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Management of agnsw Diabetic Ketoacidosis. ABBAS E. KITABCHI, PH.D., M.D., and BARRY M. WALL, M.D., University of Tennessee, Memphis, College of Medicine, Memphis, Tennessee. Am Fam Physician. 1999 Aug 1;60(2):455-464. This article exemplifies the AAFP 1999 Annual Clinical Focus on management and prevention of the complications of about Homelessness Longer an Issue diabetes . Diabetic ketoacidosis is an emergency medical condition that can be life-threatening if not treated properly. The incidence of this condition may be increasing, and art sets, a 1 to 2 percent mortality rate has stubbornly persisted since the 1970s. Diabetic ketoacidosis occurs most often in patients with type 1 diabetes (formerly called insulin-dependent diabetes mellitus); however, its occurrence in patients with type 2 diabetes (formerly called non#x2013;insulin-dependent diabetes mellitus), particularly obese black patients, is not as rare as was once thought. The management of patients with diabetic ketoacidosis includes obtaining a thorough but rapid history and performing a physical examination in law abiding film, an attempt to identify possible precipitating factors. The major treatment of this condition is initial rehydration (using isotonic saline) with subsequent potassium replacement and low-dose insulin therapy. The use of bicarbonate is not recommended in most patients.

Cerebral edema, one of the most dire complications of diabetic ketoacidosis, occurs more commonly in children and adolescents than in adults. Continuous follow-up of patients using treatment algorithms and flow sheets can help to agnsw, minimize adverse outcomes. Preventive measures include patient education and instructions for the patient to contact the physician early during an trilogy by aeschylus illness. Diabetic ketoacidosis is a triad of hyperglycemia, ketonemia and acidemia, each of which may be caused by other conditions ( Figure 1 ) .1 Although diabetic ketoacidosis most often occurs in agnsw, patients with type 1 diabetes (formerly called insulin-dependent diabetes mellitus), more recent studies suggest that it can sometimes be the presenting condition in obese black patients with newly diagnosed type 2 diabetes (formerly called non#x2013;insulin-dependent diabetes mellitus).2 , 3. Diagnostic Triad of Diabetic Ketoacidosis. The rightsholder did not grant rights to reproduce this item in electronic media. On Robinson Crusoe. For the missing item, see the original print version of agnsw this publication. The commonly used diagnostic criteria for diabetic ketoacidosis and average deficits of comparing judaism water and electrolytes are given in Table 1 .4 The therapeutic regimen, which consists of replacing fluid and electrolyte losses and administering low-dose insulin, is based on an understanding of the pathogenesis of the condition. Although protocols for the treatment of diabetic ketoacidosis are well established, a 1 to art sets, 2 percent mortality rate has persisted since the 1970s,5 emphasizing the need for careful, ongoing evaluation of law abiding film this sometimes #x201c;routine#x201d; medical emergency.

Diagnostic Criteria and Typical Total Body Deficits of Water and Electrolytes in Diabetic Ketoacidosis. Blood glucose: 250 mg per dL (13.9 mmol per agnsw L) Serum bicarbonate: 15 mEq per L. Serum ketone: positive at 1:2 dilutions#x2020; Serum osmolality: variable.

Water: 6 L, or 100 mL per kg body weight. Sodium: 7 to 10 mEq per kg body weight. Potassium: 3 to example of empathy, 5 mEq per kg body weight. 1.0 mmol per kg body weight. *#x2014; Not all patients will meet all diagnostic criteria, depending on hydration status, previous administration of diabetes treatment and other factors . #x2020;#x2014; Nitroprusside reaction method . Adapted with permission from Ennis ED, Stahl EJ, Kreisberg RA. Diabetic ketoacidosis. Agnsw. In: Porte D Jr, Sherwin RS, eds. Ellenberg and Rifkin's Diabetes mellitus. 5th ed. Of Empathy. Stamford, Conn.: Appleton Lange, 1997;827#x2013;44 . Diagnostic Criteria and Typical Total Body Deficits of agnsw Water and Electrolytes in Diabetic Ketoacidosis. Blood glucose: 250 mg per dL (13.9 mmol per L)

Serum bicarbonate: 15 mEq per L. Serum ketone: positive at 1:2 dilutions#x2020; Serum osmolality: variable. Water: 6 L, or 100 mL per kg body weight. Sodium: 7 to 10 mEq per kg body weight. Potassium: 3 to 5 mEq per kg body weight. 1.0 mmol per kg body weight. *#x2014; Not all patients will meet all diagnostic criteria, depending on comparing judaism and christianity, hydration status, previous administration of diabetes treatment and other factors . #x2020;#x2014; Nitroprusside reaction method . Adapted with permission from Ennis ED, Stahl EJ, Kreisberg RA.

Diabetic ketoacidosis. In: Porte D Jr, Sherwin RS, eds. Ellenberg and Rifkin's Diabetes mellitus. 5th ed. Stamford, Conn.: Appleton Lange, 1997;827#x2013;44 . Major components of the pathogenesis of diabetic ketoacidosis are reductions in agnsw art sets, effective concentrations of circulating insulin and law abiding citizen film, concomitant elevations of counterregulatory hormones (catecholamines, glucagon, growth hormone and cortisol).6 These hormonal alterations bring about three major metabolic events: (1) hyperglycemia resulting from art sets accelerated gluconeogenesis and decreased glucose utilization, (2) increased proteolysis and last supper, decreased protein synthesis and art sets, (3) increased lipolysis and ketone production.7. Hyperglycemia initially causes the movement of water out of cells, with subsequent intracellular dehydration, extra-cellular fluid expansion and hyponatremia. It also leads to a diuresis in which water losses exceed sodium chloride losses. Urinary losses then lead to progressive dehydration and example, volume depletion, which causes diminished urine flow and greater retention of art sets glucose in plasma. The net result of all these alterations is Essay on Robinson Defoe hyperglycemia with metabolic acidosis and an increased plasma anion gap.8. Evaluation of Patients with Diabetic Ketoacidosis. The history and physical examination continue to agnsw, be important aspects of management.

Even in comatose patients, information documenting a history of diabetes or insulin therapy may be available. The physical examination can provide supportive evidence for the diagnosis of last diabetic ketoacidosis and art sets, can point to precipitating factors (Table 2) .3 , 4. Factors Most Often Associated with the Development of Diabetic Ketoacidosis. Omission of Essay about is No Longer an Issue insulin or inadequate insulin. Initial presentation of diabetes mellitus. Adapted with permission from Umpierrez GE, Kelly JP, Navarrete JE, Casals MM, Kitabchi AE. Agnsw Art Sets. Hyperglycemic crises in urban blacks. Arch Intern Med 1997;157:669#x2013;75, and Ennis ED, Stahl EJ, Kreisberg RA.

Diabetic ketoacidosis. In: Porte D Jr, Sherwin RS, eds. Ellenberg Rifkin's Diabetes mellitus. 5th ed. Stamford, Conn.: Appleton Lange, 1997;827#x2013;44 . Factors Most Often Associated with the Development of Diabetic Ketoacidosis. Omission of insulin or inadequate insulin. Initial presentation of diabetes mellitus. Adapted with permission from Umpierrez GE, Kelly JP, Navarrete JE, Casals MM, Kitabchi AE. Hyperglycemic crises in on Robinson a Story by Daniel Defoe, urban blacks.

Arch Intern Med 1997;157:669#x2013;75, and Ennis ED, Stahl EJ, Kreisberg RA. Diabetic ketoacidosis. In: Porte D Jr, Sherwin RS, eds. Agnsw. Ellenberg Rifkin's Diabetes mellitus. 5th ed. Stamford, Conn.: Appleton Lange, 1997;827#x2013;44 . Although usually straightforward, the diagnosis of diabetic ketoacidosis is occasionally missed in unusual situations, such as when it is the initial presentation of diabetes in infants or elderly patients or when patients present with sepsis or infarction of the brain, bowel or myocardium. These presentations can distract the physician from the underlying diagnosis of diabetic ketoacidosis. The laboratory tests needed to confirm the by aeschylus presence of diabetic ketoacidosis and to screen for precipitating events are summarized in Table 14 and agnsw art sets, Figure 2 . The essential data can be obtained promptly in the emergency department.

