American family physician
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Insulinoma, glucagonoma, gastrinoma (Zollinger-Ellison syndrome), vipoma, somatostatinoma and a tumor that secretes human pancreatic polypeptide are the primary endocrine-secreting tumors of the pancreas. hormones are produced by specific tumor cell types and cause a variety of dramatic clinical pictures. Diagnosis often requires hormone assays. Computerized tomography may be helpful. Definitive surgical treatment is possible, but metastases may be present.
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Arterial blood gases are useful in establishing acid-base status, determining the degree of impairment of the lungs as a gas exchanger, diagnosing such important phenomena as pulmonary emboli and implementing or adjusting oxygen therapy. The balance among H+, HCO3- and CO2 is represented by the equation H+ + HCO3- in equilibrium CO2 + H2O. Primary alterations of either component of the left-hand side of the equation result in metabolic acid-base balance disturbances; primary alterations of CO2 result in respiratory acid-base balance disturbances.
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Conversion hysteria differs from hysteria in that it arises suddenly, rather than being a lifelong disorder. It is monosymptomatic rather than polysymptomatic, and is seen in men almost as frequently as in women. ⋯ Treatment may include removing the patient from a stressful environment and removing the "payoff" yielded by the illness. A confrontation with the patient is generally to be avoided.
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Adult respiratory distress syndrome is a type of acute respiratory insufficiency which is preceded by a variety of serious illnesses. The radiologic appearance ranges from scattered densities early in the course to complete consolidation later. ⋯ Treatment generally includes intubation, suctioning, oxygen and mechanical ventilation with positive end-expiratory pressure. Diuretics and methylprednisolone may also be used.