Percutaneous intervention

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  • The perfect cardiac catheterization technique, including good diagnostic and therapeutic qualities, without risk and with no recovery time for the patient, does not exist. Obtaining initial access to the arterial circulation is the first and most frequent catheterization difficulty encountered by the interventional cardiologist during the procedure. Often, it is also the only difficult part of the exam for the patient because it may cause a vagal reaction or painful spasm.

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  • The last quarter of a century has seen dramatic developments in the management of cardiovascular diseases. Besides the pioneering developments in the medical management of cardiovascular disorders the field of interventional cardiology has also emerged as a major discipline with a huge impact on the clinical management of acute coronary syndrome, chronic coronary artery disease, congestive heart failure, and peripheral vascular and valvular diseases.

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  • It is only 26 years since the first percutaneous transluminal coronary angioplasty (PTCA) was carried out by the pioneering Swiss radiologist, Andreas Greuntzig, heralding the dawn of interventional cardiology. In this short time, interventional cardiology has overcome many limitations and undergone major evolutionary changes—most notably the development of the coronary stent. Worldwide, many thousands of patients now safely undergo percutaneous coronary intervention every day, and the numbers continue to grow.

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  • Measurement of the worldwide prevalence of abortion-related mortality and morbidity is difficult. At a population level, national vital registration systems routinely under-count such deaths. 15 Calculation of the proportion of maternal deaths due to abortion complications is even more challenging. Abortion-related mortality often happens after a clandestine or illegal procedure, and powerful disincentives discourage reporting.

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  • The perfect cardiac catheterization technique, including good diagnostic and therapeutic qualities, without risk and with no recovery time for the patient, does not exist. Obtaining initial access to the arterial circulation is the first and most frequent catheterization difficulty encountered by the interventional cardiologist during the procedure. Often, it is also the only difficult part of the exam for the patient because it may cause a vagal reaction or painful spasm.

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  • Microvascular perfusion is often impaired after primary percutaneous coronary intervention (PCI). We proposed that in situ thrombosis might contribute to poor myocardial perfusion in this setting. To test this hypothesis, we evaluated the effect of lowdose intracoronary streptokinase administered immediately after primary PCI. Methods Forty-one patients undergoing primary PCI were randomly assigned to receive intracoronary streptokinase (250 kU) or no additional therapy.

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  • EDRN is at the forefront of technology-driven research on the use of biomarkers for the early detection of cancer. By identifying and validat- ing biomarkers, such as novel proteins or changes in gene expression, it is possible to measure an individual’s disease risk, progression of disease, or response to therapy. Ultimately, EDRN research will aid in prevention and in early therapeutic intervention, based on early detection of disease.

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  • The aim of the strategy is to improve through optimal feeding, the nutritional status, health, growth and development and thus the survival of infants and young children. The objectives of the strategy are:  To raise awareness of the main problems facing IYCF, identify approaches to their solution and provide a framework for essential interventions.

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  • Despite its limitations, unfractionated heparin has been the standard anticoagulant used during percutaneous coronary intervention (PCI). Several small studies have suggested that intravenous enoxaparin may be a safe and effective alternative. Our primary aim was to assess the safety of enoxaparin as compared with that of unfractionated heparin in elective PCI. Methods In this prospective, open-label, multicenter, randomized trial, we randomly assigned 3528 patients with PCI to receive enoxaparin (0.5 or 0.

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  • In its most general form, a distributed event notification service is composed of interconnected servers, each one serving some subset of the clients of the service, as shown in Figure 1. (Some use the terms proxy and broker instead of the term server.) The clients are of two kinds: objects of interest, which are the generators of events, and interested parties, which are the consumers of event notifications. Of course, a client can act as both an object of interest and an interested party.

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  • Overall the allergy is a sustained process of chronic inflammation why aspects of quality of life and the contribution and understanding of the psychological dimension, emotional and psychiatric naturally had to be enrolled in this book. The chapters on treatment modalities and new strategies bring the latest concepts on the use of actual and very promising researches based on the better understanding of the mechanism of the allergic disease. Each of these topics is as current as possible and written by a leader in the field. Clinicians will all benefit from these reviews....

