Recommendations on percutaneous coronary intervention for the reperfusion of acute ST elevation myocardial infarction

Little information is currently available from the various societies of cardiology on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Since primary PCI is the main method of reperfusion in AMI in many centres, and since of all cardiac emergencies AMI represents the most urgent situation for PCI, recommendations based on scientific evidence and expert experience would be useful for centres practising primary PCI, or those looking to establish a primary PCI programme. To this aim, a task force for primary PCI in AMI was formed to develop a set of recommendations to complement and assist clinical judgment. This paper represents the product of their recommendations.

[The World's Columbian Exposition. Portfolio of views issued by the Department of photography, C.D. Arnold, chief. Chicago and St. Louis, National Chemigraph Company, 1893, 36 phot., don du marquis Davidsard en 1930]

Donateur : Davidsard (18..-18.. ; marquis)

Audit report on the City of St. Charles, Iowa for the year ended June 30, 2012

Audit report on the City of St. Charles, Iowa for the year ended June 30, 2012

[Voyage en Italie : 1824-1830]. , Eglise du St Esprit : détail d'une Chapelle : [élévation intérieure, plan et vue perspective] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 134

[Voyage en Italie : 1825-1830]. , Justice de Paix, via Maggiore ; palais sur la place du St Esprit : [deux plans] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 151

Impact of medical practice guidelines on the assessment of patients with acute coronary syndrome without persistent ST segment elevation.

OBJECTIVE: To assess the impact of introducing clinical practice guidelines on acute coronary syndrome without persistent ST segment elevation (ACS) on patient initial assessment. DESIGN: Prospective before-after evaluation over a 3-month period. SETTING: The emergency ward of a tertiary teaching hospital. PATIENTS: All consecutive patients with ACS evaluated in the emergency ward over the two 3-month periods. INTERVENTION: Implementation of the practice guidelines, and the addition of a cardiology consultant to the emergency team. MAIN OUTCOME MEASURES: Diagnosis, electrocardiogram interpretation, and risk stratification after the initial evaluation. RESULTS: The clinical characteristics of the 328 and 364 patients evaluated in the emergency ward for suspicion of ACS before and after guideline implementation were similar. Significantly more patients were classified as suffering from atypical chest pain (39.6% versus 47.0%; P = 0.006) after guideline implementation. Guidelines availability was associated with significantly more formal diagnoses (79.9% versus 92.9%; P < 0.0001) and risk stratification (53.7% versus 65.4%, P < 0.0001) at the end of initial assessment. CONCLUSION: Guidelines implementation, along with availability of a cardiology consultant in the emergency room had a positive impact on initial assessment of patients evaluated for suspicion of ACS. It led to increased confidence in diagnosis and stratification by risk, which are the first steps in initiating effective treatment for this common condition.

[Voyage en Italie : 1824-1830]. , Chapelle souterraine de St Janvier : [plan, coupe transversale] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 226

[Voyage en Italie : 1824-1830]. , Chapelle souterraine de St Janvier, sur une échelle de 002 P.M. : [coupe longitudinale] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 227

[Voyage en Italie : 1824-1830]. , BAPTISTERE, église de St Jean : [élévation toute hauteur d'une des faces intérieures du Baptistère] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 145

[Voyage en Italie : 1824-1830]. , Baptistère. Eglise de St Jean, Sur une Echelle de 0,005 P.M. : [plan du rez-de-chaussée (partie gauche) et au niveau des tribunes (partie droite)] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 143

[Voyage en Italie : 1824-1830]. , [La basilique et la place] St Pierre : [vue perspective] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 538