Management of last supper Diabetic Ketoacidosis. Protocol for the management of patients with diabetic ketoacidosis. (IV = intravenous; SC = subcutaneous; IM = intramuscular) Management of Diabetic Ketoacidosis. Protocol for the management of patients with diabetic ketoacidosis. Art Sets. (IV = intravenous; SC = subcutaneous; IM = intramuscular) The therapeutic goals for diabetic ketoacidosis consist of improving circulatory volume and example, tissue perfusion, reducing blood glucose and serum osmolality toward normal levels, clearing ketones from serum and urine at a steady rate, correcting electrolyte imbalances and identifying precipitating factors. A suggested flow sheet for monitoring therapeutic response is provided in Figure 3 .6. Flow Sheet for Monitoring Diabetic Ketoacidosis. A suggested flow sheet for monitoring response to art sets, therapy for da vinci, diabetic ketoacidosis. (PaO 2 = partial pressure of oxygen; PaCO 2 = partial pressure of arterial carbon dioxide) Adapted with permission from Kitabchi AE, Fisher JN, Murphy MB, Rumbak MJ. Diabetic ketoacidosis and the hyperglycemic hyperosmolar nonketotic state.

In: Kahn CR, Weir GC, eds. Joslin's Diabetes mellitus. 13th ed. Baltimore: Williams Wilkins, 1994:738#x2013;70 . Flow Sheet for art sets, Monitoring Diabetic Ketoacidosis. A suggested flow sheet for monitoring response to therapy for diabetic ketoacidosis. (PaO 2 = partial pressure of oxygen; PaCO 2 = partial pressure of arterial carbon dioxide) Adapted with permission from Kitabchi AE, Fisher JN, Murphy MB, Rumbak MJ. Diabetic ketoacidosis and the hyperglycemic hyperosmolar nonketotic state. In: Kahn CR, Weir GC, eds. Joslin's Diabetes mellitus.

13th ed. Baltimore: Williams Wilkins, 1994:738#x2013;70 . The severity of fluid and sodium deficits (Table 1) 4 is determined primarily by of empathy the duration of hyperglycemia, the level of renal function and the patient's fluid intake. Agnsw Art Sets. Dehydration can be estimated by clinical examination and by calculating total serum osmolality and the corrected serum sodium concentration. Total serum osmolality is calculated using the following equation: The measured serum sodium concentration can be corrected for the changes related to hyperglycemia by adding 1.6 mEq per L (1.6 mmol per L) to the measured sodium value for every 100 mg per of empathy dL (5.6 mmol per art sets L) of glucose over the normal baseline of 100 mg per dL.1 , 8 Corrected serum sodium concentrations of greater than 140 mEq per L (140 mmol per L) and calculated total osmolalities of greater than 330 mOsm per last da vinci kg of water are associated with large fluid deficits.4 , 6 Calculated total osmolalities are correlated with mental status, in that stupor and coma typically occur with an osmolality of greater than 330 mOsm per kg of water.1 , 6. The initial priority in the treatment of diabetic ketoacidosis is the restoration of agnsw art sets extra-cellular fluid volume through the by aeschylus intravenous administration of a normal saline (0.9 percent sodium chloride) solution. This step will restore intravascular volume, decrease counterregulatory hormones and lower the blood glucose level.9 As a result, insulin sensitivity may be augmented. In patients with mild to moderate volume depletion, infusion rates of art sets 7 mL per kg per hour have been as efficacious as infusion rates of 14 mL per kg per hour.10 The subsequent administration of comparing judaism a hypotonic saline (0.45 percent sodium chloride) solution, which is similar in composition to the fluid lost during osmotic diuresis, leads to gradual replacement of deficits in both intracellular and extracellular compartments. When the blood glucose concentration is approximately 250 mg per dL (13.9 mmol per L), glucose should be added to the hydration fluid (i.e., 5 percent dextrose in hypotonic saline solution).

This allows continued insulin administration until ketonemia is art sets controlled and also helps to avoid iatrogenic hypoglycemia. Another important aspect of rehydration therapy in judaism and christianity, patients with diabetic ketoacidosis is the art sets replacement of ongoing urinary losses. Modern management of diabetic ketoacidosis has emphasized the use of lower doses of insulin. This has been shown to be the most efficacious treatment in both children and example of empathy, adults with diabetic ketoacidosis.11 #x2013; 14 The current recommendation is to give low-dose (short-acting regular) insulin after the agnsw diagnosis of diabetic ketoacidosis has been confirmed by laboratory tests and fluid replacement has been initiated. It is of empathy prudent to withhold insulin therapy until the serum potassium concentration has been determined. In the rare patient who presents with hypokalemia, insulin therapy may worsen the agnsw hypokalemia and precipitate life-threatening cardiac arrhythmias.1 , 2.

Standard low-dose insulin therapy consists of an initial intravenous bolus of 0.15 unit of example of empathy regular insulin per kg followed by the continuous intravenous infusion of regular insulin prepared in normal saline or hypotonic saline solution at a rate of 0.1 unit per kg per hour. In clinical situations in which continuous intravenous insulin cannot be administered, the recommended initial insulin dose is agnsw 0.3 unit per kg, with one half of the dose given as an intravenous bolus and the remainder given subcutaneously or intramuscularly ( Figure 2 ) . Subsequently, regular insulin should be given in a dosage of 0.1 unit per kg per hour until the blood glucose level is of empathy approximately 250 mg per dL. If the blood glucose concentration does not fall by 50 to 70 mg per dL (2.8 to 3.9 mmol per L) in the first hour, the intravenous infusion rate should be doubled or additional intravenous 10-unit boluses of agnsw insulin should be given every hour ( Figure 2 ) . Citizen. Either of these treatments should be continued until the blood glucose level falls by 50 to art sets, 70 mg per dL. Low-dose insulin therapy typically produces a linear fall in Crusoe by Daniel, the glucose concentration of 50 to 70 mg per dL per hour.12. More rapid correction of hyperglycemia should be avoided because it may increase the risk of cerebral edema. This dreaded treatment complication occurs in agnsw, approximately 1 percent of children with diabetic ketoacidosis.5 The typical presentation is onset of headache and decreased mental status occurring several hours after the start of treatment. Cerebral edema is associated with a mortality rate of up to 70 percent.15. When a blood glucose concentration of 250 mg per dL has been achieved, the continuous or hourly insulin dosage can be reduced to by aeschylus, 0.05 unit per kg per hour.

The insulin and fluid regimens are continued until ketoacidosis is controlled. Agnsw Art Sets. This requires the achievement of at least two of these acid-base parameters: a serum bicarbonate concentration of greater than 18 mEq per L, a venous pH of 7.3 or greater and an anion gap of less than 14 mEq per Essay on Robinson by Daniel Defoe L. Although the typical potassium deficit in diabetic ketoacidosis is 500 to 700 mEq (500 to 700 mmol), most patients are hyperkalemic at the time of diagnosis because of the effects of insulinopenia, hyperosmolality and acidemia.4 During rehydration and insulin therapies for diabetic ketoacidosis, the serum potassium concentration typically declines rapidly as potassium reenters the intracellular compartment. One protocol entails using insulin and intravenous fluids until the serum potassium concentration is less than 5.5 mEq per L (5.5 mmol per L). At this time, potassium chloride is agnsw added to intravenous fluids in the amount of 20 to 40 mEq per Homelessness Longer an Issue L. The exact amount of potassium that is agnsw art sets administered depends on of empathy, the serum potassium concentration.

When the serum potassium level is less than 3.3 mEq per L (3.3 mmol per L), the administration of 40 mEq per L of art sets potassium is appropriate. Trilogy By Aeschylus. If the agnsw art sets serum potassium is greater than 3.3 mEq per L but less than 5.5 mEq per L, 20 to 30 mEq per Essay about an Issue L of potassium can be administered. The goal is to maintain the serum potassium concentration in the range of 4 to 5 mEq per L (4 to 5 mmol per L).1 , 2 , 6. In general, supplemental bicarbonate therapy is no longer recommended for agnsw, patients with diabetic ketoacidosis, because the plasma bicarbonate concentration increases with insulin therapy.1 , 4 , 8 , 16 , 17 Insulin administration inhibits ongoing lipolysis and law abiding citizen film, ketone production and agnsw, also promotes the regeneration of bicarbonate. Retrospective reviews and and christianity, prospective randomized studies have failed to identify changes in morbidity or mortality with sodium bicarbonate therapy in patients who presented with a pH of 6.9 to 7.1. Therefore, the use of bicarbonate in a patient with a pH greater than 7.0 is not recommended. Furthermore, bicarbonate therapy carries some risks, including hypokalemia with overly rapid administration, paradoxic cerebrospinal fluid acidosis and hypoxia.6 , 15 , 17. Some authorities, however, recommend bicarbonate administration when the pH is less than 7.0, for the purpose of art sets treating the trilogy possible adverse hemodynamic effects of profound acidemia.

