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The task force consisted of physical therapists from across the country in various acute care settings. Each laboratory test captured in this 2017 version has a brief explanation of the test or laboratory panel, reference values, clinical presentation, and clinical implications. As the task force closes its current work on this project, it does so in the understanding that this living document needs continuous updating to ensure that the needs of clinicians will be appropriately accommodated. Abnormal values are defined as those results that are outside a specific range obtained from a cohort of healthy individuals. Acute care physical therapists work in an environment that is quickly evolving and therefore should be knowledgeable regarding critical laboratory values and safe mobility recommendations. Test names and specific value ranges are easily visualized with high-priority findings. Algorithm for Mobilizing Patients with Known Lower-Extremity Deep Vein Thrombosis 10. Likewise, it is important to understand the significance of trends in the values over time. It is, therefore, prudent for therapists to be aware of the presence of cardiac biomarkers and potential delays in the diagnosing of cardiac ischemia. Physical therapists should carefully anticipate the physiological changes that might have occurred whenever a laboratory value is out of range. To fully explore the potential effects of physical therapy intervention, collaboration with other members of the interprofessional medical team is often necessary. Under these circumstances, it is prudent for the physical therapist to allow the patient a period of time for his or her body to adapt to the changes in lab values. Gender, Race, and Culture Considerations Census 2010 indicated increased minority demographic shifts in the United States. In the United States, African Americans tend to have increased muscle mass and skeletal structures compared to their Caucasian counterparts. Gender Binary social construct involving characteristics distinguishing men from women. Transsexual Outdated term for person who feels they were assigned the incorrect sex. The key factor is not whether the medical record assigns a patient a particular sex or whether the patient has undergone sexual reassignment surgery, but whether patients are taking hormone therapy that will affect their physiology and lab chemistry.
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A 56-year-old man recovered from a (e) Enzymatic myocardial infarction after his myocardium (0) Fibrinoid was entirely "saved" by immediate (E) Liquefactive thrombolytic therapy. The type of necrosis shown is best described as (Reprinted with permission from Rubin R, Strayer 0, et ai. The illustration is from a liver biopsy ofa 34-year-old woman with a long history of alcoholism. A 60-year-old woman with breast cancer hepatocytes and widespread bony metastases is found to (8) Apoptosis with replacement of damaged have calcification of multiple organs. A 56-year-old man dies 24 hours after (A) Damage to organs results from the onset of substernal chest pain radiating abnormal deposition of lead. The patient has renal agenesis, absence ofthe kidney due to failure of organ development. The congenital lack of one kidney differs from atrophy, in which a decrease in the size of an organ results from a decrease in the mass of pre-existing cells. Unilateral renal agenesis is usually a harmless malformation, and the opposite kidney is often enlarged due to compensatory hypertrophy. Bilateral renal agenesis is incompatible with life and is of special interest since it can lead to the Potter progression (see Chapter 17). Pancreatic enzymatic fat necrosis represents autodigestion by proteolytic and lipolytic enzymes released from damaged parenchymal cells ofthe pancreas. Fatty acids liberated by the digestion offat form calcium soaps, a process referred to as saponification. Caseous necrosis occurs as part of granulomatous inflammation, typified by the lesions of tuberculosis. The decreased size is due to restriction of the blood supply, one of the causes of atrophy. Swelling of the endoplasmic reticulum from increased cell water, one of the earliest ultrastructural changes observed in injured cells, is reversible and would be expected. Liquefactive necrosis is characteristic of ischemic injury in the central nervous system and suppurative infections that cause abscess formation (see Chapter 2).
