The Value of Claims-Based Nontraditional Risk Factors in Predicting Long-term Mortality After MitraClip Procedure

Background

We sought to identify nontraditional risk factors coded in administrative claims data and evaluate their ability to improve prediction of long-term mortality in patients undergoing percutaneous mitral valve repair.

Quantitative oxygen measurements before and after intravascular guanethidine blocks

In 11 patients oxygen pressure was measured transcutaneously before and after treatment with regional intravascular sympathetic blocks in extremities with pain, impairment of function, and/or dystrophy. In 50 normal individuals PO2 levels were determined in the hand. All patients showed lower than normal values before treatment. Subjective complaints were registered by means of a questionnaire before and after treatment. Improvement of PO2 levels was observed after treatment in eight out of 11 patients while complaints disappeared. Three out of 11 patients showed no improvement of PO2 levels or any lessening of complaints. Control PO2 values in the contralateral limbs stayed on the same level as before treatment in all patients. From the results in this article it can be stated that TcPO2 measurements seem to be helpful in (1) evaluating the pretreatment microvascular state of the affected limb and (2) judging the efficacy of the block.     

Recurrent psychotic depression. Evidence of diagnostic stability

A review of the research comparing psychotic and nonpsychotic depression gives considerable evidence to support the view that these groups are distinct diagnostic subtypes. A representative sample of the research favoring this view is presented. Particular note is made of Charney and Nelson's data on stability of diagnosis. Our finding of 92.3% of psychotic depressives experiencing previous and/or subsequent psychotic episodes is consistent with Charney and Nelson's findings. Additional support for stability of diagnosis is the rare occurrence of nonpsychotic depression found after the index psychotic admission. Clinical and research implications are discussed.