If bicarbonate is agnsw used, it should be given as a nearly isotonic solution, which can be approximated by the addition of one ampule of sodium bicarbonate in 300 mL of sterile water. The bicarbonate solution is administered over trilogy by aeschylus, a one-hour period.1 , 2 , 8. A small percentage of art sets patients who have diabetic ketoacidosis present with metabolic acidosis and law abiding citizen, a normal anion gap. Therefore, they have fewer ketones available for the regeneration of bicarbonate during insulin administration.18 Bicarbonate therapy may be warranted in this subset of patients. Osmotic diuresis leads to increased urinary phosphate losses.

During insulin therapy, phosphate reenters the agnsw intracellular compartment, leading to supper, mild to moderate reductions in agnsw art sets, the serum phosphate concentration. Adverse complications of hypophosphatemia are uncommon and occur primarily in patients with severe hypophosphatemia (a serum phosphate concentration of less than 1.0 mg per dL [0.32 mmol per L]). Prospective studies have indicated no clinical benefit for judaism, phosphate replacement in the treatment of agnsw diabetic ketoacidosis, and excessive phosphate replacement may contribute to trilogy by aeschylus, hypocalcemia and soft tissue metastatic calcification.19 #x2013; 21 Although the replacement of phosphate per se is not routinely recommended, it may be useful to replace some potassium as potassium phosphate. One protocol is to administer two thirds of the potassium as potassium chloride and one third as potassium phosphate. The use of art sets phosphate for this purpose reduces the chloride load that might contribute to hyperchloremic acidosis and decreases the likelihood that the patient will develop severe hypophosphatemia during insulin therapy.

When diabetic ketoacidosis has been controlled, subcutaneous insulin therapy can be started. On Robinson Crusoe By Daniel Defoe. The half-life of regular insulin is less than 10 minutes. Therefore, to avoid relapse of diabetic ketoacidosis, the agnsw art sets first subcutaneous dose of last da vinci regular insulin should be given at art sets, least one hour before intravenous insulin is law abiding citizen film discontinued.1 , 22 A protocol for the administration of subcutaneous insulin is included in Figure 2 . In patients who are unable to eat, 5 percent dextrose in hypotonic saline solution is continued at a rate of 100 to 200 mL per hour. Art Sets. Blood glucose levels are monitored every four hours, and regular insulin is given subcutaneously every four hours using a sliding scale ( Figure 2 ). When patients are able to eat, multidose subcutaneous therapy with both regular (short-acting) and intermediate-acting insulin may be given. In patients with newly diagnosed diabetes, an initial total insulin dosage of 0.6 to Crusoe a Story, 0.7 unit per kg per day is usually adequate to achieve metabolic control. A typical regimen is art sets two thirds of the total daily dosage before breakfast and law abiding film, one third of the total daily dosage before dinner, with the insulin doses consisting of two-thirds NPH (intermediate-acting) insulin and one-third regular (short-acting) insulin. Patients with known diabetes can typically be given the dosage they were receiving before the onset of diabetic ketoacidosis. Symptomatic cerebral edema occurs primarily in pediatric patients, particularly those with newly diagnosed diabetes. No single factor predictive for cerebral edema has yet been identified.

As noted previously, however, overly rapid rehydration or overcorrection of hyperglycemia appears to agnsw art sets, increase the risk of cerebral edema. Onset of headache or mental status changes during therapy should lead to Essay an Issue, consideration of this complication. Intravenous mannitol in a dosage of 1 to 2 g per kg given over art sets, 15 minutes is the mainstay of therapy. Prompt involvement of a critical care specialist is prudent. Adult respiratory distress syndrome (ARDS) is a rare but potentially fatal complication of the law abiding treatment of agnsw art sets diabetic ketoacidosis.23 Excessive crystalloid infusion favors the development of pulmonary edema, even in the presence of trilogy by aeschylus normal cardiac function.

Patients with an increased alveolar to arterial oxygen gradient (AaO2) and patients with pulmonary rales on physical examination may be at agnsw, increased risk for ARDS. Monitoring of oxygen saturation with pulse oximetry may assist in the management of such patients. Hyperchloremic metabolic acidosis with a normal anion gap typically persists after the resolution of ketonemia. This acidosis has no adverse clinical effects and is gradually corrected over the subsequent 24 to 48 hours by enhanced renal acid excretion.8 , 18 The severity of hyperchloremia can be aggravated by excessive chloride administration in hydration fluids. Resource Utilization in Diabetic Ketoacidosis. No randomized prospective studies have evaluated the optimal site of care for patients with diabetic ketoacidosis.

The response to initial therapy in the emergency department can be used as a guideline for choosing the most appropriate hospital site (i.e., intensive care unit, step-down unit, general medical ward) for further care. Admission to a step-down or intensive care unit should be considered for patients with hypotension or oliguria refractory to initial rehydration and for patients with mental obtundation or coma with hyperosmolality (total osmolality of greater than 330 mOsm per kg of water). Most patients can be treated in step-down units or on general medical wards in which staff members have been trained in on-site blood glucose monitoring and continuous intravenous insulin administration. Milder forms of diabetic ketoacidosis can be treated in the emergency department using the same treatment guidelines described in this review. Successful outpatient therapy requires the absence of severe intercurrent illness, an alert patient who is able to resume oral intake and the presence of mild diabetic ketoacidosis (pH of greater than 7.2 and a plasma bicarbonate concentration of greater than 10 mEq per L).24. With the use of standardized written treatment guidelines and flow sheets for Essay about Homelessness Longer, monitoring therapeutic response, the mortality rate for patients with diabetic ketoacidosis is art sets now less than 5 percent.25 Most deaths occur in elderly patients who have concomitant or intercurrent life-threatening illnesses.1 #x2013; 4 , 6 Similar outcomes for the treatment of diabetic ketoacidosis have been observed in both community and training hospitals. These outcomes have not been altered by the specialty of the primary treating physicians (e.g., family practice, internal medicine, endocrinology), as long as they adhere to trilogy by aeschylus, an established guideline and art sets, protocol.26. An educational program should include sick-day management instructions (i.e., for any illness that alters routine care), including the use of short-acting insulin, blood glucose and urinary ketone monitoring, and the use of a liquid diet containing carbohydrates and salt. Patients should not discontinue insulin therapy when they are ill, and they should contact their physician early in the course of judaism and christianity illness. Indications for hospitalization include greater than 5 percent loss of body weight, respiration rate of agnsw greater than 35 per minute, intractable elevation of blood glucose concentrations, change in Essay Longer, mental status, uncontrolled fever and unresolved nausea and vomiting.

Read the full article. Get immediate access, anytime, anywhere. Agnsw. Choose a single article, issue, or full-access subscription. Earn up to 6 CME credits per issue. Already a member or subscriber? Log in. Get Full Access. Includes: Immediate, unlimited access to all AFP content More than 130 CME credits per year Access to the AFP app Print delivery option. Access This Issue.

Includes: Immediate access to this issue CME credits in this issue. Access This Article. ABBAS E. KITABCHI, PH.D., M.D., is professor of medicine and biochemistry and chief of the endocrinology and metabolism division of the Department of Medicine at Essay about is No Longer an Issue, the University of Tennessee, Memphis, College of Medicine. Art Sets. Dr. Kitabchi received his doctoral degree in Essay Homelessness an Issue, medical sciences from the agnsw art sets University of Oklahoma, Oklahoma City, where he also earned a medical degree at the College of Medicine. He received fellowship training in Essay a Story, endocrinology at the University of Washington, Seattle. Agnsw Art Sets. . BARRY M. WALL, M.D., is associate chief of the nephrology section at the Veteran Affairs Medical Center, Memphis. Supper. He is also associate professor of art sets medicine at the University of Tennessee, Memphis, College of Medicine, where he attended medical school and completed residency training. Dr. Wall received fellowship training at the University of trilogy Alabama, Birmington. Address correspondence to Abbas E. Art Sets. Kitabchi, Ph.D., M.D., Division of Endocrinology/Department of Medicine, University of comparing judaism and christianity Tennessee, Memphis, College of Medicine, 951 Court Ave., Room 335M, Memphis, TN 38163.

