1. Braunwald, Fauci, Kasper et al. Harrison. Principles of Internal Medicine, 15th edition. 2. Illowsky BP. Polyclipsid and ityponahaemin in psychiatric patients. American Journal of Psychiatry 1988; 145 6 ; : 675-83 3. de Leon J, Verghese C, Tracy J, Josiassen RC, Simpson GM. Polydipsia and water intoxication in psychiatric patients: a review of the epidemiological literature. Biological Psychiatry 1994; 35: 408-19 de Leon J, Tracy J, McCann E, Me Grory A. Polydipsia and schizophrenia in a psychiatric hospital: a replication study. Schizophrenia Research 2002; 57: 293-301 Viewig et al. Death from self induced water intoxication among patients with schizophrenia disorders. J Nerv Ment Dis 1985; 173: 161-5 Loas G, Mercier-Guidez E. Fatal self-induced water intoxication among schizophrenic inpatients. Eur Psychiatry 2002; 17: 307-10 Mercier-Guidez E, Loas G. Polydipsia and water intoxication in 353 psychiatric inpatients: an epidemiological and psychopathological study. Eur Psychiatry 2000; 15: 306-11 Cooney JA. Ultimate in compulsive water drinking? The Lancet 1989: 398-99.
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Medications Medications can help control some of the symptoms of cerebral palsy CP ; , prevent complications, and treat other medical conditions related to CP. Medication Choices Antispasmodics are the most common medications used. They relax tight muscles and reduce muscle spasms. Most antispasmodics are taken orally and include: Diazepam such as Valium ; . Baclofen L8oresal ; . Dantrolene sodium Dantrium ; . Injectable antispasmodics are occasionally used to relax muscles and reduce spasms. They typically remain effective for about 3 to 6 months and include: Phenol or alcohol "washes." Botulinum toxin Botox.
Few organizations have realized the full potential of their information assets, although most consider their information to be essential to the operation. Information residing in different sources within organizations are most often believed to hold significant value but rarely is there any methodological valuation done. For that reason, it is important to consider the value of information and related risk aspects not having the right information, in the right format at the right time ; , as important factors when deciding on building an information environment that supports full exploitation and business benefits of the information assets. Knowing the value of the information assets can lead to having a better understanding of the most and least valuable information in the organization as well as greater awareness of how information is being used, its usability and reliability. It is suggested that there is a need to maintain a balance between information assets value, risk and the commitment to IT IS order to steer and not to over invest in IT IS. This requires that organizations determine how they approach valuing information and for what reason. However, the task of measuring the value of information has continued to be difficult to a large extent. Although, some success has been achieved in measuring the exchange value of information, whereas its value in trade can be considered to follow the economic laws of supply and demand, but the quantitative value of information in use within an organization has been somewhat intangible. Therefore the approach of this thesis is to establish information as a concept in order to set the stage for how information is interpreted, valuated, increased in value and finally approach how to account for and minimize risk aspects of clinical research information and benazepril.
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COUNT 7 THAT you are guilty of unprofessional conduct or conduct which, when regard is had to your profession, is unprofessional in that during March to November 2002 and whilst practicing at the Rand Clinic as a registered Physiotherapist you failed to communicate and co-operate with medical practitioners and or other health practitioners in the diagnosis and treatment of a patient. COUNT 8 THAT you are guilty of unprofessional conduct or conduct which, when regard is had to your profession, is unprofessional in that during March to November 2003 and whilst practicing at the Rand Clinic you failed to adhere to acceptable clinical protocol in that you: 1. failed to properly complete intensive unit charts by neglecting to furnish information regarding the treatment required and or specified in respect of patients; and or 2. failed to ensure that treatment that had been requisitioned by doctors was timeously administered to patients; 3. failed to keep proper medical records with regard to a plan of treatment in respect of patients; and or 4. Acted in a manner that did not or could have brought the reputation of the medical professions in disrepute. Dr T V Sishuba MP 0513172 32 2003 THAT you are guilty of unprofessional conduct or conduct which, when regard is had to your profession, is unprofessional in that on or about 23 October 2002 and with regard to Mr K Vengatass hereinafter referred to as "your patient" ; you: 1.1 1.2 1.3 Dr W J Joubert failed to arrange any follow-up with your patient; and or failed to attend to your patient when he presented to your practice for a follow-up and or participated in causing your patient to suffer extensive tissue damage; and in doing so, brought or could have brought the professions of medical practitioner in disrepute. Paid admission of Tygervalley Found guilty and has to pay costs of the inquiry as well as costs for tracing him. Kwa-Thema.
