Tuesday, October 19, 2010

Post-operative fever, Guess what!!

We can suspect and classify the cause of post-operative fever according to it`s onset by :

Days 0 to 2: It may be
* Mild fever (T <38 °C) (Common) * Tissue damage and necrosis at operation site * Haematoma * Persistent fever (T >38 °C)
* Atelectasis: the collapsed lung may become secondarily infected
* Specific infections related to the surgery, e.g. biliary infection post biliary surgery, UTI post-urological surgery
* Blood transfusion or drug reaction

Days 3-5:
* Bronchopneumonia
* Sepsis
* Wound infection
* Drip site infection or phlebitis
* Abscess formation, e.g. subphrenic or pelvic, depending on the surgery involved

After 5 days:
* Specific complications related to surgery, e.g. bowel anastomosis breakdown, fistula formation
* After the first week
* Wound infection
* Distant sites of infection, e.g. UTI
* DVT, pulmonary embolus (PE)
Post-operative fever, Guess what


Dennovliers Fascia: Robotic Prostate Surgery


Your Radiologist Explains: Abdomen & Pelvis CT


Assessment gets by Lung function tests

Lung function tests Allows assessment of :
  1.  Lung volumes
  2.  Airway calibre
  3.  Gas transfer

Spirometry: used in assessment of Lung volumes
--Volumes measured include:
* IC = Inspiratory capacity
* IRV = Inspiratory reserve volume
* TV = Tidal volume
* VC = Vital capacity
* FRC = Functional residual capacity
* RV = Residual volume
* ERV = Expiratory reserve volume
* TLC = Total lung capacity

Peak flow rates: used in assessment of Airway calibre
* Requires co-operation and maximum voluntary effort of the patient
* Flow rates measured include
- FVC = Forced vital capacity
- FEV1 = Forced expiratory volume in one second
* Absolute values depend on height, weight, age, sex and race
* FEV1 / FVC ratio is important
* Lung function can be classified as:Normal - Restrictive - Obstructive
* In restrictive lung disease FVC is reduced but FEV1/FVC is normal
* In obstructive lung disease FVC is normal or reduced and FEV1/FVC is reduced

Gas transfer: used in measurment of Arterial blood gases
* Also allow assessment of ventilation / perfusion mismatch
* Important parameters to measure are:
  •  pH
  •  Partial pressure of oxygen
  •  Partial pressure of carbon dioxide
* Pulse oximetry gives an indirect estimate of gas transfer
* Technique is unreliable in the presence of other medical problems (e.g. anaemia)


Mushrooms Benefits on Health

Mushrooms are gaining new respect from nutritionists and medical doctors, as scientists discover that mushrooms may play a role in fighting any number of ailments from high blood pressure to infections and even cancer. After more than 15 years of researchs, American scientists finally have access to a mushroom compound called AHCC (which stands for Active Hexose Correlated Compound), which was once available only in Japan and has been used extensively by Japanese hospitals and medical clinics since its development in the mid-1980s as a safe, natural way to help support the immune system.

AHCC is obtained from a hybridization of several species of medicinal mushrooms (including Shiitake), all organically cultivated in Japan. After extensive clinical research and significant evidence supporting its effectiveness, AHCC is gaining mainstream acceptance in the United States.

“The studies have been quite amazing,” says Fred Pescatore, M.D., M.P.H., who has recommended AHCC adjunct therapy for many of his patients. “It has been shown to work well in patients with cancer, hepatitis, immunocompromised patients and liver disease.

The immune system in our body works in part by detecting and eliminating foreign cells. For people with healthy immune systems, viruses, bacteria and abnormal cells are routinely found and destroyed before any damage is done, often before the person ever feels sick. AHCC has been shown in clinical studies to safely and naturally support a healthy immune response by activating and increasing the number of certain types of immune cells, and triggering related immune reactions in the body.

The excitement among scientists is growing as research progresses. U.S. clinical trials are underway at the More-house School of Medicine and Yale University. These studies follow a number of previous studies conducted by prestigious Japanese universities.

After one such study, a human clinical study of liver cancer patients conducted at the Kansai Medical University in Osaka, Japan and published in the July 2002 Journal of Hepatology, researchers remarked that “AHCC intake resulted in improved liver function, the prevention of recurrence of hepatocellular carcinoma (HCC), and the prolonged survival of postoperative HCC patients without any adverse effect.”

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Major non-antibiotics Teratogenic drugs

Before that we will talk about some principles, first adapted by James Wilson, highlight the nature of teratogens:

Principle 1: Susceptibility to teratogenesis depends on the genotype of the embryo

Principle 2: Susceptibility to a teratogenic agent depends on the developmental stage when the exposure occurs

Principle 3: Different teratogenic agents effect developing cells and tissues in various ways

Principle 4: The final manifestations of abnormal development are death, malformation, growth retardation, and functional disorder

Principle 5: The nature of the detrimental environmental agent impacts its access to the fetus.

Principle 6: As dosage increases the manifestations of abnormal development increase in degree from the no-effect to the lethal level

TAP CAP : Is the word that collct some of the most Major non-antibiotics Teratogenic drugs

Thalidomide Androgens Progestins Corticosteroids Aspirin & indomethacin Phenytoin

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Health Care Emergency Management: Principles and Practice

Jones & Bartlett Publishers; 1 edition (June 4, 2010) | ISBN: 0763755133 | 512 pages | PDF | 4 MB

Recent research underscores a serious lack of preparedness among hospitals nationwide and a dearth of credible educational programs and resources on hospital emergency preparedness. As the only resource of its kind, Health Care Emergency Management: Principles and Practice specifically addresses hospital and health system preparedness in the face of a large scale disaster or other emergency. Administrators, emergency preparedness coordinators, and clinical staff who are charged with managing preparedness and emergency management functions for hospitals or healthcare systems will turn to this guide as an essential reference in planning for disasters, terrorism, and public health emergencies. Health Care Emergency Management is also ideal for emergency preparedness courses in programs of health administration or public health. Through case studies and practical examples, this book engages the reader in active learning about this exciting, challenging, and rewarding field. Key Features: Chapters are contributed by leading authorities on the topic of disaster planning. The only text that focuses on disaster planning for hospitals and health systems. Each chapter offers concrete objectives for focused learning as well case studies and practical examples that help the reader understand key concepts. Downloadable resources including PowerPoints and a TestBank are available for qualified instructors.

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