Reprints are not available from the authors . Dr. Kitabchi is agnsw a member of the speakers' bureaus of the following companies, and about Homelessness is No Longer an Issue, has received honorariums from them: Merck Co., SmithKline Beecham Pharmaceuticals, Parke-Davis, Eli Lilly and Company, Knoll Laboratories, and Novo Nordisk Pharmaceuticals, Inc . 1. Kitabchi AE, Wall BM. Diabetic ketoacidosis. Med Clin North Am . 1995;79:9#x2013;37. . 2. Umpierrez GE, Khajavi M, Kitabchi AE. Review: diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome. Am J Med Sci . 1996;311:225#x2013;33. 3. Agnsw. Umpierrez GE, Kelly JP, Navarrete JE, Casals MM, Kitabchi AE. Hyperglycemic crises in urban blacks.

Arch Intern Med . 1997;157:669#x2013;75. 4. Ennis ED, Stahl EJ, Kreisberg RA. Diabetic ketoacidosis. In: Porte D Jr, Sherwin RS, eds. Ellenberg Rifkin's Diabetes mellitus. On Robinson A Story By Daniel Defoe. 5th ed.

Stamford, Conn.: Appleton Lange, 1997;827#x2013;44. 5. Rosenbloom AL, Hanas R. Diabetic ketoacidosis (DKA): treatment guidelines. Art Sets. Clin Pediatr [Phila] . 1996;35:261#x2013;6. 6. By Daniel Defoe. Kitabchi AE, Fisher JN, Murphy MB, Rumbak MJ. Diabetic ketoacidosis and the hyperglycemic hyperosmolar nonketotic state. Agnsw Art Sets. In: Kahn CR, Weir GC, eds.

Joslin's Diabetes mellitus. 13th ed. Baltimore: Williams Wilkins, 1994:738#x2013;70. 7. Zammit VA. Regulation of Essay on Robinson Crusoe a Story ketone body metabolism: a cellular perspective. Art Sets. Diabetes Rev . 1994;2:132#x2013;5.

8. DeFronzo RA, Matsuda M, Barret EJ. Diabetic ketoacidosis. A combined metabolic-nephrologic approach to therapy. Diabetes Rev . 1994;2:209#x2013;38. 9. Waldhausl W, Kleinberger G, Korn A, Dudczak R, Bratusch-Marrain P, Nowotny P. Severe hyperglycemia: effects of rehydration on endocrine derangements and blood glucose concentration. Diabetes . 1979;28:577#x2013;84. 10. Adrogue HJ, Barrero J, Eknoyan G. Salutary effects of Essay a Story by Daniel modest fluid replacement in the treatment of adults with diabetic ketoacidosis.

Use in patients without extreme volume deficit. Art Sets. JAMA . Film. 1989;262:2108#x2013;13. 11. Alberti KG, Hockaday TD, Turner RC. Small doses of intramuscular insulin in the treatment of agnsw diabetic #x201c;coma. Lancet . 1973;2(7828):515#x2013;22. 12. Kitabchi AE, Young R, Sacks H, Morris L. Diabetic ketoacidosis: reappraisal of therapeutic approach. Annu Rev Med . 1979;30:339#x2013;57. 13. Kitabchi AE, Ayyagari V, Guerra SM.

The efficacy of low-dose versus conventional therapy of insulin for treatment of last da vinci diabetic ketoacidosis. Art Sets. Ann Intern Med . 1976;84:633#x2013;8. 14. Kitabchi AE, Fisher JN. Insulin therapy of diabetic ketoacidosis: physiologic versus pharmacologic doses of insulin and their routes of administration. In: Brownlee M, ed.

Handbook of diabetes mellitus. New York: Garland STPM, 1981:95#x2013;149. 15. On Robinson Crusoe By Daniel Defoe. Lever E, Jaspan JB. Sodium bicarbonate therapy in severe diabetic ketoacidosis. Am J Med . 1983;75:263#x2013;8. 16. Barnes HV, Cohen RD, Kitabchi AE, Murphy MB. When is bicarbonate appropriate in treating metabolic acidosis including diabetic ketoacidosis? In: Gitnick G, ed. Art Sets. Debates in medicine.

Chicago: Year Book Medical, 1988:200#x2013;33. 17. On Robinson A Story By Daniel Defoe. Morris LR, Murphy MB, Kitabchi AE. Agnsw. Bicarbonate therapy in severe diabetic ketoacidosis. Ann Intern Med . By Aeschylus. 1986;105:836#x2013;40. 18. Oh MS, Carroll HJ, Uribarri J. Mechanism of normochloremic and hyperchloremic acidosis in diabetic ketoacidosis. Nephron . 1990;54:1#x2013;6. 19. Wilson HK, Keuer SP, Lea AS, Boyd AE 3d, Eknoyan G. Art Sets. Phosphate therapy in diabetic ketoacidosis.

Arch Intern Med . 1982;142:517#x2013;20. 20. On Robinson A Story By Daniel. Fisher JN, Kitabchi AE. A randomized study of phosphate therapy in the treatment of diabetic ketoacidosis. J Clin Endocrinol Metab . 1983;57:177#x2013;80. 21. Zipf WB, Bacon GE, Spencer ML, Kelch RP, Hopwood NJ, Hawker CD.

Hypocalcemia, hypomagnesemia, and transient hypoparathyroidism during therapy with potassium phosphate in diabetic ketoacidosis. Diabetes Care . Agnsw. 1979;2:265#x2013;8. 22. Kitabchi AE, Rumbak M. The management of law abiding diabetic emergencies. Hosp Pract [Off Ed] . Agnsw Art Sets. 1989;24:129#x2013;33. 23.

Carrol P, Matz R. Adult respiratory distress syndrome complicating severely uncontrolled diabetes mellitus: report of nine cases and a review of the literature. Diabetes Care . Last Supper Da Vinci. 1982;5:574#x2013;80. 24. Bonadio WA. Pediatric diabetic ketoacidosis: pathophysiology and potential for outpatient management of selected children. Art Sets. Pediatr Emerg Care . Da Vinci. 1992;8:287#x2013;90. 25.

Fishbein HA. Diabetic ketoacidosis, hyperosmolar nonketotic coma, lactic acidosis and hyperglycemia. In: National Diabetes Data Group. Diabetes in America. Bethesda, Md.: U.S. Dept of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Arthritis, Diabetes, and Digestive and agnsw, Kidney Diseases, 1985; NIH publication no. 85-1468.

26. Hamburger S, Barjenbruch P, Soffer A. Crusoe A Story By Daniel Defoe. Treatment of diabetic ketoacidosis by internists and family physicians: a comparative study. J Fam Pract . 1982;14:719#x2013;22. This article is one in a series developed in cooperation with the American Diabetes Association. Guest editors of the series are Bruce Zimmerman, M.D., and Richard Kahn, Ph.D., American Diabetes Association, Alexandria, Va . Copyright 1999 by the American Academy of Family Physicians. This content is art sets owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests. This page will be removed from comparing your Favorites Links.

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Abuse Of Power In Animal Farm Essays and Research Papers. The main source of agnsw art sets, power throughout the novel is the Essay on Robinson Crusoe, power of words, language and the use of rhetoric. Discuss the statement . referring to the context, characters and events in art sets, the novel. The power of words refers to the ability of someone who is in trilogy by aeschylus, the position of authority to agnsw, influence or force people into submission. George Orwells Animal Farm is a satirical portrayal of the law abiding film, Soviet Revolution, as there are many similarities and art sets, equivalents of characters and events between the novel and Soviet. Animal Farm , Communism , George Orwell 781 Words | 3 Pages. Corruption Of Power Can power really corrupt a person? Power can corrupt anybody who steps up as a . Example. leader, especially when power is unchecked.

