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The first 150 words of the full text of this article appear below. Key points Coronary artery disease accounts for >30% ofdeaths in Western society. The diagnosis of myocardial infarctionshould be qualified by size, causation and time from occurrence. Mortalityis reduced by immediate or primary percutaneouscoronary intervention or thrombolysis within the first 24 hof onset of ST-segment elevation myocardial infarction. Strategiesto reduce platelet activation (glycoprotein IIb/IIIa receptorantagonists, or clopidogrel) are now recommended in the treatmentof high-risk non-ST-segment myocardial infarction/unstable angina. Elevatedserum troponins may be the result of non-ischaemic myocardialdamage, especially in critical illness.
Pathophysiology
Changes in the definition of terms relating to the diagnosisof myocardial infarction (MI) have evolved by better understandingof the pathophysiology culminating in the new term of acutecoronary syndrome (ACS). Figure 1 illustrates the processesthat occur in the development of an acute coronary event. 相似文献
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An alloantiserum, termed R2, specifically agglutinates red blood cells (RBC) from line 100B chickens that are susceptible to avian leukosis viruses (ALV) belonging to subgroups B and E, but does not agglutinate RBC from congenic inbred line 7(2 )chickens that are resistant to ALV B and E. The R2 antigen was also detected on lymphocytes and thrombocytes. Using chickens from a special cross, it was found that R2 reactivity requires that the chickens must: (1) be susceptible to infection by ALV-E; and (2) express a viral envelope gene with subgroup E specificity. With R2 antiserum, a nearly perfect association was observed between agglutination and susceptibility to ALV-B in F(2) chickens containing endogenous viral genes ev2 and/or ev3. These results support earlier evidence that ALV-B and ALV-E share receptors. Moreover, the R2 antiserum was shown to neutralize ALV-E. The R2 antigen showed Mendelian segregation in chickens of a commercial White Leghorn strain-cross containing ev3, ev6 and ev9. However, commercial chickens with or without the R2 antigen did not differ in susceptibility to lymphoid leukosis induction or immune response on infection with ALV of subgroup A for complex reasons we discuss. 相似文献
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A retrospective analysis of 515 cases of blunt chest trauma is presented. The overall thoracic morbidity rate was 36% and mortality rate was 15.5%. Atelectasis was the most common complication. Severe chest trauma can be present in the absence of rib or other thoracic bony fractures. Emergency thoracotomies for resuscitation of the patient with blunt chest trauma with absent vital signs proved unsuccessful in 39 of 39 patients. A high index of suspicion for blunt chest injury occurring in blunt trauma, coupled with an aggressive diagnostic and therapeutic approach, remains the cornerstone of treatment to minimize the morbidity and mortality of such injuries. 相似文献
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Berbaum KS; el-Khoury GY; Franken EA Jr; Kathol M; Montgomery WJ; Hesson W 《Radiology》1988,168(2):507-511
The effect of knowledge of localizing symptoms and signs in the detection of fractures was studied. Forty radiographs of the extremities were examined twice by seven radiologists; the sessions were separated by 4 months. In 26 cases, a subtle fracture was present; 14 cases were normal. In half of the cases at each session, the precise location of pain, tenderness, or swelling was provided. The observer was asked to determine if the case was normal or abnormal (provide the exact location of the fracture) and to indicate the degree of confidence in the diagnosis. Responses were converted to a numeric scale for analysis. Analysis of receiver operator characteristic parameters indicates that clues regarding location of trauma facilitate detection of fractures. The improvement is based largely on an increased true-positive rate without an increased false-positive rate, regardless of the decision criteria of the radiologist (overall willingness to "overread" or "underread"). This has direct clinical applicability and reinforces the plea of radiologists for precise clinical information. 相似文献
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I?Satish?RaoEmail author Anand?C?Loya KS?Ratnakar VR?Srinivasan 《BMC clinical pathology》2005,5(1):11
Background
Lymph node infarction is known to occur in association with many non-neoplastic and neoplastic conditions however its occurrence in association with DIC is not reported hitherto in the literature. 相似文献8.
Coinfection of chicken embryo fibroblasts with reticuloendotheliosis virus (REV) and avian sarcoma virus leads to the formation of avian sarcoma viral pseudotypes which carry envelope determinants of REV. These pseudotypes can be neutralized by REV antiserum, have a host range which is different from that of any known avian sarcoma virus, and are unable to form foci in cells preinfected with REV. The REV stocks used in these experiments were plaque-purified. They were free of avian leukosis virus detectable in the COFAL tests, and their ability to form pseudotypes with avian sarcoma virus was neutralized with specific REV antiserum. 相似文献
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Acute porphyria is rare in orientals. We describe a Chinese woman with recurrent generalised tonic-clonic seizures and abdominal pain. Genomic DNA studies identified a heterozygous base substitution from guanine to adenine at nucleotide position 503, resulting in substitution of arginine by histidine at position 168 of the protein (R168H). This genetic abnormality is similar to the mutation reported in Caucasians with variegate porphyria. To the best of our knowledge, this is the first report in the English literature a Chinese patient with variegate porphyria with an identifiable mutation. A brief review of porphyria is presented. 相似文献
10.
Kviz FJ Crittenden KS Madura KJ Warnecke RB 《American journal of health promotion : AJHP》1994,8(3):191-201
Purpose. This study assesses buddy support in a community-based, minimal-contact smoking cessation program. Design. Telephone interviews with participants (n=641, response=74%) before and after (end-of-program, n=1,023, response=83%; three months n=757, response=74%; six months, n=859, response=84%; and 12 months, n=713, response=70%) intervention provided the data to be analyzed. Setting. The Chicago metropolitan area was the setting. Subjects. Subjects were a random sample of registrants for the intervention program. Intervention. A self-help smoking cessation program was used, which included a manual and complementary televised segments. Engaging a buddy was optional. Measures. Background and psychosocial characteristics of participants, characteristics of buddies, program compliance, and smoking behavior were the measures used. Results. Almost one third (30.3%) engaged a buddy. Those most likely to engage a buddy were female (33.4%), younger than 30 (37.2%), educated beyond high school (33.4%), highly determined to quit (41.8%), and more likely to need help from others (39.8%). More than half of the buddies were from outside the participant's household (55.1%), and more than half were nonsmokers (60.9%). Having a buddy was associated positively with manual use (gamma=.38), viewing televised segments (gamma=.23), recalling manual segments (gamma=.33), and recalling televised segments (gamma=.26). Among those who read the manual least, having a buddy was associated with viewing televised segments (gamma=.26, p less than .05) and with end-of-program quitting (16.8% vs. 9.8%, p less than .05). Having a buddy also was associated with higher abstinence through 12 months (5.8% vs. 2.7%, p=.013). Among those with lower determination, the end-of-program quit rate was more than three times greater (p=.013) for those with a buddy (16.1%) than without a buddy (5.2%). Participants whose buddy was their spouse or partner were more likely to quit at end-of-program (29.1% vs. 18.4%, p=.031). Conclusions. Buddy support should be promoted as an adjunct to minimal-contact smoking cessation programs. Impact of buddy support might be improved by guiding participants in choosing a buddy. 相似文献