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There are a large number of observational studies but few randomized trials comparing the RA with the SVG. The 5-year results of the Radial Artery Patency Study (RAPS) confirm a functional benefit of the RA in comparison to the SVG. The Radial Artery Patency and Clinical Outcomes (RAPCO) trial is a two-tiered 10-year biological comparison of the RA vs . the free RITA or the SVG. No significant differences were found in survival or patency between the groups at 5 years.

Two large studies of approximately 1,000 gastroepiploic artery (GEA) conduits have indicated 5-year patencies of 62% and 86%. The GEA patency was similar to that of the SV ( Oscar de la Renta Embellished Ankle Strap Pumps perfect sale online v4SIm5V
, 22 ). More recently, Suzuki reported that skeletonized GEAs had superior patencies to that of SVs ( 13 ).

Total arterial revascularization is achievable in most patients with three-vessel CAD ( 23 ). The major deterrent in this group of patients is the risk of sternal complications. This is found in patients with diabetes, obesity and pulmonary complications. With careful selection by avoiding these high-risk patients, complete arterial revascularization is readily achievable using skeletonized ITAs and yields good long-term results, even in patients with reduced ventricular function ( 24 ).

Grafting both ITAs to the left coronary system is recommended by most surgeons. Recently, the location of the second ITA was suggested not to influence the outcome of coronary bypass grafting ( 25 ). In a propensity score-matched analysis, Ruttmann compared two groups: the bilateral ITA-SVG and the LITA-RA-SVG group. The incidence of perioperative major adverse cardiac and cerebrovascular events was significantly lower in the RITA compared to the RA groups (1.4% vs . 7.6%, P<0.001). They concluded that this study provided strong evidence for the superiority of a RITA graft in comparison to a RA graft as a second conduit in multiple arterial revascularization ( free shipping footlocker pictures Tabitha Simmons Satin Slingback Flats best prices sale online discount find great Zb25i
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Patients with diabetes mellitus merit special consideration as they are at an increased risk of sternal complications from the use of extensive arterial grafting, particularly from BITA grafting. In this subset of patients the risk of sternal complications has increased from less than 1% to about 3% ( 27 - Barbara Bui PointedToe Ankle Boots for sale cheap authentic cheap low shipping fee 2014 newest online jDxXFPMfQ
). A fear of sternal complications is the main cause of surgeons rejecting the use of the RITA during a diabetic arterial reconstruction. An alternative technique is using skeletonization of the graft pedicle to reduce trauma to the chest wall and minimize sternal infections ( 30 ). In addition, the combination of single ITA grafts with one or both RA conduits may also reduce chest wall complications.

Total arterial grafting is readily applicable in many very elderly patients. Meticulous harvesting of the ITAs and preservation of the integrity of the pleural cavities reduces postoperative morbidity, particularly pulmonary status, and lowers hospital costs ( 31 ). We had adopted a similar extrapleural technique combined with skeletonization of the ITAs in 2001, which produced similar results in elderly patients ( Figure 11 ). Most surgeons who practice extensive arterial grafting restrict BITA usage in the eighth decade ( 32 - 34 ). Compared with SV harvesting, a single ITA graft to the LAD, combined with RA conduits, is a safer alternative with a higher degree of patient satisfaction.

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Description

WordPress supports featured images out of the box, allowing images to represent posts in various ways defined by the theme. This plugin adds similar support for audio, allowing musicians, podcasters, and anyone who publishes audio with WordPress to feature audio files on posts and pages in a structured way. Each post and page gets a featured audio metabox where an audio file can be uploaded or selected from the media library.

By default, featured audio is displayed at the top of posts and pages . Developers can change this by adding theme support for , via several API functions listed below.

Why use featured audio instead of embeding audio directly into posts? Featured audio organizes the content in a structured way, alowing infinite possibilities to customize the way users experience audio content on your site. The plugin ships with one example of this – the featured audio playlist widget. Add this widget to your sidebar and it’ll automatically display a playlist of all of the audio files featured on posts shown on the current view, on views with more than one post such as the main blog page or a category page. The plugin also supports a recent audio playlist widget, which behaves similarly to a latest posts widget.

For a more comprehensive way to manage with WordPress, particularly if you need to include sheet music alongisde audio, see the Sheet Music Library plugin.

Developer API Functions

Add Theme Support

Adding theme support for featured audio tells the plugin not to add the featured audio to the content automatically. Instead, you can add featured audio exactly where you want it with (see below for details).

Change Supported Post Types

By default, the and post types are supported. You can use the filter to modify this list. For example:

the_featured_audio( $args )

Display the featured audio, if it exists.

