...Review Transition to Professional Nursing Practice NUR 230 Research Article Review The authors DeMille, Deming, Lupinacci, and Jacobs published the research article entitled, “The Effect of the Neutropenic Diet in the Outpatient Setting: A Pilot Study” The authors aim was to discover if prescribing a neutropenic diet to patients receiving care in an outpatient setting was beneficial in reducing fevers in those patients. They also sought to find out how compliant these patients would be with a neutropenic diet and what the resulting number of positive blood cultures for gram-negative rods would be among the participants using or not using the diet. This article was interesting to me because I did a case study on patient with severe aplastic anemia with resulting pancytopenia, who was also being administered the immune suppressant, Cyclosporine. This patient was severely immune compromised and part of his neutropenic precautions was a neutropenic diet. This diet was easy to provide while he was hospitalized but I was curious about when a patient is discharged do they still follow the strict diet? This article gave me some answers and some insight to my questions. This study of the effects of a neutropenic diet in outpatients was geared toward patients who had neutropenia, the study defines neutropenia as an “absolute neutrophil count (ANC) of less than 1,000/mm3” (DeMille, 2006). The study criteria required patients who were between the ages of 18 to 70 years old who...
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...This quote is similar to another "I know just enough to be dangerous". Again this means in some areas you may need to take precautions to stay out of danger. The way I see It is some people will think they understand a subject fully, when in reality they only know an imperceptible amount. They will then use their minimal knowledge, perhaps developing an ongoing thirst for knowledge for themselves causing a calamitous effect waiting to happen. An example to demonstrate this is Marie Curie's situation. Curie knew that she was in search for Radium and she knew how to isolate it however, she wasn’t aware of the consequences of working with radioactive substances for a long period of time. This eventually led to the disastrous effect of aplastic anemia. There weren't any safety measures during her time. Curie's incomplete knowledge of Radium had caused her to die. There are numerous factors that determine whether or not learning is a dangerous thing. Perhaps a little knowledge may benefit some people. For example abecedarian knowledge of first aid is vital when you are in a situation with somebody who has an injured leg. You may not be trained professional but inherent knowledge could save a life. Another example is basic NHS leaflets. The NHS publish leaflets with simple information about a whole range of diseases. The main objective is to know the few symptoms of a life threatening condition. Once an individual (with no previous medical training) is aware of these symptoms...
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...cell syndrome. Sickle-cell disease Classification and external resources Figure (A) shows normal red blood cells flowing freely through veins. The inset shows a cross section of a normal red blood cell with normal haemoglobin. Figure B shows abnormal, sickled red blood cells log jamming, sticking and accumulating at the branching point in a vein. The inset image shows a cross-section of a sickle cell with long polymerized HbS strands stretching and distorting the cell shape. ICD-10 D57 ICD-9 282.6 OMIM 603903 DiseasesDB 12069 MedlinePlus 000527 eMedicine med/2126 oph/490ped/2096 emerg/26emerg/406 MeSH C15.378.071.141.150.150 GeneReviews • Sickle-cell disease Sickle-cell disease (SCD), or sickle-cell anaemia (SCA) or drepanocytosis, is a hereditary blood disorder, characterized by red blood cells that assume an abnormal, rigid, sickle shape. Sickling decreases the cells' flexibility and results in a risk of various complications. The sickling occurs because of a mutation in the haemoglobin gene. Individuals with one copy of the defunct gene display both normal and abnormal haemoglobin. This is an example of codominance. Life expectancy is shortened. In 1994, in the US, the average life expectancy of persons with this condition was estimated to be 42 years in males and 48 years in females,[1] but today, thanks to better management of the disease, patients can live into their 70s or beyond.[2] Sickle-cell disease occurs more commonly among people...
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...Chloramphenicol is a bacteriostatic antibiotic which inhibits protein synthesis by reversibly binding to the 50S subunit of the bacterial ribosome thus preventing aminoacyl-tRNA binding. It is active against gram-positive and negative organisms, but ineffective against Pseudomonas aeruginosa.6 It is widely used in Australia, New Zealand and many more countries however there is some hysteria in the USA discouraging its use due to the rare association of fatal aplastic anaemia with topical medication. The association between use of chloramphenicol and aplastic anaemia has not been proven, however caution has been given to its use in patients with a family history of chloramphenicol drug induced aplastic anaemia. It has other uncommon local effects such as hypersensitivity and stinging and is therefore considered a safe drug for topical use.11 Oral therapy is the mainstay of treatment as there is better penetration to meibomian glands than topical medication. Tetracyclines and erythromycin are the most commonly used oral antimicrobials and in some cases, long-term treatment may be called for. In the treatment of rosacea, targeting blepharitis can be achieved with Doxycycline. It is normally given as a 3 month course of 100mg daily,2 however other sources suggest a longer period of treatment including taper, starting with...
