What is a technology enhanced treatment intervention?
Many of these technology-enhanced treatment interventions are Web-based versions of evidence-based, in-person treatment components such as CBT and MET.
What are the intensity of the treatment regimens offered?
The intensity of the treatment regimens offered can vary substantially across program types. The American Society of AddictionMedicine (ASAM) has categorized these programs into “levels” of care to guide referral based on an individual patient's needs.93-95
What is early intervention and treatment engagement?
Early Intervention: Identifying and Engaging Individuals At Risk for Substance Misuse and Substance Use Disorders Treatment Engagement: Reaching and Reducing Harm Among Those Who Need Treatment Principles of Effective Treatment and Treatment Planning
What are the challenges in implementing medication assisted treatment (MAT)?
These include provider, public, and client attitudes and beliefs about MAT; lack of an appropriate infrastructure for providing medications; need for staff training and development; and legislation, policies, and regulations that limit MAT implementation.5 Medication-Assisted Treatment for Opioid Use Disorders
Abstract
Severe acute pancreatitis (SAP), which is the most serious type of this disorder, is associated with high morbidity and mortality. SAP runs a biphasic course. During the first 1-2 wk, a pro-inflammatory response results in systemic inflammatory response syndrome (SIRS). If the SIRS is severe, it can lead to early multisystem organ failure (MOF).
INTRODUCTION
Severe acute pancreatitis (SAP) is associated with high morbidity and mortality due to the development of pancreatic and extra-pancreatic necrosis, their subsequent infection and multisystem organ failure (MOF) [ 1 - 3 ].
NATURAL CLINICAL COURSE OF SAP
SAP develops in two phases (Figure (Figure1). 1 ). During the first 1-2 wk, a pro-inflammatory response occurs, which results in systemic inflammatory response syndrome (SIRS), a sterile response in which sepsis or infection rarely occurs.
DIAGNOSIS OF SAP
Diagnosis of SAP is based on clinical presentation, laboratory tests, and imaging results [ 29 - 34 ]. Physical and radiologic scoring systems have been developed with the aim of predicting which patients will have a severe clinical course and which patients might recover without major physiologic insult [ 32, 34 ].
BASIS OF THERAPY IN SAP
SAP should be managed in an intensive care unit that is equipped to apply intensive monitoring and systemic support, including supportive care, prompt fluid resuscitation to maintain circulation volume and prevent electrolyte imbalance, nutritional supplements, analgesics, oxygen supplementation, mechanical ventilation, as well as monitoring for respiratory, cardiovascular and renal insufficiency and their early correction [ 3, 7, 53 - 55 ].
IMAGING-GUIDED AND ENDOSCOPIC PROCEDURE FOR TREATMENT OF NECROTIZING PANCREATITIS
Image-guided percutaneous interventions, which seem technically feasible in a vast majority of patients with necrotizing pancreatitis, range from needle aspiration to the placement of multiple drainage catheters [ 2, 3 ].
SURGICAL APPROACH TO NECROTIZING PANCREATITIS
The indication for surgical intervention and the optimal timing of intervention in necrotizing pancreatitis are frequently subject to discussion [ 85 ].
Why is volume expansion important?
Plasma volume expansion is essential to improve orthostatic tolerance, and fluid and sodium chloride intake should be increased. Most patients can be treated successfully with volume expansion or fludrocortisone or both in combination with a sympathomimetic agent.
What is the hallmark of both central and peripheral causes of neurogenic orthostatic hypotension?
The hallmark of both central and peripheral causes of neurogenic orthostatic hypotension is the failure to release norepinephrine appropriately upon standing. Patient education is the cornerstone of management.
What is orthostatic hypotension?
Orthostatic hypotension is the most incapacitating symptom of autonomic failure. This disorder occurs with both central autonomic neurodegenerative disorders, such as multiple system atrophy and Parkinson's disease, and peripheral autonomic disorders, such as the autonomic peripheral neuropathies and pure autonomic failure. The hallmark of both central and peripheral causes of neurogenic orthostatic hypotension is the failure to release norepinephrine appropriately upon standing. Patient education is the cornerstone of management. There are several measures that can be implemented to improve orthostatic tolerance prior to pharmacological intervention. Plasma volume expansion is essential to improve orthostatic tolerance, and fluid and sodium chloride intake should be increased. Most patients can be treated successfully with volume expansion or fludrocortisone or both in combination with a sympathomimetic agent. Desmopressin acetate and erythropoietin are useful supplementary agents in patients with more refractory symptoms. There are rare patients who will require additional agents to treat their symptoms. A small group of patients remain refractory to all therapeutic modalities.
