Pursuit of abnormal coagulation screening tests generates modest hidden preoperative costs. How to interpret and pursue an abnormal prothrombin time, activated partial thromboplastin time, and bleeding time in adults. Lupus anticoagulant-hypoprothrombinemia syndrome: report of 8 cases and review of the literature. Consensus recommendations for the diagnosis and treatment of acquired hemophilia A. Twelve years of experience of acquired hemophilia A: trials and tribulations in South Australia. The relevance of the bleeding severity in the treatment of acquired haemophilia - an update of a single-centre experience with 67 patients. Critical issues in hematology: anemia, thrombocytopenia, coagulopathy, and blood product transfusions in critically ill patients. Long-term outcome of otherwise healthy individuals with incidentally discovered borderline thrombocytopenia. Platelet function disorders and menorrhagia in adolescents: a review of laboratory diagnosis. Suspected collagen disorders in the bleeding disorder clinic: a case-control study. Dental surgery with minimal factor support in the inherited bleeding disorder population at the Alfred Hospital. Effectiveness in controlling haemorrhage after dental scaling in people with haemophilia by using tranexamic acid mouthwash. Rebalanced hemostasis in patients with liver disease: evidence and clinical consequences. Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant. Rare bleeding disorders: general aspects of clinical features, diagnosis, and management. Guidelines on the selection and use of therapeutic products to treat haemophilia and other hereditary bleeding disorders. Multisite management study of menorrhagia with abnormal laboratory haemostasis: a prospective crossover study of intranasal desmopressin and oral tranexamic acid. Cardiac surgery in patients with haemophilia B: a case report and review of the literature. The blood-saving effect of tranexamic acid in minimally invasive total knee replacement: is an additional pre-operative injection effective? Effectiveness and safety of tranexamic acid in reducing blood loss in total knee arthroplasty: a meta-analysis. Relationship between diagnosis and intervention in women with inherited bleeding disorders and menorrhagia. Oral vitamin K lowers the international normalized ratio more rapidly than subcutaneous vitamin K in the treatment of warfarin-associated coagulopathy. Comparison of oral vs intravenous phytonadione (vitamin K1) in patients with excessive anticoagulation: a prospective randomized controlled study. Time course of reversal of anticoagulant effect of warfarin by intravenous and subcutaneous phytonadione. Disruption of the kringle 1 domain of prothrombin leads to late onset mortality in zebrafish Steven J. Prothrombin (F2) contributes to both primary and secondary hemostasis through the activation of platelets and the conversion of soluble fibrinogen to insoluble fibrin, respectively. We have previously demonstrated the ability of zebrafish to tolerate loss of both pro- and anticoagulant factors that are embryonic lethal in mammals, making them an ideal model for the study of prothrombin deficiency. Homozygous mutant embryos develop normally into early adulthood, but demonstrate eventual complete mortality with the majority of fish succumbing to internal hemorrhage by 2 months of age. We show that despite the extended survival, the mutants are unable to form occlusive thrombi in both the venous and arterial systems as early as 3-5 days of life, and we were able to phenocopy this early hemostatic defect using direct oral anticoagulants.
