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What impression stereotypes of the united states did the guatemalan have.what was their sourace of information about el norte?
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bad impression
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How many sisters and brothers does katerina Kaif havewhat are there names?
6 sisters and 1 brother
What information is included in an audience profile?
Some good questions to ask to develop a full audience profile are:What is the audience's DemographicsWhat do they do for a living/for funHow much influence do they haveWhat do they usually likeWhat are their political leaningsWhat do they not like
What information is included an audience profile?
Some good questions to ask to develop a full audience profile are:What is the audience's DemographicsWhat do they do for a living/for funHow much influence do they haveWhat do they usually likeWhat are their political leaningsWhat do they not like
The first four outer planets do not have solid?
All the outer planets probably have solid cores. However, they do not havewhat we call a solid surface.Incidentally, there are only four outer planets altogether.There are only 4 "outer planets". They do not have a solid surface.
What are adjective and noun clauses introduced by?
An adjective clause is a clause with one or more adjectives, which modifies a noun. An adjective clause begins with a relative pronoun (such as who, that, which) or a relative adverb (who, where, when).
What are the book codes for o-star-reporter?
Here are the Club Penguin book codes for Star Reporter:What word is on page 6, 5 words from the left on line 5? printedWhat word is on page 7, 6 words from the left on line 12? staffWhat word is on page 8, 2 words from the left on line 19? assuresWhat word is on page 8, 6 words from the left on line 19? reporterWhat word is on page 9, 3 words from the left on line 13? penguinWhat word is on page 10, 7 words from the left on line 19? gamesWhat word is on page 10, 9 words from the left on line 9? blueWhat word is on page 13, 3 words from the left on line 7? bulbWhat word is on page 13, 6 words from the left on line 15? playWhat word is on page 14, 1 word from the left on line 6? proveWhat word is on page 14, 5 words from the left on line 8? cornerWhat word is on page 18, 4 words from the left on line 9? shoutWhat word is on page 19, 7 words from the left on line 4? officeWhat word is on page 22, 4 words from the left on line 21? proudWhat word is on page 22, 6 words from the left on line 6? 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Carotid artery surgery?
DefinitionCarotid artery surgery is a procedure to restore proper blood flow to the brain.Alternative NamesCarotid endarterectomy; CEA; Carotid angioplasty and stenting; CAS; Endarterectomy - carotid artery; Angioplasty - carotid artery; Percutaneous transluminal angioplasty - carotid artery; PTA - carotid artery; Angioplasty - carotid arteryDescriptionYou have an artery on each side of your neck called the carotid artery. This artery brings needed blood to your brain and face.The blood flow in this artery can become partly or totally blocked by fatty material called plaque. A partial blockage is called carotid artery stenosis (narrowing). Blockage in your carotid artery can reduce the blood supply to your brain. A stroke can occur if your brain does not get enough blood.Sometimes the plaque may close off the artery enough to cause a stroke.Other times a blood clot may form in the artery, block the narrow part, and stop blood from reaching the brain. This type of clot is called a thrombus. It stays in one place.Other times, the clot can travel and get stuck in a smaller blood vessel in the brain. A clot that travels like this is called an embolism.There are 2 ways to treat a carotid artery that has plaque buildup in it. One is surgery called endarterectomy. The other is a procedure called angioplasty with stent placement.During carotid endarterectomy:You will probably receive general anesthesia. This will make you unconscious and unable to feel pain. Some hospitals may use local anesthesia instead. With local anesthesia, only the part of your body being worked on will be made numb with medicine so that you will not feel pain.You will lie on your back on a padded operating table with your head turned to one side. The side that will face up is the side your blocked carotid artery is on.Your surgeon will make an incision (a cut) on your neck over your carotid artery. Your surgeon will put a catheter (a flexible tube) in place. Blood will flow through the catheter around the blocked area during surgery.Then your surgeon will open your carotid artery. The surgeon will then remove the plaque inside your artery.Your artery will be closed up with stitches after the plaque is removed. Blood will now flow through the artery to your brain.Your heart and brain activity will be monitored closely during your surgery.Carotid angioplasty and stenting (CAS) is a less invasive way to repair the blockage in your carotid artery:Your surgeon will make an incision in your groin after using some numbing medicine. You will also be given medicine to relax you.Your surgeon will insert a catheter (a flexible tube) through the incision into an artery. The doctor will carefully guide the catheter up to your neck to the blockage in your carotid artery.Your surgeon will use live x-ray pictures to see your artery. This kind of x-ray is called fluoroscopy.Next your surgeon will pass a guide wire through the catheter to the blockage. Another catheter with a very small balloon on the end will be pushed over the guide wire and into the blockage. Then the balloon will be blown up. The balloon then presses against the inside wall of your artery. This opens the artery and restores proper blood flow to your brain.A stent (a wire mesh tube) may also be placed in the blocked area. The stent is inserted at the same time as the balloon catheter. It expands when the balloon is blown up. The stent is left in place to help keep the artery open. The surgeon then removes the balloon.Why the Procedure Is PerformedThere are several ways your doctor may know you have narrowing or blockage in your carotid artery. Two common ones are:You may have had symptoms of a stroke or a transient ischemic attack (TIA, also called a "mini-stroke"). Some of these symptoms are weakness, blurred vision, confusion, or slurred speech.You may not have any symptoms, but your doctor may find a problem during a physical exam. Your doctor may hear something called a bruit when using a stethoscope to listen to your blood flow. A bruit is an abnormal sound in your artery.Your doctor will need to do one or more tests to see how blocked one or both of your carotid arteries are.If you have had a stroke, your doctor will consider whether treating your blocked artery is safe for you. Your doctor will compare your risk of having another stroke if you do not have surgery with the risk of having serious problems from the surgery itself. Your doctor must consider:How bad the narrowing in your carotid arteries isWhat symptoms you haveWhat other medical problems you may haveYour ageTreatment options your doctor will discuss with you are:No treatment, other than checking your carotid artery with tests every yearMedicine and diet to lower your cholesterolTests to check your carotid artery and blood-thinning medicines to lower your risk of stroke. Some of these medicines are aspirin, clopidogrel (Plavix), and warfarin (Coumadin).Surgery to remove the buildup in your carotid arteryMost times, patients who have carotid angioplasty and stenting to treat severe narrowing of their carotid artery have this procedure because carotid endarterectomy would not be safe for them.RisksThe risks for any anesthesia are:Allergic reactions to medicinesBreathing problemsThe risks for any surgery are:BleedingInfectionRisks of carotid surgery are:Blood clots or bleeding in the brainBrain damageStroke (this is rare)Heart attackSeizures (this is rare)Swelling near your airway (the tube you breathe through)Allergic reaction to dye (only with carotid artery angioplasty)More blockage of the carotid artery over timeBefore the ProcedureYour doctor will do a thorough physical exam and several medical tests.Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.During the 2 weeks before your surgery:You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), naprosyn (Aleve, Naproxen), and other drugs like these.Ask your doctor which drugs you should still take on the day of your surgery.If you smoke, you need to stop. Ask your doctor or nurse for help quitting.Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.Do NOT drink anything after midnight the night before your surgery, including water.On the day of your surgery:Take your drugs your doctor told you to take with a small sip of water.Your doctor or nurse will tell you when to arrive at the hospital.After the ProcedureYou may have a drain in your neck that goes into your incision. It will drain fluid that builds up in the area. It will be removed within a day.After surgery, your doctor may want you to stay in the hospital overnight so that nurses can watch you for any signs of bleeding, stroke, or poor blood flow to your brain. You may be able to go home the same day if your operation is done early in the day and you are doing well.Outlook (Prognosis)Carotid artery surgery may help lower your chance of having a stroke. But you will need to make lifestyle changes to help prevent plaque buildup, blood clots, and other problems in your carotid arteries over time. You may need to change your diet and start an exercise program, if your doctor tells you exercise is safe for you.ReferencesChaturvedi S, Bruno A, Feasby T, Holloway R, Benavente O, Cohen SN, et al. Carotid endarterectomy -- an evidence-based review: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2005;65:794-801.Goldstein LB. Prevention and management of stroke. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: W.B. Saunders; 2007:chap 58.Mas JL, Chatellier G, Beyssen B, Branchereau A, Moulin T, Becquemin JP, et al. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N Engl J Med. 2006;355(16):1660-1671.Eckstein HH, Ringleb P, Allenberg JR, et al. Results of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) study to treat symptomatic stenoses at 2 years: a multinational, prospective, randomised trial. Lancet Neurol. 2008;7(10):893-902.
