After primary PCI was completed, intracoronary nitroglycerin (100-200 μg) was administered and a coronary pressure wire (St. Jude Medical) was calibrated, equalized to the guide catheter Background-Most methods for assessing microvascular function are not readily available in the cardiac catheterization laboratory. The aim of this study is to determine whether the Index of Microcirculatory Resistance (IMR), measured at the time of primary percutaneous coronary intervention, is predictive of death and rehospitalization for heart failure. Methods and Results-IMR was measured immediately after primary percutaneous coronary intervention in 253 patients from 3 institutions with the use of a pressure-temperature sensor wire. The primary end point was the rate of death or rehospitalization for heart failure.

Compared to standard measures, IMR appears to be a better predictor of microvascular damage after STEMI, both acutely and in short term follow-up.

The data suggest that neither socio-demographic factors nor previous exposure to PWMI was related to attitudes towards PWMI. Although the attitudes of Omanis toward PWMI appear to fluctuate in complex ways, traditional beliefs on mental illness have yet to be eroded by exposure to a biomedical model of mental illness. This study largely supports the view that the extent of stigma varies according to the cultural and sociological backgrounds of each society.

As the population of postmenopausal women increases, interest in the effects of estrogen grows. The influence of estrogen on several body systems has been well-documented; however, one area that has not been explored is the effects of estrogen on skin. Estrogen appears to aid in the prevention of skin aging in several ways. This reproductive hormone prevents a decrease in skin collagen in postmenopausal women; topical and systemic estrogen therapy can increase the skin collagen content and therefore maintain skin thickness. In addition, estrogen maintains skin moisture by increasing acid mucopolysaccharides and hyaluronic acid in the skin and possibly maintaining stratum corneum barrier function. Sebum levels are higher in postmenopausal women receiving hormone replacement therapy. Skin wrinkling also may benefit from estrogen as a result of the effects of the hormone on the elastic fibers and collagen. Outside of its influence on skin aging, it has been suggested that estrogen increases cutaneous wound healing by regulating the levels of a cytokine. In fact, topical estrogen has been found to accelerate and improve wound healing in elderly men and women. The role of estrogen in scarring is unclear but recent studies indicate that the lack of estrogen or the addition of tamoxifen may improve the quality of scarring. Unlike skin aging, the role of endogenous and exogenous estrogen in melanoma has not been well established.

The FFR(cor), and, by extension, microcirculatory resistance can be derived without the need for P(w). This method enables assessment of coronary microcirculatory status before or without balloon inflation, in the presence of epicardial stenosis.

Background-Recent studies show that coronary microcirculatory impairment is an independent predictor of poor outcomes in patients with cardiovascular disease. However, controversy exists over whether microcirculatory resistance, a measure of coronary microcirculatory status, is dependent on epicardial stenosis severity. Previous studies demonstrating that microcirculatory resistance is dependent on epicardial stenosis severity have not accounted for collateral flow in their measurement of microcirculatory resistance. We investigated whether the index of microcirculatory resistance is independent of epicardial stenosis by comparing the index of microcirculatory resistance (IMR) levels in patients before and after percutaneous coronary intervention (PCI). Methods and Results-Consecutive patients undergoing elective PCI of the left anterior descending artery were recruited.Patients who developed periprocedural myocardial infarction were excluded. A pressure-temperature sensor wire was used to measure the apparent IMR (IMR app ), which does not adjust for collateral flow, and the true IMR (IMR true ), which incorporates wedge pressure measurement to account for collateral flow, before and after PCI. In 43 patients, there was no difference between pre-and post-PCI IMR true (mean differenceϭ0.8Ϯ11.7, Pϭ0.675 Key Words: index of microcirculatory resistance Ⅲ microvascular function Ⅲ percutaneous coronary intervention Ⅲ stenosis R ecent studies demonstrate that coronary microvascular impairment, as indicated by increased microcirculatory resistance, is an independent predictor of poor outcomes in patients with cardiovascular disease. 1,2 However, controversy exists over whether microcirculatory resistance is affected by epicardial stenosis severity.Previous studies using intracoronary Doppler wires to measure microcirculatory resistance showed an increase in the minimum achievable microcirculatory resistance as a result of increasing epicardial stenosis. [3][4][5][6][7] However, the indices used to measure microcirculatory resistance in these studies were derived from epicardial coronary Doppler velocity measurements to calculate coronary flow, with the assumption that coronary flow is equal to myocardial flow, without accounting for collateral flow. Myocardial flow consists of both coronary flow and collateral flow, and it is important to account for collateral flow in the presence of severe epicardial stenosis for the accurate measurement of microcirculatory resistance. 8 The index of microcirculatory resistance (IMR) is a pressure temperature sensor guide wire-based measurement of the minimum achievable microcirculatory resistance. 8 -11 In 2 recent studies, IMR was shown to be constant in the presence of varying coronary stenosis, artificially and acutely generated by balloon inflation in a porcine model 11 and in humans, 10 as long as collateral flow was taken into account. The aim of this study is to determine whether chronic and more severe native epicardial stenosis affects microvascular resistance by measuring...

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Purpose Despite hypothesized relationships between lack of partner support during a woman’s pregnancy and adverse birth outcomes, few studies have examined partner support among teens. We examined a potential proxy measure of partner support and its impact on adverse birth outcomes (low birth weight (LBW), preterm birth (PTB) and pregnancy loss) among women who have had a teenage pregnancy in the United States. Methods In a secondary data analysis utilizing cross-sectional data from 5609 women who experienced a teen pregnancy from the 2006-2010 National Survey of Family Growth (NSFG), we examined an alternative measure of partner support and its impact on adverse birth outcomes. Bivariate and multivariable logistic regression were used to assess differences in women who were teens at time of conception who had partner support during their pregnancy and those who did not, and their birth outcomes. Results Even after controlling for potential confounding factors, women with a supportive partner were 63% less likely to experience LBW [aOR: 0.37, 95% CI: (0.26 - 0.54)] and nearly two times less likely to have pregnancy loss [aOR: 0.48, 95% CI: (0.32-0.72)] compared to those with no partner support. Conclusions Having partner support or involvement during a teenager’s pregnancy may reduce the likelihood of having a poor birth outcome.