Couples' Coping Strategies with Left Ventricular Assist Device Implantation: A Qualitative Dyadic Study.

A left ventricular assist device (LVAD) is a mechanical device that treats advanced heart failure. Patients coping with an LVAD need extensive instrumental and medical support, which is usually provided by the spouse. Therefore, it seems that dyadic coping strategies play a crucial role as either mitigators or hinderers of couples' illness management in the context of LVADs.

Barriers to Accessing Video-Based Telehealth Appointments at a Community Veterinary Clinic During the COVID-19 Pandemic.

Objective: To assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic, to explore the impact of the pandemic on marginalized communities, and to understand perceptions regarding barriers and incentives of telehealth appointments as a method to increase care access.

Sample: 205 active Community Veterinary Medicine Clinic clients at Tufts at Tech Community Veterinary Clinic in Worcester, MA.

Procedures: This cross-sectional study used a survey-based method to assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic.

Syncope and undifferentiated shock.

Ventricular free wall rupture is a rare post myocardial complication with a high associated mortality. In this article we discuss the case of an elderly patient who presented to our emergency department in shock after an episode of syncope. Using Point Of Care Ultrasound (POCUS), identification of cardiac tamponade and pericardial thrombus was possible, signs indicating a diagnosis of free wall rupture.

Olfactory learning prevents MK-801-induced psychosis-like behaviour in an animal model of schizophrenia.

There is mounting evidence to support the concept that education is associated with the formation of a functional reserve in the brain, a process that appears to provide some protection against certain aspects of severe central nervous system disorders. The goal of this study was to examine whether learning prevents psychosis-like behaviour in an animal model of schizophrenia. A series of behavioural tasks were used to assess olfactory learning-induced protection against the effects of NMDA channel blocker, MK801.

Upregulation of neurotrophic factors selectively in frontal cortex in response to olfactory discrimination learning.

We have previously shown that olfactory discrimination learning is accompanied by several forms of long-term enhancement in synaptic connections between layer II pyramidal neurons selectively in the piriform cortex. This study sought to examine whether the previously demonstrated olfactory-learning-task-induced modifications are preceded by suitable changes in the expression of mRNA for neurotrophic factors and in which brain areas this occurs. Rats were trained to discriminate positive cues in pair of odors for a water reward.

Defining radiographic osteoarthritis for the whole knee.

Objective: To determine in the knee which individual radiographic feature or combination of features in the patellofemoral and tibiofemoral joints correlate best with a nonradiographic definition of clinical osteoarthritis in order to recommend a definition of radiographic osteoarthritis for use in studies.

Methods: Using data from the Framingham Osteoarthritis Study, we tested the correlation of clinical OA, defined as frequent knee pain plus crepitus, with a variety of definitions of radiographic OA including those based on individual radiographic features, e.g.

Radiographic hand osteoarthritis: incidence, patterns, and influence of pre-existing disease in a population based sample.

Objective: Osteoarthritis (OA) is the most common type of arthritis; involvement of joints in the hand is highly prevalent, especially in the elderly. Few data are available on the incidence of hand OA in men and women or on the association between OA in one hand joint with incidence in others.

Methods: We studied the cumulative incidence of radiographic hand OA in a population based group of men and women, and evaluated whether baseline OA in one joint affected OA rates in other joints in the hand.

Risk factors for incident radiographic knee osteoarthritis in the elderly: the Framingham Study.

Objective: Knee osteoarthritis (OA) is highly prevalent, especially in the elderly. Preventive strategies require a knowledge of risk factors that precede disease onset. The present study was conducted to determine the longitudinal risk factors for knee OA in an elderly population.

Cardiac structure and exercise blood pressure in urban and rural Canadian men of Icelandic descent.

The objective of the study was to determine the relationship between exercise systolic blood pressure (ESBP), during bicycle ergometry, and echocardiographically determined left ventricular structure in rural and urban Canadian men of Icelandic descent. The study was cross-sectional in design. The settings were urban Winnipeg and the rural Interlake District in the province of Manitoba, Canada.

Lack of association between thyroid status and chondrocalcinosis or osteoarthritis: the Framingham Osteoarthritis Study.

Objective: To assess whether current thyroid status is associated with chondrocalcinosis or osteoarthritis (OA), we examined the cross sectional association of serum thyrotropin (thyroid stimulating hormone, TSH) with chondrocalcinosis and with knee OA in members of the Framingham OA study.

Methods: Knee radiographs were taken at the 18th biennial examination (1983-85) and measurement of serum TSH at either the 15th (1977-79) or the 18th biennial examination. Chondrocalcinosis was dichotomized as absent or present and knee OA was based on a Kellgren and Lawrence score of grade 2 or greater in either knee.

Are risk factors for patellofemoral and tibiofemoral knee osteoarthritis different?

