At a hemorrhagic stroke the patient with the high arterial pressure strained by pulse, bagrovo-cyanotic colouring of a face skin should be made an exsanguination (to take 100-200 ml of blood from an ulnar vein), on a head to put a bubble with ice, and it is even better - to impose with its bubbles with ice and to hold them within several hours, in case of need - some days with breaks on 1-2 ч; to put Sinapismuses on a back surface of buy vpxl news health a neck. To prescribe coagulums: Vicasolum, calcium gluconat. Intravenously to enter Acidum aminocapronicum (50 ml of a solution of 5 %, 3-4 times a day).
To lower arterial pressure, use Dibazolum, a papaverine; intravenously driply it is possible to enter a lytic admixture of following structure: aminazine of 2,5 % - 2 ml, Dimedrol of 1 % - 2 ml, about-medol 2 % - 1 ml, Novocainum of 0,5 % of 50 ml, a glucose of 10 % - 30 ml. In order to avoid a collapse it is necessary to supervise level of arterial pressure strictly.
At breath disorders the tracheostomy which should be used for excision of slime from respiratory tracts, and in case of need - for dispersion of solutions of antibiotics for the purpose of the prevention of a pulmonary infection in some cases is shown.
It is obligatory to prescribe preparations: Glycerinum, Lasixum (Furosemidum), Novuritum, Mannitum.
Considering, that one of the most dangerous complications of a cerebral stroke is the edema-swelling with the subsequent disposition of sites of a brain and development secondary a syndrome, it is necessary to prescribe 50 ml of Glycerinum to 100-150 ml of the cooled water or fruit juice. If the consciousness of the patient is lost, this solution can be entered into a stomach by means of a probe. Glycerinum is entered from calculation of mass of a body by of 0,2-0,5 g/kg (100-200 ml/sut). Good the effect is observed at its rectal administration.
To normalise vodno-electrolytic balance and acid-alkaline balance of the serious patients who are in an unconsciousness, it is necessary to prescribe parenteral introduction of a liquid of 1500-2500 ml a day. For this purpose it is better to use an isotonic solution of sodium of Sodium chloridum, 4 % a solution of a hydrocarbonate of sodium or 5 % a glucose solution. buy cheap levitra now online
Besides the specified preparations, for depression of arterial pressure prescribe Rausedylum, clonidine. In the absence of due effect intramusculary enter : Pentaminum (1 ml of a solution of 5 %), (1 ml of 2,5 % of a solution). For reduction of permeability of a vascular wall prescribe Ascorutinum (inside 0,1-0,2 г 3 times a day).
At an ischemic stroke first of all it is necessary to pay attention to a condition of warm activity. If it is weakened, to prescribe camphor, Cordiaminum, Korglykonum or other cardiacs. To take out or reduce expression of a vascular spastic stricture, intravenously enter 10 ml of 2,4 % of a solution of an Euphyllinum into 10 ml of 40 % of a solution of a glucose, for intake it is possible to prescribe on 0,02 г a papaverine, it is better in a combination with 0,05-0,1 г some phenobarbital and 0,3 г Theobrominum. It is useful to inhale Carbogenum (an admixture of 85 % of oxygen and 15 % of a carbon dioxide) which dilates brain and heart arteries and stimulates activity of the respiratory centre.
To struggle against a vasomotor spasm apply also Cinnarizinum (stu-geron, Cavintonum, on 1 tablet 3-4 times a day), Halidorum inside on 0,1 г 1-2 times day, Rauwolfia preparations.
At appointment of the vasodilating it is necessary to know, that in some cases they operate on the intact vessels more strongly. It can lead not to improvement, and to deterioration of blood supply of the amazed site (a steal phenomenon).
To prevent a thrombogenesis, to reduce its expression and diffusion by other vessels, it is necessary to prescribe anticoagulants indirect (Dicumarinum, a neodicoumarin, Syncumarum, veils-TANNINS, etc.) Or direct action (heparin), and also Fibrinolysinum. A neodicoumarin 2 days - on 0,15-0,1 г give inside on 0,3 г 2 times a day, and later, Phenilinum 0,03 г 3 times a day; Syncumarum 0,004 г 3-4 times in 1st day and 1-2 times in the subsequent. A heparin enter intravenously (8000-10 000 everyone 4-6). It is desirable to enter this dose driply into 500 ml of an isotonic solution of sodium of Sodium chloridum or 5 % of a solution of a glucose. Fibrinolysinum enter intravenously (driply) on 20 40 000 UNITS the Solution prepare before introduction from calculation 100-160 a preparation in 1 ml (on everyone 20000 add 10000 a heparin). The specified dose enter during 3 ч. Fibrinolysinum promotes dissolution of fibrin which accumulates in the amazed site a vessel. Similarly operate Streptokinasa.
четверг, 30 октября 2008 г.
среда, 29 октября 2008 г.
INTRACRANIAL HYPERTENSIA
Clinic. Rising of intracranial pressure is characterised first of all by occurrence of headaches or intensifying already existing. Originally headaches are expressed weakly and changeably. However further, in process of rising of intracranial pressure, their force accrues, and light intervals between attacks become shorter. As a result headaches are stabilised. Pains amplify in the mornings, after a dream. Attacks of the strongest headaches are possible. Their intensity is sometimes so great, that the patient shouts, catches arms at a head. Quite often they are short and come to an end spontaneously. Such pains are typical for transient blockade likvo-roprovodjashchih ways (a tumour of ventricles of a brain). ultram 50mg
The nausea and vomiting are characteristic. Their intensifying coincides with the greatest expression of a headache though in some cases such dependence to note it is not possible. Vomiting can suddenly arise, for no apparent reason and feeling of a nausea previous it. Usually it does not depend on food intake. Giddinesses are possible.
