...What is a brain aneurysm? A brain (cerebral) aneurysm is a bulging, weak area in the wall of an artery that supplies blood to the brain. In most cases, a brain aneurysm causes no symptoms and goes unnoticed. In rare cases, the brain aneurysm ruptures, releasing blood into the skull and causing a stroke. When a brain aneurysm ruptures, the result is called a subarachnoid hemorrhage. Depending on the severity of the hemorrhage, brain damage or death may result. The most common location for brain aneurysms is in the network of blood vessels at the base of the brain called the circle of Willis. What causes a brain aneurysm? A person may inherit the tendency to form aneurysms, or aneurysms may develop because of hardening of the arteries (atherosclerosis) and aging. Some risk factors that can lead to brain aneurysms can be controlled, and others can't. The following risk factors may increase your risk of developing an aneurysm or, if you already have an aneurysm, may increase your risk of it rupturing:1 • Family history. People who have a family history of brain aneurysms are twice as likely to have an aneurysm as people who don't. • Previous aneurysm. About 20% of patients with brain aneurysms have more than one. • Gender. Women are twice as likely to develop a brain aneurysm or to suffer a subarachnoid hemorrhage as men. • Race. African Americans have twice as many subarachnoid hemorrhages as whites. • Hypertension. The risk of subarachnoid hemorrhage is greater...
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...A Hybrid Operating Suite at Community Medical Center Russell F Stahl, M.D., Carmen Sciandria, CCP, Cassandra Cuesta, BA The Evolution of Treatment of Cardiovascular Disease Surgery for coronary artery disease (CABG), valve repair and replacement, and the treatment of aortic disease, all have a remarkable history of success and evolution. Just as with computer technology, the trend in surgery has been to become smaller, faster and better. The treatment of cardiovascular disease (CVD) is moving towards less invasive and, in many cases, catheter based technologies. First interventional radiologists, then cardiologists, and now cardiac and vascular surgeons have embraced this trend. Clinicians are encouraged by outcomes that appear to be at least as good, albeit with trade-offs, and a high level of patient acceptance. Hybrid operating rooms - rooms combining operating room sterility and functionality with fixed angiography and echocardiographic imaging- are rapidly growing in prevalence and gaining increased interest from hospital administrators. These rooms are used by cardiac surgeons, vascular surgeons, interventional cardiologists, and neuro-interventionalists, and are suited for both open and closed procedures, as well as collaborative “hybrid” procedures. Given the dynamic nature of this room, these investments require thoughtful preparation operationally and logistically, especially when planning for physician and support staff that will work and cover call in this...
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...for one year and can be repeated annually. The available preventative services that are offered to all Medicare enrollees are the following: annual bone mass measurements (DEXA scan), annual cardiovascular disease behavioral therapy, cardiovascular screenings every five years (lipid panel), various colon cancer screenings, annual depression screening, a one-time EKG screening, annual influenza vaccine, a one-time pneumococcal vaccine, annual mammogram, two general preventative visits, and annual prostate cancer screenings. The preventative services that are offered to enrollees that are at high-risk or meet certain medical criteria are sexually transmitted infections screening and counseling including HIV screening, a one-time abdominal aortic aneurysm screening, alcohol misuse counseling, diabetes screening and self-management training, glaucoma tests,...
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...Occlusion; Thrombosed Popliteal Aneurysm (acute obstruction) Presenting Symptom(s): The patient’s chief complaint was left leg pain from the left knee down to the left foot. When asked the patient he was unable to appropriately respond to the question due to confusion. History of present illness: The patient is a male in his mid 70s. The patient presented with new onset left lower extremity ischemia. He was started on an IV heparin drip and transported to ED. He was found to have am occluded left popliteal aneurysm with occlusion of all tibial vessels. The patient was taken to the OR with vascular service for initiation of thrombolysis therapy. He is currently hospitalized for left lower extremity ischemia, angiogram, thrombolysis, bypass femoral popliteal thrombectomy, irrigation and debridement of wound, and a fasciotomy. Then, he was taken back to the OR for debridement of left anterolateral muscular compartment necrosis. This morning, he was noted to be “confused”. The patient was stable and oriented until at least yesterday evening. Per the primary team, he did not appear confused when seen at 6am. He was also noted to have a temperature of 37.4. He did not have any labs checked for 2 days, but this morning his labs were notable for leukocytosis of 13 from 9, hemoglobin on 6.2 from 7.6, and Na of 131 from 136. The patient denies any specific complaints, but does not appear to focus on questions. Pathophysiology: Popliteal aneurysms are defined as localized dilatations...
