Archive for the 'Critical Care' Category

Blood Glucose Testing

Thursday, November 20th, 2014 No Commented
Under: Critical Care


There are a bewildering number of strips and meters on the market. Which are the best to use?

A few years ago most people were using strips without a meter. This required performing a complicated procedure in order to obtain an accurate blood glucose result. Now in the UK you can only use a strip with a meter. The meters are very similar in terms of reliability and performance. There are small differences, for example the amount of blood required to perform a test or the time it takes for the meter to produce the results. Nearly all the meters can be downloaded onto a PC and software is usually available free from the manufacturers.  BLOOD GLUCOSE

Blood testing is not just about doing the test but making sense of the results. Your healthcare professional will show you how to use your meter, and you will need further time to discuss your results and what you might need to change in order to achieve the levels you want.

Blood glucose testing strips are available on prescription from your GP. The meters are quite inexpensive and may be available free from your diabetes nurse.

I have recently started testing my blood sugar levels but my results do not compare well with the clinic results. What is the reason for this?

It is not clear if your blood sugar results are being compared with blood sugar tests at the hospital or with another test known as the HbA1c, glycosylated haemoglobin or long-term test. The HbA1c is usually measured only once or twice a year. The test measures the amount of glucose that has attached itself to the red blood cells, throughout their 2-3 month life span (see section Haemoglobin Ale later in this chapter). Research tells us that to avoid complications of diabetes the HbA1c should be under 7.5%. The HbA1c is often described as an average of blood sugar levels but strictly speaking it is not an average. For example, if your HbA1c is 12% your blood sugar levels are likely to be averaging around 19 mmol/L. When you perform a blood sugar test at home you are measuring the result as it is at that minute in time. Two hours later it could be much lower or much higher. The HbA1c is not measuring the highs and lows but what has accumulated in the previous two to three months.

In summary, it is possible that your home blood glucose tests are being compared with the HbA1c which is a different kind of test. Alternatively, the blood is being tested at a different time or on a different blood testing machine, which can cause a variation in results.

Studies suggest that corticosteroids might affect tissue remodeling

Friday, October 17th, 2014 No Commented
Under: Critical Care

Corticosteroids are commonly used in the management of lung diseases induced or exacerbated byenvironmental tobacco smoke and characterized by airflow limitation such as asthma and COPD. The beneficial effects of corticosteroids in this setting are often ascribed to their powerful anti-inflammatory activity. However, studies suggest that corticosteroids might affect tissue remodeling as well. Vanacker et al showed that FP, the corticosteroid used here, inhibited the progression of allergen-induced structural changes in the airways of rats. These effects were associated with inhibition of epithelial cell proliferation, goblet cell hyperplasia, and airway wall thickening. Blyth et al showed significant resolution of established subepithelial fibrosis in a murine model of atopia.

Canadian News J-Medical


Moreover, Chetta et al showed that fluticasone can reduce the vascular component of airway remodeling. In humans, Hoshino et al showed that inhaled corticosteroids can reduce the lamina reticularis of the basement membrane by modulating insulin-like growth factor-I expression in bronchial asthma, and Olivieri et al showed that fluticasone might control the intensity of airway remodeling. Together, these studies suggest that corticosteroids can diminish lung tissue remodeling, thereby ameliorating the progression of disease Myviagrainaustralia. However, the exact mechanisms by which corticosteroids exert their anti-tissue remodeling effects remain to be fully elucidated.

We hypothesize that corticosteroids modulate lung tissue remodeling by affecting intracellular signaling pathways that control the expression of extracellular matrix genes. The data presented here suggest that this hypothesis is correct. We report that nicotine stimulates the production of fibronectin in transformed and primary lung fibroblasts. The induction of fibronectin was due to increased transcription of the fibronectin gene followed by accumulation of fibronectin mRNA and secretion of its protein.

Consistent with our hypothesis, we found that FP inhibited the production of fibronectin in lung fibroblasts by blocking the transcription of the fibronectin gene, thereby decreasing fibronectin protein production. This inhibitory effect was related to blockade of CREB phosphorylation, a transcription factor known to be important in regulation of fibronectin gene transcription. In turn, inhibition of CREB phosphorylation was associated with decreased CREB binding to DNA leading to diminished gene transcription.

