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"ABSTRACTAcute lower urinary pathway obstruction is accompanied by renal blood flow alteration and vasoconstriction. The vasoconstriction rate (VCR) provides a morphological tool for measuring the degree of vasoconstriction. The present study consisted of two parts: animal experiments and autopsy case examinations. The experimental work focused on the VCR in the renal arterial system of rabbits with complete unilateral ureteral ligation. At 6 hours after unilateral ureteral obstruction (UUO) in the rabbits, the VCR in the renal and arcuate arteries increased above normal, whereas the interlobular artery VCR remained unchanged. The non-obstructed kidney did not show any significant change in VCR. Blood flow measurements were performed after various time intervals: 15 min, 90 min, and 6 hours. The mal blood flow during UUO in the rabbits increased within minutes after ligation, peaking at 15 min and gradually decreased thereafter. At 6 hours after complete ligation of the ureter, the blood flow of the kidney was 64.6% of baseline. The contra lateral kidney blood flow decreased 13.6%. The glomerulli of the rabbits exhibited ischemic changes characterized by separation of the capillary lobules and shrinkage towards the vascular pole, eventually causing a fairly distended Bowman's space. At 6 hours, electron microscopic examinations revealed focal destruction of the intracellular reticulum with electron dense granule deposition in the tubeles. The non-obstructed kidney showed no changes in morphology from among about 2000 autopsy cases accumulated in 1977-1985 at the Department of Pathology, Nihon University School of Medicine, 5 cases were selected on the basis of clinical and pathological scrutinization to assess how renal arterial vasoconstriction might implicate the kidney in the presence of ureter obstruction as a result, it was found that the renal arterial system experienced vasoconstriction during the presence of lower ureteral obstruction, paralleling the procedure of direct stoppage of urinary flow."

"ABSTRAKPendahuluan: Proses industri banyak menghasilkan limbah industri yang pada akhirnya dapat berdampak terhadap kesehatan, salah satunya adalah polusi udara yang berdampak terhadap kesehatan respirasi. Industri pengolah besi banyak dihubungkan dengan penyakit paru. Banyak komponen dari pengolahan besi yang dapat berpotensi mempengaruhi paru meskipun setiap individu akan merespons secara berbeda bila terkena debu dan gas. Salah satu cara untuk menilai dampak respirasi yaitu dengan menilai keluhan dan faal paru khususnya kelainan obstruksi dari para pekerja pabrik tersebut. Sehingga diperlukan data mengenai profil keluhan respirasi dan kelainan obstruksi saluran napas pada pekerja pabrik besi baja serta mengetahui faktor-faktor apa yang mempengaruhinya.Tujuan: Penelitian bertujuan untuk mendapatkan informasi mengenai keluhan respirasi dan kelainan obstruksi saluran napas pada pekerja pabrik besi baja di PT. X Cilegon serta faktor- faktor yang mempengaruhi.Metode: Penelitian ini merupakan studi potong lintang dilakukan di Medical Check Up RS. Krakatau Medika, Cilegon. Pengambilan sampel dengan consecutive sampling pada pekerja yang telah bekerja ge; 5 tahun di bagian produksi. Pengumpulan data dilakukan dengan wawancara berdasarkan Epidemiology Standardization Project American Thoracic Society ATS selanjutnya dilakukan pemeriksaan spirometri.Hasil: Dari 112 subjek, hanya 107 subjek yang masuk kriteria inklusi. Berdasarkan wawancara terhadap subjek serta pengisian kuisioner didapatkan subjek yang mengalami keluhan respirasi sebanyak 22 subjek 20,6 meliputi batuk kronik 5 subjek, berdahak kronik 1 subjek, sesak napas 15 subjek serta berdahak kronik dan sesak napas 1 subjek. Berdasarkan pemeriksaan faal paru dengan spirometri pada subjek didapatkan kelainan pada 30 subjek 28,1 . Kelainan obstruksi berupa obstruksi ringan ada 2 subjek 1,9 .Kesimpulan: Keluhan respirasi terbanyak adalah sesak napas tanpa disertai mengi dan hal tersebut berbeda dengan penelitian-penelitian sebelumnya yang mendapatkan data bahwa batuk kronik dan berdahak merupakan keluhan respirasi yang terbanyak. Penelitian ini mendapatkan ada hubungan bermakna antara usia, status gizi dan masa kerja dengan keluhan respirasi. Kelainan obstruksi hanya didapatkan pada 2 subjek. Karena prevalens obstruksi hanya sedikit pada penelitian ini sehingga tidak dapat dianalisis lebih lanjut.Kata kunci: faal paru, obstruksi, besi baja "

