Mr. P is a 70-year-old male with originally seen at gastrointestinal surgical Oncology clinic after esophagogastroduodenoscopy (EGD) at his local hospital showed a 5cm laterally spreading polypoid mass with submucosal invasion in the second part of the duodenum. The pathology study of the mass showed tubular adenoma. Once surgical resection of the mass was considered, initial preoperative cardiac evaluation revealed high risk of perioperative complications. Cardiologist was consulted and Mr. P underwent left heart catheterization (LHC) after abnormal pharmacologic stress testing result. LHC revealed normal coronary arteries and normal left ventricle ejection fraction of 55%. Cardiologist cleared Mr. P for surgery based above result.
Mr. P underwent
laparotomy with duodenal mobilization, duodenostomy with local excision of duodenal adenomas, and primary repair of duodenotomy. Post-surgery, he had few reading of high blood pressure which was treated with labetalol. Besides that, his recovery was uneventful. On, post-operative day (POD) two, he was transferred from intensive care unit (ICU) lower level of care and deemed ready for discharge to skilled nurse facility on POD four. All paperwork was completed for discharge on POD five. On the evening of POD four, he was found hypoxic with oxygen saturation (SaO2) of 77% on room air. He was alert and orientated without any complaints. He was immediately supplement with four liter oxygen and his SaO2 improved to 91-92%. Less than an hour, Mr. P cardiac arrested with initial rhythm of VF. He received multiple rounds of defibrillation and advanced cardiac life support (ACLS) for approximately 40 minutes before return of spontaneous circulation (ROSC) achieved. He was then transferred to ICU for normothermia protocol and post arrest management. The first encounter with Mr. P starts from this point. All the above information was gather was the chart. Mr. P arrived to ICU intubated on amiodarone, epinephrine, norepinephrine, and heparin drip. All vital signs were in acceptable range. He is unresponsive even to persistent external obnoxious stimuli. Cardiology and neurology team was consulted and orders placed based on their recommendation. Normothermia protocol initiated for target temperature of 35 to 36 degree Celsius. An electroencephalogram (EEG) was also initiated simultaneously with normothermia protocol. Neurology team voice their concerned that the patient is likely suffering from anoxic brain injury with little chance of recovery. The following studies are completed: - stat Bedside echocardiogram, 12-lead electrocardiogram (ECG), pacer integration, computed tomography pulmonary angiography (CTPA), chest radiography, and computed tomography (CT) scan of the abdomen and pelvis and head without contrast was completed. The most significant finding from the imaging studies is left ventricle (LV) dysfunction with LVEF 25% to 30%. All other finding failed to isolate a disease process that led to CA. The ecology of CA is uncertain, could be related to primary cardiac event or hypercapnic respiratory failure (HRF). All the finding including all test results and possible complications and outcome were discussed with family members.
HPI: MR is a 70 y.o. male patient who presents to ER with constant, dull and RUQ abdominal pain onset yesterday that irradiate to the back of right shoulder. Client also c/o nauseas, vomiting and black stool x2 this morning. He reports that currently resides in an ALF; they called the ambulance after his second episodes of black stool. Pt reports he drank Pepto-Bismol yesterday evening without relief. Pt states that he never experienced similar symptoms in the past. Denies any CP, emesis, hematochezia or any other associated symptoms at this time. Client was found with past history gallbladder problems years ago.
According to the doctor, the patient might have developed congestive heart failure. Is it right-sided or
The first laparoscopic cholecystectomy (LC) using keyhole approach was done by Professor Mouret of Lyon, France in 1987, when he was completing a gynecologic laparoscopy on a woman also suffering from symptomatic gall stones, he removed it laparoscopically instead of opening up. Dr. Eddie Reddick reported 100 cases of laparoscopic cholecystectomy in 1989. The classical four port technique of LC as described by Reddick became the most widely adopted technique.
This module of study has focused on many aspects of human health, anatomy, and the disease process. It has included such topics as the human organ systems, the mechanism of disease and the resulting disruption of homeostasis, the integumentary system, and the musculoskeletal system. The following case studies explore how burn classification will affect treatment, how joint injuries can disrupt mobility, and last, how a sedentary lifestyle can contribute to a decline in a person’s health status. The importance of understanding disease and knowing when to seek treatment is the first step toward enjoying a balanced and healthy life.
