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Constipation

Constipation refers to bowel movements that are infrequent or hard to pass. The stool is hard and dry. Other symptoms may include abdominal pain and feeling as if one has not passed the bowel movement. Complications from constipation may include anal fissure or fecal impaction; the normal frequency of bowel movements in adults is three per week. Babies have three to four bowel movements per day while young children have two to three per day. Constipation has many causes. Common causes include slow movement of stool within the colon, irritable bowel syndrome, pelvic floor disorders. Underlying associated diseases include hypothyroidism, Parkinson's disease, celiac disease, non-celiac gluten sensitivity, colon cancer and inflammatory bowel disease. Medications associated with constipation include opioids, certain antacids, calcium channel blockers, anticholinergics. Of those taking opioids about 90% develop constipation. Constipation is more concerning when there is weight loss or anemia, blood is present in the stool, there is a history of inflammatory bowel disease or colon cancer in a person's family, or it is of new onset in someone, older.

Treatment of constipation depends on the duration that it has been present. Measures that may help include drinking enough fluids, eating more fiber, exercise. If this is not effective, laxatives of the bulk forming agent, osmotic agent, stool softener, or lubricant type may be recommended. Stimulant laxatives are reserved for when other types are not effective. Other treatments may include biofeedback or in rare cases surgery. In the general population rates of constipation are 2–30 percent. Among elderly people living in a care home the rate of constipation is 50–75 percent. People spend, in more than US$250 million on medications for constipation a year. Constipation is a symptom, not a disease. Most constipation is thought of as infrequent bowel movements less than 3 stools per week. However, people may have other complaints as well including: Straining with bowel movements Excessive time needed to pass a bowel movement Hard stools Pain with bowel movements secondary to straining Abdominal pain Abdominal bloating.

The sensation of incomplete bowel evacuation. The Rome III Criteria are a set of symptoms that help standardize the diagnosis of constipation in various age groups; these criteria help physicians to better define constipation in a standardized manner. The causes of constipation can be divided into congenital and secondary; the most common kind is not life-threatening. It can be divided by the age group affected such as children and adults. Primary or functional constipation is defined by ongoing symptoms for greater than six months not due to an underlying cause such as medication side effects or an underlying medical condition, it is not associated with abdominal pain. It is the most common kind of constipation, is multifactorial. In adults, such primary causes include: dietary choices such as insufficient dietary fiber or fluid intake, or behavioral causes such as decreased physical activity. In the elderly, common causes have been attributed to insufficient dietary fiber intake, inadequate fluid intake, decreased physical activity, side effects of medications and obstruction by colorectal cancer.

Evidence to support these factors however is poor. Secondary causes include side effects of medications such as opiates and metabolic disorders such as hypothyroidism, obstruction such as from colorectal cancer. Celiac disease and non-celiac gluten sensitivity may present with constipation. Cystocele can develop as a result of chronic constipation. Constipation can be exacerbated by a low-fiber diet, low liquid intake, or dieting. Dietary fiber helps to decrease colonic transport time, increases stool bulk but softens stool. Therefore, diets low in fiber can lead to primary constipation. Many medications have constipation as a side effect; some include opioids, antidepressants, antispasmodics, tricyclic antidepressants, beta-adrenoceptor antagonists, anti-diarrheals, 5-HT3 receptor antagonists such as ondansetron, aluminum antacids. Certain calcium channel blockers such as nifedipine and verapamil can cause severe constipation due to dysfunction of motility in the rectosigmoid colon. Supplements such as calcium and iron supplements can have constipation as a notable side effect.