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...HEME CLASS QUESTONS 1. Q: A 48 y/o alcoholic male presents to your primary care office c/o diarrhea that began 1 week ago. Patient admits to eating fast food 3 times day. During the exam you note yellow sclera and glossitis, lab findings show MCV>100. What are you suspecting to be the cause of his symptoms? a) folate deficiency b) B12 deficiency c) hereditary spherocytosis d) thalassemia e) lipid deficiency A 2. 67 yo homeless, white male patient was brought to ED by local EMTs. Pts stuporous, HR: 120, regular BP: 160/90 and RR: 10 non-labored. While inspecting the patient, you notice upper extremity peripheral jaundice, rosacea, finger clubbing and rhinophyma. On futher exam, JVD and LE edema is visible with palpable splenomegaly and hepatomegaly. As a part of your work up, you order a CBC with diff, which reveals normocytic, hypochromic red cells and a decreased reticulocyte count. Your CBC work up reveals the patient's likely cause of anemia. ANSWER: alcoholic with anemia of chronic disease. 3. Pregnant 28 year old female brought into the ER by her husband because she was exhibiting neuro symptoms of stupor, bloody diarrhea, and abdominal pain. On further observation patient is in renal failure, has microangiopathic hemolytic anemia, and severe HTN. You ran labs on your patient and discovered she has low thrombocytes, low haptoglobin, high reticulocyte count, high LDH and creatinine, schistocytes on peripheral smear. What would you diagnose the...
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...Anemia is a condition which occurs when there is not enough healthy red blood cells or hemoglobin. Hemoglobin is the main component of red blood cells (RBC) and binds oxygen. If there is not enough hemoglobin, the cells in the body do not receive enough oxygen what can cause anemia. Anemia is one of the most common diseases of the blood. Increased risk of anemia relates to women, children and people with chronic diseases. The major cause of anemia is deficiency of iron. There is a variety of reasons causes anemia,such as : * Certain clinical effects, like bleeding from the intestine or gut * Coeliac and Crohn’s disease * Pregnancy * Heavy menstrual periods * Thalassaemia * Leukaemia * Bone marrow problems * Kidney failure * Rheumatoid arthritis * Hormonal troubles * Improper diet * Surgery * Injury or accident Most common symptom of anemia is weakness and fatigue. Person who is anemic can find it hard to do some activities that need physical strength ,and even into normal chores. The other symptoms and signs which can help in recognizing anemia are: * Palpitations * Cold hands and feet * Memory loss * Altered taste * Depression * Low blood pressure * Shortness of breath * Pale and dull skin * Sore gums and throat The main aim in treating anemia is rebuilding the supply of red blood cells in the body. To achieve this level we can incorporate different diet supplements...
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...1. Musculoskeletal system :joint pain, muscle ache. 2. Urogenital system:Acute kidney injury, 3. Hematological system: anaemia, 4. Respiratory system:Acute respiratory distress 5. Cardiovascular system: enlarged heart and palpitations. CAUSES OF SICKLE CELL DISEASE. Sickle cell anemia is known majorly to be caused by gene mutation of the normal cell structure of the Red blood cell but this can always be precipitated by the following factors as follows: 1. Local tissue hypoxia 2.Dehydration secondary to a viral illness by parvovirusB19, or nausea and vomiting, all of which lead to hypertonicity of the plasma, may induce sickling. 3.Acidosis 4. Infection 5. Exposure to cold 6. Alcohol intoxication 7. Psychosocial stress and pregnancy can increase the sickling process.(medscape2017) SIGNS AND...
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...opportunity to also attend Sorbonne University. This education led to Curie’s many jobs. One of her first jobs was working at a lab with her new husband, Pierre Curie, here she discovered the elements radium and polonium. These discoveries won her, and Pierre, a Nobel Prize in 1903. Soon after winning the Nobel Prize her husband, Pierre, died. This tragic death, however, opened up a job opportunity for her to teach as a professor at Sorbonne University; Curie being the first women to do so. In 1911, Curie also won a second Nobel Prize in chemistry. Curie then spent time from 1920 to 1930 working on a radium institute. Curie soon became too weak to work and and later died as a result of her work. At age sixty-six Marie Curie died of aplastic anaemia, a disease caused by exposure to radioactivity. Marie Curie contributed greatly to modern science. She discovered both Polonium and Radium, along with extensive work with the x-ray. This work granted her two Nobel Prizes and a well known name in modern day sciences. One of the most important parts of Marie Curie’s life was her scientific work, in which she was completely dedicated to throughout all of her years. In December of 1898, Curie announced her discovery of the new element called Radium. However, the element was not official to the science world because it had no hard evidence. For proof, she spent four years finding the atomic mass with the mineral pitchblende. The mineral itself was very expensive, but Curie negotiated...
