general nursing management of the patient with a cast

... surgery, approximately 40 percent of patients with a retinal detachment have had prior cataract extraction.73 Cataract patients with extracapsular cataract extraction (ECCE) and intraocular lens ... Retinal Dialysis A retinal tear that occurs at the ora serrata, concentric with the ora, is called a retinal dialysis Most of these tears are less than 90 degrees, and they are rarely bilateral The ... retina appears more red than the surrounding retina, and the apex of the tear almost always points to the Retinal tufts are small areas of gliotic degeneration of the retina associated with vitreous...

Ngày tải lên: 22/03/2014, 09:20

... 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 diagnostic ... 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, ... raised, often translucent lesion >0.5 cm in diameter Wheal: A raised, erythematous, edematous papule or plaque, usually representing short-lived vasodilatation and vasopermeability Telangiectasia:...

Ngày tải lên: 06/07/2014, 20:20

... and are caused by scratching 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 ... or character Sites on hair-bearing areas may be characterized by destruction of hair follicles Table 52-3 Common Dermatologic Terms Alopecia: Hair loss; it may be partial or complete Annular: ... 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...

Ngày tải lên: 06/07/2014, 20:20

... 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 membranes of the mouth, ... 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 ... 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 been established,...

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 ... skin 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 ... 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 ... 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

... 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 sometimes relatively ... or saucerized with a scalpel or removed by punch biopsy In the latter technique, a punch is pressed against the surface of the skin and rotated with downward pressure until it penetrates to the ... 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 elements...

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, ... 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 evaluation of ... 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...

Ngày tải lên: 06/07/2014, 20:20

... Clinical Management of Adult Patients with NSAID-Induced Urticaria/Angioedema 10 Pastorello E, Zara C, Riario-Sforza GG, et al Atopy and intolerance of antimicrobial drugs increase the risk of reactions ... cyclooxygenase; NSAID nonsteroidal anti-inflammatory drug; PAD propionic acid derivatives Asero, Clinical Management of Adult Patients with NSAID-Induced Urticaria/Angioedema an increase in cardiovascular ... urticaria patients with NSAID intolerance and patients with AERD are characterized by elevated baseline urinary LTE4 levels and found that such levels are markedly increased by aspirin administration.27,28...

Ngày tải lên: 08/08/2014, 21:20

... histiocytoma, two cases each of myxofibrosarcoma and high-grade leiomyosarcoma, and one case of clear cell sarcoma were diagnosed Four of the seven cases of synovial sarcoma, two of the three cases of alveolar ... one case of synovial sarcoma (Figure 1) and one case of alveolar soft part sarcoma showed calcification on plain radiographs In all three cases of alveolar soft part Figure A plain radiograph ... form the basis of a diagnosis According to Lawrence et al [3], approximately 50% of soft tissue sarcoma patients are diagnosed at about months after patient recognition, and an additional 20% are...

Ngày tải lên: 09/08/2014, 03:22

... Neither of our patients showed a significant lower flow after a median follow-up time of 22 months, and no further operation was necessary in either case Neither patient showed complications of ... urethral stricture was found Biodegradable grafts seem to be an ideal solution for the repair of the urethra as well as other segments of the urinary tract SIS acts like a framework for the host-tissue ... (Figures 2B and 3B) The percutanous cystostomy catheter was removed on day 25 in both patients Postoperative uroflowmetry performed on the first patient on day 25 revealed a maximal uroflow of 49.1ml/sec...

Ngày tải lên: 11/08/2014, 17:21

... initial management of the patient and reviewed the manuscript NS was the senior author responsible for the management of the patient References Figure Antero-posterior radiograph of hand Antero-posterior ... Lateral radiograph of hand debridement and washout was performed The wound was then reviewed after 48 hours and a delayed primary closure performed The patient had regained good hand function and ... penetrating injury by a door handle has not previously been described in the literature A debridement procedure and antibiotic cover are generally the essence of primary management The use of broad...

Ngày tải lên: 11/08/2014, 19:21

... benzodiazepines are traditionally poorly tolerated in the older population and are associated with an increased half-life and a higher association of paradoxical reactions, agitation, and disequilibrium ... spasticity, ataxia, heat intolerance, fatigue, pain, and bowel and genitourinary dysfunction As the patient with MS ages, morbidities and p ­ hysiological changes associated with the normal aging ... However, patients with MS are imaged frequently and the increased risk may reflect an increase in detection Although patients with MS may have a lower risk of cancer than the general population, they...

