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Complete response rates for intermediate grade Non-Hodgkin’s Lymphoma in other trials have ranged from 44% to medicine man dispensary buy 50mcg thyroxine fast delivery 61% (50) medicine 8 letters generic thyroxine 50mcg amex. Younger patients who relapse after a complete response are likely to medicine engineering proven 50mcg thyroxine be considered for high dose chemotherapy and bone marrow transplant symptoms melanoma cheap 200mcg thyroxine. This data could not be identified and it was therefore decided to split the tree by age at this point. A multi-institutional study of bone marrow transplant in patients with relapsed intermediate grade non-Hodgkin’s lymphoma, addressing the role of radiotherapy has been reported. This study randomised patients to high dose treatment after a response to second line conventional chemotherapy. Radiotherapy was recommended in both arms of the study to sites of bulky disease >5cm or T3/T4 extranodal disease (30%). The addition of radiotherapy reduced the incidence of local recurrence observed in both the transplant and non-transplant arm (34). Relapse at the primary site was recorded in 50% of patients treated with chemotherapy alone compared to 26% when radiotherapy was also delivered. From this information radiotherapy should be considered to initial sites of disease in patients who relapse with these indications. Intermediate grade lymphoma, treatment for relapse after a complete response, > 70 years: Forty-four percent of patients >70 years subsequently relapsed (28). Treatment at this time will be individualised depending on the ability of the patient to tolerate further chemotherapy. Greil has published a review article on management strategies of lymphatic neoplasms in the elderly (51). Although initial curative treatment is warranted he identified that a significant proportion of elderly patients received reduced dose chemotherapy and were unable to adequately tolerate treatment. Their chance of receiving adequate treatment with chemotherapy alone on relapse is unlikely. These patients should be considered for palliative radiotherapy in the presence of bulky disease. Both a population based study and a multiinstitutional report identify similar proportions of elderly and young patients presenting with bulk disease. It was therefore concluded that a similar proportion of elderly patients would relapse with bulky disease as the younger trial group (34). This proportion (30%) was included in the analysis to distinguish a proportion of patients who should receive radiotherapy. Intermediate grade lymphoma, incomplete response to chemotherapy, > 70 years: In a population-based study 59% of patients who did not obtain a complete response to first line chemotherapy were under the age of 70 years (28). Guidelines would recommend radiotherapy to either initial sites of bulky disease or residual masses. Radiotherapy can also be considered on disease progression, with further chemotherapy more dependent on the patient’s initial tolerance to treatment. High Grade Lymphoma: this subgroup includes Burkitt’s Lymphoma (74%) and Lymphoblastic Lymphoma (26%). Guidelines recommend that they should be treated on leukaemic protocols, which include prophylactic cranial irradiation. For unfit patients, palliative radiotherapy to symptomatic lesions is recommended. Optimal Radiotherapy Utilisation Rate and Sensitivity Analysis the proportion of lymphoma patients in whom at least one course of radiotherapy is indicated is 65%, based on guideline recommendations. There are several data elements where there was uncertainty because of different proportions reported in the literature. To assess the impact that these uncertainties have on the overall estimate of the need for radiotherapy in all lymphoma patients, a oneway sensitivity analysis was performed for each of the variables and the impact that these variables have on the overall results is illustrated by a tornado diagram. The graph shows that the proportion of lymphoma patients that should receive radiotherapy based on evidence and incidence of attributes for radiotherapy was 65-66%. As lymphoma represents 4% of all reported malignancies, the proportion of lymphoma patients where radiotherapy is indicated represents 2. Mucosa-associated lymphoid tissue lymphoma is a disseminated disease in one-third of 158 patients analysed. Eradication of Helicobacter pylori and stability of emissions in low-grade gastric B-cell lymphomas of the mucosa-associated lymphoid tissue: results of an ongoing multicenter trial. Cure of Helicobacter pylori infection and duration of remission of low-grade gastric mucosaassociated lymphoid tissue lymphoma. Prognosis of follicular lymphoma: a predictive model based on a retrospective analysis of 987 cases. Prolonged single agent versus combination chemotherapy in indolent follicular lymphomas:a study of the cancer and leukaemia group B. Patterns of survival in patients with recurrent follicular lymphoma: a 20-year study from a single centre. Survival after progression in patients with follicular lymphoma: analysis of prognostic factors. A Revised European-American Classification of Lymphoid neoplasms: A proposal from the International Lymphoma Study Group. Effects of cranial radiation in children with high risk T cell acute Lymphoblastic leukemia: a Pediatric Oncology Group report. Th e incidence ofattributes used to define indications forradioth erapy K ey Populationor A ttribute Proportionof Q uality of R eferences N otes subpopulationof populationwith information interest th is attribute A A llC ancers L eukaemia 0. Incidence of Leukaemia: Leukaemia accounts for 3% of all new cancers reported in Australia according to the 1998 Australian Institute of Health Welfare statistics 1998(6). The treatment of leukaemia differs between the paediatric age group (defined here as patients < 15 years) and the adult age group 3. Concerns about potential late effects of cranial irradiation prompted a reappraisal of its role in childhood. Over the past decade, prophylactic cranial irradiation has been replaced by intrathecal chemotherapy (15;28) except for patients classified as ‘high risk’. This definition varies amongst different groups usually including the presence of one of the following criteria: inadequate cytoreductive response, >1000/ul leukaemic cells in the peripheral blood on day 8, incomplete response within 1 month, translocation t (9;22) or t (4;11) and age(10;12;29). Children are usually treated on National/International protocols or clinical trials. Thus information available on prognostic factors is available from multicentre trials rather than population databases but they probably reflect population distributions better than clinical trials in solid tumours. Approximately 12% of children are classified as high risk, which is similar among studies even allowing for the slight variation in the definition between groups (10;11). Proportion of low risk patients who relapse: this proportion was identified from several of the large multicentre trials that treated low risk patients without cranial radiotherapy. These patients should receive radiotherapy as part of their further treatment in combination with aggressive systemic therapy (31;32). Although a proportion of patients will be treated with cranial irradiation it is difficult to identify which patients. Different trials either used cranial or intrathecal therapy exclusively rather than identifying risk groups. Hoelzer et al has produced tables including some of the more recent publication from multiinstitutional groups. Guidelines recommend reinduction chemotherapy followed by allogeneic bone marrow transplant if a suitable donor is identified. The majority of patients are elderly with 69% of patients presenting over the age of 55 years(17). Acute Myeloid Leukaemia, <15 years: Although there is a higher rate of central nervous disease at presentation treatment is with systemic and intrathecal chemotherapy. A recently published study from the Australian And New Zealand Children’s Cancer Study Group treated all patients with intrathecal methotrexate, even in the presence of craniospinal disease. All were considered for bone marrow transplant after remission-induction therapy, using a conditioning regimen of busulphan and cyclophosphamide (35). Acute Myeloid Leukaemia, > 15 years, risk group and response to initial treatment: Initial treatment is with chemotherapy using a combination of an anthracycline and cytarabine. We have stratified the patients by risk to identify a high/intermediate risk group who should be considered for early bone marrow transplant.

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Stone analysis revealed a 8 composition of 20% weddellite (calcium oxalate dehydrate) and 80% apatite (calcium phosphate) symptoms zithromax 100 mcg thyroxine overnight delivery. Three months 10 later the guinea pig was doing very well and diagnostic imaging revealed no abnormalities or new 11 stone formation in the bile duct treatment bronchitis purchase thyroxine 50 mcg otc. This is the first reported case of naturally occurring cholelithiasis in a 12 guinea pig medications peripheral neuropathy cheap thyroxine 100 mcg free shipping. The owner reported unusual behaviors such 19 as repeated turning of the head to medicine 93832 buy 75 mcg thyroxine the left side of the abdomen, sitting in the same spot, occasionally 20 falling or lying on the side, and intermittent vocalization. Diet included hay 24 (different dried grasses and herbs) ad libitum, fresh vegetables (lettuce, cucumber, fennel, sweet 25 pepper, various fresh herbs) offered daily, and a small amount of a commercial guinea pig diet of 26 mixed grains once weekly. During the summer the owner 27 additionally offered common dandelion (Taraxacum officinale). Branches of the Norway spruce 28 (Picea abies) or apple tree (genus Malus) were provided throughout the year for enrichment. Although the 32 owner reported increased respiratory effort, this was not noted at the time of examination and 33 auscultation of heart and lungs was unremarkable. Upon palpation, the caudal borders of the stomach were not detected, and large ingesta35 filled intestinal loops were present. Due to moderate signs of discomfort (vocalization and defensive 36 movements), a more complete palpation of the abdomen was not performed. Blood analysis 37 including chemistry and hematology revealed no clinically significant abnormalities. Radiographic diagnoses 41 included cholelithiasis, hepatomegaly, and abdominal effusion. Abdominal ultrasound was 42 recommended for further evaluation, including localization and characterization of the mineralized 43 foreign body. The liver appeared slightly enlarged with slightly 47 rounded margins, but showed normal architecture and intrahepatic bile ducts. The gallbladder was 48 moderately filled with bile of mildly increased echogenicity. An ovoid, somewhat irregular, strongly 49 echogenic structure with distal acoustic shadowing was lodged in the neck of the gallbladder. Small 