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...Demographics The exact number of people in any country with anemia is difficult to determine because the disorder often goes undiagnosed. According to the National Heart, Lung, and Blood Institute (NHLBI), anemia affects more than 3 million Americans. Other sources estimate that 4% of men and 8% of women in the general populations of Canada, the United States, and Western Europe have mild anemia. It is thought that the rates of anemia are 2-5 times higher in the developing countries. According to the World Health Organization (WHO), iron deficiency is the most important nutritional disorder in the world. WHO, estimates that 80% of the world's population may be iron deficient. The prevalence of vitamin B12 deficiency among the geriatric population is estimated at 5-15%. Although the prevalence of anemia is greater in women than men aged less than 75, by age 75, male prevalence surpasses female prevalence by about 5%. Anemia can be mild, moderate, or severe enough to lead to life-threatening complications. More than 400 different types of anemia have been identified, many of which are rare. Iron deficiency anemia The onset of iron deficiency anemia is gradual and, at first, there may not be any symptoms. The deficiency begins when the body loses more iron than it derives from food and other sources. Because depleted iron stores cannot meet the red blood cell's needs, fewer red blood cells develop. In this early stage of anemia, the red blood cells look normal but they are...
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...be given a lump sum of advantages. According the website of insurance info (http://www.insuranceinfo.com.my/_system/media/downloadables/medical_and_health_takaful.pdf), the Medical and Health Takaful plan cover the benefits of hospitalization, visit by doctors, ambulance services, intensive care unit, pre-hospitalization visits, outpatient treatment, surgery, anesthetic, and death benefits. Insurance info’s website also claims that there are 36 critical illnesses that covered by the plan of critical illness which is heart attack, blindness, kidney failure, terminal illness, Acute Bacterial Meningitis, Apallic syndrome, Multiple Sclerosis, deafness, loss of speech, major burns, Coronary artery bypass surgery, Parkinson’s Disease, Aplastic Anaemia, Benign brain tumour, Chronic liver disease, major organ transplant, occupationally acquired HIV infection, and brain surgery. The Medical and Health Takaful can be joined by a person through individual plan or group plan. Individual plan is the plan which a person joins the plan on himself or herself while the group plan means that a plan either employer or employees personally devote to the takaful fund. The example of the Medical and Health Takaful is ‘HealthEnrich’ which provided by PRUDENTIAL BSN TAKAFUL. According to the website of PRUDENTIAL BSN TAKAFUL (https://www.prubsn.com.my/index.php?mm=caring_for_you&sm=familytakaful&pg=healthenrich), ‘HealthEnrich’ is a medical rider plan which participants contribute regularly and...
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...Chronic Obstructive Pulmonary Disease | INTRODUCTION We are doing a case study on medical, nursing, pharmacological management of COPD (Chronic Obstructive Pulmonary Disease). We took a COPD patient and assessed the patient for clinical manifestation, the medical, nursing, pharmacological care given to the patient. In our case study we will include the care Hawwa is receiving now and the care we can add to daily routine to help her recover faster. Hawwa Ismail is admitted to Medical ward with diagnosis of COPD. She is 145cm tall, slim, with dark complexion. She is 79 years old. She said that she has difficulty in breathing, she cannot sleep in night time ,she do not feel like eating food and she was having cough. Physical assessment revealed BP 138/47mmHg right arm in lying position, pulse 84 regular and strong, and breathing pattern was irregular labored, tachypnic at 40 breathes per minute,SpO2 99% in room air and temperature 360C (96.80F).Her facial color and lips are ruddy, but nails are clean ,pale and clubbed. She has a little barrel chest, uses accessory muscle to breathe. She has prolonged expiration. While auscultating lungs, diminished breath sound in most of the lower lobes and a small wheezing sound in right lower lobe was noted. PERSONAL DETAILS PATIENT NAME: Hawwa Ismail ADDRESS:Iruvaige/R.Inguraidhoo GUARDIAN: NAME: Abdul HameedHussain CONTACT NO: 7772099 AGE: 79yrs SEX: female NATIONALITY: Maldivian LANGUAGE: Dhivehi RACE: Asian ...