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Hemoglobin A1c is expressed as a percent that refects the percentage of hemoglobin molecules that have a glucose molecule attached. The frst sign of albumin in the urine is a signal that kidney function is being compromised. Early detection can lead to more aggressive treatment to prevent continuing damage to the kidney. These fatty deposits, called plaque, cause narrowing of blood vessels and impede blood fow to muscle and tissue. Sometimes a piece of plaque dislodges from one location and is carried to another location where it may block blood fow through a vessel. Cholesterol, a risk factor for cardiovascular disease, is an important molecule for health and life. The body has an elaborate metabolic system to ensure adequate amounts and delivery of cholesterol to all the cells of the body. Fasting is defned as no caloric intake for a minimum of eight hours prior to collection of the blood sample. It rises in infammatory diseases and injuries but is undetectable in healthy individuals. The resultant lack of oxygen causes cardiac cell damage or death, and the release of internal cellular contents into the circulation. These components can be measured in laboratory tests to confrm the occurrence of a myocardial infarction. Such damage may lead to decreased heart function, thickening of the walls of heart chambers and a generalized inability to continue to pump adequate amounts of blood. It leads to accumulation of fuids in lungs and tissues (edema), shortness of breath and fatigue. Hypothyroidism causes symptoms such as fatigue, weight gain, dry skin, hair loss and chills due to poor regulation of body temperature. Hyperthyroidism causes weight loss, increased heart rate, difculty sleeping and anxiety. Since T4 and T3 both circulate with the majority of the hormone bound to a transport protein (thyroid binding globulin), a laboratory test may measure the total amount of hormone (total T4 or total T3) or may measure only the unbound or free portion (free T4 and free T3). The free portion is the biologically active portion and is often preferred to the total since the total may be afected by non-thyroid conditions that afect binding protein concentrations.
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Rodriguez de la Serna A, Domingo-Pedrol P, BlanchTorra L, Perez-Perez A, Obrador-Mayol D. Sweet syndrome following therapeutic use of granulocyte colony stimulating factor. Fukutoku M, Shimizu S, Ogawa Y, Takeshita S, Masaki Y, Arai T, Hirose Y, Sugai S, Konda S, Takiguchi T. In clinical trials, the most common adverse events reported were gastrointestinal upsets, nasopharyngitis/pain and nasal congestion/sinusitis. Oraceashould not be used to treat microbial infections, and should be used only as indicated. This drug is contraindicated in people who have shown hypersensitivity to any of the tetracyclines, and like other tetracycline drugs, may cause fetal harm when administered to a pregnant woman. Oraceashould not be used during pregnancy, by nursing mothers or during tooth development (up to age of 8 years). Although photosensitivity was not observed in clinical trials, Oraceapatients should minimize or avoid exposure to natural or artificial sunlight. All contraindications, warnings and precautions associated with tetracyclines must be considered before prescribing Oracea. Candidate will be involved in the continued growth of a busy clinical practice encompassing medical, surgical and cosmetic dermatology. In all cases, clinical judgment consistent with the standards of good medical practice should be used when applying the Guidelines.
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Fungicide: agent that destroys fungi (including yeasts) and/or fungal spores pathogenic to humans or other animals in the inanimate environment. Efficacy is demonstrated against both Salmonella choleraesuis and Staphylococcus aureus. High-level disinfectant: agent capable of killing bacterial spores when used in sufficient concentration under suitable conditions. Hospital disinfectant: disinfectant registered for use in hospitals, clinics, dental offices, and any other medical-related facility. Efficacy is demonstrated against Salmonella choleraesuis, Staphylococcus aureus, and Pseudomonas aeruginosa. Huck towel: all-cotton surgical towel with a honey-comb weave; both warp and fill yarns are tightly twisted. Incubator: apparatus for maintaining a constant and suitable temperature for the growth and cultivation of microorganisms. Infectious microorganisms: microorganisms capable of producing disease in appropriate hosts. Inorganic and organic load: naturally occurring or artificially placed inorganic. Intermediate-level disinfectant: agent that destroys all vegetative bacteria, including tubercle bacilli, lipid and some nonlipid viruses, and fungi, but not bacterial spores. Limited disinfectant: disinfectant registered for use against a specific major group of organisms (gramnegative or gram-positive bacteria). Efficacy has been demonstrated in laboratory tests against either Salmonella choleraesuis or Staphylococcus aureus bacteria. Lipid virus: virus surrounded by an envelope of lipoprotein in addition to the usual core of nucleic acid surrounded by a coat of protein. Low-level disinfectant: agent that destroys all vegetative bacteria (except tubercle bacilli), lipid viruses, some nonlipid viruses, and some fungi, but not bacterial spores. Microbicide: any substance or mixture of substances that effectively kills microorganisms. As used in health care, generally refers to bacteria, fungi, viruses, and bacterial spores. Muslin: loosely woven (by convention, 140 threads per square inch), 100% cotton cloth. Mycobacteria: bacteria with a thick, waxy coat that makes them more resistant to chemical germicides than other types of vegetative bacteria. Nonlipid viruses: generally considered more resistant to inactivation than lipid viruses. One-step disinfection process: simultaneous cleaning and disinfection of a noncritical surface or item.
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