approach to the patient with chronic liver disease and fulminant hepatic failure
Chapter 052. Approach to the Patient with a Skin Disorder (Part 1) ppt
... assume 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 ... 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 diagnostic category than ... systemic disease For instance, the sometimes minor differences in color and shape that distinguish a melanoma (Fig 52-1) from a benign nevomelanocytic nevus (Fig 52-2) can be difficult to recognize To...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 2) potx
... conditions that can be associated with pruritus include chronic renal disease, cholestasis, pregnancy, malignancy, thyroid disease, polycythemia vera, and delusions of parasitosis Figure 52-3 A schematic ... is often the predominant symptom of inflammatory skin diseases (e.g., atopic dermatitis, allergic contact dermatitis); it is also commonly associated with xerosis and aged skin Systemic conditions ... 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...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 4) doc
... 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 of the lesions has ... noted and considered during a physical examination: the distribution of the eruption, the types of primary and secondary lesions, the shape of individual lesions, and the arrangement of the lesions ... 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 be integrated with relevant historic...
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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
... suspected allergens is applied to the patient' s back under occlusive dressings and allowed to remain in contact with the skin for 48 h The dressings are removed, and the area is examined for evidence ... (e.g., erythema, edema, or papulovesicles) This test is best performed by physicians with special expertise in patch testing and is often helpful in the evaluation of patients with chronic dermatitis ... edematous, erythematous papules and plaques are characteristic of this whealing eruption Wood's Light A Wood's lamp generates 360-nm ultraviolet (or "black") light that can be used to aid the...
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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 may ... of cancer cells is that the patient feels betrayed by his or her body The cancer patient feels that he or she, and not just a body part, is diseased The Magnitude of the Problem No nationwide ... For the interval between birth and age 39, in 72 men and in 51 women will develop cancer; for the interval between ages 40 and 59, in 12 men and in 11 women will develop cancer; and for the interval...
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Chapter 077. Approach to the Patient with Cancer (Part 3) pptx
... 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 diseases ... influence the course of disease and its treatment The family history may suggest an underlying familial cancer predisposition and point out the need to begin surveillance or other preventive therapy ... 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...
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Chapter 077. Approach to the Patient with Cancer (Part 4) pps
... disease (M0 and M1 for the absence and presence, respectively, of metastases) The various permutations of T, N, and M scores (sometimes including tumor histologic grade G) are then broken into ... 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 ... 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 during the...
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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 ... radiation oncologist, and surgeon is crucial to achieving optimal results Sometimes the chemotherapy and radiation therapy need to be delivered sequentially, and other times concurrently Surgical ... modifications of standard protocols are likely to compromise treatment results The choice of treatment approaches was formerly dominated by the local culture in both the university and the practice...
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Chapter 077. Approach to the Patient with Cancer (Part 6) pdf
... trophoblastic Pregnancy disease, gonadal germ cell tumor Calcitonin Medullary cancer of the thyroid Catecholamines Pheochromocytoma Oncofetal Antigens Alphafetoprotein Hepatocellular carcinoma, ... Carcinoembryonic antigen Adenocarcinomas hepatitis Pancreatitis, of the colon, pancreas, hepatitis, lung, breast, ovary inflammatory bowel disease, smoking Enzymes Prostatic acid Prostate cancer phosphatase ... 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...
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Chapter 077. Approach to the Patient with Cancer (Part 7) ppt
... the success of cancer therapy depends on the success of the supportive care Failure to control the symptoms of cancer and its treatment may lead patients to abandon curative therapy Of equal importance, ... should strive to keep communications open and nonjudgmental, so that patients are more likely to discuss with the physician what they are actually doing The appearance of unexpected toxicity may ... occur in patients 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- ...
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Chapter 077. Approach to the Patient with Cancer (Part 8) potx
... 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 examination The patient ... 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 ... administration of chemotherapy and represents a conditioned response to visual and olfactory stimuli previously associated with chemotherapy delivery Acute emesis is the best understood form Stimuli...
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Chapter 077. Approach to the Patient with Cancer (Part 11) pot
... contribute to the sense of vulnerability Juggling the demands of work and family with the demands of treatment may create enormous stresses Sexual dysfunction is highly prevalent and needs to be discussed ... may provide more tools in the future as cytokine-mediated mechanisms are further elucidated Psychosocial Support The psychosocial needs of patients vary with their situation Patients undergoing ... another 24 h The tube is then disconnected from suction and allowed to drain by gravity If
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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 ... 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 ... acknowledgment of an incurable disease, 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...
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Báo cáo y học: "A prospective assessment of the inter-laboratory variability of biochemical markers of fibrosis (FibroTest) and activity (ActiTest) in patients with chronic liver disease" ppt
... components, in patients with chronic liver disease, and to identify factors associated with that variability Our concern was to assess whether the analytical methods adapted on the different analyzers ... for liver biopsy both for the initial decision of liver biopsy and for the follow-up of chronic hepatitis C patients To date, liver biopsy has been considered mandatory for the management of patients ... material to standardize the assay Overall, the data from the laboratories were linearly related with the reference center with a slope close to and a non-significant analytical imprecision; there...
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Báo cáo y học: "Efficacy of Radiofrequency Ablation of Hepatocellular Carcinoma Associated with Chronic Liver Disease without Cirrhosis" pdf
... CLD without cirrhosis MATERIALS AND METHODS According to our local US screening protocol, patients with Child A/B cirrhosis and those with non-cirrhotic chronic liver disease were evaluated with ... laparotomy of previously planned resection Patients and HCC main features are summarised in Table Table Characteristics of patients with hepatocellular carcinoma (HCC) with chronic liver disease without ... all the patients according to the local ethic committee No patients refused the proposed treatment PATIENTS AND HCC CHARACTERISTICS From July 1st 1997 to June 30th 2006, 200 consecutive patients...
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Báo cáo khoa học: "A concurrent approach to the automatic extraction of subsegmental primes and phonological constituents from speech" docx
... male and female, synthetic and real with different regional accents, these cues discriminate between the simplest speech segments containing an element in a minimal combination with others In the ... in terms of total amplitude or energy distribution ED across low, middle and high frequency parts of the vocal range and the angular frequencies to( F) and amplitudes a(F) of formants The first ... Table Cues used to define signatures The other segment-based cues contrast steadystate formant values at the centre of a segment with values at entrance and exit boundary They describe the context...
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Báo cáo y học: "Hypothalamic-pituitary-adrenal stress axis function and the relationship with chronic widespread pain and its antecedent" pdf
... marked when compared to that of other chronic pain patients with less widespread symptoms, including those with rheumatoid arthritis [7] and non-inflammatory low back pain [9] These findings are ... aspects of psychological status together with a history of current pain Those who agreed to further contact by the study team were asked if they would be willing to further participate in a detailed ... antibody coated to cellulose particles followed by centrifugation and decantation of the supernatant The pellet is then counted and the amount of tracer bound is inversely proportional to the concentration...
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