Authors have a variety of motives for writing, which are termed as the author’s purpose. The four main purposes for writing are to express oneself, to explain or inform, to entertain, or to persuade. In the nonfiction story, "The First Appendectomy" written by Dr. William Nolen, the author's purpose is to inform.
1There are dangers involved with Gastric Bypass surgery. Case studies show high insulin levels following meals, confusion, shaking, sweating, headaches and black outs. The patients eventually needed partial or complete removal of the pancreas, in order to prevent dangerous declines in blood glucose. Patients also experienced Dumping Syndrome, when the small intestine fills too quickly with undigested food from the stomach which can cause abdominal cramp and diarrhea. Other research has uncovered a higher-than-expected risk of death following surgery for obesity, even among younger patients.
Surgery is the most common treatment for all stages of colon cancer. Cancer cells may be removed by one of the below procedures:
Cardiomyopathies can be caused by genetic disorders/defects, viral illness, some endocrine conditions, autoimmune diseases, and excessive use of alcohol and drugs. Pharmacology treatment of diagnosed LVSD is predominately the same, although it is recognised that lifestyle advice may differ depending on the cause or exposure to environmental factors.
My patient who is a 57 year old male who has a past history of Hypertension, takes Accupril to help with his high blood pressure. Is complaining of chest and lest arm pain. He has a blood pressure of 140bpm a high heart rate, and on the ECG showing significant ST elevation and Sinus Tachycardia.
I have elected to transcribe my proposal argument on issues regarding cancer chemoprevention. I selected this topic because reasonably minute devotion has been given to cancer chemoprevention research in ethical writings, particularly in relation to the huge quantity of moral studies in cancer treatment exploration. Cancer chemoprevention trials test the ability and care of medicinal agents in averting cancer before its manifestation. I believe that phase III chemoprevention issues can be less prevalent by simply ensuring enhanced communication and etiquette between researchers and investigators.
Douglas Anthony in one of the hospital in Orlando Florida on July, 2015 this patient brought to the hospital. Patient was having severe pain in the upper part of the body and was crying in the waiting room. Receptionist and other hospital members were busy in dealing with other patients. Mr. Douglas had to wait for long time to get register in electronic record of the hospital. He was sent to the emergency room where doctor examined him for stomach pain. While checking Mr. Douglas Doctor asked him about the medical history of the stomach pain. Due to language and communication problem doctor referred him to physician with his case history. Physician checked him and send him for the Lab tests. After reading the test reports physician diagnosed him for cardiovascular
A 88-year-old male was admitted to the hospital for elective TAVR. His pre-operative transesophageal echocardiogram (TEE) demonstrated a left ventricular EF of 60-65%, a severe aortic stenosis with a mean/peak gradient of 30 mmHg/51 mmHg, and an aortic valve
Imagine losing both your parents to cancer and then going through an irreversible procedure to possibly save your life from cancer. Well that was a reality for Peter Penni, who also went through the Whipple procedure, in 2017.
Late December 2015 was, at the time, the worst month for me. It was around 8'o clock in the evening, the sun had set and the moon has risen to its’ fullest. I could smell the sweet aroma from the kitchen. I walked passed and into the living room, which was messy from all of our christmas decor. My mom yelled down the hall to my brothers.
Mayo Clinic is a hospital that is as well-known by many to be a haven of caring and concerned doctors whos’ sole focus is to give their patients the type of care they would want their families to receive if they were patients. According to Colquitt, LePine, and Wesson (Mayo Case Study, 2014), Mayo Clinic has established a customer service, patient first culture that puts the needs of those whom they serve ahead of other focuses, such as profit or patient quotas. This corporate culture has lead the hospital to become one of the most successful and iconic medical centers in the United States. Colquitt, LePine, and Wesson (Mayo Case Study, 2014) propose several very interesting questions at the end of the reading that they ask readers to ponder.