Sports First Aid: Reasons to Get Trained Up

Thursday, September 8th, 2011 No Commented
Under: Critical Care

First aid can be very useful in a variety of situations. However, having proper training can be especially useful when it comes to sports. Sports first aid is one of the most useful types of first aid you can get trained in if you are regularly involved in sporting activities, and here are a few reasons why.

Accidents are Common in Sports

One of the main reasons to learn sports first aid is because accidents are quite common in sports. All sports are different, but compared to everyday life there is generally more chance of injuries occurring during sports activities.

Even in a sport such as football, injuries occur all the time. If you are in such an environment on a regular basis then it makes sense to know what to do when something goes wrong.

Provide Vital Assistance

Unless you play a sport professionally, it is likely that you will have to wait for help to arrive before the injured person receives first aid. If you are out in the countryside partaking in an activity, far from the nearest hospital, then sports first aid can literally be a lifesaver if applied immediately. Knowing what to do in the moment can save lives, and you can also help to provide support to the person who has been injured and comfort them until help arrives.

Save a Career

Careers can be ended by some sports injuries, and if you react in the right way at the right time then you could be doing your part to help save the career of your colleague. Even relatively minor injuries can have lasting consequences if they are not dealt with properly with appropriate sports first aid techniques.

Anyone Can Get Trained

You don’t have to be partaking in the sport to get trained in sports first aid. If you are actually partaking in the sport then it is a great idea to have first aid knowledge, but even if you are involved in a different way then you can get trained up. Coaches, training staff and even spectators can all learn the skills needed in first aid situations, and anyone around the sport environment can get trained to offer their help.


Get Trained in Sports First Aid

It can be a very good idea to get trained up in sports first aid whether you are a player, coach or you are simply spectating. First aid can really help in any situation, from minor injuries to more serious accidents, and learning the skills is a very good idea.

Best First Aid Kits To Buy

Saturday, April 16th, 2011 No Commented
Under: Critical Care

When faced with an accident or disaster it is the nature of most people to want to help. When these happen at home or to our loved ones, it is essential we are equipped to assist. Where injury has occurred or life is threatened, competently delivered first aid can save a life and maintain that life until emergency services can arrive.

In the situation where Emergency Services take time to arrive to your location we must also be confident that we can best assist with first aid for others and for ourselves.

Good comprehensive first aid training and a well stocked first aid Kit, which is easily accessible, can mean the difference between life and death in an emergency situation.

It is the function of first aid Treatment to provide life saving assistance to a person until Emergency Services arrive. The trained first aid person knows that they must keep themselves safe first – assess the Danger, check the victim for a Response, send for help, Check Airways, Check for Breathing, if necessary start Compressions and if available use the Defibrillator. (DRABCD)

But which Kit? There are so many to choose from! Your choice will depend on your situation: from a backpack first aid kit for hiking, to a cabinet kit for business or industry, or a soft satchel kit placed under the seat in a car.

In each of these kits there should be some common essential supplies which include but are not limited to

  • Current first aid Book
  • Notebook and Pen
  • Zip-loc plastic bag
  • Saline Solution
  • Band Aids of various shapes and sizes
  • Gauze Pads
  • Eye Pads
  • Non stick dressings
  • Conforming bandages of various sizes (minimum 6 for snake bite)
  • Triangular Bandages
  • Safety Pins
  • Scissors
  • Tweezers
  • Splinter probe
  • Eye bath
  • Space Blanket
  • CPR mask
  • Low allergy adhesive tape
  • Latex free protective gloves
  • Wound wipes
  • Antibiotic Cream
  • Burn aid gel

Where a first aid Kit can be exposed to water, a waterproof container is of benefit, otherwise the container should be practical for your application, sturdy enough to protect the contents and allow easy access so that you can get on with the business of saving and maintaining a life.

While there is no substitute for good preparation and training when faced with an emergency situation it is better to do what you can to help than to do nothing. At the very minimum you can phone emergency services and get them on their way to your scene.

Nebulizers Can Offer An Effective Home Treatment for Breathing Problems

Thursday, April 7th, 2011 No Commented
Under: Critical Care

Nebulizers are an essential drug delivery method that can help to clear airways and ease breathing problems.

