balancing day sheets and end of month figures

... practices and standardization of care Participants reported that standardizing care within professions may facilitate opportunities for interprofessional referrals, that guidelines and care standards ... Treatment and prognosis; (3) Chest pain as a chronic, multifactorial, or comorbid condition; (4) Interprofessional coordination of care; (5) Best practices and standardization of care; and (6) ... chest pain, that the path of referral for chest pain will depend on the nature of the condition and the urgency of the situation, that the point of referral may depend on the familiarity or relationship...

Ngày tải lên: 25/10/2012, 10:06

... recommendations, details of how they were developed, and reviews of the evidence they were based on A quick reference guide – a summary of the recommendations for healthcare professionals ‘Understanding ... N2116 (‘Understanding NICE guidance’) NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales This ... irrespective of the underlying cause, is helpful and practical for both non-specialist healthcare professionals and patients However, condition-specific recommendations and research recommendations...

Ngày tải lên: 31/03/2014, 13:20

... active recreational pursuits Pain and fatigue are both independent predictors of loss of participation in activities such as recreation and hobbies [5] Studies of valued life activities demonstrate ... combinations of pain, pain management, psychosocial, and arthritis, and the search was limited to studies of adults and the English language Studies needed to measure pain as an outcome and employ ... Clinical trials of psychosocial interventions and arthritis pain A systematic review and meta-analysis of cognitive-behavioral and psychoeducational interventions found 25 trials of sufficient...

Ngày tải lên: 09/08/2014, 08:23

... critically and provided valuable inputs with regard to the management of the patient and final version of the draft All authors read and approved the final manuscript Author Details 1Department of Medicine, ... scan on day eight showed resolution of the gastric and portal venous air (Figure 3) Our patient was finally discharged home on oral proton pump inhibitors on day 10 A follow-up EGD two months ... showed no sequelae and our patient remained asymptomatic Figure Scout film showing air along the greater curvature of the stomach ures and 2) There was marked dilatation of the small and large bowel...

Ngày tải lên: 11/08/2014, 12:20

... weight, and exercise Combinations of oral agents and the use of oral agents plus insulin are often required and frequently constitute the standard of care With this foundation in place, and optimal ... Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado School of Medicine, Denver, Colorado Howard N Hodis, M.D Associate Professor of Medicine and Preventive ... elevated HbA1c and exacerbation of hyperlipidemia Many of the metabolic derangements typical of diabetes can be understood in terms of a few seminal actions of insulin The dependence of acetyl CoA...

Ngày tải lên: 14/08/2014, 07:20

... disturbance of endothelial function results in increased synthesis of growth factors and adhesion molecules, proliferation of matrix and smooth muscle cell, and increased expression of PAI-1 gene ... resistant individuals, and had normal fasting and post-glucose-challenge plasma glucose and insulin and mean plasma triglycerides of 1.50 mmol/L (133 mg/dL) and plasma HDL cholesterol of 1.16 mmol/L ... prevented the inactivation of insulin on GSK-3 and the activation of p90RSK, p70S6K, and the MAP-kinases (64) The activation of protein kinase B (PKB) is Recognition and Assessment of Insulin Resistance...

Ngày tải lên: 14/08/2014, 07:20

... stimulates the synthesis of vasoconstrictor prostaglandins, endothelin, and ACE Moreover, hyperglycemia induces endothelial cell collagen IV and fibronectin synthesis Increased activity of enzymes involved ... mean of years of follow-up, the Data and Safety Monitoring Committee of the ABCD trial recommended that the nisoldipine treatment be terminated because of the higher incidence of fatal and nonfatal ... population ages and as obesity and sedentary lifestyles become more prevalent The coexistence of diabetes and hypertension causes a very high risk for the development of macrovascular and microvascular...

Ngày tải lên: 14/08/2014, 07:20

... Furthermore, the severity of the dyslipidemia, independent of glycemic control, is an indicator of the presence of genetic causes of the dyslipidemia that are independent of the DM This can also ... cardiac death) The rupture of an atherosclerotic plaque initiates coagulation and adhesion of platelets because of exposure to blood of luminal surfaces denuded of endothelium and hence to constituents ... and thrombin-mediated formation of fibrin from fibrinogen Generation of thrombin depends on activation of procoagulant factors and is limited by antithrombotic factors and inhibitors A marker of...

Ngày tải lên: 14/08/2014, 07:20

... accentuation of postprandial lipemia, and the accumulation of TGrich lipoproteins throughout the day Both insulin resistance and compensatory hyperinsulinemia, significantly and independently, predict ... concentration of 126 mg/dL and the 2-h OGTT value of 200 mg/dL and both of these levels correlate well with the appearance of microvascular complications of diabetes including retinopathy, nephropathy, and ... compensatory hyperinsulinemia, and a cluster of related abnormalities, all of which increase risk of CHD, was identified and designated as syndrome X In the remainder of this section, the evidence...

Ngày tải lên: 14/08/2014, 07:20

... vasoconstriction, and increased sodium resorption by the kidneys Additional effects of nitric oxide, including inhibition of growth and migration of vascular smooth muscle cells and attenuation of the vascular ... development of hypertension by virtue of their characteristic obesity and insulin resistance However, the presence of systolic and/ or diastolic elevations in blood pressure are not a uniform feature of ... 10% of women of reproductive age (1,2), making it one of the most common endocrine disorders in this age group Insulin resistance and hyperinsulinemia appear to be central to the pathogenesis of...

