Myocardial Ischemia

2017 ◽  
Author(s):  
Jeremy Bennett ◽  
Kara Siegrist
Keyword(s):  
United States ◽  
Myocardial Ischemia ◽  
Supply And Demand ◽  
Perioperative Period ◽  
The United States ◽  
Therapeutic Interventions ◽  
Diagnosis And Treatment ◽  
Artery Disease ◽  
High Degree ◽  
Myocardial Oxygen Supply

Coronary artery disease is a prevalent and growing problem in the United States leading to significant morbidity and mortality including myocardial ischemia and infarction. Diagnosis and treatment of myocardial ischemia under general anesthesia can present unique challenges for the anesthesiologist including interpretation of diagnostic monitoring data and options for therapeutic interventions. There are many complex factors that determine myocardial oxygen supply and demand; when these become imbalanced, myocardial ischemia occurs that can progress to infarction. Maintaining a high-degree of suspicion for myocardial events in the perioperative period is paramount to good patient outcomes. In fact, perioperative myocardial injury within 30 days of surgery, if considered as a disease entity, would be the third leading cause of death in the United States. This chapters reviews the diagnosis and treatment of such events.

Early Psychosis: Diagnosis and Treatment

2020 ◽  
Vol 09 ◽  
Author(s):  
Nataly S. Beck ◽  
Melanie L. Lean ◽  
Kate V. Hardy ◽  
Jacob S. Ballon
Keyword(s):  
United States ◽  
Early Identification ◽  
Mental Health Problems ◽  
The United States ◽  
Early Psychosis ◽  
Screening Tools ◽  
Diagnosis And Treatment ◽  
First Episode ◽  
Psychotic Episode ◽  
First Onset

Background: The typical age of onset for psychotic disorders is concurrent with the typical age of enrollment in higher education. College and graduate students often experience new academic and social demands that may leave them vulnerable to substance use and mental health problems, including the initial onset of a psychotic episode. Objective: To provide a current overview of the guidelines and literature for the diagnosis and treatment of first-onset psychosis with special consideration for the college and graduate student population in the United States. To highlight areas of need and provide recommendations for clinicians who work at educational institutions and their health services, along with general psychiatrists and psychologists who work with post-secondary education populations, to help close the treatment gap. Method: A review of interventions and best practice for the treatment of early psychosis in college students was conducted, informed by the authors’ current experience as clinicians with this population at a United States university. Results: Thorough psychiatric interviews and screening tools can help in the early identification of individuals at clinical high risk for and at first onset of psychosis. Coordinated specialty care services are the gold standard for early psychosis services, including psychotherapy (such as cognitive behavioral therapy and individual resiliency training), as well as support for a student to return to school or work. Individuals experiencing a first episode of psychosis in general respond better to lower doses of antipsychotics and may also experience more adverse effects. Conclusion: Return to a high level of functioning is possible in many cases of first onset of psychosis, and early identification and treatment is essential.

scholarly journals Supply and Demand for Radiation Oncology in the United States: Updated Projections for 2015 to 2025

2016 ◽  
Vol 96 (2) ◽  
pp. E394-E395
Author(s):  
H.Y. Pan ◽  
B.G. Haffty ◽  
B. Falit ◽  
T.A. Buchholz ◽  
L.D. Wilson ◽  
...  
Keyword(s):  
United States ◽  
Radiation Oncology ◽  
Supply And Demand ◽  
The United States

Narrowing the mindware gap in medicine

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Pat Croskerry
Keyword(s):  
United States ◽  
Cognitive Performance ◽  
Clinical Reasoning ◽  
Medical Errors ◽  
Medical Error ◽  
Causes Of Death ◽  
The United States ◽  
Morbidity And Mortality ◽  
Medical Educators ◽  
High Degree

Abstract Medical error is now recognized as one of the leading causes of death in the United States. Of the medical errors, diagnostic failure appears to be the dominant contributor, failing in a significant number of cases, and associated with a high degree of morbidity and mortality. One of the significant contributors to diagnostic failure is the cognitive performance of the provider, how they think and decide about the process of diagnosis. This thinking deficit in clinical reasoning, referred to as a mindware gap, deserves the attention of medical educators. A variety of specific approaches are outlined here that have the potential to close the gap.

Hypothyroidism in Otherwise Healthy Hypercholesterolemic Children

PEDIATRICS ◽  
1991 ◽  
Vol 88 (2) ◽  
pp. 332-334
Author(s):  
ARTHUR LAVIN ◽  
ALAN H. NAUSS
Keyword(s):  
United States ◽  
Coronary Artery Disease ◽  
The United States ◽  
Plaque Formation ◽  
Preventive Cardiology ◽  
Treatment Regimens ◽  
Atherosclerotic Plaque Formation ◽  
Symptomatic Coronary Artery Disease ◽  
Artery Disease ◽  
High Risk Screening

Atherosclerosis is the leading cause of death in the United States. Studies in adults have shown that intervention with combined diet and medication can reduce atherosclerotic plaque formation and, as a result, the incidence of symptomatic coronary artery disease.1-4 With a strong tradition of preventive medicine, the pediatric community has begun exploring the prevention of adult atherosclerosis through intervention in childhood. Although issues such as universal vs selective high-risk screening, ideal age for screening and intervention, and treatment regimens remain unresolved and controversial, many preventive cardiology clinics, as well as individual pediatricians, have been screening and treating children.5,6 As part of an initial evaluation of hypercholesterolemic children and prior to any intervention, it is important to determine whether other disease processes are contributing to the child's dyslipoproteinemia.

