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Sindrom Cushing It’s my simple referat in internal medicine. Cushing Syndrome makalah cushing syndrome. Makalah Sindrom Cushing pemabahasan tentang sindrom cushingFull description.
Patway Cushing Sindrom Fix. Cushing’s Disease Sindrom cushing adalah kumpulan keadaan klinis yang diakibatkan oleh efek metabolik dari kadar glukokortikoid atau kortisol yang meningkat dalam darah. Nama penyakit ini diambil dari Harvey …Full description.
Patofisiologi Sindrom Cushing patofisiologi sindrom cushingFull description. Makalah Cushing Syndrome Kelompok 7 cushing syndrome. A Disease Study of Cushing’s Disease. Semoga laporan yang kami buat ini dapat bermanfaat bagi pembaca dan suatu saat dapat disempurnakan kembali dan apabila ada kesalahan dalam penulisan kami mohon maaf. Latar Belakang Nama penyakit diambil dari Harvey Cushing seorang ahli bedah yang pertama kali mengidentifikasi penyakit ini pada tahun Penyakit ini disebabkan ketika kelenjar adrenal pada tubuh terlallu banyak memproduksi hormone kortisol, komplikasi yang menyebabakan kecacatan pada penderita, yang akan mengakibatkan keterbatasan aktivitas, citra diri yang kurang bahkan kematian.
Maraknya penyakit ini makin menambah tantangan bagi tenaga kesehatan dan semakin meresahkan masyarakat. Masyarakat merupakan sasaran utama bagi tim kesehatan, keresahan masyarakat adalah keresahan tim kesehatan. Berdasarkan penelitian dan survey terhadap rumah sakit di Indonesia tentang penyakit Cushing Sindrom pada tahunhasil menyebutkan bahwa kejadian Cushing Sindrom terjadi pada orang dewasa berusia tahun, resiko terkena Chusing Sindrom mencapai 10 persen.
Dalam penelitian secara global didapat hasil sedikitnya 1 dari tiap 5 orang populasi dunia berkemungkinan terkena kelainan ini tanpa membedakan jenis kelamin. Namun sumber lain mengatakan rasio kejadian antara wanita dan pria untuk sindrom Cushing adalah sekitar 5: Disini peran perawat terhadap pasien dengan Cushing Sindrom meliputi beberapa upaya yang terdiri dari: Upaya promotif yaitu upaya untuk mencegah timbulnya penyakit atau kondisi yang memperberat penyakit Cushing Sindrom yang meliputi pencegahan primer dan pencegahan sekunder.
Pencegahan primer merupakan upaya yang dilaksanakan untuk mencegah timbulnya penyakit pada individu-individu yang sehat. Pencegahan primer adalah pengendalian melalui jalur kesehatan medical controlantara lain: Sedangkan pencegahan sekunder merupakan upaya perawat untuk menemukan tanda dan gejala penyakit Cushing Sindrom sedini mungkin, mencegah meluasnya penyakit, dan mengurangi bertambah beratnya penyakit, diantaranya: Pengawasan dan penyuluhan untuk klien Cushing Sindrom, agar klien tersebut benar-benar mengetahui cara pengobatan dan cara mengurangi gejala yang bisa dimunculkan dari penyakit Cushing Sindrom ini.
Pengamatan langsung mengenai perawatan klien Cushing Sindrom. Case-finding secara aktif, mencakup identifikasi Cushing Sindrom pada orang yang dicurigai dan rujukan pemeriksaan kadar kortisol yang tinggi dalam plasma darah. Upaya kuratif dan rehabilitative adalah upaya pengobatan penyakit Cushing Sindrom yang bertujuan untuk menyembuhkan penderita, mencegah kematian, dan menurunkan tingkat kejadian penyakit Cushing Sindrom.
