ballistic trauma in pregnancy

... arrhythmia during pregnancy The sinus rate increases by about 10 beats/minute during pregnancy, and sinustachycardia greater than 100 beats/min is common.1,2Ectopic beats, intermit-tent sinus tachycardia ... is intended to serve as a guide to understanding and managingarrhythmias in pregnant women by covering the underlying principles and dis-cussing individual arrhythmias that may be encountered Incidence ... embolism, infections and inflammatory states must be con-sidered in cases of unexplained sinus tachycardia 217 Practice points Essential investigations for suspected arrhythmia during pregnancy include:...

Ngày tải lên: 13/08/2014, 17:22

... Trang 1CHẤN THƯƠNG THAI NGHÉN (TRAUMA IN PREGNANCY) 1/ KHÁI NỆM QUAN TRỌNG NHẤT CẨN NHỚ TRONG CHẤN THƯƠNG THAI NGHÉN? - Tiên lượng ... cá nguyệt thứ ba Nồng độ fibrinogen tăng gấp đôi nồng độ được thấy nơi các bệnh nhân bị những chấn thương khác Đông máu rải rác trong lòng Trang 5mạch (disseminated intravascular coagulation) có ... (disseminated intravascular coagulation) nên được thực hiện trong tất cả các trường hợp nghi bong nhau thai - Phương pháp nhạy cảm nhất để chẩn đoán bong nhau thai sau chấn thương là monitoring...

Ngày tải lên: 13/07/2014, 16:20

... disappointingthat at the time of writing, President Mbeki of South Africa appears to bereversing this positive trend Rather than endorsing a programme of nationalfunding for perinatal zidovudine ... condi-tion In the aZuent, developed countries, up to 1994, HIV-positive women werefaced with the grim choice of either continuing with a pregnancy that carried a 1:5–6 risk of their oVspring being infected ... greatly – theaverage is around nine years.) But now HIV-infected individuals in thesecountries can hope for an increased longevity, with the maintenance of anindependent, reasonable quality of...

Ngày tải lên: 01/11/2013, 08:20

... the birth of healthy infants covers an increasingly broad spectrum of activities before, during and after the usual nine months of pregnancy In fact, depending upon the clinical situation, the ... medication and risking the well-being of their future child, or abstaining from its use for the duration of the pregnancy and seriously risking their own health and independence For women who intend to ... wisdom of initiating and continuing tocolysis for preterm labour or inducing labour for worsening gestational hypertension (Lettrie et al., 1993) There can also be serious disagreement regarding the...

Ngày tải lên: 01/11/2013, 08:20

... Paclitaxel-carboplatin — Paclitaxel-carboplatin Paclitaxel-carboplatin or Cisplatin-vinblastin- bleomycin Paclitaxel-cisplatin Paclitaxel-carboplatin Bleomycin-etoposide- cisplatin Cervical cancer Platin based ... sensorineural hearing loss, prematurity and postnatal treatment with gentamycin were confounding factors Taking these considerations into account, administration of cisplatin and cisplatin containing ... containing regimens during pregnancy resulted in absence of congenital anomalies and normal neurological development in 35 (95%) of 37 cas Carboplatin has been administered during pregnancy in...

Ngày tải lên: 05/03/2014, 15:20

... diabetes.16,17 Glargine, a long-acting insulin analog, was approved by the FDA in 2000 for use as basal insulin Insulin glargine has a glycine substitution in the a-chain at position 21 and two arginines attached ... an intrave-nous insulin infusion during labor Women should be instructed to not take their basal or long-acting insulin when in labor or the day of labor induction, and to begin an Trang 21insulin ... b-chain terminal at position 30 Glargine has been shown to provide a peakless, sustained 24-hour level of insulin with once-a-day administration at bedtime or in the morning; in certain individuals...

Ngày tải lên: 06/03/2014, 12:20

... máu (prothrombin time, partial thromboplastin time) Những phim X quang ban đầu nên gồm có chụp bên cột sống cổ (lateral cervical spine), ngực và khung chậu Sự tăng cao nồng độ transaminase hay amylase ... luôn đi trước kiểm soát tuần hoàn) 7/ NHỮNG GUIDELINE ĐỂ HỒI SỨC DỊCH CÁC TRẺ BỊ CHẤN THƯƠNG NẶNG ? Các dung dịch Normal saline và lactated Ringer là trụ cốt của điều trị Packed RBC nên được ... ÁP LỰC. Tràn khí màng phổi dưới áp lực do vết thương ngực (penetrating chest trauma) hay chấn thương do khí cấp tính (acute barotrauma) xảy ra trong khi bị chấn thương đụng dập Khí bị kẹt sau một...

Ngày tải lên: 26/07/2014, 19:20

... growth in knowledge in molecular microbiology and genetic engineering, including live and inactivated whole virus vaccines and subunit vaccines consisting of recombinant viral glycoproteins in various ... mainly by maternal first-time infection in the third trimester of pregnancy, have been published in literature Since the increasing prevalence of genital HSV infection and apparent increase in ... threshold of infection, or if they prevent or improve disease They could reduce HSV2 incidence by preventing infection or by reducing the shedding or clinical recurrences in a HSV2-infected individual...

