Stroke is a major challenge to our healthcare systems because it demands fast decisions involving several specialists. Emergency imaging and interventional neurology transformed the prognosis of stroke.
A rapid guide for short-term learning of electrocardiography history and the applications of electrocardiogram in cardiac monitoring and the diagnosis of heart pathologic conditions. Would be useful for the students who want to begin to learn this topic and the healthcare practitioners who need a review.
A vivid description of the anaesthetic management in a case of congenital heart disease posted for non cardiac surgery.Briefing of the various CHD'S from basics.Clear description of the pathophysiology,Illustrated with flowcharts and understanding of the complex modified circulatory states.Completely discussed with Head Of the Department and Cardiac Anaesthetic.
A rapid guide for short-term learning of electrocardiography history and the applications of electrocardiogram in cardiac monitoring and the diagnosis of heart pathologic conditions. Would be useful for the students who want to begin to learn this topic and the healthcare practitioners who need a review.
A vivid description of the anaesthetic management in a case of congenital heart disease posted for non cardiac surgery.Briefing of the various CHD'S from basics.Clear description of the pathophysiology,Illustrated with flowcharts and understanding of the complex modified circulatory states.Completely discussed with Head Of the Department and Cardiac Anaesthetic.
Reverse Takotsubo Cardiomyopathy Following General AnaesthesiaPremier Publishers
Reverse takotsubo cardiomyopathy(r-TTC) is a rare condition in which regional wall motion abnormalities affect the basal segments of left ventricle in absence of significant coronary artery disease. The Diagnosis is established by characteristic echocardiographic findings, clinical manifestations, and laboratory features. In this report we demonstrate a case of general anaesthesia induced cardiomyopathy in 21 years old female.
this is a slide on myocardial infraction to figure you out what exactly it is !
though i have not mentioned the diet based causes ............etc.
so enjoy
Valsalva manoeuvre in drug refractory ventricular tachycardiaRamachandra Barik
Ventricular tachycardia (VT) is a cardiac emergency exerting significant morbidity and mortality. Differentiation between VT and supraventricular tachycardia with aberrancy (SVT-A) can be challenging,necessitating awareness of the salient lectrocardiogram (ECG)criteria1 and at times, proven refractoriness to adenosine. Despite well-established guidelines and evidence-based anti-arrhythmic medications for VT management, the role of Valsalva manoeuvre (VM) as
an effective treatment for VT remains controversial.2,3 In this case report, we describe a patient who presented with multiple
drug-refractory VTs, one of which repeatedly terminated by VM.
Definition of stroke and cerebrovascular disorders and pathophysiology of cerebral infarct and CT imaging overview of acute-subacute and chronic infarcts and penumbra.
causes of cerebral edema , Radiological signs of acute infarct and hemorrhagic infarct and comparison of MRI and CT in the diagnosis of acute infarct
Role of diffusion weighted imaging (DWI) and diffusion perfusion mismatch
Edward Fohrman | Neuroanesthesia for Cerebral Arteriovenous MalformationsEdward Fohrman
Edward Fohrman shares his presentation about Neuroanesthesia for Cerebral Arteriovenous Malformations.
Visit EdwardFohrman.com for more information about Edward and his industry insights.
EMGuideWire's Radiology Reading Room: Stress-Induced CardiomyopathySean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Stress-Induced Cardiomyopathy and is brought to you by Jenna Pallansch, MD, Claire Lawson, NP, Shelby Hixson, PA, Emily Lipsitz, PA, Ashley Moore-Gibbs, DNP, Laszlo Littmann, MD, and John Symanski, MD.
L’hôpital public_ une entreprise paralysée 23_11_2019.pptxPelouze Guy-André
French public hospitals are territorial administrations. Consequently they are managed by the state and obey to a huge regulatory system which hampers their adaptability and governance. Changes are proposed in order to improve their efficiency in an environment of continuous and fast innovation.
Pour sortir le système de soins de l'impasse actuellePelouze Guy-André
Le système de soins est bloqué par l'inorganisation, la bureaucratie, les coûts et l'immobilisme du monopole d'assureur de la sécurité sociale. Pourtant les Français paient des impôts et des cotisations obligatoires très élevés; ils doivent pouvoir choisir leur assureur maladie et le contrat qui leur convient. Ce choix permettra de dynamiser l'offre et de réguler la demande. Il faut l'assortir de deux garanties, chaque résident doit avoir au minimum un contrat socle qui garantit les soins pour les maladies essentielles et ceux qui ne peuvent économiquement l'acheter doivent bénéficier d'un chèque santé du montant moyen de ce contrat.
La dynamique du marché (qui fait défaut au système actuel) et les garanties sociales pour éviter les passagers clandestins ou bien le coût du contrat pour les économiquement faibles peuvent améliorer rapidement le système tant pour l'accès aux soins essentiels que pour mieux rémunérer les soignants.
Covid 19 - petit état des lieux de la pandémie après le variant BA.2.pdfPelouze Guy-André
The future of the pandemic is an epidemic that drags months or years. How to deal with it?
L'avenir de la pandémie est une épidémie qui traîne des mois ou des années. Comment y faire face?
Red meat, ancestral diet and environment are not to be solved with prohibitions. I describe in this opinion the biases of observational studies and the mistakes in environment issues.
How the low fat obsession enabled the obesity epidemicPelouze Guy-André
With the best intention of curbing the obesity epidemic, public policies and agribusiness industry touted low fat. Contrary to their aim, they increased obesity all over the world. Low fat is not the solution and it is part of the problem.
Le gras dans la viande, le poisson ou les végétaux est bon pour la santé.
Les acides gras saturés sont neutres du point de vue du risque cardiovasculaire, certains polyinsaturés sont indispensables et les mono-insaturés sont goûteux comme les avocats, les olives ...
Le gras du lait est excellent.
Les seuls produits à supprimer sont ceux qui contiennent des acides gras trans résultant d'un process industriel d'hydrogénation. Ceci est important.
Perspectives de la TM cardiovasculaire. Définition, histoire, modalités et efficacité sont envisagés au regard de la littérature. Puis les questions économiques et les enjeux à la faveur d'un sondage récent de Medscape sont discutés.
Why Numerus clausus failed in France since 40 yearsPelouze Guy-André
Numerus clausus is the law in France since more than 40 years for the state universities which BTW are the only authorized to have a medical school.
This number is decided by the government and the results are now clear: a massive doctor shortage.
However the suppression of NC is not the solution to this shortage, innovation in teaching, complete autonomy of universities and other conditions are mandatory to solve this catastrophic situation.
Statines en France: éléments de preuves pour favoriser le bon usagePelouze Guy-André
La polémique sur les statines prend un tour dangereux: il y a les pour et les contre. C'est bien évidemment stupide. d'ailleurs ceux là même qui sont contre évite de parler des patienst athéromateux ayant fait un accident et ceux qui sont contre ne commentent jamais les résultats du régime méditerranéen...
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Evaluation of antidepressant activity of clitoris ternatea in animals
A 82 years old man with hemispheric stroke: decisions in a complex case
1. A 82-year-old man with
a hemispheric stroke:
decisions in a complex
case
Hans Jørgen MOE² and Guy-André PELOUZE°
²Medical student at University of Szeged, Hungary
°Chirurgien Thoracique et Cardiovasculaire, Centre
Hospitalier de Perpignan
torsdag 27. oktober 2011
2. Description of case
A 82-year-old man was emitted to the ER after a
domestic accident presenting a left hemiparesis,
suggesting a right embolic stroke. The patient
presented with a moderate facial paralysis and
dysarthria. No previous cerebrovascular symptoms
such as amaurosis fugax (temporary vision loss
due to lack of blood flow to the retina), TIA nor
cardiovascular risk factors were known. He was
successfully thrombolyzed (Actilyse) 3,5 hours
after the vascular accident.
torsdag 27. oktober 2011
3. CT scan - at admission 22/07.
Showed a right hemispheric
infarction
torsdag 27. oktober 2011
4. Past medical history
His past medical history included no cardiovascular or other related
diseases.
He was on Aspirin, Enoxeparin (LMWH) and Fresubin nutrition drink
prior to the attack.
On examination, the patient had a Glascow coma scale of 15 points, his NIH
score was 17 before the thrombolysis, his pulse was regular, and blood
pressure 147/76.
After the neurological ischemic accident the patient was sent to a
rehabilitation center. Six weeks later he was referred back to the hospital for
imaging and reevaluation of his status.
torsdag 27. oktober 2011
5. What type of investigations are indicated
in the EARLY stage?
At admission brain imaging is necessary for two reasons.
At first a brain hemorrhage need to be excluded (responsible for 10 % of all
strokes). Brain tumor is the next pathology to be excluded.
The computed tomography brain scanning was positive at admission.
Showing a right hemispheric infarction.
