Medical interventions

Elaborate precautions must be taken to prevent the entrance of Pu iato the worker s body by ingestion, inhalation, or entry through the skin, because all common Pu isotopes except for Pu ate a-emitters. Pu is a P-emitter, but it decays to Am, which emits both (X- and y-rays. Acute intake of Pu, from ingestion or a wound, thus mandates prompt and aggressive medical intervention to remove as much Pu as possible before it deposits in the body. Subcutaneous deposition of plutonium from a puncture wound has been effectively controlled by prompt surgical excision followed by prolonged intravenous chelation therapy with diethylenetriaminepentaacetate (Ca " —DTPA) (171). 

A common cause of PTH-dependent hypercalcemia results from benign, or occasionally malignant, enlargement of one or more parathyroid glands, a condition known as primary hyperparathyroidism (PHPT). Although many patients with PHPT present in an asymptomatic state that does not require medical intervention, some are afflicted with excess bone loss, kidney stones, or other complications. If patients are... 

One of the earliest symptoms of hypertensive crisis is headache (usually occipital), followed by a stiff or sore neck, nausea, vomiting, sweating, fever, chest pain, dilated pupils, and bradycardia or tachycardia. If a hypertensive crisis occurs, immediate medical intervention is necessary to reduce the blood pressure Strokes (cerebrovascular accidents) and death have been reported. 

Determine if the patient requires medical intervention to prevent the development of or treatment for secondary hyperparathyroidism. 

Compared with many other types of infections, CNS infections are less common, with 4 to 6 cases of meningitis reported per 100,000 adults annually. 4 However, the severity of these infections demands prompt medical intervention and treatment. CNS infections can be caused by bacteria, fungi, mycobacteria, viruses, and spirochetes. 

Baseline is a common clinical concept. You might hear your physician say, Let s get a baseline cholesterol reading for you. The idea behind a baseline measurement is to determine the state of a patient before some expected event so that a subsequent comparison to that state can be made. For instance, you and your physician may want to get a baseline cholesterol reading early in life, as cholesterol typically increases with age. In clinical trials, you want to obtain a baseline measurement before a medical intervention to see what kind of effect the intervention had. Usually, the baseline value is the last reading prior to medical intervention. The following figure illustrates this concept for cholesterol measurements ... 

Human toxicity data are limited to secondary citations. Because these citations provided no experimental details, they cannot be considered reliable. Deaths have occurred from aniline ingestion and skin absorption, but doses were unknown. Reviews of the older literature indicate that a concentration of 5 ppm was considered safe for daily exposures, concentrations of 7 to 53 ppm produced slight symptoms after several hours, a concentration of 40 to 53 ppm was tolerated for 6 h without distinct symptoms, a concentration of 130 ppm may be tolerated for 0.5 to 1 h without immediate or late sequalae, and 100 to 160 ppm was the maximum concentration that could be inhaled for 1 h without serious disturbance. In studies of accidents with unknown exposure concentrations, methemoglobin levels of up to 72% were measured. Recoveries occurred with a minimum of medical intervention following cessation of exposure. 

Levinsky et al. (1970) reported on three men exposed to an unknown concentration of arsine for an estimated, 2, 3, and 15 min. Signs and symptoms of exposure (malaise, headache, abdominal pain, chills, nausea, vomiting, oliguria/ anuria, hematuria, bronze skin color) developed within 1-2 h. All three individuals required extensive medical intervention to save their lives. Clinical findings were indicative of massive hemolysis and repeated blood exchange transfusions were necessary for the survival of these individuals. 

Pinto (1976) also reported similar characteristics regarding acute arsine poisoning. Although, an exposure concentration was unavailable, exposure to newly formed arsine for less than 1 h resulted in severe (likely fatal without medical intervention of exchange transfusion) signs and symptoms, including... 

Numerous cases of arsine poisoning have been reported (Elkins and Fahy 1967 DePalma 1969). However, these reports lack definitive exposure concentration data and usually lack exposure duration data as well. Some of the more recent and complete reports involving nonlethal consequences are described in the following section. These reports do not provide quantitative data suitable for AEGL derivations, but they do provide valuable insight into the nature and progression of arsine poisoning in humans. In most cases, the severity of the effects was usually sufficient to necessitate medical intervention to prevent lethality. Some of the more prominent reports and those with the best descriptive data have been summarized, but the overview is by no means exhaustive. 

A case report of acute arsine poisoning in which a 27-y-old man was exposed to arsine during chemical manufacturing was reported by Pinto (1976). The subject was exposed to arsine as a result of arsine production via a reaction between a galvanized bucket and an arsenic-containing sulfuric acid solution. The exposure (duration not specified) produced toxic effects characterized by abdominal cramping, thoracic discomfort, and hematuria. Over the next week, the patient s hematocrit declined from 42.5 to 27.1 and hemoglobin dropped from 14.1 to 9.5 g/dL even with medical intervention (blood transfusions and mannitol diuresis). Nine hours after exposure, blood arsenic was 159 g/dL and urinary arsenic was 1862 ug/L. 

My husband recognized that he couldn t leave me by myself and he recognized his limitations, so we decided to get some help. I went into a hospital a couple of times. I spent two weeks in a psychiatric unit of a hospital. I needed to separate from what was going on. I wouldn t be here today if I hadn t had some medical intervention. I m very grateful for that resource. And some good counseling has helped me to express my feelings. But I have battled depression off and on. 

I never would have survived my debilitating injury and illness without the gracious help of fine physicians. I look forward to one day passing on to others some of the wisdom, compassion and medical interventions that have been so helpful to me. Hopefully I can help others with chemical and electromagnetic sensitivities to overcome their fears and to strengthen their bodies so that their tolerance can be increased. 

Multiple Chemical Sensitivity A Survival Guide. Pamela Reed Gibson. Oakland, CA New Harbinger Publications, 1999. Features survival tools for coping with many aspects of MCS coping with the life impact of a chronic illness and with the unique aspects of MCS the need for social support, medical intervention and environmental controls self-help options identity and psychological issues applying for disability benefits and much more. 

Interventions for improved compliance interventions can have a much larger impact on the population s health than any specific medical intervention... 

The concept of biochemical individuality has become part of most contemporary clinical and experimental medical and nutritional research. People are now known to fit into personally unique biochemical profiles based upon their own genetic structure, nutrition and environment.5 There is no such thing as a truly "normal" individualmeaning average. We are all biochemically unique and need to be dealt with as such. The Recommended Dietary Allowances (RDAs) which were developed by the Food and Nutrition Board of the National Research Council to establish the nutritional needs of "practically all healthy people" were not based upon the more recent information concerning the range of biochemical individuality among individuals. The RDAs that describe "normal" nutritional needs have questionable relevancy to the concept of optimal nutrition based upon individual needs. The contributions of Dr. Williams have opened the door for personally tailored nutritional and medical interventions that take biochemical individuality into account. 

The cocaine addict most often presents during withdrawal after a binge of cocaine use. Cocaine withdrawal is not life threatening and does not require medical intervention in the same sense as alcohol or opiate withdrawal. It is, however, associated with a profound depression that can render the addict suicidal for 24-48 hours. The crashing cocaine addict should be assessed for suicide risk and, if indicated, the patient should be monitored in an emergency psychiatric setting or may require a brief 1-2 day inpatient psychiatric admission until the withdrawal resolves and the suicide risk is relieved. 

Although several markers for functional hepatic mass determination are currently used in clinical settings, most of them were originally used as drugs for various medical interventions. Nonetheless, these markers remain the mainstay of dynamic hepatic function monitoring, some of which are discussed below. 

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