...The Role of Imaging in Rheumatoid Arthritis Rheumatoid arthritis (RA), is a chronic, systemic inflammatory disease of unknown etiology that affects 0.5-1.0% of the general population [1]. It is the most common type of inflammatory arthritis and is characterized by synovial inflammation that can lead to structural damage of cartilage, bone and tendons [15]. There has been increasing evidence that the early use of disease-modifying anti-rheumatic drug (DMARD) leads to better outcomes [2]. However to be able to treat patients early they need to be diagnosed early and early diagnosis and treatment monitoring are the primary roles of imaging with regards to RA. Diagnosis of RA is frequently done through clinical examination and patients with RA typically present with pain and stiffness in one or multiple joints. The wrists, metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint are most commonly affected. However it is important to note that any synovial joint can be affected. The joints involved are usually bilateral and symmetric and women are more commonly affected than men. Characteristic deformities may also be seen in the hands. [11] CR: Traditionally, radiographs are used for evaluating RA and the...
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...Guidelines for the Use of Platelet Rich Plasma The International Cellular Medical Society Presented by DRAFT Version 1.0 Committee Members Kim Harmon, MD Ron Hanson, MD Jay Bowen, MD Scott Greenberg, MD Ed Magaziner, MD James Vandenbosch David Harshfield, MD Brian Shiple, MD David Audley The International Cellular Medical Society (ICMS) asserts that a need exists to create standards for platelet rich plasma (PRP) protocols, preparations, techniques and tracking. We believe that physicianled organizations will serve the needs and interests of both patients and physicians toward achieving the best outcomes. In order to advance PRP in particular (and autologous cellular medicine therapies in general), we have developed these guidelines to assist physicians in performing safe therapies, promote patient education, encourage robust clinical research and begin to define the scope and anticipated effects of these procedures. Platelet Rich Plasma: Historical Perspective The application of PRP has been documented in many fields. First promoted by M. Ferrari in 1987 (1) as an autologous transfusion component after an open heart operation to avoid homologous blood product transfusion, there are now over 5200 entries in the NCBI for PRP ranging in fields from orthopedics, sports medicine, dentistry, otolaryngology, neurosurgery, ophthalmology, urology, wound healing, cosmetic, cardiothoracic and maxillofacial surgery. The initial popularity of PRP grew from its promise as a safe...
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...Running head: PAIN CASE STUDY Case Study: Pain Amit Dhir, Omeid Heidari, Sean Mayer, Ololade Ikuomola & Adam Boyce NR110.542 Physiological/Pathophysiological Basis for Advanced Nursing Practice I 09/29/2015 Johns Hopkins University School of Nursing On our honor, we pledge that we have neither given nor received any unauthorized assistance on this assignment. 1 Running head: PAIN CASE STUDY CASE STUDY Pain Use this document in documenting your response to the Patient Case Questions. CHIEF COMPLAINT “My back is killing me. The pain is mostly sharp and stabbing, and sometimes it’s a dull ache. You’ve got to do something. Those Tramadol pills aren’t cutting it and they’ve bound me up.” “I am not sleeping because of the pain.” MEDICAL HISTORY P.M. is a retired, 81yearold male being seen for a routine health maintenance visit. He has a history of lower back pain, morbid obesity, hypertension, hypothyroid, occipital lobe stroke, bilateral total knee arthroplasty, GERD and sleep apnea. Now reporting pain in feet. He has been a smoker for the past 64 years, reporting 12 ppd. He is accompanied by his wife of 62 years. CURRENT MEDICATIONS Tramadol 50100 mg p.o. Q 12 hrs prn back pain Atenolol 25 mg p.o. Q a.m. Levothyroxine sodium 125 mcg p.o. Q a.m. Clopidogrel 75 mg p.p. Q a.m. Ibuprofen 600 mg ii p.o. prn knee pain Aspirin 650 mg p.o. prn “when I can’t get to sleep” ...
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...The stiffness and aches are most prominent and active when individuals wake up in the mornings, and also followed long periods of sedentariness ("Rheumatoid Arthritis: Symptoms & Treatment | Arthritis Foundation," n.d.). Flares are marked by swollen, tender, and painful joints, and are most commonly seen in the hands and the wrists. Individuals afflicted with RA develop difficulties carrying out every day activities such as opening bottles or turning doorknobs. As RA progresses, the joints of the knees and feet also become inflamed leading to pain when walking. A rare symptom of RA is when the inflammation affects the cricoarytenoid joint, which is responsible for “the tightening of our vocal cords.” When this joint is inflamed, it can result hoarseness, as well as a change in the tone of the voice ("Rheumatoid Arthritis Index by MedicineNet.com,"...