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...MANAGEMENT OF DELIRIUM IN THE ICU Colleen Gottlieb Erica Powell Mary Tool July 16, 2013 **think this has to be double spaced Management of Delirium in the ICU Introduction Delirium is a serious condition that can affect patients in and outside the hospital. With its presence being unknown to many nurses and providers, delirium has significant long term complications that can last well beyond discharge. Noise, medication, and infection are significant in the development and progression of delirium and these are more than abundant within intensive care patients. The importance of nurse’s knowledge cannot be stressed enough regarding the assessment, symptoms, and interventions of delirium, in an effort to decrease its occurrence and the implications thereafter. With the proper assessment and improved nursing interventions, data should display an increase in patient safety, decrease in prevalence, and reduce costs related to longer hospital stays. The state of being delirious occurs with a sudden decrease in a patient’s level of consciousness. It may be accompanied by inattention directly related to the care being given or by a change in cognition. (cite AACN practice alert) There are a variety of possible causes of delirium. These causes include: alcohol withdrawal, sepsis, pneumonia, electrolyte imbalances, liver failure, encephalitis, head trauma, meningitis, the use of many medications and abrupt withdrawal of medications. Most medical diagnosis and their possible...
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...could help prevent a great deal of possible health conditions. Athletes have a higher risk of developing a higher risk if they are predisposed. There are athletes that do not realize that they are predisposed to heart defects and that they could develop one. Table of Contents Introduction 5 Background 5 Theoretical Framework 6 Statement of the problem. 6 Research question. 6 Purpose for the study. 7 Significance 7 Limitations of the Study 7 Definitions of Terms 8 Arrhythmias 8 Athletic Career 8 Electrocardiogram 8 Hypertrophic cardiomyopathy: 8 Sudden Cardiac Death: 8 Review of Related Literature 9 What is causing the sudden death of young athletes? 9 Successful Prevention 10 Role of NCAA 11 Summary 12 Methodology 13 Design 13 Setting and Participants 13 Data Collection 14 Treatment of the Data 14 Implications for Future Research 15 References 16 Appendix A 16 Appendix B 21 Appendix C 22...
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...Assessment Data Milwaukee is the city of focus for The Final Community Health Paper. The City of Milwaukee is populated woth just under 600,000 people. Milwaukee lies along the shores and bluffs of Lake Michigan, which supplies three rivers: the Menomonee, the Kinnickinnic and the Milwaukee. Milwaukee’s lakefront resembles that of an oceanfront Lake Michigan is too large to see across. Milwaukee's terrain is relatively flat, except for steep bluffs along the lakeshore that begin about one half mile north and four miles south of the downtown. According to the United States Census Bureau, the city has a total area of 96.9 square miles. 96.1 square miles of it is land and 0.9 miles squared of it is water. Included in this graph is some basic demographic information: General Characteristics | Number | Percent | U.S. | Total population | 596,974 | | | Male | 285,363 | 47.8 | 49.1% | Female | 311,611 | 52.2 | 50.9% | Median age (years) | 30.6 | (X) | 35.3 | Under 5 years | 47,545 | 8.0 | 6.8% | 18 years and over | 425,990 | 71.4 | 74.3% | 65 years and over | 65,123 | 10.9 | 12.4% | | | | | One race | 580,824 | 97.3 | 97.6% | White | 298,379 | 50.0 | 75.1% | Black or African American | 222,933 | 37.3 | 12.3% | American Indian and Alaska Native | 5,212 | 0.9 | 0.9% | Asian | 17,571 | 2.9 | 3.6% | Native Hawaiian and Other Pacific Islander | 301 | 0.1 | 0.1% | Some other race | 36,428 | 6.1 | 5.5% | Two or more races | 16,150 | 2.7 | 2.4%...
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...I. Introduction - Shock (Chapter 11) A. Review of anatomy and physiology B. Pathophysiology Initiation | * Decreased tissue oxygenation * Decreased intravascular volume * Decreased Myocardial contractility (cardiogenic ) * Obstruction of blood flow (obstructive) * Decreased vascular tone (distributive) * Septic (mediator release) * Neurogenic (suppression of SNS) | No observable clinical indications Decreased CO may be noted with hemodynamic monitoring | Compensatory | * Neural compensation by SNS * Increased HR and Contractiliy * Vasoconstriction * Redistribution of blood flow from nonessential to essential organs * Bronchodilation * Endocrine Compensation (RAAS, ADH, glucocorticoid release) * Renal reabsorption of sodium, chloride, and water * Vasoconstriction * Glycogenolysis | * Increased HR (EXCEPT NEUROGENIC) * Narrowed pulse pressure * Rapid, deep respirations causing respiratory alkalosis * Thirst * Cool,moist skin * Oliguria * Diminished bowel sounds * Restlessness progressing to confsion * Hyperglycemia * Increased specific gravity and decreased creatinine clearance. | Progressive | * Progressive tissue hypoperfusion * Anaerobic metabolism wih lactic acidosis * Failure of sodium potassium pump * Cellular edema | * Dysrhythmias * Decreased BP with narrowed pulse pressure * Tachypnea * Cold, clammy skin * Anuria * Absent bowel sounds * Lethargy progressing...
