...Introduction: Most penetrating cardiac trauma is the result of either gunshot injuries or stab wounds [13]. In 55-69% of patients presenting with stab wounds, cardiac tamponade develops [1][11].Cardiac Tamponade is a life-threatening, slow or rapid compression of the heart due to the pericardial accumulation of fluid, pus, blood, clots, or gas, as a result of effusion, trauma, or rupture of the heart. The primary abnormality is rapid or slow compression of all cardiac chambers as a result of increasing intrapericardial pressure which prevents atrial and ventricular filling, suppressing cardiac output and in turn, precipitating a fall in systemic blood pressure [2]. Stab wounds produce a small tear in the pericardium itself which seals off, resulting in acute cardiac tamponade in 80-90% of cases [4]. Due to its postero-lateral position, penetrating injuries of the left ventricle are rare as compared to the right ventricle [5] [12]. Stab wounds to the heart can serve to be fatal and in Karachi, 7.6% of deaths from stab wounds involved the heart [9]. Here we present a case where a 24 year old male presenting with a history of stab wound developing cardiac tamponade....
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...the eyes and the heart in the manifestation of love. Utilizing conceit—or a fanciful form of extended metaphor—Shakespeare tackles the extant renaissance notion of the eye and the heart from a more infatuating, legal standpoint. In the case of number 46, the verdict is simple: lustful, longing eyes will always be able to gaze upon potential lovers; but passionate hearts will always have the power to become intertwined. In almost perfect iambic pentameter, the sonnet maintains a common structure with most of Shakespeare’s sonnets. Its rhyme scheme, which appears to be simply alternating as ABAB, does however have some deviances 1. In the end, it seems to formulate to ABAB || CDCD || EFEF/FF ||. In terms of syntactical construction the sonnet may be divided into four units—three quatrains of four lines, however concluding with a couplet. Because #46 is of the harder sonnets in terms of understanding—due to it’s extended metaphor and legal jargon—I will break up the text along with citing the OED in order to convey it’s underlying meaning. 1 Mine eye and heart are at a mortal war / 2 How to divide the conquest of thy sight; / 3 Mine eye my heart thy picture's sight would bar, / 4 My heart mine eye the freedom of that right. || ------------------------------------------------- 1 The rhyme scheme turns out to be ABAB CDCD EFEFFF—deviating from the pattern by closing the last stanza with a couplet, an unusual scheme in terms of sonnets. The words “heart” and “part” are also...
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...new mutation, and is rarely inherited. Although the term Progeria applies strictly to all diseases characterized by premature aging symptoms, and is often used as such, it is often applied specifically in reference to Hutchinson-Guilford Progeria Syndrome. At present there are 53 known cases of Progeria around the world and only 2 in the UK. There is a reported incidence of Progeria of approximately 1 in every 4 to 8 million newborns. Both boys and girls run an equal risk of having Progeria. Progeria appears to affect children of all races equally. Over the last 15 years the following countries have had reported cases - Algeria, Argentina, Australia, Austria, Canada, China, Cuba, England, France, Germany, Israel, Italy, Mexico, the Netherlands, Poland, Puerto Rico, South Africa, South America, South Korea, Switzerland, Turkey, the US, Venezuela, Vietnam and Yugoslavi. Children with Progeria are born looking healthy. When they are about 10 to 24 months old, features of accelerated aging start to appear. Signs of Progeria may include: growth failure, loss of body fat, loss of hair, skin starts to look aged, stiffness in the joints, hip dislocation, generalized atherosclerosis (cardio and heart disease), and stroke. Although they may come from varying ethnic backgrounds, children with...
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...She says she has a PH.D. in statistics, but she doesn’t seem to entitle the reader if she has any health and medical experience. After quickly reading it’s almost as if she is going against the doctor’s analysis. Further, she entices the reader multiple times on stories and this induces the listener/reader to watch/read. Talithia Williams next explains about a case of the 95% confidence interval and how this relates to a 0.1 percent chance doubling; to 0.2 percent due to the reason that the due date had passed. He was going by the statistics for the general population and Talithia infers to the reader that it is an unnecessary additional risk to be put in (4:13 Talithia Williams ted talk). She intertwines all the statistic and knowledge to entice the reader to become more involved. The only problem with her argument is it lacks the professional doctors’ point of view (she seems to be putting him in the category liable to be at fault). Talithia Williams states” I am not anti-medical intervention” (debaters need to look at a broader view)....