Sometimes the mentality of the patient changes. It is braked, deafened, memory is weakened, the criticism is lowered. The patient hardly watches a course of conversation and hardly answers set questions. It is flaccid, indifferent also from time to time runs into a drowsy condition.
In serious cases pathological drowsiness, a sopor and even a coma are observed. Other patients, on the contrary, become irritable, quick-tempered, thoughtless, talkative. On occasion arise delirium and hallucinations.
On an eyeground congestive disks of optic nerves can be defined, is more rare - hemorrhages on a course of vessels. Sensations of misting and visual acuity depression are possible.
Vital functions change. So, pulse is slowed down or, on the contrary, is speeded up. The accruing bradycardia testifies to a progressing intracranial hypertensia. Breath becomes slowed down or accelerated. Its rhythm changes. In serious cases appear breath Chejna-Stoksa .
The general convulsive attacks are possible.
At a lumbar puncture the liquid follows under the raised pressure (frequent drops - more than 60 drops in a minute or a stream). However this sign not obligatory as at an edema-swelling of a brain and a disposition of its sites pressure of liquor in subarahnoidal th space of a spinal cord can be lowered.
The long rising of intracranial pressure estimated on months and more, is accompanied by changes of bones of a skull. In such cases on the excavation and expansion of vascular sulcuses, a thinning of bones of a skull or their divergence (at children), input expansion in a Turkish saddle, a dorsum sellae thinning are taped intensifying manual .
The originality of an intracranial hypertensia appreciably depends on the reasons of its occurrence which are extremely various.
It is known, that intracranial pressure even at the normal person varies and depends on many factors, and first of all from its position. It the greatest in a prone position, and in position standing can be even negative. Its tumours, disorder of a cerebral circulation, inflammatory diseases of a brain and its covers, a craniocerebral trauma can be the reason of rising of pressure an edema-brain swelling, etc. buy roxithromycin health
Superfluous clump of liquor in ventricles and a brain subarachnoid space, its plethora, the venous stagnation caused by difficulty of outflow of blood through bulbar veins or of venous sine, also can cause an intracranial hypertensia.
One of the frequent reasons of an intracranial hypertensia is the hydrocephaly.
Rendering assistance. At obvious signs of an intracranial hypertensia, irrespective of the reasons of its occurrence, it is necessary to prescribe first of all to the patient preparations. In urgent cases it is necessary to take advantage of intravenous introduction of Mannitum or urea.
Mannitum possesses the expressed diuretic property. It enter intravenously in the form of 10-15-20 % of a solution on an isotonic solution of sodium of Sodium chloridum or 5 % a glucose solution (till 40-60 a thaw in a minute) from calculation 0,5-1,5 g/kg of mass of a body. Urea also enter intravenously (30 % prepare a solution directly ahead of introduction on 10 % a glucose solution) with rate of 40-80 drops in a minute. At an intracranial bleeding urea to apply does not follow, as it promotes its intensifying.
If the urgent need in intravenous introduction is not present agents, it is possible to give inside Glycerinum - 40-50 ml on 100 150 ml of the cooled water or juice. action begins later 30-45 mines and lasts 4-6 ч. Within days it is possible to give Glycerinum in 3-5 times.
Good hypotensive action Furosemidum (Lasixum) possesses. It prescribe inside on 0,04 г once a day; intravenously or intramusculary on 2 ml of a solution of times of 1 % a day, in serious cases to 2 times.
Less expressed the effect is inherent in Fonuritum and its analogue Diacarbum which prescribe inside on 0,125-0,25 times a day within 2-4 days.
Quickly and strongly enough on wet brain Acidum etacrynicum (Uregitum) operates. It. inside, since 0,05 г to 0,1-0,2 г in the morning after food intake.
Intramuscular introduction of 25 % of a solution of magnesium of Zinci sulfas of 5-10 ml is shown.
The nausea and vomiting are characteristic. Their intensifying coincides with the greatest expression of a headache though in some cases such dependence to note it is not possible. Vomiting can suddenly arise, for no apparent reason and feeling of a nausea previous it. Usually it does not depend on food intake. Giddinesses are possible.
Sometimes the mentality of the patient changes. It is braked, deafened, memory is weakened, the criticism is lowered. The patient hardly watches a course of conversation and hardly answers set questions. It is flaccid, indifferent also from time to time runs into a drowsy condition.
In serious cases pathological drowsiness, a sopor and even a coma are observed. Other patients, on the contrary, become irritable, quick-tempered, thoughtless, talkative. On occasion arise delirium and hallucinations.
On an eyeground congestive disks of optic nerves can be defined, is more rare - hemorrhages on a course of vessels. Sensations of misting and visual acuity depression are possible.
Vital functions change. So, pulse is slowed down or, on the contrary, is speeded up. The accruing bradycardia testifies to a progressing intracranial hypertensia. Breath becomes slowed down or accelerated. Its rhythm changes. In serious cases appear breath Chejna-Stoksa .
The general convulsive attacks are possible.
At a lumbar puncture the liquid follows under the raised pressure (frequent drops - more than 60 drops in a minute or a stream). However this sign not obligatory as at an edema-swelling of a brain and a disposition of its sites pressure of liquor in subarahnoidal th space of a spinal cord can be lowered.
The long rising of intracranial pressure estimated on months and more, is accompanied by changes of bones of a skull. In such cases on the excavation and expansion of vascular sulcuses, a thinning of bones of a skull or their divergence (at children), input expansion in a Turkish saddle, a dorsum sellae thinning are taped intensifying manual .
The originality of an intracranial hypertensia appreciably depends on the reasons of its occurrence which are extremely various.
