diet of the normal child and adolescent
Nelson essentials of pediatrics , 7th edition
Ngày tải lên :
27/08/2014, 19:08
... between the need to protect and support the health of the individual and the public with the rights of the individual and involves ethical issues of distributive justice in regard to the costs and ... radiographs on the basis of the number and size of calcified epiphyseal centers; the size, shape, density, and sharpness of outline of the ends of bones; and the distance separating the epiphyseal ... understanding of the information at frequent intervals and by recapitulating at the close of the visit, the interviewer and patient and family can ensure that they understand each other If the clinician’s...
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Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 1) docx
Ngày tải lên :
07/07/2014, 04:20
... Assessment of the patient's general appearance and vital signs, skin and soft tissue examination, and the neurologic evaluation are of particular importance The patient may appear either anxious and ... Measurement of blood pressure, heart rate, and respiratory rate helps determine the degree of hemodynamic and metabolic compromise The patient's airway must be evaluated to rule out the risk of obstruction ... associated with toxic shock syndrome (TSS) and drug fever The soft tissue and muscle examination is critical Areas of erythema or duskiness, edema, and tenderness may indicate underlying necrotizing...
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Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 2) pptx
Ngày tải lên :
07/07/2014, 04:20
... score of ≥25 and/ or multiorgan failure b Hydrocortisone (50-mg IV bolus q6h) with fludrocortisone (50-µg tablet daily for days) may improve outcomes of severe sepsis, particularly in the setting of ... administered at a dose of 24 µg/kg per hour for 96 h It has been approved for use in patients with severe sepsis and a high risk of death as defined by an Acute Physiology and Chronic Health Evaluation ... to β-lactam agents Adjust treatment as soon as the diagnosis is confirmed d The optimal dose of IV immunoglobulin has not been determined, but the median dose in observational studies is g/kg...
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Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 3) pps
Ngày tải lên :
07/07/2014, 04:20
... succumb to sepsis at 58 times the rate of the general population; 50–70% of cases occur within the first years after splenectomy, with a mortality rate of up to 80%, but the increased risk persists ... outside the United States, especially in developing countries in Africa and Asia The septic form is particularly rare and is associated with shock, multiorgan failure, and a 30% mortality rate These ... empirical therapeutic regimens are presented in Table 115-1 Sepsis Without an Obvious Focus of Primary Infection These patients initially have a brief prodrome of nonspecific symptoms and signs...
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Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 4) potx
Ngày tải lên :
07/07/2014, 04:20
... on the wrists and ankles and then spread over the legs and trunk The lesions become hemorrhagic and are frequently petechial The rash spreads to palms and soles later in the course The centripetal ... transmitted by larval mites or chiggers and is one of the most common infections in southeastern Asia and the western Pacific The organism is found in areas of heavy scrub vegetation (e.g., along ... status, and meningismus However, the rapidly progressive form of disease is not usually associated with meningitis The rash is initially pink, blanching, and maculopapular, appearing on the trunk and...
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Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 5) docx
Ngày tải lên :
07/07/2014, 04:20
... sudden onset of malaise, chills, fever, and hypotension The patient develops bullous or hemorrhagic skin lesions, usually on the lower extremities, and 75% of patients have leg pain The mortality ... Colonization rather than overt infection of the vagina or a postoperative wound, for example, is typical with staphylococcal TSS, and the mucosal areas appear hyperemic but not infected The diagnosis of ... Ebola and Marburg virus infections in Africa), and Flaviviridae (e.g., yellow fever in Africa and South America and dengue in Asia, Africa, and the Americas) Lassa fever as well as Ebola and Marburg...
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Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 6) docx
Ngày tải lên :
07/07/2014, 04:20
... decreases because of thrombosis of the small blood vessels and destruction of the peripheral nerves—an ominous sign The mortality rate is 25–30% overall, >70% in association with TSS, and nearly 100% ... febrile, apathetic, tachycardic, and tachypneic and may express a feeling of impending doom Hypotension and renal failure develop later, and hyperalertness is evident preterminally The skin over the ... present along with sepsis and hemodynamic instability Rapid recognition of the toxic patient with central neurologic signs is crucial to improvement of the dismal prognosis of these entities Subdural...
