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.
Forty-one patients undergoing primary PCI were randomly assigned to receive intracoronary
streptokinase (250 kU) or no additional therapy.
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.
In this prospective, open-label, multicenter, randomized trial, we randomly assigned
3528 patients with PCI to receive enoxaparin (0.5 or 0.
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.
It is well-known that, in the past few decades, imaging techniques,
and in particular ultrasonography, have led to great advances in
clinical hepatology. In fact, the widespread use of these techniques
resulted in the clinical discovery of hepatocellular carcinoma and
other liver tumours. Hepatocellular carcinoma was practically
unknown to the clinician before the advent of diagnostic ultrasound.
Coronary heart disease is the leading cause of death worldwide,
and 3.8 million men and 3.4 million women die of the disease each
year. After an acute myocardial infarction, early and successful myocardial
reperfusion with the use of thrombolytic therapy or primary percutaneous coronary
intervention (PCI) is the most effective strategy for reducing the size of a myocardial
infarct and improving the clinical outcome. The process of restoring blood
flow to the ischemic myocardium, however, can induce injury.
Concern was expressed over a number of issues surrounding the successful use of selfmonitoring,
and recognised that its cost meant that it had to be effectively deployed. It should
only be supported in the context of a provision of a package of care, including structured
education, from a primary or secondary diabetes care team. The initial education should be
provided by a properly trained and skilled professional with understanding of the problems of
A little over 50 years ago, my father had a heart
attack. He was driven to the hospital by friends
after having “indigestion” for 2 days. He spent
2 weeks as an inpatient on an unmonitored rehabilitation
ward and was treated principally with
warfarin and digitalis. He was lucky and survived,
but in that era, more than 20% of patients
with an acute myocardial infarction died.