Standardized ultrasound evaluation of carotid stenosis for clinical trials: University of Washington Ultrasound Reading Center

<p>Abstract</p> <p>Introduction</p> <p>Serial monitoring of patients participating in clinical trials of carotid artery therapy requires noninvasive precision methods that are inexpensive, safe and widely available. Noninvasive ultrasonic duplex Doppler velocimetry provides a precision method that can be used for recruitment qualification, pre-treatment classification and post treatment surveillance for remodeling and restenosis. The University of Washington Ultrasound Reading Center (UWURC) provides a uniform examination protocol and interpretation of duplex Doppler velocity measurements.</p> <p>Methods</p> <p>Doppler waveforms from 6 locations along the common carotid and internal carotid artery path to the brain plus the external carotid and vertebral arteries on each side using a Doppler examination angle of 60 degrees are evaluated. The UWURC verifies all measurements against the images and waveforms for the database, which includes pre-procedure, post-procedure and annual follow-up examinations. Doppler angle alignment errors greater than 3 degrees and Doppler velocity measurement errors greater than 0.05 m/s are corrected.</p> <p>Results</p> <p>Angle adjusted Doppler velocity measurements produce higher values when higher Doppler examination angles are used. The definition of peak systolic velocity varies between examiners when spectral broadening due to turbulence is present. Examples of measurements are shown.</p> <p>Discussion</p> <p>Although ultrasonic duplex Doppler methods are widely used in carotid artery diagnosis, there is disagreement about how the examinations should be performed and how the results should be validated. In clinical trails, a centralized reading center can unify the methods. Because the goals of research examinations are different from those of clinical examinations, screening and diagnostic clinical examinations may require fewer velocity measurements.</p

M76-121: Pencil Sketch

Pencil sketch of Senator Mansfield with Pipe by Hank Sevaried.https://scholarworks.umt.edu/mansfieldartifacts/1549/thumbnail.jp

CBS Radio News Analysis

CBS Radio News commentary about Hays' loss in the Congressional electio

CBS Radio News Analysis - Page 2

CBS Radio News commentary about Hays' loss in the Congressional electionPage 2 the sticker was handed out to voters as they entered the polling places, and was attached to a printed plug for Alford, the was another law violation; that the law was further violated because there was no party designation after Alford’s name nor the word“independent.” The state laws appear pretty specific on these points. The further question is raised that Alford may have broken another law by running against the duly nominated Democratic Party candidate after he himself had registered as a Democrat and so voted in the primary. In some states that would mean dismissal from the party. The last conjecture will be looked into by those Democrats in the House who are determined to try to forbid any Democratic committee assignments to Alford, even if his election is not challenged and he does take his seat. His would not be the hot seat, exactly; it would be the cold and lonely seat of a man unwanted by the majority of either party, a man who has helped destroy the political career of one of the chamber’s most popular and respected members. Alford, of course, is small fry. But Arkansas’ Senator Fulbright, the potential chairman of the Foreign Relations Committee, is not. He does not come up for re-election for another four years, but there is little doubt that his name is next in the Faubus black book; and unless the conditions of both Faubus and Arkansas sentiment change radically in the next four years, the Fulbright career, too, could be cut off just as it reaches its zenith of influence. This is Eric Sevareid in Washington