... Management is mostly symptomatic. Raynaud's phenomenon can be treated with calcium channel blockers while proton pomp inhibitors are given for gastric reflux. Low doses of corticosteroids with immunosuppressive agents may be needed in cases with progressive lung fibrosis. Pulmonary vasodilators are given in case of pulmonary arterial hypertension.(17) Regarding lung involvement in Systemic Sclerosis,the decision about whether to start treatment or not is often the most difficult challenge for the pulmonologists. Patients having a short duration of disease with recent deterioration in DLCO are candidates for immunosupressive therapy.(71) Various drugs including...
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...I. INTRODUCTION A. Number of cases/Statistic data of the disease A.1 Statistics Accurate pre-eclampsia statistics are difficult to obtain because the condition ranges from extremely mild to severe. Mild cases are sometimes not included in official figures. Furthermore, mild cases may have no effect on pregnancy, which is why the figures for pre-eclampsia as a whole are higher than for those that actually complicate pregnancies. Around 10% of pregnant women develop pregnancy-induced hypertension (high blood pressure) or pre-eclampsia (high blood pressure with protein in the urine).Worldwide more than four million women per year will develop pre-eclampsia, and over 63,000 maternal deaths are due to pre-eclampsia. Action on Pre-Eclampsia estimates that every year in the UK pre-eclampsia is responsible for the deaths of six mothers and 500 to 600 babies. A 2005 to 2006 study showed a promising fall in the numbers of women developing eclampsia since 1992, from 4.9/10,000 to 2.7/10,000. This has arisen as a result of the introduction of management guidelines for eclampsia and pre-eclampsia. Pre-eclampsia is much more common in first pregnancies, and there is a reduced incidence of pre-eclampsia in the second pregnancy. The risk of women who have had pre-eclampsia developing it again in future pregnancies is 16 percent, and 25 percent if they suffered from severe pre-eclampsia, eclampsia or they delivered pre-term. This rises to 55 percent if their baby was delivered before...
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...procedure and hope to one day work in this area. Pre operative mortality is the most feared outcome of bariatric surgery, it is reported to happen between 0.5 ad 1.5% of patients. In this article it identifies mortality fore either open or laparoscopic Roux-en-y bypass. The database is from Virginia Commonwealth university and was queried for patients who had undergone either an open gastric bypass (O-GBP) or a laparoscopic gastric bypass (L-GBP). A multivariate logistic regression analysis to identify factors related to perioperative mortality was performed. The factors examined included was age, gender, body mass index, preoperative weight, hypertension, diabetes mellitus, sleep apnea, obesity hypoventilation syndrome, venous 3. Analysis of a Research Report Article stasis ulcers, intestinal leak, small bowel obstruction, and pulmonary embolus. The data was found to find independent factors related to early death. Early death was defined as death that occurs within 30 days of the initial procedure or as a direct result of a complication of the original procedure (Annals of Surgery p3). In this article tables were used to compare demographic information of the O-GBP and L-GBP groups. The O-GBP has a higher incidence of male gender and heavier patients. Except for diabetes mellitus, that is found in the L-GBP, the incidence of the rest of the recorded comorbid conditions is significantly higher in the O-GBP group. The rates of life threatening...
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...------------------------------------------------- Hypertensive emergency From Wikipedia, the free encyclopedia A hypertensive emergency is severe hypertension (high blood pressure) with acute impairment of an organ system (especially the central nervous system, cardiovascular system and/or the renal system) and the possibility of irreversible organ-damage. In case of a hypertensive emergency, the blood pressure should be substantially lowered over minutes to hours with an antihypertensive agent. Contents [hide] * 1 Treatment * 2 Incidence * 3 Definition * 3.1 Hypertensive emergency as a generic term * 4 Pathophysiology * 5 Mortality * 6 Clinical history * 7 References * 8 See also | ------------------------------------------------- [edit]Treatment Several classes of antihypertensive agents are recommended and the choice for the antihypertensive agent depends on the cause for the hypertensive crisis, the severity of elevated blood pressure and the patient's usual blood pressure before the hypertensive crisis. In most cases, the administration of an intravenous sodium nitroprusside injection which has an almost immediate antihypertensiveeffect is suitable but in many cases not readily available. In less urgent cases, oral agents like captopril, clonidine, labetalol, prazosin, which all have a delayed onset of action by several minutes compared to sodium nitroprusside, can also be used. It is also important that the blood pressure is lowered not too...