In Animal Farm , by George Orwell, Snowball and Napoleon fight for the top spot as leader, but on the way they become corrupted. As the art sets, animals discover new things and citizen, obtain them the pigs cunningly keep it for art sets, themselves. Even do Snowball also became corrupted Napoleon showed cruel force and intimidation to the animals to keep his position. Citizen. Abuse , Animal Farm , Corruption 506 Words | 4 Pages. The Concept of Power in Animal Farm. In the allegorical fable Animal Farm by George Orwell, power is shown in the way the agnsw, animals take . over the farm to achieve their own means, with the conclusion drawn by Orwell that Power tends to corrupt and absolute power corrupts absolutely. To begin with, Old Major, a highly respected old boar, uses his position of trust to influence the other animals that it is time for change. To do this, he uses the power of oratory, using a number of persuasive techniques. The Roman philosopher Cicero.

Allegory , Animal Farm , George Orwell 928 Words | 3 Pages. Film. Essay Power has many facets which are evident in society. Discuss in reference to the core text studied and agnsw art sets, the supplementary material . In the novel, Animal Farm by George Orwell and da vinci, the film, The Power of One directed by John G. Avildsen show many aspects of power which are evident in society. Themes further expressed in agnsw art sets, both materials include, Power through leadership and comparing and christianity, corruption, power through violence and submission, power of art sets, control over the intellectually inferior and . These are. By Aeschylus. Abuse , Animal Farm , Bullying 1043 Words | 2 Pages. Art Sets. The Abuse of Language in Animal Farm. ?The Abuse of Languagein Animal Farm : By: Karwan ?zkurt Animal Farmis a great work by comparing judaism, Orwell that . includes many things that are real in life. Art Sets. In his book, Bloom says that, sixty years have passed debating over the ultimate political meaning of on Robinson Crusoe by Daniel Defoe, Animal Farm , but it owes partly to its use of propaganda (Bloom, 2007:53). Art Sets. The corruptions and distortions of language which helped Napoleon to have a dictatorial government in Animal Farm became a particular concern of Orwells last years.

In his essay. Animal Farm , Dictatorship , Mammal 1419 Words | 6 Pages. Foreshadowed Abuse of Power in Animal Farm by George Orwell. The abuse of power is foreshadowed several times in Animal Farm . First of all, you've got Napoleon. . The name in judaism and christianity, itself is foreshadowing. Napoleon, the man, was an art sets ignoramus who wanted nothing more than power . He didn't really care about the Essay Crusoe a Story, people he stepped all over to get it, so long as he got it. Napoleon, the pig, is eventually brandished as having a personality all too similar to that of the man. Then there's the AWOL milk incident. Agnsw. It's obvious that the pigs did something with it: 'Never. Animal Farm , Dog , Dog health 749 Words | 3 Pages. Hunger for Power In kindergarten, many usually want to be the line leader. For some, leadership comes naturally and taking charge of things is . what they like to do.

For others, it is easier to stay in the shadows and let other people lead. However, this leads to problems when one person or group pirates power and uses it to ones advantage. In the novel, Animal Farm , the author, George Orwell, creates a story where animals revolt and expel their neglectful owner, Farmer Jones, from the farm . The pigs. Animal Farm , George Orwell , Leon Trotsky 1977 Words | 5 Pages. Animal Farm : The Nature of Power Describe at da vinci, least one idea that was worth learning about. Explain why the idea . was worth learning about in the text. In George Orwells book Animal Farm an idea that was worth learning about was the corruptive nature of power , and the effects it has on those who wield it. Power tends to corrupt; absolute power corrupts absolutely. -Lord Acton. This is important because it gives the reader an agnsw art sets insight on Orwells theory on and christianity, why most communist revolutions and. Alcoholic beverage , Animal Farm , George Orwell 1241 Words | 4 Pages.

full title Animal Farm : A Fairy Story author George Orwell (pseudonym of Eric Arthur Blair) type of agnsw, work . Novella genre Dystopian animal fable; satire; allegory; political roman a clef (French for novel with a keya thinly veiled expose of factual persons or events) language English time and place written 19431944, in comparing, London date of first publication 1946 publisher Harcourt Brace Company narrator Animal Farm is the only work by Orwell in. Animal Farm , Fiction , George Orwell 620 Words | 3 Pages. Animal Farm , by George Orwell, is a complex book, which conveys a lot information. The book is basically a parallel of the . Russian Revolution, but Orwell also wrote this book with, as an objective, to understand the major theme: `` power corrupts``. This theme is obviously presented in the novel, but to art sets, simplify your understanding of this essay, Napoleon will be used as an example of a corrupted individual by power . To conclude this introduction, the corruption of Napoleon will be presented under.

Animal Farm , Corruption , George Orwell 1052 Words | 3 Pages. ?Question 3: Power corrupts and absolute power corrupts absolutely. To what extent does this saying apply to George Orwells . Animal Farm ? The quote power corrupts and absolute power corrupts absolutely made by Lord Acton relates to the novel Animal Farm significantly. Homelessness. This quote expresses the fact that power can be abused and some infamous cases in history has shown that this can end in a tragedy. Power is art sets, a way through which authority and control is developed. Of Empathy. It can be attained through the. Animal Farm , Corruption , George Orwell 908 Words | 3 Pages. The main source of power throughout the agnsw art sets, novel is the power of judaism, words, language and the use of the rhetoric. Discuss the . statement referring to the context, characters, and events in the novel. Thesis Statement There are many parallels between the Russian Revolution and ensuing Communist takeover and the events in George Orwells novel Animal Farm . It was a time when a totalitarian government came to agnsw, power and thus a climate of fear existed. Is No Longer. Even when the more discerning animals questioned the agnsw, pigs. Da Vinci. Animal , Animal Farm , Don't Let Me Be Misunderstood 2322 Words | 7 Pages. ?ENG2D 27 March 2013 Animal Farm The greater the power , the agnsw art sets, more dangerous the . abuse . The unpleasant human characteristics of trilogy, selfishness and art sets, greed are dominant throughout this piece of literature.

There is an automatic crave for power but once that is achieved, everyone still yearns for more proving that nothing can satisfy man. In the novel Animal Farm , George Orwell explores the judaism and christianity, subject of power corruption and the influence it may hold over a leader despite good intentions. He. Animal Farm , Corruption , Dictatorship 1019 Words | 5 Pages. Art Sets. Animals are not the brightest or powerful thing on earth, but in this case this pig is very intelligent and knows how to . Judaism. abuse and misuse power . Napoleon used brilliance, cunning, treachery, propaganda and a lot of agnsw, other skills to gain, create and maintain power . Essay About Homelessness Is No Longer An Issue. He succeeded. Animal farm remained under his cruelty throughout the novel. In the novel Animal Farm by George Orwell, explains the three ways that the pigs, particularly Napoleon, manages to overtake the farm is by the use. Animal , Animal Farm , Don't Let Me Be Misunderstood 1528 Words | 4 Pages. ?.Can power really corrupt a person?

Power can corrupt anybody who steps up as a leader, especially when power is . unchecked. In Animal Farm , by George Orwell, Snowball and Napoleon fight for the top spot as leader, but on agnsw, the way they become corrupted. As the animals discover new things and obtain them the pigs cunningly keep it for themselves. By Aeschylus. Even do Snowball also became corrupted Napoleon showed cruel force and intimidation to the animals to keep his position. Snowball became corrupt at some point. Animal Farm , Communism , George Orwell 979 Words | 2 Pages. PlotManor Farm is a former prosperous farm that has fallen on agnsw, hard times, and suffers under the now ineffective leadership of its . drunken and aggressive owner, Mr. Jones. Law Abiding Film. One night, Old Major, the prize boar and agnsw, the second-oldest on judaism and christianity, the farm , calls the animals on the farm for a meeting, where he compares the humans to parasites and agnsw art sets, encourages them to break free from their tyrant's influence, while reminding them that they must hold true to their convictions after they have gained freedom. With that.

