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Author: Sheila Glennis Haworth
Publisher: Elsevier Health Sciences
ISBN: 8131231763
Category : Medical
Languages : en
Pages : 182
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Book Description
Pulmonary hypertension is defined as a mean pulmonary artery pressure (mPAP) ≥25 mmHg, with Pulmonary Capillary Wedge Pressure ≤ 15 mmHg, measured by cardiac catheterization. The etiology of PH has a varied spectrum extending right from Drugs, toxins and portal hypertension to HIV, Collagen Vascular Diseases and Persistent Pulmonary Hypertension of Newborn, etc. The estimation of disease prevalence has been nearly impossible owing to the geographic distribution and economic diversity, along with significant regional variations in human development and healthcare infrastructure. A large number of patients with PH never reach the health centers capable of diagnosing the disease condition correctly. Advance pulmonary vascular disease as a result of uncorrected CHD is a major health challenge in the developing world. PH exists as a major component of many forms of cardiac and pulmonary disease. While breathlessness is the most common feature of PH, patients often also present with chest pain, syncope, fatigue, weakness and abdominal distension. The precordial signs include a right ventricular lift, accentuated pulmonary component of S2, a pansystolic murmur of Tricuspid regurgitation, a diastolic murmur of pulmonary regurgitation and a right ventricular S3. The standard diagnostic workup in developed countries includes a series of investigations to rule out the secondary causes. Additional tests are required to estimate the disease severity and plan the appropriate treatment. These include the cardiac catheterization, selective pulmonary angiography by direct injection of pulmonary arteries, high resolution CT scan, cardiac magnetic resonance, ABGs, nocturnal O2 saturation, etc. While most of the basic management is feasible in the Indian conditions, most of the newly introduced drugs are either not available or are available at costs that far exceed the paying capacity of an average citizen of a developing economy. An underdeveloped health insurance system adds further to the financial burden of the treatment. Measures like formulation of guidelines for diagnosis and treatment of PAH, educating clinicians and scientists and making medications affordable to poor patients might ensue a breakthrough in the overall management of pulmonary hypertension.
Author: Sheila Glennis Haworth
Publisher: Elsevier Health Sciences
ISBN: 8131231763
Category : Medical
Languages : en
Pages : 182
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Book Description
Pulmonary hypertension is defined as a mean pulmonary artery pressure (mPAP) ≥25 mmHg, with Pulmonary Capillary Wedge Pressure ≤ 15 mmHg, measured by cardiac catheterization. The etiology of PH has a varied spectrum extending right from Drugs, toxins and portal hypertension to HIV, Collagen Vascular Diseases and Persistent Pulmonary Hypertension of Newborn, etc. The estimation of disease prevalence has been nearly impossible owing to the geographic distribution and economic diversity, along with significant regional variations in human development and healthcare infrastructure. A large number of patients with PH never reach the health centers capable of diagnosing the disease condition correctly. Advance pulmonary vascular disease as a result of uncorrected CHD is a major health challenge in the developing world. PH exists as a major component of many forms of cardiac and pulmonary disease. While breathlessness is the most common feature of PH, patients often also present with chest pain, syncope, fatigue, weakness and abdominal distension. The precordial signs include a right ventricular lift, accentuated pulmonary component of S2, a pansystolic murmur of Tricuspid regurgitation, a diastolic murmur of pulmonary regurgitation and a right ventricular S3. The standard diagnostic workup in developed countries includes a series of investigations to rule out the secondary causes. Additional tests are required to estimate the disease severity and plan the appropriate treatment. These include the cardiac catheterization, selective pulmonary angiography by direct injection of pulmonary arteries, high resolution CT scan, cardiac magnetic resonance, ABGs, nocturnal O2 saturation, etc. While most of the basic management is feasible in the Indian conditions, most of the newly introduced drugs are either not available or are available at costs that far exceed the paying capacity of an average citizen of a developing economy. An underdeveloped health insurance system adds further to the financial burden of the treatment. Measures like formulation of guidelines for diagnosis and treatment of PAH, educating clinicians and scientists and making medications affordable to poor patients might ensue a breakthrough in the overall management of pulmonary hypertension.
Author: R R Kasliwal
Publisher: Elsevier Health Sciences
ISBN: 8131231771
Category : Medical
Languages : en
Pages : 176
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Book Description
Acute coronary syndrome (ACS) is the term for the clinical signs and symptoms of myocardial ischemia: unstable angina, non–ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). Unstable angina and NSTEMI normally result from a partially or intermittently occluded coronary artery, whereas STEMI results from a fully occluded coronary artery. The patients present with a wide arena of signs and symptoms like chest pain, nausea/vomiting, exertional pain, palpitation, shortness of breath, fatigue, etc. Angina, or chest pain, continues to be recognized as the classic symptom of ACS. In unstable angina, chest pain normally occurs either at rest or with exertion and results in limited activity. Chest pain associated with NSTEMI is usually longer in duration and more severe than chest pain associated with unstable angina. The diagnosis of ACS is based on triad of clinical presentation, electrocardiography and cardiac biomarkers. Electrocardiography is the most important initial diagnostic procedure when doctors suspect an acute coronary syndrome. Findings on a 12-lead ECG help the practitioner to differentiate between myocardial ischemia, injury, and infarction, locate the affected area and assess related conduction abnormalities. But at the same front, the definition of unstable angina, NSTEMI and STEMI is based on the levels of cardiac biomarkers too. Acute coronary syndromes are medical emergencies that need prompt action. Half of deaths due to a heart attack occur in the first 3–4 hours after symptoms begin. The sooner treatment begins, the better the chances of survival. Anyone having symptoms that might indicate an acute coronary syndrome should obtain prompt medical attention. Management of ACS involves a spectrum of interventions. It encompasses cardiac monitoring, thrombolysis, antiplatelet therapy, anticoagulant therapy, reperfusion therapy and invasive investigation and revascularization therapy. Reperfusion therapy (percutaneous coronary intervention) mainly holds for the ST-elevation myocardial infarction. Prognosis of the ACS patients depends on the post-myocardial risk stratification. The main highlights of risk stratification are risk stratification scores, assessment of cardiac function and stress testing, and management.