Safe and Effective Treatment

Patients suffering from respiratory conditions can face a number of challenges when it comes to treatment. Getting medication quickly and effectively into the airways and lungs is difficult. Previously if patients suffered from breathing problems they would most likely have had to be admitted to hospital for treatment.

The invention of nebulizers revolutionised medical practices though and provided a fast and effective way for liquid medicine to be delivered directly to the airways and lungs. work by transforming liquid into a mist. This can then be inhaled directly into the respiratory system for instant treatment. One of the main benefits of nebulizers is that they can be used safely at home by patients. This has reduced the need for hospitalisation for respiratory problems dramatically.

Benefits of Using Nebulizers

Nebulizers can offer many benefits for both physicians and patients:

Self-Administration – nebulizers are easy to use. This means that patients can self-administer their medication without having to rely on anyone else. This can provide much more freedom for patients suffering from respiratory problems.

Portable – nebulizers are portable. Patients will be able to use them at home and also when they are travelling around.

Instant Relief – suffering from breathing problems can be very distressing for patients. When they have a serious attack nebulizers can offer instant relief to open airways and allow patients to breathe more easily. This fast acting delivery can be essential in the treatment of conditions which affect the airways and lungs.

Painless – nebulizers offering painless delivery methods. The liquid medicine is turned into a mist-like state which is easy to inhale. This encourages patients to follow their treatment plans and take the medication when they need it. This pain free treatment method is also ideal for children and vulnerable patients.

Reduces Admittance – nebulizers reduce the burden on emergency health services. They avoid the necessity for patients suffering from respiratory problems to be admitted to hospital every time they have an attack. The nebulizers allow the patient to get fast and effective treatment at home.

Buying Nebulizers

You can buy nebulizers from specialist medical equipment suppliers. There are a wide range of nebulizers on the market so you will need to get further advice from your doctor. You will need to know what types of medication you need to take before you buy a nebulizer. Models are designed to work with particular types of medication so it is very important you get the right one.

Conditions of Premature Babies

Saturday, December 4th, 2010 No Commented
Under: Critical Care

Premature babies, or preemies, are born before the 37th week of pregnancy. Since they are born too early, they weigh much less than full-term babies. Their organs are not yet develop, causing them to have health problems and thus they need special and close monitoring in a NICU or neonatal intensive care unit by a neonatologist to assess their medical condition. Babies are discharged out of NICU when their organs are already developed.

Since organs of premature babies are not fully developed, they may have the following conditions: apnea of prematurity (AOP)-a condition which premature infants stop breathing for 15 to 20 seconds during sleep; bronchopulmonary dysplasia (BPD)-is a serious lung condition that affects premature infants needing oxygen therapy; intraventricular hemorrhage (IVH)-is bleeding inside or around the ventricles, the spaces in the brain containing cerebral spinal fluid; necrotizing enterocolitis (NEC)-a gastrointestinal disease involving infection and inflammation that causes destruction of the bowel or part of the bowel; patent ductus arteriosus (PDA)- a heart problem that characterized by the occurrence of abnormal blood flow between the two major arteries connected to the heart; periventricular leukomalacia (PLV)-is characterized by the death of the white matter of the brain due to softening of the brain tissue which is brought about by the lack of oxygen or blood flow to the periventricular area of the brain; respiratory distress syndrome (RDS)- is brought about by immature lungs which cannot produce enough surfactant. Surfactant is a liquid coating that allows lungs to open and not to collapse while breathing; retinopathy of prematurity (ROP)-occurs when abnormal blood vessels grow and spread throughout the retina which causes scarring and pulling out of the retina in position that further leads to visual impairment and blindness; transient tachypnea of the newborn (TTN)-a lung condition which causes newborns’ breathing during the first hour of life more rapid and labored than normal; very low birth weight-babies who are born weighing less than 1,500 grams (3 pounds, 4 ounces).

Feeding becomes the most important during babies’ stay in the NICU to ensure growth and development, therefore breastfeeding is encouraged. Breast milk has a lot of benefits for babies especially for premature and sick ones. However, premature babies aren’t ready to suck yet. They are feed through a tube. Mothers should learn how to pump their milk so it can be delivered by tube to the babies’ stomach.

