RESUMO
ST-segment myocardial infarction (STEMI) is a time-sensitive emergency that requires swift and seamless integration of prehospital and emergency department resources in order to achieve early diagnosis and reperfusion therapy. This issue reviews the current literature on emergency department management of STEMI, including recognition of more subtle diagnoses on electrocardiogram, identification of STEMI mimics, an update on treatment therapies, and strategies to achieve more effective management of STEMI across gender and age groups.
Assuntos
Serviço Hospitalar de Emergência , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Analgésicos/uso terapêutico , Anticoagulantes/uso terapêutico , Biomarcadores/sangue , Fármacos Cardiovasculares/uso terapêutico , Diagnóstico Diferencial , Diagnóstico por Imagem , Eletrocardiografia , Humanos , Intervenção Coronária Percutânea , Valor Preditivo dos TestesRESUMO
An efficient route to various sugar lactones has been developed. Key to the overall transformation is the sequential osmium-catalyzed dihydroxylation of 2,4-dienoates. The simplest (one-step/racemic) example of this reaction occurs when the dihydroxylation is performed with aqueous NMO in MeOH. When the first dihydroxylation is performed using the AD-mix procedure, an enantioselective variant results. When a matched AD-mix procedure is used for the second dihydroxylation, an exceedingly diastereo- and enantioselective synthesis of galacto-1,4-lactone results. [Reaction: see text]
