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Overall, in children and young adults with ischemic stroke, the main diagnoses to be considered are carotid and vertebral dissection, drug abuse (mainly cocaine), thrombosis induced by birth control pills (see below), antiphospholipid antibody syndrome, and patent foramen ovale (PFO) Migraine might be added to this list, but it is a diagnosis by exclusion in these circumstances and CADASIL, albeit rare, should also be considered if migraine headaches and TIAs precede a stroke Inherited prothrombotic states such as those caused by the various clotting factor de ciencies discussed above, Fabry disease, moyamoya, and Takayasu arteritis arise in the younger age group and require exploration if clinical circumstances suggest on the basis of unusual TIAs (orthostatic or hyperventilation induced), Down syndrome, or strong family history of strokes in youth

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order processing system, you might have two tables One contains the list of orders, the other contains a list of order lines A join between the two would enable you to obtain all of the information from a single order You specify a logical join using the WHERE clause to the SELECT statement, specifying an expression that links the two tables together For example:

Thus, we have developedan estimateof the truncationelror in tenns of the integral estimatesand their step sizesThis estimate can then be substituted into I : I(hz) _t E]tz) to yield an improvedestimateof the integral: I : l(hz) + -1-t-- ll ttt:l ttttrtl fl84)

Oral Contraceptives, Estrogen, and Cerebral Infarction The early studies of Longstreth and Swanson and of Vessey et al clearly indicated that women who take oral contraceptives in the childbearing years particularly if they are older than 35 years of age and also smoke, are hypertensive, or have migraine are at increased risk of cerebral infarction as well as of ischemic heart disease and subarachnoid hemorrhage Cerebral infarction in these cases is due to arterial occlusion, occurring in both the carotid middle cerebral and vertebrobasilar territories In most of the reported fatal cases, the thrombosed artery has been free of atheroma or other disease This has been taken to indicate that embolism is responsible for the strokes, but the source of embolism can rarely be demonstrated Cerebral and noncerebral venous thromboses are other relatively rare complications These observations, coupled with evidence that estrogen alters the coagulability of the blood, suggest that a state of hypercoagulability is an important factor in the genesis of contraceptive-associated infarction The vascular lesion underlying cerebral thrombosis in women taking oral contraceptives has been studied by Irey and colleagues It consists of nodular intimal hyperplasia of eccentric distribution with increased acid mucopolysaccharides and replication of the internal elastic lamina Similar changes have been found in pregnancy and in humans and animals receiving exogenous steroids, including estrogens Whether these promote in situ thrombosis is not known Mainly at increased risk of stroke are women taking high-dose (050-mg) estrogen pills; lowering the estrogen content has substantially reduced this risk The use of progestin-only pills (POPs) or of Norplant (subcutaneously implanted capsules of progestin) alone has not been associated with an increased risk of stroke (Petitti et al) It has also become clear that mutations of the prothrombin gene are far more frequent in patients who have cerebral venous thrombosis while on oral contraceptive pills These genetic abnormalities are thought by Martinelli and associates to account for 35 percent of idiopathic cases of cerebral vein thrombosis; they contend that contraceptives increase the risk 20-fold.

SELECT OrderOrder_ID, ItemOrder_ID, ItemItem_ID, ItemPLU, OrderTotal FROM Order, Item WHERE OrderOrder_ID = ItemOrder_ID PROGRAMMING WITH PERL

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Amniotic uid embolus may also cause stroke in this manner and should be suspected in multiparous women who have had uterine tears In the latter, there are almost invariably signs of acute pulmonary disease from simultaneous occlusion of lung vessels A rare peripartum cardiomyopathy is yet another source of embolic stroke

The join can be to another table, or to the same table in the case of nested information, such as staff and their supervisors There are other types of joins, such as inner and outer joins, and left, right, and full outer joins For more information on the different types of joins and the results they produce, see SQL from the Ground Up, by M Pyefinch (Osborne/McGraw-Hill, 1999)

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It can be shown (Ralston and Rabinowitz, 1978) that the error of this estimate is we of O(h4) Thr-rs, havecombined two trapezoidal estimates O(h2) to yielda newesrule timateof O(h\ For the special casewherethe intervalis halved(h2: hr12),thisequation becomes

The INSERT statement adds a row of information to a table An INSERT statement has the following syntax: