Heart disease (Hagerstown, Md.)最新文献

{"title":"Tinzaparin","authors":"","doi":"10.1007/978-3-030-57401-7_300513","DOIUrl":"https://doi.org/10.1007/978-3-030-57401-7_300513","url":null,"abstract":"","PeriodicalId":83724,"journal":{"name":"Heart disease (Hagerstown, Md.)","volume":"110 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50968167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of humanistic qualities among medical students, residents, and faculty physicians in internal medicine.","authors":"Wei-Nchih Lee,&nbsp;Michael Langiulli,&nbsp;Arif Mumtaz,&nbsp;Stephen J Peterson","doi":"10.1097/01.hdx.0000098641.24830.86","DOIUrl":"https://doi.org/10.1097/01.hdx.0000098641.24830.86","url":null,"abstract":"<p><p>Humanistic qualities of integrity, respect and compassion are important components of medical education. Studies, however, suggest that students may not perceive their faculty physicians as humanistic. Knowing how the perception of humanistic qualities varies by training level may offer insight on how we teach humanism. In this study, the authors compared humanistic quality scores of fourth-year medical students, internal medicine residents, and attending physicians on a general medicine ward of a teaching hospital. A validated nursing survey to assess humanistic qualities among physicians was distributed to randomly selected nurses on the medicine wards. The survey measured physician relationships with other medical staff, the patient, and family members. Each item was scored on a 5-point Likert scale. Composite scores for physician to staff relationships and physician to patient/family relationships, as well as an overall evaluation score, were compared across levels of physician training. A t test was done to determine statistical significance across training levels. No statistically significant differences were found between internal medicine residents and attending physicians. Subinterns appear to have better perceived qualities of humanism compared with resident and attending physicians. Because resident and attending physicians play an important role in medical education, efforts should be made to improve the perceived humanistic qualities of both resident and attending physicians.</p>","PeriodicalId":83724,"journal":{"name":"Heart disease (Hagerstown, Md.)","volume":"5 6","pages":"380-3"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hdx.0000098641.24830.86","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24089146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term (2-4 year) weight reduction with metformin plus carbohydrate-modified diet in euglycemic, hyperinsulinemic, midlife women (Syndrome W).","authors":"Harriette R Mogul,&nbsp;Stephen J Peterson,&nbsp;Bernard I Weinstein,&nbsp;Jianyu Li,&nbsp;A Louis Southren","doi":"10.1097/01.hdx.0000098361.84908.9c","DOIUrl":"https://doi.org/10.1097/01.hdx.0000098361.84908.9c","url":null,"abstract":"<p><p>Long-term weight reduction remains the ultimate objective and challenge of obesity management. Few long-term dietary or pharmacointervention studies have been conducted and there is a critical need for long-range treatment strategies that are effective, safe, and acceptable. The authors conducted a retrospective cohort analysis of 21 euglycemic, hyperinsulinemic women with progressive, refractory, midlife weight gain (Syndrome W) who had previously lost weight (> or =10% reduction from baseline) with a comprehensive 1-year treatment program that included metformin and a hypocaloric, carbohydrate-modified (low-glycemic index) diet, as well as, other lifestyle modifications. The goal of the analysis was to determine long-term efficacy of the composite intervention using NHLBI criteria for weight stabilization, weight regain < or =3 kg (6.6 lb) in 2 years. Of a total of 26 consecutive women with Syndrome W who achieved goal weight during a 3-year period (1998-2001), 21 women (mean [standard error] age, 55.2 [2.4] years; mean body mass index, 34.2 [1.3] kg/m(2)) continued metformin and returned for annual follow-up visits. Weight maintenance was observed at the final (2-4 year) follow-up visit in 19/21 (90.5%) of women. Mean final follow-up weight (77.5 [2.8] kg) correlated highly with mean weight at 1-year protocol completion (77.2 [2.7] kg), (correlation coefficients r(xy) and sigma(xy) = 0.96, P = 0.000), demonstrating long-term weight reduction in the surveillance phase. Significant and robust decrements in fasting insulin (-28.4% [8.1%] to -43.4% [3.7%]) were observed at all follow-up visits (P < or = 0.002). This preliminary case series suggests that metformin may be an effective long-term adjunct to dietary and other interventions in the treatment of obesity in hyperinsulinemic patients. A randomized clinical trial of the dual regimen should be considered in nondiabetic women with midlife weight gain and hyperinsulinemia (Syndrome W) and, quite possibly, in additional euglycemic overweight and obese subjects with documented hyperinsulinemia and other portentous features of the Metabolic Syndrome.