50 mucosal proliferations reduced the luminal definition of the gallbladder wall. Ultrasonographic diagnosis was cholelithiasis, cholecystitis, 52 hepatomegaly and mild abdominal effusion. The guinea pig was then premedicated with ketamine, 20mg/kg, 64 subcutaneously (Ketanarkon 100, Streuli Pharma, Uznach, Switzerland) and medetomidine, 65 0. An intravenous catheter was placed in the right 68 cephalic vein and crystalloids were given at a rate of 10ml/kg/h. During anesthesia, the heart rate 69 was monitored via auscultation and the respiratory rate via observing of chest movement. The gall bladder appeared visually normal without any signs of 73 inflammation; however the mineralized mass was palpable (Fig. The common bile duct did not 74 appear distended and the bile was readily expressed through the bile duct. After expression, the gall 75 bladder was bluntly dissected free from the liver using sterile cotton tipped swabs. The cystic duct 76 and the cystic artery were double ligated using nonabsorbable monofilament suture material 77 (Prolene 3/0, Ethicon, Johnson & Johnson, Schaffhausen, Switzerland) and the gall bladder was 78 resected. The cholelith 87 was submitted for stone analysis, and gall bladder for histopathology. Histologic examination of the gall bladder revealed 93 mild edema of the lamina propria mucosa. Ultrasound of the liver showed a normal size, shape, and architecture with 98 normalization of the previously mentioned changes. The guinea pig has been used extensively as a research model, and cholelithiasis is 1-8 104 triggered by high-cholesterol diets and biliary stricture. In humans, cholelithiasis can cause visceral pain, but in some 9, 10 107 cases clinical symptoms can also be absent. In this patient periodic obstruction of the cystic duct 108 may have produced intermittent pain. Because there is no information in the literature about the 109 clinical occurrence of gallstones in pet guinea pigs, it is not known how many might have choleliths 110 without apparent clinical signs. In the studies on experimentally induced choleliths in guinea pigs, 1-8 111 clinical signs suggesting pain were not reported. During the subsequent 3 months after 114 cholecystectomy no further episodes were observed and the general condition of the patient was 115 excellent. The sonographic examination helped confirm 118 cholelithiasis and visualized the stone in the gallbladder neck. Abdominal effusion could be a sequela to inflammation of the gall 120 bladder, although histologic examination of the gall bladder did not confirm cholecystitis. Guinea pigs on a cholesterol122 supplemented diet not only developed hypercholesterinemia and fatty infiltration of the liver, but 1, 6 123 also mild anemia, which were not observed in this patient. The guinea pig had a slight 124 hepatomegaly, which could possibly represent a fatty infiltration or storage disease. Since 125 hepatomegaly was not evident 3 months after treatment, it is possible it was caused by an ascending 126 hepatitis or biliary stasis induced by the gallstone. Bacterial culture of the excised gall bladder was 127 not performed; however, the guinea pig improved rapidly after surgery without antibiotic treatment. Apatite gallstones were found in 3 hamsters, but the exact chemical constitution of the 11 131 apatite was not determined. Hydroxyand carbonate-apatite are the two most common biological 12 132 forms of apatite. In guinea pigs with 136 intermittent gastrointestinal symptoms, anorexia or reduced appetite and cranial abdominal pain, 137 cholelithiasis should be considered as a differential diagnosis. This case demonstrated that surgical 138 removal was feasible, well tolerated, and appeared to benefit the patient. Okey R: Gallstone formation and intake of B vitamins in cholesterol-fed guinea pig. Bielefeldt K: Black bile of melancholy or gallstones of biliary colics: historical perspectives on 162 cholelithiasis. Note a small, irregular, ovoid, mineral opaque structure in the area of the gallbladder 175 (black arrow). Mild, patchy loss of serosal detail reduced the definition of the mildly rounded 176 caudoventral liver margin. A small 180 amount of free fluid accumulated around the gallbladder and the liver margins (white arrow heads). An ovoid, strongly echogenic structure with distal acoustic shadowing was present in the neck 183 of the gallbladder (large white arrow). Note the 187 dark, round structure, which represents the cholelith within the gallbladder. Cholecystitis is inflammation of the gallbladder, a small organ near the liver that plays a part in digesting food. Normally, fluid called bile passes out of the gallbladder on its way to the small intestine. If the flow of bile is blocked, it builds up inside the gallbladder, causing swelling, pain, and possible infection. A gallstone stuck in the cystic duct, a tube that carries bile from the gallbladder, is most often the cause of sudden (acute) cholecystitis. Infection or trauma, such as an injury from a car accident, can also cause cholecystitis. Acute acalculous cholecystitis, though rare, is most often seen in critically ill people in hospital intensive care units. It occurs when the gallbladder remains swollen over time, causing the walls of the gallbladder to become thick and hard. The most common symptom of cholecystitis is pain in your upper right abdomen that can sometimes move around to your back or right shoulder blade. You may have blood drawn and an ultrasound, a test that uses sound waves to create a picture of your gallbladder.