What is the process of informed consent?
The process of informed consent occurs when communication between a patient and physician results in the patient’s authorization or agreement to undergo a specific medical intervention.
When should informed consent form be included in medical records?
Document the informed consent conversation and the patient’s (or surrogate’s) decision in the medical record in some manner. When the patient/surrogate has provided specific written consent, the consent form should be included in the record. In emergencies, when a decision must be made urgently, the patient is not able to participate in decision ...
Why is informed consent important?
Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care. Successful communication in the patient-physician relationship fosters trust and supports shared decision making.
What is the best treatment for hypervolemia?
Diuretics are often prescribed to treat hypervolemia. There are several approaches to treatment for hypervolemia. One of the most common treatments for hypervolemia is diuretics. Diuretics are drugs that increase the amount of urine the body produces. However, any underlying health conditions must also be addressed.
What is the purpose of a hypervolemia checkup?
Because hypervolemia is often caused by other health problems, a doctor may also undertake a comprehensive checkup to look for underlying conditions , such as heart failure, kidney problems, and liver disease.
Why does hypervolemia occur?
When there is too much salt present, the body retains water to balance it. Usually, hypervolemia occurs because the body has a problem regulating sodium and water, but other causes include certain medications or medical procedures .
What is the condition where the heart cannot pump enough blood to meet the body's needs?
Congestive heart failure is a condition in which the heart cannot pump enough blood to meet the body’s needs. When the heart’s blood pumping ability decreases, the kidneys cannot work as they should, which leads to an excess of fluid in the body.
Can birth control cause hypervolemia?
Also, some antidepressants, blood pressure medications, and nonsteroidal anti-inflammatory drugs ( NSAIDs) can cause mild hypervolemia.
Does IV fluid cause hypervolemia?
IV fluids typically contain sodium (salt) and water to replenish the body’s fluids and balance the sodium levels. However, too much IV fluid can result in hypervolemia, especially if other health conditions are present. One study found that too much IV fluid both during and after surgery was associated with hypervolemia and a higher risk ...
What is the treatment for asphyxiation?
Some treatments for asphyxiation include cardiopulmonary resuscitation (CPR) and oxygen therapy. If someone becomes unconscious due to asphyxiation, their heart may stop beating. When a person provides CPR, they essentially take on the role of the heart and lungs, helping blood and oxygen move around the body.
What is the term for a sexual act wherein a person cuts their oxygen supply to enhance sexual gratification
Autoerotic asphyxiation. Autoerotic asphyxiation refers to a sexual act wherein a person cuts their oxygen supply to enhance sexual gratification. People who try this tend to use an object to cause asphyxiation. For example, they may tie a rope tightly around their neck while masturbating.
What is the term for a person who inhales a chemical that interferes with oxygen intake or use?
Chemical asphyxia. Chemical asphyxia occurs when a person inhales a chemical that interferes with oxygen intake or use. One example of chemical asphyxia is carbon monoxide poisoning. If a person breathes in carbon monoxide, it mixes with the red blood cells that are carrying oxygen around the body.
What is the term for a baby that does not receive enough oxygen?
Asphyxiation during childbirth. Doctors refer to asphyxiation during birth as perinatal asphyxia. This occurs when the infant does not receive enough oxygen before, during, or after the birthing process. This can cause them to develop brain damage, breathing problems, or organ failure.
What is autoerotic asphyxiation?
Autoerotic asphyxiation. Summary. Asphyxiation occurs when the body does not get enough oxygen. This impairs normal breathing and may cause a person to become unconscious. It may also lead to death. Keep reading to learn more about asphyxiation, including some causes, symptoms, risk factors, and prevention techniques.
How to prevent asphyxiation from drowning?
Drowning: To prevent asphyxiation from drowning, a person may wish to avoid unfamiliar waters for which they do not know the current. If a person does not know how to swim, they may wish to consider taking swimming lessons.
What is the mask used for in oxygen therapy?
During oxygen therapy, a person wears either a mask over their nose and mouth or just a tube in their nose. The mask or tube is attached to a cylinder that provides air containing more oxygen than usual.