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Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 7) doc
Ngày tải lên :
07/07/2014, 04:20
... fever, and almost 90% have back pain Paresthesia, bowel and bladder dysfunction, radicular pain, and weakness are frequent neurologic complaints, and examination of the patient may reveal abnormal ... sinusitis, and wound infection Rapid clinical deterioration and death can be associated with destruction of the primary site of infection, as is seen in endocarditis and in necrotizing infections of the ... examination of the patient may reveal abnormal reflexes and motor and sensory deficits The ESR and leukocyte counts are usually elevated Rapid recognition and treatment, which may include surgical drainage,...
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Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 8) ppt
Ngày tải lên :
07/07/2014, 04:20
... have occurred primarily in Southeast Asia, particularly Vietnam However, evidence of a rapidly expanding geographic distribution of the virus throughout the world is of grave concern Avian influenza ... may develop and may precede respiratory symptoms Dyspnea develops a median of days after the onset of symptoms and can progress to respiratory distress syndrome, multiorgan failure, and death within ... distinguish these patients from other infected febrile patients who will not progress to fulminant disease The alert physician must recognize the acute infectious disease emergency and then proceed...
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Báo cáo y học: "Improving outcomes for ill and injured children in emergency departments: protocol for a program in pediatric emergency medicine and knowledge translation science" doc
Ngày tải lên :
11/08/2014, 05:21
... interviews and focus groups with the following professionals: a focus group of emergency physicians; a focus group of emergency nurses and respiratory therapists; the chief medical officer of the ED; and ... accuracy of the rule, and physician comfort and compliance Implementation of the rule has the potential to significantly reduce health care costs and improve the efficiency and safety of patient ... specific to the ED setting These include: the diversity of cases from minor to major and the diversity of conditions seen; limited continuity of care; management of children across primary and secondary...
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báo cáo khoa học: " Improving outcomes for ill and injured children in emergency departments: protocol for a program in pediatric emergency medicine and knowledge translation science" potx
Ngày tải lên :
11/08/2014, 16:20
... interviews and focus groups with the following professionals: a focus group of emergency physicians; a focus group of emergency nurses and respiratory therapists; the chief medical officer of the ED; and ... accuracy of the rule, and physician comfort and compliance Implementation of the rule has the potential to significantly reduce health care costs and improve the efficiency and safety of patient ... specific to the ED setting These include: the diversity of cases from minor to major and the diversity of conditions seen; limited continuity of care; management of children across primary and secondary...
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Báo cáo khoa học: "Clinical review: Outreach — a strategy for improving the care of the acutely ill hospitalized patient" pps
Ngày tải lên :
12/08/2014, 20:20
... and quality of end -of- life care [28,29] The Study to Understand Prognosis and Preferences for Outcomes and Risks of Treatment in the USA [29] demonstrated that 31% of the cohort of patients admitted ... [22,23], and this is related at least in part to the complexity of diseases, the multiplicity of therapies, frequent invasive interventions and, within the intensive care unit (ICU), the intensity of ... and the skills and abilities of the ward staff Both the Audit Commission [57] and the Department of Health working party report ‘Comprehensive Critical Care’ [55] supported the development of...
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Báo cáo khoa học: "Hypocholesterolemia in sepsis and critically ill or injured patients" ppsx
Ngày tải lên :
12/08/2014, 20:20
... cholesterol levels within a few days of the burn, with the lowest values occurring between the days and 10 They noted that both LDL and HDL, which carry over 80% of the total cholesterol in humans, ... condition’ during the febrile phase of tuberculosis In 1920, Kipp noted a relationship between the degree of hypocholesterolemia and the severity of infection We were unable to identify other articles ... triglyceride-rich very-low-density lipoproteins increased in the acute phase Of the various reasons offered for the hypocholesterolemia seen in critically ill and injured patients, especially those with sepsis,...
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Báo cáo khoa học: " Is albumin administration in the acutely ill associated with increased mortality? Results of the SOAP study" pps
Ngày tải lên :
12/08/2014, 23:20
... on admission, the timing of onset of albumin administration, use of other colloids and blood products (red blood cells, fresh frozen plasma), and the mean fluid balance, the degree of organ failure ... coagulation, and neurological) being collected on admission and every 24 hours thereafter For a single missing value, a replacement was calculated using the mean value of the results on either side of the ... Table shows the baseline characteristics of the propensity-matched patients on admission on the basis of age, gender, comorbidities, type of admission, SAPS II and SOFA scores, procedures, and sepsis...
