Background Clinical trials have shown that β-adrenergic blocking drugs are effective and well tolerated in patients with mild to moderate heart failure, but the utility safety of these advanced disease not been evaluated. Methods Results We enrolled 56 severe chronic failure into a double-blind, placebo-controlled study vasodilating β-blocker carvedilol. All had as evidenced by mean left ventricular ejection fraction 0.16±0.01 maximal oxygen consumption 13.6±0.6 mL · kg −1 min despite...

We examined demographic, microbiologic, and clinical data from patients presenting during 1988, 1998, 2004 flood-associated diarrheal epidemics at a diarrhea treatment hospital in Dhaka, Bangladesh. Compared with non-flood periods, individuals were older, more severely dehydrated, of lower socioeconomic status. During epidemics, Vibrio cholerae was the most commonly identified cause diarrhea, only pathogen whose incidence proportionally increased each epidemic compared seasonally matched...

Background Exercise stress tests are conventionally performed to assess risk of coronary artery disease. Using the FHS (Framingham Heart Study) Offspring cohort, we related blood pressure (BP) and heart rate responses during after submaximal exercise incidence failure (HF). Methods Results We evaluated Framingham Study participants (n=2066; mean age, 58 years; 53% women) who completed 2 stages an test (Bruce protocol) at their seventh examination (1998–2002). measured pulse pressure,...

Abstract In this study, the authors' objective was to determine influence of blood lead, meso 2,3-dimercaptosuccinic acid (DMSA)-chelatable and tibial lead on systolic diastolic pressures hypertension in 543 former organolead manufacturing workers. All workers had past exposure inorganic organic lead. The authors used linear regression model pressure separately, logistic for modeling status (i.e., > 160 mm Hg, ≥ 96 or current use antihypertensive medications). Blood DMSA-chelatable levels...

The author reviews over a decade of science and the arts programming he his colleagues have produced disseminated. programs been supported by National Science Foundation, American Physical Society, Graduate Center City University New York various foundations corporations. gives detailed examples using to reach public students with respect related play Copenhagen, opera Doctor Atomic, & Arts Series, major international conference on Communicating Public, many other outreach efforts.

The incidence rates and importance of traditional risk factors in dilated cardiomyopathy among first-degree relatives are unknown. We identified all probands with (n = 13,714, mean age at diagnosis 63 years) from the Danish nationwide registries between 1994 2017. Incidence 29,671, 38 for up to 10 age- sex-matched controls were calculated. Totally 233 (0.8%) 285 (0.1%) developed during a median follow-up 8.2 (Q1-Q3 4.4–13.3) years. (per 100,000 person-years) 86.4 (95% confidence interval...

System dynamics (SD) modeling belongs to the rapidly evolving, interdisciplinary field of system science research. This adds value more traditional health research by contributing design and testing complex integrated models change, examine performance patient outcomes. Using selected milestones in HIV care management frame our simulation research, we created a SD model three subgroups women color (WOC) represented multi-site cohort, classified their seeking status at baseline. Asked reflect...

A variety of teaching strategies for undergraduate science, technology, engineering, and mathematics (STEM) educationhave been studied over the years.Most them are centered at active/collaborative pedagogy.However, most research is focused on introductory, topic courses very little targeted more advanced, calculus based core STEM majors.Even fewer papers provided detailed sufficient classroom implementation these strategies.This paper to fill gap provide example sample assignments two...

Monoclonal gammopathy of undetermined significance (MGUS) is associated with renal dysfunction, inflammation, and increased cardiovascular mortality, but the risks are not fully understood.The authors explored association MGUS a spectrum diseases using Danish nationwide databases.Between 1995 2018, patients 18 years older were age- sex-matched (1:10) control followed prospectively until December 31, for occurrence diseases. Patients diagnosed multiple myeloma, lymphoma, or amyloidosis...

Metastatic squamous cell carcinoma (SCC) involving the gastrointestinal tract as sole site of metastatic disease is exceedingly rare. We report a patient with known cutaneous SCC that metastasized to regional lymph nodes who, after therapy, appeared be free until small lesion was identified on colonoscopy within diverticular orifice. He subsequently noted have more diffuse involvement, including bowel not previously imaging. The presence in this setting should prompt consideration exclude...

Background: Attainment of blood pressure (BP) goals in patients with diabetes is critical both to reduce the risk cardiovascular events and delay progression renal disease. While therapeutic guidelines advise initial therapy an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, monotherapy these agents may not be sufficient attain target BP. Objective: The ADHT (Amlodipine Diabetic Hypertension Efficacy Response Evaluation Trial) evaluated efficacy safety adding...

The relations between recent and cumulative exposure to organic inorganic lead blood levels were examined in 222 organolead manufacturing workers. Personal monitoring data grouped by 29 zones used derive estimates of occupational exposure. Recent combined significantly positively associated with levels. Exposure duration was found modify the relation Age cigarette smoking levels, whereas alcohol use lower This is notable contrast influence consumption on among workers or general population....

We evaluated associations of tibial lead levels with polymorphisms in the vitamin D receptor (VDR) 504 former organolead manufacturing workers past exposure to lead. In this cross-sectional study, we measured by (109)Cd K-shell X-ray fluorescence. Tibial was subjects different VDR genotypes defined using BsmI restriction enzyme, adjusting for confounding variables. Study participants had a mean age +/- SD 57.4 7.6 years. A total 169 (33.5%) were homozygous site (designated bb), 251 (49.8%)...

Recent Canadian, American and European studies have reported increased ampicillin trimethoprim/sulfamethoxazole resistance among urinary tract isolates of <i>Escherichia coli</i>. This trend suggests that a reevaluation first- second-line therapies for the treatment community-acquired infections is necessary. Mecillinam, β-lactam with preferential activity against gram-negative penicillin binding protein 2 (unlike other β-lactams which preferentially bind proteins 1a, 1b or 3),...

Background The goals of the present study were to compare and contrast associations blood lead, DMSA-chelatable current tibia back-extrapolated "peak" lead with four peripheral nervous system (PNS) sensory motor function measures in older males past exposure organic inorganic lead. Methods Data collected from former organolead manufacturing workers an average 16 years since last occupational exposure. Current levels measured by 109Cd x-ray fluorescence. Sensory pressure thresholds (index...

In the Neurology Clerkship at our institution, we introduced a medical education curriculum to increase student competency in providing discharge patients with neurologic disease, and knowledge of QI principles. The was peer-based, that it developed by students, experienced clerks, modified over time their feedback, which tracked using exit surveys. Patients counseled were predominantly male (67%) white (55%), stroke or TIA together representing most common diagnoses (58%). A high proportion...

Background There are limited data on the lifetime risk of heart failure (HF) in people with type 2 diabetes and how incidence has changed over time. We estimated cumulative rates HF among Danish adults between 1995 2018 using nationwide data. Methods Results In total, 398 422 patients (49% women) were identified. During follow-up, 36 400 (9%) diagnosed 121 459 (30%) censored due to death. Using Aalen-Johansen estimators, accounting for death, residual at age 50 years was calculated as 24%...

Background Carvedilol may have favorable glycemic properties compared with metoprolol, but it is unknown if carvedilol has mortality benefit over metoprolol in patients type 2 diabetes (T2D) and heart failure reduced ejection fraction (HFrEF). Methods Results Using Danish nationwide databases between 2010 2018, we followed new-onset HFrEF treated either or for all-cause until the end of 2018. Follow-up started 120 days after initial diagnosis to allow initiation guideline-directed medical...