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...Definition Heart failure occurs when abnormal cardiac function causes failure of the heart to pump blood at a rate sufficient for metabolic requirements under normal filling pressure. It is characterised clinically by breathlessness, effort intolerance, fluid retention, and poor survival. Fluid retention and the congestion related to this can often be relieved with diuretic therapy. However, diuretic therapy should generally not be used alone and, if required, should be combined with the pharmacological therapies outlined in this review. Heart failure can be caused by systolic or diastolic dysfunction, and is associated with neurohormonal changes. [1] Left ventricular systolic dysfunction (LVSD) is defined as a left ventricular ejection fraction (LVEF) below 0.40. It may be symptomatic or asymptomatic. Defining and diagnosing diastolic heart failure can be difficult. Recently proposed criteria include: (1) clinical evidence of heart failure; (2) normal or mildly abnormal left ventricular systolic function; (3) evidence of abnormal left ventricular relaxation, filling, diastolic distensibility, or diastolic stiffness; and (4) evidence of elevated N-terminal-probrain natriuretic peptide. [2] However, assessment of some of these criteria is not standardised Top of Form Search the BMJ[pic][pic] Bottom of Form • BMJ • BMJ Journals • BMJ Careers • BMJ Learning • Evidence Centre • BMJ Group [pic] [pic] [pic] [pic] [pic] [pic] Home | Log in | Athens...
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...day to day lifestyle. The reduced hours of nocturnal sleep have shown to lead to serious health problems such as depression, obesity, hypertension, along with many other diseases. It also affects cognitive performance and emotionality. (1) The Endocrine system is responsible for the body’s stress systems and the release of the stress hormones necessary for adaptation and survival in the environment. Sleep deprivation are associated with increases in the hypothalamic- pituitary-adrenal axis, increased levels of cortisol and autonomic sympathetic activation and increased catecholamine levels during wakefulness. Increased sympathetic levels causes an increase in heart rate and blood pressure. Just briefly waking up from sleep for only a few seconds is associated with autonomic reflex, causing a temporary rise in heart rate and BP to the level seen while awake. This is more related to disruption and discontinuity of sleep than to the duration of sleep deprivation or the amount of sleep that is lost. HPA is a stressful stimulus that induces the release of corticotropin-releasing hormone from the hypothalamus. CRH stimulates the release of adrenocorticotropic hormone from the pituitary, and ACTH initiates the release of glucocorticoids from the adrenal cortex. Increased levels of glucocorticoids reduce neuronal plasticity increasing mood sensitivity and...
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...Case Study 11 Karley Lapointe Liberty University Abstract C.W. is a patient with a gastrointestinal bleed that produced a duodenal ulcer. This ulcer then produced a bloody diarrhea stool. C.W. Was brought to the emergency room with by his wife for having bloody diarrhea for three days and was presenting signs of weakness and hypotension. C.W. underwent surgery for his gastrointestinal bleed and then was admitted to the hospital for having a fluid volume deficit, due to his diarrhea and bleed. C.W. being volume deficit made his fluid, electrolyte and blood levels become very abnormal. His medication that he was on for prior health history was causing some of his levels to rise and drop. He has a past medical history of cardiovascular problems, which were described and attributed to his current admitting problems. While at the hospital he went into sinus tachycardia and was placed on a Swan-Ganz catheter. One of the main goals for treating C.W. is to control his tachycardia and control his levels. He has some serious cardiovascular conditions that can not be healed but medical professionals, using education and medication , can better his quality of the life he has left. Patient C.W., a 70-year-old male, was admitted to the hospital at 0430 with a 25-X15-mm duodenal ulcer causing a gastrointestinal bleed, which was presented by “ dark red “ bloody diarrhea. His wife states that he has had diarrhea for 3 days with “dark red” stool starting the night before. She states that...
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...Hypertension Shelley J. Wilson HS200, Section 2 Unit 4 Capstone Project: Case Study #3 Hypertension Kaplan University 14 October, 2014 Hypertension Hypertension is commonly known to many people as high blood pressure. Hypertension is a condition in which the arteries in the body have elevated blood pressure. When heart beats, it will pump blood throughout the body your body from your arteries. The blood pressure stems from the force of blood that pushes against the blood vessel walls. When an individual has elevated blood pressure, the harder the heart has to work to pump blood. The normal range for blood pressure is below 120/80. “The 120 in the blood pressure represents the systolic measurement, or the peak pressure in the...
