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He is instructed to rest and apply ice massages to the area cholesterol test australia 10 mg rosuvastatin visa, focus on stretching his hamstrings cholesterol weight ratio purchase rosuvastatin 10mg mastercard, and to take acetaminophen good cholesterol foods list generic rosuvastatin 10 mg with mastercard. He is permitted to ambulate normally and jog briefly cholesterol test fasting vs. nonfasting generic rosuvastatin 10mg amex, but he must stop if any pain occurs. Traction apophysitis of the tibial tuberosity was first described independently by both Osgood and Schlatter in 1903 (1). This disease is usually seen in adolescents or older children 11-15 years of age, with a male to female predominance of 3:2 (2). Girls present earlier because the secondary ossification center of the tibial tuberosity appears 2 years earlier. Osgood-Schlatter is seen in children/teens who are very active in sports requiring strenuous quadriceps muscles such as basketball and volleyball. Jumping puts the most force on the quadriceps and the insertion of the patella tendon into the tibial tuberosity. Osgood-Schlatter is also common in running sports such as soccer, baseball and football, but less so than with the jumping sports. This disease is seen more often on the left side and 25% of patients have a bilateral appearance. The exact etiology remains controversial, although repetitive trauma is the most widely accepted theory. Other less likely theories include avascular necrosis of the tibial tuberosity (although blood supply is abundant), infection (although patients are afebrile and without leukocytosis), and degeneration of the patella with heterotopic ossification (although histological studies show no tendon necrosis and normal tendon insertion) (2,3). Growth of the proximal tibia is unique because it involves two growth centers in close proximity: the proximal tibial physis and the tibial tuberosity apophysis. An apophysis is a growth plate, which does not contribute to the length of the bone. It is common for a tendon to insert over an apophysis, such as in the tibial tuberosity (patella tendon), calcaneus (Achilles tendon), etc. The cartilage growth plate of the apophysis is a weak spot which is susceptible to microseparation with trauma or overuse (pulling, traction). Southwick and Ogden described the development of the tibial tuberosity in 7 stages; 3 prenatal and 4 postnatal. Stages 1-3 involve fibrovascular ingrowth and vascularization of the area with anterior outgrowth. Postnatal stages include a separate and distinct tibial tuberosity growth plate (stage 4) that later joins with the tibial growth plate (stage 7). There is a distinct secondary ossification center in the distal portion of the tuberosity (stage 5). During maturation (stage 6) there is a coalescence of the proximal tibial epiphyseal ossification center with the tuberosity ossification center. Therefore, because of its unique anatomy and vascular supply, combined with excessive pulling forces of the extensor mechanism, there is a failure of the secondary ossification center, ultimately leading to the disease. The pain is localized to the anterior aspect of the proximal tibia over the tibial tuberosity. Although patients may complain of pain with full extension of the knee (especially against force), they have full range of motion. Patients may often have symptoms for 6-12 months prior to seeking medical attention. Although the tibial prominence may be highly indicative of Osgood-Schlatter in many cases, a full knee exam should be performed to rule out other intra-articular pathology. Unless other pathology is suspected, radiographs of the knee are usually unnecessary, since this is largely a clinical diagnosis. In more severe cases, lateral radiographs of the knee will often show a decrease in homogeneity of the infrapatellar fat pad, soft tissue swelling, and a prominence/fragmentation of the tibial tuberosity. The differential diagnosis includes acute stress fracture, contusion of the tibial tuberosity, prepatellar bursitis, and patellar tendonitis. Some have termed Osgood-Schlatter as a "tendonitis" of the patellar tendon insertion. Some consider the two terms, tendonitis and apophysitis to often be interchangeable. Despite the ominous sounding name, the end result is often the same with or without treatment; therefore, alleviating parental fear is important (2). Treatment is mainly symptomatic and involves reducing forceful use of the quadriceps, which equates to playing less, resting more during games and practices, and less jumping.