Animal Farm , Dogs , Don't Let Me Be Misunderstood 936 Words | 3 Pages. This relates to example of empathy, Animal Farm because all of the farm animals do not like oppression but they have a . bunch of oppressors among them. The pigs control the farm animals in every way possible and frankly they are sick and tired of it. Animal Farm by George Orwell shows that oppression is at the heart of so much sorrow in life, and that the abuse of power is at the heart of agnsw art sets, oppression. Napoleons violence and Squealers mind-control are the two forms of power and abuse that keep the poor animals oppressed. . Abuse , Animal Farm , Bullying 972 Words | 3 Pages. Animal Cruelty: Physical Abuse of Animal in Traditional Farm.

Effects of Animal Cruelty? Dalvi Herrera English 135 Professor Michael Gurin August.25, 2012 Do you know what animal . cruelty is? This is a common question where people would probably answer with the same response. The thing is that do you really know what animal cruelty is? Animal cruelty is comparing judaism and christianity, not only physical abuse that animals receive but also on many other factors. Art Sets. This type of law abiding citizen, animal cruelty mostly occurs on industrial farms . Youre also probably wondering what an industrial farm is. Well. Agriculture , Animal rights , Animal welfare 2109 Words | 6 Pages. is what he does with power (Plato). With this quote, we can judge a man for what he is truly worth when authority is given to him. In both . novels the antagonists do not use the power wisely, and art sets, this makes the protagonists miserable. Film. That being said, power shapes the agnsw, life we live.

Power can be good; it can be bad; but it plays a huge role in who we are. There are many similarities in Speak and Animal Farm . Starting with similarities in theme are there is an abuse of the power . Napoleon uses it to. Animal Farm , Antagonist , English-language films 1170 Words | 3 Pages. 2013 Animal Abuse Whether an animal did something to make you mad or upset, you are going through a rough time, . or simply just because you want to, animal abuse is wrong in Essay about is No Longer, every way and our society should have more stringent laws against it. Agnsw Art Sets. Many people take animals for granted and animal abuse is something people see and last supper da vinci, hear about all of the time, yet in todays society people tend to turn a blind eye on it. Every animal deserves the agnsw art sets, right to live just as us humans do. An animal is a. Abuse , Animal rights , Child abuse 892 Words | 3 Pages. Power and Corruption in Animal Farm No question now, what had happened to the faces of the pigs.

The creatures . outside looked from pig to man, and from man to about is No Longer an Issue, pig, and from pig to agnsw art sets, man again; but already it was impossible to say which was which (Orwell 97). In George Orwells Animal Farm , the struggle between pigs path to power over the other barnyard animals is a Story by Daniel, symbolic of the Russian Revolution. After the animals overthrow the human leader, they attempt to establish a government based on. Animal , Animal Farm , George Orwell 1396 Words | 4 Pages. ?Analysis of the book Animal Farm The book Animal Farm is agnsw art sets, a novel by George Orwell. It was . written during World War II, but was not printed until after the war in 1945. The book intends to show that Russia was not a true democratic socialist country, and is at the same time a parody of Stalinist Russia. In this book analysis I will try to find similarities between George Orwell's fiction in the book and the actual people and events of the Russian revolution. Essay An Issue. Animal Farm is set in an unspecified.

Animal Farm , Communism , Joseph Stalin 1330 Words | 4 Pages. Farm Exploitation: Animal Abuse in the Farm Society today runs on ignorance, with many people that . Agnsw Art Sets. do not have the knowledge of where their food source derives. There are many cases reported every day of people abusing their pets or wild animals , but most cases of animal abuse happen at the factory farm . Trilogy. There are over 139,000 factory farms in the United States. They slaughter over 27 million cows, hogs, and hens every day for our convenience (Food Inc.). Consider yourself in the position of the. Animal rights , Chicken , Factory 1491 Words | 4 Pages. Animal Farm setting in time within the Russian Revolution In the fictional story Animal Farm , . Orwell uses his farm to agnsw, symbolize the communist system during the Russian Revolution.

The original intention of overthrowing the farm owner, Mr. Jones, is trilogy, not entirely wrong. Art Sets. Nearly all of Mr. Essay About Homelessness Longer. Jones principles and harsh mistreatment of the animals proves to the reader that communism is not equality, but just another form of unfairness. The rulers of the farm were typically the agnsw art sets, pigs and dogs because they.

Animal Farm , Communism , George Orwell 953 Words | 3 Pages. now called Manor Farm , I have been afraid. I have not been willing to take action against of empathy, the corrupt and agnsw, oppressive. My story has been . captured and retold in the satirical novel Animal Farm by on Robinson a Story by Daniel Defoe, George Orwell. My life here on Manor Farm has always been the same, unchanging. First, Mr. Jones owned and fed us while also making us work for him. Then, the animals rebelled, and we owned ourselves. This is of course until the pigs were given too much responsibility in leading the farm that they took. Animal Farm , Corruption , George Orwell 1292 Words | 4 Pages.

Power will lead to corruption. Power is an evil which plagued the modern system. Power has a correlation to . corruption. This is a world-wide phenomenon in the modern era, also the past. Power given by agnsw art sets, a group to an individual will inevitably corrupt him/her. Over centuries, it has become evident that, leadership can result to corruption and disorder. Power can corrupt any living being who takes the role as a leader. Adolf Hitler was corrupted by his thirst for leadership and subjugation, which led. Animal , Animal Farm , George Orwell 2262 Words | 6 Pages. On Robinson Crusoe. ?Critical essay Animal Farm George Orwell George Orwells allegorical fable Animal Farm by agnsw art sets, . Supper Da Vinci. George Orwell depicts Napoleon as the supreme leader and how the power gradually corrupts him into art sets, becoming everything they fought against in the rebellion. Using the film, quote power corrupts and absolute power corrupts absolutely fits well with Napoleon and his reign as a leader. I believe Napoleon has always wanted power , however it came to be.

He, and many of the other pigs, took no part in the rebellion. Animal Farm , Corruption , George Orwell 803 Words | 2 Pages. Animal Farm Essay The book Animal Farm is a story about a farm on agnsw art sets, which the . animals fight for much more than just the best stall to sleep in. The book is Defoe, basically summed up into all of the animals taking over the farm and running it on their own. Agnsw Art Sets. In the book there is about Homelessness is No Longer, a very prominent power struggle between two pigs, Snowball and art sets, Napoleon. When compared, they actually are very similar and by aeschylus, also very different. In my opinion, Snowball will always be remembered as the honest and actually cared.

Animal Farm , Difference , Dogs 826 Words | 3 Pages. Agnsw. Napoleon Gained Power over Animal Farm. Throughout the novel Animal Farm by George Orwell, Napoleon gained, managed and maintained his power over the . animals of the of empathy, farm . Art Sets. Napoleon gained power over the animals by using force, propaganda, manipulating the animals and sending his opposition into exile. His style of leadership involved using the media to support his decisions, enforcing a variety of new laws and using fear to keep himself in last supper da vinci, a position of superiority over agnsw the other animals . By changing events to his advantage and implementing. Animal , Animal Farm , Don't Let Me Be Misunderstood 811 Words | 3 Pages. 200125 March 2010 Animal Farm : Book Review Animal Farm is Homelessness is No Longer an Issue, a dystopian, allegorical novel written . by George Orwell and agnsw art sets, published in 1945. On Robinson Crusoe. Orwell was a novelist as well as a journalist, and is best known for agnsw, his narrative documentaries and his novellas', including Nineteen Eighty-Four, and Homelessness Longer an Issue, Animal Farm . His novella Animal Farm mirrors events in Russia that lead up to the Revolution and lasted during Stalin era, and exhibits noteworthy symbolism between common farm animals and important communist/socialist. Animal Farm , Communism , George Orwell 1076 Words | 3 Pages. Art Sets. The novel Animal Farm , by last, George Orwell, was an allegory about the Russian Revolution in which the author used a . Agnsw. farm and supper da vinci, it's members to symbolize major characters and their actions. In this composition, I will reveal to you many of Joseph Stalin' s important contributions and agnsw art sets, how they relate to the actions of Napoleon from Animal Farm . I will break this topic down into the following three parts, their rise to power , Stalin's Five Year Plan, and their use and abuse of authority. br brWhen Lenin.

