OET4U

STROKE PREVENTION IN ELDERLY PEOPLE  Stroke prevention is the cornerstone in the management of patients with atrial fibrillation (AF). Oral anticoagulation (OAC) has been the main strategy to reduce the risk of thromboembolism in most AF patients.  However, its effective use is hampered by several challenges, including the attended bleeding risk, noncompliance, and cost.  Elderly patients are further disadvantaged with additional factors that may limit the use of OAC, such as frailty, polypharmacy, and functional dependence. In addition, there are limited data to guide stroke prevention decisions in these patients; octogenarians are typically excluded from clinical trials, and observational data specific to their age group are sparse. Nonetheless, AF continues to be a major and increasing cause of stroke and disability in this population. In a nationwide US survey, more than 40% of patients aged 85 years and older admitted with ischemic stroke in 2014 had AF.With the...

 

 

  Strategies to survive severe infection ICU patients with sepsis often present dramatically different outcomes despite having had a similar initiating pathogen or pathogen load, or even having completely eliminated the original infection. The contrasting outcomes may be explained by the need for two different but interdependent and evolutionarily conserved defense strategies to survive a severe infection: resistance, which relies on effector mechanisms to reduce pathogen load, and disease tolerance, which provides host tissue damage control and limits disease severity irrespective of pathogen load . Research on the initiation of protective immune responses has so far mostly focused on the direct sensing of microorganisms via pattern recognition receptors (PRRs). The pattern-triggered immunity model states that PRRs recognize microorganism-associated molecular patterns (MAMPs) representative of different groups of microorganisms, which leads to the activation of effector mechanisms...

 

  Agoraphobia The lifetime prevalence of the common psychological problem known as panic disorder is between 1% and 5%.Panic disorder is characterised by recurrent and unexpected panic attacks associated with several comorbid psychiatric and non-psychiatric conditions such as anxiety, depression, and cardiovascular diseases and impairment of social, work, and family functioning. Agoraphobia is a strong fear or anxiety provoked by real or anticipated exposure to a wide range of situations and is often associated with panic disorder. Successive revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III, DSM-III-R, and DSM-IV) provide similar definitions of panic disorder, refined with each new edition; but in the fifth revision (DSM-5) panic disorder and agoraphobia have been defined individually. Q.Paragraph is about. about the difference between agoraphobia and panic attack. About how DSM will define  About the separate definition of agoraphobia.

 

 

 

 

 

  Dr Jan walker  Epstein Clinic 393 Victoria Road  Richmond , Melbourne  2/9/17 Dear Dr Walker, Re: Susan Forest, D.O.B 19/05/97 I am writing to refer Ms. Forrest, a 24-year-old female, whose clinical features are suggestive of asthma, for further assessment and management. Repeated information about age.  Ms. Forest is unmarried and works as a graphic designer, was diagnosed with asthma at the age of 4¹, Adding to this, In 2015 she was admitted to hospital because of two asthmatic attacks and hence,  commenced on Ventolin, Symbicort and Zyrtec. She also had a history of eczema, anxiety disorder and allergic rhinitis. She had a strong family history of asthma. Please note she is a chronic smoker and a social drinker. Social information medical information all mixed together. Initially, on 12/3/17, Ms. Forrest presented with a complaint of diarrhea which was improved after the encouragement of electrolytes. Subsequently, Ms forest reported complaints of...

 

  24  October  2009 Ms. Jennifer Adams The Elizabeth Community Health Centre 125 Munno Parra Avenue Elizabeth, 5098 Dear Ms. Adams, Re: Mr. Martin Wilson, aged 62 I am writing to refer Mr. Martin Wilson who requires immediate attention and follow up care from your service due to gambling addiction. He is being discharged today. Attempt of suicide due to depression related tp gambling addiction - is the condition of the patient. Mr. Wilson is a retired bookkeeper, and lives with his wife and son. He is a social drinker and has depression as a result of gambling addiction which was started two years ago. Additionally, he lost his friends and a huge amount of money including his pension funds. His family was unknown about his addiction and he is in debt. He has habit of drinking alcohol is good  Since it is an urgent letter because of gambling addiction and suicide attempt  you can organise  in a better way. Mr. Wilson was admitted to hospital on 13 Octobe...

