By George W. Holcomb III, J. Patrick Murphy
Acclaimed for its unsurpassed clarity and plausible scope, Ashcraft's Pediatric surgical procedure offers authoritative, sensible tips on treating the whole variety of surgical difficulties in babies, childrens, and young people. the recent fifth version maintains this wonderful legacy with its completely up to date insurance of today's sizzling issues together with the elevated use of minimally invasive surgical procedure (MIS) for pediatric sufferers, urology, bariatric surgical procedure in children, and evidence-based remedies and results in childrens. professional seek advice functionality-new to this edition-offers handy entry to the full contents of the booklet, in addition to bonus surgical movies that show a number of the new concepts and techniques from the textual content that can assist you refine your abilities.
* Covers the total variety of surgical difficulties in babies, youngsters, and youngsters, for accomplished information in a single handy resource.
* deals insurance of minimally invasive surgical procedure, together with laparoscopy and thoracoscopy, outlining the professionals and cons of every approach.
* Discusses well timed themes reminiscent of bariatric surgical procedure in youth and evidence-based remedies and results in children.
* contains surgical videos-many new to this edition-which reveal easy methods to practice key techniques.
* Emphasizes a scientific concentration for a extensive spectrum of pediatric surgical problems, for assurance that pursuits the cloth most vital to you.
* encompasses a straight forward structure that makes assessment effortless for certification and recertification exams.
* locations an elevated emphasis on minimally invasive surgical procedure, reflecting the shift from open to closed strategies that permit for speedier restoration and higher outcomes.
* offers a brand new concentrate on evidence-based remedies and results, equipping you with today's top practices.
* deals the full textual content on-line, absolutely searchable, in addition to the entire illustrations downloadable in your own shows, and entry to surgical video clips at expertconsult.com.
* contains over 900 illustrations-more than part new to this edition-that depict today's top surgical practice.
* presents on-line references associated with PubMed for simple entry to abstracts and entire textual content articles.
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Increased muscle protein catabolism is a successful short-term adaptation during critical illness but is limited and ultimately harmful to the pediatric patient with reduced protein stores and elevated protein demands. Without elimination of the inciting stress, the progressive breakdown of diaphragmatic, cardiac, and skeletal muscle can lead to respiratory compromise, fatal arrhythmia, and loss of lean body mass. Moreover, a prolonged negative protein balance may have a significant impact on the child’s growth and development.
91 During the early ebb phase, triglyceride levels may initially increase as the rate of lipid metabolism decreases. However, this process reverses itself in the predominant flow phase. 93 The increased lipid metabolism is thought to be proportional to the overall degree of illness. The process of lipid turnover involves the conversion of free fatty acids and their glycerol backbone into, and hydrolytic cleavage from, triglycerides. Thirty to 40 percent of free fatty acids are oxidized for energy.
4 is characteristic of biochemical essential fatty acid deficiency, although this value is somewhat variable and dependent on the specific laboratory assay utilized. Signs of fatty acid deficiencies include dermatitis, alopecia, thrombocytopenia, increased susceptibility to infection, and overall failure to thrive. 5% of total calories, respectively. In addition, some evidence exists that the long-chain fatty acid docosahexaenoic acid (DHA), a derivative of linolenic acid, also may be deficient in preterm and formula-fed infants.
Ashcraft's Pediatric Surgery by George W. Holcomb III, J. Patrick Murphy