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Beyond COSS: The Evolution of Hemodynamic Imaging and Revascularization Strategies in Chronic Cerebrovascular Occlusion. 超越COSS：慢性脑血管闭塞的血流动力学成像和血运重建策略的演变。
Missouri medicine Pub Date : 2026-05-01
Fareed Jumah, Hunter Brooks, Farhan Siddiq, Balint Otvos
{"title":"Beyond COSS: The Evolution of Hemodynamic Imaging and Revascularization Strategies in Chronic Cerebrovascular Occlusion.","authors":"Fareed Jumah, Hunter Brooks, Farhan Siddiq, Balint Otvos","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chronic carotid occlusion (CCO) carries a significant risk of ischemic stroke, particularly in patients with impaired cerebrovascular reserve. Extracranial-intracranial (EC-IC) bypass emerged as a popular treatment strategy with high technical success rates. However, multiple large randomized trials, including the Carotid Occlusion Surgery Study (COSS), failed to demonstrate a statistically significant benefit, mainly due to perioperative stroke risk and limitations in patient selection. Surgical revascularization declined as a result. We aim through this review to re-examine the role of flow augmentation in CCO in light of modern advances in cerebral perfusion imaging. Contemporary modalities-including computed tomography perfusion and emerging magnetic resonance techniques-allow better identification of patients with hemodynamic compromise who may be at highest risk despite medical therapy. Future studies incorporating refined imaging criteria may better define the subset of patients most likely to benefit from selective revascularization.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 3","pages":"253-257"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
St. Louis Metropolitan Medical Society's Medical Historical Museum - National Museum of Quackery (1964-1984). 圣路易斯大都会医学会医学历史博物馆-国家庸医博物馆（1964-1984）。
Missouri medicine Pub Date : 2026-05-01
James R Wright, Kristina Hampton
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引用次数: 0
Financial Statement: Missouri State Medical Foundation. 财务报表：密苏里州医学基金会。
Missouri medicine Pub Date : 2026-05-01
{"title":"Financial Statement: Missouri State Medical Foundation.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 3","pages":"279"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medicare Advantage: What Physicians Need to Know. 医疗保险优势：医生需要知道的。
Missouri medicine Pub Date : 2026-05-01
Ed Weisbart, Kip Sullivan, Mark Krasnoff
{"title":"Medicare Advantage: What Physicians Need to Know.","authors":"Ed Weisbart, Kip Sullivan, Mark Krasnoff","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 3","pages":"187-191"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Save the Date!: 169th Annual Convention | April 2-4, 2027, InterContinental at the Plaza | Kansas City, Missouri. 保存日期！第169届年会将于2027年4月2日至4日在密苏里州堪萨斯城广场洲际酒店举行。
Missouri medicine Pub Date : 2026-05-01
{"title":"Save the Date!: 169th Annual Convention | April 2-4, 2027, InterContinental at the Plaza | Kansas City, Missouri.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 3","pages":"281"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
1 Picture = 1,000 Words. 1张图片= 1000字
Missouri medicine Pub Date : 2026-05-01
{"title":"1 Picture = 1,000 Words.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 3","pages":"224"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sweetness at a Cost: The Story and Science of High-Fructose Corn Syrup. 甜是有代价的：高果糖玉米糖浆的故事和科学。
Missouri medicine Pub Date : 2026-05-01
Shourya Tadisina, Sreenija Dukkipati, Zar Tun, Adetoye Adebayo, Darla L McCarthy, Ray Segebrecht
{"title":"Sweetness at a Cost: The Story and Science of High-Fructose Corn Syrup.","authors":"Shourya Tadisina, Sreenija Dukkipati, Zar Tun, Adetoye Adebayo, Darla L McCarthy, Ray Segebrecht","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 3","pages":"200-206"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Financial Statements: Missouri State Medical Association. 财务报表：密苏里州医学协会。
Missouri medicine Pub Date : 2026-05-01
{"title":"Financial Statements: Missouri State Medical Association.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 3","pages":"279"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Toxicology Testing: Interpreting What That Number Means. 毒理学测试：解读这个数字的含义。
Missouri medicine Pub Date : 2026-05-01
Nancy Mikati, Eniola Gros, Hannah Spungen, Michael D Levine, Evan S Schwarz
{"title":"Toxicology Testing: Interpreting What That Number Means.","authors":"Nancy Mikati, Eniola Gros, Hannah Spungen, Michael D Levine, Evan S Schwarz","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 3","pages":"207-212"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-Term Cardiac Rhythm Monitoring After Ischemic Stroke: Detecting Atrial Fibrillation in the Era of Atrial Cardiopathy. 缺血性卒中后长期心律监测：心房心脏病时代的房颤检测。
Missouri medicine Pub Date : 2026-05-01
Kimberley Pfeiffer, Alibay Jafarli, Francisco E Gomez, Brandi R French, Adnan I Qureshi, Camilo R Gomez
{"title":"Long-Term Cardiac Rhythm Monitoring After Ischemic Stroke: Detecting Atrial Fibrillation in the Era of Atrial Cardiopathy.","authors":"Kimberley Pfeiffer, Alibay Jafarli, Francisco E Gomez, Brandi R French, Adnan I Qureshi, Camilo R Gomez","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Long-term cardiac rhythm monitoring has become a central component of the diagnostic evaluation of patients with ischemic stroke in whom atrial fibrillation (AF) is suspected but not initially detected. Implantable loop recorders (ILRs) substantially increase AF detection compared with conventional short-term monitoring, particularly when surveillance is extended over months to years. However, increased detection has not consistently translated into fewer strokes, underscoring important limitations in current paradigms. Growing evidence supports atrial cardiopathy as the underlying substrate predisposing to thromboembolism, with AF representing a variable electrical manifestation rather than the primary disease itself. Electrocardiographic and echocardiographic markers of atrial cardiopathy, including abnormal P-wave indices, left atrial enlargement, and impaired atrial function, help identify patients most likely to benefit from prolonged monitoring. This review examines the role of ILRs in post-stroke patients through the lens of atrial cardiopathy, emphasizing biologic plausibility, patient selection, and disciplined interpretation of monitoring results to optimize clinical relevance and avoid uncritical escalation of therapy.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 3","pages":"248-252"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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