Author: Nagaraj Desai
Publisher: Elsevier Health Sciences
ISBN: 8131231747
Category : Medical
Languages : en
Pages : 97
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Book Description
Patients born with cardiac defects need to be identified early and the severity of symptoms also needs to be identified. In children with larger defects or with more symptoms, early institution of treatment is warranted, since in absence of treatment, the disease progresses to pulmonary hypertension and a simple pathology gets complicated. Presence of congestive cardiac failure in infancy or of pulmonary artery hypertension is indication for early surgical treatment (prior to 6 months of age). Untreated ASD may at times allow the child to grow and reach adulthood, but can cause complications in adulthood also. These issues related to understanding of natural history of the shunts and its implications in management decisions need to be addressed in clear terms. Also the role and timing of surgical therapy need to be emphasized. This book is designed to address such questions with supportive clinical scenarios. Thus, it provides an excellent opportunity to widen one’s perspective in this area.
Author:
Publisher: Elsevier Health Sciences
ISBN: 8131232476
Category : Medical
Languages : en
Pages : 209
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Book Description
Liver Transplantation (LT), until recently the ‘forbidden fruit’, is the newest, the sexiest, the most controversial and arguably, the most technically challenging subspecialty of Surgical Gastroenterology to have mushroomed in India. In a journey spanning 12 years, 28 centers and 1500 liver transplants, we imagined there would be a gripping story to tell. It was only appropriate then, that we chose to inaugurate the series with an overview of Liver Transplantation. In the last 2 decades, the field has seen rapid progress with 1- and 5-year patient survival improving from 80% and 50% to 90% and 80%, respectively, owing to technical refinement, and better immunosuppressants, intensive care, and patient monitoring. Despite being a relatively new entrant into the field, India can now boast of at least some islands of excellence that have caught up with the "best in the west". This means the evolution of LT in these centers has been fast-forwarded up a steep curve. We have come a long way from the point of every LT being considered an experimental procedure with much media and public hype to one where it is accepted as a successful and durable panacea for all liver failure. The popularity of teams running successful programs in India has swung from being ostracized when the chips were down, to being celebrated and envied when the going became good. The focus has shifted from immediate to long-term survival, from surgical heroism to building multidisciplinary teams, from anecdotal to hard data and from media reports to scientific publications. ‘Fly-by night’ operations are on the decline as realization of their futility dawns on new centers and transplant teams. They are now happier to take the longer route of developing trained in-house teams. After spending a good part of the last decade honing the technique of living donor liver transplantation, we are becoming more sensitive to the morbidity and mortality risks to the living liver donor. We want to minimize the liver volume removed from the donor, and want to develop techniques of minimal access. More importantly, we want to train our guns back on pushing donation after brain or cardiac death. We have begun to maintain databases, are getting into audit mode and want a National registry. We want standardized treatment guidelines and training curricula. We want to take part in multicenter trials and further meaningful clinical and laboratory research. As a community, the liver transplant doctors of India are on a warpath of progress. We want it all and we want it now! The first step to the march into the future is to size up the past and the present. That is what we have attempted to do in this volume.
Author: United States. Employees' Compensation Appeals Board
Publisher:
ISBN:
Category : Employers' liability
Languages : en
Pages : 790
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Book Description
Author: United States. Employees' Compensation Appeals Board
Publisher:
ISBN:
Category : Employers' liability
Languages : en
Pages : 776
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Book Description
Author: Soumitra R. Eachempati
Publisher: Springer
ISBN: 3319148249
Category : Medical
Languages : en
Pages : 231
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Book Description
This text covers all aspects of the current diagnosis and treatment of acute cholecystitis. Different diagnostic tests are discussed as well as the preoperative evaluation needed to initiate treatment. Other sections include the management of acute cholecystitis in the critically ill and elderly patients, recent advances in operative strategies that have further altered the treatment of acute cholecystitis, and the utilization of routine intraoperative cholangiography and its relative merits. Primarily intended for general surgeons and residents training in general surgery, Acute Cholecystitis will also serve as a comprehensive reference material for other health care providers, including primary care providers, mid-level nurse practitioners, emergency room physicians and medical students.
Author:
Publisher:
ISBN:
Category : Employee fringe benefits
Languages : en
Pages : 10
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Book Description
Author: United States Civil Service Commission. Medical Division
Publisher:
ISBN:
Category : Civil service
Languages : en
Pages : 492
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Book Description
Author: Dorairaj Prabhakaran
Publisher: World Bank Publications
ISBN: 1464805202
Category : Medical
Languages : en
Pages : 948
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Book Description
Cardiovascular, respiratory, and related conditions cause more than 40 percent of all deaths globally, and their substantial burden is rising, particularly in low- and middle-income countries (LMICs). Their burden extends well beyond health effects to include significant economic and societal consequences. Most of these conditions are related, share risk factors, and have common control measures at the clinical, population, and policy levels. Lives can be extended and improved when these diseases are prevented, detected, and managed. This volume summarizes current knowledge and presents evidence-based interventions that are effective, cost-effective, and scalable in LMICs.