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...| Panic DisorderPsychology Assignment | Rohit Jayal | 11/20/13 | XI-C | | | Panic DisorderPsychology Assignment | Rohit Jayal | 11/20/13 | XI-C | | Contents 1 Signs and symptoms 2 Causes 3 Psychological Models 4 Medical Model 5 Mediators and moderators of panic disorder 6 Substance abuse 7 Diagnosis 8 Treatment 9 Psychotherapy 10 Medication 11 Other treatments 12 Epidemiology. 13 Panic disorder in juveniles 14 Case Study. Definition Panic disorder is an anxiety disorder characterized by recurring severe panic attacks. It may also include significant behavioural changes lasting at least a month and of ongoing worry about the implications or concern about having other attacks. The latter are called anticipatory attacks (DSM-IVR). Panic disorder is not the same as agoraphobia (fear of public places), although many afflicted with panic disorder also suffer from agoraphobia. Panic attacks cannot be predicted, therefore an individual may become stressed, anxious or worried wondering when the next panic attack will occur. Panic disorder may be differentiated as a medical condition, or chemical imbalance. The DSM-IV-TR describes panic disorder and anxiety differently. Whereas anxiety is preceded by chronic stressors which build to reactions of moderate intensity that can last for days, weeks or months, panic attacks are acute events triggered by a sudden, out-of-the-blue cause: duration is short and symptoms are more intense. Panic attacks...
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...Memorandum To: File Reviewer From: Angela Warren Date: 11/8/13 Re: Heart Transplant As the surgeon for this case I received a call today telling me that a heart has become available for one of three patients that are in need of a transplant. I must make a quick choice in which patient will receive the heart and then schedule him/her surgery for today. I must set up anesthesia, surgery room and have all the required personnel to help with the preparation for the transplant. According to J. S. Mill, if I use the utilitarian logic for each patient that is in need of the heart transplant. Each of the three patients is a tremendously important, with many loved ones whose death would bring a great deal of grief and actual physical discomfort of their family members passing. As the acting surgeon for the patient I must decide on who gets the heart transplant and quickly. As an act of utilitarian, in this situation the question would be complicated on deciding which patient gets the donated heart transplant? I say this because Dr. Jonathan Doe has offered the hospital $2 Million Dollars in exchange so that his daughter would be able to get the heart transplant. According to Lisa’s chart, she has a history of suffering health issues all her life due to various viral infections and a lupus-like immune deficiency. Her heart has been damaged due to pneumonia that she had last year and in which her heart had actually stopped. Who is to say that she will even survive the transplant...
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...J., Kaul, P., & vanWalraven, C. (2012). Predicting the risk of unplanned readmission or death within 30 days of discharge after a heart failure hospitalization. American Heart Journal, 164(3). 365-372. Retrieved from: http://www.medscape.com/viewarticle/771215_print This article sought to find an appropriate model to predict the risk of unplanned heart failure readmissions. The primary outcome from chart reviews also included death of heart failure patients within 30 days of discharge. The study looked at Centers for Medicaid and Medicare Services (CMS) models and the LACE+ index, to mention two of many that looked at prediction ability. The LACE+ index is a model that looks at length of stay, acuity, the Charlson comorbidity score and age, to predict readmissions. They found that no one model was appropriate in predicting the 30-day readmission rates, although using a combination of the models was an improvement to that predictor. The authors are all physicians, PhDs, or have a Master’s degree- helping to establish credibility. The authors also make a statement as to the funding of the project and that they (the authors) were solely responsible for all data collection, design and submission approval writing for the project, also lending credibility to the study. The references used for this study were appropriate in age, of the 28; 13 were within the last five years. Statistical data was gathered by experts and calculations made through third party experts, lending validity...