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...Physiology of Blood Components, Characteristics, Functions of Blood Major Components of Blood 1. Formed elements - the actual cellular components of blood (special connective tissue) a.erythrocytes - red blood cells b.leukocytes - white blood cells c.platelets - cell fragments for clotting 2. Blood plasma - complex non-cellular fluid surrounding formed elements; protein & electrolytes. Separation of Components in a Centrifuge VOLUME LAYER clear/yellowish PLASMA 55% top thin/whitish buffy coat proerythroblast ->early (basophilic) erythroblast ->late (polychromatophilic) erythroblast ->(hemoglobin) normoblast -> (nucleus ejected when enough hemoglobin)reticulocyte -> (retaining some endoplasmic reticulum) ERYTHROCYTE life span: hemocytoblast -> reticulocyte 3-5 DAYS reticulocyte -> ERYTHROCYTE 2 DAYS (in blood) ERYTHROCYTE lifespan 100-120 DAYS (primarily destroyed by macrophages in the spleen) 3. Regulation of Erythropoiesis a. hormonal controls - erythropoietin is the hormone that stimulates RBC production DECREASED oxygen level in blood causes KIDNEYS to increase release of erythropoietin 1. Less RBCs from bleeding 2. Less RBCs from excess RBC destruction 3. Low oxygen levels (high altitude, illness) ...
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...Prescription behavior of doctors when prescribing drugs for Iron Deficiency anemia Research paper presented to SPPSPTM, NMIMS In partial fulfillment of the Requirement for the Degree B.Pharm + MBA (MBA PharmaTech) By Dishali Shah A073 Academic Year 2015 - 2016 Statement by candidate This is to submit that this submission report is my report entitled “Prescription behavior of doctors when prescribing drugs for Iron Deficiency anemia” represents my ideas in my own words and where others’ ideas have been included, I have adequately cited and referenced the original sources. I also declare that I have followed all the principles of academic honesty and integrity and have not misrepresented or fabricated or falsified any idea/ data/ fact / source in my submission. I understand that any violation of the above will be a cause of strict disciplinary action by the School and can also evoke penal action from the sources, which have thus not been properly cited, or from whom proper permission has not been taken when needed. P. Score________% Signature of Student Name of Student SVKM’s NMIMS Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, Vile Parle (W), Mumbai-400056. SHOBHABEN PRATAPBHAI PATEL SCHOOL OF PHARMACY AND TECHNOLOGY MANAGEMENT, SVKM’s NMIMS 2 Certificate The work described in this report entitled “Prescription behavior of doctors when prescribing drugs for Iron Deficiency anemia” has been carried...
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...Effects of Drugs A Term Paper Presented to the Faculty Of the English Department Of Hope Christian High School By: Aldrin Aaron M. Agulan High 4 - Purity February 27 2013 Table of contents……… Acknowledgement……………………………..…. Introduction …..………………………………..…….1 Definition of terms …………………………….…....2 Effects of Drugs ...……….……………………..….3 Complication of addiction ....……….………………14 Conclusion …………………………………………15 Findings …………………….………………………21 Bibliography………………………………………...23 Appendix……………………………………………24 Acknowledgments I would like to thank God for his unyielding guidance on my path through this term paper. I would also like to extend my gratitude to all my family members who have supported me through the long hours. This paper would not be possible if not for the endless mentoring of my teacher Dr. Bella Divina Lastly, I would like to give thanks to my one and only almamater who have been my home since the start of my education and the wealth of knowledge she has given me. -Aldrin Introduction Many people do not understand why individuals become addicted to drugs or how drugs change the brain to foster compulsive drug abuse. They mistakenly view drug abuse and addiction as strictly a social problem and may characterize those who take drugs as morally weak. One very common belief is that drug abusers should be able to just stop taking drugs if they are only willing to change their...
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...Laboratory biosafety manual Third edition World Health Organization Geneva 2004 WHO Library Cataloguing-in-Publication Data World Health Organization. Laboratory biosafety manual. – 3rd ed. 1.Containment of biohazards - methods 2.Laboratories - standards 3.Laboratory infection - prevention and control 4.Manuals I.Title. ISBN 92 4 154650 6 (LC/NLM classification: QY 25) WHO/CDS/CSR/LYO/2004.11 This publication was supported by Grant/Cooperative Agreement Number U50/CCU012445-08 from the Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC. © World Health Organization 2004 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning...
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