Controlling High Blood Pressure: An Evidence-Based Blueprint for Change.

Recently published national data demonstrate inadequate and worsening control of high blood pressure (HBP) in the United States, outcomes that likely have been made even worse by the coronavirus disease 2019 (COVID-19) pandemic. This major public health crisis exposes shortcomings of the US health care delivery system and creates an urgent opportunity to reduce mortality, major cardiovascular events, and costs for 115 million Americans. Ending this crisis will require a more coherent and systemic change to traditional patterns of care.

Diagnosis and neurosurgical treatment of intracranial vascular occlusive syndromes.

Intracranial atherosclerosis represents the most prevalent form of intracranial vascular occlusive disease in the adult population and is a major contributor to ischemic stroke. The most reliable method for diagnosing intracranial stenosis relies on conventional catheter angiography; MRI and CT imaging and transcranial Doppler currently are valuable screening tools, and ongoing advances in these modalities may render angiography nonessential for accurate diagnosis in the future. Given the potential for hemodynamic compromise from intracranial occlusive disease, a variety of imaging modalities may be used to assess the adequacy of cerebral perfusion, relying on direct measurements of oxygen extraction fraction or the response to vasodilatory stimuli to determine hemodynamic status.

Artificial adaptive systems and fuzzy measures for translation of clinical trial results to the bedside.

Medical science relies uniquely on statistical evidence from large clinical trials or laboratory experiments to deal with uncertainties regarding clinical decisions. The statistical evidence is stated in probabilities. Probability theory is based on the logical rules set forth by Aristotle: the law of noncontradiction, excluded middle, and identity.