Institution
Saint Louis University
Education•St Louis, Missouri, United States•
About: Saint Louis University is a education organization based out in St Louis, Missouri, United States. It is known for research contribution in the topics: Population & Health care. The organization has 18927 authors who have published 34895 publications receiving 1267475 citations. The organization is also known as: SLU & St. Louis University.
Topics: Population, Health care, Poison control, Transplantation, Medicine
Papers published on a yearly basis
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TL;DR: Flow velocity measurements may be performed distal to a coronary stenosis with the Doppler guide wire and changes in distal flow velocity patterns and diastolic/systolic velocity ratio appeared to be more relevant than the hyperemic response in assessing the immediate physiologic outcome of coronary angioplasty.
281 citations
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TL;DR: Two technologically diverse functional measures of stenosis severity--Doppler-derived poststenotic hyperemic intracoronary flow reserve and vasodilator stress 99mTc-sestamibi myocardial perfusion imaging--are highly correlated.
Abstract: BACKGROUND The physiological assessment of angiographically intermediate-severity stenoses remains problematic. Functional measurements of poststenotic intracoronary Doppler coronary flow reserve can be performed in humans but have not been correlated with hyperemic myocardial perfusion imaging or angiographic data in this patient population.
METHODS AND RESULTS Thirty-three patients undergoing diagnostic quantitative coronary angiography (QCA) for assessment of intermediate-severity coronary artery disease (mean QCA percent diameter stenosis, 56 +/- 14%) were studied. Proximal and distal poststenotic Doppler coronary flow velocities were measured (left anterior descending coronary artery, 16; right coronary artery, 10; left circumflex artery, 7 patients) before and during peak maximal hyperemia with intracoronary adenosine (8 to 12 micrograms). Intravenous pharmacological stress (adenosine, 20 patients; dipyridamole, 13 patients) 99mTc-sestamibi tomographic perfusion imaging was performed within 1 week of coronary flow-velocity studies. kappa statistics were calculated to measure the strength of correlation among coronary flow velocities, perfusion imaging data, and QCA results. QCA stenosis severity (abnormal, > or = 50% diameter stenosis) and poststenotic Doppler coronary flow reserve (ratio of abnormal distal hyperemic to basal flow, < or = 2.0) were correctly correlated in 20 of 27 patients (74%; kappa = .48). QCA stenosis severity and 99mTc-sestamibi imaging (abnormal if one or more reversible myocardial segments were present in the poststenotic zone) were correlated in 28 of 33 patients (85%; kappa = .63). 99mTc-sestamibi imaging results agreed with the basal (nonhyperemic) proximal-to-distal velocity ratio (normal, < 1.7) in 15 of 31 patients (48%; kappa = .17). The strongest correlation occurred between hyperemic distal flow-velocity ratio measurements and 99mTc-sestamibi perfusion imaging results in 24 of 27 patients (89%; kappa = .78). All 14 patients with abnormal distal hyperemic flow-velocity values had corresponding reversible 99mTc-sestamibi tomographic defects. More reversibly hypoperfused segments were present in patients with abnormal poststenotic hyperemic flow-velocity ratios (abnormal, 2.4 +/- 0.7 segments; normal, 0.6 +/- 1.0 segments; P < .05). The number of poststenotic myocardial 99mTc-sestamibi perfusion defects was correlated with the QCA percent cross-sectional area reduction (P < .02) and with minimal luminal diameter (P < .05) of intermediate-severity coronary artery stenoses.
CONCLUSIONS Two technologically diverse functional measures of stenosis severity--Doppler-derived poststenotic hyperemic intracoronary flow reserve and vasodilator stress 99mTc-sestamibi myocardial perfusion imaging--are highly (89%) correlated. The physiological assessment of coronary stenoses of angiographically intermediate severity may be improved by the use of these techniques.
281 citations
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TL;DR: The results suggest that acute nicotine shares with other drugs of abuse the characteristic of being more effective in stimulating A10 than A9 neurons, and that dopamine receptors are not directly involved in the nicotinic action.
281 citations
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TL;DR: O Ongoing clinical trials are focused on an array of disease mechanisms and reviewed here are how these treatments fit into the current paradigm of substrate overload lipotoxic liver injury.
Abstract: Non-alcoholic fatty liver disease has emerged a major challenge because of it prevalence, difficulties in diagnosis, complex pathogenesis, and lack of approved therapies. As the burden of hepatitis C abates over the next decade, non-alcoholic fatty liver disease will become the major form of chronic liver disease in adults and children and could become the leading indication for liver transplantation. This overview briefly summarizes the most recent data on the pathophysiology, diagnosis, and treatment of non-alcoholic fatty liver disease. Ongoing clinical trials are focused on an array of disease mechanisms and reviewed here are how these treatments fit into the current paradigm of substrate overload lipotoxic liver injury. Many of the approaches are directed at downstream events such as inflammation, injury and fibrogenesis. Addressing more proximal processes such as dysfunctional satiety mechanisms and inappropriately parsimonious energy dissipation are potential therapeutic opportunities that if successfully understood and exploited would not only address fatty liver disease but also the other components of the metabolic syndrome such as obesity, diabetes and dyslipidemia.
280 citations
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Royal Melbourne Hospital1, Scripps Research Institute2, University of Hamburg3, University of Toronto4, Indiana University5, Pennsylvania State University6, University of the Witwatersrand7, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico8, Istituto Italiano di Tecnologia9, Tsinghua University10, National Institutes of Health11, National University of Singapore12, Peking University13, Saint Louis University14, University of Freiburg15, French Institute of Health and Medical Research16
TL;DR: The International Coalition to Eliminate HBV (ICE-HBV) as mentioned in this paper is a coalition of experts dedicated to accelerating the discovery of a cure for chronic hepatitis B. Following extensive consultation with more than 50 scientists from across the globe, as well as key stakeholders including people affected by HBV, they have identified gaps in our current knowledge and new strategies and tools that are required to achieve HBV cure.
280 citations
Authors
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Name | H-index | Papers | Citations |
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Douglas G. Altman | 253 | 1001 | 680344 |
John E. Morley | 154 | 1377 | 97021 |
Roberto Romero | 151 | 1516 | 108321 |
Daniel S. Berman | 141 | 1363 | 86136 |
Gregory J. Gores | 141 | 686 | 66269 |
Thomas J. Smith | 140 | 1775 | 113919 |
Richard T. Lee | 131 | 810 | 62164 |
George K. Aghajanian | 121 | 277 | 48203 |
Reza Malekzadeh | 118 | 900 | 139272 |
Robert N. Weinreb | 117 | 1124 | 59101 |
Leslee J. Shaw | 116 | 808 | 61598 |
Thomas J. Ryan | 116 | 675 | 67462 |
Josep M. Llovet | 116 | 399 | 83871 |
Robert V. Farese | 115 | 473 | 48754 |
Michael Horowitz | 112 | 982 | 46952 |