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Difference in risks of teeth damage between beginners and expertsDifferenceduringin risksintubationof teeth damagewas betweensurveyedbeginnersby usingand mannequins. Stress on teeth was especially high for emergency 10 32 medical students32 anesthesiologists and Stressintubationonamongteeth beginners. Vogel, Stubinger, Kaufmann, Krastl, Filippi 2009 115,151 personsundergoing general Retrospective study MousepieceAnterior maxillarydid not teethseem verydamageeffectivewas andlargestdentalin checkupnumber. Oral care intervention using chlorhexidine gluconate before Bergan, Tura, Lamas 2014 226 patients undergoing Prospective surgery has significantly reduced incidence of postoperative 18 226 patients undergoingcardiovascular surgery intervention studyProspective Oral care intervention using chlorhexidine gluconate before Bergan, Tura, Lamas 2014 pneumonia. Risk of infection by immunosuppressants used following transplant surgery is a serious problem. Risk of infection by immunosuppressants used following Dentaltransplant surgery is a serious problem. Poor20%dentalhadhealthperiapicalwas observedpathosis, 20 Barbero, Garzino Demo, Milanesio, Ottobrelli 1996 80 liver transplant Cohort study andin 85% of patients. Poor oral health condition can increase risk of acute Zwiech, Bruzda-Zwiech 2013 recipients Cohort study Poorrejectionoral andhealthhospitalizationcondition can amongincreaserenalrisk ofallograftacute 23 rejectionrecipients. Patients scheduled for Oral health training and motivation program were found to heart transplant and liver Oral health training and motivation program were found tobe effective for improvement of oral health. Dental Somacarrera, Lucas, Cuervas-Mons, Hernandez 1996 Patients scheduled for Cohort survey be effective for improvement of oral health. Dentalpreventive treatment was found to be effective in reducing 24 heart transplant and livertransplant (46 patients risk of postoperative complications. It was considered that Somacarrera, Lucas, Cuervas-Mons, Hernandez 1996 transplant (46 patientseach) Cohort survey preventive treatment was found to be effective in reducing 24 risk of postoperative complications. Oral checkup before surgery and time-dependent bacteria Bagyi, Haczku, Marton, Szabo, Gaspar, Andrasi, 2009 23 patients undergoing Prospective cohort Oralculture were conducted. Severity of periodontal diseases was significantly associated Varga, Toth, Klekner 2009 brain surgery study with incidence of postoperative pneumonia (p=0. Severity of periodontal diseases was significantly associated 28 with incidence of postoperative pneumonia (p=0. The postoperative pneumonia prevention program Wren, Martin, Yoon, Bech 2010 Subjects: 3,319 general Prospective cohort (respiratoryThe postoperativerehabilitationpneumoniaplus oral care)preventionperformedprogramprior to 29 Subjects: 3,319 generalsurgery patients studyProspective cohort (respiratorysurgery has rehabilitationreduced incidenceplus oralof postoperativecare) performedpneumoniaprior to Wren, Martin, Yoon, Bech 2010 surgery patients study surgeryto 25%. Dental checkup and oral bacteria culture were performed 39 thoracic esophageal beforeDental surgery. Postoperative pneumonia was observed in 30 Shiratori, OchiaiAkutsu, Matsubara, Okazumi, Shimada, Shuto, 39 thoracic esophageal studyProspective cohort 14 patients (35. Bacteria present in plaque was a risk factor for 2008 cancer patients scheduledfor surgery postoperative pneumonia for thoracic esophageal cancer 30 Shiratori, Ochiai for surgery study Bacteria present in plaque was a risk factor for postoperativepatients. Dental checkup and oral bacteria culture were performed Akutsu, Matsubara, Shuto, Shiratori, Uesato, 2010 Subjects: 39 thoracic Dentalbefore surgery. Postoperative pneumonia was observed in 31 Akutsu, Matsubara, Shuto, Shiratori, Uesato, 2010 Subjects: 39 thoracic study Bacteria present in plaque was a risk factor for Miyazawa, Hoshino, Murakami, Usui, Kano,Miyauchi Apr;147(4):497-502.