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Báo cáo khoa học: "The role of thyroid hormone therapy in acutely ill cardiac patients" pot
Ngày tải lên :
12/08/2014, 22:22
... rT3, the authors ask whether we should consider treating cardiac patients who have the euthyroid sick syndrome with T3 (and not T4) to facilitate cardiac recovery There is now evidence that the ... function is an important indicator of outcome after an acute myocardial infarction [9] Although there will be resistance from the endocrinology community to trials of T3 therapy in acutely ill patients, ... illness: the ‘euthyroid sick syndrome’ Endocr Rev 1982, 3:164-217 Bianco AC, Salvatore D, Gereben B, Berry MJ, Larsen PR: Biochemistry, cellular and molecular biology, and physiological roles of the...
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Báo cáo khoa học: "Kidney function assessment in the critically ill child: is it time to leave creatinine behind" pot
Ngày tải lên :
13/08/2014, 03:21
... and colleagues argues strongly for the study of other markers, including cystatin C and β2M, in the near future Competing interests The author declares that they have no competing interests References ... duration and site of injury So, is it time to leave serum creatinine behind as a marker of renal function in patients with AKI? Currently, the answer is no, but the work of Herrero-Morin and colleagues ... [12] and KIM-1 (kidney injury molecule-1) [13], is required in pediatric patients to develop a panel of markers for the accurate and reliable assessment of early AKI development, AKI duration and...
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Báo cáo khoa học: "Medical treatment for the terminally ill: the ‘risk of unacceptable badness’"
Ngày tải lên :
25/10/2012, 10:45
... Perceptions by family members of the dying experience of older and seriously ill patients SUPPORT Investigators Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments Ann Intern ... end -of- life issues to patients and their families [11] It is not uncommon for physicians to ask loaded questions in their quest for end -of- life decisions For example, ‘This is your grandmother’s ... technically futile Under the current rules, the only test of futility is that embodied by the question, ‘Will this treatment result in sustained life?’ If the answer is ‘yes’, then virtually any treatment...
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Báo cáo y học: "Clinical Strategy for the Management of Solid Pseudopapillary Tumor of the Pancreas: Aggressive or Less"
Ngày tải lên :
25/10/2012, 11:40
... whom the mass was located in the portion of body or tail of the pancreas For tumors of SPT located in the neck and body of the pancreas, resection of the midportion of the pancreas and the mass ... in the other reported series.7 Literatures showed the head and tail of the pancreas were the preferential sites of the occurrence of SPT.3,7,10,14,15,16 In our series, the presenting clinical and ... preserving the rim of the head and tail portion can be achieved However, for the patient in whom the mass was located within the head of the pancreas, given the low malignancy, well-defined margin and...
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- hệ việt nam nhật bản và sức hấp dẫn của tiếng nhật tại việt nam
- xác định các mục tiêu của chương trình
- xác định các nguyên tắc biên soạn
- khảo sát các chuẩn giảng dạy tiếng nhật từ góc độ lí thuyết và thực tiễn
- khảo sát chương trình đào tạo của các đơn vị đào tạo tại nhật bản
- khảo sát chương trình đào tạo gắn với các giáo trình cụ thể
- xác định thời lượng học về mặt lí thuyết và thực tế
- tiến hành xây dựng chương trình đào tạo dành cho đối tượng không chuyên ngữ tại việt nam
- điều tra đối với đối tượng giảng viên và đối tượng quản lí
- điều tra với đối tượng sinh viên học tiếng nhật không chuyên ngữ1
- khảo sát thực tế giảng dạy tiếng nhật không chuyên ngữ tại việt nam
- khảo sát các chương trình đào tạo theo những bộ giáo trình tiêu biểu
- nội dung cụ thể cho từng kĩ năng ở từng cấp độ
- xác định mức độ đáp ứng về văn hoá và chuyên môn trong ct
- phát huy những thành tựu công nghệ mới nhất được áp dụng vào công tác dạy và học ngoại ngữ
- mở máy động cơ lồng sóc
- mở máy động cơ rôto dây quấn
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- đặc tuyến hiệu suất h fi p2