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Goldman Cardiac Risk factors Nine independent risk factors are evaluated on a point scale : Third heart sound (S3); 11 Elevated jugulovenous pressure; 11 Myocardial infarction in past 6 months; 10 ECG: premature arterial contractions or any rhythm other than sinus; 7 ECG shows > 5 premature ventricular contractions per minute; 7 Age more than 70 years; 5 Emergency procedure; 4 Intra-thoracic, intra-abdominal or aortic surgery; 3 Poor general status, metabolic or bedridden; 3 Patients with scores >25 had a 56% incidence of death, with a 22% incidence of severe cardiovascular complications. Patients with scores <26 had a 4% incidence of death, with a 17% incidence of severe cardiovascular complications. Patients with scores <6 had a 0.2% incidence of death, with a 0.7% incidence of severe cardiovascular complications.

Proceedings of the Twenty-Eighth International Symposium on Blood Transfusion, Groningen, NL, Organized by the Sanquin Division Blood Bank North-East, Groningen. It is in many ways fitting that the last of these international symposia on blood transfusion should end with neonatal blood transfusion. The most fragile, least well studied and most at risk population requires special care and concern. We need to expand our knowledge of their unique physiology, biochemical pathways and in planning treatment and interventions, always "do no harm." This proceedings of the last Groningen symposium presents a wealth of information on developmental immunology, the molecular basis of haematopoeisis, physiological basis of bleeding and thrombosis, transfusion risks and benefits and lastly, future therapies. Infants provide us with much to learn but in turn they will be the providers of (through cord blood) and the recipients of (through cellular engineering) the best that science can offe...

download link : please click here Product Description Lippincott's Illustrated Reviews: Pharmacology, Fourth Edition enables rapid review and assimilation of large amounts of complex information about the essentials of medical pharmacology. Clear, sequential pictures of mechanisms of action actually show students how drugs work, instead of just telling them. As in previous editions, the book features an outline format, over 500 full-color illustrations, cross-references to other volumes in the series, and over 125 review questions. Content has been thoroughly updated, and a new chapter covers toxicology. New to this edition will be a companion Website containing all of the illustrations, fully searchable text, and an interactive question bank. NOTE: International Edition available for sales outside North America and Caribbean (ISBN: 978-1-60547-200-3) "Doody's Core Titles™ 2009." Product Details * Paperback: 560 pages * Publisher: Lippincott Williams & Wil...

download link : please click here Review "The book does an excellent job of integrating basic science concepts with clinical medicine. Each of the organ system chapters reviews the normal anatomy, physiology and histology, then follows with the pathophysiology, clinical findings, and pathology of the more commonly encountered disorders. Additionally there are chapters on genetic diseases, immune diseases and neoplasia which similarly link basic science principles with clinical disease entities. Each chapter contains periodic "checkpoint" questions which guide the reader to the most important concepts. Each chapter also ends with several case studies with questions and discussions, similar to those encountered on board examinations." Product Description A complete case-based review of the essentials of pathophysiology – covering all major organs and systems This trusted text introduces you to clinical medicine by reviewing the pathophysiologic basis of the signs and ...

Heart Structure and Blood Supply It seems odd that the tissues making up the heart must have their own separate blood supply. You might think that the torrent of blood rushing through the heart every minute would more than adequately meet the needs of the organ. The walls of the heart, however, consist of layers of specialized muscle. These walls are quite thick—the wall of the left ventricle is often over 1 inch thick. Since the lining of the heart is watertight, the blood cannot seep through the layers of muscle to provide the nourishment essential to these constantly working masses. Blood is carried through the muscle layers that form the heart wall by means of the two coronary arteries. These two small vessels branch off the aorta just after it leaves the heart and curl back across the surface of the chambers, sending twigs through the walls (Fig. 4-1). The coronary arteries are so named because of the supposed resemblance to a crown or “corona” of the little arteries as they...

Blood Flow Through the Heart Blood is pumped through the chambers of the heart and out through the great vessels by a simple squeezing action of the heart chambers. You have probably seen a bulb syringe with a glass nozzle like the one pictured in Figure 3-1. Suppose it is full of water. If you squeeze forcefully, expelling the water, you would be imitating the contraction of a heart chamber. This is called systole (sis-toe-lee). After the syringe had been emptied, imagine that you placed the nozzle in a container of water and let the bulb expand so that it filled. This is what a heart chamber does when it relaxes and fills with blood. The movement is called diastole (die-as-toe-lee). You can picture the process by holding your left hand over your right, fists clenched. If your left hand represents the atria, your right hand will represent the ventricles. Now clench your left fist (the atria) while opening your right fist (the ventricles). This is what happens during atrial systole whe...