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Hospital Administration Considerations for Implementation of Normothermic Regional Perfusion DCD Heart Transplant Program. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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A Tribute to Stephen Allan Baldwin. Mol Membr Biol 2015; 32:33-4. [PMID: 26094888 DOI: 10.3109/09687688.2015.1031834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Comparison of 3.0-T MR vs 3.0-T MR arthrography of the hip for detection of acetabular labral tears and chondral defects in the same patient population. Br J Radiol 2015; 88:20140817. [PMID: 26090824 DOI: 10.1259/bjr.20140817] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE We report our experience in diagnostic sensitivity of 3.0-T conventional MR vs 3.0-T MR arthrography of the hip for detection of acetabular labral tears and chondral defects in the same patient population. METHODS 43 consecutive patients had both conventional hip MR and MR arthrography examinations performed. These examinations were reviewed retrospectively by independent reading of two musculoskeletal radiologists who read the MR and MR arthrogram examinations in a randomized fashion (i.e. MR and MR arthrogram examinations were read at separate sittings and in a randomized fashion so as not to bias reviewers). Scans were assessed for acetabular labral tears and chondral defects. All patients went on to arthroscopy. RESULTS Of these 43 patients, 40 had acetabular labral tears read by Reader 1 and 39 had acetabular labral tears read by Reader 2 on MR arthrogram, 39 had acetabular labral tears read by Reader 1 and 38 had acetabular labral tears read by Reader 2 on conventional MR examination. There were 42 labral tears in 43 patients at arthroscopy. There were four false-negative labral tears compared with arthroscopy on MR and three false negatives on MR arthrography for Reader 1 and five false negatives on MR and four false negatives on MR arthrography for Reader 2. Each reader had one false-positive labral tear compared with arthroscopy on both MR and MR arthrography. There were 32 acetabular chondral defects at arthroscopy. Reader 1 saw 21 acetabular chondral defects on conventional MR and 27 chondral defects at MR arthrography. Reader 2 saw 19 acetabular chondral defects at conventional MR and 25 acetabular chondral defects on MR arthrography. There were no false-positive readings of chondral defects compared with arthroscopy on MR and one false positive for Reader 1 and two false positives for Reader 2 on MR arthrography as compared with arthroscopy. On conventional MR examination, sensitivities and specificities as compared with arthroscopy were as follows: Reader 1 acetabular labral tear (90% sensitivity, 0% specificity) and Reader 2 acetabular labral tear (88% sensitivity, 0% sensitivity). On MR arthrogram, sensitivities and specificities as compared with arthroscopy for Reader 1 were 93%, 0% and for Reader 2 were 90%, 0%, respectively. Sensitivities and specificities for detection of acetabular chondral defects as compared with arthroscopy were Reader 1 conventional MR (65% sensitivity, 100% specificity), Reader 1 MR arthrography (81% sensitivity, 91% specificity), Reader 2 conventional MR (59% sensitivity, 100% specificity) and Reader 2 MR arthrography (71% sensitivity, 82% specificity). CONCLUSION In this series, 3.0-T MR demonstrated sensitivity for detection of acetabular labral tears that rivals the sensitivity of 3.0-T MR arthrography of the hip. In this series, 3.0-T MR arthrography was more sensitive than conventional 3.0-T MR for detection of acetabular chondral defects. ADVANCES IN KNOWLEDGE 3.0-T MR and MR arthrography are near equivalent in the diagnosis of acetabular labral tears. This information is useful for pre-operative planning.