</p>","PeriodicalId":83724,"journal":{"name":"Heart disease (Hagerstown, Md.)","volume":"5 6","pages":"384-92"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hdx.0000098361.84908.9c","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24089721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of carotid angioplasty-stenting on short-term mortality and stroke.","authors":"Anthony L Pucillo,&nbsp;Romeo B Mateo,&nbsp;Wilbert S Aronow","doi":"10.1097/01.hdx.0000098360.69268.1b","DOIUrl":"https://doi.org/10.1097/01.hdx.0000098360.69268.1b","url":null,"abstract":"<p><p>Carotid angioplasty-stenting (CAS) was attempted in 78 carotid arteries in 74 patients (45 men and 29 women) with occlusive internal carotid arterial disease and was technically successful in 77 of 78 arteries (99%). Of 77 arteries with successful CAS, 58 (75%) were asymptomatic, 15 (20%) were associated with transient ischemic attacks or amaurosis, and 4 (5%) were associated with prior stroke. Of 77 arteries with successful CAS, 34 (44%) were associated with prior carotid endarterectomy with recurrence of occlusive carotid disease, and 43 arteries (56%) were associated with primary CAS. Sixty-eight of 74 patients (92%) who underwent CAS had high-risk features. Cerebral protection was given to 22 of 74 patients (30%). None of the 74 patients (0%) died of CAS. Minor stroke developed in 3 of 74 patients (4%). These data show that CAS is effective for treating symptomatic and asymptomatic patients with occlusive carotid arterial disease.</p>","PeriodicalId":83724,"journal":{"name":"Heart disease (Hagerstown, Md.)","volume":"5 6","pages":"378-9"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hdx.0000098360.69268.1b","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24089719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ximelagatran: a new oral anticoagulant.","authors":"Lenka Hrebickova,&nbsp;James J Nawarskas,&nbsp;Joe R Anderson","doi":"10.1097/01.hdx.0000099777.39577.e8","DOIUrl":"https://doi.org/10.1097/01.hdx.0000099777.39577.e8","url":null,"abstract":"<p><p>Although there have been many significant advances over the last 50 years with regards to anticoagulant therapy, warfarin remains the definitive standard for the long-term prevention of thromboembolic events in many patients at risk for these complications. Although effective, warfarin has a narrow therapeutic window, necessitating frequent laboratory monitoring for anticoagulant effect. Ximelagatran is an investigational anticoagulant that directly inhibits thrombin, unlike heparin or warfarin, which are indirect inhibitors. Although indirect thrombin inhibitors are mainly only effective at inhibiting circulating thrombin, direct thrombin inhibitors are able to inhibit both free and clot-bound thrombin, thereby producing more effective anticoagulation. Ximelagatran is the first orally available direct thrombin inhibitor to reach phase 3 clinical trials. Ximelagatran is a prodrug for the active metabolite melagatran, and has been demonstrated to have a relatively wide therapeutic window in terms of bleeding and antithrombotic effect compared with warfarin. Clinical studies have demonstrated ximelagatran to be comparable in efficacy to warfarin and low-molecular-weight heparins (LMWH) for prophylaxis of venous thromboembolism, comparable to warfarin for stroke prevention in the setting of atrial fibrillation, and, when combined with aspirin, possible more effective than aspirin alone at preventing major adverse cardiovascular events in patients with a recent myocardial infarction. Adverse effects with ximelagatran primarily involve bleeding complications, which are more frequent than with placebo, but appear comparable to those occurring with standard anticoagulant treatment (ie, warfarin and LMWH). Ximelagatran has also been demonstrated to cause transient increases in liver enzymes, the significance of which will need to be addressed in ongoing phase 3 studies. Should ongoing trials prove ximelagatran to have at least similar therapeutic efficacy and safety as warfarin, ximelagatran may become a first-line anticoagulant due to its ease of administration and lack of a need for drug monitoring. The results of these trials are eagerly awaited in helping to defining the place in therapy for this promising new agent.