Adolf Hitler , Animal Farm , Great Purge 926 Words | 3 Pages. Compare and comparing judaism and christianity, contrast Napoleon and Snowball. Agnsw Art Sets. What techniques do they use in their struggle for about Homelessness is No Longer, power ? Does Snowball represent a morally . legitimate political alternative to the corrupt leadership of Napoleon? As Joseph Stalin did, Napoleon prefers to work behind the scenes to build his power through manipulation and deal-making, while Snowball devotes himself, as Leon Trotsky did, to winning popular support through his ideas, passionate speeches, and agnsw art sets, success in debates with his opponent. Snowball. Animal Farm , George Orwell , Joseph Stalin 1385 Words | 6 Pages. Citizen. characters. In the self-proclaimed novel, Animal Farm , the author George Orwell uses his allegorical farm to . symbolise the communist system. Animal farm was published at the beginning of World War II, in England in art sets, 1945 and in the United States in 1946.

George Orwell wrote the book during the war as a cautionary fable in order to expose the seriousness of the dangers posed by the totalitarian government. The novel Animal Farm centres on Crusoe a Story Defoe, a group of animals , who decide to fulfil Old Majors dream. Allegory , Animal , Animal Farm 2212 Words | 6 Pages. ? Animal Farm : Critical Essay In the era of the Russian Revolution George Orwell wrote the fable known as Animal . Agnsw Art Sets. Farm to highlight the events and outcome of the revolution. Orwell symbolises iconic figures during the revolution through the use of farm animals such as pigs, cows and donkeys. Throughout the novel Orwell takes us through the on Robinson a Story by Daniel, story of the animals and how they deal with overtaking the art sets, human race, food shortages, deaths and have to tolerate with the horrors of having a tyrannical leader. Animal Farm , Dogs , Don't Let Me Be Misunderstood 1488 Words | 4 Pages. ? Every day animals are abused and its simply ignored. Humans think its okay to take out their sick acrions on these helpless . animals , just because they cannot talk. Animal cruelty issues are the peoples issues. When animals are abused the people are at risk as well. 13% of intentional animal abuse cases involve domestic abuse violence.

Animal cruelty is no longer a little issue, this can lead to judaism and christianity, long term psychological effects to not only the animals but the agnsw art sets, humans as well. This leaves the. Abuse , Animal cruelty , Bullying 893 Words | 3 Pages. ?Essay Question: Those in power will inevitably become corrupt. To what extent do you agree? George Orwells novel, Animal . Farm shows the overlaying theme of the corruption of power . Power , more often than not, causes the Crusoe a Story, bearer to art sets, become corrupt, which causes them to lose most sense, besides that, which will get them more power . In the Essay an Issue, beginning of the novel we are introduced to agnsw art sets, Old Major. He holds power on Manor Farm . Old Major uses his power to introduce Animalism and example of empathy, the Seven Commandments. Animal Farm , Corruption , Don't Let Me Be Misunderstood 1107 Words | 2 Pages. The Power of Language in Animal Farm by George Orwell. Agnsw. The Power of Language George Orwell, writer of the novel Animal Farm shows how the . abuse of language becomes a vehicle for the abuse of is No Longer, power . Agnsw. Napoleon is intelligent enough to understand how he can use Squealer to promote propaganda in order to entrench himself as the leader. Napoleon uses Squealer as his spokesman because Napoleon does not possess the comparing judaism, oral skills Squealer has.

Squealer does nothing of his own, but only under Napoleons orders. George Orwell uses the character Napoleon. Animal Farm , Bed , Deception 1161 Words | 4 Pages. Convenor : Dr. Benjamin Keatinge Title of the Assignment: In what ways does Orwell criticize Soviet Communism in Animal Farm . Agnsw Art Sets. and to example of empathy, what extent is his analysis based on real historical events? George Orwells Animal Farm is a master piece where as politics and satire are concerned. Agnsw. It is a tale where animals as individuals are oppressed by their owner Mr. Jones. The animals , which can speak and actually share a lot of human characteristics, are being mistreated and neglected having wanted. Animal Farm , Communism , Leon Trotsky 931 Words | 3 Pages.

August 2014 George Orwell, the example, author of the agnsw, novel Animal Farm describes how the animals on the . farm use self- preservation in order to protect themselves from the damage that the humans are causing. One particular character Squealer, who was a pig in second in command to the leader also known as Leader Comrade Napoleon. Squealer is an essential asset to Napoleon, cause he uses Squealer to deliver messages to the other animals on the farm . Although Squealer is important to Napoleon, Squealer. Animal Farm , Food preservation , George Orwell 939 Words | 4 Pages. Loyalty is last, Power Loyalty is the willingness to art sets, make an investment or personal sacrifice to strengthen a cause. Loyal subjects are . vulnerable to exploitation because of their trust in their leaders agenda.

In George Orwells political satire, Animal Farm , a pig named Napoleon leads the animals of Manor Farm in a rebellion against the tyrannical farmer Mr. Jones. They succeed in driving away all the humans, turning the farm into supper, an animal utopia, and establishing their own system of government. Animal Farm , Don't Let Me Be Misunderstood , George Orwell 1381 Words | 4 Pages. initiating the war with Japan. The lack of people caused issues in factories and farms which then resulted in a shortage of food and material. . The people rioted against the poor conditions and agnsw art sets, low pay but Czar Nicholas did not agree and came back at trilogy, them with violence. This is what caused the Russian Revolution. In Animal Farm , the animals of Manor Farm felt that their farmer, Mr. Jones, was treating the animals of the farm poorly by letting them go hungry for days, lashing out at them, making them work.

Animal , Animal Farm , Dogs 1895 Words | 6 Pages. Agnsw Art Sets. Animal Farm George Orwell who wrote Animal Farm uses animals to show how the . influences and nature of power can be used for ultimate good or absolute evil. Example. George attempts to show how the good idea of communism can be easily corrupted by agnsw, the greed of the leader. It is about a group of animals that rebel against the farm owner in order to gain control of the example of empathy, farm and to be treated with more respect. Old Major explains was one of the agnsw art sets, most respected animals in the farm . He called a meeting one. Animal Farm , Don't Let Me Be Misunderstood , Eric Burdon 1686 Words | 5 Pages. Animal Farm Bibliography: Orwell, George. Animal Farm . New York: Penguin Books Ltd, 1989 . Introduction and Summary: Animal farm is an about Homelessness is No Longer animal fable with a deliberate purpose. It is very realistic about society and agnsw, its politics. There are a number of conflicts in Animal Farm : the animals versus Mr. Jones, Snowball versus Napoleon, the common animals versus the pigs, Animal Farm versus the neighbouring humans, but all of them are expressions of the by aeschylus, underlying tension between the oppressors.

Animal , Animal Farm , Dogs 2584 Words | 7 Pages. ? ANIMAL FARM A Preliminary Bibliography Boos, Florence, and William Boos. Orwell's Morris And Old Major's Dream. English . Agnsw Art Sets. Studies 71.4 (1990): 361-371. Academic Search Complete. Web. By Aeschylus. 11 Nov. 2013. Compares and contrasts the political literature of nineteenth century writer William Morris and twentieth century writer Eric Blair/George Orwell.

Morris wrote essays, journalism and poetry, including: News from Nowhere and The Earthly Paradise; George Orwell's novels: Animal Farm and 1984;. Animal Farm , Communism , Fairy tale 1240 Words | 5 Pages. is an inspiration to the other animals . Describe Boxers role in the novel and who or what does he symbolise? INTRODUCTION 1; George . Orwells Animal Farm is agnsw, a historical fable that represents the Russian revolution INTRODUCTION 2; In George Orwells historical fable Animal Farm , Boxer has an important role and is shown as the last supper da vinci, inspirational, dedicated, hard-working horse that is agnsw art sets, literally willing to die of labour for the benefit of the judaism, farm and art sets, the other animals . Boxers cry I will work harder. Animal Farm , Communism , Karl Marx 781 Words | 3 Pages. Animal Farm - Karl Marx Is based on trilogy by aeschylus, the work of the German Philosopher Karl Marx Karl Marx was a German Philospher . Agnsw. Ms F Grech - Form 3 The worker becomes all the Crusoe a Story, poorer the more wealth he produces, the more his production increases in power and range. 1 Animal Farm - Karl Marx The worker becomes an ever cheaper commodity the more commodities he creates. What does this mean? A useful or valuable thing Karl Marx was talking about Capitalism.

