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help in writing essays 1 mild uc typically involves up to four bloody or watery stools per day without systemic signs of toxicity or elevation of erythrocyte sedimentation rate (esr). Moderate disease is classified as more than four stools per day with evidence of systemic toxicity. Severe disease is considered more than six stools per day and evidence of anemia, tachycardia, or an elevated esr or c-reactive protein (crp). Lastly, fulminant uc may present as more than 10 stools per day with continuous bleeding, signs of systemic toxicity, abdominal distention or tenderness, colonic dilation, or a requirement for blood transfusion. A similar classification scheme is used to gauge the severity of active cd. 2 patients with mild to moderate cd are typically ambulatory and have no evidence of dehydration. Systemic toxicity. Loss of body weight. Or abdominal tenderness, mass, or obstruction. Moderate to severe disease is considered in patients who fail to respond to treatment for mild to moderate disease or those with fever, weight loss, abdominal pain or tenderness, vomiting, intestinal obstruction, or significant anemia. Severe to fulminant cd is classified as the presence of persistent symptoms or evidence of systemic toxicity despite outpatient corticosteroid treatment, or the presence of cachexia, rebound tenderness, intestinal obstruction, or abscess. Treatment desired outcomes treatment goals for ibd involve both management of active disease and prevention of disease relapse. Major treatment goals include alleviation of signs and symptoms and suppression of inflammation during acute episodes and maintenance of remission 310  section 3  |  gastrointestinal disorders thereafter. Addressing active ibd in a timely and appropriate manner may prevent major complications and reduce the need for hospitalization or surgical intervention. Once control of active disease is obtained, treatment regimens are designed to achieve these long-term goals. (a) maintain remission and prevent disease relapse, (b) improve the patient’s quality of life, (c) prevent the need for surgical intervention or hospitalization, (d) manage extraintestinal manifestations, (e) prevent malnutrition, and (f) prevent treatment-associated adverse effects. General approach to treatment pharmacologic interventions for ibd are designed to target the underlying inflammatory response. When designing a drug regimen for treatment of ibd, several factors should be considered, including the patient’s symptoms. Medical history. Current medication use. Drug allergies. And extent, location, and severity of disease. The history may also help identify a family history of ibd or potential exacerbating factors, such as tobacco or nsaid use. Nonpharmacologic therapy no specific dietary restrictions are recommended for patients with ibd, but avoidance of high-residue foods in patients with strictures may help prevent obstruction. Avoidance of excess dietary fat may also be preferred. Nutritional strategies in patients with long-standing ibd may include use of vitamin and mineral supplementation. Administration of vitamin b12, folic acid, fat-soluble vitamins, and iron may be needed to prevent or treat deficiencies. In severe cases, enteral or parenteral nutrition may be needed to achieve adequate caloric intake. Patients with ibd, particularly those with cd, are also at risk for bone loss. This may be a function of malabsorption of vitamin d or repeated courses of corticosteroids. 16 risk factors for osteoporosis should be determined, and baseline bone density measurement may be considered. 16 vitamin d and calcium supplementation should be used in all patients receiving long-term corticosteroids. Oral bisphosphonate therapy may also be considered in patients receiving prolonged courses of corticosteroids or in those with osteopenia or osteoporosis.

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http://www.cs.odu.edu/~iat/papers/?autumn=tess-of-the-d39urbervilles-essay-help tess of the d39urbervilles essay help Pregnant or lactating women, elderly, and patients with cardiovascular disease, diabetes, or glaucoma. Table 72–6 summarizes some of the available agents used for cold symptoms. Antipyretics and analgesics can be used for fever, pain, and discomfort. Local anesthetics (eg, benzocaine, dyclonine) relieve throat pain and are available in lozenges and sprays. Decongestants cause vasoconstriction that can improve congestion, but use of intranasal products should be limited to 3 days to avoid rebound congestion. 44,49 1088  section 15  |  diseases of infectious origin patient care process for streptococcal pharyngitis clinical presentation and diagnosis of the common cold patient assessment. •• based on patient history, review of systems, and physical examination, determine if streptococcal pharyngitis is likely. If so, perform a rapid antigen detection test and/or follow-up throat culture to confirm the diagnosis. •• perform a medical review and conduct a medication history (including prescription and nonprescription medications and natural products). Does the patient have any medication allergies or adverse reactions?. Symptoms begin 24 to 72 hours after infectious contact. They peak at day 3 to 4, begin to wane by day 7, and resolve by day 10 to 14. Signs and symptoms44,45 •• onset. Malaise, fatigue, headache, pharyngitis, low-grade fever (can be higher in infants and children) •• secondary. Nasal and/or postnasal drainage (often clear at onset, but can become thick and purulent). Congestion. Cough and/or throat clearing. Sneezing. Conjunctivitis. Irritability. Impaired smell or taste complications •• aom, abrs, chronic bronchitis, bronchiolitis (in infants and children less than 2 years), pneumonia, asthma exacerbation diagnosis •• clinical diagnosis. Most common method. Based on history, presence of symptoms, and physical examination •• radiographic studies.

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http://projects.csail.mit.edu/courseware/?term=self-introductory-essay self introductory essay Pmcpmc3871276. 34. Chidlow g, wood jp, casson rj. Pharmacological neuroprotection for glaucoma. Drugs. 2007;67(5):725-59. Epub 2007/03/28. Doi. 6756 [pii].

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