[Note from the editor]

The MCV Quarterly ceases publication with this issue. No journal of this type can be self-supporting and we bow to the inevitable reality of inflation. The idea of the Quarterly came from Sami Said. Almost single handed he cajoled and coerced the Dean of the School of Medicine into finding the money for publication. Throughout its existence MCV/Q has remained true to its stated purpose of disseminating “scientific information from all sources”, resisting several attempts to convert it into a “house journal” or popular newssheet. In essence, it has been the printed pivot of continuing education in the medical school

The Changing Pattern of General Practice and Its Educational Implications

The results of a mail questionnaire sent to members of the Virginia Academy of General Practice demonstrate the changes occurring in the content of family practice. Practitioners in small towns practice more obstetrics and less internal medicine than those in large cities, and conversely. The implications for training in general practice are discussed

The Gay Nineties: Oscar Wilde Reconsidered

Sex and hypocrisy have always been bedmates, but never more than in Victorian England. In the “Gay Nineties” promiscuity was widely accepted in all social classes, although the aristocracy hid its lust behind a strict code of propriety. Country house parties catered to infidelities with the approval of the Prince of Wales, himself a notorious womanizer

Selected manufacturing cost control functions and their application to casualty insurance office operations

Thesis (M.B.A.)--Boston Universit

Book Review

Book reviews for Epidemics, Geoffrey Marks and William K. Beatty, Scribner\u27s, 1976 and Plagues and Peoples, William H. McNeill, Doubleday, 1976

Book Review

Book review for New Words for Old, Philip Howard, Oxford University Press, 1977

Introduction

For many years the pathology department at the Medical College of Virginia has been an important center for studies in paleopathology. Over the past ten years members of the department have collaborated with numerous investigators both in the United States and abroad, giving seminars and training to physicians, anthropologists, and archaeologists. In the spring of 1977, a symposium was organized at the annual meeting of the American Association of Physical Anthropologists in Seattle, Washington, to bring together investigators in the area of paleoepidemiology. At this meeting researchers from MCV and other institutions attempted to correlate data from a variety of sources and provide scholars in many disciplines with a resume of some disease manifestations of varied etiologies

Survival after hospital discharge for ST-segment elevation and non-ST-segment elevation acute myocardial infarction: a population-based study

BACKGROUND: Limited recent data are available describing differences in long-term survival, and factors affecting prognosis, after ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI), especially from the more generalizable perspective of a population-based investigation. The objectives of this study were to examine differences in post-discharge prognosis after hospitalization for STEMI and NSTEMI, with a particular focus on factors associated with reduced long-term survival. METHODS: We reviewed the medical records of residents of the Worcester, MA, USA metropolitan area hospitalized at eleven central Massachusetts medical centers for acute myocardial infarction (AMI) during 2001, 2003, 2005, and 2007. RESULTS: A total of 3762 persons were hospitalized with confirmed AMI; of these, 2539 patients (67.5%) were diagnosed with NSTEMI. The average age of study patients was 70.3 years and 42.9% were women. Patients with NSTEMI experienced higher post-discharge death rates with 3-month, 1-year, and 2-year death rates of 12.6%, 23.5%, and 33.2%, respectively, compared to 6.1%, 11.5%, and 16.4% for patients with STEMI. After multivariable adjustment, patients with NSTEMI were significantly more likely to have died after hospital discharge (adjusted hazards ratio 1.28; 95% confidence interval 1.14-1.44). Several demographic (eg, older age) and clinical (eg, history of stroke) factors were associated with reduced long-term survival in patients with NSTEMI and STEMI. CONCLUSIONS: The results of this study in residents of central Massachusetts suggest that patients with NSTEMI are at higher risk for dying after hospital discharge, and several subgroups are at particularly increased risk

Trends in the medical management of patients with heart failure

BACKGROUND: Despite the availability of effective therapies, heart failure (HF) remains a highly prevalent disease and the leading cause of hospitalizations in the U.S. Few data are available, however, describing changing trends in the use of various cardiac medications to treat patients with HF and factors associated with treatment. The objectives of this population-based study were to examine decade-long trends (1995 - 2004) in the use of several cardiac medications in patients hospitalized with acute decompensated heart failure (ADHF) and factors associated with evidence-based treatment. METHODS: We reviewed the medical records of 9,748 residents of the Worcester, MA, metropolitan area who were hospitalized with ADHF at all 11 central Massachusetts medical centers in 1995, 2000, 2002, and 2004. RESULTS: Between 1995 and 2004, respectively, the prescription upon hospital discharge of beta-blockers (23%; 67%), angiotensin pathway inhibitors (47%; 55%), statins (5%; 43%), and aspirin (35%; 51%) increased markedly, while the use of digoxin (51%; 29%), nitrates (46%; 24%), and calcium channel blockers (33%; 22%) declined significantly; nearly all patients received diuretics. Patients in the earliest study year, those with a history of obstructive pulmonary disease or anemia, incident HF, non-specific symptoms, and women were less likely to receive beta blockers and angiotensin pathway inhibitors than respective comparison groups. In 2004, 82% of patients were discharged on at least one of these recommended agents; however, only 41% were discharged on medications from both recommended classes. CONCLUSIONS: Our data suggest that opportunities exist to further improve the use of HF therapeutics

Six-month mortality rates are lower in patients with an acute coronary syndrome treated with the combination of clopidogrel and a statin than in patients treated with either therapy alone: An analysis from the global registry of acute coronary events

La remunta la podem data de l'any 1928, aproximadament.Primer pla d'un edifici d'habitages, inicialment de planta baixa i pis, en què es remunten tres plantes en la part de la parcel·la que forma xamfrà a tres carrers. La remunta forma un volum molt potent que revalora estèticament l'edifici