Heme onc questions

Have trouble differentiating between the lights on the plane. Pilots have to wait at least 6 hours after taking Viagra before they can fly a plane. Metformin: contraindications include renal failure (Cr > 1.5 for M or 1.4 for F), decreased Cr clearance, CHF, liver disease, and EtOH abuse. Since metformin is processed by kidneys and liver, there is increased risk of lactic acidosis in thes pt. Metformin should also be suspended temporarily in pt who undergos radiologic procedures usinc contrast. High risk pt should be Rx with Na bicarbonate or normal saline infusion and acetylcysteine to prevent contarast induced ARF. c-ANCA: positive in pt with polyarteritis nodosa and wegener’s granulomatosis. PAN can happen with chronic hep B infection. Both PAN and wegener’s have normal serum complement levels. Heme Onc Supraventricular Tachycardia: look for a narrow QRS complex. There are many types of SVT (AV nodal reentry, afib, a flutter). One way to distinguish btw these is to increase vagal tone to the heart by Valsalva or adenosine administration. This slows the heart rate until a rhythm can be regonized, and can potentially break the SVT and return pt to normal sinus rhythm. Metastatic Brain cancer: survival is 1 month if untreated. Whole brain radiation therapy is Rx of choice. It can improve survival for 3-6 months. Steroids can also help increase pt survival for 2 months. Chemo generally isn’t useful, since it doesn’t penetrate the BBB. Sickle Cell Crisis: episode of acute pain with a wide range of severity. MC locations include the back, chest, extremities, and abdomen. Some triggers include nocturnal hypoxemia, cold, infection, stress, alcohol, dehydration. FSOM is to give IV fluids or oral fluids to ensure hydration. IV morphine or ketolorac are the painkillers of choice in sickle cell pt. Give them after fluids are started. Splenic Sequestratino Crisis: Young kids with SCD are susceptible, since their spleens aren’t fibrotic yet. In SCC, a dramatic fall in Hb occurs secondary to vasoocclusion within the spleen, and there is splenic pooling of red blood cells. The spleen rapidly enlarges, and the pt can go on to experience hypovolemic shock. Pt with SCC who don’t receive blood transfusions in time can have mortality up to 15%. Thus, be wary of any kid that has spllenomegaly. FSOM is to get a CBC. Of note, any pt with splenomegaly is at increased risk for splenic rupture (not just mono). Primary

Iron plays a number of critical roles in the body, which makes iron-rich foods an essential part of any balanced diet. Fortunately, plenty of great iron-rich foods fit into all kinds of diets, from low carb to plant-based.According to Sarah Gold Anzlovar, RDN, a Boston-based nutritionist in private practice, “Most well known is that iron is a key component of red blood cells and helps transport oxygen from your lungs to the rest of the body.”According to research, iron deficiency is the most common nutritional deficiency globally — especially among children and pregnant women — and it affects up to 30 percent of both women and children in the United States.Iron deficiency, a condition called anemia, makes it difficult for your red blood cells to deliver oxygen, according to the Mayo Clinic.Needless to say, it’s vitally important to ensure that you keep up an adequate iron intake. With that said, read on to learn about some of the best healthy, iron-rich foods.How Much Iron Do You Need Per Day?According to the National Institutes of Health Office of Dietary Supplements, here’s how much iron different groups of people need per day:Nonpregnant Women Ages 19 to 50 18 milligrams (mg)Pregnant Women 27 mgWomen Age 51 and Older 8 mgMen Age 19 and Older 8 mgInfants and Children 7 to 15 mg, depending on ageAvoid Consuming Too Much IronThe Office of Dietary Supplements cautions against taking in more than 45 mg of iron per day if you are a teenager or adult and more than 40 mg per day among those age 13 and younger.Heme vs. Non-Heme Iron: What’s the Difference?“There are two types of iron: heme iron from animal sources and non-heme iron from plant sources,” says Frances Largeman-Roth, RD, a nutritionist and the author of Eating in Color: Delicious, Healthy Recipes for You and Your Family. The Office of Dietary Supplements notes that meat, poultry, and seafood contain both heme and non-heme iron.Heme iron is more easily absorbed by the body than plant-based non-heme iron, states the Cleveland Clinic. This means it can be beneficial to get both types of the