</p>","PeriodicalId":83724,"journal":{"name":"Heart disease (Hagerstown, Md.)","volume":"5 6","pages":"397-408"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hdx.0000099777.39577.e8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24089141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing and duration of administration are crucial for antiinfarct effect of AMP 579 infused at reperfusion in rabbit heart.","authors":"Zhelong Xu,&nbsp;James M Downey,&nbsp;Michael V Cohen","doi":"10.1097/01.hdx.0000098614.29006.a7","DOIUrl":"https://doi.org/10.1097/01.hdx.0000098614.29006.a7","url":null,"abstract":"<p><p>The adenosine A(1)/A(2) receptor agonist AMP 579 has been reported to protect the heart against infarction even when administered after the onset of ischemia. The present study explored both the timing and the duration of treatment required to limit infarct size in in situ rabbit hearts subjected to 30 min of regional ischemia and 3 hours of reperfusion. In groups 1 and 2, AMP 579 was infused from 10 min before reperfusion and continued for either 30 or 40 min. In group 3, AMP 579 was begun at the onset of reperfusion and continued for 70 min. In group 4, AMP 579 was also infused for 70 min but begun 10 min after reperfusion. In untreated hearts 36.4 +/- 3.1% of the risk zone infarcted. Protection was observed only in hearts having a 70-minute infusion of AMP 579 starting at reperfusion (13.0 +/- 1.9%, P < 0.05). Therefore, AMP 579 must be present at the moment of reperfusion and have a continued presence of more than 30 min thereafter to protect. Importantly, because AMP 579 can protect when administered up to the time of reperfusion, it likely prevents a reperfusion injury, and, therefore, has impressive clinical potential.</p>","PeriodicalId":83724,"journal":{"name":"Heart disease (Hagerstown, Md.)","volume":"5 6","pages":"368-71"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hdx.0000098614.29006.a7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24089716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence for the extrapulmonary localization of inhaled nitric oxide.","authors":"Sandrine Lecour,&nbsp;Gaelle Clermont,&nbsp;Eugène du Toit,&nbsp;Laurent Gilson,&nbsp;Véronique Maupoil,&nbsp;Steven Lowe,&nbsp;Patrick Dupuis,&nbsp;Claude Girard,&nbsp;Luc Rochette","doi":"10.1097/01.hdx.0000098613.53486.08","DOIUrl":"https://doi.org/10.1097/01.hdx.0000098613.53486.08","url":null,"abstract":"<p><p>Inhaled nitric oxide (NO) has emerged as a promising pulmonary vasodilator to treat pulmonary hypertension associated with heart disease and ventilation/perfusion mismatching. However, the pharmacokinetics of inhaled NO still remains obscure and its cardiopulmonary selectivity appears to be increasingly under debate. In the present study measured NO content and levels of cyclic guanosine 3',5'monophosphate (cGMP), a mediator of NO-induced vasodilation, in a variety of organs from rats subjected to NO inhalation. Electron spin resonance spectroscopy associated to a spin trapping technique using N-methyl D-glucamine dithiocarbamate (FeMGD) was used to directly quantify NO levels in the lung, kidney, liver, aorta, and heart from anesthetized Wistar rats subjected to various doses (0, 20, 50, 100, or 200 ppm) and various times (0, 30, 45, or 75 minutes) of inhaled NO. Inhaled NO at a dose of 100 and 200 ppm significantly increased the NO-FeMGD complex in all organs studied. An increase of cGMP was detected in the lung and the aorta after inhaled NO for 45 minutes at the dose of 50 ppm. No changes in NO levels and its metabolites were shown between 30 and 75 minutes of inhaled NO. The results show that inhaled NO at a dose of 100 ppm or more increases NO levels in other organs beside the lung, strongly suggesting that inhaled NO would be more than a pulmonary vasodilator and its selectivity remains to be reconsidered when used for therapeutic purposes.