Coronary artery disease
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Coronary artery disease · Aug 2006
Randomized Controlled Trial Clinical TrialClinical and biochemical predictors affect the choice and the short-term outcomes of different thrombolytic agents in acute myocardial infarction.
The presence of plasminogen activator inhibitor-1, angiotensin-converting enzyme and others may play a role in unsuccessful recanalization after thrombolytic therapy. ⋯ Rapid determination of pretreatment angiotensin-converting enzyme and plasminogen activator inhibitor-1 plasma levels in patients with acute myocardial infarction may influence the choice and outcomes of the thrombolytic agents. The presence of a high plasma level of either angiotensin-converting enzyme or plasminogen activator inhibitor-1 is significantly associated with adverse short-term outcomes after treatment with reteplase or metalyze.
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Coronary artery disease · Aug 2006
Comparative StudyThe initial anion gap is a predictor of mortality in acute myocardial infarction.
To determine the relationship between the anion gap and outcomes in patients with acute myocardial infarction. ⋯ The admission anion gap provides important incremental information for initial risk stratification in acute myocardial infarction.
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Coronary artery disease · Aug 2006
Editorial Historical ArticleTime for another revolution? The Flexner Report in historic context, reflections on our profession.
The Flexner Report, published in the early 20th century, turned medicine toward a firm scientific foundation and raised standards of education and practice. This corrected many of the profession's deficiencies present at the turn of the century such that medicine became capable of improving the health of humanity. While the focus of education on the sciences suited the needs of the era, the pendulum may have swung too far. ⋯ This history demonstrates how medicine can impact humanity detrimentally when the broader scope of the humanities and arts is lost. In spite of this understanding, medical education has been dogmatic and resistant to change. The paper ends with a description of the crisis in modern medicine that is on par with the problems it faced in the early 1900s and concludes that it is indeed time for another revolution.