Onassis Cardiac Surgery Center

Athens, Greece

Onassis Cardiac Surgery Center

Athens, Greece
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Farsalinos K.E.,Onassis Cardiac Surgery Center | Romagna G.,Abich s.r.l. Toxicological Laboratory
Clinical Medicine Insights: Case Reports | Year: 2013

Introduction: Smoking is a major risk factor for a variety of diseases. Electronic cigarettes are battery-operated devices that deliver nicotine to the lungs by evaporation of a liquid. Chronic idiopathic neutrophilia is a condition characterized by elevated white blood cell and neutrophil counts without any underlying disease; smoking has been implicated as a potential cause. Case Presentation: A male Caucasian patient, born in 1977, presented in September 2005 with asymptomatic elevation of white blood cell and neutrophil count, and mildly-elevated C-reactive protein levels. He was a smoker since 1996 and was treated with 20 mg/day of simvastatin since 2003 due to hyperlipidemia. Clinical examination, and laboratory and imaging investigations ruled out any infectious, haematological, rheumatological, or endocrine conditions. He was followed-up regularly and was advised to stop smoking. He had 2 unsuccessful attempts to quit smoking; one was unassisted and the second was performed with the use of both varenicline and nicotine replacement therapy (patches). During the subsequent 6.5 years, his leukocyte and C-reactive protein levels were repeatedly elevated; the condition was consistent with chronic idiopathic neutrophilia. In February 2012, he started using electronic cigarettes and he managed to quit smoking within 10 days. After 6 months, laboratory examination showed normalized leukocyte count and C-reactive protein levels, confirmed immediately by a second laboratory and by repeated tests after 1 and 2 months. Conclusion: Smoking cessation with the use of electronic cigarette led to reversal of chronic idiopathic neutrophilia. The daily use of electronic cigarette may help preserve the beneficial effects of smoking cessation. © the author(s), publisher and licensee Libertas Academica Ltd.

Farsalinos K.E.,Onassis Cardiac Surgery Center | Kistler K.A.,Pennsylvania State University | Gillman G.,Enthalpy Analytical Inc | Voudris V.,Onassis Cardiac Surgery Center
Nicotine and Tobacco Research | Year: 2015

Introduction: The purpose of this study was to evaluate sweet-flavored electronic cigarette (EC) liquids for the presence of diacetyl (DA) and acetyl propionyl (AP), which are chemicals approved for food use but are associated with respiratory disease when inhaled. Methods: In total, 159 samples were purchased from 36 manufacturers and retailers in 7 countries. Additionally, 3 liquids were prepared by dissolving a concentrated flavor sample of known DA and AP levels at 5%, 10%, and 20% concentration in a mixture of propylene glycol and glycerol. Aerosol produced by an EC was analyzed to determine the concentration of DA and AP. Results: DA and AP were found in 74.2% of the samples, with more samples containing DA. Similar concentrations were found in liquid and aerosol for both chemicals. The median daily exposure levels were 56 μg/day (IQR: 26-278 μg/day) for DA and 91 μg/day (IQR: 20-432 μg/day) for AP. They were slightly lower than the strict NIOSH-defined safety limits for occupational exposure and 100 and 10 times lower compared with smoking respectively; however, 47.3% of DA and 41.5% of AP-containing samples exposed consumers to levels higher than the safety limits. Conclusions: DA and AP were found in a large proportion of sweet-flavored EC liquids, with many of them exposing users to higher than safety levels. Their presence in EC liquids represents an avoidable risk. Proper measures should be taken by EC liquid manufacturers and flavoring suppliers to eliminate these hazards from the products without necessarily limiting the availability of sweet flavors. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.

Georgiadou P.,Onassis Cardiac Surgery Center | Adamopoulos S.,Onassis Cardiac Surgery Center
Current Heart Failure Reports | Year: 2012

Skeletal muscle abnormalities are well-established in patients with heart failure from an early stage in the progression of the disease and contribute to their symptoms and the limitation of physical activity. Heart failure-induced skeletal muscle pathology includes morphologic, histologic, and enzymatic changes along with derangements in skeletal muscle metabolism and autonomic function. These alterations influence both peripheral and ventilatory muscles, are present at rest, and deteriorate during exercise and their occurrence depends upon the severity and the duration of CHF syndrome. Future studies will be needed to elucidate the origin of skeletal "myopathy" and its reversibility, which is associated with improvement in exercise capacity, observed after physical training programs. © 2012 Springer Science+Business Media, LLC.

