Changes in Medical Management after Coronary CT Angiography

AbstractIntroduction:Coronary computed tomography angiography (CCTA) allows for non-invasive coronary artery disease (CAD) phenotyping. There are still some uncertainties regarding the impact this knowledge has on the clinical care of patients.Objective:To determine whether CAD phenotyping by CCTA influences clinical decision making by the prescription of cardiovascular drugs and their impact on non-LDL cholesterol (NLDLC) levels.Methods:We analysed consecutive patients from 2008 to 2011 submitted to CCTA without previous diagnosis of CAD that had two serial measures of NLDLC, one up to 3 months before CCTA and the second from 3 to 6 months after.Results:A total of 97 patients were included, of which 69% were men, mean age 64 ± 12 years. CCTA revealed that 18 (18%) patients had no CAD, 38 (39%) had non-obstructive (< 50%) lesions and 41 (42%) had at least one obstructive ≥ 50% lesion. NLDLC was similar at baseline between the grups (138 ± 52 mg/dL vs. 135 ± 42 mg/dL vs. 131 ± 44 mg/dL, respectively, p = 0.32). We found significative reduction in NLDLC among patients with obstrctive lesions (-18%, p = 0.001). We also found a positive relationship between clinical treatment intensification with aspirin and cholesterol reducing drugs and the severity of CAD.Conclusion:Our data suggest that CCTA results were used for cardiovascular clinical treatment titration, with especial intensification seen in patients with obstructive ≥50% CAD.

Level of Physical Activity and In-Hospital Course of Patients with Acute Coronary Syndrome

Abstract Background: Acute coronary syndrome (ACS) is one of the main causes of morbidity and mortality in the modern world. A sedentary lifestyle, present in 85% of the Brazilian population, is considered a risk factor for the development of coronary artery disease. However, the correlation of a sedentary lifestyle with cardiovascular events (CVE) during hospitalization for ACS is not well established. Objective: To evaluate the association between physical activity level, assessed with the International Physical Activity Questionnaire (IPAQ), with in-hospital prognosis in patients with ACS. Methods: Observational, cross-sectional, and analytical study with 215 subjects with a diagnosis of ACS consecutively admitted to a referral hospital for cardiac patients between July 2009 and February 2011. All volunteers answered the short version of the IPAQ and were observed for the occurrence of CVE during hospitalization with a standardized assessment conducted by the researcher and corroborated by data from medical records. Results: The patients were admitted with diagnoses of unstable angina (34.4%), acute myocardial infarction (AMI) without ST elevation (41.4%), and AMI with ST elevation (24.2%). According to the level of physical activity, the patients were classified as non-active (56.3%) and active (43.7%). A CVE occurred in 35.3% of the cohort. The occurrence of in-hospital complications was associated with the length of hospital stay (odds ratio [OR] = 1.15) and physical inactivity (OR = 2.54), and was independent of age, systolic blood pressure, and prior congestive heart failure. Conclusion: A physically active lifestyle reduces the risk of CVE during hospitalization in patients with ACS.

Medical decision making: perspectives of patients and physicians

Magdeburg, Univ., Fak. für Wirtschaftswiss., Diss., 2013

Illustrative visualization of medical data sets

Magdeburg, Univ., Fak. für Informatik, Diss., 2014

Illustrative visualization of medical data sets

Magdeburg, Univ., Fak. für Informatik, Diss., 2014

Software phantoms in medical image analysis

Magdeburg, Univ., Fak. für Informatik, Diss., 2015

Perception-guided evaluation of 3D medical visualizations

Magdeburg, Univ., Fak. für Informatik, Diss., 2015

Some mites of Yemen collected by the Medical Mission of the United States Naval Medical Research Unit No.3. / Charles D. Radford.

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Ticks (Ixodoidea) from wild sheep and goats in Iran and medical and veterinary implications / Harry Hoogstraal, Raul Valdez.

n.s. no.6(1980)

American medical botany :being a collection of the native medicinal plants of the United States, containing their botanical history and chemical analysis, and properties and uses in medicine, diet and the arts /by Jacob Bigelow.

v. 1

American medical botany :being a collection of the native medicinal plants of the United States, containing their botanical history and chemical analysis, and properties and uses in medicine, diet and the arts /by Jacob Bigelow.

v. 2

American medical botany :being a collection of the native medicinal plants of the United States, containing their botanical history and chemical analysis, and properties and uses in medicine, diet and the arts /by Jacob Bigelow.

v. 3

Outlines of lectures on materia medica and botany :delivered in Jefferson Medical College, Philadelphia /by William P.C. Barton.

v.2 (1827)