To define the prevalence of total coronary occlusion in the hours after transmural myocardial infarction, we used coronary arteriography to study the degree of coronary obstruction in 322 patients admitted within 24 hours of infarction. Total coronary occlusion was observed in 110 of 126 patients (87 per cent) who were evaluated within four hours of the onset of symptoms; this proportion decreased significantly, to 37 of 57 (65 per cent), when patients were studied 12 to 24 hours after the onset of symptoms. Among 59 patients with angiographic features of coronary thrombosis, the thrombus was retrieved by Fogarty catheter in 52 (88 per cent) but was absent in seven (12 per cent false positive). Among an additional 20 patients without angiographic features of thrombosis, a thrombus was discovered in five (25 per cent false negative). Thus, total coronary occlusion is frequent during the early hours of transmural infarction and decreases in frequency during the initial 24 hours, suggesting that coronary spasm or thrombus formation with subsequent recanalization or both may be important in the evolution of infarction.

https://www.nejm.org/doi/pdf/10.1056/NEJM198010163031601?listPDF=true

Prevalence of Total Coronary Occlusion during the Early Hours of Transmural Myocardial Infarction

Objective: To assess the prognostic significance of left ventricular mass and geometry in initially healthy persons with essential hypertension. Design: An observational study of a prospectively id...

Relation of Left Ventricular Mass and Geometry to Morbidity and Mortality in Uncomplicated Essential Hypertension

Removal of Fatty Acids from Serum Albumin by Charcoal Treatment

Physical and mental health effects of intimate partner violence for men and women.

Physical and Mental Health Effects of Intimate Partner Violence for Men and Women

Titration of free fatty acids of plasma: a study of current methods and a new modification.

A point-score system for the ECG diagnosis of left ventricular hypertrophy

Evidence collected over the last 20 years indicates that physical and sexual violence against women is an enormous problem. Much of this violence is perpetrated by women's intimate partners or in relationships that would presumably carry some protective aura (eg, father-daughter, boyfriend-girlfriend). This violence carries with it both short- and long-term sequelae for women and affects both their physical and psychological well-being. The high prevalence of violence against women brings them into regular contact with physicians; at least one in five women seen in emergency departments has symptoms relating to abuse. However, physicians frequently treat the injuries only symptomatically or fail to recognize the injuries as abuse. Even when recognized, physicians are often without resources to address the needs of abused women. This report documents the extent of violence against women and suggests paths that the physician community might take to address the needs of victims. (JAMA. 1992;267:3184-3189)

https://jamanetwork.com/journals/JAMA/articlepdf/397899/jama_267_23_032.pdf

Violence Against Women: Relevance for Medical Practitioners

Electrocardiographic analysis of the P waves occurring in a series of 113 normal subjects and 100 patients with specifically defined valvular lesions are reviewed. The former methods of analysis showed a marked lack of specificity. By dividing the P wave in lead V1 into initial and terminal portions, a measure designated as the P terminal force has been derived. This measure is of value in two respects: (1) it correctly separates normal subjects from those patients with left-sided valvular lesions in 92 per cent of this series and (2) once a given valve lesion is suspected clinically, this measure enables one to make an estimation of the severity of that lesion from the degree of abnormality of the P terminal force at V1. The P terminal force does not indicate the type of valvular disease present, nor does it correlate with any one specific hemodynamic measure. The abnormality does appear to be related, within each separate type of valve disease, to the specific hemodynamic abnormality of that type of val...

P-wave analysis in valvular heart disease.

Physical activity has been associated with the prevention and control of several medial conditions that are major causes of death and disability in the United States. The criterion-based approach adopted by the US Preventive Services Task Force is used to objectively evaluate the evidence regarding the effectiveness of physical activity counseling for healthy adults as a primary preventive intervention in the clinical setting. This evaluation addresses: (1) the burden of suffering attributable to physical inactivity; (2) the efficacy of physical activity in disease prevention in regard to six medical conditions; and (3) the characteristics of the intervention in terms of simplicity, cost, safety, acceptability, and patient compliance. Based on consideration of the evidence for each of these issues, specific recommendations are made regarding the role of physical activity counseling in routine clinical practice. In addition, practical guidelines are presented to aid clinicians in physical activity counseling.

Physical Activity Counseling for Healthy Adults as a Primary Preventive Intervention in the Clinical Setting: Report for the US Preventive Services Task Force

E. Harvey Estes

Papers

Titration of free fatty acids of plasma: a study of current methods and a new modification.

A point-score system for the ECG diagnosis of left ventricular hypertrophy

Violence Against Women: Relevance for Medical Practitioners

P-wave analysis in valvular heart disease.

Physical Activity Counseling for Healthy Adults as a Primary Preventive Intervention in the Clinical Setting: Report for the US Preventive Services Task Force