One of the most common indications for obtaining a Doppler echocardiographic study is to ascertain left ventricular (LV) systolic function. There are many ways in which LV function can be determined, but an important assumption that is often overlooked is that every measure that we commonly use is only a surrogate marker of LV function due to the fact that it is impossible to characterize the complex geometric and volumetric function of the ventricle (or myocyte) in a single number. Stated in another way, there is no one perfect measure of LV function. The ejection fraction has emerged as the preeminent method to express LV performance, but although ejection fraction is universally accepted, there are a number of other techniques that can assess LV function and, when taken together, provide a more comprehensive picture both of global and regional LV function. Each of these measures (including ejection fraction) has variable dependence on loading conditions, heart rate, and geometric position that limits its accuracy. Understanding the limitations of each measure will allow the physician to more intelligently understand the true status of the myocardium.
In this non-psychiatric-treatment-seeking population, there appear to be relationships between various forms of trauma (especially sexual abuse) and borderline personality symptomatology, reinforcing the role of childhood trauma in borderline personality disorder.
Bivalirudin use was associated with both improved clinical outcomes and decreased hospital costs in this large "real-world" database. To our knowledge, this study is the first to demonstrate the ideal comparative effectiveness end-point of both improved clinical outcomes with decreased costs in PCI.
Borderline personality disorder (BPD) is characterized by inherent difficulties with self-regulation. While a number of studies have examined the relationship between BPD and body mass index (BMI)/overweight/obesity, findings have been mixed. In this cross-sectional study of a consecutive sample of 238 participants presenting for cardiac stress testing, we investigated the relationship between borderline personality symptoms, according to two self-report measures, and BMI. Compared to participants who were negative on both measures of borderline personality symptoms, participants who were positive on either measure of borderline personality symptoms demonstrated no differences in current BMI or highest BMI in adulthood. These results in a unique study population mirror the findings of other studies in medical and community populations.
There has been much interest and increasing research focused on developing newer and improved imaging modalities to establish diagnosis. CMR and F- FDG-PET are now considered imaging modalities of choice in most centers worldwide, but the data comparing both methodologies head-to-head is limited. Nevertheless, novel radiotracers (i.e.Ga-DOTANOC, F-Flurpiridaz,N-Ammonia) and hybrid combination PET/CMR imaging are coming to spotlight with improved sensitivity and specificity for earlier detection of myocardial sarcoid. As CMR and PET are showing increased utilization in cardiac sarcoidosis, Th-SPECT,Tc MDP SPECT, Ga Scintigraphy, andRb PET are falling out of favor. Newer imaging modalities, radionuclide tracers, and hybrid PET/CMR combinations have been promising in better detecting cardiac sarcoidosis and are currently being evaluated in larger trials.
While self-harm behavior has been studied in various psychiatric populations, particularly the behaviors of suicide attempts and completions, little empirical data exists on the lifetime prevalence of various self-harm behaviors in non-psychiatric populations. In the present study, using a cross-sectional approach and a self-report survey methodology, we examined the lifetime prevalence of 22 self-harm behaviors in a consecutive sample of 250 patients undergoing cardiac stress testing. Results indicated that abuse alcohol was most common (17.2%) followed by promiscuity (10.4%); 6% reported a previous suicide atatempt. Findings indicate areas of clinician inquiry for self-harm behaviors in non-psychiatric patients.
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