Spanish Presentation - Obesity Amongst Latinos in America

http://www.asu.edu/courses/css335/whyconcern.htm

An article written by Greg Critser, titled "Let them Eat Fat", examines how certain fast food joints strategically place restaurants in certain areas and certain communities. Those communities are generally in low income, low wage areas. Because of low prices and affordable menus, people with low income can enjoy their food. These are generally built in Hispanic and African American communities, and this is suspected to be a reason that African Americans and Hispanics rank one and two in highest rates of obesity and related diseases.


http://www.npr.org/templates/story/story.php?storyId=106268439


http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Hispanics-and-Heart-Disease-Stroke_UCM_444864_Article.jsp


Labels:


Nursing Fundamentals Research Paper






­Stevens-Johnson Syndrome (SJS)
Daniel Contreras
 Nursing Fundamental Concepts PTVN P009 CRN 30350
Mrs. Elizabeth Keele
April 9, 2014









Stevens-Johnson Syndrome
     It is well-known that medications may bring certain side effects onto the individual taking them. One major, often drug-related, side effect is a body abnormality known as erythema multiforme. This condition is caused by either a viral infection or an allergic reaction against medication(s) within a certain individual. Erythema multiforme’s most severe and life-threatening form is known as Stevens-Johnson Syndrome (SJS) (U.S. National Library of Medicine, 2012); in fact, it was named after the two pediatricians Albert Mason Stevens and Frank Chambliss Johnson whom discovered it in 1922 (Iannelli, 2013). To understand this rare and unpredictable medical condition, one must look at how Stevens-Johnson Syndrome affects the afflicted person’s physiological processes, what the main causes are, the signs and symptoms, and lastly how to diagnose and treat the condition.
Pathophysiology
     Even though Stevens-Johnson Syndrome (SJS) is a life-threatening condition, it is very rare within healthy populations. Its occurrence is actually as low as 0.05 to 2 people per million every year (Barvaliya & Sanmukhani & Patel & Paliwal & Shah & Tripathi, 2011). However, SJS is more common amongst the populations with Human Immunodeficiency Virus (HIV) or Acquired Immunodeficiency Syndrome (AIDS) because their immune systems are more vulnerable and susceptible to allergic reactions or infections (Barvaliya, 2011). Additionally, Stevens-Johnson Syndrome appears mostly in children and older adults (U.S. National Library of Medicine, 2012). This is because both children and elderly take various types of medications which are associated with the condition (Skin Association, n.d.); therefore, they increase their chances on having an allergic reaction and possibly developing SJS.
     Stevens-Johnson Syndrome (SJS) is characterized primarily by blistering throughout the body (RelayHealth, 2013). Also, the shedding of the epidermis and mucositis (the inflammation of mucous membranes) occurs which may lead to further problematic issues such as conjunctivitis (inflammation of the eyes or eyelids). During the initial stage, Stevens-Johnson Syndrome may feel like a common cold and bring flu-like symptoms (Mayo Clinic Staff, 2011); however, it is uncommon that SJS is caused by a virus such as the Herpes virus or a Mycoplasma virus (U.S. National Library of Medicine, 2012). Next, rashes or blisters begin to appear which may spread quickly throughout the body in places such as the eyes, genital areas, and mouth (Skin Association, n.d.). These are typically itchy or painful to the person and may cause chronic discomfort. Typically, less than 10 percent of the skin is affected by Stevens-Johnson Syndrome; anything more than 10 percent is considered Toxic Epidermal Necrolysis (Butt & Cox & Lewis & Ferner, 2011). After the second stage, shedding of the skin’s top layer occurs and then a burn-like appearance manifests (RelayHealth, 2013).      
     The most common cause of Stevens-Johnson Syndrome (SJS) is by an allergic reaction towards a drug or medicine. Here is an incomplete list of some drugs that have been linked to SJS: anticonvulsants (seizure-treating drugs), non-steroid anti-inflammatory drugs (NSAIDS), anti-microbial drugs (penicillin), and barbiturates all have appeared in several cases of people with SJS (Barvaliya, 2011).
Clinical Manifestation
     A patient with Stevens-Johnson Syndrome (SJS) can be identified by some physical features such as dry or inflamed eyes, and sores in the mouth or tongue (U.S. National Library of Medicine, 2012). The patient tends to feel itchy and overall ill due to the flu-like symptoms and skin lesions (U.S. National Library of Medicine, 2012). Because of the abnormalities in their mouth, some patients with SJS are hospitalized in order to supply them with anti-inflammatory medicine, fluids, and essential nutrients through intravenous (IV) therapy (RelayHealth, 2013). Also, arthralgia (pain in the joints) is present within SJS patients because of the inflamed membranes, so it may feel uncomfortable for them to be active for long periods of time (U.S. National Library of Medicine, 2012).
     Besides the obvious physical changes, patients with Stevens-Johnson Syndrome (SJS) tend to form new opinions towards health care workers. In a detailed study containing 14 SJS survivors, researchers concluded that most patients developed a sense of distrust in health care professionals or in medicines in general (Butt et al, 2011). Additionally, the majority thought that SJS could have been avoided if health care providers paid closer attention to the patients’ medical histories or list of allergies (Butt et al, 2011).     
     The most helpful diagnostic test that can help the health care provider find out if the condition can be classified as Stevens-Johnson Syndrome (SJS) is through a skin biopsy (skin sample). In this method, the health care professional numbs the patient and takes a part of the skin to go get examined (RelayHealth, 2013). The health care professionals view the sample under a microscope for certain features such as the detached epidermis and dermis. Additionally, the physician may ask about the patient’s medical history and about what medications they have taken recently.
Medical Management
     The treatment for Stevens-Johnson Syndrome (SJS) is usually not as simple. Health care providers need to simultaneously monitor things such as controlling the condition itself, avoiding future infections, and treating the underlying causes (U.S. National Library of Medicine, 2012). To treat SJS, the doctor may prescribe an antihistamine to control the itching sensations; the doctor may also give antiviral medicine if the condition is caused by a virus (e.g. Herpes); additionally, corticosteroids help regulate the inflammation (National Library of Medicine, 2012). However, some side effects of steroids are gastrointestinal ulcers, osteoporosis, and abnormal response to physical stimuli (Fields, 2009). If the condition is caused by a medicine, then the doctor may ask the patient to stop taking it (RelayHealth, 2013). If necessary, the patient can be treated in an intensive care unit for serious symptoms of SJS such as eye damage and skin necrosis. (National Library of Medicine, 2012).
Conclusion
     Stevens-Johnson Syndrome (SJS) is a complex condition that is treated differently within patients. While it is not common, SJS has severe symptoms that make a lasting impression on those whom survive the condition. SJS may begin as a simple rash or blister, but if left unchecked, it could result in death. SJS is an unpredictable condition that can be caused by an allergic reaction to a medication or virus (National Library of Medicine, 2012). It is beneficial to investigate the common drugs associated with SJS. If the SJS symptoms ever appear while taking one of those specific drugs, then it could help make it easier to seek assistance from a health care provider while explaining that the condition could possibly be Stevens-Johnson Syndrome.