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...pharmacokinetic and pharmacodynamic changes in older people. 2. Evaluate the pharmacotherapy regimens of older people to support the maintenance of optimal physical and mental function. 3. Identify inappropriate medication prescribing in older people. 4. Recommend appropriate pharmacotherapy for patients with dementia. 5. Evaluate the risks and benefits of the use of antipsychotics (APs) (including atypical APs) in older patients with dementia. 6. Recommend appropriate interventions for patients suffering from behavioral symptoms related to dementia. 7. Identify the types of urinary incontinence and recommend appropriate treatments. 8. Given a patient’s American Urology Association Symptom Index for benign prostatic hyperplasia, recommend appropriate therapy. 9. Recommend appropriate analgesic therapy for older patients with osteoarthritis. 10. Discuss risks and benefits of medication classes used to treat rheumatoid arthritis. 2. Which of the following is the single most important intervention you can make to reduce her risk of falls? A. Suggest to J.T. that her neurologist reassess her Parkinson disease...
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...New Medical Devices in the US August 13 2010 Table of Contents 1. Introduction……………………………………………………………………………………………………………………………………2 2. Background and Framework……………………………………………………………………………………………………………4 2.1 Priority Medical Devices for the Netherlands…..……………………………………………………………………4 2.2 The US Vision: From see and treat to predict and prevent……………………………………………………6 2.3 Conclusions…………………………………………………………………………………………………………………………..7 3. Medical device sector in the US………………………………………………………………………………………………………8 3.1 Economic Impact…..………………………………………………………………………………………………………………8 3.2 The Sector by State…..…………………………………………………………………………………………………………10 3.3 Key Institutes: Patent Applications in the Cluster Areas…..………………………………………………….13 3.4 Conclusions…..…………………………………………………………………………………………………………………….20 4. Turning research into novel medical devices………………………………………………………………………………….22 4.1 The Medical Device Development Process…..……………………………………………………………………..22 4.2 CIMIT: A Structure for Medical Device Innovation…..………………………………………………………….23 4.3 Stanford Biodesign: Innovation as a Discipline…..………………………………………………………………..26 4.4 Conclusions and Recommendations…..……………………………………………………………………………….28 5. Summary and Conclusions…………………………………………………………………………………………………………….30 6. Acknowledgements……………………………………………………………………………………………………………………….32 7. References…………………………………………………………………………………………………………………………………….33 Appendices A1 Selection of Key Institutes A2 Results Patent Analysis A3 Research...
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...Villavelez, Carmina Anne Z. BSN III-C Submitted to: Mrs. Miraluna Echavez, RN, MN March 2013 UTERINE LEIOMYOMA/ UTERINE FIBROIDS Uterine fibroids are noncancerous growths of the uterus that often appear during your childbearing years. Also called fibromyomas, leiomyomas or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer. As many as 3 out of 4 women have uterine fibroids sometime during their lives, but most are unaware of them because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound. In general, uterine fibroids seldom require treatment. Medical therapy and surgical procedures can shrink or remove fibroids if you have discomfort or troublesome symptoms. Rarely, fibroids can require emergency treatment if they cause sudden, sharp pelvic pain or profuse menstrual bleeding. Symptoms In women who have symptoms, the most common symptoms of uterine fibroids include: * Heavy menstrual bleeding * Prolonged menstrual periods — seven days or more of menstrual bleeding * Pelvic pressure or pain * Frequent urination * Difficulty emptying your bladder * Constipation * Backache or leg pains Rarely, a fibroid can cause acute pain when it outgrows its blood supply. Deprived of nutrients, the fibroid begins to die. Byproducts from a degenerating fibroid can seep into surrounding tissue, causing pain and fever...
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...GI and Diabetes Exam Study Guide Tube Feeding – (enteral nutrition) refers to the administration of a nutritional balanced liquefied food or formula through a tube inserted into the stomach, duodenum, jejunum. It is used to provide nutrients via the GI tract either alone or as a supplement to oral or parenteral nutrition. - Nasogastric (NG) Tube – is most commonly used for short-term feeding problems. Other means of feeding are; esophagostomy, gastrostomy or jejunostomy. Transpyloric tube placement or placement into the jejunum is used when physiologic condition warrant feeding the pt below the pyloric sphincter. Special Indications – anorexia, orofacial fractures, head and neck cancer, neurologic or psychiatric conditions that prevent oral intake, extensive burns and those who are receiving chemotherapy or radiation therapy. Procedure for tube feeding 1. Patient position – 30-45 degrees position. Head remain elevated for 30-60 mins 2. Patency of tube – Tube should be irrigated with water before and after each feeing to ensure patency. 3. Tube Position – Placement of tube is checked before each feeing or every 8 hours with continuous feeings. Checking methods; aspiration and pH. 4. Formula 5. Administration of feeding – feeing are given either by gravity drip method or by feeding pump. 6. General Nursing Considerations – daily weight, accurate I’s and O’s. Blood glucose check. Complication Related To tube and feeding - Vomiting and or Aspiration -...