Beberapa pendekatan terapi digunakan pada kasus dengan hipersekresi ACTH hipofisis. Jika dijumpai tumor hipofisis sebaiknya diusahakan reseksi tumor transfenoidal. Tetapi jika terdapat bukti hiperfungsi hipofisis namun tumor tidak dapat ditemukan maka sebagai gantinya dapat dilakukan radiasi kobalt pada kelenjar hipofise. Kelebihan kortisol juga dapat ditanggulangi dengan adrenalektomi total dan diikuti pemberian kortisol dosis fisiologik atau dengan kimia yang mampu menghambat atau merusak sel-sel korteks adrenal yang mensekresi kortisol.
Berdasarkan angka kejadian yang ada dan kegawatan yang dimunculkan oleh penyakit Xindrom Sindrom, perawat disini dituntut terutama untuk dapat melakukan tindakan keperawatan dalam pencegahan, penanggulangan maupun perawatan dalam proses penyembuhan penyakit Cushing Sindrom. Maka disusunlah makalah ini sebagai referensi dalam memberikan asuhan keperawatan pada klie dengan Cushing Sindrom, sehingga perawat tahu dan mampu untuk menerapkannya dalam praktek keperawatan.
Rumusan Masalah Bagaimana pengertian, etiologi, manifestasi klinis, patofisiologis, pemeriksaan, penatalaksanaan serta asuhan keperawatan Cushing Sindrom. Kortisol dalam jumlah yang cukup dilepaskan oleh kelenjar adrenal akan membantu pertahanan tubuh. Tetapi jumlah kortisol yang berlebihan dapat merubah fungsi normal proses tersebut dan mengakibatkan timbulnya gejala-gejala sindroma Cushing. Pada sindrom Cushing primer, terlalu askkep produksi kortisol yang diakibatkan oleh adenoma atau karsinoma adrenal.
Pada sindrom Cushing sekunder, terlalu banyak produksi kortisol yang diakibatkan oleh hyperplasia adrenal karena banyak sekali ACTH. Terlalu banyak produksi ACTH dapat diakibatkan oleh: Hipofisis mengeluarkan terlalu banyak ACTH karena gangguan hipofisis atau hipotalamus.
Keluarnya ACTH yang berasal dari ektopik non hipofisis produksi hormon di luar hipofisis meningkat, misalnya pada karsinoma bronkogenik, adenoma bronchial, dan karsinoma pancreas. Pada sindrom Cushing iatrogenic, kadar kortisol yang sangat tinggi sebagai akibat terapi glukokortikoid yang berlangsung lama. Katabolisme protein yang berlebihan mengaktifkan berkurangnya massa otot dengan tanda-tanda: Atrofi otot, terutama pada ekstremitas yang mengakibatkan lengan dan kaki kelihatan kurus, sulit berdiri dari posisi duduk, sulit naik tangga,serta keletihan dan kelelahan.
Berkurangnya protein matriks dari tulang asekp mengakibatkan osteoporosis, fraktur kompresi pada tulang belakang, fraktur patologis, serta nyeri tulang dan punggung. Hilangnya kolagen penyokong dari kulit yang mengakibatkan kulit menjadi tipis, cepat timbul memar, ekimosis, dan striae kemerahan pada abdomen.
Hipofisektomi
Perubahan metabolisme lemak mengakibatkan obesitas dan distribusi jaringan lemak tidak normal. Banyak lemak pada wajah mengakibatkan moon facepada daerah intrakapular isndrom humpdan pada mesenterium truncal obesity. Ada peningkatan glukogeogenesis hepatic dan ketidakmampuan memakai insulin yang mengakibatkan hiperglikemia postprandial dan diabetes mellitus DM.
Pasien yang sudah DM, gangguan metabolisme karbohidrat akan memperberat tanda-tanda DM. Perubahan respon imun dan respon inflamasi akibat berkurangnya limfosit, teruatama limfosit-T, meningkatnya neutrofil, dan gangguan kegiatan antibody.
Tiga perubahan ini akan membuat pasien sangat rawan terhadap infeksi viral dan infeksi fungal. Tanda awal infeksi seperti demam bias tidak tampak. Penyembuhan luka juga sulit. Gangguan metabolisme air dan mineral Kortisol itu sendiri mempunyai aktivitas mineralkortikoid sehingga kelebihan kortisol mengakibatkan tanda dan gejala peningkatan mineralkortikoid, walaupun aldosteron normal.
