Attosecond impulsive stimulated X-ray Raman scattering in liquid water.

We report the measurement of impulsive stimulated x-ray Raman scattering in neutral liquid water. An attosecond pulse drives the excitations of an electronic wavepacket in water molecules. The process comprises two steps: a transition to core-excited states near the oxygen atoms accompanied by transition to valence-excited states.

Effects of left ventricular geometry and obesity on mortality in women with normal ejection fraction.

Left ventricular (LV) geometry is an independent predictor of cardiovascular morbidity and mortality. Although obesity is a known risk factor for cardiovascular diseases, studies have suggested a paradoxical relation between obesity and prognosis. We retrospectively assessed 26,126 female patients with normal LV ejection fraction to determine the impact of LV geometry, including normal structure, concentric remodeling, and eccentric or concentric LV hypertrophy, and obesity on mortality during an average follow-up of 1.

The importance of recognizing and treating low levels of high-density lipoprotein cholesterol: a new era in atherosclerosis management.

Low levels of high-density lipoprotein cholesterol (HDL-C) represent a major cardiovascular risk factor, with a stronger relationship to coronary heart disease than that seen with elevated levels of low-density lipoprotein cholesterol (LDL-C). HDL-C has important antiatherogenic effects, including reverse cholesterol transport, inhibition of LDL-C oxidation, and antiplatelet and anti-inflammatory actions. Patients with low HDL-C are also at an amplified risk of coronary heart disease due to the common coexistence of other risk factors, including excess adiposity, metabolic syndrome, type 2 diabetes mellitus, hypertriglyceridemia, and the atherogenic dyslipidemia characterized by small dense LDL-C.

Spontaneous coronary artery dissection.

A 45-year-old female athlete with no history of cardiovascular disease or coronary risk factors presented with a non-ST-segment elevation myocardial infarction due to spontaneous right coronary artery dissection. She was treated medically with resolution of her symptoms. Repeat angiography due to recurrent exertional chest discomfort showed TIMI-3 flow and no evidence of dissection.

Disparate effects of left ventricular geometry and obesity on mortality in patients with preserved left ventricular ejection fraction.

Left ventricular (LV) geometry predicts cardiovascular events. Although obesity is a risk factor for cardiovascular diseases, studies have noted a paradox regarding obesity and prognosis. To our knowledge no studies have determined the impact of obesity on LV geometry as well as mortality in patients with preserved ejection fraction.

Osborn waves in sepsis.

A patient with severe sepsis, who presented with moderate hypothermia and the classical electrocardiographic findings that have been described in patients with accidental hypothermia is presented. Rewarming was associated with proportional improvement of the initial electrocardiographic abnormalities. A brief discussion is included about the electrophysiologic mechanisms of Osborn waves, the differential diagnosis of this electrocardiographic finding as well as other findings described in patients with hypothermia.

Risk of anaphylaxis after reexposure to intravenous lepirudin in patients with current or past heparin-induced thrombocytopenia.

Objective: To retrospectively assess the signs and symptoms indicative of adverse reactions to repeated exposures to lepirudin in patients with heparin-induced thrombocytopenia who received at least 2 courses of lepirudin therapy.

Patients And Methods: Medical records were retrospectively assessed from adult patients who received at least 2 courses of lepirudin therapy separated by at least 1 week between January 1999 and June 2002 at The Cleveland Clinic, Cleveland, Ohio. We evaluated the list of 289 low-level terms for possible signs and symptoms of anaphylactic reactions In the medical dictionary for regulatory activities as well as patient vital signs to detect manifestations of immediate hypersensitivity reactions.

Amiodarone induced thyrotoxicosis: diagnostic and therapeutic strategies.

Amiodarone causes thyrotoxicosis in 3% of US patients who use it. Two types of amiodarone-induced thyrotoxicosis are recognized, designated type 1 and type 2, based on whether or not the patient had a preexisting thyroid disorder. Distinguishing between the two can be difficult, but it is important for providing appropriate therapy promptly.