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Surviving critical illness is not always the happy ending we imagine for patients. Many ICU survivors suffer from a range of long-lasting physical and psychological issues such end stage renal disease, congestive heart failure, cognitive impairment, neuromuscular weakness, and depression or anxiety, which affect their overall quality of life and ability to lead productive lives. This lingering burden or 'legacy' of critical illness is now recognized as a major public health issue, with major efforts underway to understand how it can be prevented, mitigated, or treated. The Textbook of Post-ICU
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This second edition has been comprehensively updated to reflect current clinical practice and the latest technical developments, including pre-implantation genetic diagnosis, array CGH, QF-PCR, non-invasive prenatal diagnosis and next generation sequencing amongst others. The first section covers basic principles, while the second outlines the more common situations where obstetrics and gynaecology interact with medical genetics. The third section contains real-life clinical case scenarios which have been selected to represent typical problems and to highlight areas which, if mismanaged, could have serious medico-legal consequences. Together with its accompanying website (www.essentialmedgen.com), it provides an invaluable guide to the use and selection of useful online genetic resources. This book is essential reading for candidates preparing for the MRCOG postgraduate examination, and any health professionals requiring a clear understanding of medical genetics and its increasingly frequent uses in obstetrics and gynaecology, where incorrect genetic advice can have serious consequences.
Medical genetics. --- Pregnancy --- Complications.
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The fully updated third edition of this popular handbook provides a concise summary of perioperative management of high-risk surgical patients. Written by an international group of senior clinicians, chapters retain the practical nature of previous editions, with concise text in a bulleted format offering rapid access to key facts and advice. Several new chapters cover topics including: anesthetic mortality; cardiopulmonary exercise testing; perioperative optimization; obstructive sleep apnea and obesity hypoventilation syndrome; smoking, alcohol and recreational drug abuse; intraoperative ventilatory management; the role of simulation in managing the high-risk patient; anesthesia, surgery and palliative care; anesthesia and cancer surgery; neurotrauma and other high-risk neuro cases; anesthesia for end-stage renal and liver disease; and transplant patients. Essential reading for trainee anesthesiologists managing seriously ill patients during surgery or studying for postgraduate examinations, this is also a valuable refresher for anesthesiologists and intensivists looking for an update on the latest evidence-based care.
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Diabetes --- Kidneys. --- Complications --- Prevention.
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Drugs prescription for pregnant women represents a real therapeutic challenge.Some chronic diseases do not allow to consider the interruption of treatment. More specifically, epilepsy is a common disease affecting according to the WHO, approximately 1% of the world population. of which nearly one third is in childbearing age.However, most epileptic medication has a significant teratogenicity. Expectant mothers too often tend to stop. on their own initiative and without medical advice, their medication for fear of what might happen to their future child. It is however essential that epilepsy remains controlled at all times. including throughout the pregnancy. Indeed, seizures can interfere with the development of the embryo or fetus. In addition, uncontrolled epilepsy can also be dangerous for the pregnant woman herself. Therefore, women suffering from epilepsy should, if possible, plan their pregnancy and receive prior information by health professionals during a preconception examination. In some cases; the discontinuation of the treatment during the pregnancy may be considered. When such an interruption does not prove possible health professionals will determine what antiepileptic medication can be used and which once should absolutely be avoided. So, treatments with valproïc acid will be considered most at risk for children exposed in utero and will not be recommended for women of childbearing age. The new antiepileptic drugs will also be avoided given the lack of hindsight that we have at present, with the exception of lamotrigine. an anticonvulsant already extensively studied and which has proven to be the safest during pregnancy. According to international recommendations of health professionals, any epileptic pregnant woman should receive appropriate monitoring. Folic acid supplementation will also be established to prevent neural tube defects. For inducing AEDs, an intake of vitamin K will also be recommended to prevent early neonatal bleeding for the chiId. In 90% of the cases, pregnancies with antiepileptic treatments happen quite normally thanks to close monitoring. La prescription d'un médicament chez la femme enceinte représente un réel défi thérapeutique. Certaines pathologies chroniques ne permettent pas d'envisager une interruption de traitement. Plus particulièrement, répilepsie est une maladie courante qui affecte environ 1 % de la population mondiale, selon l'OMS, dont près d'un tiers est en âge de procréer. Or, la plupart des antiépileptiques ont un pouvoir tératogène non négligeable. Les futures mères ont trop souvent tendance à arrêter de leur propre initiative et sans avis médical préalable leur médication par crainte de ce qu'il pourrait arriver à leur futur enfant. Il est pourtant primordial que l'épilepsie soit contrôlée en tout temps, y compris tout au long de la grossesse. En effet, les crises peuvent interférer avec le développement de l'embryon ou du fœtus. De plus, une épilepsie non contrôlée peut aussi s'avérer dangereuse pour la femme enceinte elle-même. C'est pourquoi, les femmes épileptiques devraient, si possible, planifier leur grossesse et ainsi recevoir les information s préalables par des professionnels de santé lors d'un examen préconceptionnel. Dans certains cas, l'interruption du traitement durant la grossesse pourra être envisagée. Quand un tel arrêt ne s'avère pas possible, les professionnels de santé détermineront quels sont les antiépileptiques pouvant être utilisés et lesquels devront être absolument évités. Ainsi, les traitements à base d'acide valproïque seront considérés comme étant le plus à risque pour les enfants exposés in utéro et ils seront déconseillés chez les femmes en âge de procréer. Les nouveaux antiépileptiques seront également évités étant donné le peu de recul que l'on a à l'heure actuelle ; exception fait de la lamotrigine, un anticonvulsivant déjà beaucoup étudié et qui s'est révélé être le plus sûr durant la grossesse. Selon les recommandations internationales des professionnels de santé, toute femme épileptique enceinte devrait recevoir un suivi adapté. Une supplémentation en acide folique sera aussi établie afin de prévenir les malformations du tube neural. Pour les antiépileptiques inducteurs, un apport en vitamine K sera également préconisé pour éviter les hémorragies néonatales précoces chez l'enfant. Dans 90% des cas, les grossesses sous antiépileptiques se déroulent tout à fait normalement grâce à cette étroite surveillance.
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Diabetes --- Kidneys. --- Complications --- Prevention.
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Diabetes --- Treatment. --- Complications
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How can one best master a rupture of the posterior capsule during cataract surgery? How should one operate on a dropped nucleus? What is the ideal management for a subluxated intraocular lens? If you are seeking answers to these and similar questions, then this is the book for you. Every surgeon is afraid of complications, but while complications cannot be entirely avoided, it is possible to learn to master them. This practical handbook clearly explains how to manage the various complications that may arise during cataract surgery. It provides the surgeon with clear instructions on how best to proceed in the manner of a cookbook, by first describing the ingredients (equipment) and preparation (planning) and then providing step by step descriptions of technique with the aid of numerous helpful color illustrations and several accompanying surgical videos. Surgical pearls and pitfalls are highlighted. Using this book, the reader will become a better and more complete cataract surgeon, well equipped to cope with the full range of potential complications.
Cataract --- Surgery --- Complications. --- Complications and sequelae --- Ophthalmology. --- Medicine --- Eye --- Diseases
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Laryngeal Neoplasms --- Osteoradionecrosis --- complications --- Laryngeal Neoplasms. --- Osteoradionecrosis. --- Laryngeal Neoplasms - complications
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