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    W., Warren-Reese, C., DeLong, J., Ricks-Cord, A., Durr, L. 5645–5650, journal of Neuroscience 21.

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  • As a result, the individual’s sleep is not maximally restorative viagra para mi mujer for a number of nights in a row, leading to increasing difficulty being alert during the daytime. Moreover, the direction of flight does not ensure the direction of circadian phase Sleep and Circadian Control of Neurobehavioral Functions 235 adjustment—some people physiologically phase delay to an eastward (phase advanced) flight, which can require many more days for physiological adjustment to occur. The effects of jet lag are also partly dependent on the direction of travel.

    These cumulative effects (see figure 13.1) can be very incapacitating and can take 1–2 weeks to fully dissipate through full circadian reentrainment to the new time zone. A typical jet lag experience involves arriving at a destination (new time zone) with an accumulated sleep debt (i.e., elevated homeostatic sleep drive). Eastward travel tends to be more difficult for physiological adjustment than westward travel because eastward transit seeks to impose a phase advance on the circadian clock, while westward transit imposes a phase delay.

    Lengthening a day by a few hours is somewhat easier to adjust to physiologically and behaviorally than advancing a day by the same amount of time, although adjustment to either eastward or westward phase shifts of more than a couple of hours is a slow process, often requiring at least a 20-hour period for each time zone crossed and resulting in a substantial but still incomplete adjustment for most people, assuming they get daily exposure to the light-dark cycle and social rhythms of the new environment. This ensures that the first night of sleep in the new time zone will occur—even if it is abbreviated due to a wake-up signal from the endogenous circadian clock—but on the second, third, and fourth nights the person will most likely find it more difficult to obtain consolidated sleep because of the circadian disruption.

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    But generally includes retinoic viagra para mi mujer acid, the optimal maintenance therapy is currently investigated in studies. Patients who reach a second remission should be investigated for a SCT or BMT. Another agent with activity in APL is arsenic trioxide in patients who relapsed after chemotherapy and/or ATRA). The prognosis of APL is improved if the patient receives maintenance chemotherapy, different from other types of AML. In APL, the disappearance of the PML/RAR a gene product corresponds to a stable remission, whereas the reappearance heralds relapse in many cases.

    Currently, the effect of arsenic incorporated into induction regimens for APL is being investigated.

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    (Notes. (Bottom) Components of the basal ganglia. Figure 13-1. Block diagram illustrating the general features of the inputoutput organization of the basal ganglia.

    The input nuclei receive their major projections from the entire cerebral cortex, but only the frontal lobe receives output from the basal ganglia, relayed via the thalamus.