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How often do surgeons intervene on shoulder labral lesions detected at MR examination? A retrospective review of MR examinations correlated with arthroscopy. Br J Radiol 2014; 87:20130736. [PMID: 24712320 DOI: 10.1259/bjr.20130736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE We report the prevalence of surgical intervention on shoulder labral lesions detected at MR examinations and how surgeons describe labral tears seen at MR examinations in their arthroscopy reports. METHODS A retrospective review of 100 consecutive patients aged 50 years or younger who had shoulder labral tears on MR and went on to have surgery performed. It was determined whether surgical intervention was performed on the MR lesions. RESULTS Of these 100 patients, 72 had superior labral anterior to posterior (SLAP) tears, 38 had posterior labral tears and 28 had anterior labral tears on MR examination. All 100 patients went on to arthroscopy. All lesions described on MRI were described on arthroscopy. Of the 72 SLAP tears, 64 were described as fraying on arthroscopy with 51 debrided. The remaining eight SLAP tears were tacked surgically. Of the 38 posterior labral tears, 36 were described as fraying on arthroscopy with 29 debrided and 2 had surgical tacking performed. Of the 28 anterior labral tears described on MR examination, 26 had surgical tacking performed and 2 were debrided. There were four SLAP tears, two anterior labral tears and three posterior labral tears seen on arthroscopy but not seen on MR examination. CONCLUSION In this series, a high percentage of SLAP tears and posterior labral tears described on MR examination did not have surgical tacking. Most anterior labral tears had surgical tacking. Based on the above, our surgeons request we describe superior and posterior labral lesions as fraying and/or tearing, unless we can see a displaced tear. Most anterior labral lesions are treated with surgical tacking. ADVANCES IN KNOWLEDGE MRI allows for sensitive detection of labral tears. The tears often are not clinically significant.
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Abstract
Research suggests that a significant proportion of inpatients in general medical wards may lack capacity to make treatment decisions, a situation that often goes unrecognised by clinicians. We would like to briefly discuss two cases from a non-psychiatric setting, where a mental disorder served to inhibit the individual's ability to weigh-up associated risks when deciding to refuse potentially life-sustaining healthcare interventions. In both cases the history of mental disorder was well established yet, for markedly different reasons, the respective presentation was such that the influence of the disorder on decision-making was not evident to the treating teams.
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Abstract
Negative feedback is a widespread feature of signaling pathways. In an unexpected twist described in this issue, He and colleagues identify a membrane-tethered metalloprotease named Tiki that inhibits Wnt signaling by removing an essential eight-residue fragment from Wnt itself.
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Editorial. Semin Cell Dev Biol 2007; 18:571-2. [PMID: 17928245 DOI: 10.1016/j.semcdb.2007.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2007] [Accepted: 08/30/2007] [Indexed: 11/19/2022]
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Abstract
Post-translational modification by covalent attachment of lipid groups helps proteins to associate with membranes, both intra- and extracellularly. The enzymology of protein S-acylation with fatty acids has been a stumbling block, but three pathways for this modification have now been identified in eukaryotes. It is not yet clear whether this reaction is enzymatic or facilitated by a chaperone-like mechanism. Work with Ras proteins has shown that an S-acylation/deacylation cycle, in cooperation with prenylation and carboxyl-methylation, may regulate their cycling between intracellular membrane compartments and subdomains, hence controlling their signalling activity. The two types of prenyl group, geranylgeranyl and farnesyl, themselves have surprisingly specific targeting roles for Ras superfamily members.
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Abstract
The Src family tyrosine kinase Lck is essential for T cell development and T cell receptor (TCR) signaling. Lck is post-translationally fatty acylated at its N-terminus conferring membrane targeting and concentration in plasma membrane lipid rafts, which are lipid-based organisational platforms. Confocal fluorescence microscopy shows that Lck colocalizes in rafts with GPI-linked proteins, the adaptor protein LAT and Ras, but not with non-raft membrane proteins including the protein tyrosine phosphatase CD45. The TCR also associates with lipid rafts and its cross-linking causes coaggregation of raft-associated proteins including Lck, but not of CD45. Cross-linking of either the TCR or rafts strongly induces specific tyrosine phosphorylation of the TCR in the rafts. Remarkably, raft patching alone induces signalling events analogous to TCR stimulation, with the same dependence on expression of key TCR signalling molecules. Our results indicate a mechanism whereby TCR engagement promotes aggregation of lipid rafts, which facilitates colocalization of signaling proteins including Lck, LAT, and the TCR, while excluding CD45, thereby potentiating protein tyrosine phosphorylation and downstream signaling. We are currently testing this hypothesis as well as using imaging techniques such as fluorescence resonance energy transfer (FRET) microscopy to study the dynamics of proteins and lipids in lipid rafts in living cells undergoing signaling events. Recent data show that the key phosphoinositide PI(4,5)P2 is concentrated in T cell lipid rafts and that on stimulation of the cells it is rapidly converted to PI(3,4,5)P3 and diacylglycerol within rafts. Thus rafts are hotspots for both protein and lipid signalling pathways.
