The American journal of the medical sciences
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Glycated hemoglobin A1c (A1C) levels have traditionally been the gold standard for assessing glycemic control and treatment efficacy in patients with type 2 diabetes. However, A1C does not take into account fluctuations in blood glucose levels known as glycemic variability (GV). In recent years, GV has become increasingly clinically relevant, because of a better understanding of the need to reach target A1C while avoiding hypoglycemia. ⋯ Diabetes treatments targeting multiple pathophysiological mechanisms are most beneficial in controlling A1C and reducing GV. In clinical trials, a number of metrics are used to measure GV, many of which are not well understood in the clinical practice. Until a gold standard metric for GV is established, the variety of measurements available may confound the choice of an optimal treatment for an individual patient.
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Hypertrophic cardiomyopathy is a primary cardiac disease characterized by left ventricular hypertrophy, myocyte hypertrophy and irregularities and interstitial fibrosis in the absence of any cardiac or systemic diseases and may lead to sudden cardiac death (SCD). Galectin-3 is a β-galactoside-binding lectin that has been associated with cardiac fibrosis and inflammation. In this study, we aimed to investigate the relationship between serum galectin-3 levels and the criteria for 5-year sudden death risk, recently defined in the European Society of Cardiology guidelines (2014), in patients with hypertrophic cardiomyopathy. ⋯ Galectin-3 may be an inexpensive and easily accessible parameter to predict arrhythmia risk. In addition, it can be used to determine antiarrhythmic prophylaxis as a predictor of an arrhythmia storm in implantable cardioverter defibrillator-implanted patients who are not available for magnetic resonance imaging.
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Historical Article
"This is a Christian institution and we will tolerate no Jews here": The Brooklyn Medical Interns Hazings.
Anti-Semitic quotas to restrict access to medical school, graduate medical education and hospital privileges were common in the United States from the 1920s to the 1960s. In Brooklyn, New York, medical education prejudice resulted in violence. In 1916 a Jewish intern at Kings County Hospital, Matthew Olstein, was bound and gagged by Christian interns, put on a train at Grand Central Station, and warned that if he returned he would be thrown in the East River. ⋯ Six gentile physicians were charged with assault. Criminal proceedings and public investigations followed. These attacks are the only known episodes of violence associated with American medical education anti-Semitism.