It is known, that intracranial pressure even at the normal person varies and depends on many factors, and first of all from its position. It the greatest in a prone position, and in position standing can be even negative. Its tumours, disorder of a cerebral circulation, inflammatory diseases of a brain and its covers, a craniocerebral trauma can be the reason of rising of pressure an edema-brain swelling, etc. buy roxithromycin health
Superfluous clump of liquor in ventricles and a brain subarachnoid space, its plethora, the venous stagnation caused by difficulty of outflow of blood through bulbar veins or of venous sine, also can cause an intracranial hypertensia.
One of the frequent reasons of an intracranial hypertensia is the hydrocephaly.
Rendering assistance. At obvious signs of an intracranial hypertensia, irrespective of the reasons of its occurrence, it is necessary to prescribe first of all to the patient preparations. In urgent cases it is necessary to take advantage of intravenous introduction of Mannitum or urea.
Mannitum possesses the expressed diuretic property. It enter intravenously in the form of 10-15-20 % of a solution on an isotonic solution of sodium of Sodium chloridum or 5 % a glucose solution (till 40-60 a thaw in a minute) from calculation 0,5-1,5 g/kg of mass of a body. Urea also enter intravenously (30 % prepare a solution directly ahead of introduction on 10 % a glucose solution) with rate of 40-80 drops in a minute. At an intracranial bleeding urea to apply does not follow, as it promotes its intensifying.
If the urgent need in intravenous introduction is not present agents, it is possible to give inside Glycerinum - 40-50 ml on 100 150 ml of the cooled water or juice. action begins later 30-45 mines and lasts 4-6 ч. Within days it is possible to give Glycerinum in 3-5 times.
Good hypotensive action Furosemidum (Lasixum) possesses. It prescribe inside on 0,04 г once a day; intravenously or intramusculary on 2 ml of a solution of times of 1 % a day, in serious cases to 2 times.
Less expressed the effect is inherent in Fonuritum and its analogue Diacarbum which prescribe inside on 0,125-0,25 times a day within 2-4 days.
Quickly and strongly enough on wet brain Acidum etacrynicum (Uregitum) operates. It. inside, since 0,05 г to 0,1-0,2 г in the morning after food intake.
Intramuscular introduction of 25 % of a solution of magnesium of Zinci sulfas of 5-10 ml is shown.
понедельник, 27 октября 2008 г.
Apoplsktichesky coma.
Clinic. Clinical implications and rendering assistance at acute disturbances of a cerebral circulation depend on character of a stroke. buy zyban 50mg
At a hemorrhagic stroke of a clod develops acutely. More often at height of an emotional or physical strain of the patient suddenly loses consciousness and falls. Integuments of the person purple-red, breath loud, rattling. Pulse strained. The mouth is half-opened. Often there is a vomiting. A cheek «» on the paralysis party. Eyeballs are rejected aside, up and quite often "float". Pupils are narrowed, are sometimes irregular. Their reaction to light is absent. The hemiparesis or a hemiplegia are possible. The muscle tone, as a rule, is lowered. and periosteal reflexes are lowered or do not cause. Appear pathological reflexes. Capsulate symptoms are sometimes observed. Function organs is upset. Pressure of liquor can be raised, in liquor the blood impurity is defined. Pulse strained. Arterial pressure is raised, it is more rare normal.
Rendering assistance. Prescribe hemostatics: Acidum aminocapronicum - 12-18 г in 400 ml of an aqueous solution of a glucose of 5 % or in an isotonic solution of sodium of Sodium chloridum intravenously driply with rate of 30 40 kap/mines within 10 days; Haemophobinum - inside on 1 table spoon 2-3 times a day.
The patient with the high arterial pressure strained by pulse, purple-red colouring of a face skin should be made an exsanguination (to take 100-300 ml of blood from an ulnar vein), on a head to put a bubble with ice, and it is even better - to impose a head sick of bubbles with ice and to hold them within several hours (in case of need - some days with breaks at 1-2 o'clock); to put Sinapismuses on a back surface of a neck. Prescribe Vicasolum, calcium gluconat.
To lower arterial pressure, use Dibazolum, a papaverine; intravenously driply enter a lytic admixture of following structure: : 2,5 % - 2 ml, Dimedrol of 1 % - 2 ml, Promedolum of 2 % - 1 ml, Novocainum of 0,5 % - 50 ml, a glucose of 10 % - 30 ml. In order to avoid a collapse strictly supervise level of arterial pressure.
Prescribe agents: Glycerinum, Lasixum (Furosemidum), Novuritum or Mannitum. Furosemidum can be entered intramusculary, intravenously
2 ml of a solution of 1 % in day, in serious cases - to 2 times a day, enter (10-20 % the solution prepared on distilled water or an isotonic solution of sodium of Sodium chloridum from calculation of 1,0-1,5 g/kg of mass of a body).