Chambers J.B.,Guys and St Thomas Hospitals | Pomar J.L.,University of Barcelona | Mestres C.A.,University of Barcelona | Palatianos G.M.,Onassis Cardiac Surgery Center
Journal of Thoracic and Cardiovascular Surgery | Year: 2013

Objective: The aim of the study was to establish clinical event rates for the On-X bileaflet mechanical heart valve (On-X Life Technologies Inc, Austin, Tex) using an audit of data from the 3 centers within Europe with the longest history of implanting. Methods: All patients receiving the On-X valve between March 1, 1998, and June 30, 2009, at 3 European centers were studied. Data were collected using questionnaire and telephone surveys augmented by outpatient visits and examination of clinical records. Results: There were 691 patients, with a mean age of 60.3 years, who received 761 valves in total: 407 mitral valve replacements, 214 aortic valve replacements, and 70 aortic + mitral valve replacements (dual valve replacement). Total follow-up was 3595 patient-years, with a mean of 5.2 years (range, 0-12.6 years). Early (≤30 days) mortality was 5.4% (mitral valve replacement), 0.9% (aortic valve replacement), and 4.3% (dual valve replacement). Linearized late (>30 days) mortality expressed per patient-year was 3.6% (mitral valve replacement), 2.2% (aortic valve replacement), and 4.1% (dual valve replacement), of which valve-related mortality was 0.5% (mitral valve replacement), 0.2% (aortic valve replacement), and 1.8% (dual valve replacement). Late linearized thromboembolism rates were 1.0% (mitral valve replacement), 0.6% (aortic valve replacement), 1.8% (dual valve replacement). Bleeding rates were 1.0% (mitral valve replacement), 0.4% (aortic valve replacement), and 0.9% (dual valve replacement). Thrombosis rates were 0.1% (mitral valve replacement), 0% (aortic valve replacement), and 0.3% (dual valve replacement). Reoperation rates were 0.6% (mitral valve replacement), 0.2% (aortic valve replacement), and 1.2% (dual valve replacement). Conclusions: The On-X valve has low adverse clinical event rates in longer-term follow-up (mean 5.2 years and maximum 12.6 years). Copyright © 2013 by The American Association for Thoracic Surgery.

Mavrogeni S.,Onassis Cardiac Surgery Center
Inflammation & allergy drug targets | Year: 2013

Rheumatoid arthritis (RA) affects many organs, including the heart. Cardiac magnetic resonance (CMR) can assess heart pathophysiology in RA. To evaluate, using CMR, RA patients under remission with recent onset of cardiac symptoms. Twenty RA under remission (15F/5M), aged 60±5 yrs, with recent onset of cardiac symptoms (RAH), were prospectively evaluated by CMR. The CMR included left ventricular ejection fraction (LVEF), T2-weighted (T2-W), early (EGE) and late gadolinium enhanced (LGE) images evaluation. Their results were compared with those of 20 RA under remission without cardiac symptoms (RAC) and 18 with systemic lupus erythematosus (SLE) with clinically overt myocarditis. Cardiac enzymes were abnormal in 5/20 RAH. CMR revealed inferior wall myocardial infarction in 2/20 (1M, 1F) and myocarditis in 13/20 (8M/5F) RAH. The T2 ratio of myocardium to skeletal muscle was increased in RAH and SLE compared to RAC (2.5 ± 0.05 and 3.4±0.7 vs 1.8 ± 0.5, p<0.001). EGE was increased in RAH and SLE compared to RAC (15 ± 3 and 12±4.7 vs 2.7±0.8, p<0.001). Epicardial LGEs were identified in 10/13 and pericarditis in 6/13 RAH. Coronary angiography, performed in 5 RAH with increased cardiac enzymes, proved a right coronary artery obstruction in 2/5. In 3/5 with CMR positive for myocarditis, coronary arteries were normal, but endomyocardial biopsy revealed inflammation with normal PCR. An RA relapse was observed after 7-40 days in 10/13 RAH with myopericarditis. The one year follow up showed that a) RAH with myocarditis had more disease relapses and b) CHF was developed in 4 RAH with myocarditis. Myopericarditis with atypical presentation, diagnosed by CMR in RA under remission, may precede the development of RA relapse. In 1 year follow up, RA patients with history of myocarditis have a higher frequency of disease relapse and may develop CHF.

