Saturday, July 31, 2010

Emergency Management of Infectious Diseases

576 pages
Publisher: Cambridge University Press; 1 edition (June 30, 2008)
Language: English
ISBN-10: 052187176X
ISBN-13: 978-0521871761

Infectious disease ranks only behind trauma in the prevalence of cases seen on a daily basis in the emergency room and takes lives from every culture and socioeconomic class. The changing epidemiology of infectious diseases is a considerable challenge to any physician, as acute, nearly eradicated, and tropical diseases now enter American emergency rooms on a daily basis. This book is a new clinically oriented reference book for the management of such infections in the emergency room and focuses on all diagnostic protocols and treatment strategies that emergency room physicians need to be proficient when managing patients battling infectious disease. The orientation of the book is uniquely organ-based, with coverage of all viral, bacterial, fungal, and parasitic disease. The narrative is supplemented with explanatory photos, diagnostic tables, and charts of drug regimens and will prove an invaluable reference for physicians confronting the various manifestations of infectious disease.


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Atlas of Human Anatomy - Netter 4th edition

640 pages
Publisher: Saunders; 4 edition (July 13, 2006)
Language: English
ISBN-10: 1416036997
ISBN-13: 978-1416036999

Netter’s Atlas of Human Anatomy is the most loved and best selling anatomy atlas in
the English language. In over 540 beautifully colored and easily understood illustrations, it teaches the complete human body with unsurpassed clarity and accuracy. This new edition features 57 revised, 200 relabeled and 17 wholly new plates, drawn fully in the tradition of Frank Netter, and includes more imaging and clinical images than ever before. * Includes uniquely informative drawings that allow you – and have allowed generations of students - to learn structures with confidence. * Associates normal anatomy with an application of that knowledge in a clinical setting. * Offers a strong selection of imaging to show you what is happening three dimensionally in the human body, the way you see it in practice.

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complete arcus senilis ( gerontoxon )

Image Comments:

The arcus senilis usually starts inferiorly and then appears superiorly. In some cases the two arcs will meet at 9:00 o'clock and 3:00 o'clock as in the photo. There may be a recessive inheritance aspect.
By the way an arcus senilis is not usually related to serum lipids or cholesterol.

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A cutaneous side effect of intravenous fluorouracil infusion

This 61-year-old man with recently diagnosed, inoperable esophageal squamous-cell carcinoma was treated with induction chemotherapy combining cisplatin and fluorouracil and concurrent radiotherapy. Because of worsening renal function, the use of cisplatin was suspended, and the chemotherapy was shifted to weekly high-dose fluorouracil and leucovorin. After the seventh infusion of fluorouracil–leucovorin, thrombosis developed in the right jugular and subclavian veins. This venous thrombosis prohibited further use of the permanent tunneled central-infusion catheter. The eighth infusion of fluorouracil–leucovorin was administered continuously over a 24-hour period by means of a peripheral catheter in the left forearm.

A day later, the patient noticed a mildly stinging rash that traced the path of the injected chemotherapeutic agents. Over the next few days, this erythema spread centripetally and became brown (arrows). This condition, known as serpentine supravenous hyperpigmentation, is a cutaneous side effect of intravenous fluorouracil infusion that is thought to result from extravasation of the cytotoxic agent after endothelial damage, causing epidermal basal hyperpigmentation and dermal melanin incontinence. Unlike tender, clot-forming thrombophlebitis, serpentine supravenous hyperpigmentation is characterized by underlying vessels that are patent.
Other chemotherapeutic agents, such as vinorelbine, fotemustine, and docetaxel, have also been found to cause serpentine supravenous hyperpigmentation. This complication is self-limiting and can be prevented by avoiding, if possible, peripheral infusion of these chemotherapeutic drugs, as well as fluorouracil. In this patient, the serpentine supravenous hyperpigmentation faded and had completely resolved 2 months after diagnosis.

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