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The park has installed equipment/system in each space housing museum collections to control relative humidity and temperature does cholesterol medication prevent heart attacks rosuvastatin 10mg with mastercard. Dust covers are used on open shelving when objects are not otherwise protected from dust cholesterol score of 220 rosuvastatin 10mg low cost. Keys to museum storage spaces cholesterol in eggs 2013 generic rosuvastatin 10 mg visa, exhibit cases cholesterol medication for weight loss discount rosuvastatin 10mg on-line, and work and research/reference spaces are issued to only those employees having direct responsibility for the collections. Issuing of keys to museum storage spaces and exhibit cases is strictly controlled by the use of a signed hand receipt. Written, approved procedures for controlling access to the museum collections by non-curatorial staff, outside researchers, and visitors are implemented. All researchers, visitors, and non-curatorial staff who enter the storage area are escorted at all times by unit curatorial staff. A visitor/researcher sign-in log is used to record name and address of visitor, date of visit, time entered and time departed, and reason for visit. Opening and closing procedures for museum spaces are written, approved and practiced. Museum objects in exhibit spaces are given additional protection at times of high risk, such as during times of crowding or of special activities. Installed intrusion detection systems are inspected and maintained on a regular schedule to ensure that they are fully operational. Entrances to museum spaces are equipped with metal or solid-core wood doors that have deadbolt locks. Intrusion detection systems appropriate to the risks involved and to the nature of the museum collection are installed and operable in museum storage and exhibit spaces. Small, highly sensitive and valuable museum objects, archival documents, and natural history type specimens housed in museum storage spaces are kept in locked cabinets with keyed or combination locks. Irreplaceable or particularly sensitive or valuable objects used in exhibits are protected in cases or by other means that provide protection from theft or vandalism, without making curatorial access impractical. Fire detection and suppression systems are inspected and maintained on a regular schedule to ensure that they are fully operational. Museum objects on top of shelving or museum cabinets do not obstruct the discharge heads for fire suppression systems and are not closer than 18 inches to the ceiling. Orientation on the location, nature, significance, and specific needs of museum property has been provided to fire fighting entities who are responsible for responding to the suppression of a fire. Fire detection and suppression systems appropriate to the risks involved, to the nature of the museum collection, and to the structure housing the collections are installed and operable. An appropriate number and type of fire extinguishers are installed according to the anticipated types of fires, the nature of the collection, and the size of the protected area. Flammable liquids and materials are housed outside museum storage spaces and, regardless of where stored, such materials are housed in approved flammables storage cabinets. All paper museum records are kept in a locking, insulated safe, file, or vault with equivalent or better protection that will maintain an interior temperature of less than 350 degrees Fahrenheit during a one-hour exposure to exterior temperatures of at least 1700 degrees Fahrenheit. If the container described in item 11 is housed on a level of a building above grade, the container also is rated to withstand a drop of 30 feet. Written rules and procedures are available to provide staff with guidance on the handling and moving of museum objects. Smoking, drinking, and eating and displaying living plants, fresh flowers, and foodstuffs in museum storage and exhibit spaces and in research, working, and research/reference spaces are prohibited in writing. If a hygrothermograph is used to monitor relative humidity and temperature, it is regularly maintained. The housekeeping plan for museum spaces is reviewed annually and is revised as necessary. Working with museum environment specialists, the unit has established optimum relative humidity and temperature levels and acceptable highs and lows based on data recorded from ongoing monitoring program. An Integrated Pest Management Plan for all spaces housing museum collections has been written. A housekeeping plan has been written for museum storage, exhibit, work, and research spaces.

Conservation treatment is the deliberate alteration of the chemical and/or physical aspects of museum objects aimed at prolonging their existence cholesterol medication zocor side effects cheap rosuvastatin 10 mg overnight delivery. Earlier treatment techniques endogenous cholesterol definition buy rosuvastatin 10mg low cost, including those performed by conservators cholesterol ratio is 2.5 purchase 10 mg rosuvastatin with visa, have negatively impacted or even destroyed important features of objects cholesterol guidelines calculator rosuvastatin 10mg otc. When deciding whether to pursue conservation treatment or to maintain an object through preventive conservation practices, it is your responsibility to always opt for the approach that best serves the long term well-being of the object. Base your decision on close consultation with conservators as well as your regional curator, park superintendant, and other knowledgeable colleagues. Stabilization treatments are generally the least invasive (interventive) form of conservation treatment. Information can be destroyed with any interventive treatment, even if performed only with preservation as the goal. New analytical techniques are always being developed and later generations often re-evaluate objects and have different ideas about what makes them significant. Even simple cleaning permanently changes an object and can result in the destruction of information about the object. Restoration is treatment procedure intended to return objects to a known or assumed former state, often