Writing: As with spoken speech, writing is fluent but can be difficult to understand due to misspelling (paraphasic errors). Neuroanatomical correlates: Lesion of dominant temporoparietal area, particularly the supramarginal gyrus and underlying white matter such that the arcuate fasciculus is damaged. Patients can recover and evolve to an anomic aphasia or almost completely resolve. While speech output is generally rapid and effortless, speech rate is interrupted by occasional pauses for apparent word finding problems. Mild difficulty may be evident in complex multi-step directions and/or syntacically-dependent phrases. Some pauses in writing occur as with speech, suggesting word-finding difficulties. Because anomic aphasia can present with a variety of neurological conditions (see below), may be associated with a variety of neurological and neuropsychological deficits. Neuroanatomical correlates: Except in the case of acute, isolated anomic aphasia, there is little localizing value. In acute isolated onset of anomic aphasia, lesion is often dominant (left) hemisphere outside the perisylvian language area in the inferior temporal area or angular gyrus of the parietal lobe area. Anomic aphasia is frequently identified in a variety of neurodegenerative conditions. In addition, patients with 12 Aphasia Syndromes 279 anterior temporal lobectomy often present with an anomic aphasia. A semantic category organization has been proposed with famous faces/people more localized to anterior temporal tip, animals more localized to inferior temporal region, and tools more localized to left posterior lateral region. Anomic aphasia is the end phase of recovery from a broad range of mild to moderate aphasia syndromes, and remain quite static in these cases. Recovery from acute, isolated anomic aphasia from localized ischemic event can be nearly complete. Recovery from other etiologies, such as head injury and/or degenerative disorders may not occur, and in fact evolve to other aphasia syndromes. Alexia and Agraphia are frequently observed concurrently with aphasia syndromes identified above, and follow the pattern of deficits in comprehension (for alexia) or fluency (for writing) of the aphasia syndromes. However, both alexia and agraphia may be observed independently (and together), and should be individually assessed. Scott Auditory comprehension /Normal /Normal Normal Repeat Normal Normal Normal Naming Reading /Normal Normal Normal Anomic /Normal Normal Normal Normal Aphemia/pure Mute only Normal Normal Mute. Able Normal word mutism Can write to write Alexia w/o agraphia (and Normal* Normal Normal Normal pure word blindness) Note: Trans motor = Transcortical motor aphasia; Trans sensory = transcortical sensory aphasia; Mixed trans = mixed transcortical aphasia; = minimal impairment; moderate impairment; = severe impairment * Unable to read aloud Alexia without agraphia is a classic syndrome in which a patient is able to write fluently with normal content, but who is unable to read, even their own writing. Other language functions, including fluency, comprehension, repetition, and naming are entirely intact. Frequent comorbid conditions: Right homonymous hemianopia and anomias, particularly color anomia. Neuroanatomical correlates: Alexia without agraphia is a classic disconnection syndrome, reflecting a lesion of the dominant (left) occipital lobe that involves the white matter of the posterior corpus collosum. Alexia with agraphia reflects the inability to write or read, with other language functions preserved such that fluency, comprehension, repetition, and naming are intact. When alexia with agraphia predominate, mild dysnomia and/or paraphasias may be present. Neuroanatomical correlates: Discrete lesion of the dominant (left) angular gyrus in the inferior parietal lobe. Agraphia without aphasia reflects the inability to write in the absence of other language impairments, and is infrequently observed. Neuroanatomical correlates: Relatively small lesion of the dominant (left) angular gyrus in the inferior parietal lobe. Aphemia is an acquired inability to articulate speech, such that speech output is slow and very effortful. In milder forms, aphemia may sound as if the speaker was attempting to speak in an unusual accent. In all cases, writing is completely preserved as are the other language functions of comprehension, repetition, and naming. Scott Cortical deafness is a rare, but classic acquired, syndrome in which a patient is unable to respond to either spoken language (verbal sounds) or nonverbal sounds (buzzer, dog bark, etc.
For the training set, which contains 11269 documents, the smallest and the largest categories contain 376 and 599 documents, respectively. For practical reasons, we only try a small subset of candidate C values in parameter search, which can also influence the difference on performance in Figure 6(a). Performing very careful parameter search on C could possibly shrink the difference. This observation is consistent with what we have observed on the per-class distributions over topics in Figure 3. As Blei and McAuliffe (2007) did, we take logs of the response values to make them approximately normal. Those terms make the max-margin estimation and latent topic discovery attached more tightly. We also build another real data set of hotel review rating18 by randomly crawling hotel reviews from TripAdvisor,19 where each review is associated with a global rating score and five aspect rating scores for the aspects20 -Value, Rooms, Location, Cleanliness, and Service. This data set is very interesting and can be used for many data mining tasks, for