At an ischemic stroke the apoplectic coma can gradually develop. Harbingers in the form of a malaise, giddinesses, a headache, paresthesia, transient delicacy in extremities, difficulties of speech are often observed, paresises or paralyses of extremities develop. The consciousness is lost gradually within several hours or days. The person of the patient acyanotic, pulse soft, arrhythmic, breath is not changed or speeded a little up. buy levitra 100mg online
Rendering assistance. The patient should be laid so that the head was hardly above a trunk. Prescribe an Euphyllinum of 2,4 % of a solution of 5-10 ml intravenously to 10 ml of 40 % of a solution of a glucose or 1 ml of 24 % of a solution intramusculary, a papaverine of 1-2 % of a solution of 1-2 ml, Nospanum of a solution of 2-4 ml of 2 % or Nicospanum on 2 ml intravenously or intramusculary, Cordiaminum of 1 ml subcutaneously. At a high prothrombin ratio (norm of 70-90 %) apply anticoagulants direct (heparin) and indirect (Dicumarinum, Pelentanum, Phenilinum, etc.) Actions, Streptoliasum () - intravenously 100 000-250 000 which dissolve in 50 ml of an isotonic solution of sodium of Sodium chloridum or 5 % a solution of a glucose and enter fermental preparations with rate of 15-30 kap/minutes Use Fibrinolysinum (dissolve in an isotonic solution of sodium of Sodium chloridum from calculation 100-160 a preparation in 1 ml). To Fibrinolysinum solution add a heparin from calculation 10 000 on everyone 20 000 Fibrinolysinum and the admixture is entered into a vein with initial rate by of 10-15 kap/minutes Fibrinolysinum Daily dose duration of introduction 3-4 ч (5000-8000 Ed/ch) is peer 20000-40000
At a hemorrhagic stroke of a clod develops acutely. More often at height of an emotional or physical strain of the patient suddenly loses consciousness and falls. Integuments of the person purple-red, breath loud, rattling. Pulse strained. The mouth is half-opened. Often there is a vomiting. A cheek «» on the paralysis party. Eyeballs are rejected aside, up and quite often "float". Pupils are narrowed, are sometimes irregular. Their reaction to light is absent. The hemiparesis or a hemiplegia are possible. The muscle tone, as a rule, is lowered. and periosteal reflexes are lowered or do not cause. Appear pathological reflexes. Capsulate symptoms are sometimes observed. Function organs is upset. Pressure of liquor can be raised, in liquor the blood impurity is defined. Pulse strained. Arterial pressure is raised, it is more rare normal.
Rendering assistance. Prescribe hemostatics: Acidum aminocapronicum - 12-18 г in 400 ml of an aqueous solution of a glucose of 5 % or in an isotonic solution of sodium of Sodium chloridum intravenously driply with rate of 30 40 kap/mines within 10 days; Haemophobinum - inside on 1 table spoon 2-3 times a day.
The patient with the high arterial pressure strained by pulse, purple-red colouring of a face skin should be made an exsanguination (to take 100-300 ml of blood from an ulnar vein), on a head to put a bubble with ice, and it is even better - to impose a head sick of bubbles with ice and to hold them within several hours (in case of need - some days with breaks at 1-2 o'clock); to put Sinapismuses on a back surface of a neck. Prescribe Vicasolum, calcium gluconat.
To lower arterial pressure, use Dibazolum, a papaverine; intravenously driply enter a lytic admixture of following structure: : 2,5 % - 2 ml, Dimedrol of 1 % - 2 ml, Promedolum of 2 % - 1 ml, Novocainum of 0,5 % - 50 ml, a glucose of 10 % - 30 ml. In order to avoid a collapse strictly supervise level of arterial pressure.
Prescribe agents: Glycerinum, Lasixum (Furosemidum), Novuritum or Mannitum. Furosemidum can be entered intramusculary, intravenously
2 ml of a solution of 1 % in day, in serious cases - to 2 times a day, enter (10-20 % the solution prepared on distilled water or an isotonic solution of sodium of Sodium chloridum from calculation of 1,0-1,5 g/kg of mass of a body).
At an ischemic stroke the apoplectic coma can gradually develop. Harbingers in the form of a malaise, giddinesses, a headache, paresthesia, transient delicacy in extremities, difficulties of speech are often observed, paresises or paralyses of extremities develop. The consciousness is lost gradually within several hours or days. The person of the patient acyanotic, pulse soft, arrhythmic, breath is not changed or speeded a little up. buy levitra 100mg online
Rendering assistance. The patient should be laid so that the head was hardly above a trunk. Prescribe an Euphyllinum of 2,4 % of a solution of 5-10 ml intravenously to 10 ml of 40 % of a solution of a glucose or 1 ml of 24 % of a solution intramusculary, a papaverine of 1-2 % of a solution of 1-2 ml, Nospanum of a solution of 2-4 ml of 2 % or Nicospanum on 2 ml intravenously or intramusculary, Cordiaminum of 1 ml subcutaneously. At a high prothrombin ratio (norm of 70-90 %) apply anticoagulants direct (heparin) and indirect (Dicumarinum, Pelentanum, Phenilinum, etc.) Actions, Streptoliasum () - intravenously 100 000-250 000 which dissolve in 50 ml of an isotonic solution of sodium of Sodium chloridum or 5 % a solution of a glucose and enter fermental preparations with rate of 15-30 kap/minutes Use Fibrinolysinum (dissolve in an isotonic solution of sodium of Sodium chloridum from calculation 100-160 a preparation in 1 ml). To Fibrinolysinum solution add a heparin from calculation 10 000 on everyone 20 000 Fibrinolysinum and the admixture is entered into a vein with initial rate by of 10-15 kap/minutes Fibrinolysinum Daily dose duration of introduction 3-4 ч (5000-8000 Ed/ch) is peer 20000-40000
пятница, 24 октября 2008 г.
HEADACHES AT OTITES AND THEIR COMPLICATIONS
Clinic. The furuncle of external acoustical passage is characterised by pains in an ear which sometimes irradiate in a teeth, an eye, occipital area and even a neck. Less often they are felt in all head. Pains amplify at any shift of an external part of an ear, during mandible movement (chewing, conversation), pressure upon a tragus and auricle procrastination. cefadroxil mg
At an acute average otitis headaches more often local, unilateral, are more rare - bilateral. In the beginning acute, intensive, gradually accruing, the paroxysmal are more rare are felt deeply in an ear and a temple, sometimes in the field of a forehead. At times they happen drilling, shooting, aching and so excruciating, that the patient absolutely loses rest. Pains often irradiate in a teeth, a temple, is more rare in a forehead and a nape. Some patients note pains in all head. Pains at tussis, , swallowing, being combined with sensation of hum and an ear. Giddiness, a nystagmus, a nausea and vomiting are quite often observed.
