approach to the patient in a critical care setting

... 52-3) and to formulate a differential diagnosis (Table 52-4) For instance, the finding of scaling papules (present in patients with psoriasis or atopic dermatitis) places the patient in a different ... lesions If the examiner focuses on linear erosions overlying an area of erythema and scaling, he or she may incorrectly assume that the erosion is the primary lesion and the redness and scale are secondary, ... >0.5 cm in diameter Wheal: A raised, erythematous, edematous papule or plaque, usually representing short-lived vasodilatation and vasopermeability Telangiectasia: A dilated, superficial blood vessel...

Ngày tải lên: 06/07/2014, 20:20

... epidermal atrophy) Scar: A change in the skin secondary to trauma or inflammation Sites may be erythematous, hypopigmented, or hyperpigmented depending on their age or character Sites on hair-bearing ... that elicits the desire to scratch Pruritus is often the predominant symptom of inflammatory skin diseases (e.g., atopic dermatitis, allergic contact dermatitis); it is also commonly associated ... Poikiloderma: Skin that displays variegated pigmentation, atrophy, and telangiectases Polycyclic: A configuration of skin lesions formed from coalescing rings or incomplete rings Pruritus: A sensation...

Ngày tải lên: 06/07/2014, 20:20

... examining the skin it is usually advisable to assess the patient before taking an extensive history This way, the entire cutaneous surface is sure to be evaluated, and objective findings can ... 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 well as the mucous ... hospitalized patient with a generalized erythematous exanthem is more likely to have a drug eruption than is a patient with a similar rash limited to the sun-exposed portions of the face Once the distribution...

Ngày tải lên: 06/07/2014, 20:20

... A D 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 ... disease is characterized by small and large erythematous papules and plaques with overlying adherent silvery scale Figure 52-8 ...

Ngày tải lên: 06/07/2014, 20:20

... contact (Fig 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 multiple erythematous plaques with a target or iris morphology It usually represents a hypersensitivity reaction to drugs (e.g., sulfonylamides) or infections (e.g., ... 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 ...

Ngày tải lên: 06/07/2014, 20:20

... melanoma, atopy, psoriasis, or acne) 10 Social, sexual, or travel history as relevant to the patient DIAGNOSTIC TECHNIQUES Many skin diseases can be diagnosed on gross clinical appearance, but ... superficial anatomic structures in selected areas of the body In this procedure, a small area of skin is anesthetized with 1% lidocaine with or without epinephrine The skin lesion in question can be ... relatively simple diagnostic procedures can yield valuable information In most instances, they can be performed at the bedside with a minimum of equipment Skin Biopsy A skin biopsy is a straightforward...

Ngày tải lên: 06/07/2014, 20:20

... 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, edematous, ... 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 in patients ... of certain skin disorders For example, a Wood's lamp will cause erythrasma (a superficial, intertriginous infection caused by Corynebacterium minutissimum) to show a characteristic coral pink color,...

Ngày tải lên: 06/07/2014, 20:20

... Intervention The aim of the intervention was to support healthcare providers in using CAHE, specifically for Surinamese and Ghanaian patients Interventions are more likely to elicit change in healthcare ... Determine how a patient wants to be addressed (formally or informally) Determine the patient' s preferred language for speaking and reading (Dutch or another language) Use this information in your interaction ... GP assistants The GPs were not Page of 10 invited because almost all of them had completed a somewhat similar training, organised by the PCHCs at an earlier stage After the training, the tools...

Ngày tải lên: 10/08/2014, 10:22

... returned to the clinic one week later complaining that the pain in his left calf area persisted and could be further aggravated by tiptoeing and weight bearing maneuvers Again, US examination in the ... did not reveal any abnormal sonographic findings After two normal sonographic findings in the prone position, the examiner tried a different approach The patient was placed in the supine position ... muscle Am J Sports Med 1977, 5:191-193 Takebayashi S, Takasawa H, Banzai Y, Miki H, Sasaki R, Itoh Y, Matsubara S: Sonographic findings in muscle strain injury: clinical and MR imaging correlation...

Ngày tải lên: 11/08/2014, 17:21

... Mathematical Analysis and Applications, vol 158, no 1, pp 106–113, 1991 20 Th M Rassias, “On the stability of functional equations in Banach spaces,” Journal of Mathematical Analysis and Applications, ... in Nonlinear Differential Equations and Their Applications, Birkh¨auser, Boston, Mass, USA, 1998 24 S.-M Jung, Hyers-Ulam-Rassias Stability of Functional Equations in Mathematical Analysis, Hadronic ... Rassias, “On the stability of the linear mapping in Banach spaces,” Proceedings of the American Mathematical Society, vol 72, no 2, pp 297–300, 1978 D G Bourgin, “Classes of transformations and...

Ngày tải lên: 20/12/2015, 08:14

... with the ears inclining downwards, or even touching the surface; traverse the adjoining places in order to disturb the birds, and make them fly towards the snare, and, by pecking at the ears of ... smaller kinds assemble for pairing They are chiefly on the wing from daybreak to noon, and always fly against the wind The birdcatchers, therefore, lay their nets towards that point to which the wind ... hawks, are made with an arm and spring at right angles to the plate, so that they may be fastened to the post which supports them In setting these traps great care and skill are necessary; and...

