...generally defined as the implantation of the placenta over or near the internal os of the cervix. There are four types of placenta previa; total, low-lying, partial, and marginal. The higher incidence of low-lying placenta and placenta previa is sonographically diagnosed in the second trimester and ranges from 6% to 46%. This rate, however, decreases to as low as 0.5 % at delivery (11). Despite advances in blood transfusion techniques and surgical procedures, abnormal placentation still remains a difficult challenge for obstetricians. Intrapartum maternal hemorrhage and the need for emergency cesarean section or hysterectomy related to abnormal placentation are main causes of maternal-fetal morbidity and mortality. The overall incidence of placenta previa at delivery is reported as 0.5 % in most studies (3, 5) and the risk factors for placenta previa include advanced maternal age (above 35 years), parity, smoking, and, most importantly, prior cesarean delivery. Placenta previa with prior cesarean delivery increases risk up to 1% - 4%. As the number of previous cesarean deliveries increases, the incidence of placenta previa and abnormal placentation shows a linear increase (3). Vaginal ultrasound is the most accurate method for localizing and diagnosing placenta previa, because it can provide a better resolution in the lower margin of the placenta (4, 6, 11). There is a little increase in congenital anomalies associated with placenta previa when compared to normal pregnancies, but...
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...MBA 5101 Unit 1 Case Study Gary Campbell Our text defines a tort as “a civil wrong” and negligence as “a tort, a civil or personal wrong” (Pozgar, 2012). Negligence as it is related to healthcare is an unintentional commission or omission of an act that a reasonably prudent person or organization would or would not do under normal circumstances. Not following a recognized standard of care could be considered negligence. The case I have chosen to study is one from the Circuit Court of Baltimore City Maryland and is that of Enso Martinez a minor by and through his parent (Rebecca Fielding) vs The Johns Hopkins Hospital in Baltimore Maryland July 2013. I would describe this as a landmark, “David vs Goliath” case involving medical negligence in the form of nonfeasance and malpractice. Reckless and willfulness disregard for safety is called criminal negligence and is often considered a form of gross negligence, a more serious tort (Pozgar, 2012). The question in my mind throughout the read was; “did the conduct of the provider and the hospital constitute criminal negligence”? The jury’s verdict and plaintiff’s award seemed to suggest yes. As a health professional, while I might agree with the Jury’s decision, I’m not so sure I agree with the size of the award. Did Johns Hopkins Hospital (the Hospital), negligently fail to perform a timely Caesarean section, causing Martinez to suffer from cerebral palsy, retardation, and other disorders. The following are...
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...the gene is enough to cause the disease” (para: Genetic Principles and Exceptions Thereof in Familial PD). There is some interest that DNA repair may play a factor in developing PD. According to a study published in 2012, researchers found 3 DNA repair gene variants that show association with increased risk for Parkinson’s disease (Gencer, M., Dasdemir, S., Cakmakoglu, B., Cetinkaya, Y., Varlibas, F., and Aydin, M., para: Conclusion). After doing some more research on the Parkinson’s Disease Foundation website, I found a list of multiple factors by Caroline Tanner (2011) that could contribute to the development of Parkinson’s Disease. The foundation did make it clear that even though there are outside genetic factors that could contribute to developing Parkinson’s disease symptoms, exposure alone does not cause symptoms, that there is usually an underlying genetic predisposition. “In fact, there is no conclusive evidence that any environmental factor, alone, can be considered a cause of the disease” (www.pdf.org, 2014, para: Potential Risk Factors). Exposure to the following list can increase the chance of Sporadic-PD: Age: about 1% of the population over 60 will develop some form of Parkinson’s; Gender: Parkinson’s is more common among men than women; Head Injury: these types of injuries can cause swelling to the brain tissue, which has been seen to increase the chance of developing PD later in life; Occupation: Consistent exposure to pesticides, metals, and solvents and polychlorinated...
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...The mother could be in danger of developing intracerebral hemorrhage, which is the most common cause of death to women related to preeclampsia. For those who do develop this and survive could be permanently disabled (Davidson et al., 2012, p. 463). The possibly of developing disseminated intravascular coagulation (DIC), placental abruption and possibly experiencing a fetal death adds to the stress the mothers and families are facing. After delivery, the threat of most of the complications will go away (HELLP syndrome). When a mom is presenting with symptoms of preeclampsia it is important to keep her safe and get her and her baby ready for a possible soon delivery. The mother might be given corticosteroids to help the baby’s lungs mature. She may also be given medications for her high blood pressure and some form of blood product to keep her vital signs as stable as possible (Barnett & Kendrick 2010). There is no cure for preeclampsia or HELLP syndrome but delivery of the baby will help the mother return to her...