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And children with asthma. N Engl J Med 2001; 345: 1529-36. Juniper EF, O'Byrne PM, Guyatt GH, Ferrie PJ, King DR. Development and validation of a questionnaire to measure asthma control. Eur Respir J 1999; 14: 902-7. Juniper EF, Svensson K, Mork AC, Stahl E. Measurement properties and interpretation of three shortened versions of the Asthma Control Questionnaire. Respir Med 2005; 99: 553-8. Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. J Respir Crit Care Med 1999; 159: 179-87. Juniper EF, Guyatt GH, Cox FM, Ferrie PJ, King DR. Development and validation of the Mini Asthma Quality of Life Questionnaire. Eur Respir J 1999; 14: 32-8. Juniper EF, Guyatt GH, Feeny DH, Ferrie PJ, Griffith LE, Townsend M. Measuring quality of life in children with asthma. Qual Life Res 1996; 5: 35-46. Revicki DA, Leidy NK, BrennanDiemer F, Sorensen S, Togias A. Integrating patient preferences into health outcomes assessment: the multiattribute Asthma Symptom Utility Index. Chest 1998; 114: 998-1007. Bateman ED, Boushey HA, Bousquet J, et al. Can guideline-defined asthma control be achieved? The Gaining Optimal Asthma ControL study. J Respir Crit Care Med 2004; 170: 836-44. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Stat Assoc 1958; 53: 457-81. Cox DR. Regression models and lifetables. J R Stat Soc [B] 1972; 34: 187-220. McCullagh P, Nelder J. Generalized linear models. New York: Chapman & Hall, 1989. 27. Liang K-Y, Zeger S. Longitudinal data, because lioresal injection.
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Untriggered and may refer pain to many distant structures. Standard muscle relaxants such as diazepam Valium ; , methocarbamol Robaxin ; , or cyclobenzaprine Flexeril ; appear to work by decreasing central nervous system signals. Unfortunately, trigger points "do not pay attention to what the brain is saying, " and are not well treated by these medications. Instead, medications that were originally used for cerebral palsy or spinal cord injuries such as baclofen Lioreaal ; and tizanidine Zanaflex ; appear to be more effective because of their central effect on alpha-2 adrenergic receptors. In addition, we should mention a special note regarding carisoprol Soma ; . Though widely used, it is felt to be highly addictive and is condemned by most contemporary pain management physicians. It is metabolized to meprobamate, an old major tranquilizer Miltown ; that has been taken off the market. Meprobamate potentiates the euphoric effects of opioids, and is now a schedule IV medication; there is a strong regulatory effort to ban it altogether. Anxiolytics: Pain is often associated with anxiety and depression, and they are sometimes difficult to separate. Traditional anxiolytics, such as lorazepam Ativan ; and diazepam Valium ; , come primarily from the benzodiazepine family, which constitute the largest group of prescribed drugs in the US today. Benzodiazepines act on the GABA receptors to inhibit excitatory neurons, and act on glycine receptors to reduce muscle spasms. Unfortunately, all benzodiazepines interfere with Stage 4 sleep, and all except flurazepam Dalmane ; interfere with REM sleep. Withdrawal causes seizures in 70 percent of patients and has been shown to cause at least a 12-point drop in IQ scores in 60 percent of patients1. Serotonin is inhibited, making them depressants, not antidepressants. Given their addictive properties, they are mostly condemned by pain management specialists, though there is a role for the longer acting benzodiazepines such as clonazepam Klonopin ; . Other options include the azapirones such as buspirone BuSpar ; and gepirone Ariza ; , which have a direct effect on 5HT1A receptors. Phenothiazine tranquilizers such as chlorpromazine Thorazine ; block norepinephrine as well as block dopamine postsynaptically, and have a strong atropine-like effect. Fluphenazine Prolixin ; will also block dopamine but there is less norepinephrine blockade and less atropine-like effects. Butyrophenones like haloperidol Haldol ; are the most potent dopamine and norepinephrine blockers and have the least acetylcholine release. Antihistamines such as hydroxyzine Vistaril, Atarax ; can also be used as anxiolytics.
