Tuesday, December 28, 2010

Tropical Dermatology

Stephen K. Tyring, Omar Lupi, Ulrich R. Hengge - Tropical Dermatology
Ch r ,ch .l L g s to .e | ISBN: 0443067902 | 2005-05-06 | PDF | 528 pages | 134 Mb

This is a guide to the mucocutaneous manifestations of tropical diseases. Introductory chapters offer an overview of syndromal tropical dermatology and discuss issues for travelers and those working in the tropics. Protozoa, helminths, viral infections, fungal infections, bacterial infections, and ectoparasitic diseases are then covered, including discussions of epidemiology, diagnosis, differential diagnosis, pathology, laboratory tests, management, and prevention. Non- infectious conditions are also considered in chapters on nutritional diseases, fogo selvagem, pigmentary disorders, and environmental causes of dermatitis.

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SPA (Single Port Access) Cholecystectomy


Brain Stem Model - Sagittal View - Thalamus & Epithalamus


Ambulation Algorithm

1. Non-weight bearing: Patient is unable to bear weight through both lower extremities or weight-bearing through both lower extremities is contraindicated.

Partial weight bearing: This will include situations where the patient may be allowed: a) Limited weight bearing on one lower extremity and full weight bearing on the other extremity; b) Partial weight bearing through both lower extremities.

Safety risks may include: decreased cognition; decreased ability to cooperate/ combativeness; medical stability.

Factors that contribute to low safety risk: a) Lack of combativeness; b) Ability to follow commands; c) Medical stability; d) Experience with the assistive device.

Factors that contribute to high safety risk: a) Combativeness; b) Lack of ability to follow commands; c) Medical instability; d) Lack of experience with
the assistive device, e) neurological deficits.

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Acute Care Surgery: Principles and Practice

The practice of general and trauma surgery frequently involves a broad range of emergency situations. Surgeons must be familiar with diagnosis and operative management principles in the fast-paced environment of the emergency setting. Acute Care Surgery: Principles and Practice comprehensively presents the full spectrum of surgical emergencies, including trauma and non-traumatic acute surgical diseases of the abdominal, pelvic, and cardiothoracic organs as well as the extremities, skin and soft tissue, and head and neck. Management of surgical infections is also discussed. Edited by an internationally renowned trio of experts, Acute Care Surgery is the ideal reference text for surgical trainees as well as practicing surgeons. Authoritative, comprehensive, and user- friendly, the text features over 40 chapters complete with case studies as well as question and answer commentaries. Every chapter begins with a box highlighting the key points and current areas of controversy. In addition to clinically focused discussions on surgical emergencies in all the major organ systems, the editors include chapters on basic principles of initial assessment and early resuscitation, anesthesia and emergency surgery, the intensive care unit, pharmacology and pharmacokinetics in the emergency setting, and management of the hemodynamically labile patient. In addition, a timely section on ethics and legal issues discusses the challenges of providing care in the emergency setting with chapters on advanced directives, informed consents, and organ procurement. The text is augmented by more than 500 tables and illustrations. emergency surgery is destined to be the gold-standard reference for surgeons faced with split-second decision making in the acute setting.

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Anterior Sternal Dislocation

An 83-year-old man was admitted to the acute medical ward after having fallen down in his home. On admission he was confused and agitated.
Physical examination revealed a swelling with bruising over his right sternoclavicular joint (Panel A) and periorbital bruising. He had a white-cell count of 14×103 per cubic millimeter, a C-reactive protein level of 56 mg per liter, and a urinalysis that was positive for a urinary tract infection. A social history was taken and revealed no suggestion of abuse. Radiography of the chest (Panel B) showed a right sternoclavicular dislocation, which was clinically confirmed to be anterior.
Anterior sternoclavicular dislocations often result from an indirect force to the shoulder, rotating the shoulder posteriorly. The physician must always consider the possibility of abuse having caused this type of injury. The patient was treated for his urinary tract infection. His anterior sternoclavicular dislocation was treated conservatively. The confusion resolved, and after a short period of rehabilitation, he regained good function of his right upper limb.

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IDENTIFICATION of Giardia lamblia

Giardia lamblia - trophozoite
10-20 µm long by 5-15 µm wide
1. Note sucking disk.
2. Iron-hematoxylin stain
Giardiasis is diagnosed by finding cysts or trophozoites in the feces, and both life cycle stages have a characteristic appearance.

The trophozoites average 10-20 μm in length, 5-15 μm in width, have a distinct “teardrop” or “pear” shape and two nuclei at the anterior end .........


Total lap hysterectomy for previous c section

Pinna Contusion and Hematoma

Blunt external ear trauma may cause a contusion or hematoma of the pinna which, if untreated, may result in cartilage necrosis and chronic scarring or further cartilage formation and permanent deformity or "cauliflower ear." Open injuries include lacerations (with and without cartilage exposure) and avulsions.
Pinna Contusion. Contusion without hematoma is present...........

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