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...Chronic Obstructive Pulmonary Disease (COPD; Emphysema) Pathophysiology Abakyereba Kwansemah June 4, 2014 Abstract D.Z.is a 65-year-old man admitted to medical ward with an exacerbation of chronic obstructive pulmonary disease (COPD; emphysema). Past medical history (PMH) indicates hypertension (HTN), well managed with enalapril (Vasotec) past six years, diagnosis (Dx) of pneumonia yearly for the past three years. D.Z. appears cachectic with difficulty breathing at rest. Patient reports productive cough with thick yellow-green sputum. He seems anxious and irritable during subjective data collection. He states, he has been a 2-pack-a-day smoker for 38 years. He complains of (c/o) insomnia and tiredness. His vital signs (VS) are 162/84, 124, 36, 102° F, SaO2 88%. Admitting diagnosis is chronic emphysema with acute exacerbation. Admitting orders includes: diet as tolerated; out of bed with assistance; oxygen (O2) to maintain SaO2 of 90%; maintenance IV of D5W at 50 ml/hr.; intake and output (I&O); arterial blood gases (ABGs) in AM; CBC with differential, basic metabolic panel (BMP), and theophylline (Theo-Dur) level on admission; chest x-ray (CXR) q24h; prednisone 60 mg/day PO; doxycycline 100 mg PO q12h x10 days, azithromycin 500 mg IV piggyback (IVPB) q24h x2 days then 500 mg PO x 7 days; theophylline 300 mg PO bid; heparin 5000 units SC q12h; albuterol 2.5 mg (0.5 ml) in 3 ml normal saline (NS) and ipratropium 500 mg by nebulizer q4-6h;...
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...Abstract This paper will present with a patient’s case study revelations throughout her recent heath problems. It will discuss the patient’s underlying disease of diabetes mellulitiis. The six body systems affected by this disease will be discussed and the major pathophysiologic concepts within each system will be elaborated on. Our Patient’s Case Study Revelelations Our patient is a 62 year old female with cellulitis of her right lower leg. This patient has a history of smoking three packs a day for 40 years and unfortunately has admitted to smoking again. She has high blood sugar; however, she cannot remember the name of the medication she is taking for it. She has a “touch” of high blood pressure and claims she controls her hypertension by eating a low salt diet. Her husband passed away 14 years ago and she states that she misses him very much. As the weeks continue, our patient is experiencing dyspnea upon rising in the morning. She has bilateral diminished lung sounds along with crackles. Our patient’s condition continues to worsen and she is diagnosed with congestive heart failure. She is complaining of pain in her extremities and abdomen. Her lab work shows azotemia, red blood cells and protein in her urine, and elevated blood glucose level. The fluid buildup continues in her lungs and her urine output is minimal. Heart failure and fluid volume excess seems evident, as well as, her renal system appears to be impaired. Underlying Disease This patient’s...
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...1. The first thing that we would ask the patient is about his sleeping habits. How many hours a night are you sleeping? How often do you get up during the night? Do you have any medical conditions or take any medications? By obtaining a complete health history on the patient we will be better equipped to make a nursing diagnosis. VS and O 2 saturation Pertinent medical history: lung diseases such as asthma or emphysema, diabetes mellitus, hypothyroidism Environmental factors: wood-burning stove, animals in the home (especially birds and cats) Pertinent nasal problems: deviated septum, chronic sinusitis Allergies: particularly airborne particles such as animal dander, dust mites, cockroach droppings Medications he is currently taking: opioids, modafinil (Provigil), amphetamines (prescribed and illegal), OTC drugs, and herbals 2. The two main types of sleep apnea are Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). OSA is the more common type and is usually a result of obesity. Obstructive sleep apnea occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue. When the muscles relax, your airway narrows or closes as you breathe in, and you can't get an adequate breath in. This may lower the level of oxygen in your blood. Your brain senses this inability to breathe and briefly rouses you from...
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...Lab report As part of my module Nip1002 I was required to perform a set of observational skills which included; pulse, blood pressure, respirations, hand washing and urinalysis and then compare them to previous results. In this lab report I am going to discuss blood pressure in detail. Procedure * Explain the procedure to the patient and gain consent * Wash hands thoroughly following the hand wash technique to prevent the transfer of bacteria * Clean equipment e.g. blood pressure cuff and stethoscope using antibacterial wipes * Ensure the patient is comfortable and has been resting for 10 minutes * Remove tight clothing and support the arm at heart level, overestimation or underestimation can occur if it is not at the appropriate level * Ensure you have the correct cuff size for the patient or this could give an inaccurate reading * Locate the brachial artery and apply the cuff * Estimate the systolic pressure by using the radial pulse and inflate the cuff until the pulse cannot be felt. This is important to provide an estimation and avoids error in reading. * To take the patient’s blood pressure use a stethoscope and place on the brachial artery pulse and inflate 20-30 mmHg higher than the estimated systolic pulse * Immediately release the pressure using the thumb valve at approximately 2mmHg per second. If it is deflated too rapidly you may not hear the sounds accurately * The systolic pressure is the level when clear tapping sounds...