References
Barvaliya, M. M., Sanmukhani, J. J., Patel, T. T., Paliwal, N. N., Shah, H. H., & Tripathi, C. C. (2011). Drug-induced Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS-TEN overlap: A multicentric retrospective study. Journal Of Postgraduate Medicine, 57(2), 115-119.
Butt, T. F., Cox, A. R., Lewis, H., & Ferner, R. E. (2011). Patient Experiences of Serious Adverse Drug Reactions and Their Attitudes to Medicines. Drug Safety, 34(4), 319-328. 
Fields, T. (2009, July 17). Steroid Side Effects: How to Reduce       Corticosteroid Side Effects. Retrieved     April 8, 2014 from       http://www.hss.edu/conditions_steroid-side-effects-how-to-      reduce-corticosteroid-side-effects.asp
Iannelli, V. (2013, September 26). Stevens-Johnson Syndrome:    Stevens-Johnson Syndrome Symptoms and Treatments. Retrieved     April 7, 2014 from       http://pediatrics.about.com/od/diseasesandconditions/a/610_       _johnson_syndrome.htm
Mayo Clinic Staff (2011, April 09). Definition of Stevens-Johnson    syndrome. Retrieved on March 27, 2014.
RelayHealth (2013). Erythema Multiforme and Stevens-Johnson     Syndrome. Retrieved on March 27, 2014.
Skin Association (n.d.). What is Stevens Johnson Syndrome?.     Retrieved on March 27, 2014.
U.S. National Library of Medicine (2012, November 20). Erythema             Multiforme. Retrieved on March 27, 2014.

Labels: