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Documentation must include the date buy generic erectafil 20 mg line, name purchase 20mg erectafil with visa, amount of radiopharmaceutical, the route of administration, identification of the administering person, and the time of administration. This information is to be recorded on the nuclear medicine requisition and the report of exam in the patient record. Failure to comply will result in Vanderbilt being fined up to $15,000 per occurrence. They are required by law and it is the responsibility of all employees to observe them. All staff must be aware of the hallway in Special Procedures and not cross the yellow line with food or drinks. Masks and goggles must be worn whenever there is a possibility of a splash - you may not wear only goggles. The medical records generated by an occupational exposure incident and vaccination records must be kept confidential for the duration of employment plus 30 years. There are special needle holders available in exam rooms to allow for the recapping of needles when necessary. Needles should not be recapped and the sharps must be placed in needle box immediately after use. Hepatitis B vaccinations are offered to all employees that are at risk to exposure to blood or body fluids. Cassettes, exam tables, lead aprons, lead gloves, gonad shields, restraint devices and positioning tools should be cleaned whenever contaminated with body fluids and on a frequent basis. We must all remember that compliance is mandatory and will be effective at prevention of unwanted diseases. Take care not to pull catheter out when moving patient from wheelchair or stretcher to scanning table. Once patient is on scanning table be sure the bag is hung beneath the table, but not too far as to cause pulling, making the patient uncomfortable. Note: Should catheter either come unplugged (disconnection between bag and catheter) or pulled out of the bladder completely, notify the nuclear medicine physician and then call the floor notifying the charge nurse, who will in turn call the intern or residents assigned to the particular patient. All Nuclear Medicine procedures should be scheduled during the first 10 days after last menstrual period in childbearing age women, if possible. If a pregnant patient is scheduled for a Nuclear Medicine procedure, the patient should be immediately referred to the Nuclear Medicine physician. The risks and benefits of the procedure will be discussed with the referring physician and the patient, and a decision to perform the study will be made in the best interest for the patient. A written informed consent should be obtained from all female patients under age 55 and above age 12 as per the following form. Please sign the statement below if you are not pregnant and not currently breastfeeding. The standard adult dose used in the hospital is listed as 100%, and the body weight in kilograms is plotted on the curve that results in a dose per body surface area. Therapy Hyperthyroidism 131I Na I 6-60 mCi Thyroid cancer 131I Na I 29-330 mCi Bone mets 59Strontium 3-5 mCi Bone mets 153Samarium 10 mCi Myeloma 32P sodium phosphate 3-7 mCi Various 32P chromic phosphate 0. Daily - Follow automated protocol for automatic tuning, peaking, and extrinsic uniformity measurement. Monthly - Follow automated protocol for spatial resolution and linearity measurement. Daily - Execute automated protocol for checking entire system and standard values. Note: Dose calibrator measurements and radiation surveys are monitored by Radiation Safety Office. In some diseases, notably carcinoma of the breast, the bone scan findings can completely reorient the therapeutic approach; in other entities, notably osteomyelitis, the bone scan makes diagnoses earlier than is possible with alternative diagnostic modalities, thus permitting earlier, more appropriate therapy. Invariably, in multi-focal disorders, there is greater involvement on the bone scan than can be seen on conventional radiographs; while in the arthritides and in certain metabolic disorders, the stage of the pathologic process and its activity can be delineated most accurately by the bone scan. The precise mechanism of action for the technetium bone scanning agents has yet to be determined. Basically, it appears that these agents adhere to the hydroxyapatite crystal of bone by a process known as chemisorption. Blood flow plays a major role in tracer delivery and distribution, while reaction bone formation also significantly affects the appearance of the scan. Bone images are obtained 2-4 hours after the injection of the radiopharmaceutical. If clinically indicated, the injection may be made with the patient positioned under the gamma camera so that a radionuclide angiogram and blood pool images can be obtained (three phase bone scan). The bone scan has an overall false negative rate of about 2% for metastatic disease, while the skeletal survey has false negative rates that in certain tumors can approach 50%. Most primary tumors, (with the exception of most