example, extracting the textual mentions of each aspect. Also, the rich features in reviews can be exploited to discover interesting latent structures with a conditional topic model (Zhu and Xing, 2010). In these experiments, we focus on predicting the global rating scores for reviews. To avoid too short and too long reviews, we only keep those reviews whose character length is between 1500 and 6000. We randomly select 1000 reviews for each rating and the data set consists of 5000 reviews in total. By removing a standard list of stopping words and those terms whose count frequency is less than 5, we build a dictionary with 12000 terms. As shown in the above experiments, our simulation experiments below, as well as the follow-up works (Yang et al. There are several possible reasons for the comparable (not dramatically superior) classification performance we obtained on the 20 Newsgroups data: (1) the fully factorized mean field inference method could potentially lead to inaccurate estimates. We have tried more sophisticated inference methods such as collapsed variational inference and collapsed Gibbs sampling,22 both of which could lead to superior prediction performance. For the topics, we randomly draw kn Beta(1, 1), where means that we need to normalize k to be a distribution over the terms in a given vocabulary. We consider three different settings of binary classification with a vocabulary of 500 terms. The document lengths for each setting are randomly draw from a Poisson distribution, whose mean parameter is L, that is, d, Nd Poisson(L). We randomly draw the class label for document d from a distribution model 1 p(yd = 1 d) =, where k N (0, 0. We randomly draw the class label for document d from a distribution model 1 p(yd = 1 d) =, where i j N (0, 0. Since the synthetic words do not have real meanings, below we focus on presenting the prediction performance, rather than visualizing the discovered topic representations. Finally, comparing the three settings, we can see that for Setting 2, since the true class labels heavily depend on the input word counts, increasing the average document length L generally improves the classification performance of all models. In other words, the classification problems become easier because of more discriminant information is provided as L increases. In contrast, we do not have the similar observations in the other two settings because the true labels are heavily (or solely in Setting 1) determined by, whose dimensionality is fixed.
Climbing up trees, mountains, ant-hills and undula- ting grounds, etc, and going up to a waterfall as well as riding on a wild and strictly unbroken horse or elephant are prohibited. One should not descend into an unknown tank, den as well as into the sea or into a river at flood times. Old haunted and deserted houses, forests cre- mation grounds and solitary shunned. Passing between elders, is two rows of fire, between cows, Brahmanas, moving cradles and a married couple forbidden. Even shadow of a (tree degraded and sick person as well as of ground) should not not gaze should not at cow, Brahmana, divine image, banner or of a Chaitya growing on a cremation upon. A man his should never repress any natural urging of body, nor should he pass water or evacuate excrein ments an open or public place, within the confines of a town or village, close to a cremation ground or any reservoirs place of worship, at the crossing of roads, in of water or on the high road nor should he do so facing a fire, in the presence of his superiors, cows, the sun and the moon nor facing against the wind. Never keep time with music by beating the body or the hair, nostrils, ear holes, teeth or the the cheeks with the hands or by striking the finger nails against each other. Never expose yourself fire to the rays of the sun, or to the gusts of wind blowing in your face. Sleeping, waksitting, lying down, walking, jumping, running fast, in water, plunging a swimming, riding on a horse or laughing, physical in vehicle, talking, sexual iiitercourse and taking (any other) exercise though accus- tomed and recommended should not be inordinately indulged in. A a bad habit should be gradually discontinued and (beneficial good one even when all at to health) should similarly be gradually inculcated by a quarter only and not once. Exercise, addiction to wine, gambling and music are One should not bear witness to any fact (before a * Dallana adds that curd should not be taken without an addition of water and salt as well. One should not use the shoe, umbrella, garland (of flowers), orna- ments or ragged clothes previously used by anothjer. Never defile a Brdhmana, or a fire, or a cow by touching them before washing (your hands and mouth) after eating. Water boiled and subsequently cooled should be drunk in summer and meat-juice in Prdvrit. Any Sneha regularly digestive (such as oil or clarified butter) satura- ted with powdered Saindhava salt and Pippali should be taken for capacity. A Sneha (oleaginous substance) should be freely and largely used during the Pr^vrit and the spring seasons as well as in antumn (Sarat)as such a proceeding would act as a good appetising measure and a cure for diseases. Emetics, purgatives and applications of Vastis are respectively beneficial in diseases due to the actions of the deranged Kapha, Pitta andVayu, whereas a regular course of physical exercise all tends (equally) to curb an ag- gravation of so in the three preceding Doshas of the body, taking regularly much so that their aggravation can never be detected in persons the habit of it every day, though otherwise addicted to an incompatible