REMOTE-FIRST COMPANY/IRVINE, Calif.--(BUSINESS WIRE)--NextGen Healthcare, Inc. (Nasdaq: NXGN), a leading provider of innovative, cloud-based healthcare technology solutions, today announced its clinical data exchange solution, Mirth® Connect, has achieved the Office of the National Coordinator for Health Information Technology (ONC Health IT) 2015 Edition Cures Update certification. Mirth Connect met the rigorous standards for security of healthcare data required to receive certification by SLI Compliance®, an ONC Authorized Certification Body (ONC-ACB).Effective interoperability between providers is critical for positive patient outcomes. The complexity between different organizations, data types and formats, and the variety of connectivity methods used to exchange patient information requires a high degree of flexibility and customizability to meet specific healthcare needs. Mirth Connect was created with this in mind. ONC-ACB certification signifies that Mirth Connect complies with all applicable certification requirements in support of the 21st Century Cures Act. With this certification, users have greater assurance of data integrity as well as optimal security when exchanging patient data.“Mirth Connect simplifies data exchange so that providers can glean meaningful insights that lead to improved patient outcomes,” said David Sides, president and chief executive officer at NextGen Healthcare. “The certification of our open-source application, which has the flexibility, compatibility, and functionality to integrate into most healthcare systems, is yet another example of how NextGen Healthcare is leading the way in interoperability and secure data exchange.”“The seamless exchange of data that Mirth Connect enables is unrivaled,” said Robert Werner, senior interface developer at University of Toledo Medical Center. “I’ve been using integration engines for 25 years, and Mirth Connect, by far, blows away the competition.”Last year, NextGen Healthcare announced NextGen® Enterprise was the first complete EHR to receive ONC Health IT Cures Certification. Soon after, NextGen® Office, the company’s award-winning electronic health record and practice management (EHR/PM) platform for small practices, also attained certification.A worldwide integration engine leader, Mirth Connect is used by domestic and international hospitals, health systems, clinics, provider groups, labs and testing facilities, public health agencies, government entities, health IT organizations, pharmacies, and more. These organizations rely on Mirth Connect to deliver compliant data with speed and accuracy.For more information about Mirth Connect, visit the website here.About This CertificationMirth Connect version 4.2 is 2015 Edition Cures Update compliant and has been certified by an ONC-ACB in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. This certification does not represent an endorsement by

