Tìm thấy 14+ kết quả cho từ khóa "Approach to the Patient"
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Approach to the Patient with Cancer. However, many months usually pass between the diagnosis of cancer and the occurrence of these complications, and during this period the patient is severely affected by the possibility of death.. The patient imagines the worst in preparation for the end of life and may go through stages of adjustment to the diagnosis.
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Approach to the Patient with Cancer. Approach to the Patient with Cancer: Introduction. The application of current treatment techniques (surgery, radiation therapy, chemotherapy, and biological therapy) results in the cure of nearly two of three patients diagnosed with cancer. Nevertheless, patients experience the diagnosis of cancer as one of the most traumatic and revolutionary events that has ever happened to them.
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Approach to the Patient with Cancer. Pain occurs with variable frequency in the cancer patient: 25–50% of patients present with pain at diagnosis, 33% have pain associated with treatment, and 75% have pain with progressive disease.
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Approach to the Patient with Cancer. Cancer Around the World. When broken down by region of the world, ~45% of cases were in Asia, 26% in Europe, 14.5% in North America, 7.1% in Central/South America, 6% in Africa, and 1% in Australia/New Zealand (Fig. Lung cancer is the most common cancer and the most common cause of cancer death in the world. Its incidence is highly variable, affecting only 2 per 100,000 African women but as many as 61 per 100,000 North American men.
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Approach to the Patient with a Skin Disorder. APPROACH TO THE PATIENT WITH A SKIN DISORDER:. The challenge of examining the skin lies in distinguishing normal from abnormal, significant findings from trivial ones, and in integrating pertinent signs and symptoms into an appropriate differential diagnosis. The fact that the largest organ in the body is visible is both an advantage and a disadvantage to those who examine it.
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Approach to the Patient with Cancer. Making a Treatment Plan. From information on the extent of disease and the prognosis and in conjunction with the patient's wishes, it is determined whether the treatment approach should be curative or palliative in intent. Cooperation among the various professionals involved in cancer treatment is of the utmost importance in treatment planning.
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Approach to the Patient with Cancer. Fluid may accumulate abnormally in the pleural cavity, pericardium, or peritoneum. Asymptomatic malignant effusions may not require treatment.. Symptomatic effusions occurring in tumors responsive to systemic therapy usually do not require local treatment but respond to the treatment for the underlying tumor.
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Approach to the Patient with Cancer. The recognition and treatment of depression are important components of management. The incidence of depression in cancer patients is ~25% overall and may be greater in patients with greater debility. This diagnosis is likely in a patient with a depressed mood (dysphoria) and/or a loss of interest in pleasure (anhedonia) for at least 2 weeks.
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Approach to the Patient with a Skin Disorder. An example of ACD in its acute phase, with sharply demarcated,. ACD in its chronic phase demonstrating an erythematous, lichenified, weeping plaque on skin chronically exposed to nickel in a metal snap. Manner in which the eruption progressed or spread. Symptoms associated with the eruption. Associated systemic symptoms (e.g., malaise, fever, arthralgias). Social, sexual, or travel history as relevant to the patient.
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Approach to the Patient with a Skin Disorder. Tzanck Smear. A Tzanck smear is a cytologic technique most often used in the diagnosis of herpesvirus infections [herpes simplex virus (HSV) or varicella zoster virus (VZV)] (see Figs. An early vesicle, not a pustule or crusted lesion, is unroofed, and the base of the lesion is scraped gently with a scalpel blade.
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Older patients and those with a Karnofsky performance status <70 have a poor prognosis unless the poor performance is a reversible consequence of the tumor.. Functional Capability of the Patient. Increasingly, biologic features of the tumor are being related to prognosis.
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For example, a hospitalized patient with a generalized erythematous exanthem is more likely to have a drug eruption than is a patient with a similar rash limited to the sun-exposed portions of the face. Once the distribution of the lesions has been established, the nature of the primary lesion must be determined. In this manner, identification of the primary lesion directs the examiner toward the proper diagnosis
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Tumor markers may be useful in patient management in certain tumors.. Response to therapy may be difficult to gauge with certainty. However, some tumors produce or elicit the production of markers that can be measured in the serum or urine and, in a particular patient, rising and falling levels of the marker are usually associated with increasing or decreasing tumor burden, respectively.. Some clinically useful tumor markers are shown in Table 77-5.
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Fewer studies than in the past have implicated Ureaplasma. Coliform bacteria can cause urethritis in men who practice insertive anal intercourse. The initial diagnosis of urethritis in men currently includes specific tests only for N. The following summarizes the approach to the patient with suspected urethritis:.
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Approach to the Acutely Ill Infected Febrile Patient. Approach to the Acutely Ill Infected Febrile Patient: Introduction. The physician treating the acutely ill febrile patient must be able to recognize infections that require emergent attention. If such infections are not adequately evaluated and treated at initial presentation, the opportunity to alter an adverse outcome may be lost.
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Approach to the Acutely Ill Infected Febrile Patient. 18) Maculopapular rashes may reflect early meningococcal or rickettsial disease but are usually associated with nonemergent infections.. Exanthems are usually viral. Primary HIV infection commonly presents with a rash that is typically maculopapular and involves the upper part of the body but can spread to the palms and soles.
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Approach to the Acutely Ill Infected Febrile Patient. The Acutely Ill Patient: Treatment. In the acutely ill patient, empirical antibiotic therapy is critical and should be administered without undue delay. Increased prevalence of antibiotic resistance in community-acquired bacteria must be considered when antibiotics are selected.. Table 115-1 lists first-line treatments for infections considered in this chapter.
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Approach to the Acutely Ill Infected Febrile Patient. Adjunctive treatments may reduce morbidity and mortality and include dexamethasone for bacterial meningitis. low-dose hydrocortisone and fludrocortisone for septic shock. and drotrecogin alfa (activated), also known as recombinant human activated protein C, for meningococcemia and severe sepsis.
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Rapid recognition of the toxic patient with central neurologic signs is crucial to improvement of the dismal prognosis of these entities. Subdural empyema arises from the paranasal sinus in 60–70% of cases. Microaerophilic streptococci and staphylococci are the predominant etiologic organisms. The patient is toxic, with fever, headache, and nuchal rigidity. Of all patients, 75% have focal signs and 6–20% die.
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The host may have comorbid conditions such as underlying malignancy, diabetes mellitus, intravenous drug use, or alcoholism. The patient presents with fever, fatigue, and malaise <2 weeks after onset of infection. On physical examination, a changing murmur and congestive heart failure may be noted. particularly of the aortic valve, results in pulmonary edema and hypotension..