Castle AF.ppt

•Download as PPT, PDF•

0 likes•41 views

W

Castle afib trial

GIM Journal Club
Friday March 9th 2018
Dr. Don Redelmeier
Wasim Mansoor

Selection Criteria
Inclusion Exclusion
- Participants from USA, EU, Australia (2008 –
2016)
- Symptomatic atrial fibrillation
- Failure or intolerance to anti-arrhythmics
- LVEF ≤ 35%
- NYHA class ≥ II
- ICD/CRTD with Home Monitoring capabilities
implanted
- Previous left heart ablation procedure for AF
- Contraindication to chronic anticoagulation
therapy
- Documented left atrial diameter >6 cm
- ACS or CVA within 2 months
- Planned cardiovascular intervention
- Listed for heart transplant
- Cardiac assist device implanted
- Life expectancy ≤ 12 months
- Uncontrolled hypertension
- Untreated thyroid disease
- Dialysis
- Mental or physical disability
- Pregnant or actively breast feeding

Baseline
Characteristics

What was the Main Result?

Secondary Outcome: What about All Cause Mortality ?

Subgroup
Analysis

• Failure of Blinding
• Post-randomization exclusions
• Inadequate search for toxicity
What’s wrong with this study?

Question Score
1. Were they really randomized? 0.8
2. Are the patients similar to our own? 0.8
3. Are the results both statistically and clinically
significant?
1.0
4. Is the maneuver feasible? 0.7
5. Are all relevant outcomes reported? 0.5
6. Were all entered patients accounted for at the
conclusion?
0.7
What would David Sackett Say?
Total = 4.5 / 6.0 = 75%

More Related Content

Similar to Castle AF.ppt

LEADER trial- Liraglutide - Journal club

LEADER trial- Liraglutide - Journal club

LEADER trial- Liraglutide - Journal club

Simna Abdul Salam

Brown

Diabetes Care

Andrea D. Peagler

Futuro en el tratamiento de la DM2

Futuro en el tratamiento de la DM2

Futuro en el tratamiento de la DM2

Conferencia Sindrome Metabolico

[ppt] RCpsych - Failing medical care of psychiatric patients (vMar11)

[ppt] RCpsych - Failing medical care of psychiatric patients (vMar11)

[ppt] RCpsych - Failing medical care of psychiatric patients (vMar11)

Alex J Mitchell

Lenient Versus Strict Rate Control ?

Lenient Versus Strict Rate Control ?

Lenient Versus Strict Rate Control ?

ปิติ นิยมศิริวนิช

Should we implant icd only in some patients with nicmp (cons)

Should we implant icd only in some patients with nicmp (cons)

Should we implant icd only in some patients with nicmp (cons)

Alireza Ghorbani Sharif

Courage TRIAL 2007

Courage TRIAL 2007

Courage TRIAL 2007

Valmiki Seecheran

Treatment perceptions andmisunderstandings with cliniciansin people with diab...

Treatment perceptions andmisunderstandings with cliniciansin people with diab...

Treatment perceptions andmisunderstandings with cliniciansin people with diab...

Primary Care Diabetes Europe

Copyright 2016 American Medical Association. All rights reserved. Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years A Randomized Clinical Trial Jeff D. Williamson, MD, MHS; Mark A. Supiano, MD; William B. Applegate, MD, MPH; Dan R. Berlowitz, MD; Ruth C. Campbell, MD, MSPH; Glenn M. Chertow, MD; Larry J. Fine, MD; William E. Haley, MD; Amret T. Hawfield, MD; Joachim H. Ix, MD, MAS; Dalane W. Kitzman, MD; John B. Kostis, MD; Marie A. Krousel-Wood, MD; Lenore J. Launer, PhD; Suzanne Oparil, MD; Carlos J. Rodriguez, MD, MPH; Christianne L. Roumie, MD, MPH; Ronald I. Shorr, MD, MS; Kaycee M. Sink, MD, MAS; Virginia G. Wadley, PhD; Paul K. Whelton, MD; Jeffrey Whittle, MD; Nancy F. Woolard; Jackson T. Wright Jr, MD, PhD; Nicholas M. Pajewski, PhD; for the SPRINT Research Group IMPORTANCE The appropriate treatment target for systolic blood pressure (SBP) in older patients with hypertension remains uncertain. OBJECTIVE To evaluate the effects of intensive (<120 mm Hg) compared with standard (<140 mm Hg) SBP targets in persons aged 75 years or older with hypertension but without diabetes. DESIGN, SETTING, AND PARTICIPANTS A multicenter, randomized clinical trial of patients aged 75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT). Recruitment began on October 20, 2010, and follow-up ended on August 20, 2015. INTERVENTIONS Participants were randomized to an SBP target of less than 120 mm Hg (intensive treatment group, n = 1317) or an SBP target of less than 140 mm Hg (standard treatment group, n = 1319). MAIN OUTCOMES AND MEASURES The primary cardiovascular disease outcome was a composite of nonfatal myocardial infarction, acute coronary syndrome not resulting in a myocardial infarction, nonfatal stroke, nonfatal acute decompensated heart failure, and death from cardiovascular causes. All-cause mortality was a secondary outcome. RESULTS Among 2636 participants (mean age, 79.9 years; 37.9% women), 2510 (95.2%) provided complete follow-up data. At a median follow-up of 3.14 years, there was a significantly lower rate of the primary composite outcome (102 events in the intensive treatment group vs 148 events in the standard treatment group; hazard ratio [HR], 0.66 [95% CI, 0.51-0.85]) and all-cause mortality (73 deaths vs 107 deaths, respectively; HR, 0.67 [95% CI, 0.49-0.91]). The overall rate of serious adverse events was not different between treatment groups (48.4% in the intensive treatment group vs 48.3% in the standard treatment group; HR, 0.99 [95% CI, 0.89-1.11]). Absolute rates of hypotension were 2.4% in the intensive treatment group vs 1.4% in the standard treatment group (HR, 1.71 [95% CI, 0.97-3.09]), 3.0% vs 2.4%, respectively, for syncope (HR, 1.23 [95% CI, 0.76-2.00]), 4.0% vs 2.7% for electrolyte abnormalities (HR, 1.51 [95% CI, 0.99-2.33]), 5.5% vs 4.0% for acute kidney injury (HR, 1.41 [95% CI, 0.98-2.04]), and 4.9% vs 5.5% for inj.