primary intracranial malignancies) can and do metastasize to bone. Since the advent of adjuvant chemotherapy however, a significant number of patients (15%) are noted to develop bone metastases prior to, or in the absence of lung metastases. In these patients, serial bone scanning can be invaluable in establishing the early diagnosis of osseous metastases. Also, in those centers utilizing limited amputation as part of their protocols, the bone scan can aid the surgeon in selecting the precise level of amputation. Also, about one third of the patients with this disease will develop bone metastases during follow-up, often prior to, or in the absence of, lung metastases. The bone scan is therefore useful both in the initial work-up and subsequent follow-up. The initial finding is mild, diffuse increased accumulation of tracer noted at the fracture site. In uncomplicated fractures, scans that were positive will revert to normal in about two years. In children, it may only take 6-18 months, while in older, debilitated patients, the scan may take several years to revert to normal. This is in contrast to conventional radiography where even subtle findings may not be evident for a week to ten days after the onset of symptoms. A three-phase bone scan can help to differentiate osteomyelitis from soft tissue infection or degenerative bone disease. A gallium scan can be valuable in following patients with osteomyelitis, as it appears to reflect more accurately than the bone scan the response of the inflammatory process of therapy. The most commonly affected site in both the adult and pediatric patient is the femoral head. At this time, the disorder can be diagnosed by skeletal scintigraphy, but not by conventional radiography. The bone scan depicts an area of photon deficiency corresponding to the avascular skeletal part. Other entities that have been evaluated by skeletal scintigraphy include fibrous dysplasia, primary and secondary hyperparathyroidism, pulmonary osteoarthropathy and myositis ossificans. It is well established in the medical literature that the risk of morbidity and mortality from these disease processes is much greater than the risk from the radiation exposure. Therefore, bone scintigraphies are performed in children and the radiopharmaceutical dose is calculated according to body weight (see chart). Delayed images: 6 min/image • 250k or 600 sec for distal extremity spot views Scanning Instructions: 1. Place patient supine on imaging table with the area of interest in the field of view. For the dynamic flow study (if indicated), the radiopharmaceutical is injected rapidly through a butterfly followed by a flush of 10 ml normal saline with a 3-way stopcock. Images are recorded at 4 sec/frame for 64 seconds, followed by 1 static image of 500K counts or 300 sec. For pediatric patients, 3-5 mm pinhole collimation is sometimes required, 200-300k/view. Reconstruct the images in the transverse, coronal and sagittal plane (see computer instructions) 7. If being compared to an 111In leukocyte scan, acquire same views as used for the 111In images.

In Germany generic erectafil 20mg fast delivery, no official risk-to- 40 benefit assessment of calamus root has yet been published in any monograph generic 20 mg erectafil. Natural R(+) 7 camphor is obtained by steam distilling the wood of the camphor tree, 8 the product of which is then purified by sublimation. The herb consists of the essential oil 49 distilled from the ripe seedlike fruit of Carum carvi L. Caraway seeds should be crushed immediately prior to use to prevent 41 unnecessary loss of the highly volatile essential oil. Its hot and 49 spicy fruit is best known as a spice, but is also used in medicine. The herb consists of the ripe, dried 3 fruit (without calyx) of Capsicum annuum L. Topical application of the herb initially induces erythema accom- 8 panied by sensations of pain and heat, followed by a phase of insensitivity 9 (reversible or irreversible deactivation of afferent fibers). The antinocicep- 10 tor and antiphlogistic effects of the herb can persist for several hours to sev- 11 eral weeks. Deutsche Apo- 36 theker Ztg 137 (1997), 1027–1028; Anon: Phytotherapie: Pflanzliche 37 Antirheumatika—was bringen sie? Deutsche Apotheker Ztg 136 (1996), 38 4012–4015; Kreymeier J: Rheumatherapie mit Phytopharmaka. When collecting cham- 45 omile, it is important to remember that the receptacle of true (German) cham- 46 omile is hollow and conical. Only distil- 32 lates and alcohol preparations of the herb contain therapeutically effective 33 concentrations of the essential oil. Deutsche Apotheker Ztg 136 (1996), 1821–1834; Mil- 39 ler T, Wittstock U, Lindequist U, Teuscher E: Effects of some components of 40 the essential oil of chamomile, Chamomilla recutita, on Histamine release 41 from mast cells. It suppresses the release of prolactin and reduces the 5 symptoms of premenstrual syndrome. In animals, the extract was found to 6 inhibit lactation, normalize stress-induced hyperprolactinemia, and exert 7 dopaminergic effects. Z