18.05.2012
Archives of Medical ScienceHemodynamic findings in patients with brain stroke
Siebert J et al. – The hemodynamic parameters correlate with long term prognosis in patients with ischemic brain stroke.
Methods
The 45 consecutive subjects with ischemic stroke and 16 with a hemorrhagic stroke were examined additionally with impedance cardiography during the first day of hospitalization.
The heart contractility, pump performance, afterload and preload indices were recorded and calculated automatically and the data analyzed in terms of 6–month mortality.
Results
The authors found a significant association between the systemic vascular resistance index, Heather index, stroke index, heart rate, systolic and diastolic and mean arterial blood pressure and mortality in patients with ischemic stroke (p = 0.002, p = 0.008, p = 0.012, p = 0.005, p = 0.007, p = 0.009, p = 0.002 respectively).
Logistic regression analysis identified the thoracic fluid content as the most significant variable correlating with the non–survival of the patients with ischemic stroke and in the whole group (ischemic and hemorrhagic stroke).
The significant parameters were also mean arterial pressure and stroke index in ischemic stroke (the correct answer ratio was 86.67%) and heart rate in the whole group (the correct answer ratio was 80.33%).
There were no significant associations in hemorrhagic stroke.
18.05.2012
Journal of Women's HealthEvaluation of Molecular Breast Imaging in Women Undergoing Myocardial Perfusion Imaging with Tc-99m Sestamibi
Hruska CB et al. – The addition of MBI to clinically indicated stress myocardial perfusion imaging studies in women results in a high diagnostic yield of newly detected breast cancers while generating a low rate of additional unnecessary workup.
Methods
MBI was offered to women receiving Tc–99m sestamibi injection for myocardial perfusion stress testing.
During the required waiting period after stress isotope injection, MBI was performed using a dedicated breast imaging gamma camera system.
MBI examinations were interpreted by breast radiologists, with review of a recent mammogram in cases with positive MBI.
Results
Of 322 women enrolled, 313 completed MBI, comprising 5 with known breast cancer, 2 with known high–risk benign breast lesions, and 306 who were asymptomatic for breast disease with a recent negative mammogram.
Analysis was limited to the 306 patients with no known breast disease. MBI was positive in 22 of 306, giving a recall rate of 7.2% (95% confidence interval [CI] 4.8–10.6].
MBI detected 4 new cancers, resulting in a supplemental diagnostic yield of 13.1/1000 women screened (95% CI 5.1–33.2).
The number of cancers diagnosed per abnormal MBI examinations (PPV1) was 18% (4 of 22) (95% CI 7.3–38.5), and the number diagnosed per MBI–prompted biopsies (PPV3) was 44% (4 of 9) (95% CI 18.9–73.3).
18.05.2012
Biological PsychiatryUsing Attentional Bias Modification as a Cognitive Vaccine Against Depression
Browning M et al. – Positive face–based attentional bias modification (ABM) was able to reduce intermediate measures of recurrence risk in previously depressed patients. These results suggest that ABM may provide a “cognitive vaccine” against depression and offer a useful strategy in the secondary prevention of the illness.
Methods
Sixty-one patients with at least two previous episodes of depression who were currently in remission were randomized to receive either an active (positive) or placebo computer-based ABM regime.
The ABM regime presented either pictures of faces or words.
Residual depressive symptoms, measured using the Beck Depression Inventory and the cortisol awakening response were measured immediately before and after completion of the bias modification and then again after 4 weeks' follow-up.
Results
Positive, face-based ABM reduced both measures of recurrence risk (Beck Depression Inventory and cortisol awakening response).
This effect occurred during the month following completion of bias modification.
Word-based modification did not influence the outcome measures.
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