Theodore C. Chan, MD
No further hemoptysis had occurred blood pressure chart for dogs 50 mg metoprolol with mastercard, Dviral treatment blood pressure of normal person generic metoprolol 25 mg with visa, immune restoration may be compli and he had gained 2 kg body weight blood pressure medication images buy discount metoprolol online. After that blood pressure medication no erectile dysfunction generic metoprolol 100mg with visa, by tele cated by clinical events in which either previously phone, he complained of occasional fevers and malaise but subclinical infections are found or preexisting partially declined to be seen. Nine weeks after his initial visit, he treated opportunistic infections deteriorate. We report what we believe is the first record la and over the left parotid gland. The lymph nodes reduced in size, and the had been diagnosed in 1996 (a stored sample from 1989 spiking temperature resolved. A chest the Mycobacterium species was not growing well in radiograph showed left upper lobe shadowing (Figure 1, the laboratory, but M. On extension of culture, bacilli, and sputum was sent for culture, speciation, and the isolate was confirmed as M. The members of the tuberculosis complex are Conclusions not reliably distinguished on biochemical grounds. It has most commonly been described in association printing, is a time-consuming, slow, and expensive method of distinguishing members. Strains differ in the size of spacer regions that inter sperse direct repeat regions. We suggest that such cultures be extended for up to 6 months if acid-fast bacilli are noted in specimens from a patient with consistent pulmonary pathologic findings. Similar granulomatous endo brochial lesions have been described during immune restoration with M. An associated increase in markers of immune activation occurs, which seems to vary depending Figure 1. Chest radiographs at initiation of A) highly active anti on the pathogen involved (12,13). Mycobacterium microti llama-type infection present ing as pulmonary tuberculosis in a human immunodeficiency virus-positive patient. Niemann S, Richter E, Dalugge-Tamm H, Schlesinger H, Graupner D, Konigstein B, et al. Wellcome Clinical Training Fellow at the Liverpool School of Tropical Medicine, United Kingdom. Early treatment with immune plas Gustavo Palacios,*1 Thomas Briese,*1 ma was effective in Junin virus infection (8). Viral hemorrhagic fevers are associated with high Numerous systems are described for nucleic acid detection rates of illness and death. We infected, cultured cells or by assembly of overlapping syn developed a software program that culls sequence informa thetic polynucleotides. Primers are checked binding and wash buffers) were used to remove unincorpo by the basic local alignment search tool for potential rated primers before tags were decoupled from amplifica hybridization to sequenced vertebrate genomes (Table 1). Primers that fail to yield a sin Tissue culture extracts were used to examine assay gle, specific product band in agarose gel analysis are specificity. In all instances, only the appropriate gets, we are expanding the hemorrhagic fever panel to cognate mass tags were detected (data not shown). Dr Palacios is an associate research scientist in the Jerome Crimean-Congo hemorrhagic fever in eastern Turkey: clinical fea L. Prospective, double-blind, concurrent, placebo-controlled clini interactions with their hosts, and innovative pathogen detection cal trial of intravenous ribavirin therapy of hemorrhagic fever with methods. Hemorrhagic fever viruses as biological weapons: medical References and public health management. Exotic emerging viral diseases: progress Diagnostic system for rapid and sensitive differential detection of and challenges. Immunogenicity of an inactivated Rift Valley fever vaccine Address for correspondence: Thomas Briese, Jerome L. Curr Top Microbiol Greene Infectious Disease Laboratory, Mailman School of Public Health, Immunol. Field evaluation of formalin inactivated Kyasanur forest disease virus tissue culture Use of trade names is for identification only and does not imply vaccine in three districts of Karnataka state. This communication also illustrates 2 principles that However, precise recognition of E. This Interview system avoided randomly dialing Australian Capital Territory, Australia; fax: 61 thousands of households to enroll 2-6289-5100; email: martyn. Scheil W, Cameron S, Dalton C, Murray C, this control bank includes partici for appropriately matched controls Wilson D. A South Australian Salmonella because age and sex of all household Mbandaka outbreak investigation using a pants of longitudinal risk factor sur members are recorded in a database. Biases and efficiencies associ need for extensive random digit dial Escherichia coli, and cryptosporidio ated with two different control sources in a ing to recruit an adequate age sis. This would Lack of who participated in this study were make it difficult to recruit enough selected from a randomized, double Transmission of controls within the small areas affect blind, single-center study that com ed by most outbreaks, particularly Vaccinia Virus pared the safety, tolerability, and within specific age strata. Following vaccination government completed a targeted vac for use in large communitywide out and after each study visit, the vaccina