4 techniques of repair and revascularization
Ryan’s Ballistic Trauma docx
... College of Surgeons of England along with a medical scientist with an international reputation in the field of ballistic science The US editor is professor and chairman of the Department of Surgery ... a ready supply of materials – patients on which to practice In the period of unrest in Northern Ireland 1969–2002 and at the time of the Falklands War of 1982 there were masters and patients aplenty ... Division of Traumatology and Surgical Critical Care, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA Mark Byers, MBBS, MSc, MCEM, MFSEM, MRCGP Ministry of...
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Care of the Patient with Retinal Detachment And Related Peripheral Vitreoretinal Disease docx
... small and located at the posterior margin of the vitreous base.108 Retinal tears are of similar type and location, and retinal detachments have similar morphological characteristics and time of ... person often is unaware of the loss of an area of peripheral vision) The sudden onset of numerous floaters and the occurrence of flashes of light are hallmarks of a potential retinal tear Significant ... retina and the Common Signs, Symptoms, and Complications Early symptoms of retinal detachment (photopsia and/ or a sudden shower of floaters due to tearing of a retinal blood vessel) are often...
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Báo cáo y học: "Critical care management and outcome of severe Pneumocystis pneumonia in patients with and without HIV infection" pps
... interpretation of data and to the drafting of the manuscript XM and EV-P contributed equally to this study DO contributed to the collection, analysis, and interpretation of data and to the drafting of the ... collection of data, performed analysis and interpretation of data, and drafted the manuscript EV-P conceived the study, performed the collection of data, and contributed to the analysis and interpretation ... (positive end-expiratory pressure of between and cm H2O, pressure support adjusted to obtain an expired tidal volume of to 10 mL/kg of body weight, and a respiratory rate of less than 25 breaths per...
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Long-Term Care for the Elderly with Disabilities: Current Policy, Emerging Trends, and Implications for the Twenty-First Century docx
... report as a result of meetings of leading trustees and executives of both nonprofit and investor-owned organizations in long-term care The Fund and the American Association of Homes and Services for ... state and local levels At every level, the availability and quality of the current and future long-term care labor force—both professional and paraprofessional— have received the least attention of ... status of the three key dimensions of long-term care policy— financing, delivery, and workforce and identifies some of the major demographic and policy trends that will affect the demand for, and...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 1) ppt
... the interpretation of skin lesions, a variety of descriptive terms have been developed to characterize cutaneous lesions (Tables 52-1, 52-2, and 52-3 as well as Fig 52-3) and to formulate a differential ... common type of melanoma Such lesions usually demonstrate asymmetry, border irregularity, color variegation (black, blue, brown, pink, and white), a diameter >6 mm, and a history of change (e.g., ... (Figs 52-4 and 52-5, respectively) It is also important to differentiate primary from secondary skin lesions If the examiner focuses on linear erosions overlying an area of erythema and scaling,...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 2) potx
... of epidermis without an associated loss of dermis Ulcer: Loss of epidermis and at least a portion of the underlying dermis Excoriation: Linear, angular erosions that may be covered by crust and ... Atrophy: An acquired loss of substance In the skin, this may appear as a depression with intact epidermis (i.e., loss of dermal or subcutaneous tissue) or as sites of shiny, delicate, wrinkled ... configuration of skin lesions formed from coalescing rings or incomplete rings Pruritus: A sensation that elicits the desire to scratch Pruritus is often the predominant symptom of inflammatory...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 4) doc
... eruption, the types of primary and secondary lesions, the shape of individual lesions, and the arrangement of the lesions An ideal skin examination includes evaluation of the skin, hair, and nails as ... evaluated, and objective findings can be integrated with relevant historic data Four basic features of a skin lesion must be noted and considered during a physical examination: the distribution of the ... lesions and make it possible to assess the distribution of the eruption accurately The patient should first be viewed from a distance of about 1.5–2 m (4–6 ft) so that the general character of the...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 5) pptx
... The distribution of some common dermatologic diseases and lesions Figure 52-7 Psoriasis This papulosquamous skin disease is characterized by small and large erythematous papules and plaques with...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 6) pdf
... 52-10) or primary irritant dermatitis In contrast, lesions with a generalized arrangement are common and suggest a systemic etiology Figure 52-9 Erythema multiforme This eruption is characterized by ... a hypersensitivity reaction to drugs (e.g., sulfonylamides) or infections (e.g., HSV) (Courtesy of the Yale Resident's Slide Collection; with permission.) Figure 52-10 ...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 7) ppt
... scalpel blade, and the removed scale is collected on a glass microscope slide then treated with to drops of a solution of 10–20% KOH KOH dissolves keratin and allows easier visualization of fungal ... pseudohyphae and budding yeast in Candida infections (see Fig 196-1), and "spaghetti and meatballs" yeast forms in tinea versicolor The same sampling technique can be used to obtain scale for culture of ... decision may require expertise in skin diseases and knowledge of superficial anatomic structures in selected areas of the body In this procedure, a small area of skin is anesthetized with 1% lidocaine...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 8) pptx
... under a Wood's lamp, and previously unsuspected areas of involvement often become apparent A Wood's lamp may also aid in the demonstration of tinea versicolor and in recognition of ash leaf spots ... a lesion and noting the amount of blanching that occurs Granulomas often have an opaque to transparent, brown-pink "apple jelly" appearance on diascopy Figure 52-11 Urticaria Discrete and confluent, ... distribution and striking depigmentation as a result of loss of melanocytes Patch Tests Patch testing is designed to document sensitivity to a specific antigen In this procedure, a battery of suspected...