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...the student relies less on memory and more on logical pathophysiology. The text has been updated to include current information on rapidly developing topics, such as HIV and AIDS (vaccine efforts and all the new anti-HIV medications), Ebola virus, Hantavirus, E. coli outbreaks, Mad Cow Disease, and brand-new antimicrobial antibiotics. The mnemonics and cartoons in this book do not intend disrespect for any particular patient population or racial or ethnic group but are solely presented as memory devices to assist in the learning of a complex and important medical subject. We welcome suggestions for future editions. 1) Write in a conversational style for rapid assimilation. 2) Include numerous figures serving as "visual memory tools" and summary charts at the end of each chapter. These can be used for "cram sessions" after the concepts have been studied in the text. 3) Concentrate more on clinical and infectious disease issues that are both interesting and vital to the actual practice of medicine. MARK GLADWIN, MD BILL TRATTLER, MD D CONTENTS Preface v PART 1 1 2 3 BACTERIAL TAXONOMY CELL STRUCTURES, VIRULENCE FACTORS, and TOXINS...
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...A kid with Hepatitis A can return to school 1 week within the onset of jaundice. 2. After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact. positive sweat test. indicative of cystic fibrosis 1. Herbs: Black Cohosh is used to treat menopausal symptoms. When taken with an antihypertensive, it may cause hypotension. Licorice can increase potassium loss and may cause dig toxicity. 2. With acute appendicitis, expect to see pain first then nausea and vomiting. With gastroenitis, you will see nausea and vomiting first then pain. 3. If a patient is allergic to latex, they should avoid apricots, cherries, grapes, kiwi, passion fruit, bananas, avocados, chestnuts, tomatoes and peaches. 4. Do not elevate the stump after an AKA after the first 24 hours, as this may cause flexion contracture. 5. Beta Blockers and ACEI are less effective in African Americans than Caucasians. 1. for the myelogram postop positions. water based dye (lighter) bed elevated. oil based dye heavier bed flat. 2.autonomic dysreflexia- elevated bed first....then check foley...
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...sector in the US………………………………………………………………………………………………………8 3.1 Economic Impact…..………………………………………………………………………………………………………………8 3.2 The Sector by State…..…………………………………………………………………………………………………………10 3.3 Key Institutes: Patent Applications in the Cluster Areas…..………………………………………………….13 3.4 Conclusions…..…………………………………………………………………………………………………………………….20 4. Turning research into novel medical devices………………………………………………………………………………….22 4.1 The Medical Device Development Process…..……………………………………………………………………..22 4.2 CIMIT: A Structure for Medical Device Innovation…..………………………………………………………….23 4.3 Stanford Biodesign: Innovation as a Discipline…..………………………………………………………………..26 4.4 Conclusions and Recommendations…..……………………………………………………………………………….28 5. Summary and Conclusions…………………………………………………………………………………………………………….30 6. Acknowledgements……………………………………………………………………………………………………………………….32 7. References…………………………………………………………………………………………………………………………………….33 Appendices A1 Selection of Key Institutes A2 Results Patent Analysis A3 Research Profiles 1. Introduction This report analyzes the R&D infrastructure in the United States in the field of new medical devices. It is part of the Innovative Medical Devices Initiative the Netherlands (IMDI.NL) thematic program that aims to focus the Netherlands’ R&D infrastructure for medical devices on health care demands and economic growth (1). The study is a collaboration...
