Xem 1-20 trên 470 kết quả Several patients
  • Death and Dying The most common causes of death in patients with cancer are infection (leading to circulatory failure), respiratory failure, hepatic failure, and renal failure. Intestinal blockage may lead to inanition and starvation. Central nervous system disease may lead to seizures, coma, and central hypoventilation. About 70% of patients develop dyspnea preterminally. However, many months usually pass between the diagnosis of cancer and the occurrence of these complications, and during this period the patient is severely affected by the possibility of death. ...

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  • Pain Pain occurs with variable frequency in the cancer patient: 25–50% of patients present with pain at diagnosis, 33% have pain associated with treatment, and 75% have pain with progressive disease. The pain may have several causes. In ~70% of cases, pain is caused by the tumor itself—by invasion of bone, nerves, blood vessels, or mucous membranes or obstruction of a hollow viscus or duct.

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  • Adjunctive treatments may reduce morbidity and mortality and include dexamethasone for bacterial meningitis; intravenous immunoglobulin (IVIg) for TSS and necrotizing fasciitis caused by group A Streptococcus; low-dose hydrocortisone and fludrocortisone for septic shock; and drotrecogin alfa (activated), also known as recombinant human activated protein C, for meningococcemia and severe sepsis.

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  • Prevalence of severe mental distress and its correlates in a population-based study in rural south-west Uganda Eugene Kinyanda1*, Laban Waswa1, Kathy Baisley2 and Dermot Maher1,2 Abstract Background: The problem of severe mental distress (SMD) in sub-Saharan Africa is difficult to investigate given that a substantial proportion of patients with SMD never access formal health care. This study set out to investigate SMD and it’s associated factors in a rural population-based cohort in south-west Uganda.

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  • The Acutely Ill Patient: Treatment In the acutely ill patient, empirical antibiotic therapy is critical and should be administered without undue delay. Increased prevalence of antibiotic resistance in community-acquired bacteria must be considered when antibiotics are selected. Table 115-1 lists first-line treatments for infections considered in this chapter. In addition to the rapid initiation of antibiotic therapy, several of these infections require urgent surgical attention.

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  • Sepsis with Skin Manifestations (See also Chap. 18) Maculopapular rashes may reflect early meningococcal or rickettsial disease but are usually associated with nonemergent infections. Exanthems are usually viral. Primary HIV infection commonly presents with a rash that is typically maculopapular and involves the upper part of the body but can spread to the palms and soles. The patient is usually febrile and can have lymphadenopathy, severe headache, dysphagia, diarrhea, myalgias, and arthralgias.

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  • Purpura Fulminans (See also Chaps. 136 and 265) Purpura fulminans is the cutaneous manifestation of DIC and presents as large ecchymotic areas and hemorrhagic bullae. Progression of petechiae to purpura, ecchymoses, and gangrene is associated with congestive heart failure, septic shock, acute renal failure, acidosis, hypoxia, hypotension, and death. Purpura fulminans has been associated primarily with N. meningitidis but, in splenectomized patients, may be associated with S. pneumoniae and H. influenzae.

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  • Brain Abscess (See also Chap. 376) Brain abscess often occurs without systemic signs. Almost half of patients are afebrile, and presentations are more consistent with a space-occupying lesion in the brain; 70% of patients have headache, 50% have focal neurologic signs, and 25% have papilledema. Abscesses can present as single or multiple lesions resulting from contiguous foci or hematogenous infection, such as endocarditis. The infection progresses over several days from cerebritis to an abscess with a mature capsule.

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  • Inhalational Anthrax (See also Chap. 214) Inhalational anthrax, the most severe form of disease caused by Bacillus anthracis, had not been reported in the United States for more than 25 years until the recent use of this organism as an agent of bioterrorism (Chap. 214). Patients presented with malaise, fever, cough, nausea, drenching sweats, shortness of breath, and headache. Rhinorrhea was unusual. All patients had abnormal chest roentgenograms at presentation. Pulmonary infiltrates, mediastinal widening, and pleural effusions were the most common findings.

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  • Carotid stenting is less invasive than endarterectomy, but it is unclear whether it is as safe in patients with symptomatic carotid-artery stenosis. Methods We conducted a multicenter, randomized, noninferiority trial to compare stenting with endarterectomy in patients with a symptomatic carotid stenosis of at least 60%. The primary end point was the incidence of any stroke or death within 30 days after treatment.

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  • Infectious diseases continue to represent a major diagnostic and therapeutic challenge in the critical care unit. Infectious diseases maintain their preeminence in the critical care unit setting because of their frequency and importance in the critical unit patient population. Since the first edition of Infectious Diseases in Critical Care Medicine, there have been newly described infectious diseases to be considered in differential diagnosis, and new antimicrobial agents have been added to the therapeutic armamentarium.

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  • (BQ) Ebook 100 Cases in Acute Medicine presents 100 acute conditions commonly seen by medical students and junior doctors in the emergency department, or on the ward, or in the community setting. A succinct summary of the patient's history, examination, and initial investigations, including photographs where relevant, is followed by questions on the diagnosis and management of each case.

     

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  • (BQ) Ebook 100 Cases in Orthopaedics and Rheumatology presents 100 scenarios commonly seen by medical students and junior doctors in orthopaedic and rheumatology clinics, or in the emergency department. A succinct summary of the patient's history, examination and initial investigations, with clinical and/or imaging photographs, is followed by questions on the diagnosis and management of each case.

     

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  • Vitamin C can be transported into the cell either as its reduced form or dehydroascorbate (oxidized form), using active sodium-dependent transporters (SVCT1 and SVCT2) and facilitative glucose transporters (GLUTs) (André et al., 2010). GLUTs also permit the permeation of vitamin C into mitochondria.

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  • Non-invasive Breslow index determination would allow one-time procedure for melanoma clinical management which would be of utmost medical interest for several reasons: unimpaired sentinel lymph node status, low morbidity, pain and stress associated to surgical excision margins. However, as explained throughout the current chapter, such a determination requires melanoma diagnosis prior to Breslow determination.

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  • Over the past several years U.S. EPA’s Office of Reinvention has been involved in a number of “regulatory responsiveness” initiatives. These include the Common Sense Initiative, Project XL, and Pollution Prevention in Permitting Program (P4). In working with a variety of businesses in the context of these initiatives, certain project participants noted that corporate manufacturing strategies and initiatives often produced substantial resource productivity enhancements (that translate directly into improved environmental performance).

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  • One way in which agencies work together is by adopting a program known as local mutual aid. This program allows neighboring communities to pool resources and share liability for damages or loss of equipment. If one community needs a particular piece of equipment, it may borrow it from a neighboring community. The equipment will become an asset of the borrowing community and will be covered under their insurance until it is released and returns to its home organization.

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Three novel beta-galactosidase gene mutations in Han Chinese patients with GM1 gangliosidosis are correlated with disease severity

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  • Several figures in this primer show the cumulative percent change in private health insurance or health insurance premiums (Figures 11, 15, and 20). These cumulative increases may vary from figure to figure because different years are used, the data sources differ, and what is being measured varies.

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  • "Market orientation," may actually encompass several different approaches to the strategic alignment of the organization with the external environment. This article develops a market orientation typology matrix as a pedagogical and heuristic tool to summarize these distinct approaches. Specifically, firms can decide to focus primarily on either competitors or customers as the situation dictates, or perhaps attempt the difficult task of simultaneously monitoring both with equal emphasis.

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