Ngày tải lên: 12/08/2014, 04:21

... reduction in systemicvascular resistance bring about the increase in cardiac output necessary to sus-tain pregnancy Circulating blood volume An increase in blood volume has been documented in a number ... others suggest that it increases continuouslyuntil term.6The increase in blood volume is more pronounced in twin pregnan-cies.7Red cell mass increases as much as 40% above pre-pregnancy levels.2,5 ... the first pregnancy may be the only pregnancy In addition to protecting the child, itsafeguards patients with fragile circulatory reserve by eliminating maternalphysical effort and expediting the...

Ngày tải lên: 13/08/2014, 17:22

... that, withincreasing cyanosis, as reflected in the maternal hemoglobin, the incidence ofspontaneous abortion increased and the handicap to fetal growth was morepronounced.2In their series, no infant ... complexcongenital heart disease are surviving into the reproductive age after surgery ininfancy or childhood.1–4Congenital heart disease is not infrequently discoveredfirst during pregnancy, particularly now ... 1974. 9 Turner AF The chest radiograph in pregnancy Clin Obstet Gynecol 1975;18:65–74. 10 Morley CA, Lim BA The risks of delay in diagnosis of breathlessness in pregnancy. BMJ 1995;311:183–4. 11 Campos...

Ngày tải lên: 13/08/2014, 17:22

... relatively short duration of action of inhaled iloprost requires between six and nine 5- to 15-minute inhalations daily to obtain a sustainedclinical benefit Co-administration of iloprost with other ... resistance and result in a namically unstable milieu with increased clinical risk hemody-Hemodynamic perturbations in pregnancy Pregnancy normally induces profound changes in the maternal ics Cardiovascular ... explains why stenotic heart valve diseases arepoorly tolerated during pregnancy, in particular because of the physiological in-crease in cardiac output, which reaches 30–50% at the beginning of...

Ngày tải lên: 13/08/2014, 17:22

... monitoring of warfarin therapyduring pregnancy Substitution of warfarin with intravenous unfractionatedheparin in the first 6–12 weeks is associated with a low rate of warfarin em-bryopathy The initiation ... vasodilators, taking intoaccount the contraindication to the use of angiotensin enzyme-converting(ACE) inihibitors and angiotensin receptor blockers throughout pregnancy.Even in the case of heart ... timefor the same warfarin dose, resulting in use of higher doses of warfarin With in-ternational sensitivity indices (ISIs) ranging from 1.7 to 2.8, in the USA pro-thrombin time ratios of between...

Ngày tải lên: 13/08/2014, 17:22

... combined team, including physicians with experience in PHT, ina center with fully equipped intensive care and neonatal units Inhaled nitricoxide and intravenous, as well as inhaled prostacyclin ... recommendations include unfractionatedheparin between weeks 6 and 12 and close to delivery, maintaining warfarinduring the rest of pregnancy81(see Chapter 9) Low-dose aspirin can be used as-in association ... hyperventilation.12In a further study in the Andes at 4300 m, SaO2was 83% in the non-pregnant state and 87% in week 36 of pregnancy.13Inspite of a fall in hemoglobin concentration ([Hb]) in pregnancy,...

Ngày tải lên: 13/08/2014, 17:22

... fractional shortening <30% and/or — end-diastolic dimension >2.7cm/m 2 Trang 14A consensus opinion from the workshop in 1997 was of an incidence in tween 1 in 3000 and 1 in 4000 in the USA7,19which ... prevalence of intracardiac thrombosis and embolism in tum cardiomyopathy than in dilated cardiomyopathy outside pregnancy is at-tributable to the hypercoagulable state existing in pregnancy, which increasesthe ... other cardiomyopathies, pre-existing dilated cardiomyopathy, acute myocardial infarction, ritodrine-induced pulmonary edema in patients given the drug byinfusion in saline, fluid overload after surgical...

Ngày tải lên: 13/08/2014, 17:22

... who, increasingly are trained within narrow specialty and sub-speciality fields This is leading to what an eminent colleague of this author calls “… deployed surgeons hunting in teams.” Working in ... Ballistic Trauma in Children 529 Graeme Pitcher xx Contents 36 Ballistic Trauma in Pregnancy 549 Michael J Socher and Peter E Nielsen 37 Managing Ballistic Injury in the NGO Environment ... coalition, the invasion of Iraq by a US led coalition in 2003, terrorist bombings in Madrid in 2004, terrorist bombings in London in July 2005, and countless other terrorist and insurgency events...

Ngày tải lên: 29/06/2014, 09:20

... pre-existing retinal holes, the increase in retinal detachment following cataract extraction is substantial.104 Prevalence and Incidence The incidence of phakic nontraumatic retinal detachment in the ... fluorescein dye is injected intravenously into the vascular circulation and observed as it transits the retina and choroid Pneumatic retinopexy The injection of air or expanding gases into the eye in ... resulting in what is called a "retinal tear." Traction at the site of a tear can initiate retinal detachment surrounding the tear by pulling on the surface of the adjacent retina The break in the...

Ngày tải lên: 22/03/2014, 09:20

... services are integrated with housing needs In defining long-term care, then, several points are worth emphasizing: • • Long-term care is primarily concerned with maintaining or improving the ability ... systems with a single point of accountability; and flexible funding with incentives to integrate funding streams and minimize cost shifting (Booth et al., 1997) Despite the rhetoric of integration, ... of integrated administration, information, financing, and care management arrangements to help providers work together in minimizing costs while maximizing the long-term health and well-being...

Ngày tải lên: 28/03/2014, 17:20