Copyright 2016 American Medical Association. All rights reserv.docx

Copyright 2016 American Medical Association. All rights reserv.docx

Copyright 2016 American Medical Association. All rights reserv.docx

melvinjrobinson2199

Copyright 2016 American Medical Association. All rights reserved. Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years A Randomized Clinical Trial Jeff D. Williamson, MD, MHS; Mark A. Supiano, MD; William B. Applegate, MD, MPH; Dan R. Berlowitz, MD; Ruth C. Campbell, MD, MSPH; Glenn M. Chertow, MD; Larry J. Fine, MD; William E. Haley, MD; Amret T. Hawfield, MD; Joachim H. Ix, MD, MAS; Dalane W. Kitzman, MD; John B. Kostis, MD; Marie A. Krousel-Wood, MD; Lenore J. Launer, PhD; Suzanne Oparil, MD; Carlos J. Rodriguez, MD, MPH; Christianne L. Roumie, MD, MPH; Ronald I. Shorr, MD, MS; Kaycee M. Sink, MD, MAS; Virginia G. Wadley, PhD; Paul K. Whelton, MD; Jeffrey Whittle, MD; Nancy F. Woolard; Jackson T. Wright Jr, MD, PhD; Nicholas M. Pajewski, PhD; for the SPRINT Research Group IMPORTANCE The appropriate treatment target for systolic blood pressure (SBP) in older patients with hypertension remains uncertain. OBJECTIVE To evaluate the effects of intensive (<120 mm Hg) compared with standard (<140 mm Hg) SBP targets in persons aged 75 years or older with hypertension but without diabetes. DESIGN, SETTING, AND PARTICIPANTS A multicenter, randomized clinical trial of patients aged 75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT). Recruitment began on October 20, 2010, and follow-up ended on August 20, 2015. INTERVENTIONS Participants were randomized to an SBP target of less than 120 mm Hg (intensive treatment group, n = 1317) or an SBP target of less than 140 mm Hg (standard treatment group, n = 1319). MAIN OUTCOMES AND MEASURES The primary cardiovascular disease outcome was a composite of nonfatal myocardial infarction, acute coronary syndrome not resulting in a myocardial infarction, nonfatal stroke, nonfatal acute decompensated heart failure, and death from cardiovascular causes. All-cause mortality was a secondary outcome. RESULTS Among 2636 participants (mean age, 79.9 years; 37.9% women), 2510 (95.2%) provided complete follow-up data. At a median follow-up of 3.14 years, there was a significantly lower rate of the primary composite outcome (102 events in the intensive treatment group vs 148 events in the standard treatment group; hazard ratio [HR], 0.66 [95% CI, 0.51-0.85]) and all-cause mortality (73 deaths vs 107 deaths, respectively; HR, 0.67 [95% CI, 0.49-0.91]). The overall rate of serious adverse events was not different between treatment groups (48.4% in the intensive treatment group vs 48.3% in the standard treatment group; HR, 0.99 [95% CI, 0.89-1.11]). Absolute rates of hypotension were 2.4% in the intensive treatment group vs 1.4% in the standard treatment group (HR, 1.71 [95% CI, 0.97-3.09]), 3.0% vs 2.4%, respectively, for syncope (HR, 1.23 [95% CI, 0.76-2.00]), 4.0% vs 2.7% for electrolyte abnormalities (HR, 1.51 [95% CI, 0.99-2.33]), 5.5% vs 4.0% for acute kidney injury (HR, 1.41 [95% CI, 0.98-2.04]), and 4.9% vs 5.5% for inj.

Copyright 2016 American Medical Association. All rights reserv.docx

Copyright 2016 American Medical Association. All rights reserv.docx

Copyright 2016 American Medical Association. All rights reserv.docx

bobbywlane695641

RIESGO CARDIOMETABOLICO

RIESGO CARDIOMETABOLICO

RIESGO CARDIOMETABOLICO

AFFIRM trial JC NOVANT

AFFIRM trial JC NOVANT

AFFIRM trial JC NOVANT

Journal Article Analysis: African-American Heart Failure Trial (A-HeFT)

Journal Article Analysis: African-American Heart Failure Trial (A-HeFT)

Journal Article Analysis: African-American Heart Failure Trial (A-HeFT)

Old vs new targets april 2015

Old vs new targets april 2015

Old vs new targets april 2015

Aderenta si riscul cardiovascul

Aderenta si riscul cardiovascul

Aderenta si riscul cardiovascul

ALEXANDRU ANDRITOIU

Comprehensive exam - Alzheimer's disease - 10-9-14

Comprehensive exam - Alzheimer's disease - 10-9-14

Comprehensive exam - Alzheimer's disease - 10-9-14

Caroline Humbles

Automated Use of Clinical Laboratory Results

Automated Use of Clinical Laboratory Results

Automated Use of Clinical Laboratory Results

Benjamin Littenberg

3 year clinical outcomes in patients

3 year clinical outcomes in patients

3 year clinical outcomes in patients

Trimed Media Group

week 9 Assessment and Management of Patients with Hypertension- crisis.ppt

week 9 Assessment and Management of Patients with Hypertension- crisis.ppt

week 9 Assessment and Management of Patients with Hypertension- crisis.ppt

AbdallahAlasal1

Similar to Castle AF.ppt (20)

LEADER trial- Liraglutide - Journal club

LEADER trial- Liraglutide - Journal club

LEADER trial- Liraglutide - Journal club

Brown

Diabetes Care

Futuro en el tratamiento de la DM2

Futuro en el tratamiento de la DM2

Futuro en el tratamiento de la DM2

[ppt] RCpsych - Failing medical care of psychiatric patients (vMar11)

[ppt] RCpsych - Failing medical care of psychiatric patients (vMar11)

[ppt] RCpsych - Failing medical care of psychiatric patients (vMar11)

Lenient Versus Strict Rate Control ?