The CT scan can only recognize a ischemic infarction 48 hours after the
vascular accident.
Routine blood tests (full blood count, urea, electrolytes, and clotting),
electrogardiogram, and chest X-ray were performed before the CT-scan of
the brain. He had regular sinus rhythm, and ECG examination didn´t show
any new or old MI.
torsdag 27. oktober 2011
6. Causes of stroke
10 %
Ischemic stroke
Hemorrhagic stroke
90 %
Resource: Stroke interventions, why time is of the essence www.intervention-iq.org
torsdag 27. oktober 2011
7. What was the management plan at this
stage?
The following drugs were used Atorvastatine (Tahor®) 80mg, a
prior to the operation: statin to stabilize the plaque, and
to reduce the recurrency of
cardiovascular events elsewhere.
Aspirin (Kardégic®)160mg,
Additional former treatment:
Enoxaparin (Lovenox®) 4000 Fluoxetine (Prozac®) 20mg,
IU/0.4ml, (anti depressive SSRI), Folic acid
3x/d, Tardiferon (Fe supplement,
in Fe def. anemia) 1x2/d,
Lercanidipine (Lercan®) 10 mg, Duphalac 2/d (lactulose- aganist
a calcium channel blocker against constipation)
hypertension,
Heparine IV 45000 IU/d,
torsdag 27. oktober 2011
8. Discussion - causes of ischemic
stroke
The causes of ischemic stroke is grossly classified into 3 groups: large artery
atherosclerosis, small artery occlusion and cardiac embolism.
Large artery atherosclerosis leads to cerebral ischemia due to perfusion
failure and artery-to-artery embolism.
In small artery occlusion the thrombosis is caused by atherothrombotic
states.
Cardiac embolism which leads to cerebral ischemia may be due to
myocardial infarction, atrial fibrillation or other cardiac diseases.
torsdag 27. oktober 2011
10. How did we identify the source of the
stroke?
A continuous doppler ultrasound showed a severe
stenosis of the right internal carotid artery. The left
side was also stenosed, but does not reach
hemodynamically significance.
torsdag 27. oktober 2011
11. Investigation of carotid artery stenosis
The first choice imaging technique in concern of carotid artery stenosis is
continuous doppler ultrasound. This is a non-invasive method of low cost
and can easily be repeated. The severity of the stenosis should be
measured (cross-sectional area or in diameter).
However, the gold standard at present is Angio - MRI, or for someone
Angio-CT. An angio-MRI was done just after the therapeutic thrombolysis
procedure.
Right internal carotid(IC) measured a stenosis of 95 %, and 55% stenosis in
the left IC was discovered.
Earlier, selective arteriogram was the most used technique to investigate
CAS. However, this procedure can provoke a stoke and is hence less used
torsdag 27. oktober 2011
12. Angio CT showing - 95 % right
internal carotid artery stenosis
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torsdag 27. oktober 2011
13. The role of carotid endarterectomy to
prevent recurrent events
In a historical perspective the first carotid reconstructive surgery was
performed by Eascott, at St.Marys hospital in London in 1954. In the mid
90´s carotid artery surgery showed by evidence better outcome than medical
therapy in patient with symptoms of decreased internal carotid artery blood
flow.
The symptomatic patients may show symptoms of amaurosis fugax (short
loss of vision), hemiparesis, transient ischemic attacks or stroke.
torsdag 27. oktober 2011
14. After a hemispheric stroke, how soon
should carotid endarterectomy be
The patient underwent elective endarterectomy under general anesthesia 8
weeks after the neurovascular accident. Normally surgeons do the operation
4-6 weeks after the accident to allow the auto regulative mechanism of the
brain to recover.
The patient was discharged at the 7 postoperative day. He recovered very
well after the surgical therapy. However, he went into epileptic crises «état
de mal» at the second postoperative day. The theory of delayed epileptic
attack is based on hyper excitability of the cells after the revascularization of
the ischemic brain area.
In our case the surgery was done 8 weeks after the cerebrovascular accident.
(21/7 - 22/9)
torsdag 27. oktober 2011
15. Preventive surgery
In the view of carotid surgery there are some delicate cases where pros and
cons need to be considered.
Some factors could increase the risk of the operation. Such risk could be
prior coronary bypass surgery.
Asymptomatic patients with CAS the rate of stroke is 1-5% per year with the
best medical management.
