In a retrospective study, the risk factors for development of IPS and prognostic factors for outcomes were evaluated in 94 patients with relapsed Hodgkin disease treated with BCNU containing high-dose chemotherapy and hematopoietic support. The ability of the exercise stress test to identify (or to exclude) individuals with CAD is influenced by (a) their exercise capacity (ie, can the individual perform maximal or nearly maximal exercise?); (b) the presence of baseline ECG abnormalities (ie, bundle-branch block or ST segment depression) that may interfere with evaluation of ST segment changes; (c) medications that affect the ECG or the hemodynamic response to exercise (ie, digoxin and beta-adrenergic blocking agents, respectively); and (d) concomitant cardiac conditions that are associated with ECG abnormalities (ie, left ventricular hypertrophy, paced rhythm, pre-excitation) (Table e11-5). An initial validation of pulse oximetry with direct measurement of SaO2 is recommended in any critically ill patient. Restrictive lung function can be produced by increased elastic recoil of the lung parenchyma (interstitial lung disease), respiratory muscle weakness, mechanical restrictions (chest wall deformities), and/or poor effort. Signs and symptoms of a maculopapular skin rash include erythematous macules and papules that may be pruritic. Mortality rates up to 20% have been estimated in severe infection if left untreated, whereas patients receiving proper supportive care have only a 1% mortality rate. Some patients may be more prone to developing hypersensitivity ADRs and risk factors include the following: prior drug reaction (inducing drug-specific antibodies), multiple drug therapy or intermittent/repeated use of the same drug (vs continuous therapy), some concurrent illnesses (eg, HIV, Epstein-Barr virus, and CMV), dosage/serum drug level increases (eg, IV vancomycin administration rate), topical route of administration (more immunogenic than subcutaneous > intramuscular > oral > IV), certain genetic factors (eg, certain HLA-B alleles predispose for drug allergies), and certain comorbidities (eg, asthma). Great variability exists among individuals in response to drug therapy, and it is difficult to predict how effective or safe a medication will be for a particular patient. Certain cultures have strong family values or close-knit family structures. Obtaining an accurate history may be difficult because a number of neurologic diseases may affect patients' communication and memory. For example, the Microalbumin 2-1 Combo Strip (Teco Diagnostics) is a semiquantitative test for both albumin and creatinine in a spot urine sample. Several lifesaving options may be warranted for patients with cardiogenic shock that is refractory to conventional therapy, such as electrical cardiac pacing, intraaortic balloon counterpulsation or cardiopulmonary bypass. Halothane, sulfamethoxazole, carbamazepine, nevirapine, fluoroquinolones, and antitumor necrosis factor (TNF) alpha inhibitors are associated with autoimmune injuries. The approval was based on a phase III double-blind clinical trial in which 903 patients with advanced or mRCC, who had progressed after previous therapy with IFN-О± and/or IL-2, were randomized to treatment with sorafenib or placebo. Before labeling the patient as allergic to insulin, consideration should be given to the patient's insulin administration technique. Adaptation to the host has taken a number of forms: loss of locomotor organelles in the protozoan Sporozoa; partial and complete lack of digestive systems in the trematodes and cestodes, respectively; elaboration of proteolytic enzymes to penetrate the host intestinal mucosa by Entamoeba histolytica; the cercariae of the blood fluke that penetrate the skin of the host by elaborate enzymes; and, finally, the ability to infect an intermediate host to increase reproductive capacity, as seen among the cestodes and trematodes.
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