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...Therefore as a treatment option, L-arginine can be administered to individuals with SCA as a nitrogen donor for nitric oxide, which increases blood flow by dilating the blood vessels (Morris et al, 2003). The increased blood flow helps counteract the effects pulmonary hypertension. The enzyme arginase trumps nitric oxide production when arginine concentration is low (Morris et al, 2003). The arginine rate is limited when synthesizing nitric oxide. L-arginine therapy can also improve pulmonary arterial pressures in collaboration with hydroxyurea (Morris et al, 2001; Steinberg 2003). When treating SCA, the implementation of gene therapy presents a challenge because clinicians are not fully proficient in replacing an abnormal sickle cell gene with a normal gene (Scutti, 2017). Along with gene therapy, arginine therapy is a promising intervention that warrants further research. However, on their own, gene therapy nor arginine supplementation are adequate enough to stop the sickling process. A combination of treatments are recommended for increased...
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...-philTitle : a study of morbidity nutrition and socio-economic character of the young smoker and non smoker. Introduction: Smoking is a practice in which a substance most commonly tobacco is burned and the smoke is tested or inhaled. This is primarily practiced as a route of administration for recreational use. The available absorption of tobacco through the lungs. The most common method of smoking today is through cigarettes. Primarily industrially manufactured but also hand rolled from loose tobacco. & rolling paper. It has been suggested that smoking related disease like hypertension, chronic obstructive pulmonary disease , asthma, heart failure, diabetes are causer of more than one half of all long time smokers. But the disease may also be contracted by non- smoker. It is already proved that heart disease, hypertension, diabetes & many of lungs pathology are responsible for smoking. The prevalence of smoker in the age group between 18 years to 25 years is very high is Bangladesh. Most of them are the college & university going students associated with the people those are illiterate & lived below the poverty line. These people take smoking is a process of recreation. So it is the high time to think about the bad affects of smoking in general for both smokers & non-smokers. Objectives 1. To find out the morbidity of a smoker beside non-smoker. 2. Find out the health status of smoker beside non-smoker. 3. Economical, social, psychological...
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...Pneumonia Case Study August 27th, 2014 Mrs. Yolanda Bone South University Pneumonia Case Study A major cause of morbidity and mortality is Pneumonia. Pneumonia is a lung infection caused by bacteria, fungi or viruses (Center for Disease Control, 2014).The infection is classified into two categories; community-acquired pneumonia (CAP) or health care-associated pneumonia (HCAP). The classification is determined by the environment in which the infection develops (CDC, 2014). HCAP develops during or following a stay in a healthcare facility. In contrast, patients who are diagnosed with CAP have had no contact within a health care setting prior to presenting with the infection (Driver, 2012). Pneumonia may be present as a mild illness but has the potential to be life-threatening. Despite advances in research, pneumonia remains a common illness contributing to the death of young children in developing countries and the elderly population of developed countries throughout the world (Ruuskanen, et al., 2011). In 2010, approximately 50,000 people in the U.S. died after developing the infection (CDC, 2014). From a global perspective, 450 million cases of pneumonia are recorded annually and roughly 4 million of those diagnosed will die from this illness (Ruuskanen, et al., 2011). CAP is the eighth-leading cause of death within the U.S. and is the leading cause of death from infection in the developed world (Brown, et al., 2012). While anyone is susceptible to contracting...
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...Central University of Technology, Bloemfontein Early detection and prevention of Chronic Kidney Disease Contents page Definition of key terms used in the assignment Abbreviations used in the assignment Introduction Chronic Kidney Disease, a condition characterised by a gradual loss of kidney function. CKD is often misdiagnosed owing to the lack of knowledge about the disease. With early detection and prevention of the progression of the disease CKD patients can still enjoy life to the fullest while they manage their disease, however if the healthcare professionals fail to identify the disease on time the patient can suffer dire consequences. Besides the financial implications associated with the disease, there are the emotional implications together with physical and psychological. This assignment seeks to explore such implications in an effort to highlight the importance of early detection and prevention of kidney disease, with the best interest of the patient at heart Background Normal kidney anatomy http://doctorstock.photoshelter.com/image/I000096SqkYwaLhE The bean-shaped kidneys lie in retroperitoneal position in the superior lumbar region. Extending approximately from T12 to L3, the kidneys receive some form of protection from the lower part of the rib cage (E.N. Marieb, K Hoehn, 2010) The kidneys functions can be divided into two, non-excretory functions and excretory functions. Under excretory we have Glomerular filtration, Tubule...