Bone marrow transplant?
DefinitionA bone marrow transplant delivers healthy bone marrow stem cells into the patient. It replaces bone marrow that is either not working properly or has been destroyed (ablated) by chemotherapy or radiation.Alternative NamesTransplant - bone marrow; Stem cell transplant; Hematopoietic stem cell transplant; Reduced intensity, nonmyeloablative transplant; Mini transplant; Allogenic bone marrow transplant; Autologous bone marrow transplant; Umbilical cord blood transplantDescriptionBone marrow is the soft, fatty tissue inside your bones. Stem cells are immature cells in the bone marrow that give rise to all of your blood cells. Your blood is made of:Red blood cells (which carry oxygen to your tissues)White blood cells (which fight infection)Platelets (which help your blood clot)In a bone marrow transplant, you will receive healthy stem cells after your own bone marrow has been destroyed.There are three kinds of bone marrow transplants:Autologous bone marrow transplant. "Auto" means "self." Stem cells are taken from the patient before the patient gets chemotherapy or radiation treatment. When chemotherapy or radiation is done, the patient gets their stem cells back. This is called a "rescue" transplant. It allows the patient to receive high doses of chemotherapy and radiation.Allogeneic bone marrow transplant. "Allo" means "other." Stem cells come from another person, who is called a donor. Donor stem cells come from the donor's bone marrow or their blood. Most times, a donor must have the same genetic typing as the patient, so that their blood "matches" the patient's. Special blood tests will tell whether a possible donor is a good match for the patient. A patient's brothers and sisters have the highest chance of being a good match (25% chance for each full sibling), but sometimes parents and children of the patient and other relatives may be matches. Donors who are not related to the patient may be found through national bone marrow registries.Umbilical cord blood transplant. Stem cells are taken from an umbilical cord right after delivery of an infant. The stem cells are tested, typed, counted, and frozen until they are needed for a transplant. Umbilical cord blood requires less stringent matching because the stems cells are so immature.Many patients get high doses of chemotherapy, radiation, or both, before the bone marrow transplant. This is called ablative (or myeloablative) treatment. It kills any cancer cells that might remain, and it makes room in the bone marrow for the new stem cells to grow.Today, some patients are getting less chemotherapy and radiation before their transplant. This is called a reduced intensity (nonmyeloablative) or "mini" transplant.After the patient gets chemotherapy and radiation, a doctor will do the stem cell transplant. The patient gets the stem cells through a tube called a central venous catheter. The process is similar to receiving a blood transfusion. The cells go right into the bloodstream and find their own way to the bone marrow. Usually, no surgery is required.Donors may have minor surgery to collect their bone marrow and stem cells. For a bone marrow harvest, they will be unconscious and pain-free (under general anesthesia) while their bone marrow is removed from their hip bone. In many cases however, stem cells can be collected right from the blood. The donor will first receive injections for a few days.When receiving stem cells, a patient may have these symptoms:PainChillsFeverHivesChest painDrop in blood pressureShortness of breathNauseaFlushingHeadacheFunny taste in the mouthWhy the Procedure Is PerformedBone marrow or stem cell transplant may be recommended for:Certain cancers, such as leukemia, lymphoma, and multiple myelomaIllnesses where the bone marrow does not produce the right kind of or enough cells. Some of these are: Sickle cell anemiaAplastic anemiaThalassemiaCongenital neutropeniaSevere immunodeficiency syndromesRescue transplant to replace bone marrow, when treatment for cancer has destroyed a patient's bone marrowRisksAll bone marrow transplants have risks. The risk is higher or lower depending on many factors. Some of these factors are:What disease you haveWhat type of treatment (chemotherapy, radiation) you have before the