cination strategy limited to healthcare breaks, outbreaks that occur over tion site was covered with an OpSite workers, first responders, and the mil large regions. On postvaccina virus, the etiologic agent of smallpox, Additionally, the lengthy start-up time tion days 7, 10, and 15, a sterile might be used as a biowarfare agent required for questionnaire program Calgiswab type 2 applicator (Harwood (1). Fox,* adverse reactions resulting from sec bath towel, and the inside area of a D. Computer-assisted telephone mental samples were taken to serve as contact occurs (4). Louis lation of fluid cultures of Vero cells University Institutional Review grown in 12-well plates. We hypothesized that live vac was defined as positive if cytopathic cinia virus shed from the skin reaction effects were observed (10). Blum,* All 516 environmental samples dissemination of vaccinia virus out and Thomas P. Centers for Disease Control and ed on day 7 had measurable titers of lenges regarding the sampling and Prevention.
Pulsed Doppler ultrasound arrhythmia newborn best order metoprolol, in combination with two-dimensional and M-mode sonography blood pressure for 6 year old order 12.5mg metoprolol amex, has proved useful in the evaluation of both fetal dysrhythmias and structural anomalies hypertension over the counter medication order metoprolol 25mg. Pulsed Doppler can be useful in the detection and assessment of severity of valvar abnormalities (stenosis pulse pressure 83 order metoprolol without prescription, insufficiency). Analysis of atrioventricular inflows, hepatic veins and inferior vena cava can also be used to assess cardiac rhythm. Primum atrial septal defect is the simplest form of the atrioventricular septal defects (see below). Secundum atrial septal defect, which are the most common, are usually isolated, but may be related to other cardiac lesions (such as mitral, pulmonary, tricuspid or aortic atresia) and are occasionally found as part of syndromes (including Holt-Oram syndrome in which there is hypo aplasia of the thumb and radius, triphalangeal thumb, abrachia, and phocomelia). Prevalence Secundum atrial septal defects, which represent about 10% of congenital heart defects, are found in about 1 per 3,000 births. Diagnosis Although the in utero identification of secundum atrial septal defect has been reported, the diagnosis remains difficult because of the physiological presence of the foramen ovale and only unusually large defects can be recognized with certainty. Prognosis Atrial septal septal defects are not a cause of impairment of cardiac function in utero, as a large right-to-left shunt at the level of the atria is a physiological condition in the fetus. They are classified into perimembranous, inlet, trabecular or outlet defects depending on their location on the septum. Perimembranous defects (80%) involve the membranous septum below the aortic valve, but also extend to variable degrees into the adjacent portion of the septum. The inlet defects are on the inflow tract of the right ventricle and thus affect the implantation of the septal chordae of the tricuspid valve. The trabecular defects occur in the muscular portion of the septum, and the outlet defects are in the infundibular portion of the right ventricle. Prevalence Ventricular septal defects, which represent 30% of all congenital heart defects, are found in about 2 per 1,000 births. Diagnosis Echocardiographic diagnosis depends on the demonstration of a dropout of echoes in the ventricular septum. Since most ventricular septal defects are perimembranous and subaortic, a detailed view of the left outflow tract is the best picture to image them. While evaluating the ventricular septum in search of defects, multiple views should be used. Overall, small isolated ventricular septal defects are difficult to detect prenatally, and both false positive and false negative diagnoses have been made. Ventricular Septal Defects In dubious cases, Color Doppler may be useful, in that many ventricular septal defects are associated with a demonstrable left to right shunt. Prognosis Ventricular septal defects are not associated with hemodynamic compromise in utero because the right and left ventricular pressures are very similar and the degree of shunting should be minimal. Large defects present with congestive heart failure at 2-8 weeks of life and require medical treatment (digoxin and diuretics). Rarely very large defects, associated with massive left to right shunt, can be associated with congestive heart failure soon after birth. If medical treatment fails surgical closure is undertaken; survival from surgery is more than 90% and survivors have a normal life expectancy and normal exercise tolerance. Abnormal development of these structures is commonly referred to as endocardial cushion defects, atrioventricular canal or atrioventricular septal defects. In the complete form, persistent common atrioventricular canal, the tricuspid and mitral valve are fused in a large single atrioventricular valve that opens above and bridges the two ventricles. In the complete form of atrioventricular canal, the common atrioventricular valve may be incompetent, and systolic blood regurgitation from the ventricles to the atria may give rise to congestive heart failure. Prevalence Atrioventricular septal defects, which represent about 7% of