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Biomedical subjects

C Gladstone

Publications and source records attributed to C Gladstone.

5 recordsLinked to original sources

Higher prevalence and greater severity of coronary disease in short versus tall men referred for coronary arteriography.

The incidence of myocardial infarction is higher in short individuals than in tall ones. To test whether the prevalence and severity of coronary disease is greater in short than in tall individuals, we compared a group of short men (height < [mean height - one SD]) to a group of tall men (height > [mean height + one SD]) drawn from a sample of 1046 consecutive men referred for coronary arteriography. Short men had a higher frequency of > or = 50% diameter stenosis; more diseased vessels (1.61 +/- 1.09 vs 1.15 +/- 1.11, p = 0.0004); a higher frequency of three-vessel disease (26.8% vs 16.1%, p = 0.04); and more total occlusions (40.1% vs 27.3%, p = 0.03). By multivariate analysis, height independently predicted > or = 50% lesions in the right coronary artery (p = 0.01) and left anterior descending artery (p = 0.06); three-vessel disease (p = 0.04); total occlusion (p = 0.04); and the number of diseased vessels (p = 0.005). This higher prevalence and greater severity of coronary disease may explain the higher incidence of and deaths caused by myocardial infarction previously reported in short men.

Aged↗

Spectral analysis of demodulated ultrasound returns: detection of scatterer periodicity and application to tissue classification.

Ultrasound returns from tissue display variations in amplitude on several spatial scales. Although large-scale variations result from factors such as attenuation, variations on smaller scales are caused by tissue characteristics such as variations in scatterer spacing and reflectance. These small scale variations cause a corresponding variation in the amplitude of the ultrasound return. A simple and direct method for detecting and quantifying periodicity in these variations in the presence of attenuation is described. The radiofrequency ultrasound return is first demodulated by full-wave rectification. The normalized power spectrum of the demodulated return then yields an index that we call the relative Fourier energy. Both computer simulations and in vitro experiments were performed in order to study how relative Fourier energy performed in discriminating between periodic and random scatterer distributions. Computer simulations demonstrated significant differences between the returns from periodic and random scatterer distributions. Ultrasound returns from aortic tissue yielded a relative Fourier energy index that was significantly different between normal vs. atherosclerotic tissue (normal: 0.868 +/- 0.076, mean +/- s.d., fibrofatty plaque: 0.705 +/- 0.109, p < 0.01 vs. normal, calcified plaque: 0.753 +/- 0.078, p < 0.01 vs. normal). In contrast, no difference was found in comparisons of overall reflectance.

Aorta, Thoracic↗

Effect of coronary artery size on the prevalence of atherosclerosis.

To investigate the effect of coronary artery size on the prevalence of atherosclerosis, we measured the diameters of the major coronary arteries prospectively in 884 consecutive patients referred for coronary arteriography. For each artery, we assigned patients to 3 groups: group S (small) and group L (large) with diameters >1SD smaller and larger, respectively, than the mean; and group A (average), with diameters within 1SD of the mean. As specified during study design, we compared the frequency of lesions > or = 50% diameter stenosis in groups S and L for each artery. We adjusted for relevant covariates by performing logistic regression on data from all 884 patients with coronary diameter entered as a continuous variable. In group S versus L, respectively, the frequency of > or = 50% lesion was 6.5% versus 2.4% (p = 0.13) in the left main artery; 61.3% versus 35.8% (p = 0.0001) in the right coronary artery; 58.1% versus 40.7% (p = 0.008) in the left anterior descending artery, and 47.4% versus 22.2% (p = 0.0001) in the circumflex artery. Multivariate analysis showed that coronary diameter was a significant independent predictor of lesions in the right coronary artery (p = 0.000001), left anterior descending artery (p = 0.001), and circumflex artery (p = 0.0002) and nearly significant in the left main artery (p = 0.077). Thus, small coronary artery size may be a risk factor for atherosclerosis.

Aged↗

Orientation programs for nurse-adult learners: fostering a sense of community.

Are you searching for ways to create a sense of community among the students and faculty in your program? The authors find that an orientation that combines humor, warmth, empathy, and introduces the concept that students and faculty share the identity of "adult learner" is key to developing a community of scholars. Based on their experience, the authors describe three principles for developing an orientation program for nurse-adult learners that can be adapted to other educational settings.

Education, Nursing↗