Lenient Versus Strict Rate Control ?

Lenient Versus Strict Rate Control ?

Should we implant icd only in some patients with nicmp (cons)

Should we implant icd only in some patients with nicmp (cons)

Should we implant icd only in some patients with nicmp (cons)

Courage TRIAL 2007

Courage TRIAL 2007

Courage TRIAL 2007

Treatment perceptions andmisunderstandings with cliniciansin people with diab...

Treatment perceptions andmisunderstandings with cliniciansin people with diab...

Treatment perceptions andmisunderstandings with cliniciansin people with diab...

Copyright 2016 American Medical Association. All rights reserv.docx

Copyright 2016 American Medical Association. All rights reserv.docx

Copyright 2016 American Medical Association. All rights reserv.docx

Copyright 2016 American Medical Association. All rights reserv.docx

Copyright 2016 American Medical Association. All rights reserv.docx

Copyright 2016 American Medical Association. All rights reserv.docx

RIESGO CARDIOMETABOLICO

RIESGO CARDIOMETABOLICO

RIESGO CARDIOMETABOLICO

AFFIRM trial JC NOVANT

AFFIRM trial JC NOVANT

AFFIRM trial JC NOVANT

Journal Article Analysis: African-American Heart Failure Trial (A-HeFT)

Journal Article Analysis: African-American Heart Failure Trial (A-HeFT)

Journal Article Analysis: African-American Heart Failure Trial (A-HeFT)

Old vs new targets april 2015

Old vs new targets april 2015

Old vs new targets april 2015

Aderenta si riscul cardiovascul

Aderenta si riscul cardiovascul

Aderenta si riscul cardiovascul

Comprehensive exam - Alzheimer's disease - 10-9-14

Comprehensive exam - Alzheimer's disease - 10-9-14

Comprehensive exam - Alzheimer's disease - 10-9-14

Automated Use of Clinical Laboratory Results

Automated Use of Clinical Laboratory Results

Automated Use of Clinical Laboratory Results

3 year clinical outcomes in patients

3 year clinical outcomes in patients

3 year clinical outcomes in patients

week 9 Assessment and Management of Patients with Hypertension- crisis.ppt

week 9 Assessment and Management of Patients with Hypertension- crisis.ppt

week 9 Assessment and Management of Patients with Hypertension- crisis.ppt

Recently uploaded

Abortion pills in Kuwait city !🌆+919101817206) Where to get cytotec pills in salmiyah, WhatsApp '''(+919101817206)''' Explore Discreet and Safe Abortion Pill Options in Dubai, Empowering Women With Confidential and Medically Supervised Choices For Reproductive Health" Abortion Pills In Dubai, Abu Dhabi/Alain/Sharjah/RAK City Satwa-Mifepristone and Misoprostol Available in Dubai/Abu Dhabi - i Pills in Dubai and Cost Of Cytotec in WhatsApp (+919101817206) Abortion Pills in Dubai/Abu Dubai/ Abu Dhabi. Are you stranded with unwanted pregnancy in Dubai, Abu Dhabi , the United Arab Emirates (U.A.E), Qatar, Oman, Saudi Arabia or Kuwait? you can now contact us now on Whatsapp 9101817206 buy safe abortion pills In Dubai, Abu Dhabi, Sharjah, Al Ain, Ajman, RAK City, Ras Al Khaimah and Fujairah to terminate an unwanted pregnancy in Dubai and the United Arab Emirates. Get your Discreet 100% Safe (+919101817206)*Effective Abortion Pills For Sale in Dubai, Abu Dhabi, KUWAIT, QATAR, BAHRAIN, DOHA, SALMIYA, Sharjah, Ajman, Alain, Fujairah, Ras Al Khaimah, Umm Al Quwain, UAE. BUY Mifepristone and Misoprostol (Cytotec), Mtp Kit In UAE. Abortion pills available in UAE (United Arab Emirates), Saudi Arabia, Kuwait, Oman, Bahrain and Qatar. Contact us today. +919101817206 -The UAE’s leading abortion care service in Dubai. Abortion Treatment. Medical Abortion. Surgical Abortion. Find A Clinic like Dr Maria Abortion clinic in Dubai We have Abortion Pills / Cytotec Tablets Available in Dubai, Abu Dhabi, KUWAIT, QATAR, BAHRAIN, DOHA, SALMIYA, Sharjah, Ajman, Alain, Fujairah, Ras Al Khaimah, Umm Al Quwain, UAE., buy cytotec in Dubai abortion Pills Cytotec also available Oman Qatar Doha Saudi Arabia Bahrain We sell original abortion medicine which includes: Cytotec 200mcg (Misoprostol), Mifepristone, Mifegest-kit, Misoclear, Emergency contraceptive pills, Morning after sex pills, ipills, pills to prevent pregnancy 72 hours after sex. All our pills are manufactured by reputable medical manufacturing companies like PFIZER. Medical abortion is easy and effective for everyone to perform in their own privacy. There are very few complications that may arise from medical abortion if one follows the right guidelines as instructed by the obstetrician. Abortion Pills in Dubai Can Now Be Offered at Dr Maria Abortion clinic in Dubai, F.D.A. Mifepristone and Misoprostol, the first of two drugs in medication abortions, previously had to be dispensed only by clinics, doctors or a few mail-order pharmacies like Dr Maria Abortion clinic in Dubai . Now, We can provide it. For the first time, retail pharmacies, like Dr Maria Abortion clinic in Dubai, will be Able to offer abortion pills in Dubai under a regulatory change made Tuesday by the Food and Drug Administration. The action could significantly expand access to abortion through medication. Cytotec Abortion Pills are Available In Dubai / UAE, you will be very happy to do abortion in Dubai we are providing cytotec 200mg abortion pi

Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia

Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia

Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia

Jual Obat Aborsi Cytotec di Makassar WA 085226114443 Apotek Online 24 Jam WA ( 085226114443 ) Obat Cytotec Makassar, Jual Obat Cytotec Makassar, Penjual Obat Cytotec Makassar, Alamat Penjual Obat Cytotec Makassar, Toko Online Jual Obat Cytotec Makassar, Apotek Jual Obat Cytotec Makassar, Klinik Jual Obat Cytotec Makassar, Jual Obat Cytotec Wilayah Makassar, Jual Obat Cytotec Daerah Makassar, Jual Obat Cytotec Asli Di Makassar, Obat Aborsi Makassar, Obat Aborsi Cytotec Makassar, Jual Obat Aborsi Makassar, Jual Obat Aborsi Cytotec Makassar, Penjual Obat Aborsi Makassar, Alamat Penjual Obat Aborsi Makassar, Toko Online Jual Obat Aborsi Makassar, Apotek Jual Obat Aborsi Makassar, Klinik Jual Obat Aborsi Makassar, Jual Obat Aborsi Wilayah Makassar, Jual Obat Aborsi Daerah Makassar, Jual Obat Aborsi Asli Di Makassar, Obat Penggugur Kandungan Makassar, Jual Obat Penggugur Kandungan Makassar, Penjual Obat Penggugur Kandungan Makassar, Alamat Penjual Obat Penggugur Kandungan Makassar, Toko Online Jual Obat Penggugur Kandungan Makassar, Apotek Jual Obat Penggugur Kandungan Makassar, Klinik Jual Obat Penggugur Kandungan Makassar, Jual Obat Penggugur Kandungan Wilayah Makassar, Jual Obat Penggugur Kandungan Daerah Makassar, Jual Obat Penggugur Kandungan Asli Di Makassar. Jual Obat Aborsi Penggugur Kandungan Cytotec Asli Terpercaya (Whatsapp) 085226114443 Selamat Datang Di APOTEK resmi Penjualan obat aborsi Misoprostrol Cytotec, dan Mifepristone Asli di Makassar. Kami Adalah Apotek Penjual Obat Aborsi Cytotec Yang Sangat Terpercaya Untuk Membantu Masalah Penggugur Kandungan Dengan Produk Unggulan Kami Yaitu Obat Misoprostrol Cytotec 200mcg dan 400mcg, dan Mifepristone. TENTANG CYTOTEC MISOPROSTOL Cytotec Misoprostol cara yang digunakan untuk menggugurkan kandungan ketika tes mengungkapkan bahwa janin abnormal. Obat Misoprostol Cytotec sangat dianjurkan bila kesehatan ibu beresiko. Cytotec misoprostol dan Mifeprestone Miferex dan mifegen lebih manjur dari obat telat bulan tradisional kami menjual Cytotec yang sering disebut dengan nama obat aborsi, yang kami jual adalah Misoprotol Cytotec dari Pfizer Australia, Misoprostol Cytotec adalah obat paling ampuh untuk menggugurkan kandungan anda dengan cepat. MISOPROSTOL CYTOTEC Obat ini lebih dikenal dengan nama merek seperti Misotrol Cytotec, dan Cyprostol. Tujuan dari obat sekunder ini adalah untuk mengosongkan rahim sepenuhnya dengan merangsang kontraksi. Studi menunjukkan bahwa di sekitar 99% kasus, menggunakan misoprostol saja berhasil mengakhiri kehamilan. Namun prosedur yang ditentukan dan dilakukan melalui layanan aborsi yang aman dan legal dengan pengawasan dokter adalah prosedur yang menggunakan dua obat terbaik yaitu Misoprostol Cytotec 200mcg dan Mifepristone. BAGAIMANA CARA KERJA OBAT ABORSI CYTOTEC MISOPROSTOL CYTOTEC – Sering dijuluki sebagai pil aborsi, dan juga diidentifikasi sebagai RU 486, obat ini adalah salah satu dari dua obat yang digunakan di klinik aborsi. Obat ini bekerja

Obat Aborsi Makassar WA 085226114443 Jual Obat Aborsi Cytotec Asli Di Makassar

Obat Aborsi Makassar WA 085226114443 Jual Obat Aborsi Cytotec Asli Di Makassar

Obat Aborsi Makassar WA 085226114443 Jual Obat Aborsi Cytotec Asli Di Makassar

Session-1-MBFHI-A-part-of-the-Global-Strategy.ppt

Session-1-MBFHI-A-part-of-the-Global-Strategy.ppt

Session-1-MBFHI-A-part-of-the-Global-Strategy.ppt

Medidas Medical Center INC

Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptx

Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptx

Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptx

Top 20 sexiest Indian pornstars list rated by popularity and hotness. Best Indian pornstar are Sunny Leone, Anjali Kara, Shazia Sahari. Browse the list of the hottest indian pornstars at pornpics.de. ❤️Here you can find FREE porn pics of the best female pornstars from India. INDIAN TOP PORNSTAR – #1 ANJALI KARA. Anjali Kara Indian Porn Star. The name Anjali Kara comes to mind when talking the top Indian female porn star name. CheckOut My website : https://www.niamh.in/indian-pornstars.html If you are a fan of Indian Porn Star then you will get here lots of Hot photos of Indian Porn Star. One of the top best Hot Indian Porn Star Name. You know that peoples are crazy about watching the videos of Indian Porn Stars. And here you will find the best porn star name to have fun with. Top Indian Pornstars We have to tell you about all the porn star models ( https://www.niamh.in ) who have made Indian XXX videos so far. Because in today’s time, many women and girls of our age have started having sex a lot. If you look, the list of all Indian porn star is given below for you. Here it will also be told which porn star’s hot sex video is uploaded on which website. How many more videos have been made? All kinds of information about all Indian sex girls will also be provided to you. Many of you have had to go through this. All are Hot Indian porn star girls. Which one is there and a new desi girl porn star’s video has come. Or we have to find out his name and information. Or there are many people like this in our India. Who like to watch sex videos as per their choice. बॉलीवुड एक्ट्रेस सनी लियोनी को हम एक ऐसी पोर्न स्टार के तौर पर जानते हैं जो भारतीय मूल की हैं.

