Archive for May, 2011

HEART AND BLOOD CIRCULATION

May 23
Trouble with the human body may be approached from the point of view of its structure or its function. The heart may be enlarged, or its valves may leak or be narrowed, or its blood supply may be inadequate because of blocking. The changes in structure produce changes in function which are reflected in symptoms. From the functional point of view the heart may beat too fast or too slowly, or irregularly. Its beat may be weak or strong. The heart may be overactive or underactive.
When the heart is overactive people complain of palpitation. The heart sounds are loud and the pulse is full and bounding. Signs of an overactive heart may be seen when one has had severe exercise or emotional stress. With excessive action of the thyroid gland the heart beats more rapidly, as it does also with severe anemia. Whenever there is fever or lack of oxygen the heart becomes overly active.
When the circulation of blood through the blood vessels is insufficient because of failure of the heart, which means under-activity, the symptoms include apathy and lassitude, sometimes faintness, and collapse. If a sudden hemorrhage occurs the circulation fails. With failure of the heart the blood pressure falls and the skin becomes cold, clammy, dry, and inelastic.
In heart failure congestion of the lungs follows, with shortness of breath and the difficulty with breathing that occurs because of fluid. The doctor can hear with his stethoscope sounds in the lung that show the congestion. The patient coughs to get rid of the congestion.
*3/318/5*
Filed Under: Cardio & Blood-Cholesterol

ADAPTING TO A CANCER DIAGNOSIS: SOME TIPS ABOUT FAMILY, FRIENDS AND SPIRITUALITY

May 12
Inform family and friends of the diagnosis and treatment.
Nominate who will be your spokesperson to occasionally communicate with the doctor in extreme situations. Explain to your family and friends why you have chosen a particular person to help, and not others. Reassure them they will be kept just as informed and discuss other ways in which they can help. Ask for practical support, but take control of how you want to manage this time. It will be a natural protective urge for others to ‘wrap you in cotton wool’ and smother you with kindness. Dependency at such an early stage can reduce your capacity to feel like you are in charge of the situation. Some families and loved ones are often scared to talk about your condition for fear that ‘bringing it up’ might be worse for you or make you sadder. Sometimes confronting your fears together will bring not only tears, but relief.
Some women, however, will relish in the attention and care. Draw up lists of how your friends can best help to reduce the load of the roles you normally have. Remember that loved ones need to be doing something for you at this stage … it may often be of more help to them than to you!
Reassure your children that you have the best of care and that you are fine.
Managing children at this time requires extra sensitivity. Children are not stupid. Their radar instantly tunes in to any tension or anxiety in the family. Not informing them, in a manner appropriate to their age, will create more anxiety later. The hospital social worker or Cancer Council will provide information and support on how to communicate with children of all ages. They will advise on how to prepare them for your absence in hospital, or change in physical appearance. Purchase something special for the child to take care of for you in your absence – a toy, plant to nurture, special project. Give each child a special photograph of you that they will have when you go in to hospital. Some centers have special programs for the children of cancer patients. However, most children with limited knowledge of the world will be feeling highly vulnerable at this time. Identify who is really special in your child’s life and arrange for them to take special care.
Spirituality
Many women have religious and spiritual values. Others turn to a ‘higher force’ in times of urgent need only. Ask networks of friends, acquaintances and strangers to pray for survival and healing. Carers and friends need to be aware that your spirituality may evolve and change during the emotional healing process and they should not be alarmed.
*21/144/5*

ADAPTING TO A CANCER DIAGNOSIS: SOME TIPS ABOUT FAMILY, FRIENDS AND SPIRITUALITYInform family and friends of the diagnosis and treatment.Nominate who will be your spokesperson to occasionally communicate with the doctor in extreme situations. Explain to your family and friends why you have chosen a particular person to help, and not others. Reassure them they will be kept just as informed and discuss other ways in which they can help. Ask for practical support, but take control of how you want to manage this time. It will be a natural protective urge for others to ‘wrap you in cotton wool’ and smother you with kindness. Dependency at such an early stage can reduce your capacity to feel like you are in charge of the situation. Some families and loved ones are often scared to talk about your condition for fear that ‘bringing it up’ might be worse for you or make you sadder. Sometimes confronting your fears together will bring not only tears, but relief.Some women, however, will relish in the attention and care. Draw up lists of how your friends can best help to reduce the load of the roles you normally have. Remember that loved ones need to be doing something for you at this stage … it may often be of more help to them than to you!
Reassure your children that you have the best of care and that you are fine.Managing children at this time requires extra sensitivity. Children are not stupid. Their radar instantly tunes in to any tension or anxiety in the family. Not informing them, in a manner appropriate to their age, will create more anxiety later. The hospital social worker or Cancer Council will provide information and support on how to communicate with children of all ages. They will advise on how to prepare them for your absence in hospital, or change in physical appearance. Purchase something special for the child to take care of for you in your absence – a toy, plant to nurture, special project. Give each child a special photograph of you that they will have when you go in to hospital. Some centers have special programs for the children of cancer patients. However, most children with limited knowledge of the world will be feeling highly vulnerable at this time. Identify who is really special in your child’s life and arrange for them to take special care.
Spirituality Many women have religious and spiritual values. Others turn to a ‘higher force’ in times of urgent need only. Ask networks of friends, acquaintances and strangers to pray for survival and healing. Carers and friends need to be aware that your spirituality may evolve and change during the emotional healing process and they should not be alarmed.*21/144/5*

Filed Under: Cancer

TREATMENT OF ACUTE CALCULOUS CHOLECYSTITIS

May 2
In approximately 75% of cases, acute calculous cholecystitis will subside with conservative therapy, which consists of maintenance of a fasting state, intravenous fluid hydration, and analgesia. Although acute calculous cholecystitis is primarily an inflammatory process, secondary bacterial infection of the gallbladder can occur, particularly when complications ensue. The organisms found in the biliary tract in these instances are typically the same as normal intestinal flora. Empiric antimicrobial therapy should be directed at these organisms. When the results of antimicrobial susceptibility testing become available, more specific antibiotic therapy should be substituted. Antibiotics are typically not required for the treatment of uncomplicated cholecystitis, since they do not appear to affect the outcome of the attack or decrease the incidence of local infectious complications.
The selection and timing of surgical intervention depend on the severity of symptoms and the patient’s overall risk of surgery. Surgical intervention should be considered in patients with a known or suspected complication (gangrene, pericholecystic abscess, perforation with peritonitis) or in those with intractable pain and progressive fever despite supportive therapy. Consultation with a general surgeon should be obtained to assist in the selection of definitive therapy. Although open cholecystectomy had been considered the gold standard for the treatment of acute calculous cholecystitis, laparoscopic cholecystectomy has become the operative procedure of choice. In unstable patients in whom surgical intervention is contraindicated, drainage of the gallbladder may be performed with an ultrasound- guided percutaneous cholecystostomy. This involves placing a catheter into the gallbladder with the patient under local anesthesia. Complications include bacteremia, bleeding, and peritonitis due to bile leak.
*103/348/5*
Filed Under: Anti-Infectives

 

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