing on employees who work on aviation, trucking, railroads, mass transit, and pipelines. Today, mostly everywhere you apply for a job a drug test is mandatory. Which is reasonable because if illegal drugs are involved, drug use can affect workplace concentration and judgment which could put the employee at risk. 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