Dimensions of Jewish-American Identity

1973 ◽  
Vol 33 (3) ◽  
pp. 891-900 ◽  
Author(s):  
Itai Zak
Keyword(s):  
United States ◽  
Factor Analysis ◽  
Test Scores ◽  
Common Factor ◽  
The United States ◽  
American Identity ◽  
Jewish American ◽  
Cast Doubt ◽  
The Common ◽  
High Degree

The main problem posed in this study is: What are the content and structure of Jewish and American identity? The Jewish-American Identity Scale, which was adapted and refined for this study, was administered in 1971 to four samples, totaling 1006 Jewish-American college students from various parts of the United States. Initially, factor analysis was applied to the separate samples. Intersample comparisons of factor structures indicated a high degree of congruency; consequently, the samples were combined for subsequent analyses. Factor analysis of the test scores demonstrated that most of the common factor variance was appropriated by two relatively orthogonal factors. Items dealing with American identity and those dealing with Jewish identity had medium to high loadings on the two respective factors. These findings supported the hypothesis of the duality and the orthogonality of dimensions of Jewish and American identity, and cast doubt on the notion forwarded by some researchers that Jewish-American identity forms a bipolar continuum.

scholarly journals Prevalence and Clinical Correlates of Coronary Artery Disease among New Dialysis Patients in the United States: A Cross-Sectional Study

2001 ◽  
Vol 12 (7) ◽  
pp. 1516-1523 ◽  
Author(s):  
AUSTIN G. STACK ◽  
WENDY E. BLOEMBERGEN
Keyword(s):  
United States ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
The United States ◽  
Comorbid Conditions ◽  
Clinical Correlates ◽  
History Of ◽  
Artery Disease

Abstract. Despite the high prevalence of coronary artery disease (CAD) among patients with end-stage renal disease (ESRD), few studies have identified clinical correlates using national data. The purpose of this study was to determine the prevalence and clinical associations of CAD in a national random sample of new ESRD in the United States in 1996/1997 (n = 4025). Data on demographic characteristics and comorbidities were obtained from the Dialysis Morbidity and Mortality Study, Wave 2. The principal outcome was CAD, defined as the presence of a previous history of CAD, myocardial infarction, or angina, coronary artery bypass surgery, coronary angioplasty, or abnormal coronary angiographic findings. Multivariate logistic regression analysis was used to assess the relationship of conventional factors and proposed uremic factors to the presence of CAD. CAD was present in 38% of patients. Of the total cohort, 17% had a history of myocardial infarction and 23% had angina. Several conventional risk factors, including advancing age, male gender, diabetes mellitus, and smoking, were significantly associated with CAD. Of the proposed uremic factors, lower serum albumin levels but higher residual renal function and higher hematocrit values were significantly associated with the presence of CAD. Vascular comorbid conditions, structural cardiac abnormalities, white race, and geographic location were also strongly correlated with the presence of CAD. This national study suggests that several conventional CAD risk factors may also be risk factors for CAD among the ESRD population. This study identifies nonconventional factors such as serum albumin levels, vascular comorbid conditions, and structural cardiac abnormalities as important disease correlates. Future logitudinal studies are required to explore the relative importance of the relationships observed here.

scholarly journals Orthopedic Problems in Overweight and Obese Children

2018 ◽  
Vol 1 (1) ◽  
pp. 05-07
Author(s):  
GL Di Gennaro
Keyword(s):  
United States ◽  
Coronary Artery Disease ◽  
Body Mass Index ◽  
Childhood Obesity ◽  
Body Mass ◽  
The United States ◽  
Obese Children ◽  
The World ◽  
Prevalence Of Obesity ◽  
Artery Disease

According to the data published by Haslam and James, about 10% of the world populations aged up to 18 areoverweight or obese [1]. In Europe, there are about 20% children with excessive body mass, 5% of whom sufferfrom obesity [2,3]. Childhood obesity is an ongoing epidemic in the United States [4,5]. The most recent data fromthe US indicate that 16.9% of children and adolescents are obese, defined as a body mass index (BMI) for age >95thpercentile [6,7] and there is evidence that the prevalence of obesity among children will reach 30% by 2030 [8].Childhood obesity is a risk factor for greater morbidity later in life, including diabetes, coronary artery disease andincreased mortality [4,5,9,10].

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