diet, etc. The course, attention should not be diverted to any other subject at the time of urination, defecation, sexual inter- taking of food, as well as at the time of taking etc. It is emetics and purgatives, not wise to anticipate a future and indulge in the gloomy thoughts of 87-88. All sexual as excesses should be studiously abstained are inasmuch epilepsy, they sure to produce Sula (colic), cough, asthma, fever, convulsions, emaciation, etc. One may all a woman) on each year except in fourth night in the seasons of the summer when he Women may see her once a fortnight. Sexual intercourse by a man who spirit, is strict- hungry, or thirsty, or who may be suffering from any disease, or may a be angry, or in a cheerless ly forbidden. A is man should not go unto a urging for woman by or it repressing urine, or if natural in a Vdta (flatus), stool he weak sexual state of health, (as would lower of be highly injurious to his health). A woman big with child is extremely painful to the foetus confined in the and injurious to vital womb. A going unto a or sterile deformed, uncleanly, spiteful, non amorous, infamous, or woman, is or at an unclean, the exposed place detrimental to semen and intellect of the visitor 89-D. Similarly, sexual intercourse enjoyed by a man thirsty, at noon time, or by one who hungry state of in a cheerless is in an enfeebled, or the body, in a standing up posture, or mood, brings on an excessive is loss of semen and aggravation of the bodily Vdyu. Pain, enlargement the spleen, epilepsy gratifica- and the even death may follow of from sexual health. Hence these (injurious and harmful) practices should be shunned by a man for his welfare in this life as well as for that in the next. On is the contrary, repression of a a natural and (legitimate) sexual desire, from sense of unwise delicacy or shame, healthy a physical sin. Fatigue coition moved by the enjoyment of a bath f, a cool breeze, or a * It this should be always borne in mind that God has implanted desire in the mind of man and provided him with the necessary only for the organic appendages the gratification propagation of his species and not or for is of any diseased morbid sexual propensity which found nowhere else in Nature save subjects and and except in debauched human of brutes.
Septa are produced from the inner and broader fibrillar electron-lucid layer and are characterized by septal pores. The plasma membrane is a thin, electron-dense delimiting membrane contiguous with the inner surface of 2-1. Presentation, cat: the cat presented with a nodular lesion in the dorsolateral thorax with a draining tract and a serosanguineous exudate. Haired skin, cat: the dermis is expanded by coalescing poorly formed pyogranulomas. In the cytoplasm, a large central vacuole surrounded by an electron-dense tonoplast enclosing electron-lucent flocculent material is visible. Mitochondria having no polarity are scattered throughout the cytoplasm of the hyphae and can be filamentous or spherical. Mitochondria have double membrane and extensive cristae that might extend across the organelles. Single membrane bound vesicles with central bodies are also present at the margins of the hyphae. Additional features are the presence of single membrane bound vesicles with central bodies with high electron opacity. Clinical, gross and microscopic findings were representative of a deep dermatophyte infection consistent with feline dermatophytic pseudomycetoma. The disease associated with Microsporum canis has been described also in d o g s,1,8 h o r s e s12 a n d h u m a n s. The frequent localization of the lesions in the dorsal trunk, most commonly in outdoor cats, suggests a traumatic implantation of organisms from hair follicles with dermatophytic colonization by biting or fighting. Positive dermatophyte cultures from normal-appearing areas distant from the dermatophytic pseudomycetoma indicate that affected cats may previously have been inapparent carriers. Haired skin, cat: Ultrastructural examination of fungal hyphae demonstrates several cross sections of a thick lamellar cell wall enclosing granular cytoplasm with moderate numbers of mitochondria and vacuoles and transverse septations. Intraabdominal dermatophytic granulomatous peritonitis sharing many features with pseudomycetoma has been reported in Persian cats. These are tangled and delicate, and contain numerous large, clear, bulbous, thick-walled dilatations, resembling spores. Smaller swellings within the hyphae create a vacuolated or bubbly appearance to these structures. The fungal aggregates are imbedded in amorphous eosinophilic material to form large tissue grains, or granules that are also visible grossly. Granules are cuffed by and intermingled with large 7 macrophages, giant cells, and variable, sometimes numerous neutrophils. In some cases, fragments of hyphae are present within individual macrophages beyond the boundaries of tissue grains or granules. Reactive fibroblasts and collagen may surround or dissect the lesions often creating lobules composed of multiple granules and their attendant inflammation. Organisms can be stained with periodic acidSchiff, Gomori methenamine silver, Grocott stains and Fonata-Masson. There are contrasting reports regarding poor4 or successful response of feline pseudomycetomas following terbinafine treatment. The marked breed predilection for Persian cats is helpful in increasing the index of suspicion for dermatophytic pseudomycetoma. Histologically, most of the systemic and opportunistic fungi affecting cats and dogs are smaller and more uniform in appearance and do not form granules or grains in tissue.
