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Stage Classification of Gastric Ulcer by Sakita-Miwa

23 July, 2009 Guillermo Firman

The gastric ulcer are staged, by using of the endoscopic staging system of Sakita, into 3 stages (active, healing, scarring) as follows.

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Perioperative Cardiovascular Evaluation for Noncardiac Surgery

21 July, 2009 Guillermo Firman

Clinical Predictors of Increased Perioperative Cardiovascular Risk (Myocardial Infarction, Heart Failure, Death)

Major

• Unstable coronary syndromes
  • Acute or recent MI* with evidence of important ischemic risk by clinical symptoms or noninvasive study
  • Unstable or severe† angina (Canadian class III or IV) Continue reading “Perioperative Cardiovascular Evaluation for Noncardiac Surgery”

Case Definition for Influenza A (H1N1) Virus Infection (Swine Flu)

13 July, 2009 Guillermo Firman

After identification of novel influenza A (H1N1) virus infection in Mexico, a case definition was developed. The initial definition of suspected novel influenza A (H1N1) virus infection included any hospitalized patient with severe acute respiratory illness. On May 1, 2009, this definition was expanded to include any person with acute respiratory illness defined as fever and either sore throat or cough. On May 11, 2009, the definition of suspected case was changed again to include any person with:

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The 2008 ACR Recommendations for Rheumatoid Arthritis Treatments

1 July, 2009 Guillermo Firman

• Initiating treatment with methotrexate or Arava (leflunomide) was recommended for most rheumatoid arthritis patients.
• Methotrexate plus Plaquenil (hydroxychloroquine) was recommended for rheumatoid arthritis patients with moderate to high disease activity.

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Indications of Dialysis in Renal Failure

19 June, 2009 Guillermo Firman

Indications of dialysis in acute renal failure (ARF)

• Severe fluid overload
• Refractory hypertension
• Uncontrollable hyperkalemia
• Nausea, vomiting, poor appetite, gastritis with hemorrhage
• Lethargy, malaise, somnolence, stupor, coma, delirium, asterixis, tremor, seizures,
• Pericarditis (risk of hemorrhage or tamponade)
• bleeding diathesis (epistaxis, gastrointestinal (GI) bleeding, etc.)
• Severe metabolic acidosis
• Blood urea nitrogen (BUN) > 70 – 100 mg/dl Continue reading “Indications of Dialysis in Renal Failure”

Guidelines for Urinary Indices in Acute Renal Failure (ARF)

12 June, 2009 Guillermo Firman

Guidelines for urinary indices whereby established Acute Renal Failure (ARF) can be distinguished from renal vasoconstriction with intact tubular function (prerenal azotemia).

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Criteria for Brain Death in Adults and Children

9 June, 2009 Guillermo Firman

Physicians, health care workers, members of the clergy, and laypeople throughout the world have accepted fully that a person is dead when his or her brain is dead. Continue reading “Criteria for Brain Death in Adults and Children”

Diagnostic Criteria for Cholangitis

28 May, 2009 Guillermo Firman

Acute cholangitis, also referred to as ascending cholangitis, is an infection of the biliary tree characterized by fever, jaundice, and abdominal pain, which in most cases is the consequence of biliary obstruction. Diagnosis is commonly made by the presence of clinical features, laboratory tests, and imaging studies. Continue reading “Diagnostic Criteria for Cholangitis”

Indications and Contraindications for Tube Thoracostomy

19 May, 2009 Guillermo Firman

In current hospital practice chest drains are used in many different clinical settings and doctors in most specialities need to be capable of their safe insertion. Continue reading “Indications and Contraindications for Tube Thoracostomy”

Indications and Contraindications for Abdominal Paracentesis

19 May, 2009 Guillermo Firman

Removal of abdominal fluid is of value in evaluating patients with ascites of new onset or unknown etiology, and provides symptomatic relief in patients with known disease or in the setting of a decompensating clinical state. Abdominal paracentesis is a simple procedure that may be performed rapidly and with a minimum of equipment.

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