The impact of coronary calcium score as an addition to myocardial perfusion imaging in altering clinical management (ICCAMPA trial).

Introduction: AIM: Myocardial perfusion imaging (MPI) is a key tool for the identification and risk stratification of patients with coronary artery disease. The use of a coronary calcium score further adds to prognostic data above MPI alone. In this study, our aim was to evaluate the extent to which the use of a coronary artery calcium (CAC) score, when co-reported with MPI, impacts changes in clinical management in patients without a history of coronary artery disease (CAD) undergoing functional imaging.

Molecular Outcome, Prediction, and Clinical Consequences of Splice Variants in COL1A1, Which Encodes the proα1(I) Chains of Type I Procollagen.

Approximately 10%-20% of germline pathogenic variants alter mRNA splicing, with phenotypes often dependent on the stability of the mRNA produced by the mutant allele. To better understand the relationships between genotype, mRNA splicing, and phenotype, we examined clinical and molecular data from 243 probands with osteogenesis imperfecta (OI) representing 145 unique splicing variants within the type I procollagen gene, COL1A1. All individuals with IVSX-1G>A mutations had OI type I because the substitution shifted the splice acceptor site 1 nt downstream and destabilized the mRNA.

Gastronomic nostalgia: Salvadoran immigrants' cravings for their ideal meal.

Immigrants typically express cravings for the food of their homeland, but for undocumented and temporarily documented Salvadoran immigrants living in the United States, the hunger for their traditional cuisine is particularly poignant. To cope with a history of food scarcity in El Salvador and their documentation liminality in the United States, Salvadoran immigrants in this study crave symbolically rich foods. Salvadoran women provide these foods by recreating for their families an ideal Salvadoran meal into which they "groom" meanings of an imagined past and a hoped for present and future.

Degradation of a pharmaceutical in HPLC grade methanol containing trace level formaldehyde.

An anomalous peak was observed in the HPLC/UV analysis of a developmental drug product. High resolution LC/MS revealed that the mass of this degradant was 12 Da greater than the drug substance, corresponding to a net gain of a single carbon atom. The degradant was reproduced by incubating the drug substance with formaldehyde, followed by isolation using normal phase chromatography and structure elucidation by NMR.

Critical pathway for an aggressive diagnostic strategy for patients who present with chest pain but a nondiagnostic electrocardiogram to the emergency department.

Background: The prolonged length of stay for patients who seek treatment in the emergency department with chest pain and normal or nondiagnostic electrocardiogram has led to a backlog of patients in the emergency department and the telemetry unit. Correct early management requires risk stratification processes that can effectively separate the majority of these patients into low-risk, low/intermediate-risk, intermediate-risk, and high-risk subsets.

Methods And Results: Patients who seek treatment in the emergency department with chest pain are risk-stratified into low-risk, low/intermediate-risk, and high-risk categories using a Risk Score to determine who would benefit from immediate exercise stress testing.