20
Dec

SPLENIC ABSCESS

by admin Posted in Anti-Infectives


Splenic abscesses are uncommon lesions that are usually the result of hematogenous dissemination, as a result of bacteremia or septic embolization. Infected splenic infarcts and contiguous spread of infection are also potential mechanisms.
Patients often present with fever, chills, and left upper quadrant abdominal pain. Irritation of the diaphragm may lead to pleuropulmonary symptoms and referral of pain to the left shoulder. A quarter of cases involve a polymicrobial infection. Causative organisms include S. aureus and Streptococcus species (usually in cases of bacterial endocarditis), as well as Salmonella species and other enteric bacteria, including anaerobes. Fungi, especially Candida species, are important causes of splenic abscesses in immunocompromised hosts.
Broad-spectrum empiric antimicrobial therapy, as recommended for secondary peritonitis, is required. Although the treatment of choice is generally splenectomy, percutaneous drainage may be considered in some cases.
*99/348/5*

SPLENIC ABSCESSSplenic abscesses are uncommon lesions that are usually the result of hematogenous dissemination, as a result of bacteremia or septic embolization. Infected splenic infarcts and contiguous spread of infection are also potential mechanisms.Patients often present with fever, chills, and left upper quadrant abdominal pain. Irritation of the diaphragm may lead to pleuropulmonary symptoms and referral of pain to the left shoulder. A quarter of cases involve a polymicrobial infection. Causative organisms include S. aureus and Streptococcus species (usually in cases of bacterial endocarditis), as well as Salmonella species and other enteric bacteria, including anaerobes. Fungi, especially Candida species, are important causes of splenic abscesses in immunocompromised hosts.Broad-spectrum empiric antimicrobial therapy, as recommended for secondary peritonitis, is required. Although the treatment of choice is generally splenectomy, percutaneous drainage may be considered in some cases.*99/348/5*

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15
Dec

HOW BDD AFFECTS LIVES: ANGER AND VIOLENCE

by admin Posted in Anti Depressants-Sleeping Aid


Sometimes anger and violence are directed toward the surgeon or dermatologist who provided unsatisfying treatment. I’m aware of a man who severely assaulted his plastic surgeon because he was so upset over the outcome of his surgery. Another tried to murder his dermatologist after the treatment didn’t work. And there are a number of published reports of people with apparent BDD who threatened, stalked, attempted to kill, or actually killed their dermatologist or plastic surgeon. In a 2001 survey of 265 members of the American Society for Aesthetic Plastic Surgery, 2% said they had been threatened physically, and 10% had been threatened both legally and physically, by a patient with BDD.
BDD can spawn illegal behavior. As I discussed above, BDD can lead to illegal drug use. Ian broke into houses across the country so he could get to California to get a tan. Todd shoplifted from drug stores. “I don’t like to do it,” he said, “but I have to get stuff for my skin, and I don’t have any money.” Over several months, he’d stolen nearly $1000 worth of items. “I’m afraid I’ll get caught,” Todd said, “and I feel guilty doing it. But I can’t resist. My acne is destroying my life. I have to make my skin look better!”
Another man had done many illegal things—such as assaulting people and breaking and entering—in the hope that he’d go to jail. He explained, “That way, no one would see me except the other inmates. And it’s too hard for me to keep a job because I look so bad, and I wouldn’t have to worry about it in jail. Jail would be better than this hell I live in every day.”
*142\204\8*

HOW BDD AFFECTS LIVES:  ANGER AND VIOLENCESometimes anger and violence are directed toward the surgeon or dermatologist who provided unsatisfying treatment. I’m aware of a man who severely assaulted his plastic surgeon because he was so upset over the outcome of his surgery. Another tried to murder his dermatologist after the treatment didn’t work. And there are a number of published reports of people with apparent BDD who threatened, stalked, attempted to kill, or actually killed their dermatologist or plastic surgeon. In a 2001 survey of 265 members of the American Society for Aesthetic Plastic Surgery, 2% said they had been threatened physically, and 10% had been threatened both legally and physically, by a patient with BDD.BDD can spawn illegal behavior. As I discussed above, BDD can lead to illegal drug use. Ian broke into houses across the country so he could get to California to get a tan. Todd shoplifted from drug stores. “I don’t like to do it,” he said, “but I have to get stuff for my skin, and I don’t have any money.” Over several months, he’d stolen nearly $1000 worth of items. “I’m afraid I’ll get caught,” Todd said, “and I feel guilty doing it. But I can’t resist. My acne is destroying my life. I have to make my skin look better!”Another man had done many illegal things—such as assaulting people and breaking and entering—in the hope that he’d go to jail. He explained, “That way, no one would see me except the other inmates. And it’s too hard for me to keep a job because I look so bad, and I wouldn’t have to worry about it in jail. Jail would be better than this hell I live in every day.”   *142\204\8*

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09
Dec

COMBATTING ASTHMA IN CHILDREN: ANTI-INFLAMMATORY DRUGS – STEROIDS: PROPHYLACTIC DRUGS

by admin Posted in Asthma


Cromolyn. It is a white powder derived from a plant called Khellin. It prevents an attack by inhibiting the production or release of substances that create allergic reaction. It does not act as a bronchodilator and is never used, and should never be used, during an attack. Cromolyn cannot treat or reverse bronchoconstriction once it has occurred, but is useful in preventing attacks when taken regularly.
Cromolyn can be taken by an inhaler, either as a dry powder or as a solution. In some children, inhalation of the powder may cause coughing. It is important to remember that cromolyn has to be taken regularly for one to two months before it is effective.
If cromolyn is effective, which it is in 20-40 per cent of children, then it can be used as an alternative to inhaled steroids. But if asthma is not controlled fully then a low dose of an inhaled steroid can be given to children.
Inhaled steroids in low doses is much more effective than cromolyn. It is, therefore, important to have the best possible level of control for each child.
*68\260\8*

COMBATTING ASTHMA IN CHILDREN: ANTI-INFLAMMATORY DRUGS – STEROIDS: PROPHYLACTIC DRUGSCromolyn. It is a white powder derived from a plant called Khellin. It prevents an attack by inhibiting the production or release of substances that create allergic reaction. It does not act as a bronchodilator and is never used, and should never be used, during an attack. Cromolyn cannot treat or reverse bronchoconstriction once it has occurred, but is useful in preventing attacks when taken regularly.Cromolyn can be taken by an inhaler, either as a dry powder or as a solution. In some children, inhalation of the powder may cause coughing. It is important to remember that cromolyn has to be taken regularly for one to two months before it is effective.If cromolyn is effective, which it is in 20-40 per cent of children, then it can be used as an alternative to inhaled steroids. But if asthma is not controlled fully then a low dose of an inhaled steroid can be given to children.Inhaled steroids in low doses is much more effective than cromolyn. It is, therefore, important to have the best possible level of control for each child.*68\260\8*

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