Dimitroulas T.,Russells Hall Hospital | Mavrogeni S.,Onassis Cardiac Surgery Center | Kitas G.D.,University of Manchester
Nature Reviews Rheumatology | Year: 2012

Patients with systemic sclerosis (SSc) are at considerable risk of developing pulmonary arterial hypertension (PAH). PAH has a dramatic impact on the natural history of the disease and overall survival of the patient. Despite progress made in elucidating the pathogenesis of PAH and introduction of novel therapies, SSc-related PAH (SScPAH) remains a devastating disease that responds poorly to therapy. Although early diagnosis is of paramount importance, there are no available validated strategies for assessing SScPAH because reliable evaluation of the structure and function of the right ventricle is difficult owing to its complex geometry. Additionally, myocardial fibrosis might affect cardiac contractility and contribute to heart failure. Modern imaging modalities, such as novel echocardiographic techniques and cardiac MRI, are highly sensitive, quantitative and reproducible methods that allow noninvasive assessment of regional and global myocardial performance without relying on geometric assumptions. In this Review, we examine the imaging modalities currently available, focusing on evolving diagnostic imaging methodologies and their possible clinical implications in the SScPAH setting. © 2012 Macmillan Publishers Limited. All rights reserved.

Mavrogeni S.,Onassis Cardiac Surgery Center | Dimitroulas T.,Russells Hall Hospital | Chatziioannou S.N.,National and Kapodistrian University of Athens | Kitas G.,University of Manchester
Seminars in Arthritis and Rheumatism | Year: 2013

Objectives: Takayasu arteritis is a rare large vessel vasculitis of unknown etiology, in which both early diagnosis and follow-up present very significant challenges. The high incidence of diseaseassociated morbidity and significant risk of premature death - particularly in young adults- mandate the need to facilitate early diagnosis and aggressive treatment where appropriate. The aim of this review is to summarize the current level of knowledge regarding the usefulness of evolving imaging modalities in the diagnostic workup and management of patients suffering with Takayasu arteritis. We also propose an imaging algorithm for the evaluation of this population. Methods: A MEDLINE search for articles published between January 1999 and December 2011 was conducted using the following keywords: Takayasu arteritis, imaging modalities, echocardiogram, cardiac magnetic resonance, positron emission tomography scan, diagnosis. Results: Imaging studies-particularly cardiac magnetic resonance- can assist early diagnosis by demonstrating vascular lesions even when angiography is negative, by identifying the presence of vascular inflammation and/or wall thickening; they are also useful for monitoring purposes. However, availability, expertise, high cost, and radiation are considerable limitations. Magnetic resonance imaging, although it can detect both anatomic and pathophysiologic changes without radiation, is time-consuming, needs high expertise, and still remains an expensive tool, not widely available. Conclusions: Knowledge of the advantages and limitations of the various imaging procedures can complement the physicians' clinical assessment and, along with nonspecific serologic tests, can aid them in diagnosing active arteritis and commence relevant treatment early on, as well as monitor activity and tailor therapy subsequently. © 2013 Elsevier Inc.

Farsalinos K.E.,Onassis Cardiac Surgery Center | Polosa R.,University of Catania
Therapeutic Advances in Drug Safety | Year: 2014

Electronic cigarettes are a recent development in tobacco harm reduction. They are marketed as less harmful alternatives to smoking. Awareness and use of these devices has grown exponentially in recent years, with millions of people currently using them. This systematic review appraises existing laboratory and clinical research on the potential risks from electronic cigarette use, compared with the well-established devastating effects of smoking tobacco cigarettes. Currently available evidence indicates that electronic cigarettes are by far a less harmful alternative to smoking and significant health benefits are expected in smokers who switch from tobacco to electronic cigarettes. Research will help make electronic cigarettes more effective as smoking substitutes and will better define and further reduce residual risks from use to as low as possible, by establishing appropriate quality control and standards. © The Author(s), 2014.