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...AS Biology Unit 1 page 1 AQA AS Biology Unit 1 Contents Specification Biological Molecules Chemical bonds Carbohydrates Lipids Proteins Biochemical Tests Enzymes Eukaryotic Cells Prokaryotic Cells Cell Fractionation Microscopy The Cell Membrane Movement across Cell Membranes Exchange The Gas Exchange System Lung Diseases The Heart Coronary Heart Disease The Digestive System Cholera Lifestyle and Disease Defence against Disease Immunisation Monoclonal Antibodies 1 – Mathematical Requirements 2– The Unit 1 Exam 2 4 6 8 10 16 17 24 28 30 31 35 37 44 46 50 54 58 60 67 68 72 80 81 83 86 Cells Human Physiology Disease Appendices These notes may be used freely by A level biology students and teachers, and they may be copied and edited. Please do not use these materials for commercial purposes. I would be interested to hear of any comments and corrections. Neil C Millar (nmillar@ntlworld.co.uk) Head of Biology, Heckmondwike Grammar School High Street, Heckmondwike, WF16 0AH July 2011 HGS Biology A-level notes NCM/7/11 AS Biology Unit 1 page 2 Biology Unit 1 Specification Biochemistry Biological Molecules Biological molecules such as carbohydrates and proteins are often polymers and are based on a small number of chemical elements. • Proteins have a variety of functions within all living organisms. The general structure of an amino acid. Condensation and the formation of peptide bonds linking together amino acids to form polypeptides. The relationship...
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...Courtesy of L E K A R SPECIAL EDITION Authors: Marino, Paul L. Title: ICU Book, The, 3rd Edition Copyright ©2007 Lippincott Williams & Wilkins ISBN: 0-7817-4802-X Authors Dedication Quote Preface to Third Edition Preface to First Edition Acknowledgments Table of Contents Section I - Basic Science Review Basic Science Review Chapter 1 - Circulatory Blood Flow Chapter 2 - Oxygen and Carbon Dioxide Transport Section II - Preventive Practices in the Critically Ill Preventive Practices in the Critically Ill Chapter 3 - Infection Control in the ICU Chapter 4 - Alimentary Prophylaxis Chapter 5 - Venous Thromboembolism Section III - Vascular Access Vascular Access Chapter 6 - Establishing Venous Access Chapter 7 - The Indwelling Vascular Catheter Section IV - Hemodynamic Monitoring Hemodynamic Monitoring Chapter 8 - Arterial Blood Pressure Chapter 9 - The Pulmonary Artery Catheter Chapter 10 - Central Venous Pressure and Wedge Pressure Chapter 11 - Tissue Oxygenation Section V - Disorders of Circulatory Flow Disorders of Circulatory Flow Chapter 12 - Hemorrhage and Hypovolemia Chapter 13 - Colloid and Crystalloid Resuscitation Chapter 14 - Acute Heart Failure Syndromes Chapter 15 - Cardiac Arrest Chapter 16 - Hemodynamic Drug Infusions Section VI - Critical Care Cardiology Critical Care Cardiology Chapter 17 - Early Management of Acute Coronary Syndromes Chapter 18 - Tachyarrhythmias Section VII - Acute Respiratory Failure Acute Respiratory Failure Chapter 19 - Hypoxemia...
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...Essentials Ruth E. McCall, BS, MT (ASCP) Retired Program Director and Instructor Central New Mexico Community College Albuquerque, New Mexico President, NuHealth Educators, LLC Faculty, Emeritus Phoenix College Phoenix, Arizona Fifth Edition Cathee M. Tankersley, BS, MT (ASCP) Acquisitions Editor: Peter Sabatini Product Manager: Meredith L. Brittain Marketing Manager: Shauna Kelley Designer: Holly McLaughlin Production Services: Aptara, Inc. Fifth Edition Copyright © 2012, 2008 by Lippincott Williams & Wilkins, a Wolters Kluwer business. Two Commerce Square 2001 Market Street Philadelphia, PA 19103 351 West Camden Street Baltimore, MD 21201 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at permissions@lww.com, or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress...
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...UNIVERSITY OF THE PHILIPPINES Bachelor of Arts in Communication Research Joyce M. Aguillon Precious B. Romano SmokeCheck: A Study on the Effects of NCR Male High School Students’ Exposure to and Recall of Anti-Smoking Advertisements to Their Perceptions of and Attitudes toward Smoking Thesis Adviser: Professor Randy Jay C. Solis College of Mass Communication University of the Philippines Diliman Date of Submission April 2012 Permission is given for the following people to have access to this thesis: Available to the general public Available only after consultation with author/thesis adviser Available only to those bound by confidentiality agreement Student’s signature: Student’s signature: Signature of thesis adviser: Yes No No UNIVERSITY PERMISSION I hereby grant the University of the Philippines non-exclusive worldwide, royalty-free license to reproduce, publish and publicly distribute copies of this thesis or dissertation in whatever form subject to the provisions of applicable laws, the provisions of the UP IPR policy and any contractual obligations, as well as more specific permission marking on the Title Page. Specifically I grant the following rights to the University: a) to upload a copy of the work in these database of the college/school/institute/department and in any other databases available on the public internet; b) to publish the work in the college/school/institute/department journal, both in print and ...
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