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""ABSTRACT"Introduction Industry process produces a lot of industry waste which eventually affect human health, for example the air pollution that affecting respiratory health. Steel manufacturing industry is correlated with lung diseases. Many components in steel manufacturing have potency affecting lungs although every individual responding to dusts and gasses is different. One of the methods to evaluate respiratory effect is evaluating symptoms and lung function especially airway obstruction disorders from those company workers. Many data of respiratory symptoms and airway obstruction disorders in iron steel company workers and factors affecting them are needed.Objective This study aims to get information about respiratory symptoms and airway obstruction disorders in X workers of the iron steel company workers in Cilegon as well as factors that affecting them.Method This study uses cross sectional study in Medical Check Up Krakatau Medika Hospital Cilegon. Samples obtained using consecutive sampling method in workers who have worked ge 5 years in production section. Sample collection uses interview based on Epidemiology Standardization Project American Thoracic Society ATS and continued by spirometry measurement.Result From total 112 subjects, only 107 subjects included in inclusion criteria. Based on interview and questionnaire on subjects, there are 22 subjects 20.6 having respiratory symptoms including chronic cough in 5 subjects, chronic sputum production in 1 subject, dyspnea in 15 subjects and having chronic sputum production and dyspnea in 1 subject. Based on lung function measurement with spirometry, there are 30 subjects 28.1 having airway disorders. There are mild airways obstruction in 2 subjects 1.9 .Conclusion The highest respiratory symptoms are dyspnea without wheezing and this finding is different than the previous studies with the result of chronic cough and chronic sputum production as highest respiratory symptoms. This study results in significant relationship among age, nutrition status and working period with respiratory symptoms. Airway obstruction disorders only obtained in 2 subjects. Because of low airway obstruction prevalence in this study, this finding could not be evaluated further.Keywords lung function, airway obstruction, iron steel"

