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By adding this additional component to the frontend of the query, the business user can generate some very complex calculations In the following illustration, I simply used the Formula Editor to generate an average value for my incoming orders by using Incoming Orders Value divided by the Order Entry Quantity You can see that with this capability and the use of the key figure properties to generate calculations such as Rankings, Averages, Standard Deviations and other approaches to manipulate data, the business user can get very creative with their personal views of the queries This means that each business user needs to be well trained in the areas of performance tuning and data modeling to make sure

which are better tolerated Shooting, stabbing pain also responds to some degree to carbamazepine or phenytoin, but in general the results are unimpressive Neurontin may give somewhat better results, perhaps in part because high doses are well tolerated (Gorson et al) Nerve blocks and epidural injections have been helpful in only a few patients In the proximal asymmetrical, truncal, or ophthalmoplegic neuropathies, the severe pain usually lasts for only a short period and requires the judicious use of analgesics, as outlined in Chap 8 Prognosis in patients with the distal, symmetrical sensory neuropathy is generally for slow progression; but in the other types improvement and eventual recovery may be expected over a period of months or years

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ASYMMETRICAL AND MULTIFOCAL POLYNEUROPATHIES (MONONEUROPATHY, OR MONONEURITIS MULTIPLEX)

(See Table 46-4) Several systemic conditions may be accompanied by acute or subacute involvement of multiple individual nerves serially or almost simultaneously This gives rise to a distinctive clinical picture that has been called mononeuritis multiplex The most notable examples of this syndrome are associated with polyarteritis nodosa and other vasculitides, and another not uncommon form of idiopathic vasculitis that is con ned to the peripheral nervous system The distinctive features are the acute or subacute evolution of complete or almost complete sensorimotor paralysis of single peripheral nerves, in an asymmetric distribution and not respecting proximal or distal sites and pain Less frequently, sarcoidosis, forms of HIVrelated neuropathy, and Lyme disease present in this fashion Leprosy, a special member of this group, is discussed further on and the diabetic mononeuropathies were addressed in the preceding section

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they are comfortable with the overall processing that the system goes through to deliver the data and results via the BEx Web Analyzer

Arteritic Angiopathic Neuropathies Approximately half of all cases of mononeuropathy multiplex can be traced to a systemic vasculitis of the vasa nervorum These are the classic causes of mononeuritis mulitplex Included in this category are polyarteritis nodosa, the Churg-Strauss syndrome (allergic bronchial asthma and eosinophilia), rheumatoid arthritis, lupus erythematosus, scleroderma, cryoglobulinemia, Wegener granulomatosis, and the aforementioned idiopathic variety of vasculitis that is con ned to the cranial peripheral nerves and has no systemic manifestations A small-vessel arteritis is also the putative mechanism in the multiple mononeuropathies that complicate Lyme disease and AIDS In Said s series of 200 cases of vasculitis affecting the peripheral nerves, 36 percent were due to polyarteritis nodosa, 21 percent to rheumatoid arthritis, and 4 percent to other connective tissue diseases; in 35 percent there were no signs of vasculitis beyond the peripheral nerves Elevation of the sedimentation rate and other serologic abnormalities are typical features of this entire group This subject has been reviewed by Chalk et al; Dyck and Said; and by Kissell Polyarteritis Nodosa Perhaps 75 percent of cases of polyarteritis nodosa show involvement of the small nutrient arteries of peripheral nerves (autopsy gures), but a symptomatic form of neuropathy develops in only about half this number Involvement of the peripheral nerves may be the principal or rst clue to the diagnosis of the underlying disease when, up to that time, the main components of the clinical picture abdominal pain, hematuria, fever, eosinophilia, hypertension, vague limb pains, and asthma had not fully declared themselves or had been misinterpreted Although characteristically a disease of multiple discrete mononeuropathies, the syndrome associated with polyarteritis nodosa may appear to be diffuse and more or less symmetrical as a result of the cumulation of many small nerve infarctions, ie, it can simulate a polyneuropathy In these cases, careful clinical and electrophysiologic examinations disclose elements of mononeuritis that have been engrafted on an otherwise ostensibly generalized process For example, an asymmetrical foot or wrist drop, or a disproportionate affection of one nerve in a limb, such as ulnar palsy with relative sparing of function of the adjacent median nerve, are clues More often it takes form throughout its course of a mononeuropathy multiplex, ie, a random infarction of two or more individual nerves The onset is usually abrupt, with symptoms of pain or numbness at a focal site along a nerve or in the distal distribution of an affected nerve, followed in hours or days by motor or sensory loss in the distribution of that nerve, and then by involvement in a saltatory fashion of other peripheral nerves Both the spinal and cranial nerves may be affected but far less often than the nerves in the limbs No two cases are identical The CSF is usually normal Nerve biopsy, usually taken from the sural nerve, will usually show the necrotizing arteritis in medium sized vessels ( brinoid necrosis of all three coats of the vessel walls), usually with numerous in ltrating eosinophils and with occlusion of vessels Muscle biopsy may also show perivascular in ammation and necrosis but the diagnostic yield is less than for biopsy of an affected nerve On the basis of the smaller size of affected vessels and the presence of perinuclear antinuclear cytoplasmic autoantibodies (p-ANCA), Lhote et al have differentiated a microscopic polyarteritis an entity with which we have had little experience Rapidly progressive glomerulonephritis and lung hemorrhage are the additional features of the latter disease, neuropathy occurring somewhat less frequently than in typical polyarteritis.