Phytother 17 (1996), 237–243; Winterhoff H: Arzneipflanzen 30 mit endokriner Wirksamkeit. The herb consists of the hand-picked and 35 dried flower buds of Syzygium aromaticum (L. The 6 medicinal uses for the herb are a consequence of the therapeutic action of clove 7 oil. Roasted 29 coffee beans contain many aroma substances due to the pyrolysis of carbo- 30 hydrates, proteins, fats, and aromatic acids. Most of the effects specified for coffee 33 are attributable to the action of caffeine. It relaxes the smooth 37 muscles of the blood vessels (except in the brain, where it causes vaso- 38 constriction) and bronchi. Caffeine has short-term diuretic effects, stim- 39 ulates the secretion of gastric juices, and increases the release of 40 catecholamines. Pa- 8 tients with cardiovascular lability, kidney diseases, hyperthyroidism, a predis- 9 position to convulsions, and certain psychiatric disorders (e. The maximum safe daily dose should not 15 exceed 300 mg (equivalent to 3 cups of coffee). These effects can even occur with chronic use of as 22 little as 300–500 mg/day in sensitive individuals. Food 36 Chem Toxicol, 33 (1995), 195–201; Anon: Kaffee erhöht den Cholesterin- 37 spiegel. Deutsche Apotheker Ztg 133 (1993), 441; Bättig K: Kaffee in 39 wissenschaftlicher Sicht. Z Phytother 9 (1988), 95; Butz S: Nurses-Health- 40 Studie: Kaffee – kein Risikofaktor für koronare Herzkrankheit? Deutsche 41 Apotheker Ztg 136 (1996), 1680–1682; Garattini S: Caffeine, Coffee and 42 Health. The herb consists of dried 6 bark from the trunk and branches of Marsdenia condurango R. In animals, dandelion root 12 was found to have a saluretic effect attributable to its high concentrations 13 of minerals. Patients with gallbladder problems should not use dan- 20 delion unless instructed by a qualified health care provider owing to the risk 21 of colic. The herb consists of the secondary 45 storage roots of Harpagophytum procumbens (B. Phenylethanol 49 50 Plant Summaries—D 1 derivatives such as acteoside, verbascoside, and isoacteoside are also 2 present. In animals, it has anti- 5 inflammatory, analgesic, and antiarthritic effects, and harpagoside was 6 found to inhibit the biosynthesis of certain prostaglandins that cause 7 inflammation. Devil’s claw is an effective herbal remedy 23 that is especially well suited for adjuvant treatment of rheumatic diseases. An analytical study, anti-inflammatory and analgesic effects of 33 Harpagophytum procumbens and Harpagophytum zeyheri. In mice, the proliferation of splenic cells in- 17 creased greatly, and the production of cytokines and antibodies increased. Parenteral admin- 23 istration of echinacea as used in Europe is contraindicated during pregnancy and 24 in general discouraged. Facial swelling, difficulty in breathing, dizziness and reduction of blood 35 pressure are rare side effects. The aerial parts 49 of the plant collected at the time of flowering are used in medicine. Human studies show reduction and shortening of symp- 14 toms of viral syndromes, in particular the common cold, but other studies 15 show no effect. Parenteral administration of Purple Echinacea, as 36 used in Europe, is contraindicated during pregnancy and in general discouraged. Maxim) 1 ➤ Synonyms: Siberian ginseng 2 ➤ General comments: Siberian ginseng is a shrub with effects largely similar to 3 those of ginseng, but is native to Siberia. The herb consists of the 6 dried roots and/or rhizomes, and sometimes the dried prickly stems ofEleu- 7 therococcus senticosus R. Eleutheroside B and other components were found 16 to increase the stress tolerance of animals in many stress models (immobi- 17 lization test, swim test, cold stress, etc. The fluid extract increased the 18 number of lymphocytes, especially T lymphocytes, and killer cells in 19 healthy volunteers. Intern Praxis 32 (1992), 187; Trute A, 13 Gross J, Mutschler E, Nahrstedt A: In vitro antispasmodic compounds of the 14 dry extract obtained from Hedera helix. Planta Med 63 (1997), 125–129; 15 Trute A, Nahrstedt A: Identification and quantitative analysis of phenolic 16 dry extracts of Hedera helix. In humans, English lav- 30 ender taken by inhalation was shown to take action in the limbic cortex 31 (similarly to nitrazepam). English lavender combines well with other calming and sleep- 4 promoting herbal preparations. Z Naturforsch 46c (1991), 1067–1072; Hausen B; 10 Allgeriepflanzen, Pflanzenallergie. English plantain prep- 26 arations have a short shelf-life, because aucubigenin is unstable. Aqueous 27 English plantain extracts promote wound healing and accelerate blood co- 28 agulation. Aucubin is assumed to protect the liver and soothe the mucous 29 membranes when inflamed. Eucalyptus oil inhibits prostaglandin synthesis and has weak hyper- 49 emic effects when applied topically. The drug also has expectorant, 50 Plant Summaries—F secretomotor, antitussive, and surface-active surfactant-like effects and 1 improves lung compliance. It also should not be used 8 by patients with inflammations of the gastrointestinal or biliary tract or se- 9 vere liver diseases. Liniment: 19 Rub a few drops of 20% eucalyptus liniment onto the affected area of the 20 skin. Signs include a drop in blood pressure, circulatory disorders, col- 25 lapse, and respiratory paralysis. Eur J Med Res, 3(11) 37 (1998), 508–510; Riechelmann H, Brommer C, Hinni M, Martin C: Response 38 of human ciliated respiratory cells to a mixture of menthol, eucalyptus oil 39 and pine needle oil. The herbal preparations are syrups and 2 powdered extracts in capsules and tablets.