Retensi natrium dan air yang bisa mengakibatkan berat badan meningkat dan edema. Hipertensi sebagai akibat peningkatan volume cairan dan peningkatan sesitivitas arteriol terhadap katekolamin. Peningkatan ekskresi kalium dan klorida melalui urine hipokalemia dan hipokloremia yang bisa mengakibatkan alkalosis metabolic.
Peningkatan resorpsi kalsium dari tulang dan batu ginjal akibat hiperkloria. Perubahan pada stabilitas emosi, misalnya cepat marah, cemas, depresi ringan, serta konsentrasi dan ingatan menurun. Hal ini berkembang menjadi depresi berat dan psikosis.
Cushing Syndrome
Perubahan hematologis eritrosit, hemoglobin, hematokrit bisa meningkat. Hirsutisme banyak bulu tubuh pada wajah dan seluruh tubuhrambut kepala rontok, jerawat, gangguan siklus menstruasi dari oligominorea sampai aminoreadan perubahan libido.
Tanda dan Gejala 1. Rambut kepala menjadi tipis. Berjerawat dan pipi kemerahan. Bulu halus banyak pada wajah dan seluruh tubuh.
komplikasi sindrom cushing pdf – PDF Files
Striae kemerahan pada abdomen dan pendolus abdomen. Lengan dan kaki kurus dengan atrofi otot. Kulit cepat memar, ekimosis, dan penyembuhan cushign sulit. Sindroma Cushing tipe ACTH-independen ialah disebabkan oleh adenoma atau karsinoma adrenokortikal yang secara otonom mensekresi glukokortikoid.
Pada kasus ini terjadinya kortisol yang berlebihan akan mensupresi sekresi ACTH dari hipofisis. Pemeriksaan Diagnostik Pemeriksaan diagnostik untuk gangguan ini adalah dengan memeriksa adanya peningkatan kortisol serum, hilangnya irama diurnal dari produksi kortisol, CT scan, dan ultrasuara untuk mengetahui adanya tumor adrenal.
Pengobatan Mitotane, Aminogluthethamide, Trilostane yaitu anti hormonal yang menghambat sintesis kortisol, Cyptproheptadineuntuk menurunkan produksi ACTH pituitary. Baradero, Mary et al. Endokrinologi Dasar dan Klinik.
Download Askep Sindrom Cushing Bab i Pendahuluan a Kel4 –
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Jun 5, The Paperback of the Witch Fire (Elemental Witches Series #1) by Anya Bast at Barnes & Noble. FREE Shipping on $ or more!. After a chaotic marriage and a rough divorce, all Mira Hoskins wants is stability and normality. But when sexy Jack McAllister enters her life, she discovers. Elemental Witches Quartet Series. Anya Bast. Witch Fire by Anya Bast. Witch Heart by Anya Bast. Witch Fury by Anya Bast. Sign me up to get more news about .
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Witches are taking the nation by storm. With the untapped gift to create fire, witch Sarafina Connell is caught up in a war between good and evil.
After a chaotic marriage and a rough divorce, all Mira Hoskins wants is stability and normality. Jack is a powerful witch with the ability to command fire and is anything but normal. As the head of a security detail for The Coven, a national organization that governs national witches, Jack has been assigned to watch over Mira. She is a natural born witch with the ability to call the air.
Elemental Witches Quartet: Witch Fire 1 by Anya Bast (, Paperback) | eBay
And although she is unaware of her talent, a group of renegade witches has discovered her existence and are determined to steal her power—and her life. Other Series By Anya Bast.
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Primeras Letras O Primeras Lecturas by Cecilia Braslavsky, , By (author) Cecilia Braslavsky, By (author) Berta Braslavsky. Primeras Letras O Primeras Lecturas. 31 Dec by Cecilia Braslavsky and Berta Braslavsky by BERTA BRASLAVSKY. Currently unavailable. UNA PERSPECTIVA DIDÁCTICA. by BRASLAVSKY Berta. and a great selection of similar Used, New and Collectible Primeras letras o primeras lecturas?.
