Acute Pulmonary Embolism A Summary and Evaluation free essay sample

The pulmonary embolism—blockage of pulmonary arteries form blood clots (emboli) that usually originates within the veins of the legs (or deep vein thrombosis) and are usually symptomless yet deadly.   In acute pulmonary embolism, the obstruction of the arteries is undoubtedly the most important cause of compromised physiology, in which patients often have chest pain, either sudden in onset or evolving over a period of days and weeks. Venous thromboembolism, or the formation and split up of blood clots in venous valves, is a worldwide problem, particularly in people with known risk factors.   In the US alone, as many as 300,000 people die from acute pulmonary embolism, while it is less common in Asian region.   About 79% of patients who present pulmonary embolism have evidence of deep venous thrombosis in their legs and conversely, pulmonary embolism occurs in up to 50% of patients with proximal deep venous thrombosis in their legs (Tapson, 2008, 1037). Risk for pulmonary embolism may range from acquired factors and those inherent genetic predispositions. We will write a custom essay sample on Acute Pulmonary Embolism: A Summary and Evaluation or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Patients who have had total hip and knee surgery and surgery for cancer are at high risk, as do patients who had trauma and spinal cord injury.   While hospitalized patients are particularly at high risk, some symptoms do not appear until after their discharge. Reduced mobility and sedentary lifestyle, notably occupations involving sitting for long periods of time, also confers increased risk, though the extent of development of the disease remains unclear.   Persons who are subjected to extended air or ground travel also have an increase risk of thromboembolism.   Aging, notably persons over the age of 40 years is considered a risk factor.   Pregnant women or those in after birth (postpartum) period and women receiving hormonal therapy are all at risk for venous thromboembolism. Genetic conditions, such as deficiencies in protein C, protein S, and antithrombin substantially increase the risk of thrombosis and thromboembolic events.   Factor V Leiden, which causes activated protein C resistance, is the most common genetic risk factor for thrombophilia (Tapson, 2008, p. 1039).   In patients with conditions such as cancer and the thrompophilias, acquired risk and genetic predisposition may overlap. Diagnosing a patient can be done through clinical test; enzyme-linked immunosorbent assay (ELISA)-based d-dimer tests are found to be effective tool in diagnosis (96% to 98% correct) of the disease (Tapson, 2008, p. 1040).   The test result is best considered together with clinical probability and is helpful in assessing the likelihood that a patient has acute pulmonary embolism. Also, electrocardiogram abnormalities, including unexplained tachycardia, are common in pulmonary embolism but are not definitvive characteristic. Aside from clinical tests, medical imaging has been used in diagnosing acute pulmonary embolism, those include, magnetic resonance imaging (MRI), contrast-enhanced computed tomographic (CT) arteriography, ventilation-perfusion scanning, and standard pulmonary arteriography. CT arteriography has the greatest sensitivity and specificity for detecting emboli in the main, lobar, or segmented arteries (Tapson, 2008, p. 1041). Treatment of patients diagnosed can be done through anticoagulation procedure; using blood thinners (like low-molecular-weight heparin) as the anticoagulant agent.   The adequate use of blood thinners for patients with acute pulmonary embolism have been proven effective in treating the disease in various clinical settings. Use of an optional inferior vena caval filter (IVCF) also offers the potential for removal of clots when risk factors are believed to be temporarily. The use of filter replacement may be considered in patient with massive spread of blood clots and prevent its spread but this indication has not been studied in prospective, randomized clinical trials. While the mortality rate for untreated pulmonary embolism is relatively high, immediate diagnosis and treatment of the disease have been shown to reduce the risk of death. Prompt testing for patients suspected to have pulmonary embolism is deemed important step and assessment of risk factors and clinical probability goes together in the process. Also, preventive measures were also important for patients that have high risk of developing the disease, such as patients who have undergone surgery of the hip and knee, and also those that have trauma and spinal cord injury. Evaluation The article, entitled â€Å"Acute Pulmonary Embolism† by V. F. Tapson, M.D. discussed a thorough medical review of the disease. A detailed discussion of the epidemiology, pathophysiology, diagnostics, treatment and preventions was stated in the article making it good literature for the disease itself. Throughout the article, pulmonary embolism and deep vein thrombosis (and thromboembolism) was referred to, as the latter occurs most of the time before the onset of pulmonary embolism.   It has been stated in the article that both may occur at the same time in patients with high risk of developing the disease, thus diagnostic and treatment procedures were mentioned in managing them. The published literature—a review article in nature, mainly focused on results of clinical trials and other published journals. Though it was stated there medical diagnostics and procedures, it was not clearly mentioned which of it were the advancement in those procedures and which would need further studies. In general, it was able to present details of the disease, making a clear note in the vitality of making correct diagnostics and immediate treatments for reducing mortality among patients. Reference Tapson, V. F. (2008) Acute Pulmonary Embolism. The New England Journal of Medicine, 358, 1047-1052.