History of congenital anomalies of the heart and great vessels other than the following conditions. Excepted conditions require an otherwise normal current echocardiogram within the last 12 months. History of recurrent syncope or presyncope, including black out, fainting, loss or alteration of level of consciousness (excludes single episode of vasovagal reaction with identified trigger such as venipuncture) unless it has not recurred during the preceding 2 years while off all medication for treatment of this condition. Unexplained ongoing or recurring cardiopulmonary symptoms (to include but not limited to syncope, presyncope, chest pain, palpitations, and dyspnea on exertion). Lactase deficiency does not meet the standard only if of sufficient severity to require frequent intervention, or to interfere with military duties. A documented cure for Hepatitis B is viral clearance manifested by Hepatitis B surface antigen negative/Hepatitis B surface antibody positive/Hepatitis B core antibody positive. Abnormal uterine bleeding (period greater than 7 days, or more frequent than 21 days or greater than 35 days, or soaking more than one pad per hour for several hours) within the last 12 months. Dysmenorrhea resulting in recurrent absences or activity modification within the last 6 months. History of major abnormalities or defects of the genitalia, such as hermaphroditism, pseudohermaphroditism, or pure gonadal dysgenesis. Polycystic ovarian syndrome unless no evidence of metabolic complications as specified by National Heart, Lung, and Blood Institute and American Heart Association Guidelines. History of genital infection or ulceration, including but not limited to herpes genitalis or condyloma acuminatum, if any of the following apply: (1) Current lesions are present. Abnormal gynecologic cytology within the preceding 3 years, including but not limited to unspecified abnormalities of the Papanicolaou smear of the cervix, excluding atypical squamous cells of undetermined significance without human papillomavirus and confirmed low-grade squamous intraepithelial lesion. For the purposes of this issuance, confirmation is by colposcopy or repeat cytology. History of abnormal cervical, vaginal, or vulvar cytology or pathology to include atypical squamous cells that cannot exclude high grade squamous intraepithelial lesions, low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, cervical intraepithelial neoplasia grades 2 or 3, vaginal intraepithelial neoplasia grades 2 or 3, vulvar intraepithelial neoplasia grades 2 or 3 without demonstrated resolution in accordance with American Society for Colposcopy and Cervical Pathology guidelines. Absence of both testicles, current undescended testicle, or congenital absence of one testicle not verified by surgical exploration. History of epispadias or hypospadias when accompanied by history of urinary tract infection, urethral stricture, urinary incontinence, symptomatic chordee, or voiding dysfunction or surgical intervention for these issues within the past 24 months. Current enlargement or mass of testicle, epididymis, or spermatic cord, in addition to those described elsewhere in Paragraph 5. Current hydrocele or spermatocele associated with pain or which precludes a complete exam of the scrotal contents. History of genital infection or ulceration, including but not limited to herpes genitalis or condyloma acuminatum, if: (1) Current lesions are present; (2) Use of chronic suppressive therapy is needed; (3) There are three or more outbreaks per year; (4) Any outbreak in the past 12 months interfered with normal activities; or (5) After the initial outbreak, treatment included hospitalization or intravenous therapy. History of acute prostatitis within the last 24 months, history of chronic prostatitis, or history of chronic pelvic pain syndrome. History of chronic or recurrent scrotal pain or unspecified symptoms associated with male genital organs. History of major abnormalities or defects of the genitalia such as hermaphroditism, pseudohermaphroditism, or pure gonadal dysgenesis. Lower urinary tract infection (cystitis): (1) For males, any cystitis not related to an indwelling catheter during a hospitalization. History or treatment of the following voiding symptoms within the previous 12 months in the absence of a urinary tract infection: (1) Urinary frequency or urgency more than every 2 hours on a daily basis. History of neurogenic bladder or other functional disorder of the bladder that requires urinary catheterization with intermittent or indwelling catheter for any period greater than 2 weeks. History of bladder augmentation, urinary diversion, or urinary tract reconstruction. History of abnormal urinary findings in the absence of urinary tract infection: (1) Gross hematuria. Current or recurrent urethral or ureteral stricture or fistula involving the urinary tract. Chronic or recurrent pyelonephritis or any other unspecified infections of the kidney. History of acute nephritis or chronic kidney disease of any type as evidenced by 3 months or longer of: (1) Estimated glomerular filtration rate of less than 60cc per minute per 1.