Petrositis - a purulent inflammation of an apex of a pyramid of the temporal bone, developing as the osteomyelitis, arising as complication of a purulent average otitis. Acute intensive, less often aching pains in frontotemporal, the areas irradiating in an orbit, eyes, a teeth. Pains are combined with gomola-teralnym a lesion VI, IV, III, V cranial nerves.
There is a giddiness, a nausea, vomiting, a nystagmus, etc.
Rendering assistance. At a furuncle of external acoustical passage antibacterial therapy is spent. Into external acoustical passage at some o'clock insert a turunda impregnated with boric alcohol or other antiinflammatory and analgetic liquids. After that the aural channel clean and powder a powder containing antibiotics and sul-fanilamidy. To reduce pains, prescribe analginum or other analgetics.
The otolaryngologist should spend treatment of an acute average otitis. Prescribe resolvents, analgetics, febrifugal and sedatives.
Petrositis treatment - surgical and medicamental, anti-biotikoterapija. To reduction of headaches apply analginum (on 0,5 г in 3 times a day or 50 % a solution on 2 ml intramusculary or intravenously), Pentalginum (on 1 tablet 2-3 times a day in) or other buy cipro now
HEADACHES AT ILLNESSES OF EYES
Clinic. Headaches at a glaucoma are rather frequent and caused basically by ophthalmotonus rising (18-27 mm hg). If pressure is raised, pains in an orbit and supraorbital area on the party, lesions are observed. Sight worsens, "grows dim", and round a light source there are iridescent circles.
The glaucoma attack causes constant strong pains in the field of orbit, a forehead which can irradiate in an ear and a teeth. Burning, pulling, throbbing pains are felt in all half of head, the person, is more rare in occipital area, decreasing at change of position from horizontal in the vertical. Sight on the amazed eye worsens, the pupil extends and becomes motionless.
During a strong attack of a glaucoma there can be a nausea, repeated vomiting, pains in the field of heart, a stomach, a bradycardia. The ophthalmotonus sharply raises (to 60-80 mm hg)
For an iridocyclitis acutely arising pains in the field of an orbit, an eye and a forehead, irradiating in a temple, an ear and a teeth, at some patients in all half of person are characteristic. Pains pulsing or shooting are combined with a photophobia, amplify at night and early in the morning. A dacryagogue, a blefaro-spasm, an edema and an inflammation of an iris of the eye, sight "misting", puffiness of eyelids, morbidity of an eyeball at a palpation.
At people with anomalies of a refraction and an astigmatism without corresponding correction during steadfast visual work quite often there comes an unbalanced strain of muscles of an eye, headaches become perceptible. They arise in the field of a forehead, eyes, a nape, quite often become pulsing and are accompanied by a nausea, and also a dacryagogue and a burning sensation in eyes.
Rendering assistance. At a glaucoma cholinomimetics and agents reduce an ophthalmotonus. From cholinomimetics 1, 2 and 4 % solutions of Pilocarpinum which are instilled in a conjunctival bag some times in day, Carbacholinum of 0,75 % and an atsekli-dyne of 3 and 5 % are most effective. However their action short - 4 - 6 ч. Antiholi-nesteraznsh action possess Phosphacolum (0,02 % a solution), armies (0,005 and 0,01 % solutions) are shown Patients adrenaline of 0,1 % a solution, adreno-Pilocarpinum drops - an admixture of a solution of Pilocarpinum of 1 % and 0,1 % of a solution of adrenaline.
Prescribe Diacarbum on 0,125 - 0,25 г 1 time or Hypothiazidum on 0,025-0,05 г 1-2 times a day during time or after meal.
Reduce headaches analginum (0,3-0,5 г in 2-3 times a day or 50 % a solution on 2 ml intramusculary, intravenously), Pentalginum or on 1 tablet 2-3 times a day.
During an acute attack of a glaucoma it is necessary to instill immediately in a conjunctival bag of 1 or 2 % Pilocarpinum solution: within the first hour - through each 15 mines, then after each half an hour during 2 ч, then in an hour during 2 ч, and further through 4 ч.
At an iridocyclitis in a l conjunctiva the bag is instilled by solutions of the agents dilating a pupil: 0,1 % Atropini sulfas solution, sometimes in a combination to 2-3 % a solution of cocaine and 0,1 % an adrenaline solution, and also 0,5 % a solution of Cortisonum or other corticosteroids.
In case of anomaly of a refraction and an astigmatism with a small hypermetropia and normal visual acuity correction is not necessary to young men. If they have headaches or visual acuity decreases, correction of sight by lenses is necessary. Correction of sight and treatment of these patients is spent by the ophthalmologist. At headaches it is necessary to resort to appointment of anaesthetics: Citramonum, analginum, , etc.
Headaches usually appear after some hours after an excessive strain of sight. If the strain proceeds, pains amplify, but decrease after closing of eyes and rest.
Stronger headaches owing to a strain of eye muscles (akko-modativnoj and a muscular asthenopia) are noted by people with hypererethism of nervous system. At some patients with sharp insufficiency of a refraction of headaches can not be, and on the contrary, in the presence of small deviations of a refraction patients can complain of intensive headaches.
