Usual suspects

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Recently published papers: all the usual suspects and carbon dioxide...

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  • All kinds of processes – those that make things or deliver services or operate companies – can be made more productive, and society’s continued well-being requires it. This book is for all those with a stake in improving how companies run. It introduces the concept of “swift, even l ow” and explains how that concept stands behind popular business tools such as “lean” principles and Six Sigma. More than that, it shows how swift, even l ow can lead to deep, strategic insights and fresh ideas.

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  • This is an extraordinary book, in which I am honoured to be included, and which I am even more privileged to be able to introduce. It contains contributions from an array of the leading thinkers in the field of product liability; and it provides substantial food (non-standard, and certainly not defective) for thought for practitioners, academics and students alike.

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  • As I developed the ideas for, brought together expertise from around the world for, and edited Global Inequalities at Work, I was fortunate to have a number of people at my side. The book is far better for their contribution. I decided from the start of this project that I didn’t want to just bring together “the usual suspects.” To ensure that individuals with new and fresh ideas had an opportu- nity to become part of this project, I cast the net wide.

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  • Allopurinol Together with sulfonamides and antiepileptics, allopurinol is one of the "usual suspects" that induce frequently mild maculopapular eruptions (in at least 3% of users) and may also cause more severe reactions including hypersensitivity/DRESS and SJS/TEN. Because of increasing utilization it is one of the most frequent causes of life-threatening reactions. Anti-HIV Medications In clinical trials, combinations of highly active antiretroviral treatments were frequently associated with ≥10% "drug eruptions.

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  • SUPPOSING that Truth is a woman—what then? Is there not ground for suspecting that all philosophers, in so far as they have been dogmatists, have failed to understand women—that the terrible seriousness and clumsy importunity with which they have usually paid their addresses to Truth, have been unskilled and unseemly methods for winning a woman? Certainly she has never allowed herself to be won; and at present every kind of dogma stands with sad and discouraged mien—IF, indeed, it stands at all!...

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  • Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach (Part 18) Table 124-8 Initial Management of Genital or Perianal Ulcer Usual causes Herpes simplex virus (HSV) Treponema pallidum (primary syphilis) Haemophilus ducreyi (chancroid) Usual initial laboratory evaluation Dark-field exam, direct FA, or PCR for T. pallidum; RPR or VDRL test for syphilis (if negative but primary syphilis suspected, repeat in 1 week); culture, direct FA, ELISA, or PCR for HSV; consider HSV-2-specific serology. In chancroid-endemic area: PCR or culture for H.

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  • Using the gradient method, element concentrations within the lichen are usually observed to increase as the distance to the suspected source decreases. Gough and Erdman (1977) used linear regression to evaluate the relationship between distance from a coal fired power plant and metal levels in Xanthoparmelia chlorochroa. However, as Puckett (1988) points out, concentrations of many elements will not reach zero at large distances from pollution sources because they have essential nutritional roles or are normal components of the lichen when growing in its natural environment.

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  • Orbital Cellulitis This causes pain, lid erythema, proptosis, conjunctival chemosis, restricted motility, decreased acuity, afferent pupillary defect, fever, and leukocytosis. It often arises from the paranasal sinuses, especially by contiguous spread of infection from the ethmoid sinus through the lamina papyracea of the medial orbit. A history of recent upper respiratory tract infection, chronic sinusitis, thick mucous secretions, or dental disease is significant in any patient with suspected orbital cellulitis. Blood cultures should be obtained, but they are usually negative.

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  • Clinical Manifestations of Sickle Cell Trait Sickle cell trait is usually asymptomatic. Anemia and painful crises are exceedingly rare. An uncommon but highly distinctive symptom is painless hematuria often occurring in adolescent males, probably due to papillary necrosis. Isosthenuria is a more common manifestation of the same process. Sloughing of papillae with urethral obstruction has been reported, as have isolated cases of massive sickling or sudden death due to exposure to high altitudes or extremes of exercise and dehydration.

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  • The accuracy of a biopsy depends on the expertise of the clinician. If a decision not to do a complete excision is made, partial biopsy specimens are usually taken from the most deeply pigmented, elevated, nodular, or other clinically suspect area. However, as a result of sampling error or a lack of correlation between the clinical and histological features, the portion biopsied may not be the most histologically representative portion of the lesion (Ng, Barzilai et al. 2003). Ng et al (Ng, Barzilai et al.