Parents having premature babies are often worried, may feel anxiety and confusion; not only because of the medical condition of their babies but also because of the various equipment in the NICU that may threaten them about their babies. Some of the common reactions by parents are fear, anger, guilt, loss, and powerlessness. Talking with the NICU team may help reduce the discomfort. It will help in understanding babies’ conditions and needs as well as of the parents’ conditions and capacity to handle the situation therein. Through this, they can set their level of expectations and cope with the NICU experience.

Recovering From a Hysterectomy

Monday, October 4th, 2010 No Commented
Under: Critical Care

In 1999, I had a hysterectomy (thankfully) and I got some great advice beforehand and learned a few things along the way, too. If you imagine that you might be having this surgery sometime in your life (or if you have a friend who is), I encourage you to take heed.

If your doctor says, “Take off 6 weeks”, take off 6 weeks. The best advice I heard prior to having a hysterectomy was that I could either take 6 weeks off and completely recover or I could go back to work sooner and take a year and half to recover. (thanks, Betty! You were right. I took off 6 weeks and when I went back, I was full steam).
Know you are NOT going to feel good for days. You will have more gas than you think you can stand, just for starters.
Know that anesthesia is still in your body and completely avoid alcohol for awhile. And if you have never been a drinker, this is not the time to start, by the way! HA!
Let other people bring you food. Whether you feel like eating or not, your family will and you don’t want to be worrying about them.
Sleep when you want to. You may or may not sleep much at night so take lots of naps. Get better.
Be aware that your hormones are going to be out of whack – maybe more and maybe less than they were before your surgery. If others try to help you notice some changes in your personality by saying something, try to accept it and please talk to your doctor or other health care provider about your concerns.
Just hang out. For most women, this is not easy and it even feels unnatural. Honey, I’m telling you, this is your time to just hang out and let life swirl around you. You don’t have to engage unless you really want to.
Putter around. Then be ready to sit down or take a nap whenever you feel like it.
Talk to other women who have had hysterectomies and see what their recommendations are. They are your best sources for info and all will be happy to pass along their best tips. I am.
After you’re able to drive in about 2 – 3 weeks, meet some friends for lunch. Then go home and take a nap.

I actually wondered if there was more surgery I could have after my hysterectomy because apparently it took major surgery for me to do the things listed above.

A Look at Specialists Known As Cardiologists

Wednesday, August 18th, 2010 No Commented
Under: Critical Care

If you have ever experienced problems with your heart, regardless of what it might be your primary care physician likely sent you to a specialist for further assessment and treatment. The doctor you would have seen who examined you and evaluated your condition would have been known as a cardiologist.

Cardiologists are doctors who have specialized training and skill when it comes to diagnosing, treating and preventing heart conditions and any diseases that may affect the heart. These physicians are experts when it comes to the work of the heart and the blood vessels. They know more than any other medical doctor about the cardiovascular system.

Cardiologists are also the professionals you should see to learn about the risk factors associated with heart disease. They can sit down with you and explain to you what foods to eat for heart health, as well as the importance of regular exercise and what lifestyle habits can weaken the heart and open the door for problems in the future.

A doctor of cardiology receives many years of education and the education and the education he/she receives is extensive. It would include four years attending medical school and then another three years of training and study in general internal medicine. The doctor then must spend three years and sometimes more in specialized training that is related to cardiology.

A physician of cardiology must first become certified to work in this field of medicine. Following a minimum of 10 years of schooling he/she must take and pass a two-day examination that is vigorous and very challenging. The American Board of Internal Medicine gives this examination to doctors in this specialty. The examination is very significant. Not only does it test the knowledge, skills and level of judgment of the medical professional but it also tests their ability to offer top-notch care to their future patients.

You will be sent to see such a specialist if your general practitioner believes that you are suffering from a heart condition that is serious in nature. Examples of symptoms that may signal the onset of a problem with the heart and the need for special tests include chest pains, shortness of breath, dizzy spells and recurrent episodes of fainting.

