...Case Scenario Report: Mrs. Annika Akerman, age 60 years, is a C/M/F, vegetarian, of Scandinavian descent, admitted today. She had a total gastrectomy one month ago and was discharged to her home. She was readmitted today because of numbness and tingling in her hands and feet and progressive weakness in both legs making it difficult for her to walk or stand. She has just arrived on the unit. Vital signs are Height 5’5”, weight 112 pounds, BP:102/65, Temp: 99, Pulse: 75, Respirations 18, SaO2: 90%. On oxygen at 2L per nasal canula. Heart sounds normal with no murmur. Admission History Diagnosis Arthritis 2 years ago Diagnosis Ulcerative Colitis 6 months ago after experiencing abdominal pain and bloody diarrhea. Despite treatment, progression of the disease required surgical intervention one month ago. She agreed to have a total gastrectomy done at that time. Allergies: NKDA Home Meds Sulfasalazine 1g PO QID Loperamide 2mg PRN after each loose stool Surgical History Total Gastrectomy, Dr. Slice, Wish Hospital 1 month ago Social Married 40 years, no children, retired school teacher Non-smoker Does not drink alcoholic beverages Vegetarian Diet Drinks 2-3 cups of coffee daily During the interview, Mrs. Akerman states “This is very frustrating. I have always had a well balanced diet. I just don’t understand why I feel so tired and dizzy lately. Before my surgery I used to go on a morning walk every day. But now I feel winded and unsteady just by walking around my kitchen...
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...The disease may occur at any time in life, but people are usually diagnosed between ages 20 and 50. Medications to reduce stomach acid and heal the ulcers is the usual treatment for Zollinger-Ellison syndrome. Treatment? Drugs referred to as nucleon pump inhibitors (omeprazole, Prevacid, and others) used for treating this drawback. These medicine scale back acid production by the abdomen. This helps the ulcers within the abdomen and little viscous heal. These medicines conjointly relieve abdominal pain and symptom. Surgery to get rid of one gastrinoma is also done if the tumors haven't unfold to alternative organs. Surgery on the abdomen (gastrectomy) to manage acid production isn't required. Blood Tests? The health care supplier might use blood tests to envision for associate elevated internal secretion level. A technician or nurse attracts a blood sample throughout associate workplace visit or at a poster facility and sends the sample to a science laboratory for analysis. A healthcare supplier can raise the person to quick for many hours before the check and should raise the person to prevent acid-reducing medications for a amount of your time before the check. A internal secretion level that's ten times beyond traditional suggests...
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...1.Phase II of the NoPain clinical trials requires a placebo group, whereas phase I does not. Explain why. Phase I clinical trials are used to screen the drug for safety. The maximum safe dose is established and it shows that the drug shows no side effects. When that phase is finished they then move into a new phase to establish the effect of the drug and how much should be given in order to achieve the desired affect. It is then established who will benefit from the drug and the best way to administer the dug. 2.Phase I of the NoPain trials uses only 50 subjects. Why couldn’t MedPharm save money by limiting phases II and III to 50 subjects each? Each specific drug has to undergo the certain phases in order pass to the next one. For the larger sample size ensures a high degree of statistical confidence. The sample size that the drug is administered to should show better results than the placebo group. 3. Would you classify NoPain as a palliative, active,or preventive treatment for cancer? Explain. I would classify it as a palliative treatment since it is designed to relieve the pain and bring comfort to the patient. The purpose of the drug is not to cure the disease nor cause homeostasis. 4. Mae, a 76year old retiree living on a fixed income, complains about the expense of the medications she must take to control her blood pressure and diabetes. “Why do I have to pay as much as $1.33 for one little pill?” she grumbles. Based on your reading of this case...
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...The surgical team has successfully completed thousands of procedures, including gastric bypass surgery, also commonly referred to as RNY or Roux-en-y. They are experts at handling all types of cases even the most challenging or atypical cases. This type of….. Gastric Sleeve Surgery in Mexico Gastric Sleeve surgery is also commonly referred to as Laparoscopic Vertical Sleeve surgery, sleeve gastrectomy or gastric sleeve resection. This surgery is a popular choice because it is one of the most innovative options for weight loss. It involves surgery to remove approximately 85% 0f the stomach. After surgery the stomach has a tube or sleeve like appearance which is why it is often referred to as a sleeve gastrectomy. It involves surgery …. Duodenal Switch Surgery in Mexico The Biliopancreatic Diversion (BPD) or the duodenal switch surgery is a very effective tool for weight loss management and a powerful metabolic procedure. In fact, in patients with type two diabetes, it has been found to effectively cure up to 98% of those with the disease....