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...Definition of biometals A group of chemical elements that are needed in minute quantities for the proper growth, development, and physiology of an organism. The term Biometal refers to the role of metal ions in biology, biochemistry and medicine. The metals copper, zinc, iron and manganese are examples of metals that are essential for the normal functioning of the body. It is also a term used to describe a living machine. Definition of bioceramics An advanced ceramic used to create components suitable for use or replacement in the human body. Biocompatible or osteoinductive (stimulating bone growth) ceramic material, such as hydroxyapatite or some other type of calcium phosphate ceramic, used for reconstructive bone surgery and dental implants. Definition of biosemiconductor The biosemiconductor, together with the drift of charges, ions, and radicals, may be considered as a form of "bioplasma". Bioplasma may be subject to magnetohydrodynamic (MHD) control. The EM fields emitted by trained healers may be considered as coherent, resonant biomagnetic emissions by which a less coherent EM field of the patient is "tuned" to the specific frequency and phase, and through which homeostasis can be "aligned" to induce "healing". Definition of bioelectronics The application of electronic theories and techniques to the problems of biology. The use of biotechnology in electronic devices such as biosensors, molecular electronics, and neuronal interfaces; more speculatively, the use...
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...Clin Orthop Relat Res (2010) 468:2430–2436 DOI 10.1007/s11999-009-1220-0 CLINICAL RESEARCH Natural Course of Asymptomatic Deep Venous Thrombosis in Hip Surgery without Pharmacologic Thromboprophylaxis in an Asian Population Kosuke Tsuda MD, Tomio Kawasaki MD, Nobuo Nakamura MD, Hideki Yoshikawa MD, Nobuhiko Sugano MD Received: 8 August 2009 / Accepted: 22 December 2009 / Published online: 8 January 2010 Ó The Association of Bone and Joint Surgeons1 2010 Abstract Background The clinical importance of asymptomatic deep venous thrombosis in elective hip surgery is not clearly known. Questions/purposes We determined the preoperative and postoperative incidences of asymptomatic deep venous thrombosis, identified preoperative factors associated with postoperative deep venous thrombosis or pulmonary embolism, and established its natural course in patients who underwent elective hip surgery without receiving pharmacologic thromboprophylaxis. This work was performed at Osaka University Hospital and Kyowakai Hospital. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research. K. Tsuda, H. Yoshikawa Department...
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...Restorative Care Training for the Certified Nursing Assistant Trainer Manual TABLE OF CONTENTS Introduction Making the Most of the Training Making the Most of the Lesson Plans Making the Most of the Activities Trainer Preparation Welcome Module Activity T1 Welcome to the training Activity T2 Common Rules to Follow Activity T3 Successful Completion Activity T4 You will learn Trainer Preparation Module one Module one Trainer Preparation Module two Module two Trainer Preparation Module three Module three Trainer Preparation Module four Module four Appendix A Feeding Assistance Appendix B Fall Prevention Page T3 Page T3 Page T3 Page T4 Page T5 Page T7 Page T7 Page T8 Page T8 Page 7a Page 8 Page 27a Page 28 Page 35a Page 37 Page 104a Page 105 Page 114 Page 123 T2 Restorative Care; Training for the Certified Nursing Assistant Introduction Welcome to the program Restorative Care. This is the trainer manual used by trainers to teach nurse assistants and home health aides about caring for the person with Restorative issues. This manual accompanies the student manual, Restorative Care. This training is activity based. Participants are encouraged to share in the training process, to talk about relevant experiences if they choose and to ask questions. Making the Most of the Training Program Use this training manual as a guide for training individually or in groups. If you train on an individual basis it will be more effective to brainstorm with them than to use the...