Persons aged 30 who would die before age 70 from chronic diseases, 2005-2016 14,000. Annual consumption of pure alcohol (in liters) per person (persons aged 15+), 2005-2016 3. Persons killed in road accidents by sex and population group, 2001-2017 14 12 Total population Males Females Jews Arabs 3. Smokers aged 21 and over, by sex, 2002-2017(1) 50 40 Females Males Total population 3. The survey of adult skills defines problem-solving in technology-rich environments as "using digital technology, communication tools and networks to acquire and evaluate information, communicate with others and perform practical tasks. Reading Grades 2/3 of primary education Parity index (girls/ boys) Parity index (students of rural school/ students of urban school) Parity index (low socioeconomic status/ high socioeconomic status) 1. Accreditation reflects the recognition of significant environmental education in a school and outlines a possible course of action for schools that want to start environmental activities based on existing frameworks. Green and Greener Kindergarten, 2007-2016 Green Kindergarten Greener Kindergarten (Continuing Green Kindergarten) certification 400 Number 300 200 100 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 4. The integrated plan for implementing sustainability education in the school system, 2010-2016 150 Number of schools 120 90 60 30 0 2010 2011 2012 2013 2014 2015 2016 4. Access to the following is 85% (data refer to public education only) at all levels of education: (b) the Internet for pedagogical purposes; (c) computers for pedagogical purposes. Data for women subject to violence by current or former intimate partner cannot be displayed due to high sampling errors. The data present the proportion of women in the Knesset from the first Knesset (1949) to the current twentieth Knesset (from 2015). The majority of the population not connected to wastewater treatment is the Bedouin population that lives in localities with no municipal status. The percentage of renewable energy out of the primary energy supply and out of electricity production is very low in Israel (less than 3 percent), despite the significant increase in 2008-2016. Primary energy supply Energy ratio Energy ratio and primary energy supply(1), 2005-2016 t. Activities of households as employers; undifferentiated goods- and services-producing activities of households for own use Total A B B+C D E F G H I J K L M N O P Q R S T 2,207 1,834 1,926 2,464 2,265 2,882 2,157 783 1,103 4,727 1,266 2,560 1,483 369 1,154 1,908 2,007 135 2017 1,655 2,038 U. Activities of households as employers; undifferentiated goods- and services-producing activities of households for own use 2016 Total 1,772 A B B+C D E F G H I J K L M N O P Q R S T 2,305 2,381 1,858 2,712 2,376 3,069 2,390 877 1,195 4,964 1,336 2,867 1,556 396 1,215 1,970 2,111 159 2,151 U. Persons aged 20 and over who felt discrimination(1) by sex, age and population group, 2017 100. Nonetheless, the level of participation varies from cases where citizens may express their opposition to a project to cases where a much wider public participation process exists. Cultural heritage includes museums, archives, antiquities preservation and archeological sites preservation. Public space includes the following land uses: public services, culture and leisure, infrastructure and transportation, public parks and other public open areas. Israel has yet to ratify the Ban Amendment but already complies with its provisions further limiting the export of hazardous waste. The most common corporate responsibility reporting mechanism is produced by and known as "Maala". It should be noted that Maala only publishes the final ratings of the reporting companies and not the detailed reports of the companies. In addition, individual instruction kits and checklists are prepared for each local authority. Regular local government audits carried out on behalf of national government will include audits of the implementation of the environmental guidelines. Its various subcommittees will focus on strategy, health and emergency, natural resources and agriculture and environment, energy and infrastructure and technologies, research and development, local authorities and communication and education. The chart displays chlorophyll concentrations, which indicate algal bloom as a result of nutrient pollution, at three selected sites. Samples were taken from 9 locations at different depths and marine litter hotspots. This monitoring program includes sampling of both floating marine litter and litter accumulated on the sea bottom, for both micro and macro plastics.