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...SEATTLE UNIVERSITY IMMUNIZATION RECORD PART I Name Address Date of Entry ____/_____ Date of Birth _____/_____/_____ School ID# ________________________________________ Mo Yr Mo Day Yr PART II - TO BE COMPLETED AND SIGNED BY YOUR HEALTH CARE PROVIDER OR A COPY OF YOUR OFFICIAL IMMUNIZATION HISTORY (Please fill out Part I if you are attaching photocopied records).All information must be in English. REQUIRED IMMUNIZATIONS 1. M.M.R. (Measles, Mumps, Rubella) (Two doses required at least 28 days apart for students born after 1956 and all health care professional students.) A. Dose 1 given at age 12-15 months or later.…………………………………………………………….#1 ____/____/____ Mo Day Yr B. Dose 2 given at age 4-6 years or later, and at least one month after first dose ………………..………#2 ____/____/____ Mo Day Yr OR C. MMR surface antibody Result Reactive _____ Non-reactive _____.………………… .____/____/____ ...
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...it would ignite the cotton, and filtration, because it will just tear the cotton. 6. Immunotherapy, chemotherapy, and radiotherapy are all used to treat cancer. 7. Nosocomial lung infection refers to any pneumonia contracted by a patient in a hospital at least 48–72 hours after being admitted. It is thus distinguished from community-acquired pneumonia. It is usually caused by a bacterial infection, rather than a virus. 8. The physician would use orally by pills or an oral patch because it is much faster. 9. The use of international units are important in medicine because the it would be easier to communicate and the measurements would be the same around the world. 10. Gastrotomy is the incision of the stomach. Gastrectomy involves cutting a piece of the stomach out. Gastroscopy is to look inside or examine the stomach. Gastrocentesis involves puncturing the stomach. Gastrocylsis is the irrigation of the...
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...Just a Girl in a Fast Food World Wendi L. Fleming COM/155 June 27, 2013 Kathy Gambsky Just a Girl in a Fast Food World What is a girl to do when the consumption of fast food has rapidly expanded her from a size 12 to a size 22? The United States has become a fast food world where everything must happen now. Americans want fast food, fast cars and fast results. With the ever increasing popularity of fast food restaurants becoming the standard for eating on the run, coupled with the increase in portion size, the fast food world is rapidly becoming the “fat” food world. Following the trend of needing to have everything happen quickly, one option that is widely debated is bariatric surgery. Although today’s population craves rapid results, risk of bariatric surgery to obese patients outweighs the benefits of diet and behavior modification in successful weight loss. Over the past decade, the trend in obesity has risen to 1/3 of the population of the United States. According to a study published by the Center for Disease Control (CDC) there is no delineation between adult men and women of any age, however, those over 60 years of age were more likely to be obese than young adults. (Ogden CL, 2012) Obesity is defined by a person’s Body Mass Index (BMI). BMI is an important health factor that should be monitored by...
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...surgery away called, weight loss surgery. Many people believe that this surgery is the easy way out but I fell that after you have tried with no results this is the best thing. Weight lost surgery is a surgery that changes your stomach and digestive system that limit how much food you can eat and how many nutrients you absorbs leading to weight loss. In this essay I will talk about the different types of surgery and how they worked, the requirement in order to have the surgery and also the advantage and the disadvantage of the surgery. After reading the essay you will understand weight loss surgery and why people get it. There are 4 types of weight loss surgery that people can have. They are called Gastric Bypass, Vertical Sleeve Gastrectomy, Adjustable Gastric Band and Biliopancreatic Diversion with a Duodenal Switch. In order to have these surgery there are pre-requisite that have to be followed. The first step is the doctor has to check your BMI (Body Mass Index) to see what you rate, if your BMI is 40 and greater then you qualify but if your BMI is 35 and greater and you have a serious health problem linked to obesity then you qualify for the surgery. The FDA (Food and Drug Administration) has an approved people whose BMI is 30 and greater and also a health condition linked to obesity. The other reasons are when diet and exercise have been unsuccessful, and also a team of health care professional approved. The team of health care professional including a doctor,...