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...transmitted from animal to human. While there are hundreds upon hundreds of diseases to be looked at, the ten researched below are the ones once prevalent among the veterinary technicians job in the clinic; Hip Dysplasia and Ethylene Glycol poisoning in dogs, Hyperthyroidism and Rabies in cats, Strangles and Equine Recurrent Uveitits in Horses, Cryptosporidium and Fasciola Hepatica in Ruminants and Swine, Idiopathic Epilepsy in Aviaries, and Lymphoma in Ferrets. Hip Dysplasia in dogs is a congenial condition caused by a femur that does not fit correctly into the pelvic socket, or poorly developed muscles in the pelvic area. The causes of hip dysplasia are considered heritable, but new research conclusively suggests that environment also plays a role. Although to what degree is caused by genetics versus what portion is caused by environmental factors are a topic of debate....
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...are and what they do Researchers believe stem cells offer great promise for new medical treatments. Learn about stem cell types, current and possible uses, ethical issues and the state of research. By Mayo Clinic staff You've heard about stem cells in the news, and perhaps you've wondered if they might help you or a loved one with a serious disease. You may wonder what stem cells are, how they're being used to treat disease and injury, and why they're the subject of such vigorous debate. Here are some answers to frequently asked questions about stem cells. Why is there such an interest in stem cells? Researchers hope stem cell studies can help to: * Increase understanding of how diseases occur. By watching stem cells mature into cells that eventually become bones, heart muscle, nerve cells, and other organs and tissue, researchers and doctors may better understand how a variety of diseases and conditions develop. * Generate healthy cells to replace diseased cells (regenerative medicine). Researchers hope they can train stem cells into becoming specific cells so that those specialized cells can be used to regenerate and repair diseased or damaged tissues in people. People who might benefit from stem cell therapies include those with spinal cord injuries, type 1 diabetes, Parkinson's disease, Alzheimer's disease, heart disease, stroke, rheumatoid arthritis, osteoarthritis and multiple sclerosis. Stem cells could also be grown to become new tissue for use in transplant...
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...NCSBN ON-LINE REVIEW 1.A client has been hospitalized after an automobile accident. A full leg cast was applied in the emergency room. reason for the nurse to elevate the casted leg is to A) Promote the client's comfort B) Reduce the drying time C) Decrease irritation to the skin D) Improve venous return The most important D: Improve venous return. Elevating the leg both improves venous return and reduces swelling. Client comfort will be improved as well. 2. The nurse is reviewing with a client how to collect a clean catch urine specimen. What is the appropriate sequence to teach the client? A) B) C) D) Clean the meatus, begin voiding, then catch urine stream Void a little, clean the meatus, then collect specimen Clean the meatus, then urinate into container Void continuously and catch some of the urine A: Clean the meatus, begin voiding, then catch urine stream. A clean catch urine is difficult to obtain and requires clear directions. Instructing the client to carefully clean the meatus, then void naturally with a steady stream prevents surface bacteria from contaminating the urine specimen. As starting and stopping flow can be difficult, once the client begins voiding it’s best to just slip the container into the stream. Other responses do not reflect correct technique 3. Following change-of-shift report on an orthopedic unit, which client should the nurse see first? A) B) C) D) 16 year-old who had an open reduction of a fractured wrist 10 hours ago 20 year-old...
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...00_078973706x_fm.qxd 1/14/08 2:42 PM Page i NCLEX-PN ® SECOND EDITION Wilda Rinehart Diann Sloan Clara Hurd 00_078973706x_fm.qxd 1/14/08 2:42 PM Page ii NCLEX-PN® Exam Cram, Second Edition Copyright © 2008 by Pearson Education All rights reserved. No part of this book shall be reproduced, stored in a retrieval system, or transmitted by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. No patent liability is assumed with respect to the use of the information contained herein. Although every precaution has been taken in the preparation of this book, the publisher and author assume no responsibility for errors or omissions. Nor is any liability assumed for damages resulting from the use of the information contained herein. ISBN-13:978-0-7897-2706-9 ISBN-10: 0-7897-3706-x Library of Congress Cataloging-in-Publication Data Rinehart, Wilda. NCLEX-PN exam cram / Wilda Rinehart, Diann Sloan, Clara Hurd. -- 2nd ed. p. cm. ISBN 978-0-7897-3706-9 (pbk. w/cd) 1. Practical nursing--Examinations, questions, etc. 2. Nursing--Examinations, questions, etc. 3. National Council Licensure Examination for Practical/Vocational Nurses--Study guides. I. Sloan, Diann. II. Hurd, Clara. III. Title. RT62.R55 2008 610.73'076--dc22 2008000133 Printed in the United States of America First Printing: February 2008 Trademarks All terms mentioned in this book that are known to be trademarks or service marks have been appropriately...
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