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27th Miner Franklin Lobos emerges into daylight for the first time in 69 days, and comes to an emotional reunion with his daughter. In this video you can see the president of Chile greeting all the miners as they come out, one by one, and you can see how they are been saved Luis Urzua, 54 The shift foreman, known as Don Lucho by other miners, took a leading role while they were trapped and made maps of their cave. Descriptions of the Miners: Yonni Barrios, 50 Known as “the doctor” because he has first aid skills from helping his diabetic mother. While he has been underground his wife discovered he had a girlfriend. Franklin Lobos, 53 A well known former football player known as the “magic mortar.” While underground he received a T-shirt signed by Barcelona player David Villa. Mario Sepulveda, 40 An electrical specialist known as “the presenter” because he acted as a spokesman and guide on videos the miners sent up. He ended one video saying “Over to you in the studio.” Raul Bustos, 40 The hydraulics engineer was a victim of the February earthquake in Chile. He moved north, finding work at the mine to support his wife and two children. Ariel Ticona, 29 His wife gave birth to a daughter on Sept 14 and he was able to watch the arrival on video. He named her Esperanza, which means “hope.” Daniel Herrera, 27 Truck driver was given the role of medical assistant in the mine. He complained about the psychologist dealing with the men, saying it was causing hysteria. Florencio

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FDA is alerting healthcare professionals that Meridia (sibutramine) is contraindicated in patients with a history of cardiovascular disease because the drug increases their risk of heart attack and stroke. Meridia is used to manage obesity. In November 2009, an early communication from FDA reported preliminary study results suggesting that patients on Meridia had a greater frequency of cardiovascular events than those not taking the drug. Additional data from the study has shown that the excess risk occurred in patients with a history of cardiovascular disease. Based on this information, Meridia is now contraindicated in patients with a history of cardiovascular disease, including coronary artery disease, stroke or transient ischemic attack (TIA), cardiac arrhythmias, congestive heart failure, peripheral arterial disease, or uncontrolled hypertension. Healthcare professionals should regularly monitor the blood pressure and heart rate of patients using Meridia and discontinue the drug if there are sustained increases in these measurements. They should also discontinue Meridia in patients who do not lose at least 5 percent of their baseline body weight within the first three to six months of treatment, because further treatment is not likely to be effective and exposes the patient to unnecessary risk. Patients using Meridia should talk with their healthcare professional about whether to continue using the drug.

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FINAL EXAM Case 13 Due May 3, 2010 Case 13 1.The diagnosis for the UPPER LEFT case is mitral valve: A.Stenosis B.Prolapse C.Flail D.Vegetation (infective endocarditis) 2.The segmental wall motion abnormality (SWMA) is located (UPPER RIGHT): A.Anterior IVS B.Inferolateral (posterior) wall of the LV 3.For the LOWER LEFT screen, there is LAE and LVH present. The differential diagnosis would include all of the following EXCEPT: A.Aortic stenosis (AS) B.Systemic hypertension C.Pulmonary hypertension D.Chronic renal failure (CRF) E.Cardiac amyloidosis 4.The LOWER RIGHT screen is demonstrating mitral valve: A.Stenosis B.Prolapse C.Flail D.Normal

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An interview with Prof Kevin Balanda of the Institute of Public Health in Ireland at the launch of the “Making Chronic Conditions Count” report launch (March 2010). The report describes the distribution of four chronic conditions (hypertension, coronary heart disease, stroke and diabetes) across the island of Ireland and how it is expected to change between 2007 and 2020. Its findings highlight the need for a greater emphasis on prevention and tackling health inequalties. If the “social determinants of health – poverty, unemployment, low income, poor education, inadquate housing, etc – are not addressed we can expect little further success in either of these endeavours.

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