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...Cindy Le A&P 211 June 9, 2014 Case Study #3 1. In the NoPain drug trials, phase I clinical trials did not have a placebo group because different phases are testing different aspects of the drugs. Phase I was meant to first screen the drug safety for human subjects. In phase II, the research was meant to see who would benefit from taking the drug, the benefits realized, and best administrative routes of the drug. 2. MedPharm could not reduce their test group to only 50 volunteers during phase II and phase III because they need a larger group to be able to distinguish factors such what kinds of people would benefit from the drug or test the different age groups. By having a large sample group, this will allow for higher degree of statistical confidence is the drug’s ability to work in a wide range of cancer patients. 3. The NoPain medication should be classified as a palliative treatment because it is aimed at alleviating pain in cancer patients. 4. Based on reading this article, I would tell Mae that the pill that she takes to control her blood pressure and diabetes is expensive because it has gone through a long and expensive process to make sure that the drug she is taking is safe and effective. I would tell her about the years dedicated to research as well as the millions/billions of dollars spent on paying volunteers, chemist, doctors and researchers to ensure the safety of the pill she is taking today. 5. To sterilize my cotton swabs I would use an autoclave...
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...Iron Deficiency Anemia Gretchen Tai see Chamberlain College of Nursing NR 281 Pathophysiology Professor Patton 29 May 2015 Iron deficiency anemia is a common easily treated condition that occurs if you don’t have enough iron in your body. The word "anemia" usually refers to a condition in which your blood has a lower than normal number of red blood cells. Red blood cells are responsible for the transport of oxygen and removal of carbon dioxide (a waste product) from your body. In iron deficiency anemia, the red cells appear abnormal and are unusually small (microcytic) and pale (hypochromic). The pallor of the red blood cells reflects their low hemoglobin content. There are four common causes associated with Iron deficiency anemia. The first one is decreased intake of iron in your diet. This mostly affects infants less than six months old because their diet consists of mostly breast milk and breast milk is a poor source of iron. For adults we can increase our diet with foods that are rich in iron like red meat, pork, seafood, beans, dark leafy vegetables to name a few. We should also take a vitamin C supplement or eat more foods rich in vitamin C such as broccoli, grapefruit, kiwi, oranges, and strawberries. These foods can aid in the absorption of iron. The second cause is increase demand that the body has for iron when a child or adolescent is going through a rapid growth there is an expansion of blood volume. Another example of this would be when a woman...
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...1/19/15 Daily Pak Banker (Pak.) (Pg. Unavail. Online)2015 WLNR 1829602Daily Pak Banker (Pakistan)Copyright (c) 2015 Plus Media Solutions Private Limited PakistanJanuary 19, 2015Bariatric Surgery Can Benefit Some Obese Children and Teens, Reports Journal of Pediatric Gastroenterology and NutritionStaff ReporterAlphen aan den Rijn: Wolters Kluwer has issued the following news release: ?Bariatric surgery—?as a last resort when conservative interventions have failed—?can improve liver disease and other obesity-related health problems in severely obese children and adolescents, according to a position paper in the Journal of Pediatric Gastroenterology and Nutrition, official journal of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health. ?But because of the potential for serious complications, an expert panel recommends that bariatric surgery be reserved for carefully selected subgroups of young children with severe or morbid obesity and associated medical conditions. The recommendations appear in a new position paper authored by the ESPGHAN Hepatology Committee, under the leadership of Prof. Valerio Nobili of Bambino Gesù? Children’s Hospital, Rome. ?Bariatric Surgery in Children—?Experts Review the Evidence The Committee—?made up of 12 European specialists in pediatric...
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...Osteoporosis, which means "porous bones," causes bones to become weak and brittle — so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. In many cases, bones weaken when you have low levels of calcium and other minerals in your bones. A common result of osteoporosis is fractures — most of them occur in the spine, hip or wrist. Although it's often thought of as a women's disease, osteoporosis affects men too. And aside from people who have osteoporosis, many others have low bone density, putting them at risk of developing osteoporosis. Scientists don't yet know exactly why osteoporosis occurs, but they do know that the normal bone remodeling process is disrupted. Your bone is continuously changing — new bone is made and old bone is broken down (resorption) — a process called remodeling or bone turnover. When you're young, your body makes new bone faster than it breaks down old bone and your bone mass increases. You reach your peak bone mass around age 30. After that, bone remodeling continues, but you lose slightly more than you gain. How likely you are to develop osteoporosis depends on how much bone mass you attained in your 20s and early 30s (peak bone mass) and how rapidly you lose it later. The higher your peak bone mass, the more bone you have "in the bank" and the less likely you are to develop osteoporosis as you age. The strength of your bones depends on their size and density; bone density depends in part on the amount of...
