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Management and progress of inflammatory joint disease with biological agents and the development of a seamless serviceThe World Health Organisation and the United Nations designated the first decade of this century as the Decade of Bone and Joint Disease.1 This heralded dramatic and unprecedented changes in the management of inflammatory joint diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS) and other disorders.
The management of hypertensionhe World Health Organisation (WHO) describes hypertension as “a condition in which blood vessels have persistently raised pressure”. If left untreated, hypertension can have detrimental effects on health and mortality, leading to preventable incidents such as myocardial infarction, heart failure, stroke and kidney failure. There has been a surge in the prevalence of hypertension worldwide, climbing from six hundred million in 1980 to one billion in 2008 and if appropriate action is not taken, deaths due to cardiovascular disease are projected to rise, according to WHO.
Reinforced long saphenous vein bypass graft for infrainguinal reconstruction procedures: case series and literature review.Poor rehabilitation rates and the high-cost of managing postamputation patients justify an aggressive revascularization policy in critical lower limb ischemia. Endovascular therapy is our first choice for limb salvage in these patients. However there are patients for whom endovascular therapy is not feasible. When bypass is necessary, autologous vein is a superior conduit to synthetic material. However, varicosities usually contraindicate autologous vein bypass because of the risk of aneurysm formation, rupture and increased intimal hyperplasia compared with nonvaricose venous grafts. We report the use of varicosed long saphenous vein (LSV) with external Dacron support in infrainguinal bypass procedures for limb salvage, where endovascular therapy was not feasible. The external Dacron tube was not brought close to the distal anastomotic area itself. With a mean follow-up of 18 months, duplex ultrasonography and computed tomography angiography showed no evidence of stenosis of the reinforced vein segments or aneurysmal degeneration of the residual vein. External reinforcement with Dacron prosthesis allows the use of autogenous greater saphenous veins with varicose dilatation without compromising graft patency and limb salvage.
Variations in the usage and composition of a radial cocktail during radial access coronary angiography procedures.A survey was conducted of medication administered during radial artery cannulation for coronary angiography in 2009 in Ireland; responses were obtained for 15 of 20 centres, in 5 of which no radial access procedures were undertaken. All 10 (100%) centres which provided data used heparin and one or more anti-spasmodics; verapamil in 9 (90%), nitrate in 1 (10%), both in 2 (20%). There were significant variations in the doses used. Further work needs to be done to determine the optimum cocktail to prevent radial artery injury following coronary angiography.