all congenital heart defects, are found in about 1 per 3,000 births. Diagnosis Antenatal echocardiographic diagnosis of complete atrioventricular septal defects is usually easy. Color Doppler ultrasound can be useful, in that it facilitates the visualization of the central opening of the single atrioventricular valve. In such cases, Color and pulsed Doppler ultrasound allow one to identify the regurgitant jet. The main clue is the absence of the atrial septum below the level of the foramen ovalis. Another useful hint is the demonstration that the tricuspid and mitral valves attach at the same level at the crest of the septum. This apical displacement of the mitral valve elongates the left ventricular outflow tract. The atrial septal defect is of the ostium primum type (since the septum secundum is not affected) and thus is close to the crest of the interventricular septum. Prognosis Atrioventricular septal defects will usually be encountered either in fetuses with chromosomal aberrations (50% of cases are associated with aneuploidy, 60% being trisomy 21, 25% trisomy 18) or in fetuses with cardiosplenic syndromes. In the former cases, an atrioventricular septal defect is frequently found in association with extra-cardiac anomalies. In the latter cases, multiple cardiac anomalies and abnormal disposition of the abdominal organs are almost the rule. However, the presence of atrioventricular valve insufficiency may lead to intrauterine heart failure. The prognosis of atrioventricular septal defects is poor when detected in utero, probably because of the high frequency of associated anomalies in antenatal series. About 50% of untreated infants die within the first year of life from heart failure, arrhythmias and pulmonary hypertention due to right-to-left shunting (Eisenmenger syndrome). Survival after surgical closure (which is usually carried out in the sixth month of life) is more than 90% but in about 10% of patients a second operation for atrioventricular valve repair or replacement is necessary. Therefore, univentricular heart includes both those cases in which two atrial chambers are connected, by either two distinct atrioventricular valves or by a common one, to a main ventricular chamber (double-inlet single ventricle) as well as those cases in which, because of the absence of one atrioventricular connection (tricuspid or mitral atresia), one of the ventricular chambers is either rudimentary or absent. Diagnosis In double-inlet single ventricle, two separate atrioventricular valves are seen opening into a single ventricular cavity without evidence of the interventricular septum. In mitral / tricuspid atresia, there is only one atrioventricular valve connected to a main ventricular chamber. A small rudimentary ventricular chamber lacking of atrioventricular connection is a frequent but not constant finding. Demonstration of two patent great arteries arising from the ventricle allows a differential diagnosis from hypoplastic ventricles (hypoplastic left heart syndrome, pulmonary atresia with intact ventricular septum). Prognosis Surgical treatment (the Fontan procedure) involves separation of the systemic circulations by anastomosing the superior and inferior vena cava directly to the pulmonary artery. The survivors from this procedure often have long term complications including arrhythmias, thrombus formation and protein-losing enteropathy. Supravalvar aortic stenosis can be due to one of three anatomic defects: a membrane (usually placed above the sinuses of Valsalva), a localized narrowing of the ascending aorta (hourglass deformity) or a diffuse narrowing involving the aortic arch and branching arteries (tubular variety). The valvar form of aortic stenosis can be due to dysplastic, thickened aortic cusps or fusion of the commissure between the cusps. The subaortic forms include a fixed type, representing the consequence of a fibrous or fibromuscular obstruction, and a dynamic type, which is due to a thickened ventricular septum obstructing the outflow tract of the left ventricle. The latter is also known as asymmetric septal hypertrophy or idiopathic hypertrophic subaortic stenosis. A transient form of dynamic obstruction of the left outflow tract is seen in infants of diabetic mothers, and is probably the consequence of fetal hyperglycemia and hyperinsulinemia. Prevalence Aortic stenosis, which represents 3% of all congenital heart defects, is found in about 1 per 7,000 births. Diagnosis Most cases of mild to moderate aortic stenosis are probably not amenable to early prenatal diagnosis. Severe valvar aortic stenosis of the fetus is usually associated with a hypertrophic left ventricle. Within the ascending aorta (that can be small or enlarged) pulsed Doppler demonstrates increased peak velocity (usually in excess of 1 m/sec). At the Color Doppler examination, high velocity and turbulence results in aliasing, with a mosaic of colors. Severe aortic stenosis may result in atrioventricular valve insufficiency and intrauterine heart failure. Asymmetric septal hypertrophy and hypertrophic cardiomyopathy of fetuses of diabetic mothers resulting in subaortic stenosis has been occasionally diagnosed by demonstrating an unusual thickness of the ventricular septum. Prognosis Depending upon the severity of the aortic stenosis, the association of left ventricular pressure overload and subendocardial ischemia, due to decrease in coronary perfusion, may lead to intrauterine impairment of cardiac function. Subvalvular and subaortic forms are not generally manifested in the neonatal period. Conversely, the valvar type can be a cause of congestive heart failure in the newborn and fetus as well. Order metoprolol online pills. How Can I Get an Accurate Blood Pressure Reading?.
