... volume contraction, and juxtaglomerular apparatus hyperplasia Finally, diuretic use and abuse are common causes of K+ depletion Carbonic anhydrase inhibitors, loop diuretics, and thiazides are ... paralytic ileus The electrocardiographic changes of hypokalemia (Fig 2 21- 16) are due to delayed ventricular repolarization and not correlate well with the plasma K + concentration Early changes ... wave, ST-segment depression, and a prolonged QU interval Severe K+ depletion may result in a prolonged PR interval, decreased voltage and widening of the QRS complex, and an increased risk of ventricular...
... methylxanthines, theophylline, and aminophylline stimulate ventilation and increase the ventilatory response to CO Progesterone increases ventilation and lowers arterial PaCO2 by as much as 5 10 mmHg Therefore, ... Disorders—A Companion to Brenner and Rector's The Kidney, TD DuBose, LL Hamm (eds) Philadelphia, Saunders, 2002, pp 10 9 12 8 Laski ME, Wesson DE: Lactic acidosis, in Acid-Base and Electrolyte Disorders—A ... Brenner and Rector's The Kidney, TD DuBose, LL Hamm (eds) Philadelphia, Saunders, 2002, pp 83 10 7 Madias NE: Respiratory alkalosis, in Acid-Base and Electrolyte Disorders—A Companion to Brenner and...
... 46 :1, 2002 [PMID: 11 7569 41] Nghiem P et al: Tacrolimus and pimecrolimus: From clever prokaryotes to inhibiting calcineurin and treating atopic dermatitis J Am Acad Dermatol 46:228, 2002 [PMID: 11 807435] ... Kowalski TJ: Epidemiology, treatment, and prevention of communityacquired methicillin-resistant Staphylococcus aureus infections Mayo Clin Proc 80 :12 01, 2005 [PMID: 16 178500] Krueger JG: The immunologic ... flush persists longer and longer and may eventually become permanent Papules, pustules, and telangiectases can become superimposed on the persistent flush Rosacea of very long standing may lead to...
... ALGORITHMS 283 10 Error index E1 FP FPsym EASI NPCA−RLS 10 BS ExtBS ACY FPsymth 10 10 10 Flops Fig 14 .1 Computational requirements in flops versus the statistical error index E1 (Reprinted from [14 7], ... was measured using a performance index, defined as E1 = m m X(X i =1 XX m m jpij j j j 1) + ( maxpijjp j 1) maxk jpik j k kj j =1 j =1 i =1 (14 .14 ) P BA where pij is the ij th element of the m m ... q q p1 T Xs t g (s1 ) s s1 ] = T Xs t q = (1 0 ) ^ q s sT 1g0(s1) + sT 1] ^ pT q (A.2) where the sample index t has been dropped for simplicity Making the first-order approximation E s1 g s1 , one...
... revision of VDE 0 510 in all parts into EN and IEC standards This work is in progress with the relevant CENELEC working groups 14 .12 14 .13 14 .14 OTHER GERMAN STANDARDS AND GUIDELINES VG ... in electric appliances 14 .10 STANDARDS FOR ALKALINE ACCUMULATORS (SELECTION) 14 .10 .1 Existing German National Standards (Selection) All are harmonized 14 .10 .2 IEC and EN Standards (Selection) ... of standardization of batteries, that is secondary batteries (accumulators) and primary batteries (dry batteries) at the DKE: K 3 71 AK 3 71. 0.2 AK 3 71. 0.3 AK 3 71. 0.4 AK 3 71. 0.5 UK 3 71. 1 UK 3 71. 2...
... ovulation; it then rises by ~0.6°C (1 F) with ovulation and remains at that level until menses occur Body temperature can be elevated in the postprandial state Pregnancy and endocrinologic dysfunction ... infections and rapid breathing Lower-esophageal temperatures closely reflect core temperature Tympanic membrane (TM) thermometers measure radiant heat from the tympanic membrane and nearby ear canal and ... raised, neurons in the vasomotor center are activated and vasoconstriction commences The individual first notices vasoconstriction in the hands and feet Shunting of blood away from the periphery...
... individuals, particularly during heat waves According to the Centers for Disease Control and Prevention, there were 7000 deaths attributed to heat injury in the United States from 19 79 to 19 97 The ... elevated ambient temperatures and/ or humidities In a dry environment and at maximal efficiency, sweating can dissipate ~600 kcal/h, requiring the production of >1 L of sweat Even in healthy individuals, ... Table 17 -1 Causes of Hyperthermia Syndromes Heat Stroke Exertional: Exercise in higher-than-normal heat and/ or humidity Nonexertional: Anticholinergics,...
... separate gene, and each pyrogenic cytokine has been shown to cause fever in laboratory animals and in humans When injected into humans, IL -1 and TNF produce fever at low doses (10 10 0 ng/kg); in ... illustrated in Fig 17 -1 As has been mentioned, several cell types can produce pyrogenic cytokines Pyrogenic cytokines such as IL -1, IL-6, and TNF are released from the cells and enter the systemic ... ng/kg); in contrast, for IL 6, a dose of 1 10 µg/kg is required for fever production A wide spectrum of bacterial and fungal products induce the synthesis and release of pyrogenic cytokines, as...