Patient O. stayed at the NIRS hospital from Sept. 30 to Oct. 2, 1999, when he was transferred to the department of emergency medicine, the University of Tokyo Hospital. He died on Dec. 22, 1999, and it was the 84th clinical day. Patient S. stayed at the NIRS hospital from Sept. 30 to Oct. 4, when he was transferred to the Medical Research Institute, University of Tokyo. He was transferred to the department of emergency medicine, the University of Tokyo Hospital on Apr. 10, 2000. He died on Apr. 27, 2000, and it was the 211th clinical day. Patient Y. stayed at the NIRS hospital. He was discharged from the hospital on December 20, 1999. The duration of his hospitalization was therefore 82 days. His discharge was planned several times, but finally was decided largely based on non-medical, social factors relating to coverage in the media and heightened public scrutiny and casodex.
Royal Philips Electronics has launched a new generation of "smarter" ultrasound equipment. The Philips iU22 system, with intelligent control and advanced ergonomic design, offers a wide range of high-performance features including next generation, real-time 4D imaging, voice-activated control and annotation, and automated image optimization technologies. "Clinicians have been looking for The Philips iU22 system a revolutionary leap forward in ultradisplays a 4D ultrasound sound performance and workflow. image of a fetus with The new Philips iU22 system meets its foot in its mouth. that criteria, going far beyond excellent image quality, " said Barbara Franciose, CEO of ultrasound for Philips Medical Systems. The Philips iU22 system is also designed to reduce the repetitive stress injuries common to sonographers.
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There are a number of treatment choices available for spasticity see Table 2 ; . The first line of therapy is usually oral baclofen Liorseal ; . Because baclofen may cause muscle weakness and sleepiness, it should be started slowly and given in titrated doses, noted Ms. Gogol. This is also true of most other medications that are used to treat spasticity. Anticonvulsants or antidepressants may be useful, she noted. Narcotics are sometimes used but do not appear to be as effective. Nonsteroidal antiinflammatory drugs can help to reduce pain as well as spasticity, she added. "Patients tend to request steroids frequently because many feel it improves spasticity, " Ms. Gogol pointed out. However, it is probably best to cut down on the use of steroids for spasticity because of the potential for adverse effects. "It's a good idea to minimize the use of steroids for treating spasticity because MS patients may need to take them to treat exacerbations, " she advised. For more severe cases of spasticity, baclofen is sometimes administered using a surgically implanted pump. The Multiple Sclerosis Council for Clinical Practice Guidelines recommend intrathecal baclofen as an effective treatment for patients with severe disability an MSX EDSS score of 7 or greater ; . 3 --Rosalee L. Blumer.
