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Skin biopsy — punch, shave and excision

…becomes oval when the skin is released, which allows neater closure. 4. Place the punch perpendicular to the skin and rotate under even pressure until…

Interpreting NT-proBNP and BNP in Clinical Decision-Making

…They are released principally by ventricular cardiomyocytes in response to increased transmural stress and ventricular stretch. Atrial natriuretic peptide is produced predominantly by atrial tissue…

Microvascular Angina and INOCA: Diagnosis with CFR and IMR

…or left ventricular hypertrophy. Hypertension, diabetes, and elevated NT proBNP are more frequent in this pattern. Endothelial dysfunction may contribute to both microvascular and epicardial…

Injection technique — intramuscular, subcutaneous and intradermal

…preparations and irritant drugs: pull the skin and subcutaneous tissue 2–3 cm to one side, inject, wait 10 seconds, withdraw the needle and release…

Metabolic Syndrome: Definition and Clinical Significance

…effects and releases additional inflammatory and profibrotic mediators. Perinephric fat is associated with hypertension and blood pressure variability, while obesity and hypertension together promote left…

Unstable Angina: Definition and Contemporary Management

…infarction (AMI), in which myocardial ischaemia is accompanied by cardiomyocyte necrosis and cardiac troponin release meeting the criteria of the universal definition of MI. Clinically…

Gastric lavage and activated charcoal

…including carbamazepine, theophylline and quinine. Repeated dosing may also be appropriate after large ingestions of modified release preparations. Contraindications Measure Contraindication : : Medicinal charcoal A reduced…

Hyperkalaemia: quick reference for emergency treatment

…1. Perform an ABCDE assessment, attach cardiac monitoring, secure intravenous access and record an ECG. 2. Confirm the potassium with a repeat sample, but do…

Opioid therapy in severe pain

…must be taken into account). Known allergy to the preparation — rare; itching and urticaria are usually due to histamine release, not allergy. Concurrent MAO inhibitor…

Poisoning: quick reference for antidotes and initial management

…with modified release preparations, mixed poisoning, pregnancy, children, a need for an antidote or dialysis, and whenever the clinical course deviates from what was expected…

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