Dates SmoothieThis easy to make smoothie uses iron rich sesame seeds and dates to make a healthy iron rich drink.Sesame seeds contain a delicious nutty flavour and are high in iron. Adding 4 dried dates with 2 tablespoons of sesame seeds will provide you with 4.45 mg of iron per serve. They’re also high in phosphorus, vitamin E, and zinc. Follow these simple steps to make a flaxseed and sesame smoothie:Add some milk and honey to a blenderPut soaked dates and sesame seeds into thisBlend till it turns smooth and thickDrink freshSummaryThese juices will help to boost your iron requirement. Also these juices are not the substitute for the treatment. If you are pregnant, consult your doctor before including these in your daily diet.Healthy Iron Rich Drink Recipes to Boost Your Hemoglobin1. Beet and Orange SmoothieIngredientsOrange: 1 (peeled)Beet: ½ cupFrozen strawberries: 1 cupApple: 1Water: ½ cupMethodBlend the ingredients until smoothYou can add lemon juice to give it a tangy flavour.2. Spinach and Pineapple SmoothieIngredientsSpinach leaves: 2 cupsPeeled orange: 1Pineapple: ½ cupLemon juice: ½ teaspoonMethodMix and blend the ingredients to get a thick smoothieSprinkle some sesame seeds to enhance the iron content and give a crunchJuices for AnaemiaSince juices differ from combining fruits and vegetables into a smoothie, the nutritious value of the meal gets affected. Smoothies contain entire fruits and vegetables that you mix. In contrast, juices involve crushing the fruit and vegetables.As a result, juices release only the liquid and leave the pulp of the food behind. Indeed, it’s smooth in texture, but the fibre content changes significantly. Furthermore, juices do not have enough vitamin C for an iron boost.The nutritional content of juices purchased at local grocery shops usually is labelled, but storage time and temperature can affect it.For example, after 31 days of opening the juice and storing it in the fridge, the vitamin C level drops by 60 to 67%. Therefore, preparing juice at home is better to achieve the taste and texture you like while also getting the vitamin C you require.Foods to Avoid that Reduce Iron AbsorptionPhytatesPhytic acid or phytates are commonly found in seeds, grains, nuts and legumes and studies have shown that they can significantly hinder iron absorption. Soaking or sprouting these foods will reduce the phytic acid content. CalciumExcessive calcium can prevent iron from getting absorbed from iron-rich diets. Thus, avoid consumption of dairy products while having an iron-rich meal. Heme and Nonheme Iron FoodsIt is advisable to eat non-heme iron foods (plant sources) with heme-iron foods. Non-heme foods include beans, dark leafy greens, beets, mint leaves, Manathakkali greens sesame seeds etc. On the other hand, Heme-iron can be obtained from animal sources like organ meat, poultry and seafood.SummaryFoods that contain

De él por un poco de dinero y por un bocado de pan, diciéndole: ’Por favor, asóciame con alguno de los servicios sacerdotales, a fin de que yo tenga un poco de pan para comer.’ " Jehovah se revela al joven Samuel 27 3 El joven Samuel servía a Jehovah delante de Elí. La palabra de Jehovah escaseaba en aquellos días, y no había visiones con frecuencia. 2 Pero aconteció cierto día, mientras Elí (cuyos ojos habían comenzado a debilitarse, de modo que no podía ver) estaba acostado en su aposento 3 y Samuel dormía en el templo de Jehovah donde estaba el arca de Dios, que antes que la lámpara de Dios fuese apagada, 4 Jehovah llamó a Samuel, y él respondió: -Heme aquí. 5 Y corrió a Elí diciendo: -Heme aquí. ¿Para qué me has llamado? Elí respondió: -Yo no te he llamado. Vuelve a acostarte. El se volvió y se acostó, 6 y Jehovah volvió a llamar: -¡Samuel! Samuel se levantó, fue a Elí y dijo: -Heme aquí. ¿Para qué me has llamado? Elí respondió: -Hijo mío, yo no te he llamado. Vuelve a acostarte. 7 Samuel todavía no conocía a Jehovah, ni la palabra de Jehovah le había sido aún revelada. 8 Jehovah llamó por tercera vez a Samuel; y él se levantó, fue a Elí y dijo: -Heme aquí. ¿Para qué me has llamado? Entonces Elí entendió que Jehovah llamaba al joven. 9 Y Elí dijo a Samuel: -Vé y acuéstate; y sucederá que si te llama, dirás: "Habla, oh Jehovah, que tu siervo escucha." Samuel se fue y se acostó en su sitio. 10 Entonces vino Jehovah, se paró y llamó como las otras veces: -¡Samuel, Samuel! Samuel respondió: -Habla, que tu siervo escucha. 11 Y Jehovah dijo a Samuel: -He aquí, yo voy a hacer algo en Israel, que a quien lo escuche le retiñirán ambos oídos. 12 Aquel día cumpliré contra Elí, de principio a fin, todas las cosas que he hablado contra su casa. 13 Yo le he declarado que juzgaré a su casa para siempre, por la iniquidad que él