"ABSTRAK Latar belakang: Tesis ini bertujuan untuk mengetahui insidens retensio urin pasca rekonstruksi POP dan faktor-faktor yang berhubungan.Retensio urinmerupakan komplikasi akut tindakan rekonstruksi dan banyak dijumpai padaprosedur operasi, termasuk operasi POP (POP). Untuk menghindari morbiditaslebih lanjut, penelitian ini bertujuan untuk mengetahui insidens rertensio urinpasca rekonstruksi POP faktor-faktor risiko yang berhubungan.Metode: Penelitian ini adalah penelitian kohort prospektif yang dilaksanakan diRS Cipto Mangunkusumo dan RS Fatmawati dengan mengikutsertakan wanitayang hendak mengalami rekonstruksi POP dalam rentang waktu April 2013hingga April 2015. Kriteria inklusi dan eksklusi subjek meliputi wanita denganPOP derajat 2,3 dan 4 tanpa riwayat retensio urin sebelumnya, konsumsi obatobatanyangdapat menyebabkan retensio urin dan tanpa cedera kandung kemih.Pasca rekonstruksi, subjek dilakukan pemasangan kateter urin selama 24 jam.Kemudian, enam jam pasca pelesapan kateter, dilakukan pengukuran residu urinpada kandung kemih. Retensio urin didefinisikan dengan didapatkannya residuurin >100 ml.Hasil: Dari 200 subjek, ditemukan 59 subjek (29,5%) mengalami retensio urin.Tidak ada hubungan antara faktor risiko umur, Indeks Massa Tubuh (IMT),derajat POP, derajat sistokel, kejadian infeksi saluran kemih, dan durasi operasiterhadap retensio urin. Jenis prosedur total vagina hysterectomy + kolporafianterior + kolpoperineorafi + sacrospinous fixation dan durasi operasi > 130menit berhubungan dengan retensio urin dengan RR 3,66 95% IK 2,91-4,60p<0,001 dan 1,66 95%IK 1,07-2,59 p=0,02, berturut-turutKesimpulan: Insidens retensio urin cukup tinggi pasca rekonstruksi POP. Jenistindakan rekonstruksi tertentu dan semakin lamanya durasi rekonstruksiberhubungan dengan kejadian retensio urin.ABSTRACT Background: The objective of this study was to know the incidence of post operativeurinaryretention after pelvic organ prolapse surgery and associatedfactors.Post operative urinary retention (POUR) is considered as an acutecomplication after a surgey in many operative procedures, including pelvic organprolpase (POP) surgery. To avoid further morbidity, this study aimed to know theincidence of POUR after POP surgery and its risk factors. Methods: This is a prospective cohort study conducted in Cipto Mangunkusumohospital and Fatmawati Hospital from April 2013 to April 2015. Subjects werewomen who wanted to undergo POP surgery with two to four degree of POP.Subjects with history of urinary retention, drugs consumption that tend to causeurinary retention or bladder unjury were excluded. After the reconstruction,urinary catheter was placed for 24 hours. Then, after six hours, catheter wasremoved and residual urine was measured. Urinary retention was defined asresidual urine more than 100 ml. Results: Of 200 subjects recruited, 59 (29.5%) had POUR. There were noassociation between age, body mass index, degree of uterine POPe, degree ofcystocele, urinary tract infectionand POUR. Duration of surgery > 130 minute andTotal vagina hysterectomy +anterior colporraphy + colpoperineorraphy +sacrospinous fixation procedure and duration of surgery > 130 minute were associated with POUR (RR 3.66, 2.91-4.60 95% CI, p<0.001 and 1.66 , 072.5995%CI,p=0.02;respectively)Conclusion: POUR incidence after POP surgery was quite high. Type of theprocedure and duration of surgery were associated with POUR.;Background: The objective of this study was to know the incidence of post operativeurinaryretention after pelvic organ prolapse surgery and associatedfactors.Post operative urinary retention (POUR) is considered as an acutecomplication after a surgey in many operative procedures, including pelvic organprolpase (POP) surgery. To avoid further morbidity, this study aimed to know theincidence of POUR after POP surgery and its risk factors. Methods: This is a prospective cohort study conducted in Cipto Mangunkusumohospital and Fatmawati Hospital from April 2013 to April 2015. Subjects werewomen who wanted to undergo POP surgery with two to four degree of POP.Subjects with history of urinary retention, drugs consumption that tend to causeurinary retention or bladder unjury were excluded. After the reconstruction,urinary catheter was placed for 24 hours. Then, after six hours, catheter wasremoved and residual urine was measured. Urinary retention was defined asresidual urine more than 100 ml. Results: Of 200 subjects recruited, 59 (29.5%) had POUR. There were noassociation between age, body mass index, degree of uterine POPe, degree ofcystocele, urinary tract infectionand POUR. Duration of surgery > 130 minute andTotal vagina hysterectomy +anterior colporraphy + colpoperineorraphy +sacrospinous fixation procedure and duration of surgery > 130 minute were associated with POUR (RR 3.66, 2.91-4.60 95% CI, p<0.001 and 1.66 , 072.5995%CI,p=0.02;respectively)Conclusion: POUR incidence after POP surgery was quite high. Type of theprocedure and duration of surgery were associated with POUR.;Background: The objective of this study was to know the incidence of post operativeurinaryretention after pelvic organ prolapse surgery and associatedfactors.Post operative urinary retention (POUR) is considered as an acutecomplication after a surgey in many operative procedures, including pelvic organprolpase (POP) surgery. To avoid further morbidity, this study aimed to know theincidence of POUR after POP surgery and its risk factors. Methods: This is a prospective cohort study conducted in Cipto Mangunkusumohospital and Fatmawati Hospital from April 2013 to April 2015. Subjects werewomen who wanted to undergo POP surgery with two to four degree of POP.Subjects with history of urinary retention, drugs consumption that tend to causeurinary retention or bladder unjury were excluded. After the reconstruction,urinary catheter was placed for 24 hours. Then, after six hours, catheter wasremoved and residual urine was measured. Urinary retention was defined asresidual urine more than 100 ml. Results: Of 200 subjects recruited, 59 (29.5%) had POUR. There were noassociation between age, body mass index, degree of uterine POPe, degree ofcystocele, urinary tract infectionand POUR. Duration of surgery > 130 minute andTotal vagina hysterectomy +anterior colporraphy + colpoperineorraphy +sacrospinous fixation procedure and duration of surgery > 130 minute were associated with POUR (RR 3.66, 2.91-4.60 95% CI, p<0.001 and 1.66 , 072.5995%CI,p=0.02;respectively)Conclusion: POUR incidence after POP surgery was quite high. Type of theprocedure and duration of surgery were associated with POUR."

