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  • RESEARCH 4 BUSINESS 2016, Ljubljana, 5 and 6 of May 2016

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    Jaundice as a primary manifestation of PBC is uncommon but strongly 202 CHAPTER 18 PRIMARY BILIARY CIRRHOSIS AND PRIMARY ScLEROSING CHOLANGITIS 183 associated with viagra tesco pharmacy the presence of advanced histologic disease. The symptoms of end-stage liver disease, such as gastrointestinal bleeding, ascites, and encephalopathy, occur late in the course of both diseases. In PSC, the development of bacterial cholangitis characterized by recurrent fever, right viagra tesco pharmacy upper quadrant pain, and jaundice may occur. A history of previous reconstructive biliary surgery, the presence of dominant extrahepatic biliary strictures, or the development of a superimposed cholangiocarcinoma may also be responsible. Although uncommon, steatorrhea in PBC and PSC is usually due to bile salt malabsorption, pancreatic exocrine insufficiency, or coexisting celiac disease.

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  • Obsessive-compulsive disorder provides an interesting parallel to drug addiction that reflects the neurocircuitry viagra tesco pharmacy for compulsive behavior. The amount of cocaine self-administered prior to the 23 days of enforced abstinence was negatively correlated with activation in the left orbitofrontal cortex. Symptoms of anxiety and depression are common in OCD. Human brain imaging has contributed comprehensively to its neuropathological basis (for review, see Baxter, 2000), and these processes may help to understand some aspects of addiction symptomatology.

    This decreased rCBF correlated with Iowa Gambling Task performance in both groups, suggesting that cocaine-related changes in dorsolateral prefrontal cortex were associated with impaired decision-making (Adinoff et al., 2002). In another study with abstinent cocaine abusers subjected to the Iowa Gambling Task, no deficits were observed, but there was decreased resting dorsolateral prefrontal cortex rCBF as measured by [99mTc-HMPAO] SPECT. There was a positive correlation with the performance and the activation in the right orbitofrontal cortex in both groups. These data point to persistent functional abnormalities in the prefrontal network involved in decision-making and anticipation of reward.

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