Any changes that show in an ECG are a valid reason to be sent to a doctor of cardiology. The same can be said for individuals who have a heart murmur. Cardiologists treat any number of heart issues including heart attacks, heart rhythm disturbances that are deemed serious and heart failure. These cardiovascular experts can provide the necessary help and guidance required by those who have suffered from heart disease. These patients need support from their doctors to return to living a high qualify life. They also need to be taught proper preventative measures to ensure a healthier heart for their future. The skills of such physicians are often called upon when significant decisions need to be made regarding medical procedures for patients such as heart surgery, cardiac catheterization and balloon angioplasty. Cardiologists often deal with life or death circumstances for the patients entrusted to their care.

Spinal Cord Injury

Thursday, July 8th, 2010 No Commented
Under: Critical Care

Some accidents require only a little bit of attention while others necessitates a more rigid medical observation. There are also accidents, however, where the victim appeared to be okay at first, but after a week’s time, some peculiarities like the inability to move parts of the body, may start to manifest. While the effects of a spinal cord injury may be immediately felt after the accident, there are instances where the symptoms appear after one or two weeks’ time.

This is why it is important to immediately seek medical help, especially after an accident that caused a sudden impact to your back, to see if you have a spinal cord injury. The symptoms for this type of injury usually vary. You may start to feel severe back pains, some numbness in your extremities, and difficulty of walking or maintaining your balance. Other symptoms that can also manifest either right after the accident or a week later include difficulty in breathing and loss of bladder control. If you figured in an accident where your back absorbed some impact, then it is really advisable to get immediate medical attention.

If you figured in an accident, with the mishap caused through the negligence of others, and it was found out that you sustained a spinal cord injury, then hiring the services of a lawyer is a step in the right direction. The specter of high medical costs and special care, in case you need them, is all too real to just set aside. Your insurance policy may not be able to cover everything in case this happens and so seeking redress from those who were negligent is always the most viable option.

A spinal cord injury lawyer could help you seek remuneration from persons or entities that acted negligently and caused the accident from which you suffered as a victim. Your lawyer can prepare all the legwork for you including all the documentation and securing witnesses to the accident. He can also seek the opinion and deposition of experts who will be able to lend credence to your claims and solidify the evidence that you have against the respondent.

Remember that if it was found out that your spinal cord injury is so severe that it might require you to seek special care including rehabilitation therapies, home aid and renovation, surgeries, and medical equipment, you may not be able to handle its financial requirements. This is where the services of a spinal cord injury attorney will be most valuable because he can demand for medical cost reimbursement, and compensation, from the parties you believed to have been remiss in their task which is why the accident happened. After all, it would be too unfair if you will pay for something that you did not cause, right?

Stress May Increase Susceptibility to Infections

Thursday, May 27th, 2010 No Commented
Under: Critical Care

When attacked by bacteria or viruses, the healthy body mobilizes its navy, air force, army, and marines so quickly that no infection occurs. These armed forces consist of lymph cells, white blood cells, antibodies, or globulins, which are ineffective without a co-worker, the complement. The viruses, and their toxins by engulfing and digesting them with the aid of enzymes or by combining with them, causing them to settle out, or by other means. An adequate diet can quickly increase all of these defenses even after an infection gets a foothold provided various nutrients are given in generous amounts the minute the first symptoms appear. The body’s armed forces are identical regardless of the location of the infection or the types of viruses or bacteria involved. Because a physician is rarely consulted until illness is advanced, each individual should know the immediate steps to take to fight an infection.
Growth hormone mexico
The Effect of Stress

The adrenal hormone DOC is so completely held in check by the excessive amounts of cortisone produced during stress that the body often cannot protect itself and infections may become rampant, as they frequently do when cortisone medication is given. If the adrenals are too exhausted to produce an adequate amount of cortisone, however, DOC is not sufficiently held in check, and lymph glands, such as the tonsils and adenoids, become enlarged; the white blood count soars; and inflammation at the point of the infection is marked by redness, swelling, pain, and fever. When one is under stress, therefore, whether too much or too little cortisone is being produced, the body becomes susceptible to infections.

During most infections, too little aldosterone can be produced, sodium is lost from the body, cells become more permeable, or sieve like, and water accumulates in the inflamed area, increasing the swelling and pain. After the blood sodium has thus been replaced, swelling often goes down in a few moments and other symptoms disappear.