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...Critical Care Case Study Crystal Meyer Mohave Community College Nursing 222 Mrs. Michelle Christensen April 1, 2014 Critical Care Case Study ADMISSION TC is a 61-year-old English speaking Caucasian female born on April 29, 1952. She weighs 99.7 Kg and is 5 feet, 5 inches in height with a BMI of 35.84. On March 5, 2014, TC was brought into the emergency department after her daughter-in-law called 911 when she found TC unresponsive at home in her bathroom. When paramedics arrived, she was found to be cool, pale, and diaphoretic with oxygen saturations in the high 70’s. Emergency responders placed a non-rebreather high flow oxygen mask and her oxygenation began to improve with saturations in the low 90’s. Upon arrival to the emergency department, TC’s vital signs were as follows: T 97.4; P 97; BP 120/95 mm Hg; RR 15 per minute; and O2 sats of 98% via NRB oxygen mask on 8L. A chest x-ray (CXR) revealed no abnormality and lungs were determined to be grossly clear. However, TC was checked for a pulmonary embolism via a pulmonary artery angiogram with IV contrast and found to have a large clot burden with a small saddle embolism. TC also complained of right ankle pain. An X-ray of her right ankle revealed a distal tib/fib fracture, which was presumed to be related to her fall during her hypoxic episode. With these findings, TC was admitted to the Intensive Care Unit of Kingman Regional Medical Center and placed on an NPO diet in preparation for placement of an inferior vena...
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...diomyopathy Topic presentation on Cardiomyopathy Topic presentation on Cardiomyopathy INDEX S.N | CONTENT | PG.NO | 1 | Introduction | 5 | 2 | Definition Cardiomyopathy | 5 | 3 | Classification | 6 | 4 | Risk Factors | 7 | 5 | Clinical Manifestations | 7 | 6 | Diagnostic Evaluation | 7-9 | 7 | Dilated CardiomyopathyDefinition,Charecteristics,Types , Causes,Diagnostic Evaluation,Pathophysiology,Clinical Manifestations,Medical Management | 10-17 | 8 | Hypertrophic CardiomyopathyIncidence,Causes,Charecteristics,Clinical Manifestations,Medical And Nursing Management | 18-21 | 9 | Restrictive Cardiomyopathy-Other Names,Causes,Pathophysiology,Clinical Manifestations,Diagnostic Evaluation,Medical Management | 23-26 | 10 | Surgical management | 27-32 | 11 | Prevention | | 12 | Nursing Management,Home Care Management | 32-40 | 13 | Complications | 40-42 | 14 | Conclusion | 42 | 15 | Research Abstract | 42-43 | 16 | References | 44 | GENERAL OBJECTIVE: On completion of the course the students aquires indepth knowledge regarding cardiomyopathy and able to apply this knowledge with a positive attitude. SPECIFIC OBJECTIVE: On completion of the course the students are able to ...
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...The Diaphragm and Congenital Diaphragmatic Hernia The diaphragm is a commonly misunderstood body part. Those who sing appreciate it purely due to their ability to control the diaphragm to enhance their singing. However, its real purpose in the human body is more important than that. The diaphragm plays such a crucial role in everyday life to the extent that one cannot survive without it. In this paper we will consider the role of the diaphragm through its anatomy and physiology. We will then review a congenital birth defect known as Congenital Diaphragmatic Hernia (CDH) and how it changes the anatomy and physiology of the body. We will also look at current research and prognosis of the disease in an effort to gain a better understanding of this often-fatal defect. The diaphragm is located almost centrally in the body. It is a continuous sheet of muscle that spreads across the bottom of the rib cage creating a divide between the thoracic cavity and the abdominal cavity. As detailed in the text Gray’s Anatomy, the convex upper surface of the diaphragm faces the thorax and forms the bottom of the thoracic cavity. The concave inferior surface is pointed towards the abdomen and is mostly covered in peritoneum forming the superior part of the abdominal cavity. The right side of the diaphragm is superior to the right lobe of the liver, the right kidney, and the right adrenal gland. The left side of the diaphragm lays over the left lobe of the liver, the fundus of...
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