Edema evaluation

Responses are evaluated 30 min to 1 h after patch removal (to allow hydration and pressure effects to subside), and again 24 h after the patch is removed. Persistent reactions may be evaluated for 3 to 4 days. The Draize scales can be used to evaluate erythema and edema however, the integrated scales ranging from 4 to 16 points are preferred. Such integrated scales are able to score popular, vesicular or bullous responses in addition to erythema/edema evaluation. Up to 10 materials can be tested simultaneously on each subject. The position that the materials are placed on the skin (i.e., upper right back, lower left back, etc.) should be systematically varied within each study since skin reactivity varies by body region. 

The nurse examines areas of edema daily to evaluate the effectiveness of drug therapy and records the finding in the patient s chart. The nurse examines the patient s general appearance and condition daily or more often if the patient is acutely ill. 

Hypertonic sahne is actively excluded from an intact BBB and also acts to draw water into the intravascular space by the creation of a sodium gradient. Various concentrations have been evaluated, with continuous sodium chloride infusions ranging from 3% to 9%, and bolus infusions up to 23.4% administered over 20 minutes in a 30 mL solution. When a continuous infusion is used, the serum sodium is typically titrated to the 155-160 range. Sodium levels above this range raise the concern for seizures and other toxic side effects. Hypertonic saline may hold an advantage over mannitol, as it has been found in animal models to decrease edema in both... 

Corticosteroids have been evaluated in several types of cerebral injury, including cerebral infarction. Corticosteroids reduce vasogenic edema, such as that associated with neoplasms, but not cytotoxic edema, the type associated with ischemic stroke. A large meta-analysis found no benefit to the use of corticosteroids in ischemic stroke (or intracerebral hemorrhage), and their use is not recommended, except to treat concomitant conditions that mandate it (e.g., COPD flare). 

Evaluate effectiveness of diuretic therapy with regard to ascitic fluid accumulation and development of peripheral edema. Ask the patient directed questions about abdominal girth, fullness, tenderness, and pain. Weigh the patient at each visit, and ask the patient to keep a weight diary. Assess for peripheral edema at each visit. 

Not all diabetic foot ulcers are infected. However, infection is often difficult to detect when perfusion and the inflammatory response are limited in the diabetic patient. The common signs and symptoms (i.e., pain, erythema, and edema) of infection may be absent.32 Still, the diagnosis of diabetic foot infection depends mostly on clinical evaluation. 

The efficacy of diuretic treatment is evaluated by disappearance of the signs and symptoms of excess fluid retention. Physical examination should focus on body weight, extent of jugular venous distension, presence of hepatojugular reflux, and presence and severity of pulmonary congestion (rales, dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea) and peripheral edema. 

Observations are made of the test and control skin sites 1 h after removal of the patches (25 h post-initiation of application). Erythema and edema are evaluated and scored on the basis of designated values presented earlier in Table 11.1. 

D. Analysis of data The data from the irradiated and nonirradiated sites are evaluated separately. The scores from erythema and eschar formation, and edema at 24, 48, and 72 hr, are added for each animal (six values). The six values are then divided by 3, yielding six individual scores. The mean of the six individual animal irritation scores represents the mean primary irritation score (maximum score = 8, as in the primary dermal irritation study). This method was developed after a human model had been developed. 

In any case, injection site responses (erythemia, edema, pain, and tenderness) and systemic responses are both evaluated in subjects (Mathieu, 1997). USFDA also has specific guidance on the tracking and reporting of adverse clinical responses to vaccines. Any adverse events or product problems with vaccines should not be sent to MedWatch but to the Vaccine Adverse Event Reporting System (VAERA), operated jointly by FDA and the national Centers for Disease Control and Prevention. For a copy of the VAERS form, call 1-800-822-7967, or download the form (in PDF format) from www.fda.gov/cber/vaers/vaersl.pdf on FDA s Website. 

Toxicoses from pine needles have been reported in field cases, but are rare and have only occurred in pregnant cattle. No toxicity other than abortion in cattle has been demonstrated from ICA or ICA derivatives. However, the abietane-type resin acids in ponderosa pine needles (concentrated in new growth pine tips) have been shown to be toxic, but not abortifacient at high doses, when administered orally to cattle, goats, and hamsters. Pathological evaluations of intoxicated animals includes nephrosis, edema of the CNS, myonecrosis, and gastroenteritis (Stegelmeier et al., 1996). While abietane-type resin acids may contribute to the occasional toxicoses reported in the field, they do not contribute to the abortions. Most cow losses in the field are associated with difficult parturition or post abortion toxemia due to retained fetal membranes. 

Mortality experience among men occupationally exposed to phosgene in the years 1943-1945 was evaluated 30 years after exposure. No excess overall mortality, or mortality from diseases of the respiratory tract, was found in a group of chemical workers chronically exposed to levels with daily excursions above Ippm. Another group of this cohort, 106 workers acutely exposed at some time to a concentration probably greater than 50 ppm, included one death from pulmonary edema, which occurred within 24 hours of exposure, and three deaths vs. 1.37 expected due to... 

In an effort to overcome the lack of solubility, poor penetration across the blood-brain barrier and decreased delivery of conventional systemic agents by a compromised intratumoral blood supply, several studies have evaluated various combinations of BCNU alone or with other agents delivered intraarterally. Unfortunately, response rates and median survival times observed in patients treated with intraarterial chemotherapy have not been significantly different than those seen in patients treated with standard intravenous nitrosurea-containing regimens, while increased rates of toxicity such as leukoen-cephalopathy, retinal injury, edema, myelosuppression, sepsis, and thrombotic complications have been noted (40-46). 

Exposed individuals with evidence of central nervous system depression or seizures should be evaluated for the presence of some other underlying disorder. Diazepam or phenobarbital may be administered to alleviate seizures. Supplemental oxygen can also be administered. If pulmonary edema occurs, conventional therapy should be considered. Additional information regarding the treatment of individuals exposed to cresols may be obtained from Bronstein and Currance (1988), Haddad and Winchester (1990), and Stutz and Janusz (1988). 

IV then based on response 250 g/48 h max Peds. 0.5—1 g/kg/dose inf at 0.05-0.1 g/min Caution [C, ] Sev e anemia cardiac, renal, or h atic insuff d/t protein load h5 pCTVolemia Contra CHF Disp Soln SE Chills, fevCT, CHF, tach, -1- BP, hypervolemia Interactions At5 pical Rxns W/ ACEI w/hold 24 h prior to plasma administration EMS May cause pulm edema, monitor resp status/lung sounds OD May cause circulatory ov load (T venous pressure) or pulm edema slow flow to KVO and evaluate... 

Evaluate for a rash accompanied by blistering, conjunctivitis, fever, general malaise, muscle or joint aches, oral lesions, and edema, which may indicate a severe, life-threatening skin or hypersensitivity reaction... 

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