…only in claudication, but before every compression treatment of a leg ulcer and as a risk marker in diabetes and known atherosclerotic disease. An ABI…

…cm suggests undernutrition in adults Calf circumference Largest circumference < 31 cm is a screening marker for sarcopenia Body composition Measurement Women Men : : : Body fat…

…low stroke volume Capillary refill < 3 s A simple and validated marker of perfusion Lactate < 1.6 mmol/L Clearance over time is…

…Severely reduced G5 < 15 Kidney failure Albuminuria Albuminuria is an independent risk marker for both kidney failure and cardiovascular death — a patient with an…

…risk. Left Atrial Diameter (LA) : Enlargement of the left atrium is a marker of elevated left ventricular filling pressures and is linked to adverse outcomes…

…be more advanced than in people without diabetes. Carotid disease is also a marker of systemic cardiovascular risk. The presence of a carotid bruit is…

…incorporating relevant demographic variables; cystatin C may also be used as a filtration marker. CKD is one of the strongest independent risk factors for cardiovascular…

…lipid rich plaque. CAC nevertheless serves as a marker of the broader atherosclerotic process, including non calcified plaques that are not directly visualized by calcium…

…DASH style diets. Their effects are multidimensional and cannot be adequately inferred from changes in a single intermediate marker such as cholesterol. Dietary composition may…

…myocardial injury. Non ischaemic conditions, including myocarditis, rapid ventricular rate atrial fibrillation, marked anaemia, hypertensive emergency, heart failure, and end stage renal disease, may produce…

…segment elevations Rapid T wave inversion Normalization (return) of ST segment elevations Successful reperfusion results in rapid and marked normalization (return) of ST segment elevations…

…markedly impaired renal function [3]. Urine output can change before creatinine but is not a pure marker of filtration. Oliguria may be due to hypovolaemia…

…too large for the available cuffs, and in a patient who does not tolerate repeated compression (for example marked thrombocytopenia). Set up and instructions Choose…

…dipping: a nocturnal fall in pressure of < 10% of the daytime value; an independent risk marker. Treatment targets Group Systolic target Diastolic : : : Adults 18…

…reflect peripheral nerve ischaemia. Motor dysfunction ranges from weakness to paralysis and is a particularly important marker of threatened limb viability. Paralysis generally indicates severe…

…findings may occur singly or in combination. Syncope is particularly important as a marker of potentially severe disease. The presence of haemodynamic instability places the…

…describe specific symptoms or physical manifestations of HTG. Moderate HTG is primarily discussed as a cardiovascular risk marker, while severe HTG is clinically important because…

…hypertrophy and kidney injury. The syndrome is therefore both a clinical risk factor cluster and a marker of broader metabolic dysfunction. Associated abnormalities may include…

…the index marker is used to determine left and right in the obtained image. Figure 1 illustrates how the index marker is used for orientation…

…stunning . This is a protective mechanism since the cessation of contractions leads to a marked reduction in cell metabolism and thus prolongs survival. Myocardial stunning…

…to a different imaging plane. Rotate : The transducer maintains a stationary position while the index marker is moved to a new position. Slide : The transducer…

…is very typical during reperfusion and in that scenario it is a good prognostic marker because it signals that coronary blood flow has been restored…

…While often asymptomatic, NSVT serves as a critical marker of arrhythmogenic risk, particularly in the setting of ischemic heart disease or reduced left ventricular ejection…

…chemistry & laboratory medicine Definition and Pathophysiology B type natriuretic peptide (BNP) and N terminal pro BNP (NT proBNP) are circulating markers of myocardial wall stress…

…can develop despite a measurable or high blood alcohol concentration, particularly in patients with marked tolerance. The most important measures in severe or complicated withdrawal…

…opposite in each case. Equivalent doses Agent Equivalent glucocorticoid dose Mineralocorticoid effect Biological half life : : : : Hydrocortisone (cortisol) 20 mg Marked Short, 8–12 hours Prednisolone…

…several non pharmacological measures at the same time, and use drugs only in severe agitation or marked distress. Delirium is an acute neuropsychiatric syndrome and…

…and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA and HHS are dynamic…

…The varying inclusion criteria in these registries explain the marked differences in characteristics and outcomes across the data sources for out of hospital cardiac arrest…

…lead ECG within 10 minutes. 3. Attach defibrillator pads if the patient is unstable or at marked risk of arrhythmia. 4. Take a full blood…

…impaired consciousness or new onset marked weakness rapidly progressive symptoms from several organ systems severe abdominal pain or repeated vomiting after probable allergen exposure sudden…

…metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients in whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction, arrhythmia…

…not given another hour. Indications CPAP: Acute cardiogenic pulmonary oedema with hypoxaemia and marked work of breathing — the strongest indication, with a rapid effect on…

…Vestibular neuritis, central cause Marked imbalance that makes walking impossible Cerebellar infarction HINTS in continuous vertigo HINTS is not a test for BPPV. It is…

…palsy — that can be assessed before and during the window of effect. The muscarinic effect may at the same time produce marked bradycardia and, rarely…

…An unsecured airway or haemodynamic instability — stabilise the patient first. Marked septal deviation towards the bleeding side (relative). Preparation and equipment Personal protective equipment (gloves…

…available. Do not then try "by feel" — refer to ENT. Relative — a low threshold for referral: Marked swelling or inflammation around the object. A small…

…4. Shift potassium into the cells with insulin and glucose. Add high dose salbutamol in marked hyperkalaemia if there is no contraindication. 5. At the…

…hypersensitivity to the preparation. Intramuscular injection in marked coagulopathy or thrombocytopenia (< 50 ×10⁹/L) — choose the subcutaneous route if possible, otherwise give IM with…

… aspiration can seed a sterile joint). Marked coagulopathy or an anticoagulant at a therapeutic dose (relative; weigh the risk against the diagnostic benefit — where sepsis…

…mouth opening below about 2 cm. Extensive pharyngeal pathology: tumour, abscess, marked swelling, previous radiotherapy. In the "can't intubate, can't oxygenate" situation there…

…suspected intracranial space occupying lesion with mass effect and midline shift. Ongoing anticoagulant treatment or marked coagulopathy. A platelet count below 50 × 10⁹/L is…

…Contraindications Type Condition : : Absolute Suspected base of skull fracture or a marked midfacial fracture — the tube can pass through a fracture in the cribriform plate…

…Marked nausea, anxiety or communication difficulties that prevent the patient from cooperating. Suspected base of skull fracture or marked coagulopathy argues against the nasal route…

…particularly with pethidine. Caution: untreated sleep apnoea, a concurrent benzodiazepine or gabapentinoid, marked hypovolaemia, head injury with impaired consciousness, biliary tract disease. There is no…

…intravascular coagulation or clinically overt bleeding Refrain until the condition has been corrected Marked coagulopathy or thrombocytopenia Routine plasma or platelets are not needed — the…

…inferior vena cava without respiratory variation Strongly suggests a raised filling pressure Marked respiratory variation in mitral and tricuspid inflow The echocardiographic counterpart of pulsus…

…an arteriovenous fistula, previous axillary clearance or lymphoedema. A limb with paresis or marked swelling. A vein suspected of thrombosis or previously thrombophlebitic. Intraosseous access…

…needed. Intubate for a threatened airway, a marked risk of aspiration, or failure that is not rapidly reversed by an antidote B Respiratory rate, saturation…

…is performed later. Contraindications Known hypersensitivity to tetracosactide or ACTH. Marked atopic disease, particularly severe asthma and a history of anaphylaxis — a relative contraindication; the…

…investigated Relative obstacles also include dementia, marked hearing loss and an inability to understand the instructions — spirometry requires active cooperation. Preparation and equipment Equipment: a…

…has not responded to atropine: Complete heart block (third degree AV block) and second degree AV block Mobitz type 2. Marked sinus bradycardia, sinus arrest…

…threshold and on whether haemodialysis should be considered. Rhabdomyolysis with marked elevation of CK and threatened kidney injury, as an adjunct to the decisive measure…

…event, where DOACs have proved inferior. Atrial fibrillation with marked renal failure or on dialysis, where DOACs lack documentation or have only weak evidence. Venous…

…infarction. IIa B Routine blood sampling for serum markers is indicated as soon as possible in the acute phase but should not delay reperfusion treatment…

…ECG amplitudes, intervals and waveforms are therefore different in children and there are marked age variations throughout childhood. Clinicians who work in pediatric and neonatal…

…related structural changes in the coronary media. The early postpartum period, when marked hormonal changes occur. Hypertension and oestrogen exposure. Emotional or chronic mental stress…

…below) have a 3 year survival rate of 50% ( Eleid et al ). The cause of aortic stenosis displays marked geographical variations. In high income countries…

…ecstasy) or amphetamines. In either scenario, there is sustained muscle activation, leading to marked heat generation, acidosis, and the subsequent development of hyperkalemia. This condition…

…declined steadily ever since. The marked decline in death rates and case fatality is most likely explained by successful primary preventive strategies, such as reduced…