Top 20 Famous Indian Female Pornstars Name List 2024

Top 20 Famous Indian Female Pornstars Name List 2024

Top 20 Famous Indian Female Pornstars Name List 2024

Leading large scale change: a life at the interface between theory and practice

Leading large scale change: a life at the interface between theory and practice

Leading large scale change: a life at the interface between theory and practice

Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto

Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto

Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto

Coach Dan Quinn Commanders Feather T Shirts

Coach Dan Quinn Commanders Feather T Shirts

Coach Dan Quinn Commanders Feather T Shirts

LFT stands for liver function test, which is a blood test that measures the levels of proteins and enzymes in the blood to provide information about the state of the liver. LFTs are also known as hepatic panels. LFT stands for liver function test, which is a blood test that measures the levels of proteins and enzymes in the blood to provide information about the state of the liver. LFTs are also known as hepatic panels. Contents Overview Test Details Results and Follow-Up Contents Overview Test Details Results and Follow-Up Overview What are liver function tests? Liver function tests are blood tests that measure different substances produced by your liver. These measurements give your healthcare provider important information about the overall health of your liver and how well it’s working. A liver panel will often measure several substances in one blood sample. It may include various enzymes, proteins and byproducts. What are the five primary liver function tests? The most common liver tests include: Liver enzymes test. Your liver enzymes include alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT). These are elevated when there’s liver injury. Total protein test.A total protein test measures levels of protein in your blood. Your liver makes protein, and low protein levels may indicate that your liver isn’t functioning optimally. Bilirubin test. Bilirubin is a waste product that your liver deposits in bile. LDH test. Lactate dehydrogenase (LDH) is an enzyme found in many of your body’s tissues, including your liver. Prothrombin Time (PT) test. This test measures how long it takes for a sample of your blood to clot, a process that involves proteins that your liver produces. These tests are all part of a routine blood panel called a comprehensive metabolic panel. When are tests done to check liver function? Your healthcare provider might want to check these values to screen you for possible hepatitis or other liver diseases. If they already know that you have liver disease, they might want to check how it’s progressing or whether a treatment is working. You may also have a liver test to monitor the side effects of certain medications that are known to affect your liver. What kinds of things can a liver panel tell you? Different values and ratios of different substances may tell your healthcare provider: If you have liver inflammation (hepatitis). Whether the inflammation is alcohol-related or nonalcoholic (metabolic). Whether you have a problem in your liver itself or in your bile ducts. If your liver function is impaired, and if so, how much. If your bile flow is impaired, and if so, how much. Whether your medications are affecting your liver, and if so, how much. Test Details How do liver function tests work? A healthcare provider draws a small amount of blood from a vein in your arm to test in the lab. They’ll look for abnormally high or low levels of different subs

Liver Function Test.ppt MBBS A healthcare provider draws a small amoun

Liver Function Test.ppt MBBS A healthcare provider draws a small amoun

Liver Function Test.ppt MBBS A healthcare provider draws a small amoun

End of Response issues - Code and Rapid Response Workshop

End of Response issues - Code and Rapid Response Workshop

End of Response issues - Code and Rapid Response Workshop

Mtp kit in kuwait௹+918133066128....) @abortion pills for sale in Kuwait City ✒Abortion CLINIC In Kuwait ?Kuwait pills +918133066128௵) safe Abortion Pills for sale in Salmiya, Kuwait city,Farwaniya-cytotec pills for sale in Kuwait city. Kuwait pills +918133066128WHERE I CAN BUY ABORTION PILLS IN KUWAIT, CYTOTEC 200MG PILLS AVAILABLE IN KUWAIT, MIFEPRISTONE & MISOPROSTOL MTP KIT FOR SALE IN KUWAIT. Whatsapp:+Abortion Pills For Sale In Mahboula-abortion pills in Mahboula-abortion pills in Kuwait City- .Kuwait pills +918133066128)))abortion pills for sale in Mahboula …Mtp Kit On Sale Kuwait pills +918133066128mifepristone Tablets available in Kuwait?Zahra Kuwait pills +918133066128Buy Abortion Pills Cytotec Misoprostol 200mcg Pills Brances and now offering services in Sharjah, Abu Dhabi, Dubai, **))))Abortion Pills For Sale In Ras Al-Khaimah(((online Cytotec Available In Al Madam))) Cytotec Available In muscat, Cytotec 200 Mcg In Zayed City, hatta,Cytotec Pills௵+ __}Kuwait pills +918133066128}— ABORTION IN UAE (DUBAI, SHARJAH, AJMAN, UMM AL QUWAIN, ...UAE-ABORTION PILLS AVAILABLE IN DUBAI/ABUDHABI-where can i buy abortion pillsCytotec Pills௵+ __}Kuwait pills +918133066128}}}/Where can I buy abortion pills in KUWAIT , KUWAIT CITY, HAWALLY, KUWAIT, AL JAHRA, MANGAF , AHMADI, FAHAHEEL, In KUWAIT ... pills for sale in dubai mall and where anyone can buy abortion pills in Abu Dhabi, Dubai, Sharjah, Ajman, Umm Al Quwain, Ras Al Khaimah ... Abortion pills in Dubai, Abu Dhabi, Sharjah, Ajman, Fujairah, Ras Al Khaimah, Umm Al Quwain…Buy Mifepristone and Misoprostol Cytotec , Mtp KitABORTION PILLS _ABORTION PILLS FOR SALE IN ABU DHABI, DUBAI, AJMAN, FUJUIRAH, RAS AL KHAIMAH, SHARJAH & UMM AL QUWAIN, UAE ❤ Medical Abortion pills in ... ABU DHABI, ABORTION PILLS FOR SALE ----- Dubai, Sharjah, Abu dhabi, Ajman, Alain, Fujairah, Ras Al Khaimah FUJAIRAH, AL AIN, RAS AL KHAIMAMedical Abortion pills in Dubai, Abu Dhabi, Sharjah, Al Ain, Ajman, RAK City, Ras Al Khaimah, Fujairah, Dubai, Qatar, Bahrain, Saudi Arabia, Oman, ...Where I Can Buy Abortion Pills In Al ain where can i buy abortion pills in #Dubai, Exclusive Abortion pills for sale in Dubai ... Abortion Pills For Sale In Rak City, in Doha, Kuwait.௵ Kuwait pills +918133066128₩ Abortion Pills For Sale In Doha, Kuwait,CYTOTEC PILLS AVAILABLE Abortion in Doha, ꧁ @ ꧂ ☆ Abortion Pills For Sale In Ivory park,Rabie Ridge,Phomolong. ] Abortion Pills For Sale In Ivory Park, Abortion Pills+918133066128In Ivory Park, Abortion Clinic In Ivory Park,Termination Pills In Ivory Park,. *)][(Abortion Pills For Sale In Tembisa Winnie Mandela Ivory Park Ebony Park Esangweni Oakmoor Swazi Inn Whats'app...In Ra al Khaimah,safe termination pills for sale in Ras Al Khaimah. | Dubai.. @Kuwait pills +918133066128Abortion Pills For Sale In Kuwait, Buy Cytotec Pills In Kuwait.Cytotec Pills௵ __}Kuwait pills +918133066128}}}/Where can I buy abortion pills in KUWAIT ,

