…tumour, primary biliary cholangitis, drugs Mixed Both raised Drug induced liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome…

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…

…to moderate heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma…

…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…

…CRP, creatinine, electrolytes, liver function tests, glucose and lactate. Add a blood gas, coagulation tests and other investigations according to the clinical picture 5 Take…

…started in an opioid naive patient, or when a conversion between drugs is made without reduction for incomplete cross tolerance. Indications Acute severe nociceptive pain…

…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…

…safe triangle (Figure 1). Outside it the risk of injuring the diaphragm, liver, spleen or internal thoracic artery increases. For diagnostic aspiration the point chosen…

…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…

…or a rising lactate Kidney A rise in creatinine, oliguria, or a urine output below 0.5 mL/kg/h Liver A rise in bilirubin,

…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…

…5]. Unexplained LV hypertrophy (LVH) or heart failure with preserved ejection fraction (HFpEF) at hospitalization warrants evaluation [5]. Heightened awareness is essential in patients with…

…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…

…extent of weight loss, the reductions in hard cardiovascular outcomes (MI, stroke) and metabolic liver disease involve significant weight independent pathways. 15 Metabolic Reprogramming and…

…depending on coronary dominance. Significant left main stenosis is generally defined as a diameter reduction of at least 50%. Severe proximal disease of both the…

…oxidative stress. Metabolic dysfunction associated fatty liver disease affects approximately 10% of non obese individuals and up to 65% of patients with metabolic syndrome. A…

…Approximately 25–30% reduction in lipoprotein(a), an effect not shared to the same extent by statins. Inclisiran Inclisiran is a liver targeted small interfering…

…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…

…validated tools, with the HAS BLED score being the most widely recommended. It evaluates Hypertension, Abnormal renal/liver function, Stroke history, Bleeding history, Labile INRs…

…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…

…renal sodium and water excretion, and reduction of cardiac fibrosis through activation of the natriuretic peptide A receptor. NT proBNP is an inactive cleavage product…

…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…

… nausea is common. Tell the patient that the test will in all probability provoke intense but short lived vertigo, and that this is precisely the…