Myocardial infarction with nonobstructive coronary arteries: a single-center retrospective study by sex and race.

Background: In myocardial infarction with nonobstructive coronary arteries (MINOCA), there are limited patient-level data on outcomes by sex and race.

Objective: The aim of this study was to assess baseline demographics and 3-year outcomes by sex and race for MINOCA patients.

Methods: Patients admitted to a single center with acute myocardial infarction (MI) between 1 January 2012 and 31 December 2018, were identified by chart and angiographic review.

Subclinical Atherosclerosis to Guide Treatment in Dyslipidemia and Diabetes Mellitus.

Purpose Of Review: Dyslipidemia and type 2 diabetes mellitus are two common conditions that are associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). In this review, we aimed to provide an in-depth and contemporary review of non-invasive approaches to assess subclinical atherosclerotic burden, predict cardiovascular risk, and guide appropriate treatment strategies. We focused this paper on two main imaging modalities: coronary artery calcium (CAC) score and computed tomography coronary angiography.

Digital Health Interventions for Hypertension Management in US Populations Experiencing Health Disparities: A Systematic Review and Meta-Analysis.

Importance: Hypertension remains a leading factor associated with cardiovascular disease, and demographic and socioeconomic disparities in blood pressure (BP) control persist. While advances in digital health technologies have increased individuals' access to care for hypertension, few studies have analyzed the use of digital health interventions in vulnerable populations.

Objective: To assess the association between digital health interventions and changes in BP and to characterize tailored strategies for populations experiencing health disparities.

Sacubitril-Valsartan (LCZ696) in the Treatment of Systemic Hypertension: An Updated Review of Neprilysin Inhibition Combined with Angiotensin II Receptor Blockade.

Sacubitril-valsartan (LCZ696) has been demonstrated to be a highly effective treatment for heart failure with preserved ejection fraction since its Food and Drug Administration approval in 2015, and a growing body of evidence suggests its emergence as a hypertensive medication. It acts as an inhibitor of both neprilysin and the renin-angiotensin-aldosterone system, approaching the control of a multi-faceted pathology in multiple unique ways. Because 48% of US adults are affected by hypertension, with less than half of patients achieving controlled blood pressure, and the high correlation between uncontrolled hypertension and cardiovascular mortality, it is crucial to investigate new pharmacotherapies for managing this disease.

The time is ripe for the renaissance of autism treatments: evidence from clinical practitioners.

Introduction: Recent changes in diagnostics criteria have contributed to the broadening of the autism spectrum disorders and left clinicians ill-equipped to treat the highly heterogeneous spectrum that now includes toddlers and children with sensory and motor issues.

Methods: To uncover the clinicians' critical needs in the autism space, we conducted surveys designed collaboratively with the clinicians themselves. Board Certified Behavioral Analysts (BCBAs) and developmental model (DM) clinicians obtained permission from their accrediting boards and designed surveys to assess needs and preferences in their corresponding fields.

Physical activity during pregnancy - past and present.

The possible implications of physical activity during the period of pregnancy have been much debated over recent decades. This brief appraisal integrates knowledge from an array of position papers, systematic reviews, meta-analyses, and recommendations provided by specialty board committees. The medical community is becoming more and more aware of the beneficial effects of mild and moderate physical activity on the mother and the fetus, including improved clinical correlates of subsequent vaginal delivery, as contrasted to the clearly unbeneficial effects of a sedentary lifestyle.

Two men with dyspnea, enlarged lymph nodes · Dx?

Systolic heart failure has been previously recognized as a cause of reversible mediastinal lymphadenopathy (MLN). Other causes of MLN include sarcoidosis, various malignancies, pulmonary infections, and occupational lung diseases. There are, however, no reports of MLN in patients with diastolic heart failure.

Impact ejecta at the Paleocene-Eocene boundary.

Extraterrestrial impacts have left a substantial imprint on the climate and evolutionary history of Earth. A rapid carbon cycle perturbation and global warming event about 56 million years ago at the Paleocene-Eocene (P-E) boundary (the Paleocene-Eocene Thermal Maximum) was accompanied by rapid expansions of mammals and terrestrial plants and extinctions of deep-sea benthic organisms. Here, we report the discovery of silicate glass spherules in a discrete stratigraphic layer from three marine P-E boundary sections on the Atlantic margin.

Resuscitation with aged blood exacerbates liver injury in a hemorrhagic rat model.

Objective: Blood loss and transfusion are frequent among patients undergoing liver surgery. Concerns have been raised about the safety and efficacy of transfusing stored blood. The influence of transfusing fresh vs.

