…liver and biliary tract . Go through the medication and any herbal preparations carefully — drug induced liver injury is the commonest cause of acute liver failure…

Cardiology Pharmacology & dosing Definition and therapeutic rationale Inclisiran is a liver directed small interfering RNA (siRNA) designed to reduce production of proprotein convertase subtilisin/kexin…

…glomerular filtration rate < 30 mL/min). Patients with mild to moderate heart failure, kidney or liver disease, especially when combined with diuretics (risk of…

…defined < 0,7 0,7 Liver vein flow S dominant Reduced S wave systolic flow reversal, jet reaching liver veins Additional quantitative parameters Mild…

…despite maximally tolerated therapy. It is a prodrug activated predominantly in the liver by very long chain acyl CoA synthetase 1. This activating enzyme is…

…By reducing intestinal cholesterol absorption, it decreases the quantity of cholesterol delivered to the liver. The resulting hepatic response includes increased expression of low density…

…APTT, creatinine, electrolytes, liver function tests, albumin, urea and a blood gas with lactate 5 Give crystalloid in small boluses with frequent reassessment. Give blood…

…significant bleeding. Pregnancy in the first trimester and close to delivery (embryopathy and fetal bleeding respectively). Marked liver failure with coagulopathy. Severe uncontrolled hypertension. Recent…

…scores. Each incorporates various clinical parameters to stratify bleeding risk. HAS BLED: Incorporates factors such as hypertension, abnormal renal/liver function, stroke history, bleeding history…

…score is an acronym that stands for: H ypertension A bnormal renal/liver function S troke B leeding history or predisposition L abile INR (International…

…History of stroke or transient ischemic attack (TIA). Severely impaired liver function classified as Child Pugh Class C. Dosage Adults Initial dose : A single loading…

…defined < 0,7 0,7 Liver vein flow S dominant Reduced S wave systolic flow reversal, jet reaching liver veins Additional quantitative parameters Mild…

…active substance or any excipient. Active bleeding. Previous intracranial hemorrhage. Severe liver impairment. Concurrent administration of ticagrelor with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin…

…metabolism, yielding desethylamiodarone as a major active metabolite. Both the parent drug and its metabolite accumulate extensively in various tissues, including the liver, lung, fat…

…may influence blood pressure, glucose–insulin homeostasis, lipids and apolipoproteins, endothelial function, systemic inflammation, liver fat synthesis, adiposity, thrombosis and coagulation, cardiac function, satiety, appetite…

…woman with preeclampsia. HELLP syndrome—haemolysis, elevated liver enzymes or transaminases, and thrombocytopenia—is generally regarded as a severe preeclamptic phenotype or variant. Pathophysiology The…

…risk must be considered alongside thromboembolic risk. The HAS BLED score includes hypertension, abnormal renal or liver function, prior stroke, bleeding tendency or previous bleeding…

…haematological malignancy, stem cell transplantation, immunosuppressive drugs, radiotherapy, bone marrow failure and certain targeted cancer treatments. Fever is not obligatory Hypothermia, new confusion, tachypnoea, hypotension…

…morphine Morphine has an active renally excreted metabolite that causes late sedation and respiratory depression Marked liver failure A reduced dose of all of them…

…75 years Start at half the adult dose and lengthen the interval Liver failure A reduced dose and a longer interval for all opioids Obesity…

…most superficially, where the distance from the skin is shortest, and where no liver, lung or vessel lies in the path of the needle. Access…

…aspiration: a new pleural effusion of unclear cause. An effusion not confidently explained by heart failure must be aspirated. Suspected empyema or complicated parapneumonic effusion…

…Taken immediately and repeated in impaired consciousness, or with insulin, a sulfonylurea, a beta blocker or liver failure Blood gas pH, pCO2, bicarbonate, lactate and…

…intervention Within 60 min Contact intensive care in shock, rapidly progressive organ dysfunction, respiratory failure, impaired consciousness, or a need for a vasopressor After initial…

…necessary. Impaired renal function : No dose adjustments are necessary. Impaired liver function : No dose adjustments are necessary. Elderly (≥ 65 years) : No dose adjustments are necessary…

…A history of increasing frequency of hospitalizations and visits for heart failure without disease recognition in the 3 years preceding diagnosis is also a notable…

…in some cases, fatty liver disease. Interpretation of the Agatston Score The score should be interpreted both by its absolute value and in relation to…

…cardiovascular risk reduction, offering profound benefits in major adverse cardiovascular events (MACE), heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD), and peripheral…

…and functional limitation Evidence of heart failure Haemodynamic stability Diabetes status Renal dysfunction and other important comorbidities Frailty Liver cirrhosis Cognitive function and life expectancy…

…further accelerate cardiovascular and renal injury. Adipokine imbalance contributes to insulin resistance, β cell failure, endothelial dysfunction and atherosclerosis. Ectopic fat deposited around or within…

…not shared to the same extent by statins. Inclisiran Inclisiran is a liver targeted small interfering RNA. It promotes degradation of the messenger RNA encoding…

…arterial hypertension (PAH). The threshold is not absolute: patient phenotype, risk factors for heart failure with preserved ejection fraction, echocardiographic findings, and left atrial size…

…Concurrently, the atrial myocardium undergoes structural remodeling driven by aging, hypertension, heart failure, and the arrhythmia itself. This remodeling manifests as interstitial fibrosis, atrial dilation…

…burn Two or more magnets (including in different nostrils) Immediately — pressure necrosis across the septum A live insect As soon as possible — kill it first…

…dietary fat and statins Popular blogs and media reach out to billions of individuals worldwide. They exert enormous influence over their visitors daily lives. However…

…predominantly by atrial tissue; its midregional pro ANP assay may provide information comparable to BNP and NT proBNP in heart failure (HF). The biologically active…

…low in healthy subjects; the 99 th percentile is less than a few nanograms per liter of blood (typically <5 ng/L). This is explained…

…heart disease (CHD) is the most common class of major congenital malformations. CHD occurs in approximately 1% of live births, and 10% of aborted fetuses…

…common cause. Ebstein's anomaly The prevalence of Ebstein's anomaly is approximately 1 case per 200.000 live births (Atthenhofer et al) . Figure 1…

…makes positioning impossible. Severe angina, heart failure or recent myocardial infarction. Red flags — investigate further instead Finding Suggests : : Nystagmus that is purely vertical, downbeating or…