(See also Chap. 256) Chest pain due to pulmonary embolism is believed to be due to distention of the pulmonary artery or infarction of a segment of the lung adjacent to the pleura.
Massive pulmonary emboli may lead to substernal pain that is suggestive of acute myocardial infarction. More commonly, smaller emboli lead to focal pulmonary infarctions that cause pain that is lateral and pleuritic. Associated symptoms include dyspnea and, occasionally, hemoptysis. Tachycardia is usually present.
Pulmonary embolism is a serious, potentially life-threatening cardiopulmonary disease
that occurs due to partial or total obstruction of the pulmonary arterial bed. Pulmonary
embolism constitutes 5-25% of in-hospital deaths, and mortality is decreased from 30%
to 8% with early treatment. Therefore, risk factors should be identified and treatment
should be planned to decrease the risk of mortality. Clinical findings, routine laboratory
data, electrocardiogram, chest X-ray, and arterial blood gases are not sufficient to
diagnose or rule out pulmonary embolus.
EventReporter is an integrated, modular and distributed solution for system
Microsoft Windows NT™, Windows 2000™ and Windows XP™ are highly capable
operating systems (we will call all of them "NT" in the following documentation).
However, their standard event reporting mechanisms are rather limited.
Administrators seeking complete control over their server environment need to
regularly check the server event logs. Adiscon's EventReporter provides central
notification of any events logged to the NT system event log.
Patterns of particle emission are different from those of the other pollutants included in the first phase of
the EU Framework Directive because of their extreme diversity of origin and source, both primary and
secondary, natural and anthropogenic, and there are significant differences in levels between Member
States and regions within states.
The limited amount of reliable PM10 data makes it difficult to establish a comprehensive overview of
PM10 concentrations and trends in Member States.
The research in this paper seeks ways for manufacturing companies to accomplish projects in real time
with less cost. This paper describes a new model using critical success factors of implementing
projects in small- and medium-sized enterprises (SMEs). The factors in the conceptual model were
identified in past studies and are validated from interviews with 20 project managers in the electronics
industry in Iran. Several prior researches have suggested critical success factors for reducing time and
cost in the development of a new product. These factors are...
In order to historicize the Workman montages, I want to point first to the Oscars
telecast for 2002, a year in which no Chuck Workman pieces appeared, and the first year
the awards were held in Hollywood. This Oscars was different: the show was held in a
theater that seated 1500 fewer guests than some previous venues (Anderton), but whose
location within the new media complex and mall at Hollywood and Highland offered—
for virtual guests—geographic cachet, ersatz Intolerance elephants, and big-screen video
displays. As commentators and stars alike remarked, this...
The world’s climate is changing. The scientific
evidence is incontrovertible: most of this change
is due to human activity, and the process is
speeding up as more and more carbon dioxide,
methane and other greenhouse gases are pumped
into the atmosphere.
The next 10 years are critical. Carbon dioxide
emissions must be cut rapidly. If they are, according
to the Intergovernmental Panel on Climate Change,
we may limit the rise in global temperatures to
two degrees centigrade.
Approach to the Patient: Hemoptysis The history is extremely valuable. Hemoptysis that is described as bloodstreaking of mucopurulent or purulent sputum often suggests bronchitis. Chronic production of sputum with a recent change in quantity or appearance favors an acute exacerbation of chronic bronchitis. Fever or chills accompanying bloodstreaked purulent sputum suggests pneumonia, whereas a putrid smell to the sputum raises the possibility of lung abscess. When sputum production has been chronic and copious, the diagnosis of bronchiectasis should be considered.
The audit procedure illustrated here should guarantee consistent, high quality IS audits and the
ability to compare the results of audits. In all steps, the audit procedure is to be documented by the
IS audit team in an orderly and understandable manner.
