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A 4-Year-Old Boy with Constipation and Abdominal Pain

A 4-year-old boy was brought to the emergency department with a long history of constipation and recent onset of abdominal pain. His mother stated that he did not have diarrhea, vomiting, or fever, but noted that “his belly is getting hard.” He had a small bowel movement 2 days previously. On the day of presentation, he woke up with abdominal pain. The patient previously had been in good health and had regularly seen his pediatric primary care physician. He had never had surgery or an illness requiring hospitalization. Physical Examination On examination, the following vital signs were obtained: oral temperature, 98.5°F; heart rate, 145 bpm; respiratory rate, 30 breaths/min; blood pressure, 108/59 mm Hg. He was pale and appeared to be uncomfortable due to the abdominal pain. The abdominal examination revealed a large mass in the right side of his abdomen. The mass was firm and slightly tender. He also had guarding. He had bilaterally descended testicles and no evidence of inguinal hernias. His musculoskeletal and neurologic examinations showed normal results, and skin examination revealed decreased turgor and coolness of peripheral extremities, with no rashes, bruising, or petechiae.

Chronic Abdominal Pain in Children
by jonnae 0 Comments favorite 2 Viewed Download 0 Times

Abdominal Complaints in School Age Children Michael A. D’Amico, MD Pediatric Gastroenterology and Nutrition May 16, 2012 Objectives • Become familiar with common causes of abdominal complaints in school age children • Understand the therapeutic approach to these conditions • Know when to make appropriate referrals • Explore presentation content further with Q & A’s Statements • No financial disclosures • I may be discussing off-label use of some medications Common Abdominal Complaints • Developmental level of child – introspection • Comfort level • Social context Often difficult to express or verbalize precise sensation Common Complaints (symptoms) • Pain – Most common – Vague • Don’t feel well, My tummy hurts, Hunger, Nausea • Upset stomach • Constipation – Hard to go, takes a long time going • Diarrhea

Managing Packaging Design Projects - Design Business Association

Packaging design is one of the most important marketing tools for many manufactured packaged goods. Packaging communicates brand and product values at point of sale, and continues to work long after promotional and advertising campaigns have run their course. The design of a pack and the surface graphics are the main features that differentiate a product from its competitors. For brands or products on limited budgets, a modest investment in redesigning the pack can reap substantial dividends in terms of increased sales, improved margins and greater product profitability But there are other reasons why there is a growing interest in packaging design: – manufacturers’ brands today have to fight harder, with less shelf space, against retailers’ own brands – the internationalisation of markets means packaging design must take into account national and cultural boundaries – new materials and technology are a continuous stimulus to innovative packaging in order to boost sales, reduce costs, and increase profits – public concern with the environment and increasing legislation is putting pressure on manufacturers to redesign packaging to minimise waste and use materials, which are biodegradable or easily recyclable.

Office Removalists Brisbane
by MathewGiffen 0 Comments favorite 10 Viewed Download 0 Times

If you require the storage for short or long term, you will always find the security and space to store your goods at Giffen furniture removals. Giffen offers you the best furniture storage solutions in Brisbane.

Top Scores from Iconic Movies
by ricall 0 Comments favorite 12 Viewed Download 0 Times

http://ricall.com/music-licensing |Movie music provides important emotional context to the stories being told on the screen. Check out these ironic scores to some memorable movie moments.

Corporation Provided Apartments or condos Great for Quick Keep

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Long-Term Health Risks and Benefits Associated with Spay / Neuter ...

At some point, most of us with an interest in dogs will have to consider whether or not to spay / neuter our pet. Tradition holds that the benefits of doing so at an early age outweigh the risks. Often, tradition holds sway in the decision-making process even after countervailing evidence has accumulated. Ms Sanborn has reviewed the veterinary medical literature in an exhaustive and scholarly treatise, attempting to unravel the complexities of the subject. More than 50 peer-reviewed papers were examined to assess the health impacts of spay / neuter in female and male dogs, respectively. One cannot ignore the findings of increased risk from osteosarcoma, hemangiosarcoma, hypothyroidism, and other less frequently occurring diseases associated with neutering male dogs. It would be irresponsible of the veterinary profession and the pet owning community to fail to weigh the relative costs and benefits of neutering on the animal’s health and well-being. The decision for females may be more complex, further emphasizing the need for individualized veterinary medical decisions, not standard operating procedures for all patients. No sweeping generalizations are implied in this review. Rather, the author asks us to consider all the health and disease information available as individual animals are evaluated. Then, the best decisions should be made accounting for gender, age, breed, and even the specific conditions under which the long-term care, housing and training of the animal will occur.