@Safe Abortion pills IN Jeddah(+918133066128) Un_wanted kit Buy Jeddah

@Safe Abortion pills IN Jeddah(+918133066128) Un_wanted kit Buy Jeddah

@Safe Abortion pills IN Jeddah(+918133066128) Un_wanted kit Buy Jeddah

Abortion pills in Kuwait Cytotec pills in Kuwait

Jual Obat Aborsi Cytotec di Jogja 081313339699 Apotik Online 24 Jam ( 081313339699 ) Jual Obat Aborsi Cod Jogja, Penjual Cytotec Di Jogja, Alamat Jual Obat Cytotec Di Jogja, Toko Jual Cytotec Di Jogja, Beli Obat Cytotec Di Jogja, Penjual Obat Gastrul Jogja, Misoprostol Asli Jogja, Tempat Jual Obat Aborsi Daerah Jogja, Obat Penggugur Kandungan Jogja, Penjual Cytotec Wilayah Jogja, Obat Aborsi Di Jogja, Harga Cytotec Di Jogja, Obat Aborsi Online Jogja, Obat Penggugur Janin Jogja, Alamat Toko Obat Aborsi Di Jogja, Apotik Yang Menjual Cytotec Di Jogja, Tempat Beli Cytotec Di Jogja, Tempat Penjualan Cytotec Di Jogja, Toko Obat Aborsi Jogja, Tempat Aborsi Jogja, Klinik Aborsi Jogja, Tidak Menerima COD, Dengan harga yang bisa anda pilih sesuai usia kandungan anda. Obat Aborsi Cytotec ini mampu menggugurkan kandungan sampai usia 1 – 5 bulan dengan sangat efektif. Hubungi Untuk Pemesanan ⇛⇛⇛ ( WhatsApp 081313339699 ) Di sini kami menjual berbagai macam obat aborsi cytotec misoprostol pfizer asli obat penggugur kandungan cytotec asli Apotik Penjual Obat Aborsi belakangan ini banyak sekali yang mengaku bidan yang bisa menggugurkan kandungan ( aborsi ) atau dokter, saya harap anda hati2 untuk bidan kuret, karena alat kuret hanya dokter yang mempunyai alat tersebut, kalau si bidan atau si dokter tersebut menawarkan obat aborsi cytotec, atau obat aborsi lainnya, pastikan dulu website atau blognya mempunyai bukti bahwa dia benar2 memiliki obat untuk aborsi janin dan kandungan tersebut, jadi kalau sebuah blog tidak punya bukti memiliki obat jangan coba2 membeli dari web atau blog tersebut, obat saja tidak punya lalu apa yang mau dikirim ? Bagi wanita di jika ingin menggugurkan kandungannya karena terbelit masalah yang sangat serius,misalnya, ada penyakit yang mengancam keselamatan sang ibu yang mengandungnya,masalah ekonomi, hasil pemerkosaan, maupun hasil hubungan gelap dan ternyata pasangannya tidak mau bertanggung jawab, oleh sebab itu jika anda tersandung masalah tersebut dan jika anda ingin melakukan tindakan aborsi dengan menggunkan obat, anda tidak salah tempat, karena disini menyediakan Obat Penggugur Kandungan yang bisa anda beli disini. Bagaimana cara mendapatkan obat di Apotik Penjual Obat Aborsi Cytotec ? kami akan memberikan kemudahan untuk anda tanpa harus mencari atau membawa resep dokter, Obat cytotec untuk aborsi merupakan tahap bagaimana seseorang dalam melakukan tindakan menggugurkan sebuah kehamilan atau kandungan dengan metode obat yang di dapat di kami dengan cara dan langkah-langkah yang diberikan oleh pihak kami yang ahli dalam proses pengguguran sebuah kandungan yang berusia 1 hingga 6 bulan lamanya obat aborsi yang tingkat keberhasilannya mencapai 100% karena obat inisudah sangat banyak digunakan bagi wanita yang tidak ingin meneruskan kandungan dikarenakan sesuatu hal tertentu, obat ini mempunyai nama Mifepristone ( juga dikenal dengan nama pil abortus, RU 486, Mifegyn, Mifeprex ), dan Misoprostol (juga dikenal dengan nama Cytotec, A

