China 
Africa 
Explore chapters and articles related to this topic
Clinical Reasoning and Diagnostic Errors
Published in Paul Cerrato, John Halamka, Reinventing Clinical Decision Support, 2020
Suppose Mr. Jones, 59 years old, with a history of hypertension, stroke, and elevated lipid levels arrives in the ED complaining of sudden-onset intense sub-sternal chest pain that radiates to his left leg but does not affect his left arm or jaw.22 An experienced clinician would likely begin to think intuitively about this patient’s diagnosis. Mr. Jones’ symptoms suggest coronary ischemia, that is, a loss of blood to the heart tissue. Naturally, the attending physician will want to do a detailed physical examination to look for more clues to help refine the list of differential diagnoses, as well as appropriate lab tests. One finding that stands out in Mr. Jones’ lab readings is an elevated troponin I level. Troponin is a muscle protein that can escape from heart tissue that has been damaged by an MI.
Carbon Monoxide Analysis
Published in David G. Penney, Carbon Monoxide, 2019
In 1972, the National Institute for Occupational Safety and Health (NIOSH) recommended an 8-h TWAE limit of 35 ppm with a ceiling concentration of 200 ppm (NIOSH, 1972). These limits were based on NIOSH’s review of the CO inhalation toxicity literature, which indicated that persons with mild coronary ischemia were at risk of myocardial infarction with an 8-h TWAE exceeding 50 ppm. The OSHA permissible exposure limit (PEL) is currently 35 ppm as an 8-h TWAE (U.S. Deptartment of Labor, 1993). One must consider the distinctions between regulatory limits and advisory recommendations and realize the delays that often accompany changes in limits and the lag between new scientific findings and promulgating new enforceable standards. Environmental health professionals are ethically bound to consider these findings and weigh them in their recommendations and interpretations.
Mechanical Effects of Cardiovascular Drugs and Devices
Published in Michel R. Labrosse, Cardiovascular Mechanics, 2018
A PTCA catheter is intended for balloon dilatation of a hemodynamically significant coronary artery or bypass graft stenosis in patients evidencing coronary ischemia, for the purpose of improving myocardial perfusion. A PCI catheter may also be intended for the treatment of acute myocardial infarction, as well as for the treatment of in-stent restenosis or postdeployment stent expansion. Percutaneous coronary intervention procedures use a system of components that work together and include a guidewire, a guide catheter, and a balloon catheter. The guide catheter is inserted through the femoral artery into the aorta, through which it is advanced around the aortic arch and positioned at the entrance of one of the main coronary arteries. Radiopaque contrast and fluoroscopy are used to identify the lesion sites and to position a thin guidewire that is advanced through the guide catheter and into the coronary branch to the lesion. The guidewire marks the lesion site for delivery of other devices, including balloon dilatation catheters (BDCs) and stents.
Transcatheter pulmonary valve replacement in pediatric patients
Published in Expert Review of Medical Devices, 2020
Wail Alkashkari, Saad Albugami, Mosa Abbadi, Akram Niyazi, Amani Alsubei, Ziyadi M. Hijazi
Acute hemodynamic complications during the procedure can result from (1) obstruction of pulmonary blood flow caused by valve dislodgement into the PA, (2) coronary ischemia resulting from CA compression, and (3) major hemorrhage resulting from conduit rupture. The rate of serious complications in the US Melody trial was 6%, including death from CA dissection (n = 1), conduit rupture (n = 1), unstable arrhythmia (n = 1), wire perforation in distal PA (n = 2), and femoral vein thrombosis (n = 1). In the COMPASSION trial, the rate of serious complications was 21% (seven patients) with no deaths reported. Valve or stent migration occurred in four patients [three requiring surgical retrieval and one was deployed in the inferior vena cava (IVC)], unstable arrhythmias in one patient, and self-limited wire perforation in the distal PA in two patients [45].
A contemporary systematic review of the complications associated with SURGICEL
Published in Expert Review of Medical Devices, 2023
Matthew Masoudi, Jacob Wiseman, Sam M. Wiseman
The most frequently reported complication was the formation of a SURGICEL-induced mass (granuloma n = 8, abscess n = 7, hematoma n = 3, cysts n = 1, textiloma n = 1). These masses were diagnosed through histological analysis [1]. There were seven studies which reported on cardiovascular complications related to the use of SURGICEL. Notably, Arora et al. reported the case of a two-year-old who had a cardiac arrest due to a swollen SURGICEL mass found behind the left pulmonary artery under the left coronary button which caused coronary ischemia due to periaortic compression [7].
Lovastatin producing by wild strain of Aspergillus terreus isolated from Brazil
Published in Preparative Biochemistry & Biotechnology, 2021
Marcella Cardoso Lemos de Oliveira, Anderson José Paulo, Carolina de Albuquerque Lima, José Luiz de Lima Filho, Cristina Maria Souza-Motta, Esteban Espinosa Vidal, Thiago Pajeú Nascimento, Daniela de Araújo Viana Marques, Ana Lucia Figueiredo Porto
Lovastatin (C24H36O5), a fungal secondary metabolite, acts as one of the competitive inhibitors of the enzyme hydroxy-methyl-glutaryl coenzyme A (HMG-CoA) reductase, which catalyzes the reduction of HMG-CoA to mevalonate during the biosynthesis of cholesterol [1,2]. Due to its ability to inhibit this biosynthesis, lovastatin is widely prescribed as therapy for hypercholesterolemia and to prevent cardiovascular diseases such as atherosclerosis and coronary ischemia [3,4].