В 

Total costs in €

Costs per capita in €a

Costs due to preobesity in € (% of total costs)

Costs due to obesity in € (% of total costs)

Costs due to overweight in € (% of total costs)

The Netherlands

6.029.469.861

476

657.302.148 (11)

528.386.496 (9)

1.185.688.644 (20)

Germany

38.737.666.667b

582

4.232.431.091 (11)

5.154.965.842 (13)

9.387.396.934 (24)

Czech Republic

763.339.408c

91

90.612.458

(12)

108.310.987 (14)

198.923.446 (26)

Creatinine Clearance Calculator For the Obese Patient

Salazar-Corcoran Equation

Patient Name:В В  Room:
Age: В В В  В В  Scr:В  В В 
Height: В В В В  Weight: В 

Background

Program is based on the following:
Estimating Creatinine Clearance (ml/min)

For Men:
[137 - age] x [(0.285 x weight(kg)) + (12.1 x height(m)2)]
-----------------------------------------------------------
(51 x SCr)

For Women:
[146 - age] x [(0.287 x weight(kg)) + (9.74 x height(m)2)]
---------------------------------------------------------
(60 x SCr)


Units: Weight: kg Height: meters.

Reference

Salazar DE, Corcoran GB: Predicting creatinine clearance and renal drug clearance in obese patients from estimated fat-free body mass. Am J Med 84: 1053–1060, 1988More accurate estimation of the creatinine clearance in the  severely obese patient - (greater than 30% over ideal body weight).
 
 
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External otitis: Fungal

History:
This is a 60 year old gentleman who presents with itching in his ear and decreased hearing. He has problems with cerumen and frequently has his ear irrigated. After the last irrigation, one month ago, he noticed weeping and drainage from his ear. Now the plugging and severe pruritis are his chief complaints.

Examination:
The canal is completely filled with a whitish debris. This can be wet or sometimes dry and airy. It has the appearance of mold.

^ Click on the arrow to view the video


History:
The above set of pictures are from a patient that had chronic ear drainage for many years. She has a candida infection with chronic itching.

Information: Fungus is frequently the cause of inflammatory external otitis.Fungal infection: An infection in which fungi grow in the canal causing superficial redness of the bony canal wall skin with musty smelling exudate and powdery appearing debris (fungal mycelia). Moisture and immunosuppresion increase the incidence of this otitis.
Commonly due to the Aspergillus species, a saprophytic fungus that forms a grayish (Aspergillus fumigatus) blotting paper membrane covered with black spores (Aspergillus niger). May also appear white (Candida albicans) or yellow (Aspergillus flavus). Upon suction removal the underlying tympanic membrane appears injected, edematous, and denuded of epithelium. Adequate suctioning of the ear canal is necessary for therapy and prevention. Topical antifungal drops, acidifying drops, or antifungal powders are frequently used. This condition becomes chronic if not completely treated.

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