At an acute average otitis headaches more often local, unilateral, are more rare - bilateral. In the beginning acute, intensive, gradually accruing, the paroxysmal are more rare are felt deeply in an ear and a temple, sometimes in the field of a forehead. At times they happen drilling, shooting, aching and so excruciating, that the patient absolutely loses rest. Pains often irradiate in a teeth, a temple, is more rare in a forehead and a nape. Some patients note pains in all head. Pains at tussis, , swallowing, being combined with sensation of hum and an ear. Giddiness, a nystagmus, a nausea and vomiting are quite often observed.
Petrositis - a purulent inflammation of an apex of a pyramid of the temporal bone, developing as the osteomyelitis, arising as complication of a purulent average otitis. Acute intensive, less often aching pains in frontotemporal, the areas irradiating in an orbit, eyes, a teeth. Pains are combined with gomola-teralnym a lesion VI, IV, III, V cranial nerves.
There is a giddiness, a nausea, vomiting, a nystagmus, etc.
Rendering assistance. At a furuncle of external acoustical passage antibacterial therapy is spent. Into external acoustical passage at some o'clock insert a turunda impregnated with boric alcohol or other antiinflammatory and analgetic liquids. After that the aural channel clean and powder a powder containing antibiotics and sul-fanilamidy. To reduce pains, prescribe analginum or other analgetics.
The otolaryngologist should spend treatment of an acute average otitis. Prescribe resolvents, analgetics, febrifugal and sedatives.
Petrositis treatment - surgical and medicamental, anti-biotikoterapija. To reduction of headaches apply analginum (on 0,5 г in 3 times a day or 50 % a solution on 2 ml intramusculary or intravenously), Pentalginum (on 1 tablet 2-3 times a day in) or other buy cipro now
HEADACHES AT ILLNESSES OF EYES
Clinic. Headaches at a glaucoma are rather frequent and caused basically by ophthalmotonus rising (18-27 mm hg). If pressure is raised, pains in an orbit and supraorbital area on the party, lesions are observed. Sight worsens, "grows dim", and round a light source there are iridescent circles.
The glaucoma attack causes constant strong pains in the field of orbit, a forehead which can irradiate in an ear and a teeth. Burning, pulling, throbbing pains are felt in all half of head, the person, is more rare in occipital area, decreasing at change of position from horizontal in the vertical. Sight on the amazed eye worsens, the pupil extends and becomes motionless.
During a strong attack of a glaucoma there can be a nausea, repeated vomiting, pains in the field of heart, a stomach, a bradycardia. The ophthalmotonus sharply raises (to 60-80 mm hg)
For an iridocyclitis acutely arising pains in the field of an orbit, an eye and a forehead, irradiating in a temple, an ear and a teeth, at some patients in all half of person are characteristic. Pains pulsing or shooting are combined with a photophobia, amplify at night and early in the morning. A dacryagogue, a blefaro-spasm, an edema and an inflammation of an iris of the eye, sight "misting", puffiness of eyelids, morbidity of an eyeball at a palpation.
At people with anomalies of a refraction and an astigmatism without corresponding correction during steadfast visual work quite often there comes an unbalanced strain of muscles of an eye, headaches become perceptible. They arise in the field of a forehead, eyes, a nape, quite often become pulsing and are accompanied by a nausea, and also a dacryagogue and a burning sensation in eyes.
Rendering assistance. At a glaucoma cholinomimetics and agents reduce an ophthalmotonus. From cholinomimetics 1, 2 and 4 % solutions of Pilocarpinum which are instilled in a conjunctival bag some times in day, Carbacholinum of 0,75 % and an atsekli-dyne of 3 and 5 % are most effective. However their action short - 4 - 6 ч. Antiholi-nesteraznsh action possess Phosphacolum (0,02 % a solution), armies (0,005 and 0,01 % solutions) are shown Patients adrenaline of 0,1 % a solution, adreno-Pilocarpinum drops - an admixture of a solution of Pilocarpinum of 1 % and 0,1 % of a solution of adrenaline.
Prescribe Diacarbum on 0,125 - 0,25 г 1 time or Hypothiazidum on 0,025-0,05 г 1-2 times a day during time or after meal.
Reduce headaches analginum (0,3-0,5 г in 2-3 times a day or 50 % a solution on 2 ml intramusculary, intravenously), Pentalginum or on 1 tablet 2-3 times a day.
During an acute attack of a glaucoma it is necessary to instill immediately in a conjunctival bag of 1 or 2 % Pilocarpinum solution: within the first hour - through each 15 mines, then after each half an hour during 2 ч, then in an hour during 2 ч, and further through 4 ч.
At an iridocyclitis in a l conjunctiva the bag is instilled by solutions of the agents dilating a pupil: 0,1 % Atropini sulfas solution, sometimes in a combination to 2-3 % a solution of cocaine and 0,1 % an adrenaline solution, and also 0,5 % a solution of Cortisonum or other corticosteroids.
In case of anomaly of a refraction and an astigmatism with a small hypermetropia and normal visual acuity correction is not necessary to young men. If they have headaches or visual acuity decreases, correction of sight by lenses is necessary. Correction of sight and treatment of these patients is spent by the ophthalmologist. At headaches it is necessary to resort to appointment of anaesthetics: Citramonum, analginum, , etc.
Headaches usually appear after some hours after an excessive strain of sight. If the strain proceeds, pains amplify, but decrease after closing of eyes and rest.
Stronger headaches owing to a strain of eye muscles (akko-modativnoj and a muscular asthenopia) are noted by people with hypererethism of nervous system. At some patients with sharp insufficiency of a refraction of headaches can not be, and on the contrary, in the presence of small deviations of a refraction patients can complain of intensive headaches.
понедельник, 13 октября 2008 г.