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The individual chapter titles correspond to medicine 93 5298 buy cheap thyroxine 75 mcg on line the major headings of standard reports treatment by lanshin buy thyroxine 75mcg low price, such as “Behavioral Observations symptoms vaginal yeast infection cheap thyroxine 100 mcg otc,” “Mental Status symptoms uric acid cheap 50mcg thyroxine mastercard,” or “Diagnostic Summary. Paging through the major numbered sections within each chapter will remind you to address each relevant area in your report. If you need to do a very comprehensive evaluation, you can use all the numbered headings within each chapter as a checklist to make certain you haven’t overlooked any important point. You can turn to a specifc chapter and its numbered sections to focus on a particular topic for writing a more fne-grained description. As you use the Clinician’s Thesaurus, you may fnd it worthwhile to highlight in color, underline, or box the words or phrases that best suit your writing style and are most relevant to your practice and Getting Oriented to the Clinician’s Thesaurus 17 setting. You may fnd it practical to use the black thumb tabs on the edge of each page to access sections of the book more quickly. When you Teach As a teacher, you simply cannot offer your students more than a fraction of the behaviors a clinician must understand. When you focus on a few diagnoses or processes, students may miss the breadth they will need. If you discuss theory, your students may miss the concrete; if you offer cases, they may learn only a few examples and not the larger picture of the disorder. This book provides another option: All the aspects of each syndrome and pattern are in the Clinician’s Thesaurus. When students need to interview, the questions here will enable them to follow up (almost) any referral question. They and you can concentrate on the higher-level functions—weighing, winnowing, and integrating—not on reinventing the standard language. Students love this book because it both reduces their anxiety and makes them more competent. When they see that (almost) everything they will need is in this one book, they breathe a sigh of relief. The book does not replace their clinical education, but it does assist the process. It is equivalent to giving a calculator to a math student: the student can concentrate on the nature of the problem, not the details of the calculation. When you Supervise Less skilled professionals or students may sometimes fail to think deeply or may write glib reports. The usual supervisor’s response to this situation is to interview the students, trying to pull from them observations of the patients that they probably never made because they lacked the terms for labeling the phenomena of interest. When you supervise, try this instead: Refer such students to the appropriate sections of the Clinician’s Thesaurus and ask them to fnd, say, three or more words to describe the cognitive aspects of a patient’s depression. Not only does this make the supervision problem into a game instead of a contest over who is smarter, but also it puts the burden of discrimination on the students, where it belongs. Moreover, this process of weighing the alternatives trains a kind of clinical judgment that I fnd almost impossible to teach in other ways. It does not write reports for anyone; students still have to learn the words’ meanings and evaluate their appropriateness for each client. A Cautionary Note and Disclaimer the entries of this book are presented simply as sample questions and lists of terms that have been used in the feld. These wordings are offered without any warranty, implied or explicit, that they constitute the only or the best way to practice as a professional or clinician. When individuals use any of the words, phrases, descriptors, sentences, or procedures described in this book, they must assume the full responsibility for all the consequences—clinical, legal, ethical, and fnancial. The author and publisher cannot, do not, and will not assume any responsibility for the use or implementation of the book’s contents in practice or with any person, patient, client, or 18 Getting Oriented to the Clinician’s Thesaurus student. The author and publisher shall not be liable in the event of incidental or consequential damages in connection with or arising out of any use by purchasers or users of the materials in this book. By employing this book, users signify their acceptance of the limits of the work and their acceptance of complete personal responsibility for all such uses. The author and publisher presume (1) that the users of this book are qualifed by education and/or training to employ it ethically and legally, and (2) that users will not exceed the limits of documentable competence in their disciplines as indicated by their codes of ethical practice. If more than the material presented here is needed to manage a case in any regard, readers are directed to engage the services of a competent professional consultant. Questions