PANCREATITIS

 Pancreatitis is inflammation in the pancreas. The

pancreas is a long, flat gland that sits tucked behind
the stomach in the upper abdomen. The
pancreas produces enzymes that help
digestion and hormones that help
regulate the way your body processes
sugar (glucose).
FORMS OF PANCREATITIS
 Acute pancreatitis is a
sudden inflammation that lasts for a short
time. It may range from mild discomfort to a
severe, life-threatening illness. Most people
with acute pancreatitis recover completely
after getting the right treatment.
 In severe cases, acute pancreatitis can
result in bleeding into the gland, serious
tissue damage, infection,
and cyst formation. Severe pancreatitis can
also harm other vital organs such as
the heart, lungs, and kidneys.
 FORMS OF PANCREATITIS
 Chronic pancreatitis is long-
lasting inflammation of the pancreas. It most often
happens after an episode of acute pancreatitis. Heavy
alcohol drinking is another big cause. Damage to the
pancreas from heavy alcohol use may not cause
symptoms for many years, but then the person may
suddenly develop severe pancreatitis symptoms.
SYMTOMS OF PANCREATITIS
Acute Pancreatitis:
 Upper abdominal pain that radiates
into the back; it may be aggravated
by eating, especially foods high in fat.
 Swollen and tender abdomen
 Nausea and vomiting
 Fever
 Increased heart rate
Chronic Pancreatitis:
 The symptoms of chronic pancreatitis are
similar to those of acute pancreatitis.
Patients frequently feel constant pain in
the upper abdomen that radiates to the
back. In some patients, the pain may be
disabling.
 Other symptoms are diarrhea and weight
loss caused by poor absorption
(malabsorption) of food. This
malabsorption happens because the
gland is not releasing enough enzymes to
break down food. Also, diabetes may
develop if the insulin-producing cells of
the pancreas are damaged.
CAUSES OF PANCREATITIS

 In most cases, acute pancreatitis is caused by gallstones or heavy alcohol use.

Other causes include medications, autoimmune disease, infections,
trauma, metabolic disorders, and surgery. In up to 15% of people
with acutepancreatitis, the cause is unknown.

 In about 70% of people, chronic pancreatitis is caused by long-time alcohol use.