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...who drink responsibly. Research suggests that alcoholism is a societal disease that negatively affects everyone because alcohol abuse creates higher crime rates, alcoholics cause more accidents and create higher costs in the workplace, and alcohol creates an increase in health-related issues. There is a strong correlation between alcohol use and violent crime, which is how the phrase “mean drunk” came about. People that abuse alcohol are six times more likely to commit a violent crime and thirteen times more likely to commit a crime on property (McMurran, 1999, p.219). This statistic proves that alcohol plays a role in crime against innocent people. Alcohol has long been suspected to cause anger management issues and violent crime. Many studies have been done to show how alcohol abuse disables the ability to problem solve, to read a situation, and understand consequences. Close to a third of all individuals...
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...highly complex, causing the different ethical theories to disperse in interpretation. The complexity of these dilemmas is precisely exhibited in the medical world- a world that showcases the immense “grey” area of morality and ethics. In essence, the following case studies illustrate how these theories can be manipulated to either justify or condemn moral dilemmas that arise in the medical world. Case Study #1: “But, Doctor, Our Daughter Didn’t Want This!” In the state of Kansas, a married couple, Janet and Jack, experienced the merciless and brutal facet of life. The married couple was expecting a child and one day as they were driving home from an ob-gyn appointment, a distracted elderly driver ran a red light and crashed into their car. The accident resulted in the death...
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...computer to assess movement time is another test for Parkinson's disease. To examine the electrophysiological characteristics of tremor and preclinical nigral dysfunction characteristic of Parkinson's EMG (electromyography recordings) can be used. Finally, a symptomatic screening is often utilized and consists of nine symptom related questions, as well as disease specific and drug specific questions. This provides an indirect functional measure of the nigrostriatal dopamine system. Increasing age strongly increases the risk of Parkinson's disease. Male gender and possibly Caucasian ancestry are associated with more modest increases in risk. The reported prevalence of Parkinson's disease varies widely in international community-based studies; ranging from 31 to 328 per 100,000 people. Whether these differences represent actual differences in the...
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...Primary prevention can be defined as reducing risk before a disease process occurs. In this case, primary prevention for the well being of mothers, infants, and children starts with prenatal care. This focuses on making sure that the child in utero is healthy, and if that there is something wrong, it can be caught early on. Secondary prevention deals with stopping the progression of an illness, an example of this would be a nutrition program for children who are overweight that need to get their weight under control. Tertiary prevention focuses on rehabilitation and improving quality of life for individuals who already have the disease. An example of this would be feeding clinics for children with special needs, with which parents need aid (University of...
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...1 Introduction to Clinical Applications Objectives In this chapter we will study • various approaches to the study of disease; • the role of the Centers for Disease Control and Prevention; • common causes of disease; • the distinction between signs and symptoms of disease; • terms used to describe the time course of a disease; and • common abbreviations for medical specialists and specialties. Homeostasis and Disease The body’s tendency to maintain internal stability is called homeostasis. Examples include the body’s relatively stable temperature, blood glucose concentration, hormone levels, acid-base balance, and electrolyte balance. When physiological variables deviate too much from their set point, the body activates negative feedback loops that tend to restore stability and maintain health. In some cases, such as the stoppage of bleeding, positive feedback loops are activated to bring about rapid change. If the attempt to regain homeostasis fails, disease results. There is a strong emphasis in medicine today on promoting wellness through prevention. However, this manual focuses on what happens when prevention fails, homeostasis is disrupted, and disease occurs. The Study of Disease Disease (illness) is any deviation from normal that interferes with correct, life-sustaining bodily function. Literally, the word means dis-ease, the opposite of ease (comfort and normal function). Disease may have underlying structural foundations, such as a broken bone, and its...
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...The following guidelines are intended only as a general educational resource for hospitals and clinicians, and are not intended to reflect or establish a standard of care or to replace individual clinician judgment and medical decision making for specific healthcare environments and patient situations. Guideline for the Use of Oxytocin December 2012 INTRODUCTION The benefits of labor induction and augmentation must be weighed against the potential maternal and fetal risks associated with this procedure (1). The induction or augmentation of labor may increase the likelihood of neonatal complications or result in unnecessary cesarean section. These risks may be necessary to assume in complicated pregnancies, in which prolongation of gestation presents further risk to the mother or fetus. Prior to initiating oxytocin, the patient should be counseled about the indications for the use of oxytocin, the methods of administration to be employed, and the risks of failure, cesarean delivery, or fetal compromise. A physician capable of performing cesarean section should be readily available during the induction or augmentation of labor (2). UNIT STRUCTURE Each hospital’s department of obstetrics should develop a standardized, single, universal written protocol for the use of oxytocin for labor induction or augmentation. Standardization of an oxytocin infusion protocol is recommended to reduce medication dosing error and improve patient assessment. Elements of a protocol should include (2):...