obat aborsi jogja wa 081313339699 jual obat aborsi cytotec asli di jogja

obat aborsi jogja wa 081313339699 jual obat aborsi cytotec asli di jogja

obat aborsi jogja wa 081313339699 jual obat aborsi cytotec asli di jogja

Technology transfer documentation and strategies

Technology transfer documentation and strategies

Technology transfer documentation and strategies

Today’s healthcare leaders are seeking technology solutions to optimize efficiencies and improve patient care. However, without effective change management and strategies in place, healthcare leaders struggle to strategically improve patient flow, space, to strategically improve patient flow, space, and schedule management, and implement daily huddles. The role of technology in supporting operational efficiency and change management initiatives is inevitable. During this webinar, attendees will learn how to optimize Ambulatory Operational Efficiencies and Change Management. Attendees will also learn about the importance of visual management boards in enhancing clinic performance and insights into effective change management approaches.

Unlock the Secrets to Optimizing Ambulatory Operations Efficiency and Change ...

Unlock the Secrets to Optimizing Ambulatory Operations Efficiency and Change ...

Unlock the Secrets to Optimizing Ambulatory Operations Efficiency and Change ...

Health Catalyst

Anthony Edwards We Want Dallas T-shirtsAnthony Edwards We Want Dallas T-shirts

Anthony Edwards We Want Dallas T-shirtsAnthony Edwards We Want Dallas T-shirts

Anthony Edwards We Want Dallas T-shirtsAnthony Edwards We Want Dallas T-shirts

Jual Obat Aborsi Cytotec di Bengkulu 081313339699 Apotik Online 24 Jam ( 081313339699 ) Jual Obat Aborsi Cod Bengkulu, Penjual Cytotec Di ambawara, Alamat Jual Obat Cytotec Di Bengkulu, Toko Jual Cytotec Di Bengkulu, Beli Obat Cytotec Di Bengkulu, Penjual Obat Gastrul Bengkulu, Misoprostol Asli Bengkulu, Tempat Jual Obat Aborsi Daerah Bengkulu, Obat Penggugur Kandungan Bengkulu, Penjual Cytotec Wilayah Bengkulu, Obat Aborsi Di Bengkulu, Harga Cytotec Di Bengkulu, Obat Aborsi Online Bengkulu, Obat Penggugur Janin Bengkulu, Alamat Toko Obat Aborsi Di Bengkulu, Apotik Yang Menjual Cytotec Di Bengkulu, Tempat Beli Cytotec Di Bengkulu, Tempat Penjualan Cytotec Di Bengkulu, Toko Obat Aborsi Bengkulu, Tempat Aborsi Bengkulu, Klinik Aborsi Bengkulu, Tidak Menerima COD, Dengan harga yang bisa anda pilih sesuai usia kandungan anda. Obat Aborsi Cytotec ini mampu menggugurkan kandungan sampai usia 1 – 5 bulan dengan sangat efektif. Jual Obat Aborsi Penggugur Kandungan Cytotec Asli Terpercaya (Whatsapp) 081313339699 Di sini kami menjual berbagai macam obat aborsi cytotec misoprostol pfizer asli obat penggugur kandungan cytotec asli Apotik Penjual Obat Aborsi belakangan ini banyak sekali yang mengaku bidan yang bisa menggugurkan kandungan ( aborsi ) atau dokter, saya harap anda hati2 untuk bidan kuret, karena alat kuret hanya dokter yang mempunyai alat tersebut, kalau si bidan atau si dokter tersebut menawarkan obat aborsi cytotec, atau obat aborsi lainnya, pastikan dulu website atau blognya mempunyai bukti bahwa dia benar2 memiliki obat untuk aborsi janin dan kandungan tersebut, jadi kalau sebuah blog tidak punya bukti memiliki obat jangan coba2 membeli dari web atau blog tersebut, obat saja tidak punya lalu apa yang mau dikirim ? Bagi wanita di jika ingin menggugurkan kandungannya karena terbelit masalah yang sangat serius,misalnya, ada penyakit yang mengancam keselamatan sang ibu yang mengandungnya,masalah ekonomi, hasil pemerkosaan, maupun hasil hubungan gelap dan ternyata pasangannya tidak mau bertanggung jawab, oleh sebab itu jika anda tersandung masalah tersebut dan jika anda ingin melakukan tindakan aborsi dengan menggunkan obat, anda tidak salah tempat, karena disini menyediakan Obat Penggugur Kandungan yang bisa anda beli disini. Bagaimana cara mendapatkan obat di Apotik Penjual Obat Aborsi Cytotec ? kami akan memberikan kemudahan untuk anda tanpa harus mencari atau membawa resep dokter, Obat cytotec untuk aborsi merupakan tahap bagaimana seseorang dalam melakukan tindakan menggugurkan sebuah kehamilan atau kandungan dengan metode obat yang di dapat di kami dengan cara dan langkah-langkah yang diberikan oleh pihak kami yang ahli dalam proses pengguguran sebuah kandungan yang berusia 1 hingga 6 bulan lamanya obat aborsi yang tingkat keberhasilannya mencapai 100% karena obat inisudah sangat banyak digunakan bagi wanita yang tidak ingin meneruskan kandungan dikarenakan sesuatu hal tertentu, obat ini mempunyai nama Mifepristone ( juga dikenal dengan nama

obat aborsi bengkulu wa 081313339699 jual obat aborsi cytotec asli di bengkulu

obat aborsi bengkulu wa 081313339699 jual obat aborsi cytotec asli di bengkulu

obat aborsi bengkulu wa 081313339699 jual obat aborsi cytotec asli di bengkulu

Pulse Check Decisions - RRT and Code Blue Workshop

Pulse Check Decisions - RRT and Code Blue Workshop

Pulse Check Decisions - RRT and Code Blue Workshop

Student ergonomics ( Samrth Pareta ) .pptx

Student ergonomics ( Samrth Pareta ) .pptx

Student ergonomics ( Samrth Pareta ) .pptx

An overview of Muir Wood Adolescent and Family Services teen treatment progra...