 

 

  Ms Jane Hall Southern valley community 64 Gladstone Road Highgate Hill Qid4101 Re:Mr Sydney Loten;DOB:14/08/1946 Dear Ms Hall I am writing to refer Mrs Loten, who was admitted in the 11/04/2020 ,with multiple polyps, however,colonpolypectomy was done on the 13th of April 2020. To add on patient developed post operative complications and has been dependent on oxygen support .He requires home nursing care as she requires daily change of dressings and oxygen consumption monitoring. Write a simple introduction stating what is the present complaint of the patient and whatservice pt requires from the receiver's end. Patient is female Mr Luten takes alcohol occasionally and he smokes cigarettes . He was diagnosed with COPD in 2010 and been managed with ipratropium bromide inhaler 1puff.Additionally, he is a known diabetic and hypertensive patient on Metformin 500mg Bid and losartan 40 mg od respectively. Social information is mixed with medical information  Clarity of the lette...

  Dr Harley Chester General Practitioners Practice 765 Brunswick Road Centreville,3072 21 September,2018 Dear Dr Chester Re:Samuel Harvey,72 years old. I am writing to refer Mr. Harvey who has been diagnosed with nephrotic  syndrome. He requires follow up of ongoing investigation and management at your Centre. He requires further referral to Dr Hoffman(Nephrologist) to do further investigations and management of his condition. Mr Harvey presented to me on 14 September,2018 with complaints of painless swelling of his legs for two months. His swelling has been increased and involved his genitals.In addition, he reported puffiness of face, frothy urine, shortness of breath and bruising of skin.ON assessment, he has signs of fluid overload in the form of pitting oedema of legs,sacrum,external genitalia and ascites.His jugular venous pressure was elevated and BP is 166/98.  On Chest auscultation, findings were consistent with pleural effusion. Subsequently, blood and urine tes...

  05 May 2010 The Community Nurse Head Care Well Hospital Birmingham Dear Nurse, Re: Mr. Alfred Billy, aged 52 I am writing to refer Mr. Billy who is recovering from removal of basal cell carcinoma.He requires ongoing care from your service followed/ following his discharged/ discharge today. Tense Forms Mr. Billy was admitted on 21 March, 2010 to our hospital and was performed skin biopsy¹ for pathological study. The study result revealed that the diagnosis is skin cancer. Consequently, he underwent the surgery and has been prescribed on Panadein Fort 500 ² mg for pain relief. 1.a biopsy was performed 2.medication was prescribed. Passive voice correction Socially, Mr. Billy is a truck driver, lives with his wife Mrs. Maria Jennifer and please /would like to be contact /contacted with her in case of an emergency. He is an alcoholic( don't be judgemental) (he has a habit of drinking alcohol and smoking cigarettes ) for the past 30 years as well as a smoker . Today, Mr. Billy ...

  03 March,2022 Mrs Mary Francis District nurse Dear Mrs Francis Re: Mrs Norris Thompson Age:52 years I am writing to update you about the current health status of MRS Norris Thompson who required for the futher care and management at your service .she has been diagnosed with venous cellulitis .she is being discharged today. Is this a known case? Writing to a district nurse .So you can't write update. Better to write the patients presenting complaint in the first sentence and then the purpose of the letter  requires -tense form  Spell check for further Mrs Thompson was admitted to the hospital due to she had fallen on the rocks and she got injury/injured on foot.  During hospitalization she was administered and abiotic . she performed blood tests including wound swab .  Antibiotics were administered is the correct usage  Spell check for antibiotics. Blood tests were performed. Mrs Thompson has diabetic four years back  Mrs X has been diagnosed wit...