"ABSTRAKLatar Belakang: Drainase temporer saluran kemih bagian atas dapat dilakukan dengan pemasangan stent ureter. Pemasangan DJ stent dapat memberikan keluhan rasa tidak nyaman pada pasien yang bervariasi dari seseorang ke orang yang lain dan bersifat idiosinkrasi Tujuan: Untuk mengetahui faktor-faktor apa yang berpengaruh terhadap gejalagejala berkemih dan nyeri pada pasien-pasien yang terpasang DJ stent di RSUP Dr. Sardjito dan RSPAU Dr. Suhardi Hardjolukito Yogyakarta. Metode: Penelitian prospektif ini dilakukan pada bulan Maret - Agustus. Semua pasien yang dipasang DJ stent diikutsertakan dalam penelitian ini. Kriteria eksklusi adalah pasien yang dipasang DJ stent dengan kasus keganasan, pasien yang menjalani pemasangan DJ stent,dan pasien dengan DJ stent bilateral.Sebelum dan 1 bulan setelah dipasang DJ stent, yakni ketika pasien dijadwalkan lepas DJ stent, pasien kembali mengisi kuesioner IPSS, USSQ dan VAS. Data IPSS, komponen berkemih USSQ dan VAS dicatat dan dianalisis dengan Chi Square/ Fisher exact test, Pearson/Spearman dan Mann Whitney Hasil: Dari 40 pasien, laki-laki 23 orang (57,5%) dan perempuan 17 orang(42,5%), rerata usia 44,92 tahun dan lama pemasangan DJ stent 38,22 hari.Berdasarkan hasil IPSS, terdapat hubungan bermakna antara IPSS total sebelum dan setelah pemasangan DJ stent (p <0,001; r = 0,628). Distribusi gejala berkemih yang sering muncul pada kuesioner USSQ adalah disuria (62,5%), frekuensi (55%), nokturia (52,5%), buang air kecil tidak lampias (47,5%), hematuria (35%), dan urgensi (15%). Pada analisis bivariate, posisi DJ stent berhubungan dengan timbulnya frekuensi (p <0,001), nokturia (<0,001), urgensi (p=0,002), buang air kecil tidak lampias (p=0,049), dysuria (p=0,030), hematuria (p=0,026) dan nyeri (p<0,001). Kesimpulan: Gejala berkemih sebelum dipasang DJ stent dan posisi DJ stentmerupakan faktor yang mempengaruhi timbulnya gejala berkemih dan nyeri pada pemasangan DJ stent.

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ABSTRACTBackground: Temporary drainage of upper urinary tract can be performed by ureteral stents. Stent discomfort can vary from one patient to another in an idiosyncratic manner. Purpose: To study factors that influence urinary symptoms and pain related to stented ureter Methode: This is prospectif study, from March 2014 to August 2014, to known factors that influence urinary symptoms and pain of patients with ureteral stent.All patients were inserted ureteral stent participated in this study. Exclusioncriteria were patients with malignancy, patients who had history of DJ stentplacement previously, and patients with bilateral DJ stents. All patients completed IPSS questionnaire before inserted stents. After 1 month, when removal DJ stents performed, all patients completed IPSS,USSQ and VAS. All data was analized with Chi square/fisher exact test, pearson/spearman correlation and Mann Whitney. Results: Fourty patients consist of 23 man (57.5%) and 17 women (42.5%)completed this study. The mean age was 44.92 years old and length of stentedureter was 38.22 days. There was significance correlation between IPSS of DJstent preinsertion and post insertion ( p<0.001; r = 0.628). Of the patients reporteddysuria (62.5%), frekuensi (55%), nocturia (52.5%), incomplete emptying(47.5%), hematuria (35%) and ugency (15%). On bivariate analysis, there wassignificance correlation between DJ stent position and frequency (p <0.001),nocturia (<0.001), urgency (p=0.002), incomplete emptying (p=0.049), dysuria(p=0.030), hematuria (p=0.026) and pain (p<0.001). Conclusion: Previous urinary symptoms and DJ stent position were factors that influence urinary symptoms and pain related ureteral stent insertion."