Ngày tải lên: 14/08/2014, 07:20

... composite endpoint of death and MI in 12,562 patients with acute coronary syndromes who were randomized to aspirin plus clopidogrel and compared with aspirin alone for up to months of blinded ... technology and of adjuvant therapy is likely to benefit both diabetic and nondiabetic patients Results from ongoing, randomized clinical trials will improve our understanding of the pathogenesis and ... circulating lipids, and alterations in insulin resistance and insulin levels in the pathogenesis of the arterial wall changes of atherosclerosis and in the precipitation of clinical cardiovascular...

Ngày tải lên: 14/08/2014, 07:20

... England (NNE) experience (33) and from the randomized BARI study (5,35) (From Ref 33.) tors such as LAD involvement, lesion length and complexity, number of lesions, and decreased LV function tend ... 10% of total calories, polyunsaturated fat less than 10% of daily calories, and monounsaturated fat in the range of 10% to 15% of daily calories is recommended For patients with type diabetes and ... further restriction of saturated fat to 7% of total calories and dietary cholesterol to less than 200 mg per day is recommended The amount of fat that a patient chooses to consume is often linked not...

Ngày tải lên: 14/08/2014, 07:20

... of type II diabetes in the offspring of diabetic parents Ann Intern Med 1990; 113:909–915 About the Editors BURTON E SOBEL is Amidon Professor and Chair of the Department of Medicine and Professor ... evolution and occlusion of vessels often reflect precipitous and often repeated rupture of vulnerable atherosclerotic plaques Thus, rupture of vulnerable plaques is the most common proximate cause of ... Professor of Medicine and Director of the Vascular Biology Unit at the University of Vermont College of Medicine, Burlington, Vermont He is the author or coauthor of more than 50 publications and...

Ngày tải lên: 14/08/2014, 07:20

... Executive Dean, Faculty of Health Sciences, University of Queensland Director, Centre of National Research on Disability and Rehabilitation Medicine, University of Queensland Professor of Pain Medicine; ... Associate Professor Gwendolen Jull Professor Peter Brooks Professor Nicholas Bellamy Acute Neck Pain Professor Nikolai Bogduk Dr Philip Bolton Associate Professor Gwendolen Jull Professor Nicholas ... University of Queensland, funded by the Commonwealth Department of Health and Ageing, and approved by the following organisations: • • • • • • • • Australian and New Zealand College of Anaesthetists,...

Ngày tải lên: 21/02/2014, 11:20

... eclaration of interest and management of potential conflict of interest 143 D SUMMARY OF PRINCIPLES AND RECOMMENDATIONS .146 REFERENCES 148 INDEX 156 >4 LIST OF FIGURES ... because of the lack of current research, Annex Research agenda was developed International requirements for the handling and procurement of morphine and other opioid analgesics for the relief of pain ... recommended course of action and only a small proportion would not; • clinicians: most patients should receive the recommended course of action and adherence to this recommendation is a measure of...

Ngày tải lên: 07/03/2014, 04:20

... epidemiology of chronic LBP (Andersson et al 1993, Cassidy et al 1998) One involved a survey of a sample of 2184 Canadian adults between 20 and 69 years of age and revealed that, in the months preceding ... average age of 65 years and reported a relatively high likelihood of night pain, aching character of symptom manifestation, spontaneous onset of symptoms, history of cancer, standing and walking ... is indicated and/ or to evaluate the effectiveness of an intervention These tests essentially involve the assessment of symmetry of bony landmarks, quantity and quality of regional and segmental...

Ngày tải lên: 08/03/2014, 14:20

... Providing advice and information is an important part of this The aim of the recommended treatments and management strategies is to reduce the pain and its impact on the person’s day- to -day life, even ... guideline – all the recommendations, details of how they were developed, and reviews of the evidence they were based on For printed copies of the quick reference guide or ‘Understanding NICE guidance’, ... and quote: • N1865 (quick reference guide) • N1866 (‘Understanding NICE guidance’) NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and...

Ngày tải lên: 31/03/2014, 13:20

... Assessment of breathing • • • • • • • • • • • Conscious level, mental state and speech Respiratory rate and pattern Arterial oxygen saturation Depth and symmetry of chest expansion Accessory muscles of ... American College of Cardiology, American Heart Association and European Society of Cardiology Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac ... an anesthetist and ENT surgeon Unconscious patient Respiratory arrest Inspiratory stridor Gurgling Grunting/ snoring Above causes Tongue and soft tissues of oropharynx Inhalation of foreign body,...

Ngày tải lên: 10/08/2014, 18:21

... causes of respiratory failure Nasal cannulae Depends on the O2 flow rate and ventilatory minute volume; L/min gives an FiO2 of roughly 25–30% Concentration of O2 delivered Prevents rebreathing and ... Association of Poisons Centres and Clinical Toxicologists Position paper: gastric lavage Clin Toxicol 2004; 42: 933–43 American Academy of Clinical Toxicology, European Association of Poisons Centres and ... 12.5) if symptoms of liver damage (nausea and vomiting >24 h after ingestion, right subcostal pain and tenderness) or abnormal liver function tests (LFTs) Reassess clinical status and LFTs (Table...

Ngày tải lên: 10/08/2014, 18:21