...Murphy’s sign may be a useful tool in establishing the diagnosis of cholecystitis. Confirmation of the diagnosis depends on a combination of physical findings and laboratory and imaging studies. A corollary, the sonographic Murphy’s sign, may be useful as well.1-5 SIGNS OF CHOLECYSTITIS MURPHY’S SIGN Elicitation: Palpate the right subcostal area while the patient inspires deeply Positive response: The patient feels pain upon this maneuver and may have an associated inspiratory arrest SONOGRAPHIC MURPHY’S SIGN Elicitation: Palpate the right subcostal area using an ultrasound transducer while the patient inspires deeply Positive response: The patient feels pain upon this maneuver, and the ultrasound transducer can confirm that the gallbladder is being pushed when the patient experiences inspiratory arrest HISTORIC PERSPECTIVE John B. Murphy (1857–1916) was a prominent Chicago surgeon from the 1880s through the early 1900s. He was well known for his thoracoplasty procedures,6,7 and also made valuable contributions to vascular, urologic, neurologic,...
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...CASE STUDY REFERRAL: To meet requirements for Evaluation and Assessment-PSY 6645. BACKGROUND: There is no prior history of a problem. The client stated that giving birth to two sons were significant events experienced. There is no history of accidents and one gallbladder surgery in 2002. The client currently suffers form depression and hypertension. Medications that the client is currently taking include Lexapro (.20 mg), Exforge (.325mg), and Ambien. The client has a history of diabetes in the family. The client has experienced several traumatic events in life that include sexual abuse at the age of 5 by a male cousin and physical and mental abuse by both spouses. Psychological problems experienced by this client are depression, anxiety attacks, and a nervous breakdown in 2000. The client has never received counseling and has only been prescribed medicines from the family doctor. The client also stated that depression is a current problem and it has been going on for the past 8 months due to the sudden suicide of ex-husband. Client is not seeking any counseling. TESTING AND PROCEDURES: NAME OF TEST: Adult Interview Report DATE OF TEST: BEHAVIORAL OBSERVATION: On the day the interview was administered, the client appeared to be very irritated and tired. The client was given the opportunity to reschedule to but refused. The client kept blowing heavily and twisting in the chair as if the test was a burden. The client finished...
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...by Centers for Disease Control and Prevention there are over 50 million and 15 percent of children are obese and overweight. Why is this important you might ask? According to the CDCP the estimated annual medical cost of obesity in the U.S. was $147 billion in the U.S. IV. Obesity is second only to tobacco in the number of deaths it causes each year. Here are some of the diseases that have been linked to obesity: High Blood Pressure, high cholesterol, diabetes, heart disease, cancer, backpain. Athiritis, Gallbladder disease and gallstones BODY I. What is obese and how do you determine if you obese or not? Height Weight Range BMI Considered 5' 9" 124 lbs or less Below 18.5 Underweight 125 lbs. to 168 lbs 18.5 to 24.9 Healthy weight 169 lbs to 202 lbs 25.0 to 29.9 Overweight 203 lbs or more 30 or higher Obese 1. 1. The term medical term is a person who has a BMI of 30% or more. This is an accurate way of accessing if you are obese in some cases but, this does not take in account your build or muscle mass....
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...rP os t 4183 APRIL 14, 2010 JOHN A. QUELCH HEATHER BECKHAM op yo Metabical: Pricing, Packaging, and Demand Forecasting for a New Weight-Loss Drug In April 2008, after 10 years of testing and $400 million in research and development costs, Cambridge Sciences Pharmaceuticals’ (CSP) newest prescription drug, Metabical (pronounced Mehtuh-bye-cal), was about to receive its coveted Food and Drug Administration (FDA) approval. CSP was an international healthcare company with over $25 billion in sales in 2007. The company, based in Cambridge, Massachusetts, focused on developing, manufacturing, and marketing products that treated metabolic disorders, gastrointestinal diseases, and immune deficiencies, as well as other chronic and acute medical conditions. Metabical was part of a strategic initiative that would allow CSP to enter the $3.74 billion market for weight-control products in the United States.1 tC CSP’s chief marketing officer, Bernard Long, said of the new product: No Metabical is revolutionary. It will be the first and only prescription drug to receive FDA approval to meet the needs of the millions of individuals struggling with moderate weight-loss goals. Previous prescription weight-loss drugs had negative side effects that, in the agency’s judgment, outweighed the benefits provided to individuals who were not considered obese. Metabical will be approved for use by those looking to shed between 10 to 30 pounds. Initial reviews...