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Computed tomography-detected abnormalities following conventional abdominal aortic aneurysm (AAA) repair. CARDIOVASCULAR SURGERY (LONDON, ENGLAND) 2002; 10:299-303. [PMID: 12359397 DOI: 10.1016/s0967-2109(02)00017-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To determine how time since the operation influences vascular abnormalities following conventional infrarenal abdominal aortic aneurysm (AAA) repair. METHODS In 47 patients computed tomography was performed 1 to 12 years following the aneurysm repair. Aortic diameters at different levels were measured and other abnormalities recorded. RESULTS Significant correlation was found between time since operation and diameter of the suprarenal aorta (R=0.51, P<0.001) but not with aortic neck diameter (R=-0.10, P=0.48) or diameter of the prosthetic graft (R=0.07, P=0.66). However, measured diameters of graft and aortic neck showed a significant positive correlation (R=0.40, P=0.005). CONCLUSIONS Dilatation of the suprarenal aorta has a different pattern from aortic neck dilatation. The latter showed correlation with the diameter of the prosthetic graft. This may be of interest for future design of endovascular stent-grafts.
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Abstract
Any biology student will know that the plasma membrane separates the inside of a cell from the outside world. Indeed, the plasma membrane is the guardian of a cell's physiology. Fewer students will be aware that cells can export bits of plasma membrane to distant sites in a tissue. Recent work demonstrates the transfer of membrane fragments in a live epithelium and, importantly, suggests that these fragments might be used as a vehicle to transport morphogens in a developing tissue.
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Abstract
OBJECTIVE Twisting injuries occur as a result of differential motion of different tissue types in injuries with some rotational force. These injuries are well described in brain injuries but, to our knowledge, have not been described in the musculoskeletal literature. We correlated the clinical examination and MR findings of 20 patients with twisting injuries of the soft tissues around the knee. DESIGN AND PATIENTS We prospectively followed the clinical courses of 20 patients with knee injuries who had clinical histories and MR findings to suggest twisting injuries of the subcutaneous tissues. Patients with associated internal derangement of the knee (i.e., meniscal tears, ligamentous or bone injuries) were excluded from this study. MR findings to suggest twisting injuries included linear areas of abnormal dark signal on T1-weighted sequences and abnormal bright signal on T2-weighted or short tau inversion recovery (STIR) sequences and/or signal to suggest hemorrhage within the subcutaneous tissues. These MR criteria were adapted from those established for indirect musculotendinous junction injuries. RESULTS All 20 patients presented with considerable pain that suggested internal derangement on physical examination by the referring orthopedic surgeons. All presented with injuries associated with rotational force. The patients were placed on a course of protected weight-bearing of the affected extremity for 4 weeks. All patients had pain relief by clinical examination after this period of protected weight-bearing. CONCLUSIONS Twisting injuries of the soft tissues can result in considerable pain that can be confused with internal derangement of the knee on physical examination. Soft tissue twisting injuries need to be recognized on MR examinations as they may be the cause of the patient's pain despite no MR evidence of internal derangement of the knee. The demonstration of soft tissue twisting injuries in a patient with severe knee pain but no documented internal derangement on MR examination may allow the orthopedic surgeon to elect for a trial of conservative nonsurgical management.
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Abstract
The Healthy Steps Initiative, funded by the Commonwealth Fund in New York and developed and implemented by Boston University School of Medicine, is an enhanced approach to pediatric care in the first 3 years of life. The goals of this effort in transforming pediatric care include (a) supporting the physical and emotional development of each infant and young child; (b) supporting a parental sense of confidence in their child-rearing knowledge and skills; and (c) supporting the clinical effectiveness of pediatric primary care practices to meet the needs of young children and families. The Healthy Steps Initiative enhances well-child care to achieve these goals by providing child development information and support as part of an expanded approach to pediatric primary care. Healthy Steps offers both pediatric practices and families a vehicle for meeting the needs of infants and young children within a preventative framework. This unique program, which is being quantitatively and qualitatively evaluated over 3 years, has been initiated in more than 24 pediatric sites nationwide.
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Abstract
OBJECTIVE Acetabular labral tears may cause considerable pain and predispose patients to premature osteoarthritis. Therefore, early and accurate examination is required. Acetabular labral tears are difficult to view on MR images. We report the association of paralabral ganglion cysts detected on MR imaging with surgically proven acetabular labral disorders. CONCLUSION Paralabral cysts may be associated with labral disorders. The appearance of a paralabral cyst on MR imaging is a useful indirect sign of acetabular labral abnormality. Use of this sign may enable earlier and more accurate examination of labral disorders.
