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Publications (4)10.12 Total impact

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    ABSTRACT: Medical art therapy (MAT) enables people who are medically ill to express their feelings through art. In heart failure (HF) depression and anxiety are common. To evaluate the influence of guided group MAT on the quality of Life and compliance to medical therapy of patients with advanced HF. Twenty advanced HF patients were randomly divided into two groups: ten in the intervention group (A) and ten in the control group (B). First and last visits were individual. During these visits the Ulman, (a MAT diagnostic tool), the Minnesota Living with HF and compliance questionnaires were recorded. Both groups met weekly for 6 weeks. A MAT therapist guided group A to express their feelings using art material. Group B met for a routine clinical visit only. Baseline Ulman, compliance and Minnesota scores were similar amongst the two groups. By the end of the study, the Ulman score improved significantly in group A compared to group B (95 +/- 10 to 82 +/- 14 p = 0.0006 vs. 86 +/- 10 to 81 +/- 12 p = 0.5) as was the compliance score (29 +/- 11 to 33 +/- 13 p = 0.05 vs. 36 +/- 5 to 366 p = 0.9). In group A, the Minnesota score improved significantly in 7 patients and did not change in 3, while in group B it improved in 2, did not change in 6 and worsened in 2. MAT improves the quality of life and compliance in advanced HF patients and it is recommended that it be integrated as part of the therapeutic arsenal in every HF clinic.
    Harefuah 02/2011; 150(2):79-83, 209.
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    ABSTRACT: Patients with rheumatic mitral valve disease (n = 48) underwent treadmill stress echocardiography and were classified as those with mitral stenosis (n = 24) or those with mitral regurgitation with mild mitral stenosis (n = 24). Despite marked differences in mitral valve area (1.1 +/- 0.3 vs 2.1 +/- 0.6 cm(2), respectively; p <0.0001), systolic tricuspid gradients were similar both at rest (37 +/- 11 vs 37 +/- 13 mm Hg) and at peak exercise (60 +/- 16 vs 55 +/- 13 mm Hg, respectively). Following stress echocardiography, an invasive procedure or modification of medical treatment was performed or recommended in 51% of the study patients.
    The American Journal of Cardiology 04/2004; 93(8):1060-3. · 3.21 Impact Factor
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    ABSTRACT: Although mitral annulus calcification (MAC) has been reported to be a significant independent predictor of stroke, no causative relationship was proven. It is also known that aortic atheroma (AA), especially those >/=5 mm thick and/or protruding and/or mobile are associated with stroke. This study was designed to determine whether an association exists between MAC and AA. We prospectively evaluated the records of 279 consecutive patients who underwent transesophageal echocardiography (TEE) for various indications to measure the presence and characteristics of AA. The 105 patients in whom a diagnosis of MAC was made on transthoracic echocardiography (TTE) immediately preceding the TEE, were compared with 174 age-matched patients without MAC. MAC was defined as a dense, localized, highly reflective area at the base of the posterior mitral leaflet. We measured MAC thickness with two-dimensional-TTE in four-chamber view and AA thickness, protrusion and mobility with TEE. AA was defined as localized intimal thickening of >/=3 mm. A lesion was considered complex if there was plaque extending >/=5 mm into the aortic lumen and/or if it was protruding, mobile or ulcerated. No differences were found between the groups in risk factors for atherosclerosis or in indications for referral for TEE. Significantly higher rates were found in the MAC group for prevalence of AA (91 vs. 44%, P<0.001), atheromas >/=5 mm thick (68 vs. 19%, P<0.001), protruding atheromas (44 vs. 15%, P<0.001), ulcerated atheromas (10 vs. 1%, P<0.001) and complex atheroma (74 vs. 22%, P<0.001). Sixty patients had MAC thickness >/=6 mm and 45<6 mm. AA thickness was significantly greater in the patients with a MAC thickness of >/=6 mm (6.1+/-2.8 vs. 5.0+/-2.6 mm, P=0.03). On multivariate analysis MAC, hypertension and age were the only independent predictors of AA (P=0.0001, 0.005 and 0.007, respectively). There is a significant association between the presence and severity of MAC and AA. MAC may be an important marker for atherosclerosis of the aorta. This association may explain in part the high prevalence of systemic emboli and stroke in patients with MAC.
    Atherosclerosis 10/2000; 152(2):451-6. · 3.71 Impact Factor
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    ABSTRACT: Aortic valve calcium without stenosis and mitral annulus calcium (MAC) are known to correlate with atherosclerotic risk factors. Recently, it has been reported that MAC is associated with atherosclerosis of the cardiovascular system, suggesting MAC as an atherosclerotic process by itself. Hence, the aim of the present study was to determine whether a similar association between aortic valve calcium and aortic atheroma exists. Ninety-six patients (54 men and 42 women, mean age 72 +/- 12 years) with aortic valve calcium who underwent transesophageal echocardiography (TEE) formed the study group. They were compared with 92 sex- and age-matched patients without aortic valve calcium who underwent TEE for the same indications during the same period. The presence and echocardiographic features of aortic atheromas were evaluated by TEE. No differences were found between the groups in risk factors for atherosclerosis or in indications for referral for TEE. Significantly higher rates were found in the aortic valve calcium group for prevalence of aortic atheroma (86% vs 30%, p = 0.001). This significant trend was also consistent with the dimension and complexity of the atheromas. On multivariate analysis aortic valve calcium, and MAC were the only independent predictors of aortic atheroma (p = 0.0001, 0.006 respectively). We conclude that there is a significant association between the presence of aortic valve calcium and the presence and severity of aortic atheroma. Thus, aortic valve calcium may serve as a window to atherosclerosis of the aorta.
    The American Journal of Cardiology 08/2000; 86(1):68-71. · 3.21 Impact Factor