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Require all non- As essential components of routine medical physician health professionals providing care safe erectafil 20mg, all physicians and other medical psychosocial addiction treatment services to professionals should provide their patients have graduate-level clinical training in with addiction-related screening and safe erectafil 20 mg, as delivering these services. Require that all needed: brief interventions; comprehensive pharmaceutical treatments for addiction be assessment to determine disease stage, provided only by a physician or in severity and the presence of co-occurring accordance with a treatment plan managed health conditions; stabilization; acute by a physician. Screening instruments should be adjusted or developed -14- to coincide with appropriate definitions of Use the Leverage of Public Policy to Speed risky substance use, and assessment Reform in Health Care Practice instruments should be adjusted or developed to mirror diagnostic criteria for addiction. As a condition of approaches, including pharmaceutical accreditation, accrediting organizations therapies (provided or managed by a should stipulate requirements for all physician demonstrating the core facilities and programs providing addiction competencies of addiction medicine or treatment with regard to professional addiction psychiatry) and psychosocial staffing (e. Recognize addiction as a individuals who engage in risky substance primary medical disease and standardize the use or who may have addiction. These language related to the spectrum of include, but are not limited to law substance use severity in current and enforcement and other criminal justice forthcoming diagnostic instruments. Public payers and connected with a trained health professional private health insurance companies should for intervention, diagnosis, treatment and encourage participating providers and disease management. Pursue and gain to the same mandatory licensing processes recognition of addiction medicine by the as other health care facilities. As a condition of Through these actions, assure that addiction licensure, federal, state and local medicine training programs are available to governments should stipulate that all physicians, that training opportunities within facilities and programs providing addiction addiction psychiatry are expanded, and that treatment adhere to established national such specialty care is formally recognized minimum standards for accreditation. Require that all health insurers--  Implement a national public health public and private--provide coverage for all campaign. Implement a nationwide public insured individuals for patient education, health campaign through federal agencies screening and intervention for risky charged with protecting the public health to substance use and treatment and educate the public about all forms of risky management of addiction (involving all substance use and addiction. As a Invest in research designed to improve and condition of reimbursement, public payers track progress in addiction prevention, and private insurance companies should be treatment and disease management and to find a cure for addiction. Create a unified national institute focused on substance use and addiction, recognizing the overarching disease of addiction rather than continuing the focus on different manifestations of the disease--tobacco, alcohol, other drug use-- and including the risky use of all addictive substances. Include in the research portfolio addiction involving behaviors other than substance use, and focus on the causes, correlates, consequences, interventions, policies and possible cures for all manifestations of the disease. The portfolio of the institute also should include health conditions resulting from risky use and addiction and other conditions which increase the risk of developing addiction. In many but not all cases, it involves the use of nicotine, † alcohol and other drugs. Addiction involving these substances typically originates with use in adolescence when the brain is still developing 2 and is more vulnerable to their effects. If untreated, it can become a chronic and relapsing condition, requiring ongoing professional 3 treatment and management. Although there has been an evolution in scientific understanding of the disease, public attitudes and health care practice have not kept pace with the science. Terms used to describe different levels of substance use and addiction’s