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Options In 2003, the Board adopted a policy not to reprice options. The Executive Compensation Committee may grant options to purchase Common Shares which may be either ISOs or NQOs. The purchase price of a Common Shares under each option will not be less that the fair market value of a Common Share as of the close of business on the day immediately prior to the date the option is granted. The option will be exercisable in accordance with the terms established by the Executive Compensation Committee. The full purchase price of each share purchased upon the exercise of any option will be paid at the time of exercise. Except as otherwise determined by the Executive Compensation Committee, the purchase price will be payable in cash or in Common Shares valued at fair market value as of the day of exercise ; , or in any combination thereof. The Executive Compensation Committee, in its discretion, may impose such conditions, restrictions, and contingencies on Common Shares acquired pursuant to the exercise of an option as the Executive Compensation Committee determines to be desirable. SARs The Executive Compensation Committee may grant an SAR in connection with all or any portion of a previously or contemporaneously granted option or independent of any option grant. An SAR entitles the individual to receive the amount by which the fair market value of a specied number of Common Shares on the exercise date exceeds an exercise price established by the Executive Compensation Committee, which will not be less than the fair market value of the Common Shares at the time the SAR is granted. Such excess amount will be payable in Common Shares, in cash, or in a combination of cash and Common Shares, as determined by the Executive Compensation Committee. The Executive Compensation Committee, in its discretion, may impose such conditions, restrictions, and contingencies on Common Shares acquired pursuant to the exercise of an SAR as the Executive Compensation Committee determines to be desirable. Other Share Awards The Executive Compensation Committee may grant bonus shares a grant of Common Shares in return for previously performed services, or in return for the individual surrendering other compensation that may be due ; , share units a right to receive Common Shares in the future ; , performance shares and performance units a right to receive Common Shares or share units, or the right to receive a designated dollar value of Common Shares that is contingent upon achievement of performance or other objectives ; , restricted shares and restricted share units a grant of Common Shares and a grant of the right to receive Common Shares in the future, with such shares or rights subject to a risk of forfeiture or other restrictions that lapse upon the achievement of one or more goals relating to completion of service by the individual or the achievement of performance or other objectives, as determined by the Executive Compensation Committee ; . Any such awards will be subject to such conditions, restrictions and contingencies as the Executive Compensation Committee determines. Deferred Compensation Plan Under the Deferred Compensation Plan, our ocers and certain other eligible employees are able to elect to defer payment of up to percent of their base salary, 90 percent of their bonuses and certain amounts which cannot be contributed to our 401 k ; Savings Plan due to limitations of the Internal Revenue Code. The minimum deferral for any calendar year is generally $5, 000. The Deferred Compensation Plan is funded into a ""rabbi trust'' and participants in the Deferred Compensation Plan are treated as our unsecured general creditors. Amounts deferred under the Deferred Compensation Plan earn a rate of return based on a hypothetical investment in investment choices selected by the participant from alternatives we provide. We and our subsidiaries and aliated companies may, but are not required to, actually invest the deferred compensation in such investment funds. Any actual investment made by an employer in its discretion is treated as part of the general assets of that employer. 17.
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A. General Rules for Determining Significance.--The relative significance of medication errors is a matter of professional judgement. Surveyors who are responsible for assessing these requirements must be qualified to exercise such judgement e.g., pharmacists, nurses ; . Follow three general rules in determining whether a medication error is significant or not: l. Patient Condition.--The patient's condition is an important factor to consider. For example, a potent diuretic erroneously administered to a dehydrated patient may have serious consequences but if administered to a patient with a normal fluid balance may not. If the patient's condition requires rigid control, a single missed or wrong dose can be highly significant. 2. Drug Category.--If the drug is from a category that usually requires the patient to be titrated to a specific blood level, a single medication error could alter that level and precipitate a reoccurrence of symptoms or toxicity. This is especially true if the half life of the drug is short. Examples of drug categories which require titration of patient blood levels include anticonvulsants, anticoagulants, and antiarrhythmic, antianginal and antiglaucoma agents. 3. Frequency of Error.--If an error is occurring with any frequency, there is more reason to classify the error as significant. For example, if a patient's drug was omitted several times, as verified by reconciling the number of tablets delivered with the number administered, classifying that error as significant would be in order. This conclusion may be especially valid when taken in concert with the patient's condition and the drug category. B. Examples of Significant and Non-Significant Medication Errors.--Examples of medication errors that have occurred in long term care facilities are presented below. Some of these are identified as significant. This designation is based upon expert opinion without regard to the status of the patient. Most experts concluded that the significance of these errors, in and of themselves have a high potential for creating problems for the typical long term care facility patient. Errors identified as non-significant have also been designated primarily upon the basis of the nature of the drug. Patient status and frequency of error could classify these errors as significant. 1. OMISSIONS DRUGS ORDERED BUT NOT ADMINISTERED AT LEAST ONCE ; HALDOL 1mg BID MOTRIN 400 mg TID QUINIDINE 200mg TID TEARISOL Drops 2 both eyes TID INDOCIN 25mg TID pc LIORESAL 10 mg TID NS NS S.
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