Kawasaki disease is an 1... vasculitis of infants and children that results in coronary artery 2... in 15% to 25% of those
affected. 3... of KD with aspirin plus high 4... doses of y-globulin, instituted within the first 10 days of 5... reduces cardiovascular sequelae, 6... it is highly desirable to identify patients with KD early in the 7... of their illness. In the absence of a definitive laboratory test result, the diagnosis of KD is dependent on the 8... of clinical features that may be mimicked by other disease processes. Indeed, the differentiation of KD from other 9... and immunologic diseases constitutes a major challenge for the practitioner. The purpose of our study was 10... those diseases that most closely mimic KD in the United States and 11... the details of the history, 12... examination, and laboratory investigation that influenced 13... clinicians to exclude the diagnosis of KD. We also used this 14... to compare certain epidemiologic 15... of KD patients and of those patients referred for evaluation of possible KD in whom 16... diagnoses were established.
1. assessment 2. lesions 3. alternative 4. features
5. treatment 6. course 7. infectious 8. to examine
9. opportunity 10. experienced 11. acute 12. to determine
Modern medicine is devoting considerable time and money to the primary prevention of coronary artery disease — before it becomes a problem. But when primary prevention" fails, the next logical step is secondary prevention of recurrent heart attacks and death. For some people who fall into this category ... enter aspirin.
Aspirin or acetylsalicylic acid — is one of the safest and least expensive medications available today. An early form of the drug, which was extracted from the bark of a willow tree, was first prescribed by the ancient Greek physician Hippocrates some 2300 years ago.
Over the years aspirin has probably been used more widely than any other medication for such problems as headaches, fever, and menstrual discomfort. Recently the United States Food and Drug Administration approved yet another use: Aspirin is now indicated for preventive treatment in some patients with cardiovascular disease. Aspirin — in the dosages prescribed by your doctor — may be effective in preventing heart attacks and stroke.
Heart attacks are usually the result of impeded blood flow through the vessels that carry blood to the heart. One possible cause of this impeded flow is a blood clot created by the buildup of platelets — tiny blood components that play an important role during blood clotting.
As a rule, blood clot formation is a desirable condition. The formation of blood clots at the site of a wound is a normal — and necessary — response to injury. If your blood did not clot, you would bleed to death following the infliction of even a small wound. However, blood clotting within the circulating bloodstream— a process that is promoted by platelet aggregation or clumping — is undesirable. Such platelet activity can lead to the formation of those blood cells that are responsible for strokes, heart attacks, and other potentially fatal circulatory problems.
Why aspirin for heart attacks?The rationale for administering aspirin" to patients who are at high risk for heart attack is that some patients with CAD have greater-than-normal platelet activity. This increased platelet activity may result in an increase in the formation of blood clots in the circulation — and. thus increase blockage in the blood vessels.
How does aspirin do it?In 1971, Dr. John R. Vane—an English scientist who received the Nobel Prize for Medicine for this work — found that aspirin interferes with the production of certain pro-staglandins, chemicals that occur naturally in the body and that are involved in platelet clumping. This, in turn, inhibits the accumulation
of platelets within a blood vessel and reduces the platelets' tendency to adhere to the vessel walls. In patients with a tendency toward platelet aggregation, aspirin may prove life saving.
But remember — the general indications for aspirin that you will find listed on your aspirin bottle do not include prevention of cardiovascular disease. Taking aspirin for heart disease should be done only on the advice of your physician.