approach to the patient with acute respiratory distress syndrome
Chapter 052. Approach to the Patient with a Skin Disorder (Part 1) ppt
... that the erosion is the primary lesion and the redness and scale are secondary, while the correct interpretation would be that the patient has a pruritic eczematous dermatitis with erosions caused ... (Table 52-4) For instance, the finding of scaling papules (present in patients with psoriasis or atopic dermatitis) places the patient in a different diagnostic category than would hemorrhagic papules, ... important to differentiate primary from secondary skin lesions If the examiner focuses on linear erosions overlying an area of erythema and scaling, he or she may incorrectly assume that the erosion...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 2) potx
... 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 with ... 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 ... Lichenoid: Violaceous to purple, polygonal lesions that resemble those seen in lichen planus Milia: Small, firm, white papules filled with keratin Morbilliform: Generalized, small erythematous macules...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 4) doc
... highly with diagnosis (Fig 52-6) For example, a 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 ... 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 skin and the distribution ... patient with cutaneous small vessel vasculitis (Courtesy of Robert Swerlick, MD; with permission.)[newpage] APPROACH TO THE PATIENT: SKIN DISORDER In examining the skin it is usually advisable to...
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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
... 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 ... usually represents 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
... against the surface of the skin and rotated with downward pressure until it penetrates to the subcutaneous tissue The circular biopsy is then lifted with forceps, and the bottom is cut with iris ... area of skin is anesthetized with 1% lidocaine with or without epinephrine The skin lesion in question can be excised or saucerized with a scalpel or removed by punch biopsy In the latter technique, ... History of allergies Presence of photosensitivity Review of systems Family history (particularly relevant for patients with melanoma, atopy, psoriasis, or acne) 10 Social, sexual, or travel history...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 8) pptx
... to document sensitivity to a specific antigen In this procedure, a battery of suspected allergens is applied to the patient' s back under occlusive dressings and allowed to remain in contact with ... best performed by physicians with special expertise in patch testing and is often helpful in the evaluation of patients with chronic dermatitis FURTHER READINGS Dermatology Lexicon Project: www.futurehealth.rochester.edu/dlp2/ ... designed to assess whether a skin lesion will blanch with pressure as, for example, in determining whether a red lesion is hemorrhagic or simply blood-filled Urticaria (Fig 52-11) will blanch with...
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Chapter 077. Approach to the Patient with Cancer (Part 1) potx
... same as the prognosis of the person with aortic stenosis who develops the first symptoms of congestive heart failure (median survival, ~8 months) However, the patient with heart disease ... malfunction one step further Not only is there a failure of the cancer cell to maintain its specialized function, but it also strikes out on its own; the cancer cell competes to survive using natural ... selection to seek advantage over normal cells in a recapitulation of evolution One consequence of the traitorous behavior of cancer cells is that the patient feels betrayed by his or her body The cancer...
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Chapter 077. Approach to the Patient with Cancer (Part 3) pptx
... The past medical history may alert the physician to the presence of underlying diseases that may affect the choice of therapy or the side effects of treatment The social history may reveal occupational ... out the need to begin surveillance or other preventive therapy for unaffected siblings of the patient The review of systems may suggest early symptoms of metastatic disease or a paraneoplastic syndrome ... 77-3 Patient Management Important information is obtained from every portion of the routine history and physical examination The duration of symptoms may reveal the chronicity of disease The past...
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Chapter 077. Approach to the Patient with Cancer (Part 4) pps
... 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 size of the primary tumor ... other prognostic factors have been identified (Chaps 104, 105, and 106) In addition to tumor burden, a second major determinant of treatment outcome is the physiologic reserve of the patient Patients ... are likely to fare worse, stage for stage, than fully active patients Physiologic reserve is a determinant of how a patient is likely to cope with the physiologic stresses imposed by the cancer...
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Chapter 077. Approach to the Patient with Cancer (Part 5) doc
... physician also has much to offer the patient for 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 ... 81) Tools are now available to minimize the acute toxicity of cancer treatment New symptoms developing in the course of cancer treatment should always be assumed to be reversible until proven otherwise ... schedule greatly limit the time a physician spends with a patient who is receiving only palliative care Resist these forces In addition to the medicines administered to alleviate symptoms (see below),...
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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 Cirrhosis, ... Neuron-specific enolase Lactate dehydrogenase Small cell cancer of the lung,neuroblastoma Lymphoma, Ewing's sarcoma Hepatitis, hemolytic many others Tumor-Associated Proteins anemia, Prostate-specific ... Carcinoembryonic antigen Adenocarcinomas hepatitis Pancreatitis, of the colon, pancreas, hepatitis, lung, breast, ovary inflammatory bowel disease, smoking Enzymes Prostatic acid Prostate cancer...
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Chapter 077. Approach to the Patient with Cancer (Part 7) ppt
... most patients who are cured of cancer return to normal lives Supportive Care In many ways, the success of cancer therapy depends on the success of the supportive care Failure to control the symptoms ... nonjudgmental, so that patients are more likely to discuss with the physician what they are actually doing The appearance of unexpected toxicity may be an indication that a supplemental therapy is being ... in the course of their disease Unsound approaches are usually hawked on the basis of unsubstantiated anecdotes and not only cannot help the patient but may be harmful Physicians should strive to...
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Chapter 077. Approach to the Patient with Cancer (Part 8) potx
... on which to indicate the severity of the pain The clinical condition is often dynamic, making it necessary to reassess the patient frequently Pain therapy should not be withheld while the cause ... chemotherapy (Chap 81) Its severity can be predicted from the drugs used to treat the cancer Three forms of emesis are recognized on the basis of their timing with regard to the noxious insult Acute ... signals in the chemoreceptor trigger zone in the medulla, the cerebral cortex, and peripherally in the intestinal tract lead to stimulation of the vomiting center in the medulla, the motor center...