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The average distress therfriendlybecauseoftheirphysicalconditions,butchallengethefoundationtoadaptmore mometer score decreased from 4. Empowering Patients and Care Givers Empowering patients and cancer caregivers with information and training Empowering patients and cancer caregivers with information and training Communication Issues and Challenges of Information Sharing, Care Plans Users of the Telephone Cancer Information Service Becomes Better at and Treatment Modalities for Cancer Patients and Families Accessing Coping With Their Situation Hospice and Palliative Care Services in Nigeria and South Africa S. Oyebola the Danish Cancer Society, Copenhagen, Denmark Pain and Palliative Medicine Department, Federal Medical Centre, Background: More than 37,000 Danes were diagnosed with cancer last year and Abeokuta, Nigeria approximately 285,000 Danes are cancer survivors. The Danish Cancer Society Background: the recent upsurge in the prevalence of cancer cases in Nigeria and offersprofessionalinformationandcounselingfreeofchargetoallpeopleaffected other African countries is fast becoming a great challenge for the clinicians and by cancer. Last year, the telephone cancer information service Krfiftlinjen reurgently required holistic interventions. Cancer diagnosis is often synonymous to a death with and short-term effects of the contact. Methods: In March-April 2017, users of the cancer information service Care, Victoria Hospital in Wynberg, South Africa, a preliminary study will be made were encouraged to answer a questionnaire about their experiences with this to identify relevant challenging issues and data among cancer patients at the service. Two hundred and twenty six users (49%) agreed to spective study will be performed of diagnosed cancer patients referred to the Pain receiveashortfollow-upquestionnairethreemonthsaftertheirinitialcontactwith and Palliative Medicine Department of the Federal Medical Centre Abeokuta, the telephone cancer information service. Their diagnosis, treatment options, treatment participated in this follow-up survey. For to changes in their perception of their situation (77%) and made them better at surviving patients attending the pain and supportive palliative oncology clinic, coping with their situation (79%). As an example, some participants described their knowledge of the disease, treatment challenges, prognostication and family that the conversation made them more calm and able to accept their situation, support willbeidentified anddocumented. Results: Theobservational gaps inthe which again led them to feel less stressed and anxious. In addition, many users retrievedinformationanddataaboutthetreatmentoutcomesandinterdisciplinary stated that they had become more able to communicate with others about their team supportandchallengeswill form thebasisorrather theprestudyplatform for disease (66%) and that the contact had let to changes in their behavior (63%). The identified knowledge and skills gap would their contact with the cancer information service and some described that they be used to design the final study in South Africa in August 2018. Others expected that the two studies will reflect communication issues and the approach had become more aware of their rights and of looking out for themselves or others. The Most participants (77%) stated that they had not felt a need to contact the cancer acquired lessons or experience during the second phase studies in the South information service again.

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Recognize signs and symptoms of drug reactions in the skin, including urticaria, fixed drug eruptions, and photodermatitis c. Differentiate between drug reactions in the skin and common dermatoses and exanthems 8. Recognize life-threatening complications of staphylococcal scalded skin syndrome d. Distinguish among various dermatoses associated with toxin-producing staphylococci, including staphylococcal scalded skin syndrome, bullous impetigo 9. Differentiate the etiology by age and understand pathophysiology of bites and infestations b. Differentiate by age, race, and climate the etiology of superficial fungal infections of the skin b. Recognize and interpret relevant laboratory studies for superficial fungal infections of the skin d. Recognize signs and symptoms associated with congenital herpes simplex virus infection c. Recognize and interpret relevant laboratory and imaging studies for herpes simplex virus d. Recognize life-threatening complications of herpes simplex virus, acquired and congenital. Differentiate the etiology by age and understand the pathophysiology of hypoglycemia b. Understand the pathophysiology and treatment of the metabolic complications of chronic hypoglycemic disorders. Recognize and interpret relevant laboratory and imaging studies for adrenal hyperplasia d. Recognize and interpret relevant laboratory and imaging studies for diabetes insipidus d. Know the etiology and understand the pathophysiology of hypoparathyroidism and hyperparathyroidism 2. Plan the management of complications of hypoparathyroidism and hyperparathyroidism b. Know the etiology and understand the pathophysiology of hyperthyroidism and thyrotoxicosis b. Recognize and interpret relevant laboratory and imaging studies for hyperthyroidism 11. Recognize and interpret relevant laboratory and imaging studies for hypothyroidism d.

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Bleeding from the nasopharynx, mouth, trachea, rectum, or bladder commonly occurs with minor trauma associated with patient care. After ruling out retained products of conception, the bleeding may be controlled by oxytocin, or creating a balloon tamponade within the uterus. The coagulopathy is corrected as much as possible, and then operation is indicated if uncontrolled bleeding persists. The same is true for spontaneous bleeding into other solid organs (liver, kidney, retroperitoneal tissue) or bleeding into the thorax or peritoneal space. When an operation is necessary, coagulation should be optimized (anticoagulation minimized) as described above. The trachea is exposed through a small incision, all with extensive electrocautery. Maintain blood flow and anticoagulation, stop the sweep gas, and cap off the oxygenator. If lung function is adequate at acceptable ventilator settings for an hour or more the patient is ready for decannulation. Decannulation the cannulas can be removed whenever the patient is ready, but ideally after the heparin has been turned off for 30 to 60 minutes. If the femoral artery has been cannulated by cutdown, vascular repair will be required. Venous and arterial cannulae placed by percutaneous access can be removed directly and bleeding controlled by topical pressure. Bronchoscopy Bronchoscopy and airway lavage are facilitated by extracorporeal support and should be used as indicated. As in any bronchopleural fistula, the first objective is to evacuate the pleural space so that the lung contacts the chest wall, leading to adhesions with closure of the visceral pleura. When the air leak has sealed, airway pressure is gradually added until conventional rest settings are reached. Bronchopleural fistula with a massive air leak directly from a bronchus or the trachea (after lung resection or trauma for example) should be managed initially as outlined above, but direct endoscopic or thoracotomy closure is often required. In choosing the cannulation approach in such patients it is important not to undersize the cannula so that the maximum flow is less than the required flow to facilitate oxygenation. Almost all such patients are managed with placement of an inferior vena caval filter. As long as renal perfusion is adequate pharmacologic diuresis can be instituted and maintained even in septic patients with active capillary leak. If respiratory function is tenuous the vascular access catheters can be left in place as described in V. Lung biopsy is best done by thoracotomy (or thoracoscopy) rather than transbronchially because of the risk of major hemorrhage into the airway with transbronchial biopsy.

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