J Dunning

..Either aspirin or clopidogrel combined with a proton pump inhibitor are equally effective for these patients...

..Surgery for these patients may remain the mainstay of treatment unless the clot burden is particularly small or the patient's co-morbidities make surgery unacceptably high-risk...

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..We sought to assess the haemodynamic profile of the Freedom stentless aortic valve compared with a stented bioprosthesis in a randomized controlled trial using echocardiography...

..Cross-clamp fibrillation is a well established method of performing coronary grafting, but its clinical effect on the myocardium is unknown. We sought to measure these effects clinically using the Khuri Intramyocardial pH monitor...

..Although there are several large, well-conducted studies on adults enabling accurate selection of patients with head injury at high risk for computed tomography scanning, no such study has derived a rule for children...

..We sought to determine the effect of this course on the management of simulated critically ill and cardiac arrest patients...

..In place of skull radiography and admission, computed tomography (CT) is advocated. The impact of these guidelines on service provision in the UK is unknown...

..An absent right vertebral artery, diseased carotid arteries or an incomplete Circle of Willis is a contraindication to left subclavian artery coverage without prior transposition or bypass grafting of the left subclavian artery...

..We investigated the long-term outcome of coronary artery bypass grafting both in terms of survival and quality of life...

..These risks should prove invaluable to clinicians for the assessment of individual patients as well as the assessment of guidelines presented for the management of minor head injuries...

..We thus sought to derive and validate a clinical decision rule to predict patients at high risk of prolonged ventilation, so that the timing of operations on high risk patients can be optimised in the context of the workload of the CSU...

..Previous studies have presented conflicting results regarding the predictive effect of various clinical symptoms, signs, and plain imaging for intracranial pathology in children with minor head injury...

..This review examines the derivation of the NICE guidelines and discusses some of the problems of putting research into practice...

..This guideline is subject to continuous informal review, and when new evidence becomes available...

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..It is common practice also to give additional antibiotics and a povodine-iodine washout although we could identify no studies other than uncontrolled cohort studies in support of this...

..Mini-bypass seems to be a promising technique with many documented benefits in studies reporting as many as 1000 patients undergoing this technique...

..It should also be acknowledged that the external wrap is not without risk and wrap dislocation, erosion or fistula formation are recognised complications...

..We conclude that currently there is very little evidence to support abdominal only CPR although these studies may support the concept that it may potentially increase the coronary and cerebral perfusion pressure...

..If these do not succeed the chance of a 4th shock succeeding is likely to be <10% and, thus, immediate chest reopening should be performed. (This is a Class-IIa recommendation using ILCOR guideline recommendations.)...

..The lesser saphenous vein may be considered as an alternative to brachial or cephalic vein in patients with unsuitable long saphenous vein, and unsuitable mammary, radial or gastroepiploic arteries...

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..Currently, the evidence is insufficient to support LAA occlusion and may indeed cause harm especially if incomplete exclusion occurs...

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..Patients may, therefore, be reassured that either strategy is acceptable...

..Our aim was to see if the intra-operative insertion of a Bellovac drain to the pleural cavity, with drainage continuing for 4-days post operation, eliminates the complication of pleural effusion...

..Workable risk models for patients undergoing percutaneous coronary intervention (PCI) are needed urgently...

..This guideline is subject to continuous informal review, and when new evidence becomes available. The formal review date will be at 5 years from publication (September 2013)...

..VATS provides a diagnostic tool, yielding tissue for histological diagnosis. Secondly, drainage of effusion and pleurectomy/decortication improves the quality of life and may increase survival as well...

..The latter may reflect a high-risk group or harm in some patients. Predictors of success or failure of rPCI may aid selection of patients to be treated...

..We compared the clinical, angiographic characteristics, 30-day and 1-year outcomes of cardiogenic shock patients undergoing rPCI with those undergoing primary percutaneous coronary intervention (PPCI)...

..A survey was conducted on CTSNet, the cardiothoracic network website in order to ascertain an international viewpoint on a range of issues in resuscitation after cardiac surgery...

..To appraise the evidence on the diagnostic accuracy of CT pulmonary angiography and the prognostic value of a negative CT pulmonary angiogram in the diagnosis of pulmonary embolism...

..The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated...

..Thus, in summary, the patency of the cephalic vein used for coronary artery bypass grafting is around 50% at three years...

..The majority of patients were operated on from the left of the table. More cases were performed with the RIMA as the conduit of choice to the LAD...

..Transoesophageal flow volume loops have been used to guide placement. Benefits seem greatest in patients with a poor ejection fraction and a wide QRS complex...

..CONCLUSIONS: A simple decision rule is presented that can be used to exclude the need for radiography in a subset of patients with mandibular trauma...

..It is concluded that a raised level of S-100b is a marker of poorer long-term outcome after both major and minor head injury...

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..Conversely up to 95% of patients with a bioprosthesis still receive anticoagulation. Survival in over 1000 prostheses pooled by meta-analysis was equivalent between biological and mechanical valves...

..Several high-quality randomized studies now exist on this topic, and we sought to summarize them by meta-analysis...

..We aimed to demonstrate that funnel plots, which aid a meaningful interpretation of the results, can be derived from the New York PCI dataset...

..The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated...

..In addition, the incidence of complications from this procedure seems low. However, other significant improvements to outcomes such as mortality, nutrition, anastomotic leakage, gastric symptoms and aspiration are yet to be established...

..Evidence from current studies has not shown a consistent benefit, but anti-embolic devices continue to be used...

..Meta-analysis suggests an overall clinical benefit from rescue PCI (lower mortality, less reinfarction and less heart failure) at the expense of an increased risk of stroke and bleeding...

..CABG and SVR surgery. With first results expected in 2009, this study will be a landmark in providing the evidence base for the selection of patients for surgical ventricular restoration surgery...

..This article evaluates a three-day cardiac surgery advanced life support course with protocols to manage critically ill cardiac surgical patients who suffer a cardiac arrest and who need their chest reopening...

..On balance, patients with moderate ischaemic mitral regurgitation having CABG should have mitral repair at the same time, although the evidence to support this is weaker than one might like...

..BITA grafting can be performed with acceptable risk in all patients including higher risk patients such as diabetics, in whom skeletonization of the internal thoracic arteries should be strongly considered rather than pedicled harvest...

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..It should be noted that surgery has only been reported in very few of these patients to date. B-natriuretic peptide has also been suggested as a further marker of better prognosis in these high-risk patients in one small study...

..Our aim is to develop a risk-stratification model for use by emergency department (ED) clinical staff in the assessment of patients attending with self-harm...

..5 mm. Further disadvantages include an inability to perform scans in patients with arrhythmias or atrial fibrillation, and a five times increased radiation dose compared to conventional angiography...

..The papers presented in our review support most of these practices!..

..In selected patients with a history of thromboembolic disease and/or coronary artery disease warfarin therapy consideration should be given to supplementing warfarin with low-dose aspirin...

..The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated...

..The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated...

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