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...2011 to 2015 the total number of surgeries has been done between was 158,000 to 196,000 (“Estimate of Bariatric”). Which shows the increased rate in surgeries as well the recommended solution by doctors for the obese. In addition, Donna H Ryan explains, “Bariatric surgical procedures produce weight loss by restricting the size of a meal (all procedures) and by their effects on gut hormones that affect appetite, such as gastric bypass and gastric sleeve. These procedures have been shown to not only produce weight loss, but to have a positive impact on diabetes, hypertension, dyslipidemia and even mortality” (Ryan, Donna H). Furthermore, there are different procedures according to the requirements which are known as Gastric Bypass, Sleeve Gastrectomy, Adjustable Gastric Band and Biliopancreatic Diversion with Duodenal Switch. NLC states, “ The estimated annual health care costs of obesity-related illness is a staggering $190.2 billion or nearly 21% of annual medical spending in the United States” (“National League”). In short, getting a surgery can have a long term effect as well as cure other health consequences related to obesity. This has been proven an effective solution. An other solution for obesity is to stay healthy. Due to increased in new technologies our individual lifestyles have changed its involves new household gadgets, television, computers and video games. At the same time, increased in quantity and service of fast food restaurants. In addition, some statistics show...
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...SHOCK, SURGICAL INFECTIONS & TRAUMA Choose the best answer: 1) More commonly, wound infections following surgery become evident on: A. Between third and fifth day B. Between eight and eleventh day C. Between first and third day D. Between fourth and seventh day E. Between twelfth and sixteenth day 2) The following is an example of Class III surgical wound: A. Urinary bladder surgery B. Herniorrhaphy C. Gastrectomy D. Resection of obstructed bowel E. Surgical drainage of pelvic abscess 3) A 70 yr old victim of an auto-pedestrian accident develops manifestation of severe sepsis 14 days after a Splenectomy. The organism most likely to be involved is: A. Staph. aureus B. Strep. Pyogenes C. Hemophilus influenza D. E. coli E. Klebsiella sp. 4) The most reliable protection for the surgeon against Hepatitis B infection is by: A. adherence to universal precautions B. administration of gamma globulins C. active immunization D. double gloving E. administration of interferons 5) Pro-inflammatory mediators in shock, EXCEPT: A. IL-4 B. IL-2 C. TNF D. IL-6 E. IL-8 6) Hypotension occurs in healthy patients if blood volume is decreased by: A. 15-30% B. More than 40% C. Up to 15 % ...
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...disease. However, there is now a large body of scientific evidence showing remission of T2DM following bariatric surgery. A large review of 621 studies involving 135,247 patients found that bariatric surgery causes improvement of diabetes in more than 85 percent of the diabetic population and remission of the disease in 78 percent. Remission of T2DM was highest for the bilio-pancreatic diversion with duodenal switch (BPD/DS) with a remission rate of 95 percent, followed by the Roux-en-Y gastric bypass (RYGB) with remission in 80 percent of patients, and the adjustable gastric band (AGB) with a remission rate of 60 percent. Other studies comparing remission of diabetes between surgeries found comparable rates between the laparoscopic sleeve gastrectomy (LSG) and RYGB, i.e. 80 percent. Causes of improvement or remission of diabetes have not been completely identified. Improvement of T2DM with AGB is related to weight loss. However, with other surgeries, such as the LSG or RYGB, diabetes remission or improvement occurs early after surgery – well before there is significant weight reduction. In fact, some bariatric patients with T2DM leave the hospital with normal blood sugar and without the need for antidiabetic medication. Changes in Quality of Life and Psychological Status with Surgery In addition to improvements in health and longevity, surgical weight-loss improves overall quality of life. Measures of quality of life that are positively affected by bariatric surgery include physical...
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