Mavrogeni S.,Onassis Cardiac Surgery Center | Dimitroulas T.,Russells Hall Hospital | Kitas G.D.,University of Manchester
Autoimmunity Reviews | Year: 2012

Autoimmune responses and inflammation are involved in the excess cardiovascular risk observed in patients with systemic inflammatory diseases. Autoimmune myocarditis is a presentation of an inflammatory reaction of the heart during the course of autoimmune disorders, with most cases seen in systemic lupus erythematosus. Early diagnosis is of great significance because of the likelihood of progression to severe and potentially fatal complications such as arrhythmias, heart block, and heart failure. The clinical presentation of the disease is silent leading to delayed diagnosis when dilated cardiomyopathy or heart failure has already advanced. Therefore, a major issue is whether the diagnosis of myocarditis will continue to require invasive procedures such as endomyocardial biopsy or can be achieved with non-invasive methods. There is increasing evidence that noninvasive cardiac imaging, including tissue Doppler echocardiography and cardiac magnetic resonance (CMR), is able to detect subclinical cases and aid in the initiation of specific treatment when it is more likely to be effective. CMR in particular, has emerged as an important technique in the evaluation of myocarditis using three types of images: T2-weighted (T2-W), early T1-weighted (EGE) images taken after 1. min, and delayed enhanced images (LGE) taken 15. min after the injection of contrast agent. If 2/3 of the imaging sequences are positive, myocardial inflammation can be predicted or ruled out with a diagnostic accuracy of 78%. As our understanding of disease mechanisms improves, multimodality imaging may aid in the development of new diagnostic and therapeutic strategies for this potentially devastating complication of systemic inflammation, but further studies are needed to formally evaluate this. © 2012 Elsevier B.V.