An overview of Muir Wood Adolescent and Family Services teen treatment progra...

An overview of Muir Wood Adolescent and Family Services teen treatment progra...

Making change happen: learning from "positive deviancts"

Making change happen: learning from "positive deviancts"

Making change happen: learning from "positive deviancts"

Recently uploaded (20)

Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia

Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia

Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia

Obat Aborsi Makassar WA 085226114443 Jual Obat Aborsi Cytotec Asli Di Makassar

Obat Aborsi Makassar WA 085226114443 Jual Obat Aborsi Cytotec Asli Di Makassar

Obat Aborsi Makassar WA 085226114443 Jual Obat Aborsi Cytotec Asli Di Makassar

Session-1-MBFHI-A-part-of-the-Global-Strategy.ppt

Session-1-MBFHI-A-part-of-the-Global-Strategy.ppt

Session-1-MBFHI-A-part-of-the-Global-Strategy.ppt

Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptx

Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptx

Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptx

Top 20 Famous Indian Female Pornstars Name List 2024

Top 20 Famous Indian Female Pornstars Name List 2024

Top 20 Famous Indian Female Pornstars Name List 2024

Leading large scale change: a life at the interface between theory and practice

Leading large scale change: a life at the interface between theory and practice

Leading large scale change: a life at the interface between theory and practice

Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto

Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto

Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto

Coach Dan Quinn Commanders Feather T Shirts

Coach Dan Quinn Commanders Feather T Shirts

Coach Dan Quinn Commanders Feather T Shirts

Liver Function Test.ppt MBBS A healthcare provider draws a small amoun

Liver Function Test.ppt MBBS A healthcare provider draws a small amoun

Liver Function Test.ppt MBBS A healthcare provider draws a small amoun

End of Response issues - Code and Rapid Response Workshop

End of Response issues - Code and Rapid Response Workshop

End of Response issues - Code and Rapid Response Workshop

@Safe Abortion pills IN Jeddah(+918133066128) Un_wanted kit Buy Jeddah

@Safe Abortion pills IN Jeddah(+918133066128) Un_wanted kit Buy Jeddah

@Safe Abortion pills IN Jeddah(+918133066128) Un_wanted kit Buy Jeddah

obat aborsi jogja wa 081313339699 jual obat aborsi cytotec asli di jogja

obat aborsi jogja wa 081313339699 jual obat aborsi cytotec asli di jogja

obat aborsi jogja wa 081313339699 jual obat aborsi cytotec asli di jogja

Technology transfer documentation and strategies

Technology transfer documentation and strategies

Technology transfer documentation and strategies

Unlock the Secrets to Optimizing Ambulatory Operations Efficiency and Change ...

Unlock the Secrets to Optimizing Ambulatory Operations Efficiency and Change ...

Unlock the Secrets to Optimizing Ambulatory Operations Efficiency and Change ...

Anthony Edwards We Want Dallas T-shirtsAnthony Edwards We Want Dallas T-shirts

Anthony Edwards We Want Dallas T-shirtsAnthony Edwards We Want Dallas T-shirts

Anthony Edwards We Want Dallas T-shirtsAnthony Edwards We Want Dallas T-shirts

obat aborsi bengkulu wa 081313339699 jual obat aborsi cytotec asli di bengkulu

obat aborsi bengkulu wa 081313339699 jual obat aborsi cytotec asli di bengkulu

obat aborsi bengkulu wa 081313339699 jual obat aborsi cytotec asli di bengkulu

Pulse Check Decisions - RRT and Code Blue Workshop

Pulse Check Decisions - RRT and Code Blue Workshop

Pulse Check Decisions - RRT and Code Blue Workshop

Student ergonomics ( Samrth Pareta ) .pptx

Student ergonomics ( Samrth Pareta ) .pptx

Student ergonomics ( Samrth Pareta ) .pptx

An overview of Muir Wood Adolescent and Family Services teen treatment progra...

An overview of Muir Wood Adolescent and Family Services teen treatment progra...

An overview of Muir Wood Adolescent and Family Services teen treatment progra...

Making change happen: learning from "positive deviancts"

Making change happen: learning from "positive deviancts"

Making change happen: learning from "positive deviancts"

Castle AF.ppt

1. GIM Journal Club Friday March 9th 2018 Dr. Don Redelmeier Wasim Mansoor

2. Selection Criteria Inclusion Exclusion - Participants from USA, EU, Australia (2008 – 2016) - Symptomatic atrial fibrillation - Failure or intolerance to anti-arrhythmics - LVEF ≤ 35% - NYHA class ≥ II - ICD/CRTD with Home Monitoring capabilities implanted - Previous left heart ablation procedure for AF - Contraindication to chronic anticoagulation therapy - Documented left atrial diameter >6 cm - ACS or CVA within 2 months - Planned cardiovascular intervention - Listed for heart transplant - Cardiac assist device implanted - Life expectancy ≤ 12 months - Uncontrolled hypertension - Untreated thyroid disease - Dialysis - Mental or physical disability - Pregnant or actively breast feeding

3. Baseline Characteristics

4. What was the Main Result?

5. Secondary Outcome: What about All Cause Mortality ?

6. Subgroup Analysis

7. • Failure of Blinding • Post-randomization exclusions • Inadequate search for toxicity What’s wrong with this study?

8. Question Score 1. Were they really randomized? 0.8 2. Are the patients similar to our own? 0.8 3. Are the results both statistically and clinically significant? 1.0 4. Is the maneuver feasible? 0.7 5. Are all relevant outcomes reported? 0.5 6. Were all entered patients accounted for at the conclusion? 0.7 What would David Sackett Say? Total = 4.5 / 6.0 = 75%