about Signs, Symptoms, 44 and Other Behavior Patterns 1 Beginning and Ending the Interview 1. Structuring the Interview There are dozens of specialized interview methods (see Hersen & Turner, 2003) and numerous structured interviews, which should be used to increase reliability and validity over more openended approaches. The format below addresses some points crucial to beginning all interviews, whether structured or unstructured. Because a client may not understand a question’s goal, or the answer may not be as informative as you hoped, Chapters 2 (“Mental Status Evaluation Questions/Tasks”) and 3 (“Questions about Signs, Symptoms, and Behavior Patterns”) offer multiple questions under each topic so that you can ask a second or third question. Introducing yourself and Noting Possible Communication Diffculties When you are interviewing clients for treatment, bear in mind that “When clients present for an evaluation, they are often in a great deal of emotional pain. They are often demoralized and hopeless because their efforts to address their problems have failed or had only limited impact. They can beneft by simply having an opportunity to share their story [sic] with a compassionate and attentive listener” (Segal & Hutchings, 2007, p. Make eye contact and introduce yourself to each client as follows: “Hello, I’m [Title] [Name]. If the area is crowded, you can announce your name and ask, “Who is here to see me at this timefi Ask about any need for glasses/contact lenses or hearing aids if not worn, and comment in your report on the effects on the client’s performance. Ask the client for suggestions to improve conditions, such as minimizing the background noise or changing the lighting. When you are interviewing hearing-impaired clients or users of American Sign Language (who call themselves deaf), it is legally required by the Americans with Disabilities Act of 1980 (amended in 1990 and 2008), as well as clinically preferable, to obtain the services of a certifed interpreter. Hearing impairment: Total/partial deafness in left/right/both ears, necessitating hearing aids/ lip reading/signing/total communication/American Sign Language; understands amplifed/ simplifed/repeated conversational speech. Limitations of movement (especially hands if you are doing testing) and ability to sit for periods of time. Use of or need for an interpreter (in the case of a client with either a hearing impairment or an English-language diffculty). Literacy: Able/unable to read aloud/understand/rephrase a paragraph from a newspaper or common magazine, national news magazine; look up a location on a map; fll out a job application; understand the instructions for a prescribed medication; follow a recipe; etc. However, because illiteracy is socially negative, few clients will acknowledge it when asked. Administering an instrument called the Rapid Estimate of Adult Literacy in Medicine (Davis et al. Low literacy and its resulting misunderstanding and low compliance should not be mistaken for resistance or low intelligence. Lastly, consider all the known variables that affect interpersonal communication, such as age, gender, ethnic, socioeconomic, and “racial” differences; language use and style of communication; the demand characteristics of the interview situation; the unstated expectations of each person about the nature and purposes of the interview; and others for your particular situation. Assessing the Client’s Understanding of the Interview Situation Ask early, especially if the client seems reluctant to raise the subject: “What have you been told about this interview/our meetingfi Attend to the client’s and examiner’s perceived expectations of the referring agent; what information is to be gathered, by what means; what is then to be done; and, if a report is written or made, who will see it. As you explain each relevant aspect, ask the client: “Would that be all right with youfi I usually use statements such as “Consider what will be in your long-term best interests” or “If you have any reservations let us discuss them before we proceed any further. Of course, issues may arise as you proceed, in which case you might say something like “You can stop me at any time during our interview if you don’t understand me or need to question what I am asking you to do. When the assessment’s purpose is to help the client qualify for some special educational service, get hired, or receive fnancial support, make it clear that your fndings and report may not support this goal—and that even when they do, the fnal decision will be made by the relevant agency, not by you. On a more positive note, you can explain that even if the goal is not achieved, the results may provide useful information to the client about further activities or interventions. Lastly, explain and have the client sign an authorization to release records for the evaluation. It may incorporate the points made above with a statement such as this: “I fully understand that no specifc outcomes can be guaranteed as a result of this evaluation.