Metabolic and endocrine problems which may lead to constipation include: hypercalcemia, hyperparathyroidism, chronic kidney disease, pan-hypopituitarism, diabetes mellitus, cystic fibrosis. Constipation is common in individuals with muscular and myotonic dystrophy. Systemic diseases that may present with constipation include systemic sclerosis. Constipation has a number of structural causes, namely through creating space-occupying lesions within the colon that stop the passage of stool, such as colorectal cancer, rectocoles, anal sphincter damage or malformation and post-surgical changes. Extra-intestinal masses such as other malignancies can lead to constipation from external compression. Constipation has neurological causes, including anismus, descending perineum syndrome, Hirschsprung's disease. In infants, Hirschsprung's disease is the most common medical disorder associated with constipation. Anismus occurs in a small minority of persons with obstructed defecation. Spinal cord lesions and

Andrea Cocco

Andrea Salvatore Cocco is an Italian footballer who plays as a striker for Olbia. Cocco made his Serie A debut on 21 December 2005 for Cagliari in a 1-0 defeat away to Parma F. C.. On 31 January 2007 he left for Venezia. and on 31 August 2007 for Pistoiese. Cocco was sold to Rovigo in a co-ownership deal in August 2008. In June 2009 Cagliari bought Cocco and Andrea Peana back, but sold them to Alghero in co-ownership deals, where Cocco met ex-team-mate Alessio Cossu, Nicola Lai and Enrico Cotza. In June 2010, few week before the bankrupt of Alghero, Cagliari bought back Cocco and Aresti for €500. Few days after Cagliari signed Gabriele Perico and Simon Laner from AlbinoLeffe in temporary deals for €750,000, Cocco was sold to AlbinoLeffe in co-ownership deal for €50,000 in a 3-year deal, making Cagliari only paid AlbinoLeffe €700,000 in cash. In June 2011 Cagliari bought back Cocco for €150,000, as well as bought Perico in a co-ownership deal for €375,000, making Cagliari paid AlbinoLeffe €500,000 cash that summer.

On 4 July 2011 Cocco returned to AlbinoLeffe in a temporary deal with option to sign outright for €200,000. Despite the club relegated, the option was excised in a 4-year contract. On the same day Perico was acquired outright for another €200,000, thus the two transfer fees were canceled each other. However, Cocco was sold by AlbinoLeffe in the same summer. On 30 July 2012, Cocco was signed by Hellas Verona in a co-ownership deal with AlbinoLeffe, for €290,000 fee in a 3-year contract. In June 2013 the co-ownership deal was renewed. After a one-year stint with Verona in August 2013, he joined Reggina on a loan deal. On 29 January 2014, he was again loaned to Portuguese Segunda Liga side Beira-Mar. In June 2014 Verona acquired Cocco and Laner outright from AlbinoLeffe for €500 each, with Simone Calvano returned to Verona for €500, he moved to Vicenza on 8 August 2014 in a 2-year contract on a free transfer. He missed few weeks of 2015–16 Serie B due to an injury in pre-season. On 31 August 2015 Cocco was signed by fellow Serie B club Pescara on a reported 3-year contract for a transfer fee of €600,000.

On 3 August 2016 Cocco was loaned to fellow Serie B club Frosinone, which the team was relegated from Serie A. After scoring just 1 league goal for the Lazio-based club, Cocco was loaned to another Serie B team Cesena on 16 January 2017, he wore number 11 shirt for his new team. On 31 January 2019, he was released from his Pescara contract by mutual consent. On 27 February 2019, he signed with Padova. On 19 November 2019, he signed a contract with Olbia until 30 June 2021. Andrea Cocco at Soccerway "2006–07 profile". Gazzetta dello Sport. C. 2007. Archived from the original on 29 September 2007

Planescape: Torment

Planescape: Torment is a role-playing video game developed by Black Isle Studios and published by Interplay Entertainment. Released for Microsoft Windows on December 12, 1999, the game takes place in locations from the multiverse of Planescape, a Dungeons & Dragons fantasy campaign setting; the game's engine is a modified version of the Infinity Engine, used for BioWare's Baldur's Gate, a previous D&D game set in the Forgotten Realms. Planescape: Torment is story-driven, with combat not being prominently featured; the protagonist, known as The Nameless One, is an immortal man. The game focuses on his journey through the city of Sigil and other planes to reclaim his memories of these previous lives, to discover why he was made immortal in the first place. Several characters in the game may join the Nameless One on his journey; the game was not a commercial success, but received critical acclaim and has since become a cult classic. Claimed by video game journalists to be the best role-playing video game of 1999, it was lauded for its immersive dialogue, for the dark and obscure Planescape setting, for the protagonist's unique persona, which shirked many characteristics of traditional role-playing games.

