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TPE removes large-molecular-weight substances such as harmful antibodies from the plasma. It is usually carried out using an automated blood cell separator to ensure fluid balance and maintain a normal plasma volume. This may require the insertion of a femoral or jugular line to allow adequate blood flow. Typically, 30–40 mL/kg of plasma (1–1.5 plasma volumes) are removed at each procedure and replaced with isotonic 4.5 or 5.0% human albumin solution (some services substitute 25–50% of replacement volume with 0.9% saline). Exchange with fresh frozen plasma (FFP) is reserved for the replacement of ADAMTS13 in thrombotic thrombocytopenic purpura (see below) or to replace clotting factors. A one plasma volume exchange removes about 66% of an intravascular constituent and a two plasma volume exchange approximately 85%. TPE is normally combined with disease modifying treatment, such as immunosuppressive drugs, for the underlying condition.
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University of California, Berkeley engineers have built the first dust-sized, wireless sensors that can be implanted in the body, bringing closer the day when a Fitbit-like device could monitor internal nerves, muscles or organs in real time.
Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown. Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis.
Shingles is a painful skin rash camera.gif. It is caused by the varicella zoster virus. Shingles usually appears in a band, a strip, or a small area on one side of the face or body. It is also called herpes zoster. Shingles is most common in older adults and people who have weak immune systems because of stress, injury, certain medicines, or other reasons. Most people who get shingles will get better and will not get it again. But it is possible to get shingles more than once.
The objective of carotid endarterectomy (CEA) is to prevent strokes. In the United States, stroke is the third leading cause of death overall and the second leading cause of death for women.[1] Among patients suffering a stroke, 50-75% had carotid artery disease that would have been amenable to surgical treatment. Several prospective randomized trials have compared the safety and efficacy of CEA with those of medical therapy in symptomatic and asymptomatic patients. Data from these prospective trials have confirmed that CEA offers better protection from ipsilateral strokes than medical therapy alone in patients presenting with either symptomatic or asymptomatic carotid artery disease.
Learn more about certified electronic health record and comprehensive hospital information system (HIS), Paragon®, from McKesson. Working with Paragon can help you achieve Stage 1 meaningful use and other important guidelines.
Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis. There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer. Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact. Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.
Diagnosis of HIV infection in infants is aided by HIV culture or DNA/RNA polymerase chain reaction (PCR); positive results are confirmed by repeating the test. In suspected cases, HIV testing should occur in the newborn period (ie, before the infant is 48 h old), at age 1-2 months, and again at age 3-6 months.
Like any syndrome, fetal alcohol syndrome (FAS) is a group of signs and symptoms that appear together and indicate a certain condition. In the case of FAS, the signs and symptoms are birth defects that result from a woman's use of alcohol during her pregnancy.
The definition of DDH is not universally agreed upon. Typically, the term DDH is used in referring to patients who are born with dislocation or instability of the hip, which may then result in hip dysplasia. More broadly, DDH may be defined simply as abnormal growth of the hip. Abnormal development of the hip includes the osseous structures, such as the acetabulum and the proximal femur, as well as the labrum, capsule, and other soft tissues. This condition may occur at any time, from conception to skeletal maturity. The author prefers to use the term hip dysplasia, considering it both simpler and more accurate. Internationally, this disorder is still referred to as congenital dislocation of the hip.