1,721,018 research outputs found
Novel strategies: challenge loop diuretics and sodium management in heart failure--part II.
No full textAn unusual presentation of massive pulmonary embolism mimicking septal acute myocardial inferction treated with tenecteplase
No full textA 31-year-old man (175 cm, 82 kg) was referred to the emergency department 2 h after the sudden onset of acute dyspnea. Immediate ECG showed sinus tachycardia with ST elevations from V1 through V2 and a diagnosis of septal acute myocardial infarction was made. ECG on admission to the cardiology department showed the same results plus the S1-Q3-T3 pattern. Echocardiogram revealed a normally contracting left ventricle, a distended right ventricle with free wall hypokinesia and displacement of the interventricular septum towards the left ventricle. Thrombolytic therapy with tenecteplase 8000 IU and heparin 5000 IU was administered 5-10 min after hospitalisation and the patient was haemodynamically stable 30 min later. Echocardiogram performed 12 h after thrombolysis showed a normal left ventricle and a less distended right ventricle. Lung spiral computed tomography (CT) and lower abdominal CT on the fourth day showed large emboli in the inferior pulmonary arteries of the right and left lung. Rarely, massive pulmonary embolism may mimic anteroseptal acute myocardial infarction on ECG and this case demonstrates the utility of echocardiography for a differential diagnosis, as well as the efficacy of tenecteplase for thrombolytic therap
Combination of a high bolus dose of tirofiban with half-dose thrombolytics for the treatment of subacute stent thrombosis
No full textAcute stent thrombosis is rare and it is usually related to complications during the procedure. Subacute thrombosis is far more common and is associated with a high incidence of acute myocardial infarction and death. Restoration of flow by thrombolysis, emergency bypass surgery or emergency percutaneous transluminal coronary angioplasty (PTCA) has had only limited success with respect to myocardial salvage. We report the case of a patient who suffered from recurrent subacute stent thrombosis, in whom administration of tirofiban at high-dose bolus in association with a half dose of recombinant tissue plasminogen activator succeeded in restoring normal myocardial flow and stable clinical conditio
High dose torasemide is equivalent to high-dose furosemide with Hypertnic saline in the treatment of refractory congestive heart failure
No full textOBJECTIVE:A randomised, double-blind study was performed to evaluate the effects of the combination of high-dose torasemide and hypertonic saline solution (HSS) infusion versus high-dose furosemide (frusemide) and HSS in the treatment of refractory New York Heart Association class IV congestive heart failure (CHF).
MATERIALS AND METHODS:Eighty-four patients (55 males, 29 females) with refractory CHF, aged 55-84 years, with an ejection fraction <35%, serum creatinine <2 mg/dL, blood urea nitrogen </=60 mg/dL, a reduced urinary volume and a low natriuresis, were randomised to two groups. Group 1 (27 males, 15 females) received an intravenous infusion of furosemide 500mg plus HSS (150mL of 1.4-4.6% sodium chloride) twice daily in 30 minutes. Group 2 (28 males, 14 females) received torasemide 200mg twice daily plus HSS during a period lasting 4-8 days. Physical examination, measurement of bodyweight, blood pressure, heart rate, evaluation of signs of CHF, and serum and urinary parameters were controlled daily during hospitalisation. Chest x-ray, ECG and echocardiogram were obtained at entry, during hospitalisation and at discharge. During the treatment and after discharge the daily dietary sodium intake was 120 mmol, with a fluid intake of 1.0-1.5L in both groups. Bodyweight and 24-hour urinary volume, serum and urinary laboratory parameters, until reaching a compensated state, were controlled daily, when intravenous furosemide and torasemide were replaced with oral furosemide administration only (250-500mg twice daily). After discharge the double-blind design was discontinued and the subsequent period was an open-label study with furosemide only; the patients were followed up as outpatients weekly for the first 3 months and subsequently once a month.
RESULTS:Baseline clinical characteristics of patients were similar in both groups. A significant increase in daily diuresis and natriuresis was observed in both groups. No difference was observed in serum sodium or potassium. Bodyweight was reduced in both groups. Blood pressure values decreased, and heart rate was corrected to normal values in both groups. In the follow-up period (12 +/- 3.9 months), 17 patients were re-admitted to the hospital for heart failure. Thirteen patients died during follow-up.
CONCLUSION:We conclude that high-dose torasemide is equivalent to high-dose furosemide in the treatment of refractory CH
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
- …
