Chronic problems

The section illustrated in Figs. 15.24 and 15.25 was removed from the door frame that supports the side-loading door to the furnace (Fig. 15.26). Failures of this type had been a chronic problem in the door frame area. The section had been fabricated by welding together three steel plates of to % in. (1.3 to 1.9 cm) thickness. 

The impeller shown in Fig. 17.9 was removed from a cooling water return line associated with a large press. Failure of these impellers was a chronic problem, requiring impeller replacement every 3 or 4 months. 

Many of these chronic problems are the direct result of improper installation. The guidelines provided in this chapter are not all encompassing, but they provide the basic elements that will assure long-term, trouble-free operation of pumping systems. 

TBW depletion (often referred to as dehydration ) is typically a more gradual, chronic problem compared to ECF depletion. Because TBW depletion represents a loss of hypotonic fluid (proportionally more water is lost than sodium) from all body compartments, a primary disturbance of osmolality is usually seen. The signs and symptoms of TBW depletion include CNS disturbances (mental status changes, seizures, and coma), excessive thirst, dry mucous membranes, decreased skin turgor, elevated serum sodium, increased plasma osmolality, concentrated urine, and acute weight loss. Common causes of TBW depletion include insufficient oral intake, excessive insensible losses, diabetes insipidus, excessive osmotic diuresis, and impaired renal concentrating mechanisms. Long-term care residents are frequently admitted to the acute care hospital with TBW depletion secondary to lack of adequate oral intake, often with concurrent excessive insensible losses. 

Acute health problems are those that directly follow drug ingestion, whereas chronic problems develop after repeated use. Stimulants, such as amphetamine or cocaine, can... 

The course of Crohn s disease is characterized by periods of remission and exacerbation. Some patients may be free of symptoms for years, while others experience chronic problems in spite of medical therapy. 

Significant changes in arterial blood gases are not usually present until the FEV is less than 1 L. At this stage, hypoxemia and hypercapnia may become chronic problems. Hypoxemia usually occurs initially with exercise but develops at rest as the disease progresses. 

The vacuum in the CST main chamber was insufficient. This was partially alleviated by tightening down the gland seals on either end of the main chamber auger. However, insufficient vacuum levels in the main chamber were a chronic problem during all CST testing and would have to be addressed in any final design. 

Talk about milking a story. The newspapers got all excited when pop star Shania Twain revealed that the secret behind her soft, supple skin wasn t some complex, highly touted product filled with liposomes, collagen, or ceramides. The secret, she said, was udderly simple Bag Balm delivered the goods. Just as it had done for cow udders since 1908, when a small Vermont company decided to take the bull by the horns and tackle the chronic problem of chapped cow udders. 

What is not as well known is that Lilly also had a chronic problem with ketamine abuse. In his disturbing 1978 autobiography The Scientist, Lilly relates that in taking ketamine for his migraines, he felt transformed by the drug s hallucinogenic effects. In his words, ketamine gave him the ability to look across the border into other realities. ... 

In the United States, a patchwork of state legislative activity that is not necessarily based on science is a chronic problem. Legislation enacted on flame-retardants has focused on PBDEs. Legislation has been enacted by several U.S. states prohibiting the use of the former penta- and octa-BDE products and articles containing them. These states include California, Hawaii, Illinois, Maryland, Minnesota, New York, and Oregon. Use-specific restrictions on deca-BDE have been enacted in Maine and Washington State. 

Monitor electrolytes and renal function tests in symptomatic patients. Administer intravenous fluids to maintain urine output and to protect the kidneys from myoglobinuria. The prognosis is good if animals do not develop rhabdomyolysis or secondary infection. No chronic problems are expected from BZ itself (Holstege, 2006). 

Heavy users of drugs often liave erratic lifestyles that mtetfere with regular sleep, good nutrition, and healtliful habits of liygiene and exercise. In addition, the drugs they take may suppress appetite, rob the body of vitamins, and upset normal metabolism. All of these effects can lead to such chronic problems as malnutrition, anemia, and decreased resistance to infection For example, dietary deficiencies m the alcoholic greatly increase the liver s susceptibility to the toxicity of alcohol and contribute to the development of Cirrhosis ... 

The fact that the shamans include family members and relatives probably intensifies the impact of occasional interventions. Due to less frequent but higher dosages in shamanistic treatment, the awareness of the self is subject to greater fluctuation. In contrast, psycholytic therapists concentrate on the treatment of chronic neurotic diseases in the course of serial sessions. These chronic problems are usually based on structural distortions of the personality, so long-term treatment in psychotherapy promises success. 

The treatment of acute episodes of exertional rhabdomyolysis is aimed at alleviating pain and muscle contracture, correcting electrolyte and/or body fluid deficiencies and addressing renal dysfunction, if present. Horses with chronic problems typically benefit more from preventative management strategies, such as the combination of a diet low in carbohydrates (concentrates) with increased daily exercise (compared with stall confinement). Supplementation of horses with fats, in the form of corn oil or rice bran, has shown considerable promise. 

The reported proportion of casualties who fully recover from sulfur mustard respiratory injury varies from over 90% (Vedder, 1925) to only 20% (Balali-Mood, 1986). Much of this variation can be explained by differences among patients and by attribution of chronic bronchitic symptoms to previous mustard gas exposure in the presence of ongoing causes such as heavy smoking. Major chronic problems such as bronchiectasis and recurrent pneumonia appear confined to casualties who had severe pulmonary infections complicating the acute injury (Urbanetti, 1988). Ocular and skin injuries generally heal completely but with the need for corneal transplantation or for skin grafting to deal with uncommon complications. 

Chronic problems with the Brine Reduction Area (BRA) and the Pollution Abatement System (PAS) continue to plague TCX3DF. 

Protein energy malnutrition occurs with high frequency (30%-50%) in hospitalized patients as well as in populations in chronic care facilities as either an acute or a chronic problem. These individuals suffer from inadequate nutrition due to a disease or depression, and are susceptible to infections due to impaired immune function. Surgical patients with protein energy malnutrition exhibit delayed wound healing with increased length of... 

---