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Chapter 077. Approach to the Patient with Cancer (Part 1) potx
... between ages 40 and 59, in 12 men and in 11 women will develop cancer; and for the interval between ages 60 and 79, in men and in women will develop cancer Overall, men have a 45% risk of developing ... Magnitude of the Problem No nationwide cancer registry exists; therefore, the incidence of cancer is estimated on the basis of the National Cancer Institute's Surveillance, Epidemiology, and End ... cancer incidence and death figures from nine sites, accounting for about 10% of the U.S population, and from population data from the U.S Census Bureau In 2007, 1.445 million new cases of invasive...
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Chapter 077. Approach to the Patient with Cancer (Part 3) pptx
... portion of the routine history and physical examination The duration of symptoms may reveal the chronicity of disease The past medical history may alert the physician to the presence of underlying ... permit careful evaluation of the histology of the tumor, its grade, and its invasiveness and to yield further molecular diagnostic information, such as the expression of cellsurface markers or ... no apparent primary site of disease Efforts should be made to define the primary site based on age, sex, sites of involvement, histology and tumor markers, and personal and family history Particular...
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Chapter 077. Approach to the Patient with Cancer (Part 4) pps
... systems of nodal grading), and the presence of metastatic disease (M0 and M1 for the absence and presence, respectively, of metastases) The various permutations of T, N, and M scores (sometimes ... tumor of larger size), the presence of nodal involvement (usually N0 and N1 for the absence and presence, respectively, of involved nodes, although some tumors have more elaborate systems of nodal ... regional lymph nodes and/ or tissue adjacent to the tumor, and inspection and biopsy of organs commonly involved in disease spread Pathologic staging includes histologic examination of all tissues removed...
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Chapter 077. Approach to the Patient with Cancer (Part 5) doc
... disappearance of all evidence of disease, and a partial response as >50% reduction in the sum of the products of the perpendicular diameters of all measurable lesions The determination of partial ... whom curative therapy is no longer an option Often a combination of guilt and frustration over the inability to cure the patient and the pressure of a busy schedule greatly limit the time a physician ... lesion or an increase of >25% in the sum of the products of the perpendicular diameters of all measurable lesions (or an increase of 20% in the sums of the longest diameters by RECIST) Tumor...
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Chapter 077. Approach to the Patient with Cancer (Part 6) pdf
... Pregnancy disease, gonadal germ cell tumor Calcitonin Medullary cancer of the thyroid Catecholamines Pheochromocytoma Oncofetal Antigens Alphafetoprotein Hepatocellular carcinoma, gonadal germ ... gonadal germ Cirrhosis, cell tumor Carcinoembryonic antigen Adenocarcinomas hepatitis Pancreatitis, of the colon, pancreas, hepatitis, lung, breast, ovary inflammatory bowel disease, smoking Enzymes ... Prostatitis, prostatic hypertrophy Neuron-specific enolase Lactate dehydrogenase Small cell cancer of the lung,neuroblastoma Lymphoma, Ewing's sarcoma Hepatitis, hemolytic many others Tumor-Associated...
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Chapter 077. Approach to the Patient with Cancer (Part 7) ppt
... treated for cancer and must be examined (Chap e13) Some problems emerge as a consequence of the disease and some as a consequence of the treatment An understanding of these disease- and treatment-related ... to control the symptoms of cancer and its treatment may lead patients to abandon curative therapy Of equal importance, supportive care is a major determinant of quality of life Even when life ... cured by salvage therapy than symptomatic relapses In view of the enormous cost of a full battery of diagnostic tests and their manifest lack of impact on survival, new guidelines are emerging for...
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Chapter 077. Approach to the Patient with Cancer (Part 8) potx
... features, provocative and palliative factors, and intensity (Chap 12); a review of the oncologic history and past medical history as well as personal and social history; and a thorough physical ... aseptic necrosis of the femoral head) In 10% of cases, pain is unrelated to cancer or its treatment Assessment of pain requires the methodical investigation of the history of the pain, its location, ... effective and may enhance the efficacy of prochlorperazine For highly emetogenic agents such as cisplatin, mechlorethamine, dacarbazine, and streptozocin, combinations of agents work best and administration...
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Chapter 077. Approach to the Patient with Cancer (Part 11) pot
... better also feel better Loss of control over how one spends time can contribute to the sense of vulnerability Juggling the demands of work and family with the demands of treatment may create enormous ... needs of patients vary with their situation Patients undergoing treatment experience fear, anxiety, and depression Self-image is often seriously compromised by deforming surgery and loss of hair ... Nutrition Cancer and its treatment may lead to a decrease in nutrient intake of sufficient magnitude to cause weight loss and alteration of intermediary metabolism The prevalence of this problem...
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