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P.C. Rakshit Physical. Chemistry. The Elements of Physical Chemistry. x. pdf.Introduction
============
Chest wall pain is a common reason for referral to the Emergency Department (ED). The differential diagnosis of chest wall pain includes pain caused by such pathology as chest wall infection, pneumothorax, acute pulmonary embolism or pericarditis. It is an absolute emergency to establish the diagnosis of these conditions as they will require specific treatment that may require urgent hospital admission.
Methods
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A retrospective study of all referrals to the ED with chest pain who had undergone a point of care cardiac troponin (Troponin POC) analysis was performed.
Results
=======
In total, 81 patients were referred to the ED with chest pain and underwent a point of care cardiac troponin (Troponin POC) analysis. The mean age of patients was 65.8 years with the age range 20 to 89 years. There were 31 patients (38%) of those studied who had symptoms of myocardial injury and thus required a further investigation. These included tachyarrhythmia, intra-aortic balloon pump insertion and cardiovascular surgery. The mean age of the patients with chest pain who did not have myocardial injury was significantly higher at 71.3 years (*P*= 0.001) compared with 65.8 years in the group who did have myocardial injury. Of the 31 patients with myocardial injury, 32% (*n*= 10) had elevated troponin levels to more than the 99th percentile. Of these, four patients were found to have myocardial infarction (MI) (two pericardial effusion, one clinically diagnosed myocarditis and one pulmonary embolism), and two had severe pulmonary embolism (PE). One of these was confirmed on the echocardiogram. The diagnosis of PE had not been made in the other patient prior to the point of care troponin analysis. This patient required a D-dimer which was positive for PE. The age of this patient at presentation was 40 years compared to an age of 71 years in the patient with myocardial infarction. Nine patients had myocarditis and all were found to be troponin negative.
Conclusion
==========
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Download File PDF P C Rakshit Physical Chemistry Book. P C Rakshit Physical Chemistry Book. Download For Download P C Rakshit Physical Chemistry Book.In a rare move, U.S. Senator Bernie Sanders and Rep. Alexandria Ocasio-Cortez, who is set to be the first member of the Congressional freshman class to join the 2020 race for the Democratic presidential nomination, have endorsed Rashida Tlaib for Congress in Michigan’s 13th congressional district.
“We have always rooted for Bernie’s success in the Democratic presidential primary. We are supporting Rashida in the 13th Congressional District,” Ocasio-Cortez tweeted. “There are reasons to respect and learn from Bernie’s presidential primary campaign—his life’s work in public service, his understanding of what it means to be a Democrat, and the class that he’s raised. But when it comes to winning races for Democrats across the country, there’s no better plan than the one we’ve got in Detroit in the 13th CD, and we need someone who will continue this fight to win there.”
“Few candidates embody the values and policies we need now more than Rashida Tlaib,” Sanders tweeted in a statement accompanying Ocasio-Cortez’s endorsement. “Like Bernie, Rashida is an independent-minded leader who will not be afraid to take on powerful interests and be a voice for the working class and all Americans. We look forward to supporting Rashida’s candidacy, and hope other members of the Democratic Party will do the same.”
Tlaib has been in Congress since 2018, after being elected as a Democrat in 2016 in Michigan’s 13th congressional district. But while the district borders Ohio, it primarily includes residents in Flint, which she has fought to