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By Russell C. Davis

A realistic consultant to educating in medication aimed toward medical professionals who sooner or later of their occupation need to educate, even if in a lecture room or in a scientific surroundings. priceless articles on conception with a better emphasis on 'how to do it'.

Authors comprise the most authoritative scientific educationalists on the planet; hence readers gets the advantage of writers who've nice educating event sponsored up through large academic examine.

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Extra resources for ABC of Heart failure

Example text

Heart failure currently accounts for 1-2% of total spending on health care in Europe and in the United States. In 1993 in the United Kingdom, heart failure cost the NHS £360m a year; the figure now is probably closer to £600m, equivalent to 1-2% of the total NHS budget, and hospital admissions account for 60-70% of this expenditure. Admissions for heart failure have been increasing and are expected to increase further. Preventing disease progression, hence reducing the frequency and duration of admissions, is therefore an important objective in the treatment of heart failure in the future.

The west Birmingham heart failure project. Eur J Gen Pract 1997;3:85-9. x Remes J, Miettinen H, Reunanen A, Pyorala K. Validity of clinical diagnosis of heart failure in primary health care. Eur Heart J 1991;12:315-21. x Rich MW, Beckham V, Wittenberg C, Leven CL, Freedland KE, Carney RM, et al. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med 1995:333:1190-5. x Stewart S, Vandenbroek AJ, Pearson S, Horowitz JD. Prolonged beneficial effects of home-based intervention on unplanned readmissions and mortality among patients with congestive heart failure.

Severe congestive heart failure Despite conventional treatment with diuretics and angiotensin converting enzyme inhibitors, hospital admission may be necessary in severe congestive heart failure. 5 litres/24 h, and dietary salt restriction may be helpful. Short term bed rest is valuable until signs and symptoms improve: rest reduces the metabolic demand and increases renal perfusion, thus improving diuresis. Although bed rest potentiates the action of diuretics, it increases the risk of venous thromboembolism, and prophylactic subcutaneous heparin should be considered in immobile inpatients.

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