bone marrow transplantHow old you areHow healthy you are when you have your transplantHow good a match your donor isWhat type of bone marrow transplant patient you are having (autologous, allogeneic, or umbilical cord blood)Complications you may have are:Infections: These may be very serious.Bleeding: This can happen in the lungs, the intestines, brain, and any other part of the body.AnemiaDiarrhea, nausea, and vomitingPainSevere mucositis (inflammation and soreness) in the mouth, throat, esophagus, and stomachDamage to the kidneys, liver, lungs, and heartCataractsEarly menopauseGraft failure, which means that the new cells do not settle into the body and start producing stem cellsGraft-versus-host disease: This is when your donor's cells attack your own body. In the first few months after the transplant, symptoms may be a skin rash, diarrhea, or abnormal liver tests. Later, symptoms may be dry eyes or mouth, tightness of the skin, scarring in the lungs, chronic diarrhea, and other problems.Children who get transplants may have delayed growth.Before the ProcedureYour health care provider will ask you about your health record and do a physical exam. You will also have many tests before your treatment begins.Your doctor or nurse should discuss the emotional stress of having a bone marrow transplant. You may want to meet with a mental health counselor talk. Talking with your family and children to help them understand and prepare is important.You will need to make plans for when you have the transplant. Items to consider are:Household choresCare of petsPayment of billsBank or financial statementsSchedules and care for your childrenInsurance coverageArranging medical leave from workAdvanced care directivesYou may need to find housing for yourself or your family near the hospital.Before the transplant, one or two catheters are inserted into larger blood vessels, usually in the neck, for you to receive treatments, fluids, and sometimes nutrition.After the ProcedureBone marrow transplant patients usually go to medical centers, or hospitals, that specialize in this treatment. Most times the patient will stay in a bone marrow transplant unit in the center to limit their chance of getting an infection.Some patients who get autologous or non-myeloablative allogeneic transplants do not have to stay in the hospital or medical center. They can get the transplant as an outpatient.Some patients may have part of their autologous or allogeneic transplant done as an outpatient.Most patients will be in the hospital for 4 to 6 weeks. During this time, you will be isolated and watched closely because of the increased risk of infection.While you are in the hospital, these things may happen:Close monitoring of your blood and vital signsYou may have to take antibiotics, antifungal medications, and antivrial medications to prevent or treat infection.You may need many blood transfusions.You may have to stay in a room where special things are done to prevent infection.You may get calories and proteins through an intravenous (IV) line until you can eat on your own, and until your diarrhea, nausea, or mouth sores have cleared up.You may have to take medicine to prevent graft-versus-host disease.Outlook (Prognosis)How well you do after transplant greatly depends on these things:What type of bone marrow transplant you hadHow well your donor's cells match yoursWhat type of cancer or illness you haveYour age and overall healthWhat type of chemotherapy or radiation therapy you had before your transplantWhat kind of complications happened after the transplantYour genetic make-upPossible results of a bone marrow transplant are complete cure of the illness being treated, a partial cure, or death. Death may be caused by complications of the bone marrow transplant or because the transplant did not work to treat the illness.If the transplant works, you can go back to most of your normal activities as soon as you feel well enough. Most times it takes up to 12 months to recover fully.ReferencesBishop MR, Pavletic SZ. Hematopoietic stem cell transplantation. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 32.Vose JM, Pavletic SZ. Hematopoietic stem cell transplantation. In: Goldman L, Ausiello D. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 184.
