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function, predominate in certain types of polyneuropathy They occur most frequently in amyloidosis and certain other hereditary small- ber polyneuropathies, especially diabetic, and several congenital types In addition, they are among the main features of an acute autonomic polyneuropathy called pandysautonomia (Young, Adams, et al, Low et al) and can be prominent in some cases of GBS These dysautonomic conditions are described in detail in Chap 26 and later in this chapter Other manifestations of autonomic paralysis are small or medium-sized unreactive pupils that are unusually sensitive to certain drugs (pages 241 and 462); lack of sweat, tears, and saliva; sexual impotence; weak bowel and bladder sphincters with urinary retention or over ow incontinence; and weakness and dilatation of the esophagus and colon As a result of vagal and other parasympathetic dysfunction, the normal variability of heart rate with respiration (sinus arrhythmia) is lost and there may be paralytic ileus or dyscoordinated peristalsis, as well as achlorhydria and hyponatremia Some of these abnormalities are found in diabetic and amyloid polyneuropathy In general these autonomic disturbances correspond to degeneration of unmyelinated bers in the peripheral nerves In any neuropathy involving sensory nerves, there is loss of autonomic function in the same zones as sensory loss This is not true of radicular diseases because the autonomic bers join the spinal nerves more distally Such changes in sweating and cutaneous blood ow may be demonstrated by a number of special tests, as described in Chap 26 Fasciculations, Cramps, and Spasms (See also Chap 55) Fasciculations and cramps, while not uncommon, are typically not prominent features in most polyneuropathies and in this respect there is a difference from diseases of the anterior horn cells where they are important features There are exceptions, however Chronic root compression can lead to fasciculations or painful spasms in the innervated muscles Occasionally one observes a state of mild motor polyneuropathy that, upon recovery, leaves the muscles in a state variably referred to as myokymia, continuous muscular activity, and neuromyotonia as discussed in Chaps 45 and 54 All the affected muscles ripple and quiver and occasionally cramp Use of the muscles increases this activity, and there is a reduction in their contractile ef ciency, which the patient senses as a stiffness and heaviness In some instances this apparently constitutes the entire neuropathic syndrome and may be relieved by carbamazepine or phenytoin Other closely related phenomena are spasms or involuntary movements of the toes and feet The latter, referred to by Spillane and colleagues as the syndrome of painful legs and moving toes, is attributed by Nathan to ectopic discharges in sensory roots, ganglia, or nerves, evoking both pain and organized movements This is one cause of a nocturnal restless leg syndrome, the more common type being idiopathic and not associated with features of peripheral nerve disease Other possible mechanisms for cramps and spasms are ephaptic cross-transmission, segmental hyperactivity from deafferentation, and neuronal sprouting during reinnervation In yet other instances, the muscle activity induces odd postures or slow writhing movements that Jankovic and van der Linden have likened to dystonia The precise pathophysiology of these spontaneous and asynchronous activities of motor neurons is not known Stimulation of a motor nerve, instead of causing a brief burst of action potentials in the muscle, results in a prolonged or dispersed series of potentials lasting several hundred milliseconds Evidently, branched axons involved in.

We will discuss a great deal about volatility in relation to equity markets, but we will also utilize examples of futures contracts and options on futures in our discussions Derivatives, or futures, are contract instruments between two parties for the exchange of a commodity It could be a physical commodity, cash instrument, or nancial instrument Futures contracts do not specify the price The price of the contract is determined in open market trading on a futures exchange Futures contracts do

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In this eld, the clinician is faced with several problems: (1) establishing the existence of disease of the peripheral nervous system; (2) distinguishing by clinical tests which of the main topographic syndromes it represents; (3) determining if the problem is predominantly of a motor or sensory nature, or is of mixed type and whether the myelin sheath or the axon is the main target of disease; and (4) establishing the temporal course of disease When taken together, these features greatly limit the diagnostic possibilities and determine the underlying disease and possible treatment

Topographic and Clinical Patterns of Neuropathy (Table 46-1)

At the outset it must be determined whether the neurologic ndings correspond to one of the following syndromic patterns: 1 2 3 4 5 6 Polyneuropathy Radiculopathy or polyradiculopathy Neuronopathy motor or sensory Mononeuropathy Multiple mononeuropathies (mononeuropathy, or mononeuritis multiplex) Plexopathy (involvement of multiple nerves in a plexus)

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The pie chart to the left of the radar chart in the previous dashboard works just fine and is a perfect example of using the appropriate chart type to drive home your information and results to the business analyst Another issue in this dashboard is to the top right in terms of the two line chart types What is the actual KPI Is it the actual versus budget gross margin profit or is it the variance I like the fact that both are shown here, since we can get a look at the information used to create the variance, but whichever is the primary KPI should really be in a bolder color scheme and highlighted It would seem, based on the positioning, that the basic information Actual and Budget represents the primary metrics and therefore should have the most room, but without some additional focus point, we can t really be sure The top left of the dashboard includes another chart that is outlining yearly the Actual and Budget values This one isn t immediately obvious but you figure it out pretty quickly As you can see, the Actual total is the complete chart area and the Budget is embedded into that area with a darker color My question is whether the scheme would be reversed if the Actual value was less than the Budget That is, would the whole area be the Budget and the Actual be just a darker area If that is the case, then this chart would start to get confusing because each month it could change format on the viewer As you can see as we go through these examples, one dashboard can have multiple issues that are not working correctly for the business analyst As long as you re aware of these pitfalls in creating dashboards, you can understand where you might be challenged on your architecture and possibly why the business users are having difficultly working with the dashboards I have seen companies invest tons of money into a dashboard approach to management and wind up having only 50 percent of their employees use it The other 50 percent continue to download the information into Excel and create their own charts for analysis purposes The goal of the dashboard approach is to eliminate this practice so that the analysts can focus on doing their jobs, which is to analyze the data, instead of gathering and formatting the data As you ve noticed, in this section I ve been italicizing certain phrases or words to emphasize a point and catch your attention This is exactly what you want to do with the dashboard You want to focus the user s eyes on a certain portion of the information first, and then have them review the other KPIs To do this, use some sort of change in the font or color scheme to highlight some specific portion of the dashboard.