For symptomatic patients with a CAS of more than 80% the risk of stroke is
15-20% the first year. After 1 year a the risk of stroke tends to be the same
as for asymptomatic patients. The operation risk is at 3%. However, these
results are improved in the recent series of the NASCET.
The surgeon propose these numbers and risks for the patient. Although, its
up to the patient and his/her family to make the final decision.
torsdag 27. oktober 2011
16. NASCET trial
The NASCET trials have helped define indications for carotid endarterectomy. It is the
current guideline in the decision to operate or not.
Through the following formula for symptomatic and asymptomatic patients the benefit of
the surgery is calculated.
The percent of stenosis = ( 1 − ( minimal diameter ) / ( poststenotic diameter ) ) × 100%.
Symptomatic patient: [50, 69% [: moderate benefit of surgery (significant for men) [70, 99 [:
marked and significant benefit in both sexes.
For symptomatic patients [50, 69% [: over 5 years the NNT is 22 to avoid a stroke.
Above [70, 99 [ the NNT is 6.3 to avoid a stroke.
In asymptomatic patients best medical treatment give a NNT of 83 in two years.
torsdag 27. oktober 2011
17. Best present medical
treatment
To avoid a new episode of stroke the patient should take a low dose of 75 mg
Aspirin daily. If the patient is «Aspirin intolerant» Clopidogrel could be a
good substitution.
The recurrent rate can be lowered even more by adding Dipyridamole.
Among lipid lowering agents only statins demonstrated an efficiency in the
prevention of a recurrent stroke. In our case the patient took Atorvastatin 80
mg daily. The patient would need statins if the LDL level exceeds 1 gram.
The LDL cholesterol was 1,06 g/L.
torsdag 27. oktober 2011
18. Carotid endarterectomy or carotid
angioplasty?
A vast amount of todays surgery is done mini-invasively. The field of
vascular surgery is no exception of this trend.
Local anesthesia has still not shown any superiority over general anesthesia
in carotid endarterectomy.
In this specific case the patient was under general anesthesia. The technical
difficulty lies in a relatively high bifurcation and a severe rigidity of the neck.
An alternative today is carotid angioplasty and stenting, which in some cases
have given less cardiovascular events.
torsdag 27. oktober 2011
19. The CREST trials, endarterectomy
still the gold standard
The CREST trial has compared CAS with CEA for patients with
symptomatic and asymptomatic carotid disease. There has been however
debate on the interpretation of the results. The CAS was associated with the
worse outcome of death or stroke. An 50 % occurred in the stenting group.
There are also other trials where there has been a tendency of more
complications in CAS. Hence the CEA is still the gold standard in the
treatment.
CREST (the carotid revascularization endarterectomy vs stenting trial) CAS (carotid angioplasty and stenting), CEA (carotid
endarterectomy)
torsdag 27. oktober 2011
20. pathological examination
The pathological evaluation showed a 4 cm long plaque lesion, where the
internal carotid measured 3 cm.
The external appearance of the vessel was highly irregular.
No complete occlusion, ulceration or hemorrhage were observed.
Conclusion: a calcified atheromatous ruptured plaque of the right internal
carotid artery.
torsdag 27. oktober 2011
23. Follow up
The recommendations in the follow up of the patients suggests a doppler
duplex scan at 1, 3, 6 and 9 months after the operation according to
Rohtwell.
Patient investigations shows that 40-50% of patients don´t follow these.
The quality of life is greatly depressed when the patient don´t follow the
rehabilitation program given by the doctor. In our case the patient has made
a great recovery. His mental status is adequate and his motor strength is 4/5
at presence.
torsdag 27. oktober 2011
24. Peripheral hospital
Nallamothu and colleagues have examined the relationship between the
experience of the surgeon and 30-day mortality rate of the patient.
The trials found out that the patients operated on by the lowest-volume
operators (less than 6/year) had increased risk of death compared to patients
operated on by high-volume surgeons (more than 24/year).
The paper also pointed out that some physicians seem to practice too much.
If a procedure is performed where the expected benefit is very low, the skill
of the surgeon is of less importance.
torsdag 27. oktober 2011
25. References
1) A 75-Year-Old Woman with a Hemispheric Stroke, Stavros K. Kakkos,
George Geroulakos*
2) Stroke interventions - interventional quarter issue 2, 2010
3) Carotid Stenting at the Crossroads Practice Makes Perfect, But Some
May Be Practicing Too Much (and Not Enough), Ethan A. Halm, MD,
MPH
4) NASCET trials
torsdag 27. oktober 2011