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...birth sac, and stillbirth (Gale, 2013). Sadly, after birth the newborn most likely dies due to an listeriosis infection (Gale, 2013). Finally with cases of Listeriosis it can affect the central nervous system (CNS). With most cases the patient will develop meningitis or inflammation of the brain and spinal cord, which is known as listerial meningitis since the listeria bacteria is still present (Rowland et al, 2015). Listerial meningitis will occur within 4-7 days after the flu-like symptoms. More symptoms that can occur are, personality changes, tremors, seizures, heart diseases, lung, joint, gallbladder, and bone infections (Rowland et al, 2015). Because Listeriosis is highly similar to food poisoning or having the flu, a doctor may not suspect that you have Listeriosis. A patient with listerial meningitis or encephalitis have more unique symptoms so a doctor might be able to tell (Rowland et al, 2015). But the most common tests to see if you have a Listeria infection can be one of the following: isolating the bacterium from blood, cerebrospinal fluid (CSF), urine, or stool (Rowland et al, 2015). Medical Management Treating Listeriosis can be difficult because the bacterium lives inside of macrophage cells and replicates when the cells do. For cases where symptoms don’t show, there isn’t any treatment given. But for those cases where symptoms appear, it can be treated with antibiotics given to any age. The drugs that can be given are “ampicillin (Omnipen), chloramphenicol...
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...METABICAL CASE STUDY REPORT INTRODUCTION Excess weight had become a big crisis in the US, affecting about 65% of the adult population leading to different kinds of health complications. In the past, several manufacturers had introduced various weight loss products like over-the-counter (OTC) drugs, herbal products, supplementary fad diets, etc. All of these have proven to be unsuccessful because of their ineffectiveness, severe side effects and lack of credibility among consumers. At this juncture, Barbara Printup, the Senior Marketing Director of Cambridge Sciences Pharmaceuticals (CSP) wants to introduce CSP’s newest revolutionary prescription drug, Metabical. It is the only FDA approved prescription drug for overweight people, which has minimal side effects and long term benefits. PURCHASING DECISION MAKING PROCESS (Q1) The communication strategy of Metabical targets both the health care provider and the consumer. Depending on the initiators there are two different purchase decision processes in the purchase of Metabical for the overweight problem. 1. For Customer: a. Problem identification: The various health awareness programs, BMI table etc help a health conscious or beauty conscious individual to identify the overweight problem. b. Information search: Once the problem is identified the individual decides on the course of action. He/She may decide to either ignore the problem or work on it. Metabical is interested in the group of individuals who are ready to...
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...4240 JULY 22, 2010 JOHN A. QUELCH HEATHER BECKHAM Metabical: Positioning and Communications Strategy for a New Weight-Loss Drug “I have tried countless diets and every new weight-loss pill that has come on the market. Nothing seems to take off those extra pounds. With diets, I am miserable because I am starving all the time, and none of the weight-loss pills seem to work. I might lose a couple pounds, but I never reach my weightloss goals and I usually end up gaining more back. I would give anything to lose this extra 20 pounds, so that I can live a longer, happier life.” — Tamara Jinkens: focus group participant, age 42 Barbara Printup, senior director of marketing for Cambridge Sciences Pharmaceuticals (CSP), listened as overweight focus group participants recounted their lifelong struggles with weight loss. Printup had just been placed in charge of the upcoming U.S. product launch of CSP’s newest prescription drug, Metabical (pronounced Meh-tuh-bye-cal). In clinical trials, Metabical proved to be safe and effective in stimulating weight loss for moderately overweight individuals. CSP was an international health care company with a focus on developing, manufacturing, and marketing products that treat metabolic disorders, gastrointestinal diseases, immune deficiencies, as well as other chronic and acute medical conditions. The company captured over $25 billion in sales in 2007. Printup had over 20 years of experience marketing prescription drugs for CSP. She had led six...
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...4240 JULY 22, 2010 JOHN A. QUELCH HEATHER BECKHAM Metabical: Positioning and Communications Strategy for a New Weight-Loss Drug “I have tried countless diets and every new weight-loss pill that has come on the market. Nothing seems to take off those extra pounds. With diets, I am miserable because I am starving all the time, and none of the weight-loss pills seem to work. I might lose a couple pounds, but I never reach my weightloss goals and I usually end up gaining more back. I would give anything to lose this extra 20 pounds, so that I can live a longer, happier life.” — Tamara Jinkens: focus group participant, age 42 Barbara Printup, senior director of marketing for Cambridge Sciences Pharmaceuticals (CSP), listened as overweight focus group participants recounted their lifelong struggles with weight loss. Printup had just been placed in charge of the upcoming U.S. product launch of CSP’s newest prescription drug, Metabical (pronounced Meh-tuh-bye-cal). In clinical trials, Metabical proved to be safe and effective in stimulating weight loss for moderately overweight individuals. CSP was an international health care company with a focus on developing, manufacturing, and marketing products that treat metabolic disorders, gastrointestinal diseases, immune deficiencies, as well as other chronic and acute medical conditions. The company captured over $25 billion in sales in 2007. Printup had over 20 years of experience marketing prescription drugs for CSP. She had led six...
