This study has shown that approximately 1 in 14 patients admitted to an acute unit had prolonged QT interval . Ventricular arrhythmias are most often associated with QTc values of 500 ms or more (17; 18) and in this group (severe long QTc) the incidence was 1.7%. This is the first study reporting incidence in acute medical admissions. By contrast, prevalence data have shown that prolonged QTc is frequently encountered in an acute stroke unit (5) or CCU (6). These data likely reflect the case mix of the various cohorts, as transmural myocardial ischaemia and intraventricular haemorrhage are factors associated with long-QT but are usually seen within a high-dependency environment. However, long QT (particularly drug-induced long QT) has …show more content…
Use of fluoroquinolones, which have been a cause for concern to their risk for TdP (23), are not promoted as first line (22). Safety issues have also been raised for use of QTc-prolonging antipsychotic medications (2; 24). Such drugs are frequently used in hospital inpatients as delirium can affect a fifth of acute medical admissions (25). NICE guidelines allow for the antipsychotics haloperidol and olanzapine to be used for up to one-week as a therapy for delirium (26). Whether QTc contributes to increased hospital mortality in those with delirium is unknown (27). Prolonged QT interval is known to predict mortality in a variety of other conditions that are frequently encountered in the AMU such as: coronary artery disease (28), heart failure (29) and diabetes mellitus (30; 31). Our data have shown in-hospital mortality of 3.8% in those with normal QTc and 6.0% of those with long QTc. The study was not powered for this outcome but such a difference would be clinically relevant; based upon these data, approximately 1500 patients in each group would need to be studied to detect a difference with 80% power and alpha of 5%. A more prolonged length of stay with long QTc in unadjusted analysis was unexpected but was no longer significant when correcting for patient age and presence of diabetes or electrolyte disturbance.
The strengths of our study include the robust inter-observer reproducibility
Iron Deficiency Anemia affects millions of individuals across the world. This disease strikes many more women than men and has harmful effects on all who suffer from this deficiency that causes oxygen-carrying capacity to decrease. The causes can vary amongst different groups, but the aggravating symptoms remain constant. Much of the research on Iron Deficiency Anemia concentrates on not only the treatment of this disease, but also the prevention of it. To attain a better understanding of how to treat this problem, one must clearly know what Iron Deficiency Anemia means, what causes this disease, the effects of it, and finally how to cure it.
Diabetes is a lifelong disease that can affect both children and adults. This disease is the sixth leading cause of death in the United States. It claims about 178,000 lives each year. Type one diabetes, also known as insulin dependent diabetes mellitus, usually occurs in people less than thirty years of age, but it also may appear at any age. Diabetes is a very serious disease with many life threatening consequences, but if it is taken care of properly, diabetics can live a normal life.
Sickle cell anemia is an inherited disease in which the body is unable to produce normal hemoglobin, an iron-containing protein. Sickle cell anemia is a disease in which the body is unable to produce normal hemoglobin, an iron-containing protein. Abnormal hemoglobin can change cells that can become stuck in narrow blood vessels, blocking oxygen from reaching organs and tissues. Tissue that does not get a normal blood flow eventually becomes damaged. This is what causes the problems of sickle cell disease. As to this day there is really no cure for Sickle Cell Disease. I choose to topic because there are a number of persons in my family who have Sickle Cell Disease (SCD). From personal experience I knew that the disease could take a toll on
Nearly 16 million people in the United States have diabetes, the disease classified as a problem with insulin. The problem could be that your body does not make insulin, does not make enough, or it simply does not know how to use it properly. Diabetes is also known as "diabetes mellitus".
The sickle cell disease is an inherited blood disorder that affects red blood cells. People with sickle cell have red blood cells that have mostly hemoglobin's, Sometimes these red blood cells become sickle-shaped or crescent shaped and have trouble going through small blood vessels. When sickle-shaped cells block small blood vessels, less blood can get to that part of the body. Tissue that does not get a normal blood flow eventually becomes damaged. This is what causes the problems of sickle cell disease.
Dyspnea was the commonest symptoms seen in all patients followed by cough and fever. Half of the patients had crackles on examination, and half were hypoxic at rest. Chest x ray showed some abnormality in 80% of cases. CT of chest is more sensitive and showed ground glass densities in 65% of cases followed by nodules in 53%. Pulmonary functions tests revealed obstruction in one third of cases. Most cases were diagnosed based on sputum examination. Transbronchial biopsy was able to establish diagnosis 75% of cases. Biopsy showed granuloma in 92% of cases. One third of patients received Antimycobacterial drugs alone and 16% of patients received steroids alone. The specific dose and duration of steroids is not reported accurately in literature and hence the optimal regime of steroid therapy is not known. If antimycobacteral treatment is considered, then American Thoracic Society(ATS) recommends treatment with three drug Azithromycin/Clarithromycin, Ethambutol and Rifampin for 12 to 18 months. While 23% of patients received both treatment, 20% of patients were not given any specific treatment except abstinence from source. Despite of the type of treatment regime used, clinical response was seen in all patients and 60% patients showed complete resolution. No death due to HTL has been reported till date.
