The Effect of Social and Cultural Factors on Ageism: Examination of the Dual-Process Motivational Model of Ideology, Politics, and Prejudice.

Objective: This study seeks to examine the applicability of the Dual-Process Model of Ideology, Politics, and Prejudice (DPM) as a theoretical explanatory frame-work to ageism.

Methods: The study is based on a secondary analysis of the European Social Survey (ESS), a quantitative project established in 2001 that includes 34 European countries. The sample was a representative random sample of the adult population of eight participating countries, and included a total of 19,073 participants.

Development and evaluation of methodologies for teaching focused cardiac ultrasound skills to medical students.

Background: Handheld ultrasound is emerging as an important tool for point-of-care cardiac assessment. Although cardiac ultrasound skills are traditionally introduced during postgraduate training, the optimal time and methodology to initiate training in focused cardiac ultrasound (FCU) are unknown. The objective of this study was to develop and evaluate a novel curriculum for training medical students in the use of FCU.

Anomalous right coronary artery: a multimodality hunt for the origin.

Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital anomaly. Although there have been several cases of ARCAPA reported in the literature, we present a case which highlights the challenges of diagnosing this rare condition and the incremental value of using multiple imaging modalities. A healthy 48 year old female presented with angina and exertional shortness of breath.

A post-myectomy heart: 20 years later.

We present the case of a 20-year old male that underwent a surgical ventricular septal myectomy at 8 months of age for symptomatic and drug-refractory obstructive hypertrophic cardiomyopathy (HCM). Though he has remained asymptomatic since the operation, he now demonstrates findings of cardiac arrhythmia and left ventricular dysfunction. His case is of particular interest as it represents a detailed and lengthy follow-up from early childhood to adulthood.

An unusual case of infective endocarditis: extension of a tricuspid valve vegetation into the left atrium through a patent foramen ovale.

Tricuspid valve endocarditis frequently occurs in the setting of intravenous drug use. A case of tricuspid valve endocarditis in a 37-year-old woman with a history of intravenous cocaine use is described. Transthoracic echocardiography showed extension of the tricuspid valve mass through a patent foramen ovale and into the left atrium.

Cardiac MRI and pulmonary MR angiography of sinus venosus defect and partial anomalous pulmonary venous connection in cause of right undiagnosed ventricular enlargement.

Objective: Patients may be referred for cardiology assessment because of an enlarged right ventricle (RV) with no cause apparent on echocardiography. Cardiac MRI can contribute to the management of these patients by detecting sinus venosus defect or partial anomalous pulmonary venous connection (PAPVC). We sought to show how often sinus venosus defect or PAPVC was detected on MRI in patients with an enlarged RV without a previously established definite diagnosis.

A single, comprehensive non-invasive cardiovascular assessment in pulmonary arterial hypertension: combined computed tomography pulmonary and coronary angiography.

Background: Comprehensive assessment of pulmonary arterial hypertension (PAH) should identify structural causes and subsequent cardiopulmonary consequences of PAH. This currently requires the use of several imaging modalities. Computed tomography (CT) is routinely used for pulmonary angiography (CTPA).

The man who could not cry and the psychoanalyst who could: mutual healing in the maternal transference/countertransference.

This is a clinical/theoretical study of mutual healing in the maternal transference/countertransference. Therapist and patient began their work when each was in extreme mourning. I detail sensory, affective transactions between them that proved transformative.

Adult presentation with vascular ring due to double aortic arch.

This is a case report on the use of cardiovascular magnetic resonance imaging to diagnose vascular ring due to double aortic arch in an adult presenting with an abnormal chest X-ray. The experience in this case and the literature review identify the benefits of using cardiovascular magnetic resonance imaging to clarify complex aortic arch anatomy.

Aortico-left ventricular tunnel in adulthood: twenty-two year follow up.

Aortico-left ventricular tunnel (ALVT) is a rare congenital cardiac defect that is usually managed by surgical or catheter intervention. This case documents the 22 year follow up of a 44 year old man who has been managed medically through a programme of close clinical and echocardiographic monitoring. This report illustrates that conservative management of Type I ALVT can be undertaken without adverse clinical consequences.

The team approach to pregnancy and congenital heart disease.

The successful pediatric management of congenital heart disease has resulted in increasing numbers of these patients in the reproductive age group and increasing clinical challenges for their physicians. These challenges can be met successfully, with improved results for mother and child, through a concerted comprehensive team approach that relies on a thorough understanding of the patient's underlying cardiac pathology and its anticipated interaction with the pregnancy, and ongoing close evaluation and communication with a team of trained and experienced specialist, including (but not limited to) cardiologist, obstetricians, anesthetists, pediatricians, clinical nurse specialists, and clinical geneticists. Such teams are not always available locally and it will be necessary to refer medium- and high-risk patients to a specialized tertiary care center.

Interventions for coronary stenosis--a Canadian experience of 30 revolutionary years.

Objective: To report 2324 coronary stenosis interventions (Vineberg procedures [VbP], coronary artery bypass graft operations [CABG] and percutaneous transluminal coronary angioplasties [PTCA]), in 1711 patients of a Canadian military hospital between 1965 and 1995 and to report their evolution and interaction in a historical context.

Design: Retrospective examination of clinical and angiographic findings in hard records, collected from the beginning for long term follow-up and later embedded in a custom-designed computer database.

Patients: Most were male, mean ages 43.

Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years.

Objectives: We sought to examine, angiographically, the longterm fate of a large number of mainly venous coronary bypass grafts and to correlate graft patency and disease with patient survival and reoperation.

Background: Much is known about bypass graft patency and disease, but the precise relation between graft fate and patient outcome has not been substantiated and documented.

Methods: A total of 1,388 patients underwent a first coronary artery bypass graft procedure at a mean age of 48.

Exercise echocardiography after coronary artery bypass surgery: correlation with coronary angiography.

Objectives: Our aim was to assess, in patients after coronary artery bypass surgery, how well exercise echocardiography predicts the presence of vascular compromise on angiography.

Background: Because late graft failure frequently occurs after bypass surgery, a reliable noninvasive technique is needed to identify those patients who would benefit from angiographic study.

Methods: In 182 patients, a total of 213 symptom-limited treadmill exercise electrocardiograms (ECGs) and exercise echocardiograms were performed in association with coronary and bypass angiography 2 weeks to 21 years after bypass surgery.

Aortocoronary vein graft spasm during angiography.

Objective: To determine the frequency and clinical significance of aorto-coronary vein graft spasm during angiography.

Design: Retrospective review of angiograms and subsequent correlation with clinical outcome.

Patients: A total of 1264 patients having bypass surgery between 1971 and 1986.

Repeated plaque rupture in the same bypass graft.

A 51-year-old man experienced a plaque rupture at the site of a shallow plaque in his anterior descending bypass graft and went on to suffer a myocardial infarct. Angiography, five months later, showed excellent recanalization; however, one month after that angiogram, the patient presented with unstable angina and evidence of plaque rupture at the same site. The presence of plaque in a graft indicates risk for future plaque rupture, but there appear to be no definite indicators to identify the specific plaque that is at highest likelihood of rupture.

Coronary bypass graft fate: long-term angiographic study.

In 222 patients, 741 venous coronary bypass grafts were studied angiographically early, at 1 year and at a late examination at greater than 6.5 years (mean 9.6) after operation; 565 of these grafts were also examined 5 years postoperatively.