No abstract

Transthoracic DSE is feasible and safe in morbidly obese patients undergoing bariatric surgery; implementation of echocardiographic contrast agents allows for adequate imaging quality in the majority of these patients. However, the very low risk of contemporary bariatric procedures questions the need for routine preoperative stress testing in asymptomatic patients.

A case of a 22-year-old African-American male who sexually assaulted and murdered six African-American females who were strangers to him is reported. Formal study of the subject eight years after the homicides revealed a mildly mentally retarded individual who had, at various times, diagnosable anxiety and depressive disorders. His diagnosed paraphilia was sexual sadism. He also met criteria for both Antisocial and Schizoid Personality Disorder, which are discussed in the context of the comorbidity of psychopathy and schizotypy among some serial murderers. Traumagenic events from his childhood and adolescence included an absent father, sexual and physical abuse, the witnessing of adult sex, and the viewing of violent pornography.

: The Graff ECG triage rule identified almost all patients for whom the CCL was activated. Modification of the rule as proposed by Glickman added very little to the rule's sensitivity, while increasing the number of ECGs required at triage.

Accredited chest pain centers have observation units whose LOSs and discharge rates are comparable to prior studies with utilization patterns that may serve as benchmarks for similar hospitals.