The LB treatment (conservative and operative).

Use a mix of regulations and market-based approaches to reward earth-sustaining behavior by businesses and consumers and discourage earth-degrading behavior.

Principles essential to building a sustainable economy

Goals:

- Reduce population growth.

- Reduce resource consumption and waste by reducing demand, increasing product durability, increasing efficiency.

- Recycle, reuse, and compost to the maximum extent possible.

- Develop a wide range of renewable energy resources.

- Protect and conserve renewable resources, such as farmland, fisheries, forest, grassland, air, and water.

- Improve renewable resource management to ensure sustainability.

- Repair past damage to natural resources by replanting forests and grasslands, reseeding roadsides, restoring streams, cleaning groundwater, and reducing overgrazing.

- Increase national and regional self-sufficiency by using renewable resources whenever possible.

- Support sustainable development projects in developing nations.

- Reduce poverty.

- Develop sustainable ethics and promote individual and corporate responsibility and action.

- Improve social conditions by promoting democracy, justice, and a more equitable distribution of wealth.

- Work for global peace and cooperation.

Some policy tools:

- Environmental education programs.

- Green taxes and full-cost pricing requirements for business

- Alternative measures (indicators) of progress, such as the NEW and ISEW, that look at a wide range of economic, social, and environmental conditions.

- Laws that harness market forces, including:

1) economic disincentives

2) economic incentives

3) tradeable and marketable permits

4) laws that eliminate market barriers that promote inefficient resources use

5) laws that remote subsidies of environmentally destructive activities.

The majority of Earth's population, located in China, India and other developing countries is reasonably claiming the rights for benefits of modern civilization. These people want to live in modern houses, have a better meals, cars and better health care. Economics globalization leads to creation of more works, construction of factories in any country with sufficiently qualified and unassuming workers. This means, that the use of natural resources and accompanying energy use will continue their increase even faster, than the increase in Earth's population. With population size doubling in size during 1990–2050, the income per capita will increase in 2,4 times based on estimations of UNO's experts, energy use – in 2,6 times, water use – in 1,5 times. The total product of the world should increase in 4,5 times during this period.

Key terms:

Questions for review:

1. Compare and contrast Natural, manufactured and human capitals.

2. Differ Economic growth and Sustainable development.

3. Describe the GNP/GDP and its strengths and weaknesses.

4. What are alternatives to measure life and environmental quality?

5. Define the term “externality” and describe how externalities can be internalized. What are the benefits of doing this?

6. What is the economically optimal level of pollution control?

7. Describe a sustainable economy. What are the main goals and some policy instruments?

Make a synopsis: Daniel D. Chiras, “Environmental Science: Creating Sustainable Future”

1. Make a précis (of 200 words) of any paragraph:

“Corporate reform: Greening the corporation” (p.634-635).

“Green products and green seals of approval” (p.635-636).

“Environmental protection versus jobs: problem or opportunity?” (p.638-640)

2. Draw the graphs: Figures 26-4 (p.618); 26-6 and 26-7 (p.626). Title them.

Critical thinking:

1. Analyze the following statement: “Economic growth is essential to a healthy economy”.

2. Analyze the following statement: “The GNP is a fundamentally sound economic measure and a good indicator of the well-being of a nation’s people because economic health means a higher standard of living for all”.

3. Analyze the following statement: “Cleaning up the environment will put thousands of people out of work. We simply can’t afford to do it”.

The LB treatment (conservative and operative).

Foremost, it is necessary to quiet a patient and instill him a confidence in a favorable end.

Medical measures must promote:

1) to the lowering of pressure in the small circle of circulation of blood;

2) to the increase of coagulation of blood;

3) to closing of lumen of bleeding vessel.

From medicinal drags use: 1% solution of chloride calcium i/v; the EACA 5% solution - 200,0 i/v; solution of dicenone; solution of vicasoly i/m. It is obligatory urgent hemotransfusion. Necessarily enter of 1-3 ml 10% camphore butters + solution of the atropine 0,1% - 1,0-2,0 s\c.

