Waste patients

Physicians who have drug problems sometimes use a process called harvesting in order to obtain the medications for their own personal use. Harvesting occurs when a physician (seemingly innocendy) asks a patient to return any unused pain or other type of mood-altering medications to the physician. The physician will tell a patient that this is for his or her protection to take away the threat of accidental use of the medicines by someone in the household. The physician will offer to dispose of the medicine properly so that it is out of the household. However, the medicines will likely be used by the physician instead of being wasted. Patients should understand that since they have paid for (or their insurance has paid for) those medicines, it is unethical for a physician to ask for them in the first place, and such a request should warn of a problem. 

In classic salt-wasting patients (such as patient... 

Cachexia refers to a physical wasting due to loss of muscle and fat. Cachexia is often found in end-stage cancer patients but is also caused by autoimmune disorders or by infectious diseases such as AIDS and tuberculosis. 

A diuretic is a drug that increases die secretion of urine (ie, water, electrolytes, and waste products) by die kidneys. Many conditions or diseases, such as heart failure, endocrine disturbances, and kidney and liver diseases can cause retention of excess fluid (edema). When die patient shows signs of excess fluid retention, die primary healdi care provider may order a diuretic. There are various types of diuretic drugs, and the primary healdi care provider selects the one that best suits die patient s needs and effectively reduces the amount of excess fluid in body tissues. 

In vivo, patients treated with AZT develop a mitochondrial myopathy with mitochondrial DNA depletion, deficiency of cytochrome c oxidase (complex IV), intracellular fat accumulation, high lactate production and marked phosphocreatine depletion (Lewis and Dalakas 1995 Dalakas 2001). Clinically, the patient presents with fatigue, myalgia, muscle weakness, wasting and elevated serum creatine kinase. Muscle biopsy shows ragged red fibers , the characteristic histopathologic changes of mitochondrial myopathy, cansed by subsarcolemmal accumulation of mitochondria (Lewis and Dalakas 1995). 

Haemodialysis is the process of circulating the patient s blood through a machine via tubing composed of a semi-permeable material such that waste products permeate into the dialysing fluid and the blood then returns to the patient Haemodialysis solutions need not be sterile but must be flee flxm heavy bacterial contamination. 

SIADH (should distinguish between cerebral salt-wasting syndrome in which patients are volume-contracted)... 

Acute renal failure (ARF) is a potentially life-threatening clinical syndrome that occurs primarily in hospitalized patients and frequently complicates the course of the critically ill. It is characterized by a rapid decrease in glomerular filtration rate (GFR) and the resultant accumulation of nitrogenous waste products (e.g., creatinine and urea nitrogen), with or without a decrease in urine output. A recent consensus statement... 

Approximately 80% of patients with a GFR less than 20 to 30 mL/minute develop metabolic acidosis.38 Metabolic acidosis can increase protein catabolism and decrease albumin synthesis, which promote muscle wasting, and alter bone metabolism. Other consequences associated with metabolic acidosis in CKD include worsening cardiac disease, impaired glucose tolerance, altered growth hormone and thyroid function, and inflammation.38... 

Cachexia is a severe wasting syndrome that is seen in many cancer patients. Although it is more common in advanced disease, it... 

Zhao GF, Wang ZJ, Zhou HD, Zhao Q (2009) Burdens of PBBs, PBDEs, and PCBs in tissues of the cancer patients in the e-waste disassembly sites in Zhejiang, China. Sci Total Environ 407(17) 4831—4837. doi 10.1016/j.scitotenv.2009.05.031... 

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