Using the Passive Voice in Spanish

Using the Passive Voice in Spanish The passive voice is an approach to structuring sentence that is used in both Spanish and English, although English speakers are more likely to use it. A sentence in which the subject of the main verb is also acted on by the verb is in the passive voice. We can also say that the verb is in the passive voice. A common use of the passive voice is to indicate what happened to the subject of the sentence without saying who or what carried out the action (although the actor can be indicated in a prepositional phrase). How the Passive Voice Is Used One reason the passive voice is much more common in English is because Spanish often uses reflexive verbs where English uses the passive voice. Writing experts usually advise against using the passive voice unnecessarily, because the active voice comes across as more lively and does a better job of conveying action. In English, the passive voice is formed by using a form of the verb to be followed by the past participle. It is the same in Spanish, where a form of ser is followed by the past participle. The past participle in such cases is modified if necessary to agree in number and gender with the subject of the sentence. The passive voice is known in Spanish as la voz pasiva. Sample Sentences Showing the Passive Voice Spanish Sentences Las computadoras fueron vendidas. Note that the subject of the sentence (computadoras) is also the object acted on. Note also that the usual way of stating this would be using a reflexive construction, se vendieron las computadoras, literally, the computers sold themselves.El coche ser manejado por mi padre. Note that the person performing the action isnt the subject of the sentence, but is the object of a prepositional phrase. This sentence is less likely to be said in Spanish than its equivalent in English would be. More common in Spanish would be the active voice: Mi padre manejar el coche. Corresponding Examples in English The computers were sold. Note that in neither language does the sentence indicate who sold the computers.The car will be driven by my father. Note that the car is the subject of the sentence; the sentence would be complete without the prepositional phrase, by my father, which indicates who is performing the action of the verb.

Confectionery Market Assignment Example | Topics and Well Written Essays - 2000 words

Confectionery Market - Assignment Example This is a comprehensive statement by MINTEL a marketing intelligence company. This explains the sudden exceptional performance of Cadbury as an impact if the overall chocolate confectionary industry sector. However, questions to be asked at this juncture are: The issue at this pointy in time for Cadbury is to sustain this growth.pattern. However, according to statistics, on one hand it would be able to match tis growth on the other hand other segments are offering greater returns. According to Industry Reports on 2006 Product Announcements and Sales "In 2006, thousands of new confectionery and snack products debuted tempting taste buds of consumers everywhere. 2,910 new confectionery products debuted, and Chocolate: 1,478 "Confectionery sales continue to cluster around major holidays, with Halloween leading sales in 2006 and Easter a close second. Halloween secured its lead with a 2.8 percent growth overall, while Easter stood out in 2006 posting a 7 percent sales increase thanks to a late April celebration. Also making gains, the winter holiday season and Valentine's Day both posted a 1 percent increase in 2006 and ranked third and fourth in overall holiday sales respectively."- www.whatsnewiningredients.com The above statement depicts a new trend in marketing that is of event marketing. All over the world companies are finding events the best way to market their products to the right audience. As for confectionaries, these are impulse products most consumed after reminder advertising, brand awareness on special occasions and events. It is thus no surprise that then sales increase by 1% due to Valentines day. New Product Development "Top trends driving product releases of 2007/08 include flavor fusions, international influences, artisan palate, sweet benefits, simply sugar-free, originally organic, reinventing classics, the dark side and child's play" (www.whatsnewiningredients.com) "Focussed attention in the premium and dark chocolate sectors of the market, which is providing strong growth opportunities. In April, Cadbury Schweppes relaunched the Old Gold dark chocolate brand and added a 70% cocoa variant. As a result, the brand grew 36% in Australia and by over 80% in New Zealand" (www.scoop.co.nz) Dark Chocolate segment: " In July, a new premium chocolate range was launched under the Cadbury Eden brand, positioning the business to tap into this fast growing segment of the market Our second half innovation program continues to build momentum with the exciting launch of Cadbury Eden into the premium chocolate segment"(www.snoop.co.nz, National Confectioners Association) It can be seen from the above statistics that the dark chocolate segment is an upcoming segment for Cadbury. Another segment that has a high potential is the organic food segment. Segmentation The various market segments that Cadbury brands are catering to are: - Cadbury gift boxes- for valentine gifts and for special occasions -priced higher. Cadbury Freddo-sells at a low price for kids to afford it. Cadbury 500 g bar with 10% more chocolate is for families with many