Specific Treatment

Treatment with potassium and magnesium may be indicated. Potassium is recommended for patients with digitalis-induced ectopic beat or tachycardia, provided the patient is not hyperkalemic, uremic, or oliguric. It is the preferred drug if the patient is hypokalemic. 

The following interventions are contraindicated Quinidine should not be used because it displaces digoxin from binding sites, and bretylium should not be used because it releases norepinephrine. Carotid sinus stimulation should be discouraged because it may precipitate ventricular fibrillation. 

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Returning to multilayer adsorption, the potential model appears to be fundamentally correct. It accounts for the empirical fact that systems at the same value of / rin P/F ) are in essentially corresponding states, and that the multilayer approaches bulk liquid in properties as P approaches F. However, the specific treatments must be regarded as still somewhat primitive. The various proposed functions for U r) can only be rather approximate. Even the general-appearing Eq. XVn-79 cannot be correct, since it does not allow for structural perturbations that make the film different from bulk liquid. Such perturbations should in general be present and must be present in the case of liquids that do not spread on the adsorbent (Section X-7). The last term of Eq. XVII-80, while reasonable, represents at best a semiempirical attempt to take structural perturbation into account. 

Although the first impulse for emission reduction is often to add a control device, this may not be the environmentally best or least cosdy approach. Process examination may reveal changes or alternatives that can eliminate or reduce pollutants, decrease the gas quantity to be treated, or render pollutants mote amenable to collection. Following are principles to consider for controlling pollutants without the addition of specific treatment devices, ie, the fundamental means of reducing or eliminating pollutant emissions to the atmosphere (30) ... 

The selection of a particular metal salt is based on such factors as local availabiUty, convenience, economics, and effectiveness for the specific treatment problem. 

Tissue Plasminogen Aetivator (tPA). While streptokinase and urokinase can effectively induce clot dissolution in the majority of patients if given early, they lack clot specificity. Treatment with these enzymes results in a systemic lytic state attributable to their degradative action on circulating fibrinogen. Tissue plasminogen activator (tPA) was developed to achieve rapid and specific thrombolysis. 

Corrosion by the fuel usually occurs in the hot section of the engine, either in the combustor or the turbine blading. Corrosion is related to the amounts of certain heavy metals in the fuel. Fuel corrosivity can be greatly reduced by specific treatments discussed later in this chapter. 

Before the selection of a specific treatment technology can be made, an understanding of the site-specific factors which drive the selection of that technology is required because these factors can influence the evaluation of the advantages and limitations of competing technologies. The information required to resolve these site-specific issues falls into four categories waste composition and matrices, waste quantity, treatment objectives, and the reactions involved in the treatment of the contaminated material. 

Chemical treatment is a class of processes in which specific chemicals are added to wastes or to contaminated media in order to achieve detoxification. Depending on the nature of the contaminants, the chemical processes required will include pH adjustment, lysis, oxidation, reduction or a combination of these. Thus, chemical treatment is used to effect a chemical transformation of the waste to an innocuous or less toxic form. In addition, chemical treatment is often used to prepare for or facilitate the treatment of wastes by other technologies. Figure 12 identifies specific treatment processes which perform these functions. 

Delirium, e.g. post-narcotic delirium, somnolence or coma, is a common complication involving dementia, with fluctuating attention and consciousness and considerable morbidity. It is not always reversible and there is no specific treatment. Some of the accompanying central cholinergic syndromes can be reversed by ChEIs. 

As was previously mentioned, a hangover-like syndrome is common the next day after use of MDMA. MDMA withdrawal, which is thought to be caused by serotonin depletion, can last for weeks and includes symptoms of depression, anxiety, restlessness, and insomnia (Allen et al. 1993 McGuite et al. 1994). No specific treatments are currently indicated fot this withdtawal syndrome, although the antidepressant bupropion may be helpful (Solhkhah... 

No specific treatments for ketamine intoxication are currently indicated (Solh-khah and Wilens 1998). General supportive care, including providing the patient with a quiet, low-stimulus environment, can be helpful (Koestets et al. 

The ability to treat brevetoxin intoxication is dependent upon diagnosis and quantifying exposure. Currently, neither an effective, specific treatment nor a reliable assay for exposure to the brevetoxins exists. We prepared a specific antiserum against the brevetoxins and evaluated its use in an assay for exposure to the brevetoxins and in the treatment and prophylaxis of intoxication. 