The lymph glands produce antibodies to fight infections. If cortisone is being synthesized normally, the proteins in these glands are broken down and the glands shrivel during the stresses that have preceded and are imposed by the bacterial or viral attack. Swollen lymph glands, such as those under the chin and behind the ears, or enlarged tonsils or adenoids always show that cortisone is not being produced in adequate amounts. Although the swollen glands are trying to fight the infection, the defense mechanisms are weak at the very time they are needed most. To recover from an infection, therefore, the first step must be to stimulate adrenal function.

Since pantothenic acid is essential for cortisone production, low resistance to spontaneous infections is the first sign of an under supply of pantothenic acids Infections appear long before other deficiency symptoms can be detected and more quickly than if any other nutrient were missing.’ Animals even mildly deficient in pantothenic acid or vitamin B6 show an immediate marked reduction in antibodies, complement, and white blood cells; and if “vaccinated,” immunity is not increased. Some strains of rats-and also certain families or individuals–require many times more pantothenic acid than others and are far more harmed by a deficiency.
Flomax in Mexico
In volunteers lacking pantothenic acid and vitamin B6, so few antibodies and white blood cells could be produced that they had continuous infections, particularly sore throats, or acute pharyngitis; and when vaccinated for tetanus, typhoid, and polio, showed no increase in antibody production. When stress has not harmed the adrenal or lymph glands too severely, giving 40 milligrams of vitamin B6 to persons with infections increased both the white blood count and the antibody production within three hours. Recovery was slow, however, even when such huge amounts as 4,000 and 600 milligrams of pantothenic acid and vitamin B6 respectively were given daily to volunteers who had been deficient in these vitamins for several weeks. In fact, 17 out of 18 patients lacking vitamin B6 showed an “absolute decrease” in white blood cells in five days.

A diet under supplied with vitamins B1, B2, folic acid, biotin, or niacin inhibits the production of antibodies, white blood cells, and the complement, though less severely than when pantothenic acid or vitamin B6 is limited. A lack of any of these vitamins also prevents the body’s defenses from being stimulated when antitoxins and other forms of immunization are given.

Air Ambulance Services

Wednesday, April 7th, 2010 No Commented
Under: Critical Care

When a patient is facing a time sensitive medical emergency or has a condition that cannot be treated in their area, air medical transport is often the most effective method of moving from one place to another. There are a few things that a patient and his or her family can expect during an air ambulance flight, which they should know about before they are in a situation where they need this service.

Once a patient has made arrangements with an air ambulance service, the medical staff will consult with the patient’s doctor or nurse to determine the necessary equipment and specialists needed for travel. The patient and his attending nurses or physician will then travel to the airfield, often in an ambulance, and the patient will be boarded onto the plane.

In the air, the plane will have all of the medical equipment and attendants necessary to transport the passenger safely, and tend to any medical emergencies that might arise during the flight. Arrangements need to be made for an ambulance or other vehicle to be waiting at the air field to safely deliver the patient to the final destination. A member of the passenger’s family can often travel along if requested, and loved ones are kept well informed of progress throughout the flight.

Many people choose to use an air ambulance service for transportation of passengers who are not facing life threatening emergencies. One of the most common types of non-emergency medical flights is for an elderly patient relocating to a new medical facility. Just like emergency medical flights, the medical staff is thoroughly briefed of their condition by the patient’s doctor prior to take-off, and the plane is equipped to provide the necessary assistance throughout the trip for every medical contingency.

All air ambulance service flights are operated by FAA licensed pilots with an excellent safety record. Although there is a wide range of aircraft that are used for emergency medical and non-emergency medical flights, the most common types of planes that are used for are Gulfstream, Learjet and twin engine Cessna models. Luxury aircraft can often be arranged for by an air medical transport company at the request of a patient or his or her family.

Most air medical transport services accept different types of medical insurance, but a patient is advised to contact his or her insurance carrier to confirm that the policy covers air transport. Approximately one third of the patients who use these services are covered by their insurance to some extent, while Medicare and Medicaid patients may need to discuss their options further with the appropriate agencies. Talking to your preferred medical transport company as well as your insurance provider should give you more information, so you can be sure you or your loved one knows exactly what to expect.

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