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  • The procedure described by Young involved a transverse incision between the ischial tuberosities 2 cm above the anus (Young, 1926). The ischiorectal fossa was then opened by blunt finger dissection, carrying the dissection medially and reflecting the rectum posteriorly. The central tendon of the perineum was then cut exposing the recto-urethralis muscle which was opened by sharp dissection and reflected laterally, exposing the capsule of the prostate (figure 5). The abnormal area on the prostate was grasped with Allis forceps and excised widely and deeply.

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  • In the literature on conflict and HIV/AIDS, African men are often presented in simplistic and explicitly negative terms. It is generally taken for granted that those who use weapons are men whilst those who suffer the consequences of conflict are women, and that men always hold power in sexual relationships whilst women are always powerless. Certainly, African women and girls have been made vulnerable by the behaviour of men and boys in conflict settings and in sexual relationships. Yet the fact that gender hierarchies also oppress some men is seldom discussed. What of...

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  • We have no recognized standards in sales, but we have plenty of sales models to choose from. Many sales forces use all of them, some of them, or some hybrid of them. Unfortunately, allowing the sales force to follow their own model creates a considerable disparity of which model is working best. Let’s examine some of the models that have been developed along the way and that sales trainers have been delivering. Which ones are you using? This model contains instructions on not only what salespeople should say, but also what they should do while saying it.

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  • Product evaluation is an important part of brewing, whether performed informally or formally and whether the product is from a commercial or home brewery. Formal beer evaluation serves three primary purposes in the context of brewing competitions. First, the beer evaluations provide feedback to the brewer concerning how well an individual recipe represents its intended beer style. This feedback can be useful as recipes are fine-tuned and attempts are made to improve the beer. Second, beer evaluations may provide brewers with troubleshooting advice.

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  • Historically, up to 5% of all myocardial infractions were associated with mechanical complications such free-wall rupture, papillary muscle rupture, and PI-VSD (Agnihotri, 2008). With current treatment algorithms that advocate early and aggressive attempts at revascularization of the acute ischemic myocardial – such as thrombolytic therapy, early percutanous interventions with coronary stenting (PCI), and, less frequently, emergent coronary artery bypass surgery (CABG) – the overall incidence has dropped significantly.

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  • Health insurance makes a difference in whether and when people get necessary medical care, where they get their care, and ultimately, how healthy people are. Uninsured adults are far more likely than the insured to postpone or forgo health care altogether and less able to afford prescription drugs or follow through with recommended treatments. Problems getting needed care are less common among children, who are generally healthy, but disparities in access to care between uninsured and insured children are as great as the adult differences.

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  • First, there needs to be a clear usage pattern established for those items deemed to be “critical supplies.” Information on increased usage during critical situations in the past, such as infectious outbreaks or infrastructure damage would be extremely useful. Second, determine the time period for which you plan to be without assistance. Third, determine what would need to be kept on hand to accommodate that time frame. This will vary significantly on your environment, especially based on a rural or urban setting, type of disaster, and availability of suppliers.

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  • Indoor air pollution poses many challenges to the health pro- fessional. This booklet offers an overview of those challenges, focusing on acute conditions, with patterns that point to par- ticular agents and suggestions for appropriate remedial action. The individual presenting with environmentally associated symptoms is apt to have been exposed to airborne substances originating not outdoors, but indoors. Studies from the United States and Europe show that persons in industrial- ized nations spend more than 90 percent of their time indoors1.

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  • For much of the early history of medicine, the heart was considered to be the most sacred and mystical of all human organs. As a General Pediatrician, I tend to expect that the children I care for will have strong, properly functioning hearts. However, in situations where the heart is congenitally malformed or affected by inflammation or myopathy, it is reassuring and important to have a pediatric cardiologist and cardiac surgeon at my side to help me with decisions about further diagnostic testing and imaging, instituting medical therapy, and assessing the need for surgical intervention....

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