many forms lack precision, obscuring important differences in the use of addictive substances and the nature and severity of the illness and complicating our ability to treat it effectively. The term addiction also has been used in reference to compulsive behaviors involving eating, gambling and other activities that affect the brain’s reward system and which may develop independent of or in combination with other manifestations of addiction. This report, however, focuses only on addiction involving nicotine, alcohol and other drugs. Use of these Advances in neuroscientific research, including substances can result from an existing brain animal studies and brain imaging, demonstrate dysfunction; use also can alter the structure and clearly that addiction is a primary and often function of the brain, dramatically affecting * 4 8 chronic disease of the brain. The amount and for developing the disease include a genetic duration of substance use that results in brain predisposition and a range of biological, changes and addiction depends on the individual 5 † 9 psychological and environmental influences. There is a growing body of evidence showing the brain circuits that are implicated in substance As yet, there is no conclusive biological marker addiction in general also are involved in other of addiction; therefore the diagnosis of addiction compulsive or addictive behaviors such as those is based on its symptoms including the related to gambling, certain forms of disordered compulsive use of addictive substances, eating (e. These are beginning to explore whether substance symptoms that characterize addiction are addiction might be part of a syndrome cognitive and behavioral manifestations of the 11 characterized by: underlying disease and its effects on the brain. The foundations of the disease may exist in certain individuals even before they ever use an  Shared neurobiological and psychosocial addictive substance and, in some cases, once the antecedents (risk factors); disease develops it persists even when an individual is not actively engaged in substance  Production of desirable effects upon 12 use. It is not the substances a person uses † that make them an addict; it is not even the The addictive potential of a substance is quantity or frequency of use. Addiction is about determined not only by its intrinsic ability to what happens in a person’s brain when they are stimulate the reward circuits of the brain, but also by exposed to rewarding substances or rewarding the speed with which it crosses the blood-brain behaviors, and it is more about reward circuitry barrier (i. Other physical signs such as intoxication, withdrawal, needle-related findings, co-infections, and laboratory findings--such as abnormalities in * A primary disease indicates that it is not simply a liver function tests or positive breath or urine tests-- symptom or effect of another disease or condition. With assessment, pleasure seeking, impulse control/ repeated use of addictive substances, the brain inhibition, emotion, learning, memory and stress begins to expect this stimulation and an addicted 15 control. On involving another substance; for example, a neurological level, this reinforcement is a nicotine use can prime the brain, making it more process carried out by chemical messengers that susceptible to developing addiction involving 18 ‡ 22 flood the reward circuits of the brain. Signals in the environment such as Virtually all addictive substances affect the seeing a drug-using friend or passing a bar, or * pleasure and reward circuitry deep in the brain emotional signals such as feeling stressed or sad which is activated by the neurotransmitter also become associated with the addictive † 19 23 dopamine. As use continues, the pleasure associated with Definition of Addiction the dopamine release that results from the American Society of Addiction Medicine ingestion of an addictive substance--or from its anticipation--can become consuming to the point Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. This is reflected in an At the same time, the brains of substance-using individual pathologically pursuing reward and/or individuals may adapt to the unnaturally high relief by substance use and other behaviors. Compared to non-substance users, the addiction often involves cycles of relapse and brains of chronic substance users appear to have remission. Without treatment or engagement in lower baseline levels of dopamine, making it recovery activities, addiction is progressive and difficult for them to achieve feelings of pleasure 24 can result in disability or premature death. The cognitive control of an motivated or directed actions such as attaining addictive substances and also influences dopamine ‡ levels in the brain. Although certain when he or she wants to cut down or stop using specific genetic factors predispose an individual 37 an addictive substance, it becomes extremely to addiction involving a particular substance, 30 difficult to do so. Advances in genetic research have enabled