News Article | December 19, 2015
Site: motherboard.vice.com

Hello, happy holidays, and welcome to Motherboard's weekly letters to the editor section. I'm Emanuel Maiberg, and I'm Motherboard's weekend and games editor. You may remember me from Motherboard stories such as this one where I paid a company $30 to break up with my girlfriend, or that time I just said yes to all the drugs in Fallout 4. But enough about me. How about you, what's on your mind? Drones and guns, it seems, judging by our inbox. We've published a lot of great stories lately about the potential dangers of vaping, high-speed internet in small towns, and CISA sneaking its way into law, but nothing got as big a reaction as Motherboard contributor Joshua Kopstein story about gun registration versus drone registration. We've included a few of those letters here, as well as a response from Joshua, and other letters that caught our eye. If you want your letter included here next week, please mail us electronically at letters@motherboard.tv. We actually read all the emails, so please send them! RE: I'll Register My Drone When You Have to Register Your Gun When a gun is purchased new, it comes from the factory, to the vendor and the person making the purchase from the vendor has to fill out an ATF Form 4473. Section D of 4473 "Must be Completed By Transferor (Seller)" and includes "Manufacturer and/or Importer, Model, Serial Number, Type, Caliber or Gauge." The personal information on 4473 filled out by the buyer includes a valid driver's license, so in the end, you have yourself a mandatory registration of the firearm. From there, every state is different. In Illinois, probably since 1968, a private seller had to take down the same personal information for a buyer to keep on record, since a year ago we had to call a number to perform a background check on the buyer. In Illinois the chain of ownership has always been traceable and I'm fine with that. Even if the chain of ownership record isn't mandatory by law in another state, it's really in the best interest of sellers anywhere in the United States to get that information anyway, because if that gun is someday found at the scene of a crime, the authorities are going to go to the manufacturer with that serial number (mandatory on all firearms since 1968) and find the first buyer who filled out that 4473. If they can't tell the police who bought it from them, I'm sure you can imagine the kind of inconveniences that may befall their lives at that point. e.g. they become prime suspect in said crime. I’m sure you’re probably thinking that there are people out there who are careless about the law and I would agree with you, but we seem to be fairly satisfied with allowing people to buy alcohol and own motor vehicles along with the laws that will ruin their life if they still decide to drink and drive, even while countless innocent people are often killed by such idiots; we balance these choices on risk and I can go into a whole other argument about the true statistical risk of gun ownership if you like. I, like many other enthusiastic gun owners, can be wary of talk about registration and background checks, mandatory training, etc. because they can and have been used as a means of backdoor restrictions that are more stringent than what a lawful purchaser can expect to face today and we won't accept that. The recent distress of the drone operator is akin to that of the gun owner. The same mentality and tactics used on gun owners are being applied to drone owners. Exacerbating the problem, are politicians reaching for a quick answer, catering to the shallow voter, or worse, supporting government expansion for the sake of growing government. There already exist laws to prevent unmanned aircraft from flying into restricted airspace (airports, etc.). Laws already exist to protect our privacy. As a non sequitur, and "solution" to nothing, the federal authorities are requiring people to register their property. People that simply wish to fly their aircraft in their backyard now have to be on a drone registry. What next, drone sale background checks? As we know, those motivated to break the law will not be impeded by these new laws. They will not register their drones and will continue to do what they will with them. The only people affected will be the law abiding citizens that are now, at the very least, inconvenienced and have to pay more money to the government. Moreover, this is yet another chip off the edifice of our civil liberties. The media and the government will have us believe that these measures are not a big deal, are in our interest, and will keep us safe. On the contrary, all these small losses of freedom add up to a very big deal. If it were in our interest, the free market would have led us there. Registration will stop no one from acting in an unsafe manner. I am a gun owner and not a drone owner. But, we need to combat the mentality that dictates the loss of liberty for political expediency, counterfeit solutions, and the expansion of governmental reach and power wherever we meet it. In your article "I'll Register My Drone When You Have to Register Your Gun" you violated a rule you probably learned in your first logic or philosophy class: you created a false equivalency between drones and guns. Drones and guns [are] vastly different things and thus only someone who has thrown logic completely out the window would say that because drones will soon have to be registered in the USA, so should guns. You might as well use the fact that motor vehicles have to be registered. Or airplanes. Or doctors. Or bicycles. You get my drift. There are many good arguments that can be made in favour of registering guns, but the fact that something entirely different has to be registered is not one of them. Even worse, you violated one of the first rules your parents taught you: "Two wrongs don't make a right." You are arguing that one wrong, the absence of gun registration, justifies another wrong - protesting registration of drones. Those flying things have become an ubiquitous hazard at airports and accident scenes, regularly hassle wildlife in parks that are supposed to be safe places for animals, and regularly fly over your neighbour's back yard while his daughter is sunbathing. Drone registration is needed to enable criminals to be tracked down as easily as tracking down the owner of a vehicle that ran a stop light. The intention wasn't to equate the two—in fact it was exactly the opposite. You're right that drones and guns are vastly different things. But the point here was to highlight the insane disparity in the political will to act on vague and mostly-hypothetical threats over known, established dangers. There are plenty of good reasons to believe drones can and will pose a threat to public safety. But the truth is no one can currently say they know exactly what will happen when drones become ubiquitous. We can use anecdotal evidence to logically deduce the various scenarios, sure, but we really don't know the exact scope or impact. Guns, on the other hand, are a known quantity. They have a body count. We have endless data showing how