Ngày tải lên: 22/03/2014, 14:20

... length of the fatty acid on the acyoxyacyl group to be mainly 15, confirming the result of the compositional analysis In the minor triacylated lipid A, the fragmentation patterns of the parent ion at ... mass spectrum revealed the presence of a monophosphoryl lipid A (Fig 3A) The molecular mass heterogeneity can be explained by the degree of acylation and the chain length of the fatty acid The ... OPS-rich fraction (30%) Mainly two sugars, Rha and Man, were detected in the OPS-rich fraction on analysis of the sugar constituents (Table 1) The approximate molar ratio of Rha to Man was : Absolute...

Ngày tải lên: 31/03/2014, 23:20

... Sauerbruch LGH, et al: Littoral cell angioma as a rare cause of splenomegaly Ann Hematol 2001, 80:45 Oliver-Goldaracena JM, Blanco A, Miralles M, Martin-Gonzalez MA: Littoral cell angioma of the ... LCA’s association with malignancies of visceral organs or immune-mediated disorders in about one-third of the reported cases Our case presentation supports the assumption of an association of ... the final diagnosis Generally thought to be benign, there are additional reports of LCA with malignant features which were divided into a low-grade variant (littoral cell hemangioendothelioma...

Ngày tải lên: 09/08/2014, 02:21

... drainage A presumptive diagnosis of necrotizing fasciitis of the left thigh was made, and the patient was immediately taken to the operation room A wide debridement of the external fascia was ... reported case highlights the importance of the removal of the primary tumor in an aymptomatic patient as an attempt to avoid concomitant serious complications Retroperitoneal abscess and NF are rare ... complications of colorectal cancers that can potentially be fatal, particularly in patients who are immunocompromised because of chemotherapy In the presence of these unclear risk factors, accurate...

Ngày tải lên: 09/08/2014, 04:21

... Assessment of patient satisfaction by means of the PASS criteria can be approached in a number of ways: satisfaction at the end of a study period, time taken to achieve patient satisfaction, or time taken ... variables – OA pain, patient' s global assessment of disease activity, and WOMAC™ LK 3.1 Function – was originally estimated using the least square means obtained from an analysis of covariance with ... Research & Therapy Vol No Dougados et al Figure Patient' s global assessment of disease activity (a) Percentage of patients considering their state as satisfactory according to Patient Acceptable activity...

Ngày tải lên: 09/08/2014, 10:20

... this article as: Papandreou et al.: Primary osteosarcoma of the urinary bladder treated with external radiotherapy in a patient with a history of transitional cell carcinoma: a case report Journal ... review of the literature Arch Pathol Lab Med 2001, 125:793-795 10 Kato T, Kubota Y, Saitu M, Yaguchi H, Sasagawa I, Nakada T, Yuda F: Osteosarcoma of the bladder successfully treated with partial ... 2Department of Pathology, General Hospital of Arta, Greece 3Department of Radiology, General Hospital of Arta, Greece Authors’ contributions CP was involved in patient care, review of literature and...

Ngày tải lên: 11/08/2014, 11:23

... fractures of the left femur, left radius and ulna, the latter managed operatively Open reduction and internal fixation was decided for the fracture of the humerus under general anaesthesia (GA) ... fracture is seen in all three types but is a major complication in the autosomal dominant form because of the normal life span of patients in this category [5] Most of the fracture patterns are ... drill was used to attain the right diameter A plate of sufficient length was used to reach beyond the area of the stress line It was possible to achieve a secure hold with all the screws After...

Ngày tải lên: 11/08/2014, 19:21

... erythema, paresthesia and increased sweating Most commonly it is associated with an intrathoracic malignancy, which can be carcinoma of the lung as well as pulmonary metastasis of other tumors and ... mortum examination confirmed the clinical diagnosis There was a large undifferentiated non-small cell lung carcinoma with a diameter of 10 cm and extension in the adventitia of the esophagus and lymphatic ... osteoarthropathy was made with the prostate cancer as an "innocent" bystander Since the patient was rapidly deteriorating palliative care was given The patient died several weeks after admission Post...

Ngày tải lên: 11/08/2014, 23:21