domingo, 30 de octubre de 2011
Frutas ainda
Eu mantive Benny ao meu lado durante todo esse serviço, pois eu queria que ele visse que sua mãe tinha sido amado por outros também, e que sua existência havia feito a diferença na vida mais do que o seu eo meu. Ele tinha apenas oito anos de idade, mas ele parecia levar o serviço a partir do conforto de que eu esperava que isso lhe daria. Ouvir sua generico do viagra mãe elogiado, ele foi incapaz de segurar as lágrimas, mas agora havia algo mais do que tristeza em seu rosto e os olhos, agora ele também estava orgulhoso dela, divertindo-se com algumas das brincadeiras que ela tinha jogado em amigos e que agora relatou e intrigado ao ouvir sobre aspectos dela que haviam até então sido desconhecido para ele.
Quando fui à procura de Benny, eu o encontrei debaixo de uma das cerejeiras no quintal. Ele se sentou com os joelhos elaborado contra o peito e os braços nas pernas, olhando para o outro lado do vale amplo sobre uma encosta de onde morávamos, mas ele parecia estar olhando comprar cialis em portugal para algo ainda mais distante. Como você está fazendo?
Ok, ele disse.
Por um tempo, nenhum de nós falou. Overhead as folhas da árvore farfalhando suavemente. A deslumbrante branco-rosa flores da primavera foram muito longe, é claro, e os ramos eram enfeitados com frutas ainda não completamente maduras. O dia estava quente, mas a árvore jogou sombra, abundantes cool.
sábado, 19 de marzo de 2011
Chest pain when eating
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brand levitra
jueves, 10 de marzo de 2011
Wilsons disease
brand cialis
immune system
great operation
metastasis
domingo, 6 de marzo de 2011
Cold sore remedies
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brand levitra
miércoles, 26 de enero de 2011
Scoring system
In this regard, in recent years, increasing attention is paid to active methods of surgical treatment plant. Thus, programmable Improved sanitation and diagnostic brand viagra relaparotomy or laparostomy, omentobursostomii combines mandatory with different ways of decompression, detoxification and decontamination of the gastrointestinal tract (GIT) [5,6]. In modern conditions, the method remedial programmable relaparotomy or nekrsekvestrektomy, being a very effective way to eradicate widespread peritonitis and pancreatic necrosis, can prevent development of septic complications distant only when proper identification testimony. Years of experience Faculty Surgical Clinic Medical University and outcomes in patients with abdominal sepsis caused by peritonitis, can give an answer to some tactical issues. Indications for relaparotomy programmable remediation should be based on an understanding of positive and negative aspects of this method and objective assessment of the severity of the patient. Advantages and disadvantages of programmable remedial laparotomy (from the point of view, and a surgeon, and intensivista ") are presented in Table. 2.
With regard to objective estimation of the severity of the patient, our clinical experience shows the need for mandatory use of scoring system. We prefer the most simplest of them - a simplified evaluation system proposed by JRLe Gall et al. in 1983 and named the authors of SAPS [12]. According to our data, the prognostic significance of assessing the likelihood of adverse outcome when using SAPS is very high.
Indications for relaparotomy programmable remediation, omentobursostomiyam with abdominal sepsis can be formulated as follows:
1. Common putrid, fecal peritonitis, signs of anaerobic infection.
2. Unrepaired at the first operation, the source of the AU.
3. Questionable viability of the area of the intestine.
4. Postoperative peritonitis.
5. Pyo-necrotic forms of pancreatic necrosis and pancreatic peritonitis.
6. SAPS - 20-25 points.
Table 2
Programmable Improved sanitation relaparotomy
Advantages:
* A complete reorganization of the abdominal cavity;
* Timely diagnosis and correction of intra-abdominal complications;
* The possibility of active drainage of the abdominal cavity;
Disadvantages:
* Adverse systemic effects of repeated interventions (including re-development of the syndrome of "mediator storm" and the toxic shock);
* Repeated trauma of the abdominal wall and abdominal organs;
* Duration of intubation (gastrointestinal tract, trachea, urinary tract) with high risk of nosocomial pneumonia and uroinfektsii;
* Duration of mechanical ventilation;
* The need for prolonged catheterization of blood vessels at high risk of "catheter infection and angiogenic sepsis;
* A high risk of intra-abdominal bleeding and the formation of intestinal fistula;
* Duration of stay in ICU and in hospital.