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Finasteride, a 5alpha-reductase inhibitor, blocks the anticonvulsant activity of progesterone in mice. J Pharmacol Exp Ther 1999; 288:679-84. [PMID: 9918575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Progesterone is an effective anticonvulsant against pentylenetetrazol (PTZ) seizures. This action is hypothesized to require the metabolic conversion of progesterone to the gamma-aminobutyric acidA receptor potentiating neuroactive steroid allopregnanolone by 5alpha-reductase isoenzymes followed by 3alpha-hydroxy oxidoreduction. We evaluated this possibility using the competitive 5alpha-reductase inhibitor finasteride. Progesterone (50-200 mg/kg, i.p.) protected mice against PTZ-induced seizures in a dose-dependent manner (ED50, 94 mg/kg). Pretreatment with finasteride (50-300 mg/kg, i.p.) produced a dose-dependent (ED50, 146 mg/kg) reversal of the protective effects of progesterone (2 x ED50 dose = 188 mg/kg). In contrast, finasteride (up to 300 mg/kg) failed to affect the anticonvulsant activity of allopregnanolone (10-30 mg/kg, i.p.; ED50, 12 mg/kg). Finasteride (up to 300 mg/kg) did not block the protective effect of high doses of progesterone (250-350 mg/kg) on tonic hindlimb extension in the maximal electroshock seizure test (progesterone ED50, 235 mg/kg). The anticonvulsant activity of progesterone against PTZ-induced seizures can be blocked by 5alpha-reductase inhibition, providing strong evidence that the anticonvulsant effect of the steroid in this model is mediated by its active metabolite allopregnanolone.
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Cloning of rat and human inducible penile nitric oxide synthase. Application for gene therapy of erectile dysfunction. Biol Reprod 1997; 56:954-63. [PMID: 9096878 DOI: 10.1095/biolreprod56.4.954] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Erectile dysfunction is mainly due to the inability of the cavernosal smooth muscle of the penis to undergo complete relaxation. In the aging rat model, erectile dysfunction is accompanied by a reduction of penile smooth muscle compliance and, in very old animals, by a decrease in penile nitric oxide synthase (NOS), which is responsible for the synthesis of the mediator of penile erection, nitric oxide (NO). We have investigated whether the stimulation of penile NOS expression by local induction or gene therapy can mitigate erectile dysfunction in the aged rat. A mix of iNOS (inducible NOS) inducers was continuously delivered to the penises of 5- ("adult"), 20- ("old"), and 30- ("very old") mo-old rats for 3-6 days, and the erectile response to electrical field stimulation of the cavernosal nerve was measured. The erectile dysfunction observed in old and very old rats as compared to adult animals was ameliorated by treatment with iNOS inducers. Penile iNOS was detectable in the penis of these rats by Western blot, NADPH diaphorase, and NOS activity assays. Inducible NOS was inducible in vitro in both rat and human corpora cavernosal tissue and in rat penile smooth muscle cells (RPSMC), as shown by Western blots. However, NO synthesis in cavernosal tissue upon iNOS protein induction remained low, indicating that the increased NOS levels were under physiological control. The iNOS cDNA was cloned from induced RPSMC mRNA and generated by reverse transcriptase polymerase chain reaction (RT-PCR) from induced human penile smooth muscle cells and corporal tissue. The coding regions from both the rat (RPiNOS) and human (HPiNOS) penile iNOS showed several amino acid differences from their analogous isoform in nonpenile tissues. RPiNOS cDNA injected into the penis mitigated the aging-associated erectile dysfunction. The iNOS construct was detected in cavernosal tissue by PCR, and its expression by RT-PCR and Western blots. These results open the way for the possible use of NOS isoforms in the management of erectile dysfunction.
