Frost Bite
– Pathophysiology: – effects of cooling: – temperature of the hands and feet is partially determined by ateriovenous regulation of blood flow; – vascular effects: – severe vasoconstriction 2nd to increased sympathetic tone; … Read more
Medications
Fondaparinux / Arixtra
– See Lovenox – Discussion: – synthetically manufactured pentasaccharide anticoagulant; – inhibitor of antithrombin (see coagulation cascade); – in contrast to heparins (which inactivate factor Xa and thrombin), fondaparinux only inhibits antithrombin; – dosage: 2.5 mg SQ q24 Effect of low molecular weight heparin (dalteparin) and fondaparinux … Read more
Femoral Shaft Nonunion
– Discussion: – general discussion of non union / infected femoral nails – femoral shaft that has not healed in 26 wks signals a delayed union; – may be more common in segmental fractures and in winquest type IV fractures; – most common iatrogenic risk factor is failure to … Read more
Enterococci Grp D
– Discussion: – type of gram positive bacteria; – term enterococcus derives from French (enterocoque) describing its enertic origin; – enterococci include: Strep faecalis, faicium, and durans; – strep faecalis inhabits the human intestinal tract and is a nonhemolytic strain of generally low pathogenicity; – … Read more
DVT/PE Prophylaxis in THR
div class=”mh-row clearfix”> h1>/h1> div class=”bodycopy”>hr size=”3″/> – See strong>a href=”/joints/hip/total-hip-arthroplasty/”>Total Hip Replacement Menu:/a>/strong> br/> br/> strong>- Discussion:/strong> (strong>a href=”/ortho/deep_venous_thrombosis”>general discussion of DVT/a>/strong>) br/> – 40-60% of THR patients who do not receive prophylaxis will get a DVT (dependment on imaging method); br/> – ref: Significance of deep … Read more
Dupuytren’s Contracture
– See: Surgical Treatment of Dupuytren’s: – Discussion: – originally described by Baron Guillaume Dupuytren in 1831; – ref: Guillaume Dupuytren: His Life and Surgical Contributions – usually appears between age 40 to 60 years; – disease occurs more often and is more severe in males or persons of Northern European Origin; – may be … Read more
Doxorubicin/Adriamycin
– See: Chemotherapy Agents: – Indications: – acute leukemias and malignant lymphomas; non-Hodgkin’s lymphomas and Hodgkin’s disease; ca of the ovary; breast; sm cell of lung; – Sarcomas: Osteogenic sarc, Ewing’s, and soft tissue sarcomas; – Metastatic ca of Breast, ca of bladder, bronchogenic ca, neuroblastoma; – Precautions: – care should be taken to avoid … Read more
Dobutamine/Dobutrex
– See: – Inotropic Agents – Inotropic agent (not vasoconstrictor); – Useful in pt w/ poor CO output, elevated left ventricular filling pressures (PAOP > 18mm Hg), & marginal systemic blood pressures; – For Shock syndrome as result of MI, endotoxins, trauma, Renal failure; – Selective B1 stimulator; – Causes direct iotropic stimulatorwith reflex vasodilation … Read more
DOCUSATE CALCIUM (SURFAK)
– For constipation prone patients (bedrest, medications); – Acts as stool softener; – Adults: 240 mg PO qd; – Peds: >6yrs: 50-150 mg PO qd; – Supplied: Caps: 50mg, 240mg; – COLACE: – Adults: 50-250 mg PO bid; – Peds: <3yrs: 10-40 mg / 24 yrs PO divided qd/qid; – 3-6 yrs: 20-60 mg/24hrs PO … Read more
Discussion of SVT
– See WPW / PAT – Atrial Rate: 150-214: average 187 – when P waves are seen they are: – inverted in inferior leads; – follow the QRS complex; – often P waves are difficult to discern Review Article: Drug Therapy: Adenosine And Supraventricular Tachycardia.