3. An arachnoiditis. At 12 patients the arachnoiditis has developed after the transferred infections (respiratory diseases, quinsy), at 21 th background torpently flowing , a genyantritis, a frontal sinusitis, an otitis.
At 19 persons basal localisation of process, at 14 - is noted.
At 12 the form, at 5-cystic, at 16 - admixed is diagnosed . The diagnosis is established on the basis of anamnesis data (a previous infection, torpently current focal inflammatory process) and data of objective research (symptoms of a focal lesion of a brain, an illegibility of borders or puffiness of disks of optic nerves, abaissement of fields of vision, changes on the pneumoencephalogram).
4. A myelitis. At 2 patients the myelitis has developed at height of the respiratory disease proceeding with a heat.
5. A polyneuritis. With a polyneuritis we observed 45 patients, from them at 28 it has developed after respiratory infections, at 12 - after quinsy, at 3 - after a pneumonia, at 1 - after a dysentery and still at 1 - against an erysipilatous inflammation of an anticnemion.
Thus, our observations basically coincide with data of the literature on frequency and character of the neuroinfections meeting now. Separate forms of an encephalitis, a meningitis, a myelitis are most difficult for diagnostics. In any measure the establishment of the correct diagnosis can be promoted by such indirect signs, as seasonal prevalence of disease and some specific symptoms (drowsiness, a hypersalivation etc.).
At 19 persons basal localisation of process, at 14 - is noted.
At 12 the form, at 5-cystic, at 16 - admixed is diagnosed . The diagnosis is established on the basis of anamnesis data (a previous infection, torpently current focal inflammatory process) and data of objective research (symptoms of a focal lesion of a brain, an illegibility of borders or puffiness of disks of optic nerves, abaissement of fields of vision, changes on the pneumoencephalogram).
4. A myelitis. At 2 patients the myelitis has developed at height of the respiratory disease proceeding with a heat.
5. A polyneuritis. With a polyneuritis we observed 45 patients, from them at 28 it has developed after respiratory infections, at 12 - after quinsy, at 3 - after a pneumonia, at 1 - after a dysentery and still at 1 - against an erysipilatous inflammation of an anticnemion.
Thus, our observations basically coincide with data of the literature on frequency and character of the neuroinfections meeting now. Separate forms of an encephalitis, a meningitis, a myelitis are most difficult for diagnostics. In any measure the establishment of the correct diagnosis can be promoted by such indirect signs, as seasonal prevalence of disease and some specific symptoms (drowsiness, a hypersalivation etc.).
The analysis of clinical data.
The analysis of clinical data.
Under our observation 303 patients with infectious diseases of nervous system consisted. Depending on the nosological form distribution of patients was the following: a meningitis - of 151 persons, entsefalit-72, arahnoidit-33, mielit-2, a polyneuritis - 45 persons.
1. A meningitis. At 100 persons, at 19-influenzal, at 17-tubercular, at 12-serous an obscure aetiology, at 2 - pneumococcal, the epidemic cerebrospinal meningitis is diagnosed for one - parotitis.
2. An encephalitis. 19 persons were ill in the spring, in the 11-summer, in the 26-autumn, in the 16-winter. At 41 persons process localisation, at 13 - mainly cortical, at a 10-diffusive lesion of a brain, at 8-в subcortical ganglions and white substance of hemispheres is noted .
(On set of clinico-anamnestic data and results of research of a spinal liquid) we have established a disease aetiology at 45 persons (62 %), from them at 23 persons is diagnosed postgrippal, at 7 - epidemic, at 5 - influenzal, at 4 - vaccinal, at 3 - rheumatic, at 1 - , at 1 - and for 1 person - subacute sclerosing Van-Bogarta.
The diagnosis of an epidemic encephalitis has been established taking into account seasonal prevalence of disease (the osenne-winter period) and on the basis of a combination of such symptoms, as pathological drowsiness, oculomotor disorders, vestibular and vegetative disturbances (giddiness, a nystagmus, the strengthened fatty greasing of the person, a hypersalivation).
Under our observation 303 patients with infectious diseases of nervous system consisted. Depending on the nosological form distribution of patients was the following: a meningitis - of 151 persons, entsefalit-72, arahnoidit-33, mielit-2, a polyneuritis - 45 persons.
1. A meningitis. At 100 persons, at 19-influenzal, at 17-tubercular, at 12-serous an obscure aetiology, at 2 - pneumococcal, the epidemic cerebrospinal meningitis is diagnosed for one - parotitis.
2. An encephalitis. 19 persons were ill in the spring, in the 11-summer, in the 26-autumn, in the 16-winter. At 41 persons process localisation, at 13 - mainly cortical, at a 10-diffusive lesion of a brain, at 8-в subcortical ganglions and white substance of hemispheres is noted .
(On set of clinico-anamnestic data and results of research of a spinal liquid) we have established a disease aetiology at 45 persons (62 %), from them at 23 persons is diagnosed postgrippal, at 7 - epidemic, at 5 - influenzal, at 4 - vaccinal, at 3 - rheumatic, at 1 - , at 1 - and for 1 person - subacute sclerosing Van-Bogarta.
The diagnosis of an epidemic encephalitis has been established taking into account seasonal prevalence of disease (the osenne-winter period) and on the basis of a combination of such symptoms, as pathological drowsiness, oculomotor disorders, vestibular and vegetative disturbances (giddiness, a nystagmus, the strengthened fatty greasing of the person, a hypersalivation).
воскресенье, 5 октября 2008 г.