they can and often do endanger the public Maybe at some point (perhaps inevitably) a drone will be used to commit mass murder. But that hasn't happened yet. This isn't about arguing which things should or should not be regulated—it's about threat modeling, and the fact that our government seems overly focused on threats that are vague, hypothetical, or extremely rare (terrorism being one example of the latter). Drones and guns are both technology when you get down to it. The question is, which technologies and threats are we prioritizing? Re: Chemicals Linked to Lung Disease Have Been Found in More Vaping Liquids A reader wrote to Motherboard staff writer Kaleigh Rogers in response to this story, asking for more details about the study. He mentioned he was a vaper, so Kaleigh asked if there were any stories in the vaping world that aren’t getting enough coverage. This was his response: There is definitely a lot to learn about this industry and not something that can be fully understood overnight. It's good to hear that you are interested in what makes the vape industry tick. Mainly, any article that is put out with research from top universities and such, we would like to read how they got the information that they did. What they tested specifically and how they tested it. We want facts that back up the claims that are made, and without further detail on how they came to the conclusions that they did, their information is clearly just a claim and not a fact. If the researchers won't release what was tested they are generally always hiding something. Hope that answers your questions, Kaleigh. One 2005 study found levels of diacetyl as high as 433 micrograms per cigarette. Most of the e-cigarette liquids tested in the Harvard study were far lower than this, with even the highest concentration at 238.9 microgram of diacetyl in one e-cigarette. This makes itsound like vaping gives 1/2 of what is in cigarettes. But an e-cig is roughly a 3/4 to 1 pack of cigarettes, so the proper comparison would be to give the diacetyl numbers for a pack of cigarettes, or at least 3/4. For the other chemicals, please note that those are present in vapor in amounts also present in room air, so it was also disingenuous for Harvard to talk about those unless they SAY that avoiding breathing entirely is the only way to be safer. (Link from reader.) I agree with Russ Wishtart that DA/AP needs to be studied, most vapers do. But the person who HONESTLY studied that was cardiologist Dr. Konstantinos Farsalinos of the Onassis Cardiac Surgery Center. (Link from reader.) While it may be true that a lot of people know that vaping is safer than smoking, in California, that is not the case, thanks to the public health department, which has done an aggressive TV propaganda campaign implying it is MORE dangerous than smoking. And even for the Harvard study, quite a few people have posted that a newly-vaping mother, father, brother, or sister, got scared and decided it was safer to smoke. So Harvard and the media leaving that out, IN CONTEXT, is, literally, causing deaths. It is tempting to say that they have no responsibility to take into account the scare stories being publicized by highly-funded nicotine prohibitionists, but pretending to be innocent of the impact of the sum of what one's organization has been doing for the past 3 years is as dishonest as saying cops that cover for a bad cop are themselves innocent of blame for police brutality. Thanks for your letter. I’ve had a few readers point out this distinction, and it definitely has merit. I think my concern is that it’s difficult to draw a direct comparison between e-cigarettes and cigarettes. One vaper might smoke half an e-cigarette cartridge in one day, another might smoke two full ones, and different models hold different levels of e-liquid. While it’s true that one e-cigarette is not a direct analog to one cigarette, since the researchers didn’t provide exact liquids levels, I used the measurement they included (micrograms per e-cigarette) to illustrate the point. I think the point still stands, but do understand your distinction. Re: Gigabit Internet Prices in This Small Town May One Day Beat Google Fiber — Dec. 14, 2015 Earlier this week we published a story on a local municipal fiber internet provider called LeverettNet. What made this particular provider special? On the surface, it looked like LeverettNet was offering Leverett, Massachusetts residents fiber internet at speeds of 2Gbps for $39.95—twice the speed of Google Fiber, for almost half the price. Not bad for a town of just 1,876 residents! But, alas, that thesis—which was the angle of a story in the town of Leverett’s local paper, and where we first learned of LeverettNet’s service—was more complicated than it originally seemed. The paper’s angle—that LeverettNet was upgrading its bandwidth from 1Gbps to 2Gbps—was technically correct. However, we interpreted this as meaning the speed to LeverettNet users had increased. Rather, a closer look at the LeverettNet website showed that it was merely the bandwidth of its “point of presence,” or access node, that had been increased. From there, the connection to subscribers’ homes remained at 1Gbps. Meanwhile, we incorrectly reported that the cost of LeverettNet service had dropped from $44.95 to $39.95 per month. In reality, this was the cost of combined internet and phone service, and not internet-only service, which costs $24.95 per month. An additional maintenance cost of $49.95 per month also applies, and was not acknowledged in the initial report. These are all errors that should have been caught during the editing process, and ultimately, invalidated the originally reported premise of the piece. That’s on me. There’s no excuse for mistakes like these on Motherboard, and I’m truly sorry our usual editorial standards were not upheld. Re: Hack Into a Linux Computer by Hitting the Backspace 28 Times I am a Linux Mint user. I read about the Hack Into a Linux Computer by Hitting the Backspace 28 Times yesterday. I tried it. It did not work. Looks like the security hole was already patched. Thank you Update Manager. I frequently read about Linux security holes. It has always been my experience that they have been patched before they have been reported in the news. While it is good to report Linux security holes, it would be nice to report about how quickly they are patched, in fact often before they appear in print. Thanks for reaching out Tom. Ubuntu, Debian and Red Hat have issued patches already, as we noted in the story. So you either got yours without noticing, or your system wasn't affected (the researchers noted that the bug depended on many factors, so perhaps our machine wasn't vulnerable at all). Re: Lawmakers Have Snuck CISA Into a Bill That Is Guaranteed to Become a Law Wow. Thanks for the article. I'm blown away by our government's determination to strip private citizens of any morsel of privacy, and the lack of real leadership by our Congress. It is infuriating that I, as a mere citizen, can do nothing but mourn the loss of my right to privacy.

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