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A1726 P1187 Exploring Health Care Providers’ Practice Gaps in Prescribing P1176 Are Patients and Physicians on the Same Pagefi P1178 Exacerbations and Healthcare Resource Utilization in Patients Sansores-Martinez symptoms 1 week after conception generic 25 mcg thyroxine overnight delivery, O medicine reminder app cheap thyroxine 75mcg line. A1730 P1192 Map the Gap: Using Regional Mapping to medicine for anxiety discount thyroxine 25 mcg visa Compare P1180 Integrating Respiratory Services Reduces the Need for Hospital Pulmonologists Workforce to treatment yersinia pestis generic thyroxine 50mcg fast delivery Chronic Obstructive Pulmonary Admissions and Improves Patient Care/M. A1746 the information contained in this program is up to date as of March 9, 2017. A1749 P1212 Occupational and Biomass Risk Factors for Emphysema in Middle-Aged and Elderly Never-Smokers Without Chronic P1200 Radiological Features of Structural Basis Where Cancer Airflow Limitation/W. Sin, Vancouver, P1201 Lung Cancer Resection and Postoperative Outcome in Canada, p. A1762 Patients with Mild to Moderate Chronic Obstructive Pulmonary P1213 Prevalence and Determinants of Chronic Obstructive Disease/E. Discussion: 11:15-12:00: authors will be present for individual discussion Shishido, A. A1767 the information contained in this program is up to date as of March 9, 2017. A1782 P519 Is Impairment Similar Between Arm and Leg Muscle Thickness P532 the Effect of Acute Illness on the Course of Chronic Disease: and Echointensity in Critically Ill Traumatic Brain Injury the Example of Multiple Sclerosis/A. A1770 P533 Relationship Between Age and Functional Impairment in a Critical Care Recovery Center/C. A7574 P522 Implementation of an Early Mobility Algorithm in a Neurosurgical Intensive Care Unit/K. A1773 Rehabilitation on Ventilator Weaning and Discharge Status in Survivors of Critical Illness/S. A7575 Intensive Care Lung Rescue Unit: Our Experience at the University of Maryland Medical Center/K. A1776 Area E, Hall B-C (Middle Building, Lower Level) Viewing: Posters will be on display for entire session. A1778 P538 Predictors of Bacteremia from the Complete Blood Count in Patients in the Intensive Care Unit/N. A1779 the information contained in this program is up to date as of March 9, 2017. A1789 P555 A Pilot Study of Cortical Oxygenation in Septic Shock by Time-Resolved Near-Infrared Spectroscopy/C. A1804 P543 Characteristics, Management and Outcomes of Patients with Invasive Candidiasis: A Prospective Cohort Study in Two P557 Red Blood Cell Adenosine Triphosphate Concentrations Are Tertiary-Care Intensive Care Units/H. A1805 P544 Admission Rate and Outcome of Patients with Major P558 the Association of Mean Platelet Volume and Red Cell Psychiatric Disorders in the Intensive Care Unit/D. A1794 P560 Respiratory Quotient and Arterial-Venous Oxygen Content Difference Are Poorly Correlated with Arterial Lactate in Septic P547 Sepsis Management: the Association of Antibiotics Prior to Shock Patients/A. A1795 P561 Dysnatremia Is Associated with Increasing Mortality in the P548 Extended Spectrum Beta-Lactamase Infection: Determining Critically Ill Patients: A Systematic Review and Meta-Analysis/ Risk Factors for Mortality/J. A1798 P564 Risk Factors for Early Mortality in an Academic Intensive Care P551 A Novel Fluid Resuscitation Protocol for the Treatment of Unit/C. A1814 P552 Impact of Early Aggressive Volume Resuscitation in Septic Patients Admitted to a Hospital Ward/T. A1815 P553 Normal Saline Vs Normosol in the Resuscitation of Septic Patients: A Retrospective Cohort Study/R. A1801 the information contained in this program is up to date as of March 9, 2017. P570 the Epidemiology of Psychiatric Illness in Survivors of Critical Mauriello, M. A1827 Illness in Korea A National Health Insurance Database Study, 2009 2014/C. A1820 P1286 Candida Glabrata Empyema Secondary to Massive Esophageal P573 Immune Status and SeMo Score Predict Outcomes in Patients Perforation/M. A1833 P575 Predicting 