Magnetic resonance imaging of luxury perfusion of the optic nerve head in anterior ischemic optic neuropathy.

A 49-year-old woman with painless reduction in visual acuity in her left eye was found to have nonarteritic anterior ischemic optic neuropathy (NAION). Fluorescein angiography revealed optic disc capillary leakage consistent with "luxury perfusion." Contrast-enhanced FLAIR magnetic resonance imaging (MRI) showed marked enhancement of the left optic disc.

Impact of Antarctic Circumpolar Current development on late Paleogene ocean structure.

Global cooling and the development of continental-scale Antarctic glaciation occurred in the late middle Eocene to early Oligocene (~38 to 28 million years ago), accompanied by deep-ocean reorganization attributed to gradual Antarctic Circumpolar Current (ACC) development. Our benthic foraminiferal stable isotope comparisons show that a large δ(13)C offset developed between mid-depth (~600 meters) and deep (>1000 meters) western North Atlantic waters in the early Oligocene, indicating the development of intermediate-depth δ(13)C and O(2) minima closely linked in the modern ocean to northward incursion of Antarctic Intermediate Water. At the same time, the ocean's coldest waters became restricted to south of the ACC, probably forming a bottom-ocean layer, as in the modern ocean.

Routine chest X-ray on hospital admission: does it contribute to diagnosis or treatment?

Background: In many hospitals a routine chest X-ray is performed on admission. There are, however, scant data regarding its usefulness in contemporary patient populations.

Methods: We studied consecutive patients admitted during a 2 month period to a single department of medicine, where hospital policy mandates performing an admission CXR.

Development of abdominal pain and IBS following gynecological surgery: a prospective, controlled study.

Background & Aims: Irritable bowel syndrome (IBS) develops after bacterial enteritis that causes injury to the bowel mucosa. It's unclear whether abdominal pain or IBS results from gynecological surgery that could injure abdominopelvic nerves. The aim of this prospective, controlled study was to assess the incidence of pain or IBS in women undergoing elective gynecological surgery compared to non-surgical controls and to identify factors associated with their development.

Do we need routine complete blood count following vaginal delivery?

Routine post partum complete blood count examination (CBC) is customary in many medical centers. The rationale behind drawing a routine CBC is to estimate blood loss during delivery and to identify patients who will need blood transfusions. The present study was aimed to determine the necessity of routine post-partum CBC following vaginal delivery.

Splenic embolus: 13 cases from a single medical department.

Background: Despite the spleen having a very rich blood supply, there is a paucity of reports of splenic emboli.

Objectives: To investigate the incidence of splenic emboli treated in a single general internal medicine department over the last 3 years.

Methods: We examined the records of a 35 bed internal medicine department in a hospital in the center of Israel.

Pregnancy outcome in women with pruritus gravidarum.

Objective: To investigate obstetric risk factors and pregnancy outcome in women with pruritus gravidarum who delivered during a 15-year period.

Methods: A population-based study comparing all pregnancies in women with and without pruritus gravidarum delivered between 1988 and 2002 was conducted. A multivariable logistic regression model was constructed in order to find independent risk factors associated with pruritus gravidarum.

Determining factors associated with shoulder dystocia: a population-based study.

Objective: The study was aimed to define obstetric factors associated with shoulder dystocia.

Methods: A population-based study comparing all singleton, vertex, term deliveries with shoulder dystocia with deliveries without shoulder dystocia was performed. Statistical analysis was done using multiple logistic regression analysis.

Pregnancy outcome of patients with gestational diabetes mellitus following bariatric surgery.

Objective: The objective of the study was to investigate pregnancy outcome of patients with gestational diabetes mellitus following bariatric surgery.

Study Design: All births to patients with gestational diabetes mellitus delivered between the years 1988 and 2002 were included in the study. A comparison between patients with and without a history of bariatric surgery was performed.

Different effects of magnesium sulfate and angiotensin II on the capacity of the fetal and maternal compartments of normal human placenta to secrete TNF-alpha and IL-6.

Three different protocols were carried out to evaluate the effect of magnesium sulfate (MgSO4) on the capacity of the normal human placenta to secrete TNF-alpha and IL-6 in presence and absence of angiotensin II (AII). Ten placentas were perfused with MgSO4 (6-7 mg%) or medium in the absence or presence of AII. Perfusate samples from fetal and maternal sites were collected and examined for IL-6 and TNF-alpha by ELISA.