From the instrumental methods of the LB stop apply bronchoscopy with occlusion of bronchi by haemostatic sponge or porolon, by the Fogarty catheter. It is the temporal stop LB. Presently, in connection with introduction of micro invasive technologies, at LB execute angiography of bronchial arteries with a subsequent embolization bleeding artery by the special spirals. This method may be independent and as preparatory to the resection methods of the LB treatment depending on basic pathology.

To the resection methods regards: segmentectomy (deleting of segment), lobectomy (deleting of lob), bylobectomy (deleting of 2 lobes), in heavy case – pulmonectomy (deleting of lung).

5.4. Rules of conduct of postoperative period, measures of prophylaxis, diagnostics and treatment of possible postoperative complications at patients with AAL.

One of threatening postoperative complication is the intrapleural bleeding. It can be one from two defects of hemostasis: surgical or biochemical. This complication meets in 7% of supervisions.

At insufficient surgical hemostasis as usually a big vessel bleeds. The clinic of LB depends on the caliber of bleeding vessel. A patient complains on a weakness, dyspnoea, thirst, a collapse comes in heavy case.

In basis of the biochemical intrapleural bleeding lying one or a few reasons from which most attention are the deficit of factors of coagulation of blood (in plasma and thrombocytes) , to surplus of anticoagulants, high fibrinolytic activity.

The window to pleural cavity is drainage by Bulau, through which in the case of the intrapleural bleeding a blood is discharged out. If a discharged blood forming the clot, it means that the bleeding is continuing, and, if on a background intensive haemostatic therapy the state of patient does not get better, rethoracotomy is needed - as a result it is necessary to find a bleeding vessel, stitch and tie it.

At the «biochemical» intrapleural bleeding the medical help consists in intensive hemotransfusion therapy - transfusion of plasma, fresh blood, fibrinogen, 1% chloride of calcium, hydrocarbonate of sodium, inhibitors of proteases (contrical, gordox and other), salt solutions, and also 5% EACA. In heavy case is possible to the reinfusion of drainage blood. The control of coagulogramm is necessary.

Thromboemboly of lung artery (TELA).

It is heavy complication of postoperative period the cause of which is blockade of trunk or branch of pulmonary artery. Sources of TELA may be system of lower vena cava or the stump of lung artery from which clot can transmits in the vessels of unoperated lung. Presently the use of fibrinolytic is the most effective method of treatment: striptease, streptokinase, farmakinase, actilise and other. These preparations can quickly dissolve a blood clot. Angiopulmonography is the most effective method of the TELA diagnostics.

Myocardial infarction after operations is not uncommon complication. As a rule this complication develops without a pain attack, a patient is on narcotic anesthetic. It is diagnosed on the basis of these ECG and clinic. Treatment of patient consists administration of coronarolytics, analgesics, antiarrhythmic preparations, oxygen therapy.

Atelectasis of the operated lung can develop gradually. It is characterized by the fever, dyspnoea, tachycardia. By percussion is marked dullness of percutory sound in the area of atelectasis, by auscultation is intensively weakened breathing above the area of atelectasis. A final diagnosis performs after roentgenologic research. Treatment of atelectasis includes immediate restoration of bronchial passage by bronchoscopy and washing of bronchial tree, administration of mucolytics, stimulations of cough.

Pneumonia of the operated lung - the most frequent reason is the presence of shallow atelectasis or low resistance of organism, due to the edema of lungs, aspirated pneumonia.

The increase of temperature, shortness of breath, tachycardia, cyanosis is marked. At auscultation there is moist rales, is special in the lower part of lung. Final diagnosis is put at roentgenologic research.

Treatment of pneumonia is powerful antibacterial therapy, introduction of fresh-frozen plasma, heparin therapy and mucolytics.

Contrlateral pneumothorax, yet name him spontaneous. It can be and iatrogenic during catheterization of subclavia vein. The state of patient gets worse sharply - the shortness of breath, cyanosis appears. At auscultation of the lung on the side of defeat breathing is not detected. It is necessary quickly to execute punction of pleural cavity and drainage of pleural cavity in II ribs interspace on a middle clavicular line.

Patients with carried AAL are subject for the supervision at pulmonologist and surgeon in regional policlinic.

Date: 2014-12-21; view: 1224