He did like what he saw at the Ivy League university: Several of the people he met seemed like vital artaria string quartet buy metoprolol 12.5 mg fast delivery, enthusiastic blood pressure of 1200 purchase metoprolol 25mg online, pleasant people; he met with two different professors arrhythmia junctional order metoprolol 25mg visa, who took a personal interest in him; and he came away with a very pleasant feeling about the campus hypertension hyperlipidemia purchase 12.5mg metoprolol mastercard. The remaining subjects were presented with am identical problem except that the possibilities for error in David L. He proceeded systematically to draw up a long list for both colleges of all the classes which might interest him and all the places and activities on campus that he wanted to see. From each list, he randomly selected several classes and activities to visit, and several spots to look at (by blindly dropping a pencil on each list of alternatives and seeing where the point landed). There was 90% agreement among coders as to the assignment of an answer to the statistical versus nonstatistical categories. Moreover, subjects in the probabilistic-cue condition were much more likely to refer to statistical considerations having to do with the adequacy of the sample. Fifty-six percent of probabilistic-cue subjects raised statistical questions in their open-ended answers, whereas only 35% of subjects in the no-cue condition did so (p <. Thus, when subjects are prompted to consider the possibilities for error that are inherent in a small sample of events, they are likely to shift to a preference for large indirect samples over small personal ones, and their open-ended answers make it clear that it is statistical considerations that prompt this shift. The findings of Study 3 are extremely ironic in that subjects are more likely to reject the superior personal evidence in the probabilistic-cue condition than to reject the inferior personal evidence in the control condition. This is because the same circumstances that serve to make the evidence superior in the probabilistic-cue condition also serve to make salient the extreme heterogeneity of the event population to be estimated and the small size of the personal sample of those events. In two slightly different within-design follow-ups to Study 3, subjects rated the probabilistic-cue sample as being superior to the sample in the control version. In one of the follow-ups (where subjects read the control problem and rated the quality of the personal evidence, then read the cue paragraph and compared the quality of the evidence there with the control version) four times as many subjects preferred the probabilistic-cue evidence as preferred the control evidence. In the other follow-up (where subjects actually acted as subjects in the control condition and then were shown the cue version), 40% more subjects preferred the probabilistic-cue evidence than preferred the control evidence. If people are capable of learning from experience that events of a given kind are heterogeneous and are produced in part by chance, then it should be possible to show that greater expertise in a domain is associated with a greater tendency to reason statistically in that domain. We anticipated that experience with sports would facilitate recognition of a regression effect in sports and that experience with acting would facilitate recognition of a regression effect in acting. Subjects were told about a small sample of extreme behavior followed by a larger sample of less extreme behavior. It was anticipated that inexpert subjects would generalize from the small sample and then would be obligated to give a causal explanation for the discrepancy between the small sample and the large sample. Expert subjects were expected to generalize less and to recognize that the discrepancy could be due to chance factors making the small sample appear extreme. One concerned a football coach who usually found that the most brilliant performers at tryout were not necessarily the best players during the football season, and the other concerned a repertory company director who usually found that the most brilliant performers at audition were not necessarily the best actors during the drama season. Unfortunately, most of these kids turn out to be only somewhat better than the rest. In his eagerness to find new talent, he exaggerates the brilliance of the performances he sees at the try-out. They probably just made some plays at the try-out that were much better than usual for them. The boys who did so well at try-out are likely to be students with other interests. Most of the subjects with athletic team experience (a majority) preferred the statistical explanation for the football problem, whereas most of the subjects without team experience preferred one of the other, deterministic explanations. Most of the subjects with acting experience (a small minority) preferred the statistical explanation