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There is such a thing as being too cautious. If you tend to be a money miser, you might find that you re not cut out to be an entrepreneur. To make a new business work, you have to take risks and spend money. I know I just finished telling you to be cautious, but don t let fear grasp and immobilize you. I ve seen contractors start a business and refuse to pay one penny for advertising. How they expect to get business if no one knows that they are in business is beyond me. My personal experience and mistakes have made it abundantly clear to me that a person can hurt him- or herself by trying to save money without thinking of the consequences. I once terminated a big, expensive ad I had in the phone book to save money. Well, I didn t have to pay the ad expense any longer, but my business dropped off dramatically. I lost much more money in reduced business than I saved. Balance your spending to achieve the best results.

1 0 10 8

Hypoventilating (breathing too slowly) increases the pCO2 (numerator of the magic equation), and, as long as [HCO 3 ] remains constant, the [H ] must increase (pH decreases). [H ] 24pCO2 [HCO 3 ]

Integer roots are reciprocal-of-integer powers Suppose we take some number or quantity a, and raise it to the power 1/p where p is a positive integer. We write this as

1 2 1 2 2

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The clearest evidence of the relationship of inattention, confusion, stupor, and coma is that patients may pass through each of these states as they become comatose or emerge from coma The authors have not observed such a relationship between coma and delirium except possibly in patients suffering from bacterial meningitis, certain drug intoxications or withdrawal states, or hepatic stupor and coma, which in some few instances may be preceded by a brief period of delirium Drowsiness and Stupor In these states, mental, speech, and physical activity are reduced Drowsiness denotes an inability to sustain a wakeful state without the application of external stimuli Inattentiveness and mild confusion are the rule, both improving with arousal The patient shifts positions in bed or chair The lids droop without closing completely; there may be snoring, the jaw and limb muscles are slack, and the limbs are relaxed.

This state is indistinguishable from light sleep, with slow arousal elicited by speaking to the patient or applying a tactile stimulus Stupor describes a state in which the patient can be roused only by vigorous and repeated stimuli, at which time he opens his eyes, looks at the examiner, and does not appear to be unconscious; response to spoken commands is either absent or slow and inadequate Restless or stereotyped motor activity is common in stuporous patients and there is a reduction in the natural shifting of positions When left unstimulated, these patients quickly drift back into a sleep-like state The eyes move outward and upward, a feature that is shared with sleep (see further on) Tendon and plantar re exes and breathing pattern may or may not be altered, depending on how the underlying disease has affected the nervous system.

In psychiatry, the term stupor has been used in a second sense to denote an uncommon condition in which the perception of sensory stimuli is presumably normal but activity is suspended and motor activity is profoundly diminished (catatonic stupor) Coma The patient who appears to be asleep and is at the same time incapable of being aroused by external stimuli or inner need is in a state of coma There are variations in the degree of coma; in its deepest stages, no reaction of any kind is obtainable: corneal, pupillary, pharyngeal, tendon, and plantar re exes are in abeyance, and tone in the limb muscles is diminished With lesser degrees of coma, pupillary reactions, re ex ocular movements, and corneal and other brainstem re exes are preserved in varying degree, and muscle tone in the limbs may be increased.

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