through the addition of non-original material. By making a reproduction of an object that can be used for interpretive and/or educational presentations, the original can be safely stored in conditions conducive to its long-term preservation. Reproductions are often used when the originals are too fragile, or would be subject to undue deterioration or loss, or the length of the exhibit will cause damage to the original. Some cannot be reversed at all, for example, you cannot replace the stain you have cleaned from a textile or dirt from a painting surface. However, conservators must use, wherever possible, treatments and materials that can be reversed or removed without damaging the original material of the object. The principle of reversibility is important for a number of reasons: Objects may need to be treated again and the materials used in a prior treatment may need to be removed first. In the future, a better and/or less invasive treatment may be developed, and the current treatment may need to be reversed. For specific information about common preservation issues for different types of materials and collections, see the appendices in this handbook. A professional conservator must undertake all interventive conservation treatments. A conservator is trained and skilled in the theoretical and practical aspects of preventive conservation and interventive conservation treatment. Most conservators specialize in the treatment of specific types of materials or objects. There is some overlap among these specialties; one conservator may work on a range of these materials. For more information on the roles that collection management specialists, curators and conservators play in the preservation of museum objects, see Chapter 3: Preservation: Getting Started. Treatment choices for objects and collections will vary based on the reasons the objects were collected and their planned use. Identify what you consider to be important about the object for the purposes of research, education and exhibit, now and in the future. Be sure to share your reasons for preserving an object or collection with the conservator and put them in writing. Consult with the regional curator and other museum professionals to learn more about your treatment options. Appropriate treatment is developed through discussion between conservator and curator: Consider all technical, historic, scientific, cultural, religious, and aesthetic aspects of an object. Developing a shared understanding of the object and its problems will lead to a treatment that takes into account all of the above factors. Do not approve a treatment simply to make an object look "like new" or meet a purely subjective aesthetic standard.

Because the corrosion products have a greater volume than the original metal cholesterol lowering eating plan south africa discount 10mg rosuvastatin otc, the corrosion process often tears the skins cholesterol free diet foods discount rosuvastatin 10mg with visa. Metal armature in taxidermy mounts and wires in study skins may be copper or nickel alloys that will produce fibrous can cholesterol medication make you tired generic 10mg rosuvastatin with mastercard, blue or green corrosion products when they react with the fats in skins cholesterol ratio levels uk cheap 10 mg rosuvastatin overnight delivery. The skins on taxidermy mounts are under great stress because the skins often shrink tightly to the form during drying. As a consequence, removing mounted specimens from their original stand changes the distribution of the stress, often causing the skins to tear or distort. If cleaned by beetles, the specimens usually are fumigated, frozen, or rinsed in alcohol to kill the insects. Then the bones may be soaked in ammonia or chlorine bleach solutions to deodorize. Bones from large animals like bears may be degreased using organic solvents or alcohol. Sometimes large long bones are drilled and the marrow is removed to reduce the potential for migration of fats and oils out of the bone. Sometimes preparators stain the bones with an organic dye and store them in glycerin solutions. Therefore, try to get documentation on exactly what processes preparators have used on bone. This means that the organic components are intimately mixed with the inorganic components and help to reinforce them and give them a certain flexibility. Acidic solutions attack the inorganic part of the composite, leaving bones soft and easily distorted. Poor storage and handling can damage bone causing cracking, abrasion and breakage. Numbers that have been written directly on the bone with indelible ink cannot be removed. Almost all types of biological specimens have been freeze-dried for exhibit purposes. After the specimens are frozen, the water is removed from them using vacuum sublimation. Specimens may be treated with a variety of chemicals as preparation for freeze-drying. After processing, preparators may use other materials to enhance specimen appearance. Large animals are difficult to freeze-dry, so these are often eviscerated before freezing. For an excellent review of the problems of freeze-dried specimens see, "The Effects of Freezing and Freeze-drying on Natural History Specimens," by Florian (1990) listed in the Section G, Selected References. Because freezedried specimens are vulnerable to rehydration, especially at relative humidity above 40%, they can rot. Place these specimens in tightly sealed cabinets to prevent pests from getting into exhibit and storage cases. These specimens are extremely vulnerable to insect attack and may be damaged or destroyed, requiring replacement. Refer to Appendix T: Care of Biological Collections, for information on care of freeze-dried specimens. A fluid-preserved specimen is "fixed," that is, treated with a chemical that causes some cross-linking of cell proteins. Then the specimen is stored in either the original fixative or in a chemical that preserves the fixed tissue. Often, you will find small to moderately sized fluid-preserved specimens stored in glass bottles or jars. Large specimens are usually stored in tanks made of a variety of plastics or metals. Collectors mount very tiny specimens on microscope slides or in small glass or plastic vials.