... receptors are called Toll-like receptors and are similar in many ways to IL -1 receptors The direct activation of Toll-like receptors also results in PGE2 production and fever Production of Cytokines ... CNS Several viral diseases produce active infection in the brain Glial and possibly neuronal cells synthesize IL -1, TNF, and IL-6 CNTF is also synthesized by neural as well as neuronal cells What ... levels and peak febrile elevations, the most valuable measurements in patients with fever are C-reactive protein level and erythrocyte sedimentation rate These markers of pathologic processes are particularly...
... period and then a relapse of days of fever In the Pel-Ebstein pattern, fever lasting 3 10 days is followed by afebrile periods of 3 10 days; this pattern can be classic for Hodgkin's disease and ... 21 days and accompany the neutropenia There is no periodicity of fever in patients with familial Mediterranean fever Recurrent fever is documented at some point in most autoimmune diseases and ... by blocking of IL -1 activity Anticytokines therefore reduce fever in autoimmune and autoinflammatory diseases Although fevers in autoinflammatory diseases are mediated by IL -1 , patients also...
... migrates, and it may be pruritic (Chap 18 6) Forchheimer spots (palatal petechiae) may develop but are nonspecific since they also develop in mononucleosis (Chap 17 4) and scarlet fever (Chap 13 0) Postauricular ... patients Atypical measles (Chap 18 5) is seen in individuals contracting measles who received the killed measles vaccine between 19 63 and 19 67 in the United States and who were not subsequently ... with the live vaccine Hand-foot -and- mouth disease (Chap 18 4), most commonly caused by coxsackievirus A16, is distinguished by tender vesicles distributed peripherally and in the mouth; outbreaks...
... appropriate travel history and a petechial rash Thrombotic thrombocytopenic purpura (Chaps 54, 10 1, and 10 9) and hemolytic-uremic syndrome (Chaps 10 9, 14 3, and 14 7) are closely related and are noninfectious ... Fever and rash Infect Dis Clin North Am 10 :10 1, 19 96 [PMID: 8698985] Weber DJ et al: The acutely ill patient with fever and rash, in Principles and Practice of Infectious Diseases, vol 1, 6th ... with disseminated candidiasis (often due to Candida tropicalis) may have a triad of fever, myalgias, and eruptive nodules (Chap 19 6) Disseminated cryptococcosis lesions (Chap 19 5) may resemble...
... hypothermia Hypothyroidism—particularly when extreme, as in myxedema coma—reduces the metabolic rate and impairs thermogenesis and behavioral responses Adrenal insufficiency and hypopituitarism also ... surface-to-mass ratio and their lack of effective shivering and adaptive behavioral responses In addition, malnutrition can contribute to heat loss because of diminished subcutaneous fat and because of ... loss), reduces thermogenesis and gluconeogenesis, and may impair judgment or lead to obtundation Phenothiazines, barbiturates, benzodiazepines, cyclic antidepressants, and many other medications...
... n; oxygen triiodot apathy; vasoconstri consumptio hyronin n; e and ia; increase in bronchorrhe thyroxin impaire cardiac d output and bronchospa increase judgme blood in a; ased increase preshiverin ... dioxide flow; thermogene production renal sis; rigidity and decrease in in renal shivering- depressi increased on increase diminishing of atrial and per level of ventricular 8°C autoreg drop in ulation ... motion; (82.4°F cerebro decrease in congestion ) vascula blood and edema; blood nerve- r pressure, 75% conduction autoreg heart ulation; and cardiac oxygen decreas decline output; re- consumptio e...
... lysis, as reflected by potassium levels > 10 mmol/L (10 meq/L) Other findings that may preclude continuing resuscitation include a core temperature < 10 12 °C, a pH < 6.5, or evidence of intravascular ... survival Diagnosis and Stabilization Hypothermia is confirmed by measuring the core temperature, preferably at two sites Rectal probes should be placed to a depth of 15 cm and not adjacent to ... is temperature-dependent, and platelet function is impaired The administration of platelets and fresh frozen plasma is, therefore, not effective The prothrombin or partial thromboplastin times...
... less heat than some other forms of active core rewarming, it eliminates respiratory heat loss and adds 1 –2°C to the overall rewarming rate Crystalloids should be heated to 40°–42°C, but the quantity ... Cardiopulmonary bypass (CPB) Circuit—full circulatory support with pump and oxygenator Perfusate-temperature gradient (5° 10 °C) Flow rates 2–7 L/min (ave 3–4) ROR up to 9.5°C/h Note: BP, blood ... provided is significant only during massive volume resuscitation The most efficient method for heating and delivering fluid or blood is with a countercurrent in-line heat exchanger Heated irrigation...
... most of the symptoms and signs of infection, notably fever and leukocytosis Shaking rigors from infection may be mistaken for shivering Except in mild cases, extensive cultures and repeated physical ... arteriovenous shunting increases tissue pressures, and edema forms Finally, thrombosis, ischemia, and superficial necrosis appear The development of mummification and demarcation may take weeks to months ... frostbite causes only anesthesia and erythema The appearance of superficial vesiculation surrounded by edema and erythema is considered second degree (Fig 20 -1) Hemorrhagic vesicles reflect a...
... semicircular canals and the otolithic apparatus (utricle and saccule) on each side The canals transduce angular acceleration, while the otoliths transduce linear acceleration and the static gravitational ... cranial nerves III, IV, and VI; spinal cord; cerebral cortex; and cerebellum The vestibuloocular reflex (VOR) serves to maintain visual stability during head movement and depends on direct projections ... the pons and, via the medial longitudinal fasciculus, to the third (oculomotor) and fourth (trochlear) cranial nerve nuclei in the midbrain These connections account for the nystagmus (to -and- fro...