Parameters:

get_the_featured_audio( $args )

Get the featured audio, if it exists, as a string. Has the same arguments as .

get_featured_audio_src( $id )

Returns the url of the featured audio file, if it exists.

Parameter:

get_featured_audio_attachment_id( $id )

Returns the id of the featured audio attachment, if it exists.

Parameter:

get_the_featured_audio_playlist()

Get the featured audio playlist, if there are multiple posts with featured audio in the current query. Used by the featured audio playlist widget.

the_featured_audio_playlist()

Displays (echoes) .

Installation

FAQ

See the “Developer API Functions” section for information on how to change where featured audio is displayed in your theme’s code.

Both low and high blood sugar can cause problems and need to be treated. Your doctor will suggest how often your child's blood sugar should be checked.

See your child's doctor at least every 3 to 6 months to check how well the treatment is working. During these visits, the doctor will do some tests to see if your child's blood sugar is under control. Based on these results, the doctor may change your child's treatment plan.

When your child is 10 years old or starts puberty, he or she will start having exams and tests to look for any problems from diabetes.

Your child's insulin dose and possibly the types of insulin may change over time. The way your child takes insulin (with shots or an insulin pump ) also may change. This is especially true during the teen years when your child grows and changes a lot.

What and how much food your child needs will also change over the years. But it will always be important to eat about the same amount of carbohydrate at each meal. Carbohydrate is the nutrient that most affects blood sugar.

Health Tools help you make wise health decisions or take action to improve your health.

Cause

Type 1 diabetes develops because the body's immune system destroys beta cells in a part of the pancreas called the islet tissue. Beta cells produce insulin. So children with type 1 diabetes can't make their own insulin. Experts do not know what causes this to happen. But the cause may involve family history and maybe environmental factors like diet or infections.

Type 1 diabetes develops when your child's pancreas stops producing enough insulin . Insulin lets blood sugar-also called glucose-enter the body's cells, where it is used for energy. Without insulin, the amount of sugar in the blood rises above a safe level. As a result, your child experiences high and low blood sugar levels from time to time. High blood sugar can damage blood vessels and nerves throughout the body and increases your child's risk of eye, kidney, heart, blood vessel, and nerve diseases.

Causes of high blood sugar

Causes of low blood sugar

Symptoms

Because your child has type 1 diabetes, he or she will experience high and low blood sugar levels from time to time. High blood sugar usually develops slowly over hours or days, so you can treat the symptoms before they become severe and require medical attention. On the other hand, your child's blood sugar level can drop to dangerously low levels in minutes.

Be alert for:

How can you tell the difference?

Sometimes it's hard to distinguish between high and low blood sugar symptoms , especially if your child is very young. Test your child's blood sugar whenever you think it may be high or low so that you can treat it appropriately. If your child has symptoms of very high blood sugar, such as a fruity breath odor, vomiting, and/or belly pain, seek emergency care. These symptoms may point to diabetic ketoacidosis , which is a life-threatening emergency.

What Happens

Every child experiences type 1 diabetes differently.

The negative effects of diabetes are caused by blood sugar levels that are above or below a target range .

Low blood sugar

Very low blood sugar is a frightening experience for you and your child. But if low blood sugar levels are treated quickly and appropriately, your child should have no lasting effects.

Young children cannot recognize low blood sugar symptoms as well as adults can, which puts them at risk for low blood sugar emergencies. Children who develop hypoglycemia unawareness , which is the inability to recognize early symptoms of low blood sugar until they become severe, or who are trying to keep their blood sugar levels tightly within a target range are also at risk for low blood sugar emergencies.

Make sure your child's caregivers, such as school nurses, know:

Let your doctor know if your child is having frequent episodes of low blood sugar. You can use this form (What is a PDF document?) to keep a record of your child's very high or very low blood sugar levels.

High blood sugar

Very high blood sugar puts your child at risk for diabetic ketoacidosis , a life-threatening emergency. Skipping insulin injections, stress, illness, injury, and puberty can trigger high blood sugar. Because blood sugar levels usually rise slowly, you can treat symptoms early and, most often, prevent diabetic ketoacidosis.

High blood sugar can also lead to:

What can be done?

The best way to help your child with type 1 diabetes live a long and healthy life is to keep his or her blood sugar levels within a target range. Work with your child's doctor, and monitor blood sugar levels frequently.

What Increases Your Risk

Risk factors for very high or low blood sugar levels in a child with type 1 diabetes include:

Call 911 or other emergency services right away if your child:

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