"Batu saluran kemih adalah salah satu kasus keperawatan kesehatan masyarakat perkotaan karena prevalensinya di Indonesia yang terus meningkat. Hal ini berkaitan dengan faktor gaya hidup yang sedikit mengkonsumsi air putih dan tinggi diit protein dan makanan berlemak. Penulisan laporan ini bertujuan untuk menganalisis asuhan keperawatan pada Tn I. klien dengan batu saluran kemih di lantai 5 bedah RSPAD Gatot Soebroto. Fokus intervensi yang diberikan adalah edukasi kesehatan mengenai peningkatan hidrasi air putih 2,5 liter perhari dan perubahan pola diit untuk mencegah kekambuhan berulang. Edukasi dilakukan sebelum dan sesudah penatalaksanaan URS Litotripsi. Hasil yang diperoleh adalah klien dan keluarga mengungkapkan peningkatan pengetahuan mengenai batu saluran kemih dan akan memperbaiki gaya hidup yang belum tepat. Kesimpulan dari penulisan karya ilmiah ini adalah upaya edukasi merupakan tindakan mandiri keperawatan untuk mencegah kekambuhan berulang dari batu saluran kemih.

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Urinary tract stones is being one of the urban public health cases because of the rising prevalence nowadays. This case related to the urban lifestyle factors that was low water intake and high protein and fatty diet intake. The aim of this scientific paper was to analyze the nursing care for Mr. I with urinary tract stones at RSPAD Gatot Soebroto. The focus of intervention was giving education about rising hydration with intake water 2,5 litres per day and changing of diet pattern. Education was given before and after the URS Litotripsy. After the intervention given, client and family expressed that the knowledge was upgraded and the client willing to change the bad behaviour. The conclusion of this paper was educationbecome one of the independent intervention that was given by nurse to promote client’s health and prevent the recurrence of stones formation."

"Pemeriksaan IVU merupakan pemeriksan yang sering digunakan di Indonesia untuk mengevaluasi traktus urinarius mengingat ketersediaannya yang luas dan cukup murah. Sekalipun demikian, pemeriksaan IVU memerlukan pajanan dan serial film yang cukup banyak sehinga dosis radiasi yang diterima pasien cukup tinggi dan biaya yang dikeluarkan untuk film cukup besar. Penelitian ini bertujuan untuk meningkatkan cost effectiveness pemeriksaan IVU dan menurunkan pajanan radiasi yang diterima pasien dengan menilai sensitivitas dan spesifisitas pemeriksaan IVU dengan serial film terpilih pada diagnosis klinis obstruksi traktus urinarius. Penelitian ini merupakan uji diagnostik yang membandingkan sensitivitas dan spesifisitas pemeriksaan IVU serial film terpilih (radiografi abdomen polos, serial film 5 menit, 20 menit, buli penuh dan post void) serta serial film lengkap (radiografi abdomen polos, serial film 5 menit, 10 menit, 20 menit, 30 menit, buli penuh serta post void). Populasi studi penelitian terdiri dari pasien dengan diagnosis klinis obstruksi traktus urinarius yang dievaluasi dengan pemeriksaan IVU standar yang tersimpan dalam Picture Archiving and Communication System (PACS) Departemen Radiologi FKUI-RSCM antara bulan Februari 2012 hingga Januari 2013 yang dipilih secara random, sehingga didapatkan jumlah subjek penelitian sebanyak 75, dengan 1 set data drop out. Masing-masing set data dievaluasi secara double blind dalam serial film terpilih dan lengkap oleh peneliti dan pembimbing. Bila terdapat ketidaksesuaian maka dievaluasi ulang oleh pihak ketiga. Didapatkan sensitivitas dan spesifisitas serial film terpilih untuk evaluasi ginjal sebesar 100% dan 99,16%, untuk evaluasi ureter sebesar 100% dan 99,29% serta hasil evaluasi keseluruhan sebesar 93,1% dan 97,7%. Pada statistik analitik yang menggunakan uji McNemar, tidak terdapat perbedaan bermakna antara evaluasi serial film terpilih dan serial film lengkap.

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IVU is commonly used in evaluation of urinary tract in Indonesia due to its widespread availability and low cost. Nevertheless, IVU posed extensive radiation exposure and requires numerous serial films, leading to high radiation dose on patients and considerable expenses on films. The aim of this research is to increase cost effectiveness of IVU and minimizing radiation exposure by assessing sensitivity and specificity of selected serial film IVU and complete serial film IVU.