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Cloning of a novel neuronal nitric oxide synthase expressed in penis and lower urinary tract. Biochem Biophys Res Commun 1996; 226:145-51. [PMID: 8806605 DOI: 10.1006/bbrc.1996.1324] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The neuronal nitric oxide synthase (nNOS) is the main NOS isoform in the urogenital tract catalyzing the synthesis of nitric oxide, the mediator of penile erection and presumably an important factor in the control of urinary voiding. We have cloned from the rat penile corpora cavernosa a cDNA coding for a novel nNOS differing from the cerebellar nNOS by the presence of a 102 nucleotides stretch and other features. This new species is the only nNOS mRNA expressed in the rat penis, urethra, prostate, and skeletal muscle, coexists with the cerebellar nNOS in the pelvic plexus and bladder, and is detectable in the cerebellum. The novel insert is present in human penile RNA and is transcribed from intron 16. The features and distribution of the penile nNOS suggest that it is may be regulated differentially from the cerebellar nNOS.
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Abstract
Small GTP-binding proteins of the Ras superfamily play diverse roles in intracellular trafficking. In order to perform these functions, the proteins must associate with specific donor vesicles and be recycled after fusion of these vesicles with their acceptor membrane target. Recent results have identified a number of lipid modifications of these proteins, occurring at the N- or C-termini, that contribute to their membrane binding. Recycling appears, in some cases, to be mediated by soluble proteins that bind the lipid-modified tails, removing them from the membrane and allowing their reutilization via the cytosol.
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Abstract
Radiologic assessment of tendon injuries requires familiarity with normal anatomy and the capabilities of available imaging modalities. Tenography, less commonly used nowadays, does not allow direct visualization of tendons, so that partial ruptures and longitudinal splits may go undetected. Ultrasonography can depict tenosynovitis, tendinitis, and complete tendon rupture of the Achilles tendon, but the other tendons are difficult to visualize with this technique. Magnetic resonance (MR) imaging is superior to computed tomography (CT) in the depiction of tenosynovitis and peritendinitis, tendinitis, tendon rupture, and tendon dislocation and subluxation. CT can demonstrate these abnormalities, but accompanying scar tissue or edema, early changes of tendon degeneration, and small amounts of inflammatory fluid are difficult to differentiate with this technique. CT is superior for demonstrating calcifications, convex retromalleolar groove, bone fragments, or spurs that complicate tendon dislocation and rupture. Although the authors prefer MR imaging, they caution that all of the modalities are not always specific and that differentiation between closely related processes such as tendinitis and early tendon rupture is difficult.
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Developing a new counselling course. Nurs Stand 1992; 6:34-6. [PMID: 1540524 DOI: 10.7748/ns.6.18.34.s41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Ventricular arrhythmias after coronary artery bypass graft surgery: incidence, risk factors and long-term prognosis. J Am Coll Cardiol 1985; 6:307-10. [PMID: 3874891 DOI: 10.1016/s0735-1097(85)80165-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The incidence, risk factors and long-term prognosis of complex ventricular arrhythmias after coronary artery bypass graft surgery are not known. Complex ventricular arrhythmias are defined as Lown grades 4a (couplets), 4b (ventricular tachycardia) and 5 (R on T phenomenon). Ninety-two patients with normal left ventricular function who underwent elective coronary artery bypass graft surgery were prospectively evaluated. Ventricular arrhythmias were documented by predischarge 24 hour ambulatory electrocardiographic monitoring; 43% of patients had no or simple ventricular arrhythmias (Lown grades 1 to 3) and 57% had complex ventricular arrhythmias. Risk factors analyzed included age, sex, diabetes, hypertension, smoking, preoperative digoxin or propranolol therapy, cardiopulmonary bypass time, aortic cross-clamp time, number of vessels bypassed, peak creatine kinase (CK) elevation and pericarditis. No risk factor identified patients at higher risk for complex ventricular arrhythmias. Patients were followed up for 6 to 24 months (mean 16). Patients with complex ventricular arrhythmias did not have a higher incidence of sudden death, cardiac death, syncope, angina, myocardial infarction or cerebrovascular accident. It was concluded that: Complex ventricular arrhythmias are common after coronary artery bypass graft surgery. None of the risk factors considered identify high risk patients. Complex ventricular arrhythmias after coronary artery bypass graft surgery do not indicate a poor prognosis in patients with normal left ventricular function.
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The emergence of maternal drug addiction as a problem in Ireland 1981. IRISH MEDICAL JOURNAL 1983; 76:86-9. [PMID: 6841026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Correction- Physiologically Active Compounds. IV. Miscellaneous Compounds Related to Aminoethyl Esters of Benzilic Acid. J Org Chem 1961. [DOI: 10.1021/jo01070a624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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