Objective: To review the principles and practice of the use of conscious sedation for IVF.Design: The pertinent literature was reviewed and recommendations are provided.Result(s): Conscious sedation appears to be the most commonly used method of pain relief for transvaginal retrieval of oocytes. Conscious sedation does not require the presence of an anesthesiologist and can be done in freestanding clinics. Agents commonly used include opioids in combination with benzodiazepines. This combination minimizes pain, decreases anxiety, and provides sedation and some amnesia Adjuvants (...) such as promethazine and hydroxyzine can also be used but often are not needed. Conscious sedation is well tolerated by patients and does not require highly specialized equipment. However, there are specific safeguards that should be followed. Only a few toxicity studies have been performed, but they are reassuring because they have not found significant effects on fertilization or cleavage.Conclusion(s): Conscious sedation appears to be a safe and cost-effective method of providing analgesia and anesthesia for transvaginal retrieval of oocytes. (shrink)

The phenomenological calculus is a relational paradigm for complex systems, closely related in substance and spirit to Robert Rosen’s own approach. Its mathematical language is multilinear algebra. The epistemological exploration continues in this paper, with the expansion of the phenomenological calculus into the realm of anisotropy.

Algebraic/topological descriptions of living processes are indispensable to the understanding of both biological and cognitive functions. This paper presents a fundamental algebraic description of living/cognitive processes and exposes its inherent ambiguity. Since ambiguity is forbidden to computation, no computational description can lend insight to inherently ambiguous processes. The impredicativity of these models is not a flaw, but is, rather, their strength. It enables us to reason with ambiguous mathematical representations of ambiguous natural processes. The noncomputability of these structures means computerized (...) simulacra of them are uninformative of their key properties. This leads to the question of how we should reason about them. That question is answered in this paper by presenting an example of such reasoning, the demonstration of a topological strategy for understanding how the fundamental structure can form itself from within itself. (shrink)

In a recent re-assessment of the medical aspects of the Plague of Athens which is, to date, the most scholarly and comprehensive, Poole and Holladay have emphasized the tendency of many infectious diseases markedly to decline in virulence over decades and centuries and, sometimes, significantly to change their clinical manifestations. In the light of modern medicine they consider four possibilities: The Plague was a disease which still exists today. This they regard as improbable, It still exists in some remote place (...) or places unknown to medical science. This is discussed and dismissed, It became extinct, It was caused by an agent which nowadays causes a significantly different clinical syndrome. They conclude as follows: ‘The truth, we suggest, almost certainly lies in possibility or . But we can see no way of choosing between them. On either view the question: “What was the Athenian Plague?” is in principle unanswerable if the questioner is wanting to attach to the Plagsie the name of some modern disease or diseases’. (shrink)

The authors discuss some of the conceptual issues that must be considered in using and understanding psychiatric classification. DSM-IV is a practical and common sense nosology of psychiatric disorders that is intended to improve communication in clinical practice and in research studies. DSM-IV has no philosophic pretensions but does raise many philosphical questions. This paper describes the development of DSM-IV and the way in which it addresses a number of philosophic issues: nominalism vs. realism, epistemology in science, the mind/body dichotomy, (...) the definition of mental disorders, and dimensional vs. categorical classification. (shrink)