Managerial accounting Managers who believe the existing system has overcharged them have leveled complaints too. Many of these same managers are also under pressure to reduce costs. They are dissatisfied with the inability to reduce their monthly voice charges by reducing their consumption of services. For example, Jim Ryan, Manager of Boeing's Huntsville Operation, has been furious with the magnitude of his voice charges. He contends the existing system overcharges him by at least 200 percent. Ryan is also attempting to slash his 1999 operating costs and has set aggressive consumption reduction goals for the upcoming year.

31 How often does verapamil cause impotence and inhibit ejaculation?

32 Why does a patient with congestive cardiac failure have excessive sweating?

33 What is cardiac asthma?

34 In a book, under the title 'Heart failure' I have seen the following phrase: 'Cardiac failure occurs when, despite normal venous pressures, the heart is unable to maintain sufficient cardiac output...'. Is it correct to say 'normal venous pressures'? All protective and compensatory mechanisms raise the venous pressure to maintain a sufficient cardiac output - according to Frank-Starling law - and this is the case in heart failure, so I think it was meant to say: '...despite high venous pressures...'.

35 I wanted to ask whether a third heart sound is present, or should be present, in all cases of heart failure, whatever the underlying cause.

36 Why can left heart failure lead to right heart failure but not vice versa? What is the physiology involved in this transition?

37 Could you explain the fetal gene program, activated in heart failure?

38 How safe is it to stop administration of carvedilol to a patient with heart failure? Can the drug be tapered off? What are the effects/dangers of stopping carvedilol suddenly? What, if any, are the reasons for discontinuing carvedilol in patients with heart failure?

39 What are the advantages and disadvantages of furosemide in the treatment of cardiac failure?

40 In heart failure, can furosemide be given once daily?