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...child during pregnancy. Because of the incompatibility, the mother's immune system may launch an immune response against the red blood cells of the fetus through the placenta, resulting in the destruction of the red blood cells (hemolysis). In the destruction of the red blood cells, the fetus can develop anemia. The red blood cell destruction ranges from mild to very severe, and fetal death from heart failure can occur, as well as life-threatening problems for future pregnancies. The Rhesus system (Rh) blood group antigen is responsible for most of the fatal cases of erythroblastosis fetalis, hence, the term Rh incompatibility disease. However, other alloimmune antigens belonging to the Kell (K and k), Duffy (Fya), Kidd (Jka and Jkb), MNSs (M, N, S, and s), Diego, Xg, P, Ee, Cc antigen systems, as well as other antigens may also produce the disease. Incompatibilities of Landsteiner (A, B and O) blood group systems do not cause erythroblastosis fetalis. A French midwife reported the first case of HDN in a set of twins, in 1609. In 1932, Diamond and colleagues described the relationship of fetal hydrops, jaundice, anemia, and erythroblasts (immature red blood cells) in the blood circulation, a condition later called erythroblastosis fetalis. Levine later determined the cause after Landsteiner and Weiner discovered the Rh blood group system in 1940. In 1953, Chown subsequently confirmed the pathogenesis...
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... Quaid - e - Azam University Dept : Animal Sciences MSc 2nd Semester Index Page # 1. Introduction 3 2. Structure and functions of liver 3,4 3. Liver Regeneration 5 4. Two layers of defense against liver injury 5 5. Dynamics of liver regeneration 6 6. Stimuli of hepatic regeneration 7 7. Regeneration by hepatocytes (1st line of defense) 8 8. Signaling networks activated after partial hepatectomy 9 9. Matrix metalloproteinase family 10 10. Recent additions 12 11. Regeneration by liver progenitor cells...
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...[pic] Term paper Stem cell therapy Irfan manzoor. Roll no: RP7002B22. Reg. no: 11000225. Course: Bsc. Biotech 1. Lovely professional university Contents 1. Stem cells and properties. 2-3 2. Stem cell therapy. 5-12 3. Stem cell use in animals 13-15 4. Recent researches in stem cell therapy 16-19 5. Conclusion 21 6. Bibliography 22 Stem cells Stem cells are cells found in all multi cellular organisms. They are characterized by the ability to renew themselves through mitotic cell division and differentiate into a diverse range of specialized cell types. Research in the stem cell field grew out of findings by Ernest A. McCulloch and James E. Till at the University of Toronto in the 1960s. The two broad types of mammalian stem cells are: embryonic stem cells that are isolated from the inner cell mass of blastocysts, and adult stem cells that are found in adult...
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...Running head: PREGNANCY TERMINATION AT WEEK 27 GESTATION Ethical Dilemma: Pregnancy Termination at week 27 Gestation Ethics: Case study week Ana Alberto Pacific College November 9, 2012 Professional Code of Ethics and client advocacy: The ethical dilemma regarding these two parents pertains to whether or not to terminate this pregnancy at 27 weeks, which is after the 24 weeks fetal viability period. Finding out a child carried to term is harmed is nothing less than jarring, to the parents, family, and physician. In this scenario we have a couple who’ve worked hard to conceive and carry a child to that point; any choices made will be very emotional. They now have to make a very big decision that can be very devastating to the family’s future. This can also be hard for the clinicians working with this family as we also have beliefs and values that can impact our ability to care for the family if the decision being...
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...into glucose (sugar) for energy The pancreas makes insulin (a hormone) to help glucose get into the cells of our body When someone has diabetes their body either doesn’t make any/enough or can’t use its own insulin as it should Glucose begins to build up in the blood Prevalence: WHO estimate in: 2000 = 177 million diabetic people 2025 = 300 million diabetic people = 9% global population IDF (international diabetes federation): 2 million diabetic people in UK with over 750,000 undiagnosed NICE: 650,000 women give birth in England & Wale each year and 2-5% (13,000-32,500) involves women with diabetes, of these: * 87.5% are Gestational Diabetes (GD) * 7.5% are Type 1 * 5% are Type 2 From 1997-2003 there was 74% rise in new cases in the UK with the West Midlands being one of the highest areas (News, 2009) Treatment: Aim: to maintain glycaemic control – regular monitoring is required Lifestyle: diet, exercise Medication – tablet or injection e.g. Insulin, rapid acting insulin analogues (Aspart, Lispro) and/or hypoglycaemic agents (Metformin and Glibenclamide) Diabetes health complications: Hypoglycaemia: Too much insulin; which can cause low blood sugar Symptoms: Paleness, shaking, hunger, sweating Specialist will advise what to do e.g. consume sugary soft drink Occasionally can cause loss of consciousness – an injection will be needed Diabetic Ketoacidosis (DKA)/Hyperglycaemia: A life-threatening complication. Near complete deficiency...
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