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  • The major clinical symptom of parasitic gastroenteritis is severe diarrhoea. Diarrhoea may result from other causes such as sharp changes in diet, especially at the beginning of the rains. Parasitic gastroenteritis may, however, be linked to the rains through an upsurge in parasite burden at this time. In acute cases of diarrhoea, there is severe loss of body fluid and minerals resulting into rapid loss of body weight and condition. Parasitic diarrhoea can usually be cured by broad-spectrum anthelmintics used strategically.

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  • In Ménière's disease, the direction of the fast phase is variableVertigo may be a manifestation of a migraine aura (Chap. 15), but some patients with migraine have episodes of vertigo unassociated with their headaches. Antimigrainous treatment should be considered in such patients with otherwise enigmatic vertiginous episodes. Vestibular epilepsy, vertigo secondary to temporal lobe epileptic activity, is rare and almost always intermixed with other epileptic manifestations.

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  • Virus-Associated Malignancies In addition to malignancy associated with gammaherpesvirus infection (EBV, KSHV) and simple warts (HPV), other tumors that are virus-associated or suspected of being virus-associated are more likely to develop in transplant recipients, particularly those who require long-term immunosuppression, than in the general population. The interval to tumor development is usually 1 year. Transplant recipients develop nonmelanoma skin or lip cancers that, in contrast to de novo skin cancers, have a high ratio of squamous cells to basal cells.

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  • Deep Soft-Tissue Infections: Treatment Once necrotizing fasciitis is suspected, early surgical exploration is both diagnostically and therapeutically indicated. Surgery reveals necrosis and inflammatory fluid tracking along the fascial planes above and between muscle groups, without involvement of the muscles themselves. The process usually extends beyond the area of clinical involvement, and extensive debridement is required. Drainage and debridement are central to the management of necrotizing fasciitis; antibiotic treatment is a useful adjunct (Table 130-3), but surgery is lifesaving.

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  • SUPPOSING that Truth is a woman—what then? Is there not ground for suspecting that all philosophers, in so far as they have been dogmatists, have failed to understand women—that the terrible seriousness and clumsy importunity with which they have usually paid their addresses to Truth, have been unskilled and unseemly methods for winning a woman? Certainly she has never allowed herself to be won; and at present every kind of dogma stands with sad and discouraged mien—IF, indeed, it stands at all! For there are scoffers who maintain that it has fallen, that all dogma lies on the ground...

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  • Diagnostic Tests The choice of diagnostic tests should be guided by the history and the physical examination. Measurements of serum electrolytes, glucose, and the hematocrit are usually indicated. Cardiac enzymes should be evaluated if myocardial ischemia is suspected. Blood and urine toxicology screens may reveal the presence of alcohol or other drugs. In patients with possible adrenocortical insufficiency, plasma aldosterone and mineralocorticoid levels should be obtained.

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  • Quadriparesis or Generalized Weakness Generalized weakness may be due to disorders of the CNS or of the motor unit. Although the terms quadriparesis and generalized weakness are often used interchangeably, quadriparesis is commonly used when an upper motor neuron cause is suspected, and generalized weakness when a disease of the motor unit is likely. Weakness from CNS disorders is usually associated with changes in consciousness or cognition, with spasticity and brisk stretch reflexes, and with alterations of sensation.

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  • Acute Monoparesis If the weakness is predominantly in distal and nonantigravity muscles and not associated with sensory impairment or pain, focal cortical ischemia is likely (Chap. 364); diagnostic possibilities are similar to those for acute hemiparesis. Sensory loss and pain usually accompany acute lower motor neuron weakness; the weakness is commonly localized to a single nerve root or peripheral nerve within the limb but occasionally reflects plexus involvement.

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  • The use of a reference standard consisting of colposcopy and directed biopsy served two purposes. The treatment decision was supposed to be based on colposcopic impression (with lab results coming later to identify any cancers that might have been missed) to reduce the number of visits and the loss to follow-up care. However, district hospital staff usually preferred to wait for the biopsy result to come back before offering treatment. Second, the use of colposcopy allowed comparison to conventional cytology and the evaluation of the proposed triage methods: VIA, VILI, and VIAM.

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