Objective: To determine whether patellofemoral (PF), tibiofemoral (TF), and combined patterns of knee osteoarthritis (OA) differ in their strengths of associations with any of the known risk factors for knee OA, and especially to evaluate whether body mass index (BMI) correlates with all 3 patterns, or only with tibiofemoral disease, as previously suggested.

Methods: We obtained anteroposterior and lateral knee radiographs on 608 participants at the 22nd biennial examination of the Framingham cohort study (1992-3). The presence or absence of OA in the TF and PF compartments of each knee was scored, and subjects were classified on the basis of the pattern of compartmental involvement in their 2 knees.

The incidence and natural history of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study.

Objective: To determine the incidence of radiographic knee osteoarthritis (OA) and symptomatic OA (symptoms plus radiographic OA), as well as the rate of progression of preexisting radiographic OA in a population-based sample of elderly persons.

Methods: Framingham Osteoarthritis Study subjects who had knee radiographs and had answered questions about knee symptoms in 1983-1985 were reexamined in 1992-1993 (mean 8.1-year interval) using the same protocol.

Universities and medical schools: reflections on a half-century of Canadian medical education.

After 50 years of accelerated development, universities and medical schools have entered a period of uncertainty and instability. The Flexnerian paradigm of medical education, rooted in biomedical science and conducted under the aegis of a university, reached its apotheosis by the late 1960s and the early 1970s. Fuelled by the introduction of comprehensive, government-sponsored health care insurance and advances in technology, the demand for health care professionals and for access to facilities increased sharply.

Habitual physical activity is not associated with knee osteoarthritis: the Framingham Study.

We evaluated the potential risk factor by examining levels of habitual physical activity during middle age, and knee osteoarthritis (OA) in later years in the Framingham Cohort. Weight-bearing knee radiographs were obtained during the 18th biennial examination (1983-85), when the 1,415 subjects had a mean age of 73 years. Cohort members had been asked at 1954-57 and 1971-73 about the number of hours spent daily at various levels of physical activity, ranging from sedentary to heavy activity.

Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study.

Objective: To evaluate the effect of weight loss in preventing symptomatic knee osteoarthritis in women.

Design: Cohort analytic study.

Setting: The Framingham Study, based on a sample of a defined population.

Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham Study.

We sought to assess occupational joint use and osteoarthritis (OA) longitudinally in a large population with multiple occupations. Subjects were members of the Framingham Heart Study cohort followed over 40 years with occupational status assessed at the beginning of the Heart Study [from Examination 1 (1948-51) through Examination 6 (1958-61)] and knee OA assessed by weight bearing knee radiograph at Examination 18 (1983-85) when mean age of subjects was 73 years. Each subject's job was characterized by its level of physical demand and whether the job was associated with knee bending.

Intrathoracic extramedullary hematopoiesis secondary to B12 and folate deficiency: CT appearance.

Intrathoracic extramedullary hematopoiesis is an unusual condition, usually associated with congenital hemolytic anemias. We present a rare case due to vitamin B12 and folate deficiency diagnosed by CT-guided biopsy.

Estrogen use and radiographic osteoarthritis of the knee in women. The Framingham Osteoarthritis Study.

Female participants of the Framingham Osteoarthritis Study (n = 831, mean age 73, age range 63-93) were evaluated for osteoarthritis with weight-bearing radiographs of the knee during 1983-1985. At each biennial examination (1963-1981), the women were asked about their use of estrogen during the previous 2 years. We categorized estrogen use as no use reported, use reported at 1 examination, or use reported at 2 or more examinations.

The prevalence of chondrocalcinosis in the elderly and its association with knee osteoarthritis: the Framingham Study.

Chondrocalcinosis and osteoarthritis (OA) both increase in prevalence with age, yet previous studies assessing their association have often been too small to adjust for age and have had biased selection of subjects. We assessed the prevalence of chondrocalcinosis and its link with OA in the Framingham Knee Osteoarthritis Study, a large population based study of the elderly. After controlling for age, we found a modestly increased rate of radiographic OA in those with chondrocalcinosis (relative risk = 1.

Injection of the subcoracoid bursa: a cause of technical failure in shoulder arthrography.

On two occasions in nine years inadvertent puncture of the subcoracoid bursa resulted in failed shoulder arthrography. This little-known bursa does not communicate with the shoulder joint. If this error is recognized at fluoroscopy the contrast medium can be withdrawn, the needle repositioned, and the procedure completed in the usual manner.

Does smoking protect against osteoarthritis?

While studying knee osteoarthritis (OA) in the first Health and Nutrition Examination Survey, we unexpectedly found a protective association between smoking and OA. After adjustment for age, sex, and weight, smokers had a significantly lower rate of OA than did nonsmokers, and heavier smokers were less likely to have the disease than were light smokers. To test this association in a separate study and see if it was due to confounding factors, we looked at the Framingham Osteoarthritis Study, a study of elderly members of the Framingham Heart Study cohort.