for the acting problem, whereas most of the subjects without acting experience preferred one of the deterministic explanations. Percentage of Experienced and Inexperienced Subjects Who Preferred the Statistical Explanation for the Football and the Acting Problems We do not wish to infer from these results that experience in a domain will make statistical explanations more salient for every kind of problem. Expertise brings a recognition of the causal factors at work in a domain as well as a recognition of the remaining uncertainty. When the problem can be approached with this expert causal knowledge, the expert may give answers that are less statistical, at least in form, than those of the novice. We may speculate that expertise reduces reliance on the representativeness heuristic, which encourages unreflective assumptions that the future will resemble the past and that populations will resemble samples, and substitutes either statistical reasoning or reasoning in accordance with well-justified causal rules. We should note also that it is possible that the tendency of experts to reason statistically may have less to do with knowledge of variability and uncertainty than with a subcultural norm for them to do so. The statistical answer may simply look more like a familiar, standard answer to the experts than to the nonexperts. For a correlational study such as Study 4, it is not easy to disentangle the undoubtedly related factors influencing statistical reasoning. Its use should be rare for domains in which (1) it is hard to discern the sample space and the sampling process, (2) the role of chance in producing events is unclear, and (3) no cultural prescription for statistical reasoning exists. These observations were made across studies, across tasks, and across subject populations, however. To demonstrate that the same subjects dealing with the same tasks in the same experiment are more likely to reason statistically for some events characterized by uncertainty than for others, Jepson, Krantz, and Nisbett (1983) presented subjects with two broad classes of problems. The first class of problems dealt with events that are assessable by objective means, such as abilities, achievements, and physical illness. The second class dealt with events that are assessable only by subjective means, for example, personal preferences among objects, assessments of leadership potential, and judgments about the need for sexual fidelity in relationships. It was reasoned that, in general, it is relatively easy to apply statistical reasoning to objective events because one is likely to have some idea of their distributions (or to be able to guess what the distributions might look like because the units of measurement and the sample space are likely to be relatively clear). In general, also, the role of chance is likely to be relatively transparent for those objectively assessable events that in fact have been observed under repeated, relatively fixed conditions. Finally, cultural prescriptions to reason statistically probably exist for many such events. In contrast, none of these things is true for most events that can be assessed only by subjective means. Since you want all factors not related to the game to be equal for a championship, then the Super Bowl is the better way to determine the world championship. Three of these classes he knows he wants, so he must decide between the other two.
Careful examination is important because not all wounds require surgical excision blood pressure kits at walgreens order line metoprolol. The surgical treatment of most war wounds is a staged process involving two main procedures blood pressure 00 order metoprolol 50mg overnight delivery, the frst being wound debridement or excision heart attack information discount 25 mg metoprolol with visa. Closure may be by simple direct suture or require sophisticated techniques of grafting and reconstruction (see Chapter 11) blood pressure facts metoprolol 25mg cheap. In a large wound with heavy bleeding, blind clamping in the depths of a blood-flled cavity is mentioned only to be condemned. Direct local pressure should be exerted while proximal and distal control of the vessels by standard surgical exposure is performed. Surgical infection requires a culture medium, which in the case of weapon wounds is a mixture of dead muscle, haematoma, bone fragments, dirty skin, foreign material (pieces of cloth or shoe, mud, gravel, leaves, dust, the missile, etc. Wound debridement is the process whereby this dead and damaged tissue, grossly contaminated with bacteria and debris, is completely cut away. This leaves an area of healthy tissue with a good blood supply and capable of combating residual surface contamination, provided the wound is not closed. Excess excision of healthy tissue, however, will increase the potential for deformity and disability. This is provided by adequate incision of the skin and fascia, and leaving the wound unsutured. A basic instrument set is all that is needed in the vast majority of cases: scalpel, Metzenbaum (tissue) and Mayo (suture) scissors, toothed dissection forceps, non toothed anatomic forceps, bone curette, six haemostats, and retractors. For the young surgeon, or one without experience of war wounds, it is best to excise the wound layer-by-anatomic-layer, proceeding from superficial tissues