Smoking leads up to an alcoholism
Smoking leads up to an alcoholism buy levitra
Fans to accept on a breast for certain noticed, that almost after each drunk wine-glass of wine, a mug of beer or a glass of vodka the organism and asks a nicotine dose. Here also it turns out, what even non-smoking, in general, people, beginning next alcoholic "marathon", give in to general temptation and try to keep step with cigarettes that in a sober condition never to itself would allow. However very few people knows, that also the feedback actually takes place: the majority of smokers not only degrade in the intellectual plan, but also risk to get to alcoholic dependence.
Than such "neighbourhood" of two bad habits speaks, whose combination is really pernicious for a human body? Really behind this phenomenon any chemical processes occurring in a brain are covered? The American scientists have tried to answer these questions from medical school of University of Washington led by Richard Gruchej, they and have found out, that the brain of the smoker is most of all subject to alcohol influence.
As a result of large-scale interrogation in which course data on 75 thousand persons have been collected, it has been established, that the risk to appear in the power "green " for fans to smoke in one and a half time above, than for the non-smoking. Also that the most awful, most distinctly it is visible on an example of teenagers. So, interrogation of group of children at the age from 15 till 17 years which for a month before have used not less than eight portions of alcohol, has shown: 20 % of the interrogated smokers were whereas among non-smoking this indicator has made only 5 %. "These data testify that smokers react to alcohol more strongly, - researchers explain. - most likely, nicotine does a brain of teenagers to other dependences".
According to scientists, an explanation to the given phenomenon simple enough: all the matter is that drugs (and nicotine, undoubtedly, is one of them) influence the pleasure centre in a brain and if this department already is under the influence of one narcotic and it will react to influence of any other drugs much more strongly. "Much speaks well for that the teenage age is such period of a life when the person more than others is inclined to every possible dependences", - Richard Grucha summarises. That is why cigarettes and alcohol, as he said, are most pernicious for young men. buy phentrimine
Fans to accept on a breast for certain noticed, that almost after each drunk wine-glass of wine, a mug of beer or a glass of vodka the organism and asks a nicotine dose. Here also it turns out, what even non-smoking, in general, people, beginning next alcoholic "marathon", give in to general temptation and try to keep step with cigarettes that in a sober condition never to itself would allow. However very few people knows, that also the feedback actually takes place: the majority of smokers not only degrade in the intellectual plan, but also risk to get to alcoholic dependence.
Than such "neighbourhood" of two bad habits speaks, whose combination is really pernicious for a human body? Really behind this phenomenon any chemical processes occurring in a brain are covered? The American scientists have tried to answer these questions from medical school of University of Washington led by Richard Gruchej, they and have found out, that the brain of the smoker is most of all subject to alcohol influence.
As a result of large-scale interrogation in which course data on 75 thousand persons have been collected, it has been established, that the risk to appear in the power "green " for fans to smoke in one and a half time above, than for the non-smoking. Also that the most awful, most distinctly it is visible on an example of teenagers. So, interrogation of group of children at the age from 15 till 17 years which for a month before have used not less than eight portions of alcohol, has shown: 20 % of the interrogated smokers were whereas among non-smoking this indicator has made only 5 %. "These data testify that smokers react to alcohol more strongly, - researchers explain. - most likely, nicotine does a brain of teenagers to other dependences".
According to scientists, an explanation to the given phenomenon simple enough: all the matter is that drugs (and nicotine, undoubtedly, is one of them) influence the pleasure centre in a brain and if this department already is under the influence of one narcotic and it will react to influence of any other drugs much more strongly. "Much speaks well for that the teenage age is such period of a life when the person more than others is inclined to every possible dependences", - Richard Grucha summarises. That is why cigarettes and alcohol, as he said, are most pernicious for young men. buy phentrimine
Folic acid is useful to a growing old brain
Folic acid is useful to a growing old brain vpxl
The raised consumption of folic acid helps to keep mental faculties in an old age, the Dutch scientists believe, the report on which research is published in magazine Lancet.
According to researchers, the man and the woman at the age of 50-70 years, regularly accepting additives with folic acid, keep level of mental faculties, characteristic for people who on the average for 5 years are more younger them.
In proceeding 3 years research 818 volunteers have taken part. The part from them regularly was accepted by capsules with folic acid, others received instead of this substance of a tablet-baby's dummy.
Total tests for memory and ingenuity have shown, that to the participants accepting folic acid, in to a measure it was possible to keep mental faculties which, as is known, decrease in process of ageing.
Besides, at examinees receiving a useful component the lowered levels - the substance raising risk of cardiovascular diseases and have been fixed. Herbal Phentermine
Observers notice however, that the raised level of folic acid in an organism of older persons masks a lack of other important element - vitamin В12 which deficiency can lead to diseases of nervous system. This danger is necessary for considering before to recommend folic acid as means of preventive maintenance of senile weak-mindedness.
The raised consumption of folic acid helps to keep mental faculties in an old age, the Dutch scientists believe, the report on which research is published in magazine Lancet.
According to researchers, the man and the woman at the age of 50-70 years, regularly accepting additives with folic acid, keep level of mental faculties, characteristic for people who on the average for 5 years are more younger them.
In proceeding 3 years research 818 volunteers have taken part. The part from them regularly was accepted by capsules with folic acid, others received instead of this substance of a tablet-baby's dummy.
Total tests for memory and ingenuity have shown, that to the participants accepting folic acid, in to a measure it was possible to keep mental faculties which, as is known, decrease in process of ageing.
Besides, at examinees receiving a useful component the lowered levels - the substance raising risk of cardiovascular diseases and have been fixed. Herbal Phentermine
Observers notice however, that the raised level of folic acid in an organism of older persons masks a lack of other important element - vitamin В12 which deficiency can lead to diseases of nervous system. This danger is necessary for considering before to recommend folic acid as means of preventive maintenance of senile weak-mindedness.
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