Our clinical experience and literature data allow to come to the conclusion that the AU under severe multiorgan failure with damage of more than 3 systems and programmable method of readjustment and revision of the abdominal cavity loses its advantages, all while maintaining significant drawbacks [5-8].
However, it appears that the results of programmed relaparotomy in the remedial treatment of AS can be improved by strict adherence to certain principles (Table 3).
Table 3
Ways to improve the results of programmed relaparotomy remediation in AS patients with peritonitis
* Optimization of testimony based on an assessment of severity and prognosis of patients with scoring system (APACHE II, SAPS).
* The optimal choice laparostomicheskogo device and the interval between repeated bailouts.
* Dynamic objectified assessment of the abdominal cavity and peritonitis.
The combination of surgery with a rational antimicrobial therapy (systemic and selective decontamination of the digestive tract).
* Effective enteral and extracorporeal detoxification.
* Suppression tsitokinogeneza.
* Optimization of oxygen transport and metabolic support.
placebo
microadenomas
wrong interpretation
tactics
myocardial infarction
domingo, 9 de enero de 2011
Tracheal transplantation
Modern medicine is in the process of continuous development and improvement of methods of treatment. One of the most innovative areas of applied medicine is transplantation. Transplantation concerned with transplantation of various human organs. Transplantation of the heart, kidneys, hair transplantation, bone marrow, is the introduction of brand viagra specialist transplant. The founder of the School of Theoretical and Experimental transplantation is a Nobel laureate Alexis Carrel in 1912. They were worked out the basic techniques and theoretical foundations of the conservation authority received from the donor. In the Soviet Union in 1933 made the first organ transplant from patient to patient, surgery is performed Yu dun. One of the most complex types of organ transplantation is a heart transplant, but only the beginning of 50s had implemented the concept of an animal heart transplant, and in December 1967, South African surgeon K. Bernard heart was transplanted man. One of the most complex operations in the practice of transplant surgeons, in addition to heart transplantation is transplantation of the trachea. In this regard, constantly seeking new methods and techniques for this type of operations. So in 2008, was first transplanted trachea, consisting of stem cells (it was previously grown, was taken as a basis for authority of the deceased person).
More recently, experts from Belgium offered a way to transplant the trachea. It lies in the fact that the need for consistent use of drugs, not carrying a body surgically severing the transplanted organ is not necessary. Message about the operation was published in the British medical journal The New England Journal of Medicine. The patient received a damaged his trachea in the accident. The Authority has narrowed. The only solution that could at that time to find a doctor - is to create a special metal struts inside the body (called stents), but the woman began to emerge of pain and discomfort. The uniqueness of the operation was that for build-up of blood vessels body was grafted into the hands of the patient, it enveloped by connective tissue. Was also carried out pay attention replacement of the trachea (the basis was taken from her cheek mucosa women). The result of the operation was a new body, not rejected by the body and does not require a person operated on continuous use of drugs that reduce immunity. The next step to a group of doctors who have spent the operation, several new patients with similar problems. It is hoped that the new method will be a real breakthrough in modern transplantation.
Lasting
traditional medicine
Basic principles
domingo, 2 de enero de 2011
Hovered somewhere
Legend first: syphilis or gonorrhea can be transmitted in the home, such as taking a bath after a sick relative.
Almost all micro-organisms that cause sexually transmitted diseases can remain viable in wet towels or washcloths in a few hours. But if you observe basic hygiene rules, that is, do not wear other people's stuff (including earrings), not someone else's cigarette dokurivat not use someone else's lipstick, not a stranger to brush your teeth with a brush and so on, can not be infected.
Cases of domestic infection is rare, but still occur. For example, a rash on his brand name viagra body overage son that his mother tried to withdraw, lubricating Zelenko, was a manifestation of secondary syphilis. Three weeks later a woman appeared on a finger wound, which the doctor classified as primary syphilis.