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...usually embolic stroke(if ischaemic) LACS- cortex NOT involved- usually due to small vessel disease(if ischaemic) POCS- posterior circulation stroke- could be embolic or small vessel disease Why is this important? TACS- worst prognosis, poorer rehab potential, longer hospital stay as opposed to LACS History Is it acute onset, time of onset of symptoms essential for thrombolysis, witness account if possible Current symptoms (assess if focal or not) Past medical history- Diabetes, HTN, Dyslipidaemic, Ischaemic heart disease, atrial fibrillation Smoking, lifestyle, medications(esp warfarin), intolerances Social history Examination Evidence of heart failure, AF, peripheral pulses Higher mental fns involved?- suggests cortical involvement Dominant- some variant of dysphasia Non dominant- neglect, dyspraxia, spatial disorientation, emotional lability, inattention Motor, sensory, hemianopia Cerebellar or brainstem signs Case 1 YD 60/F Right face,arm and leg weakness and aphasia. Time of onset...
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...Produced by the Centre for Genetics Education. Internet: http://www.genetics.edu.au TRISOMY 13 — PATAU SYNDROME Produced by the Centre for Genetics Education. Internet: http://www.genetics.edu.au FACT SHEET 8 29 Important points Trisomy 13 (also known as Patau syndrome) is a chromosomal condition in which there are three copies instead of the usual two copies of all, or a part of chromosome 13 in the cells of the body Trisomy 13 severely impacts on intellectual and physical development Appears to affect females slightly more frequently than males Occurs in about 1 in 5,000 to 1 in 12,000 live births About 1% of all recognised miscarriages occur in association with trisomy 13 Of all babies born with the extra copy of chromosome 13 in all the cells of their body, around 50% die in the first month, and the rest within the first year The chromosomal problem in trisomy 13 is due to an egg cell or, rarely, a sperm cell, that is formed containing one copy of each chromosome and an extra copy of chromosome 13, ie. 24 chromosomes rather than 23. When that egg combines with sperm containing the usual 23 chromosomes, the baby conceived has 47 chromosomes in the cell of their body rather than the usual 46 When there are three copies of chromosome number 13 in all of the baby’s cells, the condition is referred to as trisomy 13 When the extra copy of chromosome 13 is only in some of the baby’s cells due to a mistake in cell division occurring soon after conception, the chromosomes in the...
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...probable homeostatic responses to changes in the internal environment during exercise. D2: Explain the importance of homeostasis in maintaining the healthy functioning of the body. Homeostasis is highly important as many processes going on in our body are based on this phenomenon. Homeostasis processes every day in our body are diffusion, osmosis, active transport etc. Diffusion means movement of solute molecules from a section of its high concentration to the low concentration region. Osmosis is movement of water from a mixed solution to a concentrated solution through a semi-permeable membrane. Homeostasis is the balance or equilibrium. How your body works to maintain equilibrium is reflected in how your vital signs vary with activity. Heart rate, blood pressure and respiration are lowest during periods of rest and sleep. During exercise, blood pressure, pulse and respiration increase to meet the increased demand for oxygen and nutrients by your musculoskeletal system. The adjustment of vital signs to match your body's level of physical activity is an example of homeostasis in action. Homeostasis is the regulation and maintaining of the body's internal environment. These levels need to be controlled so that the body can function properly, for example enzymes work at optimum temperatures/ pH levels around the body, so in order to function the internal environments must be controlled. Levels which are controlled tend to oscillate between high and low about the normal/ set point...
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...This syndrome is characterized my physical disabilities and lack of intellect. In this condition the abnormality occurs at chromosome number 13, where there are three chromosomes instead of normal two chromosomes. This increase the total number of chromosome from 46 to 47. Children born with trisomy 13 have heart defects, spinal cord and brain defects; they might have extra finger or toe, have weak muscle tone, opening of the upper lip of opening in the roof of the mouth and ill developed eyes. There are so many abnormalities in this disease that the child that is born with this disease die in first few days or week after birth. Only around 5-10% children survive till 5 years of age. In about 16,000 births one patient suffers from trisomy 13. Trisomy can occur in child of women of any age but it is more likely to occur in women who have older age. Trisomy is not inherited it might occur due to abnormal translocation of genes during formation of eggs or sperms. Diagnostic Tests include Amniocentesis, biopsy, A1C, CAT scan and other vital that include blood pressure, blood tests and breathing rate. Diagnostic imaging can be helpful as well, imaging includes fetal ultrasound, endoscopy, genetic testing. Trisomy 13 is very life threatening and hence there is no specific treatment, the treatment is basically based on...
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