User:Shelley Schoepflin Sanders

Revision 561

Date
Author
Shelley Schoepflin Sanders
Comment
/* Morning Report 2/20/09 (temporary content) */
Size
5952 bytes
Delta
+1173 bytes
SolSeed Texts and === Poems === * When Kingfishers Catch Fire ... Gerard Manley Hopkins * No worst, there is none ... Gerard Manley Hopkins * Love is not love ... William Shakespeare * Gertrude's Prayer ... Rudyard Kipling * The Kitten ... Mary Oliver * Ribblesdale ... Gerard Manley Hopkins * A Poetry Reading at West Point ... William Matthews * Old Men Playing Basketball ... B.H. Fairchild * God Says Yes to Me ... Kaylin Haught * Spring and Fall ... Gerard Manley Hopkins * Binsey Poplars ... Gerard Manley Hopkins * Inversnaid ... Gerard Manley Hopkins * Love is Love ... Sir Edward Dyer * I Loved You ... Aleksandr Pushkin * Not Love Perhaps ... A.S.J. Tessimond * Every thought we think is creating our future ... Louise Hary * The Way We Live ... Kathleen Jamie * Sunlight (from Mossbawn: Two Poems in Dedication) ... Seamus Haney * Against ... Adam Thorpe * Did I Miss Anything ... Tom Wayman * A Conversation with a Mouse ... Robert Bly * A Considerable Speck ... Robert Frost * The Waking ... Theodore Roetke * Accidents of Birth ... William Meredith * A Linestorm Song .. Robert Frost * Birches ... Robert Frost * Mending Wall ... Robert Frost * The Windhover ... Gerard Manley Hopkins * God's Granduer ... Gerard Manly Hopkins * Number 9 (21st night, Monday) ... Anna Akhmatova "Some good for nothing..." * At the Smithville Methodist Church ... Stephen Dunn * Sweet Spring ... ee cummings * To Be of Use ... Marge Piercy * Fire and Ice ... Robert Frost * The Eagle ... Alread Loyd Tennyson * The Road Not Taken ... Robert Frost * I'm Nobody ... Emily Dickinson * In the Pine Woods ... Mary Oliver * For My Lover on Returning to His Spouse ... * from Jubilate Agno ... Christopher Smart * A Drunkard ... Ko Un * I Wake and Feel the Fell of Dark Not Day ... Gerard Manley Hopkins * Wild Geese ... Mary Oliver * Meeting at Night ... Robert Browning * Ars Poetica ... Archibold MacLeish * Thistles ... Ted Hughes * Nude Descending A Staircase ... X.J. Kennedy * Tiger, Tiger, Burning Bright ... William Blake * From Endymion by John Keats * Under the Waterfall ... Thomas Hardy * Oniomania ... Peter??? * Bhudda's dogs ... Susan Browne * Blueberries ... Robert Frost * I am Not I ... Jose Juan Jimenez (translated by Robert Bly) === Music === * Gather the Spirit ... Singing the Living Tradition #347 * We'll Build a Land ... Singing the Living Tradition #121 * Wake, Now, My Senses ... Singing the Living Tradition #298 * Come, Come, Whoever You Are ... Singing the Living Tradition #188 * All Creatures of the Earth and Sky ... Singing the Living Tradition #203 * For All That Is Our Life ... Singing the Living Tradition #128 * Love Will Guide Us ... Singing the Living Tradition #131 * Blue Boat Home ... UUHS * Spirit of Life ... Singing the Living Tradition #123 * Bring Many Names ... Singing the Living Tradition #23 * Come Sing a Song with Me ... Singing the Living Tradition #346 * I've Got Peace Like a River ... Singing the Living Tradition #100 * This Is My Song (Finlandia) ... Singing the Living Tradition #159 * Lift Every Voice and Sing ... Singing the Living Tradition #149 * For the Beauty of the Earth ... Singing the Living Tradition #21 * Morning has Broken ... Singing the Living Tradition #38 * Lo, the Earth Awakes Again ... Singing the Living Tradition #61 * Be Thou My Vision ... Singing the Living Tradition #20 * Lady of the Seasons' Laughter ... Singing the Living Tradition #51 * Once to Every Soul and Nation ... Singing the Living Tradition #119 * In the Bleak Midwinter ... Singing the Living Tradition #241 * Ye Earthborn Children of a Star ... Singing the Living Tradition #319 * Nocturne in E minor ... Op. 72, No. 1 ... Chopin ==Morning Report 2/20/09 (temporary content)== #Preeclampsia *New onset htn, proteinuria (0.3g/day) at >20 wks gestation in previously normotensive woman *Mild or severe. Severe = 1 or more of these: CNS, liver capsule stretch sx, AST/ALT 2x nl, SBP>/=160 or DBP >/- 110 on 2 occ 6 hrs apart, <100K PLT, >/=5g proteinuria in 24 hrs, oliguria, severe fetal GR, pulm edema/cyanosis, CVA. *Can persist up to 12 wks postpartum (average 16 +/- 9.5 days) *Pulm edema: high PCWP c/w oncotic pressure esp s/p delivery, LV failure, iatrogenic volume overload, capillary leak *Heart: no "direct" effects -- but early incr CO, late decr CO and incr SVR *Systematic review: s/p preeclampia, RR HTN 3.70, CAD 2.16, CVA 1.81 mean f/u around 10-11 yrs; VTE 1.79 at 4.7 yrs. Abs risk for any of these at age 50-59 17.8% vs 8.3%, so NNH = around 10 *patho phys - no one knows. endothelial dysfxn? #Chronic Htn: >140/90 before preg, before 20 wks, or after 12 wks postpartum #Preeclampsia superimposed on chronic Htn: #Gestational Htn: >140/90 but no proteinuria. By definition occurs after 20 wks and resolves after 12 wks postpartum #Eclampsa = preeclampsia or gestation htn plus sz ==Treatment== *Bedrest -- few data to support. One small randomized trial found RR 0.58 or so for going from mild to severe HTN among those who rested at home. LLD posiiton . . . *Delivery *Debate re: when to start Rx -- let SBP get too high and you have CVA hemorrhage. But 2 randomized trials of rx for mild to mod htn showed no effect on perinatal mortality, prematurity, abruptio placentae, small for gest age. ? decr resp distress syndrome. MAP drop by 10 = wt drop by 176 g in post-hoc meta-analysis. So . . . UpToDate says to rx if >150/100 or sx. Goal is 130 to 150 over 80-100. **Acutely, labetolol IV. Onset 5-10 min, lasts 3-6 hrs. Options: hydralazine, diazoxide ** Chronic: methyldopa or labetolol. CCB ok. All drugs cross placenta; no RCTs. BB small for gest age 1.3. HCTZ probably ok as long as no severe volume depletion. Goal for gest htn or chronic htn is 140-150 over 90-100 **Contraindiated: Nitroprusside (cyanide posioning last trimester); ACE-I **Postpartum breastfeeding: propranolol, labetolol (not as concentrated in breast milk); then long acting nifedipine or verapamil