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...Health History Paper HEALTH HISTORY Biographical data: Interview date/time: 2/3/2012, 8 a.m. Examiner: student nurse Client: J.P. Address: 123 Penny Lane, Anywhere, NY 12345 Birth date: 10/16/1975 Age: 36 Gender: Male Birthplace: Anywhere, NY Marital status: Married Employer: East House Corporation Occupation: Mental Health Counselor Race/ethnicity: Caucasian Identifying data: JP is a 36-year-old, married, Caucasian male, a willing participant in interview, appearing stated age; resides at 123 Penny Lane, Anywhere, NY; born 10/16/1975; mental health counselor Source of history: Contributor of data was client; alert and oriented to person, place, and time; engaged in interview, reliable Reason for seeking care: Client presents with cough with sputum production, sharp chest pain on inspiration, shortness of breath, body aches and fever, “my fever was 103.2 before coming in” History of present illness: Thirty-six-year-old male presents to office complaining of cough pain in chest, body aches and fever, states pains and fever started 6 days ago. Rates pain as 6 to 10 out of 10, continuous. Patient states he took his own temperature with an oral thermometer with temps ranging from 101.9 to 103.2. Past medical history: • Fibromyalgia • Epilepsy • Pericarditis • Heart Burn Past surgical history: Denies any past surgeries Childhood illnesses: • Chickenpox ...
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...Running Head: TEAM B COURSE PROJECT Team B Course Project Final Draft April 20, 2013 Professor Aimee James DeVry University Abstract Robotic surgery is a described as when a surgeon uses robotic equipment to assist during a surgical procedure. The surgeon manipulates controls which send information to the robotic equipment, telling it what to do. This surgical technology can be used for a wide range of surgical procedures. There are multiple benefits from choosing this type of surgery, but can also cost more than laparoscopic. Robotic surgery has been discussed for over two decades. Over the last decade, it has increased in popularity and applicability. There are many economic concerns over the use of this technology such as the cost versus the applicable use. There are also concerns about the implications the use of this technology will have on the environment, as well as moral and ethical concerns. By providing background information and history of this technology, information on the use of this technology, economical, sociological, and psychological effects and concerns associated with this technology, and information on environmental implications and moral and ethical concerns of this technology, we hope to provide readers a basis to form an educated opinion on the applicability of remote and robotic surgery. Table of Contents Abstract (Jesse Edwards)…...……………………………………………….…………………….ii Introduction (Jesse Edwards)……………………………………………….……………………..1 ...
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...Surgical Patient Case One: Activity One: With reference to anatomy explain how a gall stone can migrate into the pancreas, causing pancreatitis. The pancreas is in the upper abdomen and lies behind the stomach and intestines. It makes a fluid that contains enzymes that are needed to digest food. The enzymes are made in the pancreatic cells and are passed into tiny tubes. These tubes join together to form the main pancreatic duct. This drains the enzyme-rich fluid into the duodenum. The enzymes are in an inactive form in the pancreas, they are 'activated' in the duodenum to digest food. Groups of special cells called 'Islets of Langerhans' are scattered throughout the pancreas. These cells make the hormones insulin and glucagon. The hormones are secreted directly into the bloodstream to control the blood sugar level. The bile duct carries bile from the liver and gallbladder. This joins the pancreatic duct just before it opens into the duodenum. Bile also passes into the duodenum and helps to digest food. Pancreatitis occurs when the pancreas becomes inflamed. When pancreatitis occurs, it's largely due to digestive enzymes attacking and digesting the pancreas, which produced them in the first place. There are two types of pancreatitis: Acute pancreatitis - when the inflammation develops quickly, over a few days or so. It often goes away completely and leaves no permanent damage. Sometimes it is serious. Chronic pancreatitis - when the inflammation is persistent...
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...Chapter I Introduction Ice cream is a frozen dessert usually made from dairy products, such as milk and cream, and often combined with fruits or other ingredients and flavors. Most varieties contain sugar, although some are made with other sweeteners. In some cases, artificial flavorings and colorings are used in addition to the natural ingredients. Philippines’ version for ice cream: Sorbetes is usually produced from unknown factories and sold from carts that roam the streets, exposing it to pollution. Thus, it is also called dirty ice cream; though it is not really dirty as the name implies. Kids love ice cream, and so do grown-ups, but to indulge in this frozen delight can mean a lot of fat and calories, depending on the choices. The calories in a cup of ice cream can vary anywhere from 180 to 600, depending on brand, fat content, sugar content, and flavor. Nonfat or fat-free ice creams contain virtually no fat: vegetable gums are added to make them creamy and mixtures are made in soft serve machines to whip in additional air and ice crystals. Most nonfat ice creams contain 90 to 100 calories per half cup but not all, leaving health-conscious consumers, who avoid calories and fat, fewer options, or none at all. A newly industrialized country, the Philippine economy has been transitioning from one based on agriculture to one based more on services and manufacturing. Despite this, the agricultural sector employs close to 32% of the country's total labor force of around...
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...Minimalist contentions: Fight Club Introduction Chuck Palahniuk is one of the most influential American fiction writers who emerged in the 1990s. His debut novel, Fight Club (hereafter: FC) reached cult status after the film adaptation by David Fincher was released in 1999, and widespread and divided critical reception was soon to follow. Much of the current debate about Fight Club focuses on the political implications of the text, but most often recourse to it by way of referencing the film. These arguments usually question or celebrate the transgressive potentials of the book (Giroux; Mendieta), or address issues of masculinity brought into the fore by their literary and cinematic representations emergent in the same decade (Tuss; Friday). However, few, if any, have addressed the literary aspirations of the text and its author. Although none of the approaches to the thematic concerns of Fight Club are unjustified, in the argument that follows I will suggest that conclusions drawn and critical judgments passed have been hasty, and not only failed to take into account the formal aspects of story-telling, but that the narrative features of Palahniuk’s text have largely went unexplored, and constitute a blind spot of the reception. Critics condemning or acclaiming the novel, and, indeed, many a cultic reader of Palahniuk ignored Fight Club as a literary narrative, and have inadvertently been repeating the catchphrases of the text, either reinforcing or trying to undermine what...
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...Applied Statistical Methods Larry Winner Department of Statistics University of Florida February 23, 2009 2 Contents 1 Introduction 1.1 Populations and Samples . . . . . . . . . . . 1.2 Types of Variables . . . . . . . . . . . . . . . 1.2.1 Quantitative vs Qualitative Variables 1.2.2 Dependent vs Independent Variables . 1.3 Parameters and Statistics . . . . . . . . . . . 1.4 Graphical Techniques . . . . . . . . . . . . . 1.5 Basic Probability . . . . . . . . . . . . . . . . 1.5.1 Diagnostic Tests . . . . . . . . . . . . 1.6 Exercises . . . . . . . . . . . . . . . . . . . . 7 7 8 8 9 10 12 16 20 21 25 25 29 29 29 32 32 32 32 32 35 35 37 38 38 39 40 42 42 44 48 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Random Variables and Probability Distributions 2.1 The Normal Distribution . . . . . . . . . . . . . . . . . . 2.1.1 Statistical Models . . . . . . . . . . . . . . . . . 2.2 Sampling Distributions and the Central Limit Theorem 2.2.1 Distribution of Y . . . . . . . . . . . . . . . . . . 2.3 Other Commonly Used Sampling Distributions . . . . . 2.3.1 Student’s...
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...INTRODUCTION Review of Related Literature Pneumonitis Pneumonitis is a general term that refers to inflammation of lung tissue. It occurs when some irritating substance – solid particles, liquids, gases, radiation or bacteria – cause the tiny air sacs to become inflamed. This can hamper the exchange of oxygen and carbon dioxide in the air sacs. Pneumonia is one type of pneumonitis caused by an infection. There are several types of pneumonitis. They include: • Aspiration pneumonitis- occurs when you inhale (aspirate) foreign matter into your lungs. Stomach contents, such as ingested food or liquid, are a frequent cause of aspiration pneuomonitis. Accidental inhalation of small particles, such as tiny pieces of peanuts or vegetables, while swallowing is common in young children. • Chemical pneumonitis- is a type of aspiration pneumonitis that develops when you inhale chemicals that are toxic to your lungs. Industrial and household chemicals, such as chlorine gas, ammonia, solvents and pesticides can all cause chemical pneumonitis. • Hypersensitivity pneumonitis- is nicknamed “farmer’s lung,” “mushroom picker’s disease” and other colorful names with good reason. Dust from animal dander, molds and plants, all potential allergens, can provoke an inflammatory reaction in your lungs. Symptoms usually develop within six hours of exposure to the allergen. Some people are more susceptible to developing hypersensitivity pneumonitis than are others, although it’s...
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