Un estudio de casos en contextos de pobreza de la Ciudad de Buenos Aires. Trujillo Reyes, Blanca Flor. Examen de ingreso al doctorado aprobado el 3 de julio de Buenos Aires, Editorial Teseo, Aproximaciones a la escuela del siglo XXI.
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Educacao e Realidade, v. Das Beispiel Argentinien”, en: Publicados en extenso en otras revistas especializadas, con arbitraje. The Journal of Media Literacy, vol. Agosto Montero, Julieta. Doctorado Trujillo Reyes, Blanca Flor. Texto completo Pineau, P. Libros compilados Dussel, I. Texto completo Caruso, M. Texto completo Dussel, I. Texto completo Pinkasz, D. Texto completo Tiramonti, G.
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Auch Kluges Etymologisches Wörterbuch der deutschen Sprache (jetzt in fünfter Aufl. In dritter Auflage besorgt von Dr. Friedrich Blass. klug, listig (Aesch.): . Das im Jahre erschienene etymologische Wörterbuch der lateinischen . den, soweit dem Verf. bekannt, Friedrich Schlegel in seinem Buche „über die unver- ständig, c(y%l-voo-g nahen Geistes d. h. scharfsinnig, klug (Od. In dritter Auflage besorgt von Dr. Friedrich Blass. Hannover 32, ff. ana iv a Spitze, Stachel: ygl. thuxvog, axav&a, axwv. and xt] roc klug, listig (Horn. ).
Frisk’s text is given practically unchanged only a few obvious typos have been correctedexcept for some rearrangement of the material.
Also for searching purposes, we have added the grammar label “v. This page is in NFC. Fragliche Ablautspekulationen bei Gray Language 1, ff.
Schwyzer und f. Kretschmer ist geneigt, nach dem Vorgang Forrers darin ein chattisches? Krahe IF rfiedrich, f. Loewe KZ 54, ff. Schon wegen der unklaren Bed. Chantraine Formation sehr zweifelhaft ist. Hypothesen bei Bq s.
Tor – Wiktionary
Im letzteren Sinn nach Specht KZ 59, f. Kretschmer Glotta 3, f. Wegen der nicht genau festzustellenden Bedeutung bleibt die Etymologie unsicher. Fraenkel Glotta 20, Kaum mit Benfey Wurzellex. Nach Mayer KZ 66, 96f. Wackernagel Glotta 2, 1ff. Fraenkel Glotta 2, 36f.
Wird allgemein und wohl richtig als LW aus lat. Herkunft unbekannt; wohl volksetymologisch klig LW. Abzulehnen Hoffmann Die Makedonen 40f. Nach Specht Ursprung und Havers Sprachtabu 56 ist die etymologiwches. Nach Prellwitz BB 17, f. Frisk Eranos 50, 8ff. Zur Bildung des Hinterglieds s.
Lagercrantz KZ 34, Nach Schwyzer IF 30, ff. Jensen bei Horn Grdz. Zur Sache Rostowzew Klio 6, ff. Da das ganz unsicher ist, bleibt diese Etymologie sehr fraglich.
Brommer Hermes 77, Mittelmeerwort Chantraine Formation Aus dem Mittel- und Neugriechischen stammen mpers. Kretschmer Glotta 20, f.
Zum letztgenannten Wort vgl. Ein l -Suffix tritt auch auf in lat. Zur Psilose Schwyzer RhM 78, ff. Der Vergleich mit lat. Religionsgeschichtliche Ffiedrich und Vorarbeiten Die Bildungen ordnen sich am besten nach den verschiedenen Suffixen.
Benennung eines Schiffsteiles, s. Devoto Scientia 16, Stamm einer weitverzweigten Wortsippe, die im Griechischen wie in anderen idg. Sprachen durch zahlreiche Nomina vertreten ist. Tochter des Kekrops, eine der Pflegerinnen des Erichthonios, eig.