All working documents created to perform an IS audit for a Federal Agency are to be classified as
”VS – Nur für den Dienstgebrauch” (RESTRICTED). The individual classification is with the
office head and the affected assistant advisors, and possibly in co-operation with the Data
When toymaker Mattel launched an e-commerce website in 2009 (shop.mattel.com), it used a heavy
dose of video to increase consumer engagement and distinguish its offerings from those found on
traditional retail sites. The company, in effect, turned video into a direct sales tool: in the ﬁ rst year, as
many as 42% of the top-selling products on the Mattel site appeared after a visitor clicked on a video.
Mattel cross-promotes the store and speciﬁ c products heavily through its Facebook page and Twitter
The overriding conclusion of the Merrill Research & Associates (2003) tracking study is
that the U.S. wine industry now stands at a crossroads. For the first time in thirty years, a
new generation of young adults gives evidence of a strong preference for wine as part of
their lifestyles. Many of them are entering the category as core wine drinkers. With their
significant age-group numbers and their adoption of wine in their mid-twenties, they are
a leading indicator of great potential as their cohorts likewise reach adulthood.
This landmark principle, "All beauty is a making one of opposites, and the making one of
opposites is what we are going after in ourselves," was stated by Eli Siegel, the American poet,
critic, and educator, who founded Aesthetic Realism. It is the basis of the museum art and
anthropology classes we teach together. And this principle, we've seen, is the means for people
to have large emotions from the art of every continent—including styles unfamiliar to them—
and to see people of other cultures with authentic depth and kindness....
Physical Findings Patients with pneumococcal pneumonia usually appear ill and have a grayish, anxious appearance that differs from that of persons with viral or mycoplasmal pneumonia. Temperature, pulse, and respiratory rate are typically elevated. Elderly patients may have only a slight temperature elevation or may be afebrile. Hypothermia may be documented instead of fever and is associated with increased morbidity and mortality. Pleuritic chest pain may cause diminished respiratory excursion (splinting) on the affected side.
The term of a bond ends on the bond’s maturity date, when the
issuer repays to the investor the face amount listed on the bond.
When a bond is held to maturity, its face amount is repaid in full.
Before maturity, however, the value of a bond often fluctuates.
These continual changes in bond prices are influenced by many
factors, including interest rate movements, supply of and demand
for bonds, changes in the financial health of bond issuers, returns
offered by other investments, and the maturity date of a bond.
Price fluctuations will be addressed more fully on pages 12 and 13....
Our overarching thesis in this article is that organizations voluntarily adopting environmental and
social policies represent a fundamentally distinct type of the modern corporation that is characterized by a
governance structure that takes into account the environmental and social performance of the company, in
addition to financial performance, a long-term approach towards maximizing inter-temporal profits, and
an active stakeholder management process.
Governments in developing countries
need to spend more money on essential
public services if they are to have a
serious impact on poverty.
Take the United Nations Millennium
Development Goals (MDGs), a set of
targets for halving extreme poverty,
providing universal primary education,
halting the spread of HIV and AIDS and
much more by 2015. Ambitious, yes, but
To meet many of the MDGs, governments
will need to hire more public sector
employees, from teachers and doctors to
agricultural extension workers.
The results of the audit for fiscal year 2010 provided valuable lessons on preparing for a first-time financial statement audit. In our September 2011 report, we identified five fundamental lessons that are critical to success.
Why has relational database technology grown to become the de facto database tech-
nology since that time? A look back at previous database technology may help to
explain this phenomenon.
Database management systems were first defined in the 1960s to provide a common
organizational framework for what had been data stored in independent files. In
1964, Charles Bachman of General Electric proposed a network model with data
records linked together, forming intersecting sets of data, as shown on the left in
Figure 1-1. This work formed the basis of the CODASYL Data Base Task Group.
The yield spread – the difference between the long-term and the short-term interest
rate – is widely discussed as a leading indicator for economic activity. While the yield
spread does not affect economic activity in itself, in contrast to the level of short-term
or long-term interest rates, it may contain information about market expectations of
future changes in inflation and real interest rates, which may in turn be associated with
fluctuations in real output.