People may choose to take drugs, but no one chooses to be an addict. Genetic variations may affect a person’s ability The Risk Factors for Addiction 41 to metabolize an addictive substance or to 42 tolerate it. Studies have found that genetics Genetic factors play a major role in the account for between half and three quarters of development of addiction as do individual † 43 the risk for addiction. Genetic factors appear biological and psychological characteristics and to be stronger drivers than environmental factors 31 44 environmental conditions. A factor influences them to have a higher tolerance for that is particularly predictive of risk, however, is alcohol are at increased risk of developing the age of first use; almost all cases of addiction begin with substance use before the age of 21, 35 when the brain is still developing. Genetic Risks * Twin and adoption studies confirm a genetic role in the likelihood of substance use and the from environmental similarities. Identical twins are genetically identical and fraternal twins share an * These studies help distinguish the roles of genetics average of 50 percent of their genes, but both types of and environment in the development of addiction. Adopted children with biological tendency toward heightened dopamine response parents who have addiction involving alcohol also are at increased risk because of their are at least twice as likely as are adopted enhanced or above average experience of reward 56 children without such parents to develop or pleasure from engaging in substance use. Individuals Other biological risks may involve damage or † whose genetic makeup produces involuntary deficits in the regions of the brain responsible 57 skin flushing and other unpleasant reactions to for decision making and impulse control. Psychological Risks It’s theoretically possible to take kids before Clinical mental health disorders such as they first drink, find out whether they have any depression and anxiety and psychotic disorders gene variations, and say to them, ‘If you choose such as schizophrenia, as well as behavioral to be a drinker, then be careful because it’s very disorders such as conduct disorder and attention- likely that you’ll need to drink more to have the 58 50 deficit/hyperactivity disorder --and sub-clinical same effect. Individuals whose brain University of California, San Diego development has been altered by stress are more sensitive to the effects of addictive substances and more vulnerable to the development of Other Drugs. Twin military duty, are at increased risk of developing studies have found genetic risks for 62 addiction. People who have risk-taking or hallucinogen, opioid, sedative and stimulant use 63 impulsive personality traits or who have low 53 64 and addiction. Expectations play a role in substance use as well, since people who expect that using In addition to genetic variations, certain addictive substances will be a positive and individuals have neurological, structural or rewarding experience--in terms of physical functional differences that make them more effects, mood or behavior--are likelier to smoke, 54 susceptible to addictive substances. This is in drink alcohol or use other drugs than are those part due to individual differences in how the 67 with more balanced or negative expectations. Some research indicates that individuals with a Environmental Risks naturally low level of dopamine response to addictive substances are at increased risk of Many factors within an individual’s family, engaging in substance use in order to achieve a social circle and community, as well as the greater experience of reward. Other research larger cultural climate, increase the likelihood suggests that individuals with a biological that an individual will use addictive substances and develop addiction. The of cases, addiction originates with substance use 82 nature of the parent-child relationship is key; before the age of 21. Because the parts of the people who come from families with high levels brain responsible for judgment, decision- of parent-child conflict, poor communication, making, emotion and impulse control are not weak family bonds and other indicators of an fully developed until early adulthood, unhealthy parent-child relationship are at adolescents are more likely than adults to take 69 increased risk of substance use and addiction. At the same time, because these or convey approval of such use are at increased regions of the brain are still developing, they are 70 risk as well. Homes where liquor and combination of early initiation of use and medicine cabinets are open to teens increase the genetic, biological, psychological or 73 chances that teens will use these substances. Widespread access to controlled prescription drugs contributes to the misuse of these … [addiction] is not simply a disease of the 75 substances and increased access to marijuana brain, but it is a developmental disorder, and it 71 marketed as medicine is linked to increased begins early in life--during adolescence.