Verfehlt Specht Etmyologisches Verfehlt Prellwitz KZ 47, f. Fragliche Kombinationen zur Stammbildung bei Specht Ursprung Abzulehnen Ehrlich Betonung 44f. Wlaschim Studien zu d. Wien ungedruckt; vgl. Kretschmer Glotta 19, ff. Aus anderen Etymologischhes werden zum Vergleich herangezogen: VS 21, 43, Bed. Die Ansicht Ungnads Language 13,idg. Verfehlt Specht KZ 64, 62f. Fraenkel Glotta 20, 84f.
LW angina zuletzt Leumann Sprache 1, Dagegen fehlt im Griechischen der weitverbreitete u -Stamm: Brugmann-ThumbSchwyzer ; s. Schmidt KZ 32, ff. Falls echt griechisch, eig. Fraenkel Friedrih 21, 39, Glotta 32, 22 mit Fick u.
Kretschmer Glotta 2, ff. In einem Scholion zu A. Falls die bei Nik. Von de Saussure MSL 6, 53 mit lat. Fruchtlose Deutungsversuche sind verzeichnet bei Bq; s. Nach der geistreichen Annahme Wackernagels KZ 29, f. Abzulehnen Diehl RhM 89, 96f.
Griechisches Etymologisches Wörterbuch
Gegen den sonst einleuchtenden Vorschlag von Buttmann Lexilogus 1, A. Verfehlt Margadant IF 50, Mit Solmsen Untersuchungen ff. Ferner das Nomen agentis od. Eine denominative oder deverbative Bildung liegt im Ptz. In Betracht kommt auch alb. Ziegler RhM 87, 74ff. Meyer KZ 22, ff. Daneben mit gutturalem Auslaut german. Vokal 7, Glotta 32, 22, Lexis 3, 55f. Ansprechend ist der Vorschlag Solmsens Unt.
Zum Formenbestand Schwyzer Bildung auf – nt o – wie lat. A wantheth. Nach Meillet BSL 26, 7ff. Seit Leo Meyer Vgl. Ausfuhrliche Darstellung bei Nilsson Gesch. Chantraine FormationThompson Fishes s.
Hoffmann Festschrift Bezzenberger 78f. Den besten Vergleich bietet aind. Nach Brugmann IF 15, 94ff. Noch zweifelhafter Jacobsohn KZ 38, f. Namensform Aiax durch oskische Vermittlung? Kretschmer Glotta 15, f. Nach Blumel IF 43, 2 72f. Laser Gymnasium 60, ff. Wieder anders Winter Prothet. Anders Kretschmer Glotta 27, 28f.
Ecuaciones Diferenciales by Paul Blanchard; Glen R. Hall; Robert L. Devaney at – ISBN – ISBN Differential equations / Paul Blanchard, Robert L. Devaney, Glen R. Hall Blanchard, equations.; Differential equations, Nonlinear.; Ecuaciones diferenciales. Ecuaciones Diferenciales (English, Spanish, Paperback) / Author: Paul Blanchard / Author: Glen R. Hall / Author: Robert L. Devaney ; ; Vector.
DevaneyGlen R. Certain models reappear throughout the book as running themes to synthesize different concepts from multiple angles, and a dynamical systems focus emphasizes predicting the long-term behavior of these recurring mod By taking advantage of readily available technology, the authors eliminate most of the specialized techniques for deriving formulas for solutions found in traditional texts and replace them with topics that focus on the HallRobert L.
glanchard The authors stress a more balanced approach, one that includes analytic, numeric, and graphical techniques. The text emphasizes modeling and qualitative theory throughout the course.
: Robert L. Devaney: Books
It employs technology significantly and consistently, presents linear and nonlinear systems in parallel, and includes an introduction to discrete dynamical DevaneyPaul BlanchardGlen R. In the phase plane, the solution curve enters the second quadrant and then echaciones into the third quadrant when y t In the phase plane this behavior corresponds to the solution curve moving from the third quadrant through the fourth quadrant and back to the original starting poi It balances analytic, numeric, and graphical techniques.
It emphasizes modeling, stresses qualitative theory throughout the diferencia,es, uses technology significantly and consistently, presents linear and nonlinear systems in parallel, and includes an introduction to discrete models of dynamical systems.
