Book Reviews

Afghanistan: Transition Under Threat. By Geoffrey Hayes and Mark Sedra, editors. Enemies of Intelligence: Knowledge & Power in American National Security. By Richard K. Betts

Book Reviews

Critical Thinking and Intelligence Analysis. By David T.Moore. At The Center Of The Storm: The CIA During America\u27s Time of Crisis. By George Tenet with Bill Harlow. Female Suicide Bombers. By Rosemarie Skaine. Information Operations: Doctrine and Practice. By Christopher Paul. The Secret Sentry: The Untold History of the National Security Agency. By Matthew M. Aid. The Blood of Lambs: A Former Terrorist\u27s Memoir of Death and Redemption. By Kamal Saleem with Lynn Vincent. Attaché Extraordinaire: Vernon A. Walters in Brazil. By Frank Márcio De Oliveira

Book Reviews

Critical Thinking and Intelligence Analysis. By David T.Moore. At The Center Of The Storm: The CIA During America's Time of Crisis. By George Tenet with Bill Harlow. Female Suicide Bombers. By Rosemarie Skaine. Information Operations: Doctrine and Practice. By Christopher Paul. The Secret Sentry: The Untold History of the National Security Agency. By Matthew M. Aid. The Blood of Lambs: A Former Terrorist's Memoir of Death and Redemption. By Kamal Saleem with Lynn Vincent. Attaché Extraordinaire: Vernon A. Walters in Brazil. By Frank Márcio De Oliveira

Valvular regurgitation and surgery associated with fenfluramine use: an analysis of 5743 individuals

<p>Abstract</p> <p>Background</p> <p>Use of fenfluramines for weight loss has been associated with the development of characteristic plaques on cardiac valves causing regurgitation. However, previously published studies of exposure to fenfluramines have been limited by relatively small sample size, short duration of follow-up, and the lack of any estimate of the frequency of subsequent valvular surgery. We performed an observational study of 5743 users of fenfluramines examined by echocardiography between July 1997 and February 2004 in a single large cardiology clinic.</p> <p>Results</p> <p>The prevalence of at least mild aortic regurgitation (AR) or moderate mitral regurgitation (MR) was 19.6% in women and 11.8% in men (<it>p </it>< 0.0001 for gender difference). Duration of use was strongly predictive of mild or greater AR (<it>p </it>< 0.0001 for trend), MR (<it>p </it>= 0.002), and tricuspid regurgitation (TR) (<it>p </it>< 0.0001), as was earlier scan date (<it>p </it>< 0.0001 for those scanned prior to 1 January 2000 versus later). Increasing age was also independently associated with increased risk of AR and MR (both <it>p </it>< 0.0001). With mean follow-up of 30.3 months, AR worsened in 15.2%, remained the same in 63.1%, and improved in 21.7%. Corresponding values for MR were 24.8%, 47.4% and 27.9%. Pulmonary hypertension was strongly associated with MR but not AR. Valve surgery was performed on 38 patients (0.66% of 5743), 25 (0.44%) with clear evidence of fenfluramine-related etiology.</p> <p>Conclusion</p> <p>Regurgitant valvulopathy was common in individuals exposed to fenfluramines, more frequent in females, and associated with duration of use in all valves assessed. Valve surgery was performed as frequently for aortic as mitral valves and some tricuspid valve surgeries were also performed. The incidence of surgery appeared to be substantially increased compared with limited general population data.</p

Book Reviews

Afghanistan: Transition Under Threat. By Geoffrey Hayes and Mark Sedra, editors. Enemies of Intelligence: Knowledge & Power in American National Security. By Richard K. Betts

Book Reviews

Afghanistan: Transition Under Threat. By Geoffrey Hayes and Mark Sedra, editors. Enemies of Intelligence: Knowledge & Power in American National Security. By Richard K. Betts

Book Reviews

Afghanistan: Transition Under Threat. By Geoffrey Hayes and Mark Sedra, editors. Enemies of Intelligence: Knowledge & Power in American National Security. By Richard K. Betts

The court book of the barony of Urie in Kincardineshire 1604-1747.

"The lairds of Urie, 1430-1892": p. 185-196.Mode of access: Internet

Book Reviews

Critical Thinking and Intelligence Analysis. By David T.Moore. At The Center Of The Storm: The CIA During America\u27s Time of Crisis. By George Tenet with Bill Harlow. Female Suicide Bombers. By Rosemarie Skaine. Information Operations: Doctrine and Practice. By Christopher Paul. The Secret Sentry: The Untold History of the National Security Agency. By Matthew M. Aid. The Blood of Lambs: A Former Terrorist\u27s Memoir of Death and Redemption. By Kamal Saleem with Lynn Vincent. Attaché Extraordinaire: Vernon A. Walters in Brazil. By Frank Márcio De Oliveira