Ngày tải lên: 06/03/2014, 13:20

... endometrial carcinoma 56.0 years A study done in Larkana, Pakistan (Siyal et al., 1999) had reported that the average age of the patients with gynecological cancer was 46.5 years and the peak age ... Knowledge and health careseeking behavior in relation to gynecological malignancies in India: A study of the patients with gynecological malignancies in a tertiary care hospital of Kolkata J Cancer ... 348-54 Sarkar M, Konar H, Raut DK (2010) Symptomatology of gynecological malignancies: Experiences in the Gynecology Out -Patient Clinic of a tertiary care hospital in Kolkata, India Asian Pac J Cancer...

Ngày tải lên: 22/03/2014, 11:20

... equally to this work The authors read and approved the final manuscript Competing interests The authors declare that they have no competing interests Received: 15 April 2011 Accepted: 10 October ... doi:10.1016/j.na.2005.06.028 Bae, J-H, Park, W-G: On a cubic equation and a Jensen-quadratic equation Abstr Appl Anal 2007 (2007) Article ID 45179 Găvruta, P: A generalization of the Hyers-Ulam-Rassias stability of approximately ... points and the stability of Jensen’s functional equation J Inequal Pure Appl Math (2003) Article doi:10.1186/1029-242X-2011-82 Cite this article as: Bae and Park: A fixed-point approach to the...

Ngày tải lên: 20/06/2014, 22:20

... transformations,” Bulletin of the American Mathematical Society, vol 57, pp 223–237, 1951 Th M Rassias, “On the stability of the linear mapping in Banach spaces,” Proceedings of the American Mathematical ... “On the stability of the linear transformation in Banach spaces,” Journal of the Mathematical Society of Japan, vol 2, pp 64–66, 1950 D G Bourgin, “Classes of transformations and bordering transformations,” ... Hyers-Ulam-Rassias Stability of Functional Equations in Mathematical Analysis, Hadronic Press, Palm Harbor, Fla, USA, 2001 G L Forti, “Hyers-Ulam stability of functional equations in several variables,”...

Ngày tải lên: 22/06/2014, 11:20

... Fixed Point Theory and Applications and proved the Hyers theorem That is, Rassias proved the Hyers-Ulam-Rassias stability of the Cauchy additive functional equation Since then, the stability ... Volterra integral equation (1.2) Hyers-Ulam-Rassias stability Recently, C˘ dariu and Radu [12] applied the fixed point method to the investigation of a the Cauchy additive functional equation Using ... 143–190, 1995 [5] P G˘ vruta, A generalization of the Hyers-Ulam-Rassias stability of approximately additive a ¸ mappings,” Journal of Mathematical Analysis and Applications, vol 184, no 3, pp...

Ngày tải lên: 22/06/2014, 19:20

... remain functional and maintain a self-image as a fully intact person with just a malfunctioning part, a diseased organ ( "a bum ticker") By contrast, the patient with pancreatic cancer has a completely ... the second leading cause of death behind heart disease Deaths from heart disease have declined 45% in the United States since 1950 and continue to decline Cancer has overtaken heart disease as ... deaths are shown for various populations in Table 77-2 Along with the decrease in incidence has come an increase in survival for cancer patients The 5-year survival for white patients was 39% in...

Ngày tải lên: 07/07/2014, 01:20

... more common in Asia than North America or Africa The most common cancers in Africa are cervical, breast, and liver cancers It has been estimated that nine modifiable risk factors are responsible ... fuels, and contaminated injections Figure 77-3 Patient Management Important information is obtained from every portion of the routine history and physical examination The duration of symptoms may ... procedure, the diagnosis generally depends on obtaining adequate tissue to permit careful evaluation of the histology of the tumor, its grade, and its invasiveness and to yield further molecular diagnostic...

Ngày tải lên: 07/07/2014, 01:20

... by the International Union Against Cancer and the American Joint Committee on Cancer (AJCC) The TNM classification is an anatomically based system that categorizes the tumor on the basis of the ... physical examination, radiographs, isotopic scans, CT scans, and other imaging procedures; pathologic staging takes into account information obtained during a surgical procedure, which might include ... particular tumors for spread to adjacent or distant organs helps direct the staging evaluation Information obtained from staging is used to define the extent of disease either as localized, as...

Ngày tải lên: 07/07/2014, 01:20

... regular examinations, and taking time to talk 2 The National Cancer Institute maintains a database called PDQ (Physician Data Query) that is accessible on the Internet under the name CancerNet at ... cancer management is assessing the response to treatment In addition to a careful physical examination in which all sites of disease are physically measured and recorded in a flow chart by date, ... http://www.cancer.gov/cancertopics/pdq Information can be obtained through a facsimile machine using CancerFax by dialing 301-402-5874 Patient information is also provided by the National Cancer Institute...

Ngày tải lên: 07/07/2014, 01:20

... Medullary cancer of the thyroid Catecholamines Pheochromocytoma Oncofetal Antigens Alphafetoprotein Hepatocellular carcinoma, gonadal germ Cirrhosis, cell tumor Carcinoembryonic antigen Adenocarcinomas ... Adenocarcinomas hepatitis Pancreatitis, of the colon, pancreas, hepatitis, lung, breast, ovary inflammatory bowel disease, smoking Enzymes Prostatic acid Prostate cancer phosphatase Prostatitis, prostatic ... enolase Lactate dehydrogenase Small cell cancer of the lung,neuroblastoma Lymphoma, Ewing's sarcoma Hepatitis, hemolytic many others Tumor-Associated Proteins anemia, Prostate-specific Prostate...

Ngày tải lên: 07/07/2014, 01:20