Other causesinclude gallstones, hereditary disorders of the pancreas, cystic fibrosis,
high triglycerides, and certain medicines. In about 20% to 30% of cases, the cause
of chronic pancreatitis is unknown.
HOW PANCREATITIS IS DIAGNOSED
To diagnose acute pancreatitis, doctors measure levels in the blood of
two digestive enzymes, amylase and lipase. High levels of these two
enzymes strongly suggest acute pancreatitis.
Doctors may also use other tests, such as:
 Pancreatic function test to find out if the pancreas is making the right
amounts of digestive enzymes
 Glucose tolerance test to measure damage to the cells in the pancreas
that make insulin
 Ultrasound, CT scan, and MRI, which make images of the pancreas so
that problems may be seen
 ERCP to look at the pancreatic and bile ducts using X-rays
 Biopsy, in which a needle is inserted into the pancreas to remove a
small tissue sample for study
TREATMENT
Treatment for Acute Pancreatitis
People with acute pancreatitis are typically treated with IV fluids and
pain medications in the hospital. In some patients, the pancreatitis can be
severe and they may need to be admitted to an intensive care unit (ICU). In
the ICU, the patient is closely watched because pancreatitis can damage
the heart, lungs, or kidneys. Some cases of severe pancreatitis can result in
death of pancreatic tissue. In these cases, surgery may be necessary to
remove the dead or damaged tissue if an infection develops.
An acute attack of pancreatitis usually lasts a few days. An acute attack
of pancreatitis caused by gallstones may require removal of
the gallbladder or surgery of the bile duct. After the gallstones are removed
and the inflammation goes away, the pancreas usually returns to normal
TREATMENT
 Chronic pancreatitis can be difficult to treat. Doctors will try to relieve
the patient's pain and improve the nutrition problems. Patients are
generally given pancreatic enzymes and may need insulin. A low-fat
diet may also help.
 Surgery may be done in some cases to help relieve abdominal pain,
restore drainage of pancreatic enzymes or hormones,
treat chronic pancreatitis caused by blockage of the pancreatic
duct, or reduce the frequency of attacks.
 Patients must stop smoking and drinking alcoholic beverages, follow
their doctor's and dietitian's dietary advice, and take the proper
medications in order to have fewer and milder attacks of pancreatitis.
 Mild pain is first treated with a medicine such
as acetaminophen or ibuprofen. If you have stronger pain, you may
be given an opiate pain reliever. Pancreatic enzyme supplements.
URINARY TRACT
INFECTION
 A urinary tract infection (UTI) is an infection from
microbes. These are organisms that are too small to be
seen without a microscope. Most UTIs are caused by
bacteria, but some are caused by fungi and in rare
cases by viruses. UTIs are among the most common
infections in humans.
 A UTI can happen anywhere in your urinary tract. Your
urinary tract is made up of your kidneys, ureters,
bladder, and urethra. Most UTIs only involve the urethra
and bladder, in the lower tract. However, UTIs can
involve the ureters and kidneys, in the upper tract.
Although upper tract UTIs are more rare than lower
tract UTIs, they’re also usually more severe.
SYMPTOMS OF UTI
Symptoms of a UTI depend on what part of the urinary tract is infected.
Lower tract UTIs affect the urethra and bladder. Symptoms of a lower tract
UTI include:
 burning with urination
 increased frequency of urination without passing much urine
 increased urgency of urination
 bloody urine
 cloudy urine
 urine that looks like cola or tea
 urine that has a strong odor
 pelvic pain in women
 rectal pain in men
SYMPTOMS OF UTI
Upper tract UTIs affect the kidneys. These can be potentially
life threatening if bacteria move from the infected kidney into
the blood. This condition, called urosepsis, can cause
dangerously low blood pressure, shock, and death.
Symptoms of an upper tract UTI include:
 pain and tenderness in the upper back and sides
 chills
 fever
 nausea
 vomiting
TREATMENT
 Treatment of UTIs depends on the cause. Your doctor will
be able to determine which organism is causing the
infection from the test results used to confirm the
diagnosis.
 In most cases, the cause is bacteria. UTIs caused by
bacteria are treated with antibiotics.
 In some cases, viruses or fungi are the causes. Viral UTIs
are treated with medications called antivirals. Often, the
antiviral cidofovir is the choice to treat viral UTIs.
Fungal UTIs are treated with medications
called antifungals.
HYPOTHERMIA
 Hypothermia is a potentially dangerous drop in body
temperature, usually caused by prolonged exposure to cold
temperatures. The risk of cold exposure increases on winters.
But if you're exposed to cold temperatures on a spring hike or
capsized on a summer sail, you can also be at risk of
hypothermia.
 Normal body temperature averages 98.6 degrees. With
hypothermia, core temperature drops below 95 degrees. In
severe hypothermia, core body temperature can drop to 82
degrees or lower.
SYMPTOMS OF HYPOTHERMIA
CAUSES OF HYPOTHERMIA
 Cold exposure. When the balance between the body's heat
production and heat loss tips toward heat loss for a prolonged
period, hypothermia can occur. Accidental hypothermia usually
happens after cold temperature exposure without enough warm,
dry clothing for protection.
 However, much milder environments can also lead to hypothermia,
depending on a person's age, body mass, body fat, overall health,
and length of time exposed to cold temperatures. A frail, older adult
in a 60-degree house after a power outage can develop
mild hypothermia overnight. Infants and babies sleeping in cold
bedrooms are also at risk.
How does cold causes Hypothermia
 During exposure to cold temperatures, most heat loss -- up to 90% -- escapes through
your skin; the rest, you exhale from your lungs. Heat loss through the skin happens
primarily through radiation and speeds up when skin is exposed to wind or moisture. If
cold exposure is due to being immersed in cold water, heat loss can occur 25 times
faster than it would if exposed to the same air temperature.
 The hypothalamus, the brain's temperature-control center, works to raise body
temperature by triggering processes that heat and cool the body. During cold
temperature exposure, shivering is a protective response to produce heat through
muscle activity. In another heat-preserving response -- called vasoconstriction --
blood vessels temporarily narrow.
 Normally, the activity of the heart and liver produce most of your body heat. But as
core body temperature cools, these organs produce less heat, in essence causing a
protective "shut down" to preserve heat and protect the brain. Low body
temperature can slow brain activity, breathing, and heart rate.
 Confusion and fatigue can set in, hampering a person's ability to understand what's
happening and make intelligent choices to get to safety.
RISK FACTOR FOR HYPOTHERMIA
People at increased risk for hypothermia include:

 The elderly, infants, and children without adequate heating, clothing,

or food
 People with mental illness
 People who are outdoors for extended periods
 People in cold weather whose judgment is impaired
by alcohol or drugs
TREATMENT
Hypothermia is a potentially life-threatening condition that needs emergency medical attention.
If medical care isn't immediately available:
 Remove any wet clothes, hats, gloves, shoes, and socks.
 Protect the person against wind, drafts, and further heat loss with warm, dry clothes and
blankets.
 Move gently to a warm, dry shelter as soon as possible.
 Begin rewarming the person with extra clothing. Use warm blankets. Other helpful items for
warming are: an electric blanket to the torso area and hot packs and heating pad on the
torso, armpits, neck, and groin; however, these can cause burns to the skin. Use your own
body heat if nothing else is available.
 Take the person's temperature if a thermometer is available.
 Offer warm liquids, but avoid alcohol and caffeine, which speed up heat loss. Don't try to
give fluids to an unconscious person.
 If the hypothermic person is unconscious, or has no pulse or signs of breathing, call for
emergency help right away. CPR (cardiopulmonary resuscitation) should be given
immediately if a pulse can’t be felt and there is no sign of breathing. Feel for the pulse for up
to a whole minute before starting CPR, because the heart rate may be extremely slow and
you should not start CPR if there is any heart beat present.
 If the hypothermic person is unconscious, or has no pulse or signs of breathing, call for
emergency help right away. CPR (cardiopulmonary resuscitation) should be given
immediately if a pulse can’t be felt and there is no sign of breathing. Feel for the pulse for
up to a whole minute before starting CPR, because the heart rate may be extremely slow
and you should not start CPR if there is any heart beat present.
 In cases of advanced hypothermia, hospital treatment is required to rewarm the core
temperature. Hypothermia treatment may include warmed IV fluids, heated and
humidified oxygen, peritoneal lavage (internal "washing" of the abdominal cavity), and
other measures. Complications during recovery can include pneumonia, heart
arrhythmias, ventricular fibrillation (a dangerous "fluttering" rhythm of the heart), cardiac
arrest (a sudden stopping of the heartbeat), and death.
 AVIAN FLU
 Bird flu, also called avian influenza, is a viral infection that
can infect not only birds, but also humans and other animals.
Most forms of the virus are restricted to birds.
 H5N1 is the most common form of bird flu. It’s deadly to birds
and can easily affect humans and other animals that come
in contact with a carrier. According to the World Health
Organization, H5N1 was first discovered in humans in 1997
and has killed nearly
60 percent of those infected.
 Currently, the virus isn’t known to spread via human-to-
human contact. Still, some experts worry that H5N1 may pose
a risk of becoming a pandemic threat to humans.
 SYMPTOMS OF AVIAN FLU
 High Temperature  Runny or blocked nose
 Dry, chesty cough  Sneezing
 Sore throat  Loss of appetite
 Headache  Acute respiratory distress
 Tiredness  Shortness of Breath
 Limb or joint pain  Insomnia
 Diarrhea or stomach  Malaise
upset  Muscle aches

If you’re exposed to bird flu, you should notify staff before you arrive at the
doctor's office or hospital. Alerting them ahead of time will allow them to
take precautions to protect staff and other patients before caring for you
TREATMENT
Different types of bird flu can cause different symptoms. As a result, treatments
may vary.
 In most cases, treatment with antiviral medication such
as oseltamivir (Tamiflu) or zanamivir (Relenza) can help reduce the severity of
the disease. However, the medication must be taken within 48 hours
after symptoms first appear.
 The virus that causes the human form of the flu can develop resistance to the
two most common forms of antiviral
medications, amantadine and rimantadine (Flumadine). These medications
shouldn’t be used to treat the disease.
 Your family or others in close contact with you might also be prescribed
antivirals as a preventive measure, even if they aren’t sick. You’ll be placed in
isolation to avoid spreading the virus to others.
 Your doctor may place you on a breathing machine if you develop a severe
infection.
PREVENTION
 Your doctor may recommend you get a flu shot so that you don’t
also get a human strain of influenza. If you develop both the avian flu
and human flu at the same time, it could create a new and possibly
deadly form of the flu.
 The CDC has issued no recommendations against traveling to
countries that are affected by H5N1. However, you can minimize your
risk by avoiding:
 open-air markets
 contact with infected birds
 undercooked poultry
 Be sure to practice good hygiene and wash your hands regularly.