24-Hour Mortality After Inter-Hospital Transfer to a Tertiary Medical Intensive Care Unit: A Single-Center Facilitators: S. A1837 Discussion: 11:15-12:00: authors will be present for individual discussion P1293 A Rare Case of Adult Community-Acquired Escherichia Coli 12:00-1:00: authors will be present for discussion with assigned facilitators Meningitis as a Complication of Bacteremia and Urinary Tract Infection/S. A1839 the information contained in this program is up to date as of March 9, 2017. A1840 Necrotizing Fasciitis Due to Actinomycosis in a Sickle Cell Disease Patient/P. A1843 P1314 Marked Metabolic Acidosis Secondary to Proteus Urine Infection in an Indiana Pouch/S. A1860 P1300 Group A Streptococcus Bacteremia from Acute Pharyngitis: A P1316 Atypical Complications of an Unexpected Case of Lemierre’s Rare Source/S. A1861 P1301 Septic Shock and Shock Gut from Streptococcus pyogenes P1317 Uncommon Cause of Respiratory Failure in Oklahoma/H. A1862 Pulmonary Embolism in the Setting of Septic Shock, Septic P1318 Pneumocephalus Secondary to Spontaneous Dissemination of Arthritis, Bacterial Endocarditis, and Methicillin Sensitive Clostridium Septicum/J. A1864 P1304 Back Pain in an Immunocompetent Patient: An Unusual Case of Mediastinitis/S. A1865 P1305 A Case of Edwardsiella Bacteremia and Septic Shock: A Fatal Food Borne Infection/M. A1866 P1306 Disseminated Nocardia Cyriacigeorgica Associated with P1322 A Fatal Case of Necrotizing Fasciitis/N. A1851 P1323 Diffuse Ischemic Limb Gangrene with Palpable Pulses in a P1307 Vertebral Perforation and Osteomyelitis from Abandoned Lead Patient with Septic Shock/D. A1852 P1324 Sepsis Precipitating Valproic Acid Induced P1308 A 38-Year-Old Man with Duodenal Perforation and Sepsis: An Thrombocytopenia/S. A1870 P1309 Case Report of Extensive Air Pockets Surrounding Liver P1326 Munchausen’s Syndrome Masquerading as Septic Shock/P. A1854 P1327 Too Hot to Handle: 10 Month Old Presenting with Fever of 45 P1310 Purpura Fulminans Resulting from Pasteurella Multocoda Degrees Celsius/R. A1872 the information contained in this program is up to date as of March 9, 2017. A1885 Discussion: 11:15-12:00: authors will be present for individual discussion P590 Descriptive Study of Factors Associated with Self Extubations 12:00-1:00: authors will be present for discussion with assigned facilitators in a Diverse Population/B. A1888 During Single Liquid Swallows After Oral Endotracheal P593 Parallel Pilot Screening Frequency Trials in Elderly and Intubation/M. P582 Diaphragm Ultrasound as a Predictor of Liberation from Prolonged Mechanical Ventilation/M. A1878 12:00-1:00: authors will be present for discussion with assigned facilitators P583 Respiratory Rate Variation as a Predictive Tool for Successful Facilitators: J. Demoule, Montreal, Canada, P596 Higher Expiratory End-Tidal Oxygen Correlates with Worse p. A1881 P597 Outcomes Reported in Studies on Mechanical Ventilation in Pregnant and Postpartum Patients: A Systematic Review/J. A1892 the information contained in this program is up to date as of March 9, 2017. A1899 P600 Health Care Costs and Outcomes for Patients Undergoing P610 Grading Severity of Diastolic Dysfunction in Sepsis Using Old, Tracheostomy in an Australian Tertiary Level Referral New, and Simplified Definitions/M. Surgical P612 Performance of the Respiratory Shock Index, a New Derived Medicare Patients/S. A1896 P614 the Evolving Definition of Septic Shock: A Focus on the New Centers for Medicare and Medicaid Services Sepsis Core P603 Effects of Refractory Hypoxemia Protocol in Timing of Proning Measure Definition/J. A1897 P615 Diagnosis by Coin Flip the Chasm Between the Diagnosis of P604 Acute Respiratory Distress Syndrome In Patients With Severe Sespis or Septic Shock by Medical Coders Vs. A1905 P605 Spontaneous Breathing and Hospital Mortality in Early Acute P616 Identifying Poor Outcomes in Elderly Patients with Sepsis/N. A1912 the information contained in this program is up to date as of March 9, 2017.

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