It is considered one of the greatest video games of all time, continues to receive attention long after its release. An enhanced version, featuring enhancements made for modern platforms, was made by Beamdog and released for Windows, macOS, iOS in April 2017, for Nintendo Switch, PlayStation 4, Xbox One in October 2019. Planescape: Torment is built on BioWare's Infinity Engine, which presents the player with a pre-rendered world in an isometric perspective in which player characters are controlled; the game's role-playing ruleset is based on that of Advanced Dragons 2nd Edition. In Planescape: Torment, the player takes the role of "The Nameless One", an immortal man with amnesia on a quest to learn why. Exploration around the painted scenery is accomplished by clicking on the ground to move, or on objects and characters to interact with them. Items and spells may be employed through "quick slots", or a radial menu. An alternative to armor is the use of magical tattoos, which can be applied to The Nameless One and certain other characters to enhance their abilities.

The game begins with character creation, where the player assigns attribute points, such as strength and charisma, to The Nameless One. The Nameless One starts the game as a fighter class, but the player may freely change it to a thief or wizard; the player may recruit companions throughout the game to join the party. There are seven potential companions, but only a maximum of five may accompany The Nameless One at any given time. Conversation is frequent among party members, occurring both randomly and during conversations with other non-player characters; the gameplay focuses on the resolution of quests through dialogue rather than combat, many of the game's combat encounters can be resolved or avoided through dialogue or stealth. The Nameless One carries a journal, which helps the player keep track of the game's numerous quests and subplots; as The Nameless One is immortal, running out of health points imposes no penalty beyond respawning in a different location. Planescape: Torment uses the D&D character alignment system, in which a character's ethical and moral perspective and philosophy are determined based on the axes of "good vs. evil" and "law vs. chaos", with neutrality bridging the two opposing sides.

In Planescape: Torment, The Nameless One begins as "true neutral", but can be incrementally changed based on the character's actions throughout the game, with reactions from the game's non-player characters differing based on his alignment. Planescape: Torment is set in the Planescape "multiverse", a Dungeons & Dragons campaign setting which consists of various planes of existence, the creatures which live in them, the properties of the magic that infuses each plane. A large portion of Planescape: Torment takes place in Sigil, a large city located atop an infinitely tall spire at the center of the multiverse, that connects the planes with each other via a series of portals; the city is overseen by the powerful Lady of Pain, while numerous factions control different functions of the city related to each group's world view, with The Nameless One being able to join several of these factions during the game. The story moves on to other planes, such as Baator and Carceri, where The Nameless One continues to discover more about his past.

Throughout the game, The Nameless One learns about his previous incarnations and the influence they have had on the world. Planescape: Torment's protagonist is known as The Nameless One, a man cursed with immortality for thousands of years; every time he dies, another person in the multiverse dies to fuel his resurrection. Upon rebirth, The Nameless One has little to no recollection of his past life, with different personality than before; when the game starts, The Nameless One wakes in a mortuary as a result of his latest death. He sets out on a quest to discover how he died and why he is immortal hoping that the adventure will help him regain memories of his past incarnations. During his quest, The Nameless One meets several characters who can join him as companions: Morte, Annah-of-the-Shadows, Dak'kon, Nordom, Fall-From-Grace, Vhailor; these playable characters can interact with the Nameless One to further the game's plot. Morte is a cynical floating skull from the Pillar of Skulls in Baator.

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