Maintenance pediatric fluids: Weight Volume/24 hrs < 10 kg 100 ml/kg 10-20 kg 1000 ml + 50 ml/kg for each kg over 10 kg > 20 kg 1500 ml + 20 ml/kg for each kg over 20 kg 22. May be repeated in 5 minutes to a maximum total dose of 1 mg in a child and 2 mg in an adolescent. The most accessible route of emergent drug administration in a newborn is the umbilical vein. Standard energy dose for defibrillation in children is 2-4 Joules/kg; cardioversion is 0. Physicians in all states are mandated reporters of suspected child abuse and neglect. Shaken baby/shaken-impact syndrome includes the constellation of subdural hematomas, retinal hemorrhages, rib fractures, metaphyseal fractures of long bones. Classic electrolyte abnormality is hypochloremic, hypokalemic metabolic alkalosis. Malrotation with midgut volvulus: any bilious emesis is suspicious for this (seen in >75%) with classic presentation of sudden onset bilious emesis and abdominal distention, toxic appearing. Intussusception is the most common cause of intestinal obstruction in patients < 2 year old; classic triad is abdominal pain, vomiting, bloody stools (currant jelly); may also present with profound lethargy. Presents with massive, painless rectal bleeding (brick red) in males < 5 year old. Foreign bodies: 80-90% that make it into the stomach will pass; button batteries in esophagus must be rapidly removed to prevent erosions and mediastinitis; button batteries in the stomach must be followed with films to document passage beyond pylorus. Plain films of suspected coin ingestions will demonstrate the face of the coin in esophagus or the edge of the coin in the trachea. Appendicitis is the most common non-traumatic surgical emergency in peds; progressive symptoms 4-24 hours- abd pain, vomiting, fever, anorexia. American Academy of Pediatrics: Consent for Emergency Medical Service for Children and Adolescents. American Academy of Pediatrics: Guidelines for the evaluation of sexual abuse of children: Subject review. American Academy of Pediatrics: Practice parameter: the management of acute gastroenteritis in young children. Pearl Irish, Caty, Glick: the approach to common abdominal diagnosis in infants and children. Pearl, Irish, Caty, Glick: the approach to common abdominal diagnoses in infants and children. Touloukian, Higgins: the spectrum of serum electrolytes in hypertrophic pyloric stenosis. Discuss what constitutes a fever and the significance of fever in the newborn to 36-month age groups. Recognize the presenting signs and symptoms, describe the appropriate diagnostic studies, understand the differential diagnosis including common organisms, and describe the management including indications for hospital admission for the febrile child in an age-related fashion. Assess and manage the patient with seizures, including febrile seizures, first afebrile seizure, and status epilepticus. Recognize the presenting signs and symptoms, describe the appropriate diagnostic studies, understand the differential diagnosis, and describe the management including indications for hospital admission for pediatric respiratory diseases: 1. Recognize the presenting signs and symptoms, describe the appropriate diagnostic studies, understand the differential diagnosis, and describe the management including indications for hospital admission for pediatric cardiac diseases: Cyanotic congenital heart diseases. Know the definition of ataxia, recognize the symptoms from the physical exam, understand the differential diagnosis for ataxia, describe the appropriate diagnostic evaluation, and know the management for admission to the hospital. Formulate a differential diagnosis for the crying infant and discriminate between normal crying and colic. Differentiate between hypernatremic, isonatremic, and hyponatremic dehydration and describe the management of the pediatric patient with dehydration. Know the principles of fluid administration for enteral and parenteral rehydration. Identify the common causes of infectious diarrhea in children and know which organisms should not receive antimicrobial therapy.
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