This research is a diagnostic test comparing sensitivity and specificity of selected serial film IVU (consisting of scout film, 5 minutes, 20 minutes, full bladder and post void films) and complete serial film IVU (consisting of scout film, 5 minutes, 10 minutes, 20 minutes, 30 minutes full bladder and post void films. The study population consists of patients with clinical diagnosis of urinary tract obstruction evaluated with standard IVU which are stored in Picture Archiving and Communication System (PACS) at Radiology Department Faculty of Medicine, University of Indonesia- Cipto Mangunkusumo General Hospital (FKUI-RSCM) in February 2012 until January 2013, which are randomly selected, hence 75 subjects obtained with 1 drop out data set. Each data set undergone double blind evaluation both in selected serial film and complete serial film by the researcher and the supervisor. In case of discrepancy, re-evaluation by a third party was obtained.

Sensitivity and specificity of selected serial films in evaluation of kidneys is 100% and 99,16%, in evaluation of ureters is 100% and 99,29% while in general evaluation of urinary tract is 93,1% and 97,7%. Upon analytic statistics using McNemar test, no significant difference is found between selected serial films and complete serial films."

"The Interactions DVD provides an interactive examination of physiological processes within each system of the body using animations and interactivity to enhance understanding. At the heart of Interactions is a focus on core principles - homeostasis; communication; energy flow; fluid flow; and boundaries--that underscore the essential relationships between structure and function as well as interrelationships between systems. It is the reinforcement of these fundamental organizing principles, to which a variety of processes and concepts for each system will be attached, that sets this product apart.Body Systems Covered: Foundations; Regulation: The Nervous and Endocrine Systems; Support and Movement: The Skeletal and Muscular Systems; Distribution: The Cardiovascular and Lymphatic Systems; Disease Resistance: The Immune and Lymphatic System; Energy Acquisition and Use: Metabolism and the Digestive System; Gas Exchange and pH Balance: The Respiratory System; Balancing Fluids and pH: The Urinary System"

"The Interactions DVD provides an interactive examination of physiological processes within each system of the body using animations and interactivity to enhance understanding. At the heart of Interactions is a focus on core principles - homeostasis; communication; energy flow; fluid flow; and boundaries--that underscore the essential relationships between structure and function as well as interrelationships between systems. It is the reinforcement of these fundamental organizing principles, to which a variety of processes and concepts for each system will be attached, that sets this product apart.Body Systems Covered: Foundations; Regulation: The Nervous and Endocrine Systems; Support and Movement: The Skeletal and Muscular Systems; Distribution: The Cardiovascular and Lymphatic Systems; Disease Resistance: The Immune and Lymphatic System; Energy Acquisition and Use: Metabolism and the Digestive System; Gas Exchange and pH Balance: The Respiratory System; Balancing Fluids and pH: The Urinary System"

"The Interactions DVD provides an interactive examination of physiological processes within each system of the body using animations and interactivity to enhance understanding. At the heart of Interactions is a focus on core principles - homeostasis; communication; energy flow; fluid flow; and boundaries--that underscore the essential relationships between structure and function as well as interrelationships between systems. It is the reinforcement of these fundamental organizing principles, to which a variety of processes and concepts for each system will be attached, that sets this product apart.Body Systems Covered: Foundations; Regulation: The Nervous and Endocrine Systems; Support and Movement: The Skeletal and Muscular Systems; Distribution: The Cardiovascular and Lymphatic Systems; Disease Resistance: The Immune and Lymphatic System; Energy Acquisition and Use: Metabolism and the Digestive System; Gas Exchange and pH Balance: The Respiratory System; Balancing Fluids and pH: The Urinary System"

"The Interactions DVD provides an interactive examination of physiological processes within each system of the body using animations and interactivity to enhance understanding. At the heart of Interactions is a focus on core principles - homeostasis; communication; energy flow; fluid flow; and boundaries--that underscore the essential relationships between structure and function as well as interrelationships between systems. It is the reinforcement of these fundamental organizing principles, to which a variety of processes and concepts for each system will be attached, that sets this product apart.Body Systems Covered: Foundations; Regulation: The Nervous and Endocrine Systems; Support and Movement: The Skeletal and Muscular Systems; Distribution: The Cardiovascular and Lymphatic Systems; Disease Resistance: The Immune and Lymphatic System; Energy Acquisition and Use: Metabolism and the Digestive System; Gas Exchange and pH Balance: The Respiratory System; Balancing Fluids and pH: The Urinary System"