Capitalism , Communism , Karl Marx 313 Words | 4 Pages. Animal Farm: the art sets, morals of the novel. had written his novel Animal Farm in by aeschylus, order to warn his readers for numerous reasons. In many parts of the novel, George Orwell . clearly portrayed how ignorance was a very big part as to why the animals were so easily controlled. This in theory, lead to agnsw, the conflicted problems the animals had about last supper da vinci equality.

In particularly, equality was the key idea of the agnsw, relation between the comparing judaism and christianity, Russian Revolution and Animal Farm . Accordingly, George Orwell had expressed thoroughly how power can almost certainly be. Animal Farm , Communism , Leon Trotsky 1079 Words | 3 Pages. Agnsw Art Sets. ? Animal abuse Richard D. Acton Colorado Christian University . Supper. Animal abuse . When Richard Acton was young he had a neighbor. The neighbor was on the small side. It always seemed as if he was getting bullied. He was so shy, he always stayed in his house. He was seldom seen in the yard playing or anything.

And if he appeared in the yard, he would not stay out long. One day Richard asked his parents about art sets him, and what they thought. Law Abiding. They told Richard to sit down that. Abuse , Animal control officer , Animal cruelty 2236 Words | 10 Pages. Animal Farm Research Paper George Orwell is the author of the book called Animal Farm , and he is . probably most famous for this allegory that is agnsw, based on last supper da vinci, the events of the Russian Revolution.

George Orwell wrote some of the best satirical fiction of the twentieth century and was a man of agnsw art sets, strong opinions. Animal Farm is an anti soviet satire and displays his view on law abiding citizen film, the Russian revolution through this story (George Orwell 2). Art Sets. In this story Animal Farm by George Orwell, the Crusoe Defoe, characters and events. Communism , Leon Trotsky , Marxism 1394 Words | 4 Pages. Agnsw Art Sets. Animal Farm Journal Napoleon - It was notices that they wagged their tails to Essay on Robinson by Daniel Defoe, him in agnsw art sets, the same way as the other dogs had been . use to do to Mr. Jones. (49) Napoleon may not have the brains but he sure as that cunning personality that makes him powerful. He never took part in any of the rebellion acts. In the Battle of the Cowshed, Napoleon was the only one injured while Snowball, the pig so called to be a traitor, was shot in the back. He never shows interest in the rebellion until Snowball. Trilogy. Aerosmith , Animal , Animal Farm 863 Words | 3 Pages. ? Animal Farm Animal Farm is a novel written by George Orwell.

The novel was published by . Agnsw. Penguin-books in 1945. The story, Animal Farm , takes place on a farm that eventually is controlled by animals . Orwell portrays the consequences of a revolution where leaders misuse their power of influence. There will be a special focus on the use of citizen, language and propaganda in this essay. The owner of the agnsw, farm , Mr. Trilogy. Jones, mistreats his livestock and agnsw art sets, the animals wont tolerate it. Da Vinci. A white boar, Old Major. Art Sets. Animal Farm , Communism , E. H. Carr 826 Words | 2 Pages. ? Animal farm Eric Arthur Blair (25 June 1903 21 January 1950),[1] who used the pen name George Orwell, was an English novelist, . Last Da Vinci. essayist, journalist and critic. His work is marked by lucid prose, awareness of agnsw, social injustice, opposition to totalitarianism, and on Robinson Crusoe a Story, commitment todemocratic socialism.[2][3] Animal Farm is an allegorical and agnsw art sets, dystopian novella by George Orwell, first published in England on 17 August 1945.

According to Orwell, the book reflects events leading up to the Russian Revolution. Animal Farm , Don't Let Me Be Misunderstood , George Orwell 1843 Words | 4 Pages. Of Empathy. allegory Animal Farm (first published in 1945), written by George Orwell, both convey the same themes and morals. The values . Agnsw. presented by both Orwell and the Wachowski Brothers are abuse of power , lack of last, privacy and manipulation of people by the use of propaganda. The use of power can be taken for granted; it can be used for art sets, good or evil. In the movie, The Matrix and the novel Animal Farm they both overuse power for evil and of empathy, it ends in horrible consequences. In the novel Animal Farm the agnsw, pigs.

Morpheus , The Animatrix , The Matrix 1029 Words | 3 Pages. Animal Farm Parallels the Russian Revolution. Animal farm essay: Every text is a reflection of it compositional context, this is evident in Animal . Citizen. Farm by George Orwell. The controversial and agnsw, political corruptions that occurred in Russia during 1917 are portrayed in this book, which explores the corruption of socialist ideals in the Soviet Union and the negative impact on the uneducated working class people. Animal farm introducers the abuse of language to on Robinson, gain power , in order to satisfy personal greed as well. This book is allegorical as. Communism , Marxism , October Revolution 962 Words | 3 Pages. Lord of the agnsw, Flies and Animal Farm. Homelessness Longer An Issue. Shelley once said, Power , like a desolating pestilence, pollutes whater it touches. He meant that when somebody acquires a reasonable amount . of control or power over others, that dominance will eventually corrupt them. The corruption can quickly get to art sets, the point of extreme savagery emerging over respectable leadership, causing the people who are being ruled to suffer great hardship. This is exemplified in the novel, Lord of the Flies, by William Golding and in the film, Animal Farm , directed by John.

Animal Farm , Chicken , English-language films 1376 Words | 4 Pages. Animal farm Essay What is the satirical comment that Orwell is trying to make in Animal Farm amp; . how does he achieve this? George Orwells famous Allegorical Beast fable titled Animal Farm , comments on law abiding film, the Russian revolution and on the misuse and abuse of power . A master piece of political satire, Animal Farm is a tale of oppressed individuals who long for freedom. Through his literary links to scapegoating, revisionism and propaganda Orwell makes a satirical comment on the way in agnsw art sets, which those. Animal Farm , Communism , George Orwell 754 Words | 2 Pages. ?Smit Kataria Hon. Eng. 10 Animal Farm The Power of Symbols 5/4/14 How many times in your . Of Empathy. life have you seen symbols? Symbols are everywhere, and agnsw art sets, they have many different meanings. Symbols can symbolize words, emotions, people, places, events and more. In the book Animal Farm by George Orwell, symbolism plays a huge role. The entire story symbolizes the Russian revolution. By Aeschylus. The people, animals , places, events and agnsw, ideas all have a significant meaning relating to the revolution.

Animal Farm , Communism , George Orwell 1322 Words | 4 Pages. It is fear alone that controls the lower animals in Animal Farm. On Robinson Crusoe By Daniel Defoe. ? Animal Farm Analytical Essay Topic: It is fear along with manipulation, propaganda, the ignorance of the lower . animals and the level of intelligence that the pigs have over the other animals that controls the lower animals in George Orwell's Animal Farm . Fear, while extremely prominent, is not the only device used to control the lower animals in the allegorical masterpiece, Animal Farm by agnsw art sets, George Orwell. Along with fear, the pigs use manipulation, propaganda, the ignorance of the lower animals and. Animal , Animal Farm , Don't Let Me Be Misunderstood 1016 Words | 2 Pages. Symbolism and judaism, Allegory in Animal Farm. three aspects of Animal Farm : Old major, The Windmill and The Seven Commandments George Orwell uses symbols throughout the novel . Animal Farm to show how the upper class groups use manipulation to their advantage. Animal Farm in simple terms is the art sets, allegory of a revolution gone sour. Animalism, Communism, and Fascism are all the symbols which are used by the pigs as a means of satisfying their greed and lust for power . As Lord Acton wrote: Power tends to trilogy by aeschylus, corrupt; absolute power corrupts absolutely. Animal , Animal Farm , Communism 1648 Words | 4 Pages.

Major had a dream, few speculated that it would ultimately turn into a nightmare for agnsw, the inhabitants of Animal Farm . Old Major . Longer. fantasized about agnsw art sets a free society where animals would live in harmony and example, where they would work for themselves as opposed to working for free and art sets, being deprived of their work by example of empathy, humans who would use it for their own profit. Old Major illustrates the suppression of the animals which strongly resembles the work of Thomas Hobbes in agnsw, Leviathan when he states, our lives are miserable. Animal Farm , Communism , Friedrich Engels 1969 Words | 5 Pages.

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