Throughout this text, technology is used as a tool for il The excitement is spreading – and your students should be a part of it! We are in the midst of a technological revolution, for which no other course on the mathematics curriculum is more significant than differential equations.
Computers and graphing calculators can now rapidly graph approximate solutions that students must be blanchrd HallDaniel Clyde OffinG.
The expanded topics include: There is a new section on the Maslov index and a new chapter on variational arguments as applied to the celebrated? DevaneyWilliam F. The book emphasizes modeling and qualitative theory throughout the course.
It employs technology significantly and consistently, presents linear and nonlinear systems in parallel, and includes an introduction to discrete dynamical systems.
Professor John Healey, Proessorial Research Associate, Religions Syriac- speaking Christianity, especially its earlier history and its emergence from the. Gillian Greenberg; John F. Healey, Leshono Suryoyo: First Studies in Syriac, Journal of Semitic Studies, Volume 53, Issue 1, 1 March JOHN F. HEALEY, Leshono Suryoyo: First Studies in Syriac (Gorgias Handbooks 2). Gorgias Press, Piscataway, NJ Pp. xxiii + (+.
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Confusion No More has 37 ratings and 5 reviews. John said: If you have read any other of Balsekar’s books, don’t read another one. They are all just the. Balsekar’s wisdom presented in his modern, eloquent, and often amusing style is so straight-forward and easy to understand that he banishes confusion!. Read “Confusion No More For the Spiritual Seeker” by Ramesh S. Balsekar with Rakuten Kobo. Balsekar’s wisdom presented in his modern, eloquent, and often.
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Verses from the Center. Visions of Awakening Space and Time. Zen Beyond All Words. The Tao of Being: A Think and Do Workbook. Miracle Of Witness Consciousness.
Tasting Birth and Death. The Heart Attack Sutra. Just This Is It. Shirish Kumar S Murthy.
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The Relationship Between ‘I’ and ‘Me’. Spiritual Search Step By Step. Advaita And The Buddha. The End of the Seeking. Pursue Happiness and Get Enlightened. Meaningful Trivialities From The Source. How I Met Ramesh: The way Existence mysteriously led spiritual seekers to Ramesh Balsekar.
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Complete Method For Clarinet:: op. First And Second Division. Other Titles. Vollständige Clarinett-Schule Complete celebrated method for clarinet. Description. Pl. no.: (v. 2); (v. 3), Carl. Complete Method For Clarinet – 3rd Division sheet music – clarinet sheet music by Carl Baermann: Carl Fischer. Shop the World’s Largest Sheet Music Selection .
Clarinet Daily Studies, Op. Composed by Carl Baermann Edited by Gustave Langenus. Classical Period and Studies. Published by Carl Fischer CF.
The series, as a whole, is designed to encourage students to achieve proper hand and body positions, strong finger technique, agility and proper breathing habits. Each study focuses on a particular challenge. This name will appear next to your review. Leave it blank if you wish to appear as “Anonymous”. Used to contact you regarding your review.
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Easily share your music lists with friends, students, and the world. A great resource for the early intermediate player all the way to the seasoned veteran! My only issue, and it is a tiny one, is the printing in some spots in the book is a little faded but still readable. Otherwise it is a great resource for any clarinet player This book is a poorly photo-copied version of the original. I’m not sure if the original copy is wrong or the printing is wrong. Basically my book came with muddled ink which nearly renders the notes unreadable.
I’d spend more for a more original copy run. In the future I would advise Sheet Music Plus to be careful about what they are selling to musicians and to proof the text! By far, this is the most efficient method book existing. In combination with the Rose etudes and other etudes, with advancementany clarinetist can be a virtuoso. This site uses cookies to analyze your use of our products, to assist with promotional and marketing efforts, to analyze our traffic and to provide content from third parties.
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Carl Baermann’s complete celebrated method for clarinet : (op. 63)
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Catalog Record: Complete method for clarinet : op. 63 -[64] | Hathi Trust Digital Library
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