Several factors can influence the duration of delirium which are the age of the client, the rate of symptom resolution. According to Aguirre’s article (2010), a 72 years old female admitted in the hospital for after a hip fracture experienced signs and symptoms of delirium during her stay. He also mentioned that the client was pleasant while progressing through therapy and her pain was managed with a 1 or 2 Percocet tablets every 6 hours as needed. In addition, the client experienced her first episode of urinary incontinence due to narcotics, anesthesia and previous use of Foley catheter. However, Mrs. B suddenly became confused, paranoid and accused the staff of hurting her while trying to help her get out of bed. The staff checked the client for delirium due to patient’s high vital signs, change in behavior and function and risk for delirium which are anesthesia, narcotics, and a recent Foley catheter (Aguirre, 2010). The patient’s urinalysis result is positive for infection and was started on a course of antibiotics to treat her infection (Aguirre, 2010). The patient’s cognitive symptoms cleared after 24 hours and were able to resume physical therapy without further incident (Aguirre, 2010). In other cases delirium may be cause by dehydration or electrolyte imbalance. Once the underlying cause of delirium is treated and resolved, symptoms starts to diminish over a 3 to 7
Sickle Cell Anemia is a hereditary disease that changes the smallest and most important components of the body. A gene causes the bone marrow in the body to make sickled shapes, when this happens; it causes the red blood cell to die faster. This is what causes Hemolytic Anemia. Older children and adults with sickle cell disease may experience a few complications, or have a pattern of ongoing problems that shorten their lives. The most common and serious complications of sickle cell disease are anemia, pain, fatigue, and organ failure. Today there are many alternatives and opportunities that a sickle cell patient may consider. One outlined in this paper is the Hydroxyurea method.
Rhabdomyolysis or myoglobinuria, is the breakdown of muscle tissue that leads to the release of muscle fiber contents into the blood. These substances are harmful to the kidney and often cause kidney damage. When muscle is damaged, a protein called myoglobin is released into the bloodstream. It is then filtered out of the body by the kidneys. Myoglobin breaks down into substances that can damage kidney cells( Medline, 2015). Serum Creatine Kinase (CK) is most useful in the measurement in the condition. CK levels greater than 1000 units/L are indicative of the condition, levels that exceed 5000 unit/L indicate acute renal failure. Rhabdomyolyis, is most frequently seen in traumas that involve crush injuries, immobilization for long periods, and drug and alcohol overdoses. Although the condition is rare, serious complications including hyperkalemia, metabolic acidosis, acute renal failure and DIC (McCance..).
Phenylketonuria, otherwise known as PKU, is a rare genetic disease that is caused by a person’s body being unable to metabolize the amino acid phenylalanine. The disease can cause mental retardation because the build up of phenylalanine in the body. When phenylalanine is not broken down and turned in a different amino acid, tyrosine, it can create other enzyme routes that build up in the blood stream and body tissue. This can be extremely harmful to the body and its development. This disease is caused by missing the enzyme phenylalanine hydroxylase, this enzyme is the one that normally breaks down phenylalanine. It is rare for this enzyme to be completely absence, but this form leads to the most severe mental
The immune system consists of a defense system that guards the body against invasion from infections and other diseases. Normally, a healthy person's immune system has the capability to differentiate between its own cells and cells that represent threats to the health of the body. (Craft and Kanter, 2002). Autoimmune disease refers to a broad range of over 80 acute, long-lasting diseases that affect nearly every organ in the body. (Wrong Diagnosis.com, 2000).
A perception of mountain people, who are often denigrated and ostracized for their dissimilarities compared to the more modern civilizations, is that they lack cultural progressiveness and in most cases are running backwards from the growing economic and social municipalities of the world. For one thing, mountain people live in high altitudes that lack the necessary infrastructure for development and most importantly, they live away from capitals and major cities. Therefore, they are isolated from their capital’s political and economic affairs. Due to this isolation, most mountain people presume that their nation’s government is a part of a separate entity that has no relation to them. In other words, they believe that the government is selfish and doesn’t care about their needs for survival, therefore they must flourish on their own. Therefore, the mountain people adhere to their own cultural and traditional ways of life and in most cases are
There is a pair of kidneys in the human body. They are situated towards the back of the body under the ribs, just at the level of the waist where one on either side of the body. Each kidney is composed of about one million units which are called nephrons and each nephron consists of two parts: a filter which is called the glomerulus and a tubule leading out from the nephron (Cameron 1999). According to Marshall and Bangert (2008) the kidneys have three major functions. Firstly, the kidneys are excretion of waste from plasma in the blood. The second function is that, they maintain of extracellular fluid volume and composition. Lastly, the kidneys have a role in hormone synthesis.
Diabetes is a chronic condition in which the body produces too little insulin (Type One Diabetes) or can’t use available insulin efficiently ( Type Two Diabetes). Insulin is a hormone vital to helping the body use digested food for growth and energy.
The human body contains blood and fluid compounds and elements like chloride, phosphate, potassium, calcium, sodium, and magnesium known as electrolytes that occur naturally to control important physiologic functions. When the body levels of electrolytes are low (hypo) or high (hyper) it results in electrolyte disorder. Depending on the affected electrolyte(s), when body electrolytes are hyper (high) or hypo(low) it leads to electrolyte disorder, which in turn disrupts blood ionized salts balance ( Buttaro, et al., 2017). For instance, disruption of chloride leads to either hyperchloremia or hypochloremia, calcium (hypercalcemia or hypocalcemia ), Potassium (hyperkalemia or hypokalemia), Magnesium disruption