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Chapter 077. Approach to the Patient with Cancer (Part 11) pot
... Sexual dysfunction is highly prevalent and needs to be discussed openly with the patient An empathetic health care team is sensitive to the individual patient' s needs and permits negotiation where ... adversely affect the course of treatment Cancer survivors have other sets of difficulties Patients may have fears associated with the termination of a treatment they associate with their continued ... of vulnerability to colds and other illnesses Perhaps the most pervasive and threatening concern is the ever-present fear of relapse (the Damocles syndrome) Patients in whom therapy has been...
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Chapter 077. Approach to the Patient with Cancer (Part 12) pot
... affected by the diagnosis and is coping with it is an important goal of patient management It is best to speak frankly with the patient and the family regarding the likely course of disease These discussions ... and the goal of palliative therapy is embraced in the hope of being able to live with disease; finally, at the disclosure of imminent death, another adjustment in outlook takes place The patient ... difficult for the physician as well as for the patient and family The critical features of the interaction are to reassure the patient and family that everything that can be done to provide comfort...
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Báo cáo y học: " Pro/con clinical debate: The use of prone positioning in the management of patients with acute respiratory distress syndrome" potx
... of SAPS II Proning may benefit the most seriously ill subset of patients with acute respiratory distress syndrome Those in the quartile with the highest Simplified Acute Physiology Score II (SAPS ... injury and the acute respiratory distress syndrome N Engl J Med 2000, 342:1301-1308 Douglas WW, Rehder K, Beynen FM, Sessler AD, Marsh HM: Improved oxygenation in patients with acute respiratory failure: ... on the survival of patients with acute respiratory failure N Engl J Med 2001, 345:568-573 The ARDS Network: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute...
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Báo cáo khoa học: "Exogenous pulmonary surfactant for the treatment of adult patients with acute respiratory distress syndrome: results of a meta-analysis" pot
... Granton J, the Multicenter Oscillatory Ventilation for Acute Respiratory Distress Syndrome Trial (MOAT) Study Investigators: High-frequency oscillatory ventilation for acute respiratory distress ... abnormalities and therapeutic options Intensive Care Med 2001, 27:1699-1717 Spragg RG, Lewis J: Surfactant therapy in the acute respiratory distress syndrome In Acute Respiratory Distress Syndrome Lung ... in acute lung injury Crit Care Med 2003, 31(4 Suppl):S324-S328 Ware LB, Matthay MA: The acute respiratory distress syndrome N Engl J Med 2000, 342:1334-1349 The Acute Respiratory Distress Syndrome...
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Báo cáo y học: " KL-6 concentration in pulmonary epithelial lining fluid is a useful prognostic indicator in patients with acute respiratory distress syndrome" ppt
... probe to measure the biochemical constituents in epithelial lining fluid of patients with acute respiratory distress syndrome Crit Care Med 2001, 29(4):896-898 Ohshimo S, Yokoyama A, Hattori N, ... al.: KL-6 concentration in pulmonary epithelial lining fluid is a useful prognostic indicator in patients with acute respiratory distress syndrome Respiratory Research 2011 12:32 ... et al Respiratory Research 2011, 12:32 http:/ /respiratory- research.com/content/12/1/32 the S-S bond near the surface of the epithelial cell membrane, KL-6 can diffuse into pulmonary epithelial...
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Báo cáo y học: "Atrial natriuretic peptide infusion and nitric oxide inhalation in patients with acute respiratory distress syndrome" ppt
... assigned to each patient before the start of the protocol, according to which patients started with either ANP infusion (odd numbers) or NO inhalation (even numbers) commentary Together with each ... curve Patients were sedated with midazolam and morphine in such a way that they were unable to trigger the ventilator When necessary, they were also paralysed with pancuronium The ventilator settings ... ITTVI represents the intrathoracic thermal volume index Because we used the COLD system together with a Swan–Ganz catheter, we were also able to determine RVEDVI by the application of the following...
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Tìm thêm: xác định các mục tiêu của chương trình khảo sát các chuẩn giảng dạy tiếng nhật từ góc độ lí thuyết và thực tiễn khảo sát chương trình đào tạo của các đơn vị đào tạo tại nhật bản khảo sát chương trình đào tạo gắn với các giáo trình cụ thể xác định thời lượng học về mặt lí thuyết và thực tế khảo sát thực tế giảng dạy tiếng nhật không chuyên ngữ tại việt nam khảo sát các chương trình đào tạo theo những bộ giáo trình tiêu biểu nội dung cụ thể cho từng kĩ năng ở từng cấp độ phát huy những thành tựu công nghệ mới nhất được áp dụng vào công tác dạy và học ngoại ngữ mở máy động cơ lồng sóc mở máy động cơ rôto dây quấn các đặc tính của động cơ điện không đồng bộ đặc tuyến hiệu suất h fi p2 đặc tuyến mômen quay m fi p2 đặc tuyến dòng điện stato i1 fi p2 sự cần thiết phải đầu tư xây dựng nhà máy phần 3 giới thiệu nguyên liệu từ bảng 3 1 ta thấy ngoài hai thành phần chủ yếu và chiếm tỷ lệ cao nhất là tinh bột và cacbonhydrat trong hạt gạo tẻ còn chứa đường cellulose hemicellulose chỉ tiêu chất lượng theo chất lượng phẩm chất sản phẩm khô từ gạo của bộ y tế năm 2008 chỉ tiêu chất lượng 9 tr 25