to deeper ones in order to best visualize the anatomy and pathology. Tissue damage, haematoma, and oedema can easily alter the visible anatomy, and camouflage important structures. The most common error is to attempt to make a wound excision through a small entry or exit wound. In limbs, the incision should be made in the longitudinal axis, but not over subcutaneous bone, and at fexion creases it should curve in the usual way. The commonest mistake is to attempt a wound excision through small entry or exit holes or to make incisions too short. This extension of the skin wound not only permits better visualization, but also allows for the proper decompression of deeper tissues and their subsequent drainage. Large amounts of damaged muscle may lie underneath a small hole in the fascia; therefore, the muscular compartment should be opened up by a large incision of the deep fascia parallel to the muscle fbres along the entire length of the skin incision (Figure 10. This essential step allows wide and deep retraction to expose the depths of the wound. Post-traumatic oedema of the wound can easily cause compartment syndrome, compromising the local circulation with resultant necrosis of the muscles. The fascial incision is left open to allow oedematous and congested muscle to swell without tension, so as to avoid interference with the blood supply and to promote drainage of the infammatory exudate and haematoma. After haemorrhage control, the relief of tissue tension is the most important step in wound debridement. Deep to the fascia, the gloved fnger is the best and gentlest probe to follow the track and estimate the extent of damage. Again, particular attention should be paid to the sharp edges of any fractured bone. Note the contused and Compartment syndrome can occur in any fascial space, but is seen most commonly in necrotic muscles. Great care should be taken when dealing with any penetrating wound below the knee, with or without tibial fracture. If there is any suspicion of compartment syndrome, decompression must be performed without delay. The track of the missile through the muscles must be opened up, layer by layer, to be properly visualized. It is vital that all grossly contaminated, obviously necrotic and detached muscle lining the track be excised. During wound exploration, division of uninjured muscle in a transverse direction should be avoided. How to diferentiate between muscle that is injured but will heal from that which is not viable. All muscle that is not healthy and red, that does not contract when pinched or bleed when cut, must be excised until healthy, contractile, bleeding muscle is found. However, confusion may arise because of certain pathological changes described below. To test for contractility, 2 cm3 lumps of muscle should be picked up and pinched with a forceps and, if they do not contract, excised using scissors or knife. Cutting away lumps larger than 2 cm3 may result in the inadvertent removal of healthy tissue. If working under a pneumatic tourniquet, the anatomical structures must be clearly identifed. Fragments of bone with no attachment to periosteum or muscle are already sequestrated and should be discarded, but any bone still attached should be retained. Any bone left in situ must be cleaned of dead muscle and foreign material, dirty bone ends are trimmed by a bone-nibbling forceps (rongeur). Bone defect is not important at this stage, the wound is of paramount importance, and every attempt should be made to avoid infection, whose development will only lead to greater bone loss. Periosteum, on the other hand, is resilient and has a rich blood supply: it plays the predominant role in new bone formation. Its debridement should be conservative and restricted to obviously dirtied and contaminated edges. More defnitive bone immobilization is decided during delayed primary closure of the wound. For information on indications for diferent techniques of fracture immobilization and repair of bone defect, see Volume 2. The surgeon should pay particular attention to the possibility of a vascular injury near severely comminuted fractures with multiple fragments. If they are found to be damaged, the site and degree of damage should be recorded. A non-absorbable suture may be placed in the proximal and distal ends and pulled together to facilitate their identifcation at a future operation. Exploration of the implicated nerve should be attempted during wound debridement only if it does not involve opening up healthy tissue planes. Severed tendons, if important and requiring later repair, should be marked with a non absorbable suture as with nerves. The failure of immediate repair will only make subsequent efforts that much more difficult. Nerves and tendons should nonetheless be protected from extended exposure, by covering them with muscle or skin flaps or wet dressings. Otherwise, there are two conditions that require immediate removal of bullets and fragments, and these are related to specific proven risks and complications. Risk that the projectile may cause erosion of an important structure (usually a major blood vessel) with the possibility of major haemorrhage or embolization (Figures 10. Should the surgeon suspect a pseudoaneurysm or an arterio-venous fstula then an operation to treat these pathologies involves the removal of the foreign body. |