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Applica- ate requirements are met by the frst-year tions for admission are due by the appointed program of the School of Medicine generic 20 mg erectafil amex. The catalog for the Each student will take a minimum of 24 cred- School of Medicine should be consulted for its of courses at the 400-level or higher and admissions requirements and procedures cheap 20mg erectafil with visa. Students fulfll the course Information about applying to the com- requirement by taking two courses in the bined M. Applica- engineering, math and science cours- tions submitted for consideration of the com- es. Program admis- undergraduate courses and six core lecture sions committee for review. Additionally, all stu- ing to the combined program who wishes to dents must complete a thesis based on a be considered for the straight Ph. Department of Physiology) The Biophysics and Biophysical Chemistry Additional requirements for the Ph. Appli- This examination will normally take place cants should feel free to discuss with the during the second year of residency. After department which program is most appropri- the completion of the thesis, the student must satisfactorily complete a comprehensive oral ate for them. Biophysics and Biophysical Dissertation: Completion of an original Chemistry Program investigation and presentation of a disser- tation is required. The dissertation must be Requirements for Admission accepted by the department and must be Candidates for admission to graduate stand- considered worthy of publication by referees ing should present a Bachelor’s degree or nominated by the department. However, defciencies student participants with training in both the in some of these subjects can be made up fundamental principles of biophysics and during graduate residency. Degree throughout the University, offer opportunities During the course of graduate study the for learning in diverse and changing areas student must satisfactorily complete the fol- of research. The carefully designed set of lowing program of courses in the Univer- courses and intensive laboratory work inte- sity or their equivalent at the intermediate or grate various aspects of molecular biophys- advanced level. This list does not constitute an infexible Johns Hopkins has long been a leading program; exceptions and modifcations may research institution of world renown. The be made at the discretion of the department Hopkins biophysics community is known for to ft individual backgrounds, needs and its collaborative and congenial atmosphere. Students are encouraged to forge innova- tive paths by seeking the advice of other Required Courses biophysicists and forming collaborations that The following seven, short courses are required: enhance their research. If the funds are not deposited in a timely man- In keeping with an institution of its caliber, a ner, any offer of admission to the Program in large number of technology hubs and instru- Molecular Biophysics will be null and void. Students must continue to Biophysics, Enzymes & Metabolic Pathways, make satisfactory progress toward completion Computation & Theory, Protein Design & of their thesis research and meet annually with Evolution, Single Molecule Studies a thesis review committee starting in their ffth semester. Once thesis research is complete, Requirements for Admission students must defend their thesis before a We encourage applications from students who fnal exam committee and present a fnal the- have majored in biological sciences, biochem- sis seminar. The methods and tools of biophysics are The program derives its strength from drawn from physics, chemistry, biology, participants with various interests and back- mathematics and computer science. Individu- curriculum: Physical Chemistry of Biological al needs can be interwoven into the required Macromolecules, Proteins & Nucleic Acids, curriculum. Optimal background includes Methods in Molecular Biophysics, Comput- general chemistry, organic chemistry, physi- er Modeling of Biological Macromolecules, cal chemistry, two semesters of college-level and Organic Mechanisms in Biology. These physics, biochemistry or molecular biology, courses provide a conceptual framework for and calculus or a high-level math course. Students who have never by a training grant from the National Institutes taken courses in these areas are welcome, of Health. However, this support is limited to but not required, to take such courses dur- U. Tutorials and self-directed International applicants will be required to study provide alternative avenues for prepar- demonstrate fnancial support for their stud- ing for this evaluation. By sum- A list of the members of the staff and their mer of the frst year, a student will have joined research interests may be found in the a research group and embarked on thesis departmental statement on page 141. Beginning in the ffth semester, students meet annually with a faculty thesis review The department will admit well-qualifed stu- committee. Applicants Dissertation should have thorough training in general Completion of an original Investigation and biology, chemistry and physics, or to remove presentation of a dissertation are required. Degree How to Apply Requirements established by the Department