Hazards of occupational infection most often are doctors - surgeons, dentists and gynecologists. They are in contact with the environment in which may be pathogens, but because gloves are sometimes torn.
Legend II: If the man several times pereboleet gonorrhea, he would be impotent.
If you treat the disease immediately and correctly, the male potency is not affected. If not - gonococci their way up the urinary ways and can cause and the infertility and impotence, and other diseases.
Legend III: There are new microorganisms that can penetrate even through the condom.
In fact, condoms (and female and male) of infection in most cases protects. Provided that he has a quality certificate, valid picked (this applies to male condoms, because they come in different sizes), and properly used.
A woman can reduce the chance of infection, using candles, creams, pills. True, her partner will not protect those funds. By the way, oral sex is as dangerous as traditional. Indeed, in oral microbes can not live less comfortably than in the vagina.
Legend of the fourth: Added detection method that allows for one analysis to determine all of the disease. One of the methods of modern diagnostics - PTSTS-polymerase chain reaction - actually makes it possible to identify "culprit" of the disease, including venereal.
But this method has its own nuances. If, for example, a person sick with chlamydia, it is still for some time in his body may remain "traces" of this disease. Therefore, to choose what to do analysis (of which there are many - bacteriological, smear, serological, cultural) should be a doctor.
Legend of Five: There are antibiotics that allow to cure any infection in just three days. Universal pill for every disease there. For example, syphilis treated best with penicillins, chlamydia - tetracycline. And the special tough circuits are used only in the treatment of syphilis and gonorrhea. For other diseases physician in each case selects the medication and adjust their reception.
"Independent activity" in the treatment of sexually transmitted diseases strongly contraindicated. After using one drug at the same ailment, you can get quite different results, which depends on ... the acidity of the stomach, for example. In addition, sexually transmitted diseases rarely occur in isolation.
Most often, in company with gonorrhea have to treat trichomoniasis, or chlamydia, and sometimes far from dermatovenerology diseases such as viral hepatitis, which is transmitted through intimate contact. Cure one of them Lucky medication recommended by a neighbor or a medical reference book, it is possible to develop in other microorganisms strong immunity to the medicine.
And do not ignore the recommendations for taking medications. Did you know that alcohol even in small quantities (beer, rum, cola) interacts with the antibiotic with acid as lye "in the usual neutralization test!
Legend of Six: There is no cure chlamydia is virtually impossible. Competently carried out by treatment will relieve the patient of chlamydia. True, but antibiotics need immune-boosting drugs.
Of all diseases, sexually transmitted diseases in our country, chlamydia is found more often: almost 70 percent of patients who consult doctors put just such a diagnosis. This disease often causes both male and female infertility. But even if a woman can get pregnant, you may still be the threat of an ectopic pregnancy or miscarriage.
The Legend of Seven: When a single proximity to the patient and partner can not become infected. This happens but rarely. Throughout the world we know only a few cases when the spouses infected with HIV and AIDS fate provided supportive. Most often, infection is still enters the body.
Interestingly, the preventive treatment (nominated for the prevention of disease), such as syphilis, are subject only to those who have had close contact with patients. So what if the man changed his wife with a particular suspect and the next day returned to the marriage bed, and then came to his senses and ran to the doctor, injections designate not only the person responsible for the accident. The incubation period of most infections is large enough to wife also managed to catch.
Legend of Eight: There are methods that reduce the risk of infection in emergency situations, for example, if the condom broke. In the arsenal of the doctors really have the funds - they must be applied within a few hours after intercourse. Yet, these drugs do not guarantee absolute security. Within a few months to monitor the well-being and at the slightest suspicion seek medical attention.
And what if the condom broke, but saving drugs on hand is not "as soon as possible to empty the bladder, wash the vulva soap and do not hesitate to seek medical advice.
Legend Nine: If recourse to the State kozhvendispanser, then report the illness must be notified at work. Not true. If you own "secret" does not tell us about his illness, something about it, no one knows. Prohibits the doctor to disclose medical confidentiality is not only the Hippocratic oath, but the Criminal Code. Even if the patient was treated in hospital, the sick will not be shown the true reason of his stay.
Total lung
Fight against hepatitis