</p>","PeriodicalId":83724,"journal":{"name":"Heart disease (Hagerstown, Md.)","volume":"5 6","pages":"372-7"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hdx.0000098613.53486.08","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24089143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arrhythmogenic right ventricular dysplasia in the elderly.","authors":"Alexandre Cesar Ferreira,&nbsp;Santiago Andrés Garcia,&nbsp;Melissa A Pasquale,&nbsp;Mariana J Canoniero,&nbsp;Arley Peter","doi":"10.1097/01.hdx.0000089782.50317.54","DOIUrl":"https://doi.org/10.1097/01.hdx.0000089782.50317.54","url":null,"abstract":"<p><p>Arrhythmogenic right ventricular dysplasia (ARVD) is a form of cardiomyopathy characterized by fibrofatty infiltration of the right ventricle that leads to cardiac arrhythmias, usually sustained ventricular tachycardia or ventricular fibrillation. ARVD typically becomes recognized in young adults. The authors report a case of an octogenarian in whom third-degree atrioventricular block, low cardiac output syndrome, and failure to capture the pacer stimuli developed. ARVD was diagnosed at autopsy based on fibrofatty replacement of the right ventricle. To date, this case represents the oldest patient ever diagnosed with ARVD reported in the literature.</p>","PeriodicalId":83724,"journal":{"name":"Heart disease (Hagerstown, Md.)","volume":"5 6","pages":"393-6"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hdx.0000089782.50317.54","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24089714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives in the management of chronic coronary artery disease.","authors":"Arthur E Fass","doi":"10.1097/01.hdx.0000098642.90541.ff","DOIUrl":"https://doi.org/10.1097/01.hdx.0000098642.90541.ff","url":null,"abstract":"","PeriodicalId":83724,"journal":{"name":"Heart disease (Hagerstown, Md.)","volume":"5 6","pages":"365-7"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hdx.0000098642.90541.ff","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24089715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using insulin as a drug rather than as a replacement hormone during acute illness: a new paradigm.","authors":"Antonio Pantaleo,&nbsp;Joel Zonszein","doi":"10.1097/01.hdx.0000089839.13906.63","DOIUrl":"https://doi.org/10.1097/01.hdx.0000089839.13906.63","url":null,"abstract":"<p><p>The direct correlation between glucose levels and cardiovascular disease in individuals with type 2 diabetes can now be applied to individuals that share an abnormal metabolic milieu similar to that found in central obesity, the metabolic syndrome, and type 2 diabetes. Premature macrovascular complications with a very high morbidity and mortality rate can be found in these nondiabetic populations. The typical phenotype has visceral or central obesity, excess of free fatty acids, insulin resistance, increased insulin secretion, and hypertension. A more complex metabolic-cardiovascular syndrome develops that includes dyslipidemia, abnormal production of cytokines, chronic inflammatory state, and abnormal coagulation. The interplay of all these cardiovascular risk factors is responsible for the accelerated atherosclerotic process. The different terminologies used for populations sharing this common ground for premature cardiovascular disease now generally accepted as the metabolic syndrome, are also discussed. Aggressive insulin treatment during acute illness in individuals with the abnormal metabolic milieu is beneficial. Insulin treatment is changing from using insulin as a hormone to treat only severe hyperglycemia, to a new paradigm using insulin in high doses as a drug. Aggressive insulin regimens should be used to treat only minimal elevations of blood glucose or to prevent hyperglycemia. The newly observed properties of insulin are reviewed which include suppression of inflammatory cytokines and adhesion molecules, improved hemostasis, and other cardiac beneficial effects. The concomitant administration of intravenous glucose and insulin permits the administration of higher insulin doses that can result in improved outcome due to its nonglycemic-related benefits. The use of aggressive insulin therapy requires both better and more cost-effective algorithms to successfully treat this high-risk population during acute illness.</p>","PeriodicalId":83724,"journal":{"name":"Heart disease (Hagerstown, Md.)","volume":"5 5","pages":"323-33"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hdx.0000089839.13906.63","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40818903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}