Congestion function

A Rh catalyst with (/ ,/ )-MeDuPHOS is effective for the asymmetric hydrogenation of sterically congested functionalized olefins, a key intermediate in the synthesis of Tipranavir, an HIV protease inhibitor [32]. The cationic Rh catalyst is found to enable an highly efficient and enantioselective hydrogenation of a unique carboxylate for the 12-kg reaction scale production of candoxatril, a cardiovascular agent [33]. 

In deciding between alternative spots to place a chain atom or other substituent, a novel form of congestion function is used, qualitatively of the form ... 

Powerful AO = RBS congestion function atom prioritization and fleeing principle ring peeling Simple rotation of 3-D image for 2-D display... 

Cardiomyopathy. Cardiomyopathy, or diseased heart muscle, may reach a point at which the heart can no longer function. It arises from a combination of factors, including hypertension, arrhythmias, and valve disease. Other problems, such as congestive heart failure, cause the interrelated heart—lung system to break down. Because the heart can no longer adequately pump, duid builds up in the lungs and other areas. 

Under certain circumstances, and very rarely, the inhibition of gluconeogenesis by metformin may suppress lactic acid metabolism and precipitate a potentially fatal lactic acidosis. Impairment of renal function, liver disease, alcoholism, conditions that give rise to increased lactate production (e.g. congestive heart failure, infections) are therefore contraindications for the application of metformin. 

Both carvedilol and labetalol are contraindicated in patients with hypersensitivity to the drag, bronchial asthma, decompensated heart failure, and severe bradycardia The drugs are used cautiously in patients with drag-controlled congestive heart failure, chronic bronchitis, impaired hepatic or cardiac function, in those with diabetes, and during pregnancy (Category C) and lactation. 

The MAOI antidepressant drag s are contraindicated in patients widi known hypersensitivity to die drug s, liver and kidney disease, cerebrovascular disease, hypertension, or congestive heart failure and in die elderly. These drag s are given cautiously to patients witii impaired liver function, history of seizures, parkinsonian symptoms, diabetes, or hyperthyroidism. 

The corticosteroids are administered with caution in older adults because they are more likely to have preexisting conditions such as congestive heart failure, hypertension, osteo-poros s and arthritis which may be worsened by the use of such agents The nurse monitors older adults for exacerbation of existing conditionsduring corticosteroid therapy. In addition, lower dosages may be needed because of the effects of aging, such as decreased muscle mass renal function, and plasma volume. 

Heart failure is a clinical syndrome characterized by a history of specific signs and symptoms related to congestion and hypoperfusion. As HF can occur in the presence or absence of fluid overload, the term heart failure is preferred over the former term congestive heart failure. Heart failure results from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood.1 Many disorders such as those of the pericardium, epicardium, endocardium, or great vessels may lead to HF, but most patients develop symptoms due to impairment in left ventricular (LV) myocardial function. 

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