Heavy Duty Hydraulic Trolley Jacks - Drapertools-online.com

INSTRUCTIONS FOR. Heavy Duty. Hydraulic Trolley Jacks. Stock No.48350 Part No.TJ3/HD-LONG. 48356 TJ5/HD-LONG. 48357 TJl 0/HD-LONG. INSTRUCTIONS FOR. Heavy Duty. Hydraulic Trolley Jacks. Stock No.48350 Part No.TJ3/HD-LONG. 48356 TJ5/HD-LONG. 48357 TJl 0/HD-LONG.INSTRUCTIONS FOR. Heavy Duty. Hydraulic Trolley Jacks. Stock No.48350 Part No.TJ3/HD-LONG. 48356 TJ5/HD-LONG. 48357 TJl 0/HD-LONG.INSTRUCTIONS FOR. Heavy Duty. Hydraulic Trolley Jacks. Stock No.48350 Part No.TJ3/HD-LONG. 48356 TJ5/HD-LONG. 48357 TJl 0/HD-LONG.INSTRUCTIONS FOR. Heavy Duty. Hydraulic Trolley Jacks. Stock No.48350 Part No.TJ3/HD-LONG. 48356 TJ5/HD-LONG. 48357 TJl 0/HD-LONG.INSTRUCTIONS FOR. Heavy Duty. Hydraulic Trolley Jacks. Stock No.48350 Part No.TJ3/HD-LONG. 48356 TJ5/HD-LONG. 48357 TJl 0/HD-LONG.INSTRUCTIONS FOR. Heavy Duty. Hydraulic Trolley Jacks. Stock No.48350 Part No.TJ3/HD-LONG. 48356 TJ5/HD-LONG. 48357 TJl 0/HD-LONG.INSTRUCTIONS FOR. Heavy Duty. Hydraulic Trolley Jacks. Stock No.48350 Part No.TJ3/HD-LONG. 48356 TJ5/HD-LONG. 48357 TJl 0/HD-LONG.INSTRUCTIONS FOR. Heavy Duty. Hydraulic Trolley Jacks. Stock No.48350 Part No.TJ3/HD-LONG. 48356 TJ5/HD-LONG. 48357 TJl 0/HD-LONG.INSTRUCTIONS FOR. Heavy Duty. Hydraulic Trolley Jacks. Stock No.48350 Part No.TJ3/HD-LONG. 48356 TJ5/HD-LONG. 48357 TJl 0/HD-LONG.

Workshop Equipment Catalog - RODCRAFT Pneumatic Tools

Since 1974, the Rodcraft brand stands for high-quality products and services. Founded in Germany, Rodcraft has grown steadily to become one of the world's leading brands of pneumatic tools and workshop equipment dedicated to the vehicle service and industrial maintenance applications. Research and development Our organisation is constantly investing in research and development, and the Rodcraft product range features many patented designs such as our composite sander and latest impact wrench series. Market coverage With a strong European based sales channel, local sales offices, dedicated distributors and national importers are covering over 80 countries worldwide on a daily basis. We are close to our clients and able to provide fast service and support. Testing and quality inspections To ensure and guarantee long life performance, many strict testing and quality inspections are conducted through the tool and equipment design, production and assembly stages. All products are thoroughly tested at the Technocenter to pass EC certification according to ISO standards and many of the customer centres marketing the Rodcraft product lines are ISO 9001 and ISO 14001 certified.

HYDRAULIC TROLLEY JACK - edoqs.org
by Dockyard 0 Comments favorite 2 Viewed Download 0 Times

Thank you for purchasing this Clarke Trolley Jack. Before attempting to use the unit, please read this instruction booklet thoroughly, and follow all directions carefully, paying particular attention to the safety precautions. By doing so, you will ensure the safe operation of the unit, and the safety of yourself and others around you. You can then look forward to long and reliable service from your CLARKE Trolley Jack. This CLARKE product is guaranteed against faulty manufacture for a period of 12 months from the date of purchase. Please keep your receipt which will be required as proof of purchase. This guarantee is invalid if the product is found to have been abused in any way, or not used for the purpose for which it was intended. Faulty goods should be returned to their place of purchase, No product can be returned to us without prior permission. This guarantee does not effect your statutory rights. 1. This jack is for lifting ONLY..DO NOT move a load using the jack as a dolly 2. Always inspect the jack before use. Ensure that all parts are in good condition and operating smoothly, the wheels are sound and that no cracks or distortion is apparent. If in doubt do not use. Have the parts replaced or consult your CLARKE dealer. 3. Ensure jack is on a firm solid base, and there is no possibility of it slipping when under load. 4. Ensure the load is taken by the FULL saddle and that the point of lift on the load, is of sufficient strength to support the full load adequately. 5. Always ensure that the load is stabilised or supported in such a way that it will not shift during lifting or lowering operations. 6. Always use supports to stabilise the load once lifted. NEVER work on or under a load unless it is fully and adequately supported. NEVER rely upon the jack to hold the load in position. 7. Never push a load off the jack. 8. Ensure that all personnel are well clear of a load being raised, or lowered. 9. NEVER exceed the rated load for the jack (see ‘Specifications’). 10. Do not use if an oil leak is apparent...Consult your Clarke dealer.

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