Procedurer A corticosteroid injection into soft tissue gives rapid but time limited pain relief and rarely alters the natural history of the disease. In lateral…

…pregnancy and the period before a urological procedure. A positive urine dipstick in an older patient is difficult to interpret. Skin and soft tissue Diagnosis…

…a very large or deep abscess, a markedly unwell patient with fever and systemic upset, suspected necrotising soft tissue infection, a child who cannot tolerate…

…high Contraindications to compression The ankle brachial index measured with Doppler determines whether compression may be applied at all, and if so at what pressure…

…Mineral oil or lidocaine to kill an insect in the ear canal. A 30–60 mL syringe with a soft catheter and body temperature water…

…is too soft to pass through the skin on its own. Local anaesthesia: lidocaine 10 mg/mL, a millilitre or two intracutaneously and along the…

…of the R waves. This is believed to be due to delayed (and thus electrically unopposed) depolarization in the ischemic area. Fragmented QRS complex The…

…6. Assess the indication for antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV…

…reported in patients taking ticagrelor. This is related to ticagrelor inhibiting the P2Y12 receptor on healthy donor platelets in the test. Information about concurrent ticagrelor…

…risk of transmitting the relevant variant to each child. However, other inheritance patterns, de novo variants, incomplete penetrance and variable phenotypic expression complicate risk prediction…

…in addition to LDL and other apoB containing particles. Cardiovascular risk categories Primary prevention For adults aged 40–75 years without diabetes and with LDL…

…ischemia and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes use ATP…

…2 to 24 hours After failed fibrinolysis Immediate rescue PCI The 120 minute limit is a ceiling for the choice between primary PCI and fibrinolysis…

…Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre. Indications Brief attacks of vertigo, seconds to a minute…

…80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin…

…term interventions intended to reduce recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular…

…containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non…

…compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic…

…PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack (TIA) or stroke…

…ACS). Other cardiopulmonary causes , including myopericardial disease, pulmonary embolism, aortic emergencies, and pneumothorax. Non cardiopulmonary causes , including gastrointestinal, musculoskeletal, and anxiety related disorders. The immediate…

…In this post I would like to discuss hot topics related to coronary artery disease and I will emphasize on issues that are typically raised…

…acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI…

…sufficient Severe elevation Acute HMOD Present Absent clinically Symptoms Often present and related to the affected organ May be absent or nonspecific Treatment setting Usually…

…burden and treatment goals Diabetes, left ventricular function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and…

…rather than an isolated disorder of the lower limbs. Patients frequently have concomitant coronary, cerebrovascular or other peripheral arterial disease, and management should therefore address…

…for smoking and anticipated barriers to cessation. Exposure to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation…

…which is standard in the US and many other countries, a 2:1 block will be difficult to discern because the flutter wave may fuse…

…ECG has low sensitivity with respect to detecting biventricular hypertrophy. This is because the strong and oppositely directed forces tend to cancel each other out…

…and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to…

…velocitites to be measured. Continuous wave Doppler is therefore not limited by pulse repetition frequency (PRF). Figure 1. The principles of continuous wave Doppler and…

…tracer exhibits high extraction from blood to tissue and high retention, with a linear relationship between myocardial blood flow and measured tracer activity over a…

…on the other hand, are much less likely to be caused by ischemia ( Figure 1 B ). This is noted in both North American and European…

…electrically dissociated from each other. This condition is referred to as atrioventricular (AV) dissociation. Importantly, for the ventricles to have any electrical (and thus pumping)…

…index 15–19 kg/m² 17–22 kg/m² Ideal and dosing weight Drug dosing often requires a weight other than the actual body weight…

…as in the table above for rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible according to FASS…

…EDTA and heparin tubes according to local instructions, plus a formalin container for the biopsy. No. 11 scalpel for the skin incision, sterile dressings, pressure…

…plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous…

…on an irregular surface. Petroleum jelly around the lesion to protect the surrounding skin. Eye protection and gloves for the operator. Explain before treatment that…

…pulse oximetry and blood pressure measurement throughout the test. Oxygen, suction, a bag and mask, and access to equipment and competence for advanced life support…

…Condition Overall strategy Common first choices : : : Acute aortic syndrome Immediate rate control and rapid reduction of the systolic blood pressure towards 100 to 120 mmHg…

…or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor…

…is primarily a disorder of water balance. The plasma sodium reflects the ratio between the body's exchangeable sodium and potassium and the total body…

…suspicion to bone, pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and…

…with neutropenia related to cancer treatment. Children, pregnant women, patients after allogeneic stem cell transplantation and patients treated with CAR T cells or other advanced…

…same probe as for echocardiography) and a sterile probe cover. Continuous ECG, blood pressure and saturation monitoring; a defibrillator to hand. Sterile gown and gloves…

…connected to the patient — the device senses the rhythm through the cable, not through the pads. A pulse oximeter, a blood pressure cuff, and an…

…urine to alkalinise, and the sodium and volume load becomes pure harm. Dialysis is then the way forward. Heart failure, pulmonary oedema and other conditions…

[calc_aorta] Sinus of Valsalva (SOV) and Aortic Root Assessment The sinus of Valsalva diameter (SOVd) is a critical measurement in evaluating aortic root morphology…

…65, and concomitant drug/alcohol use. Some studies suggest HAS BLED has comparable or slightly superior predictive capability for major bleeding compared to ATRIA. ORBIT…

…is more closely associated with other comorbidities and age rather than sex alone. Consequently, the CHA₂DS₂ VA score was developed to provide a more accurate…

…contribute to bleeding risk, including uncontrolled hypertension, impaired renal or liver function, previous stroke, history of bleeding, unstable anticoagulation control, advanced age, and the use…

…for major bleeding compared to HAS BLED. The C indices were 0.60 for HAS BLED, 0.55 for HEMORR₂HAGES, and 0.50 for ATRIA…

…of these adverse events are related to the suppression of the renin angiotensin aldosterone system (RAAS), such as decreases in blood pressure and mild azotemia…

…MI. Type 1 MI is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable…

…RV pressure load and may impair RV filling and forward output. The resulting syndrome may progress to systemic congestion, reduced cardiac output, haemodynamic collapse, and…

…impair left ventricular ejection fraction. Enlargement of the left ventricle predisposes to atrial and ventricular arrhythmias. In advanced alcohol related cardiomyopathy, dilation may involve all…

…risk plaques may coexist within one coronary tree, and inflammatory activity may be widespread rather than confined to a single lesion. Plaque composition is heterogeneous…

…contribute to vascular dementia, and thromboembolism may affect organs other than the brain. Patients with AF in the setting of ACS have more comorbidities and…

…Consequently, isolated systolic hypertension and widening pulse pressure are common in later life. These changes contribute to the complexity of defining an appropriate treatment target…

…disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections. However, in some individuals the infection may be severe and deadly. Importantly…