Students must complete applications online of Cell Biology and the Doctor of Philosophy (www. Board, usually at the end of the second year The deadline for receipt of complete applica- of residence. Write a dissertation, embodying fndings will be invited to a Visiting Weekend to meet worthy of publication, and certifed to be a with faculty on both campuses, talk with stu- signifcant contribution to knowledge by at dents, and have a look around Baltimore. Program in Molecular Biophysics graduate students are supported for the frst two years 4. Present a fnal departmental oral exami- by a training grant from the National Institutes nation/seminar in the feld of the disserta- of Health. However, this support is limited to tion research certifed by from three to fve U. The department or program committee demonstrate fnancial support for their stud- must certify in writing that all departmental or ies and will be required to deposit funds cov- committee requirements have been fulflled. Core Courses If the funds are not deposited in a timely man- Students will generally fulfll the course ner, any offer of admission to the Program in requirements of the interdepartmental pro- Molecular Biophysics will be null and void. Members of the department who At their discretion, faculty members reserve work in the area of cell biology participate in the right to require students to take elective the joint program in Biochemistry, Cellular courses. Students are required to take understanding, diagnosis, treatment and four elective courses to further broaden their prevention of human diseases. Elective training in scientifc research and develop a courses may include courses at the School thorough knowledge of human biology and of Public Health and Homewood Campus. Elective course topics include bioorganic This program grew out of a need for gradu- chemistry, biophysical chemistry, human ate training at the interface between medicine anatomy, immunology, pathobiology, phar- and the traditional basic science disciplines. These laboratory rotations will be make discoveries in the laboratory that can approximately ten weeks long. At the end of be applied expeditiously to the diagnosis, the frst year, students will select a research treatment, and prevention of disease. New advisor from one of three rotation laborato- technology allows scientists to identify genet- ries and begin original research leading to ic and molecular defects causing or predis- their doctoral dissertation. The trainees in this pro- A University mandated Doctor of Philosophy gram are working precisely at this interface Board Oral examination must be completed by between science and medicine to contribute the end of the second year of study. Annual Students will work in well equipped labora- meetings are held until such time as the the- tories of approximately 125 program faculty sis committee believes the student is ready to located throughout the medical school cam- write their doctoral dissertation. These researchers are supported by tion is based on the student’s novel research; many shared facilities including microscopy, a public seminar of thesis work is a graduation molecular biology and protein chemistry. Requirements for Admission Financial Aid Applicants should have a bachelor degree with The program is supported by a combination undergraduate training in biology, inorganic of monies from the Lucille P. Cell biology and/or biochemistry are student is provided a stipend, health and recommended. The program covers admissions should be referred to the Offce of these benefts during the students’ frst year; the Graduate Program in Cellular and Molecu- in subsequent years the research advisor is lar Medicine, 1830 E. Complete a minimum of four years of reg- The work of this program extends over all istration as a full time, resident graduate stu- phases and dimensions of the development of dent. Demonstrate evidence of achievement and conceptual, cultural, and social problems. Write a dissertation, embodying fndings of medicine, science, and related felds of his- worthy of publication, and certifed to be a tory. Departmental offerings are particularly signifcant contribution to knowledge by at strong in the history of medicine and science least two referees from within the department for early modern Europe; medicine, science and two referees from outside. Present a fnal departmental seminar in the 20th centuries; history of disease and public feld of the dissertation research. For further information, Human Anatomy, Organ Histology, Evolution- see our website at: http://www. Students must also take at least four elective Program, School of Medicine, The Johns Hop- courses, to be determined through consul- kins University, 1830 E. Preference will be given to appli- mates of the Past, Paleoecology, Behavioral cants with training in some aspect of the Ecology, Animal Behavior, Geobiology, Iso- health feld, sciences, or history. Stu- the University, the School of Medicine, and dents are required to undertake pre-disserta- the Program. Prior to embarking on full-time dissertation research, candidates Fellowships will prepare themselves by a variety of cours- Predoctoral fellowships covering normal liv- es, seminars, and guided reading.

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