The reactivity of vanadyl pyrophosphate (VO)2P207, catalyst for n-butane oxidation to maleic anhydride, was investigated under steady and unsteady conditions, in order to obtain iirformation on the status of the active surface in reaction conditions. Specific treatments of hydrolysis and oxidation were applied in order to modify the characteristics of the surface layer of the catalyst, and then the unsteady catalytic performance was followed along with the reaction time, until the steady original behavior was restored. It was found that the transformations occurring on the vanadyl pyrophosphate surface depend on the catalyst characteristics (i.e., on the PfV atomic ratio) and on the reaction conditions. 

There are currently no systematic data to guide a decision on inpatient vs. outpatient treatment. However, the cheap and easy availability of PCP reported by outpatients in their living environments, and the frequent continued use of PCP by outpatients suggest that a brief period of inpatient treatment might be useful in initiating drug abstinence. There is clearly a strong need for research on specific treatment modalities for PCP abuse. 

Several pharmacologic classes are available for the treatment and maintenance of IBD. Because there may be differences in the underlying disease process, distribution, and severity between CD and UC, response rates to drugs in the same pharmacologic class may differ between these two diseases. Therefore, initial selection of an appropriate agent for patients with active IBD should be designed to deliver maximum efficacy while minimizing toxicity. Response rates to individual classes of medications for both UC and CD will be discussed within the specific treatment section for each disease. 

The goals of therapy in patients with chronic respiratory acidosis are to maintain oxygenation and to improve alveolar ventilation if possible. Because of the presence of renal compensation it is usually not necessary to treat the pH, even in patients with severe hypercapnia. Although the specific treatment varies with the underlying disease, excessive oxygen and sedatives should be avoided, as they can worsen C02 retention. 

Patient-specific treatment goals should be identified. This frequently requires reaching a compromise between efficacy and tolerability of drug therapy. These goals are not static and may change with time. 

Recommend specific treatment for a patient experiencing anaphylaxis. 

Recommend a specific treatment regimen for anemia considering the underlying cause of anemia and patient-specific variables. 

Pediatric Patients There are unique considerations in the treatment of HIV-infected children. Specific treatment guidelines exist,23 but a thorough review is outside the scope of this chapter. Most children acquire HIV infection through... 

FIGURE 87-1. Clinical pathway for non-small cell lung cancer. See text for specific treatment recommendations. 

Recent advances in the treatment of cancer of the colon and rectum now offer the potential to improve patient survival, but for many patients, improved disease- and progression-free survival represent equally important therapeutic outcomes. In the absence of the ability of a specific treatment to demonstrate improved survival, important outcome measures should include the effects of the treatment on patient symptoms, daily activities, performance status, and other quality-of-life indicators. Individualized patient care to balance the risks associated with treatment with the benefits of a specific treatment regimen is necessary to optimize patient outcomes. 

Does the patient have a known cancer at presentation Assess the patient s symptoms at presentation to determine the need for emergent treatment versus disease-specific treatment following tissue diagnosis. 

Other printed materials can be used alone or in conjunction with oral education. Newsletters are published regularly and can be used to convey information addressing specific treatment issues. For example, a newsletter article might address current treatment approaches for pediatric asthma. Because newsletters also contain information that may be of general interest to practitioners and patients, they can have broad exposure. Brochures and booklets can be used to communicate a focused message in an efficient manner. These materials typically are given to people who are expected to have an interest in the topic within. 

This section describes the treatment technologies currently in use to recover or remove wastewater pollutants normally found at coil coating facilities. The treatment processes can be divided into six categories recovery techniques, oil removal, dissolved inorganics removal, cyanide destruction, trace organics removal, and solids removal.5-14 Adoption of specific treatment processes will depend on the following ... 

Pollutant parameters and their concentrations found in the oily waste subcategory streams are shown in Table 9.9. The oily waste subcategory for the metal finishing industry is characterized by both concentrated and dilute oily waste streams that consist of a mixture of free oils, emulsified oils, greases, and other assorted organics. Applicable treatment of oily waste streams is dependent on the concentration levels of the wastes, but oily wastes normally receive specific treatment for oil removal prior to solids removal waste treatment. 

When directing U.S. EPA to establish the LDR program, Congress called for regulations that specified concentrations of hazardous constituents or methods of treatment that would substantially decrease the toxicity of hazardous waste or decrease the likelihood that contaminants in such wastes would leach. U.S. EPA responded to these requirements by establishing waste-specific treatment standards that dictate to what extent waste must be treated. All hazardous wastes, except under certain circumstances, must meet a specific treatment standard before they can be disposed of. 

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