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Sample records for nuclear cardiology procedures

  1. American Society of Nuclear Cardiology

    MedlinePlus

    ... resources to achieve your nuclear cardiology career goals Event Calendar See meetings, online activities, webinars and much ... Statements Member Login Enter Forgot your password? Meetings & Events 21 APR NC Today 2017 21 APR Abstracts ...

  2. Update in nuclear cardiology.

    PubMed

    Grambow, D W; Schwaiger, M

    1993-11-01

    Imaging techniques for the noninvasive detection and evaluation of coronary artery disease continue to develop. New techniques for the quantification of myocardial blood flow by positron-emission tomography, new approaches to metabolic imaging, and new gamma camera technology have the potential to expand the scope of cardiac nuclear medicine in many facilities. Determination of the best and most cost-effective method of assessing myocardial viability in patients with advanced coronary artery disease remains of key interest with research directed at alternative 201Tl imaging protocols, fatty acid metabolism, and viability assessment with the new 99mTc-based myocardial perfusion radiopharmaceuticals. The assessment of endothelial function and determination of coronary flow reserve with 13N-ammonia positron-emission tomography may aid in the identification of preclinical atherosclerosis, and in monitoring disease progression and response to therapy. New information in radionuclide perfusion imaging in young and elderly patients and in those with interventricular conduction disturbances may allow for more accurate identification of coronary artery disease. The role of radionuclide imaging in patients with dilated cardiomyopathy continues to evolve with the development of radiolabeled chemicals of the adrenergic nervous system and their analogues, which will be helpful in the stratification of disease severity. These new imaging techniques promise to increase the accuracy of nuclear cardiology for detection of disease, assessment of function, and prognosis.

  3. Nuclear Medicine in Pediatric Cardiology.

    PubMed

    Milanesi, Ornella; Stellin, Giovanni; Zucchetta, Pietro

    2017-03-01

    Accurate cardiovascular imaging is essential for the successful management of patients with congenital heart disease (CHD). Echocardiography and angiography have been for long time the most important imaging modalities in pediatric cardiology, but nuclear medicine has contributed in many situations to the comprehension of physiological consequences of CHD, quantifying pulmonary blood flow symmetry or right-to-left shunting. In recent times, remarkable improvements in imaging equipments, particularly in multidetector computed tomography and magnetic resonance imaging, have led to the progressive integration of high resolution modalities in the clinical workup of children affected by CHD, reducing the role of diagnostic angiography. Technology has seen a parallel evolution in the field of nuclear medicine, with the advent of hybrid machines, as SPECT/CT and PET/CT scanners. Improved detectors, hugely increased computing power, and new reconstruction algorithms allow for a significant reduction of the injected dose, with a parallel relevant decrease in radiation exposure. Nuclear medicine retains its distinctive capability of exploring at the tissue level many functional aspects of CHD in a safe and reproducible way. The lack of invasiveness, the limited need for sedation, the low radiation burden, and the insensitivity to body habitus variations make nuclear medicine an ideal complement of echocardiography. This is particularly true during the follow-up of patients with CHD, whose increasing survival represent a great medical success and a challenge for the health system in the next decades. Metabolic imaging using (18)FDG PET/CT has expanded its role in the management of infection and inflammation in adult patients, particularly in cardiology. The same expansion is observed in pediatric cardiology, with an increasing rate of studies on the use of FDG PET for the evaluation of children with vasculitis, suspected valvular infection or infected prosthetic devices. The

  4. Automated Quantitative Nuclear Cardiology Methods

    PubMed Central

    Motwani, Manish; Berman, Daniel S.; Germano, Guido; Slomka, Piotr J.

    2016-01-01

    Quantitative analysis of SPECT and PET has become a major part of nuclear cardiology practice. Current software tools can automatically segment the left ventricle, quantify function, establish myocardial perfusion maps and estimate global and local measures of stress/rest perfusion – all with minimal user input. State-of-the-art automated techniques have been shown to offer high diagnostic accuracy for detecting coronary artery disease, as well as predict prognostic outcomes. This chapter briefly reviews these techniques, highlights several challenges and discusses the latest developments. PMID:26590779

  5. Nuclear cardiology in a managed care environment.

    PubMed

    Thomas, G S; Wolin, D

    1998-01-01

    Health maintenance organizations (HMO) and nuclear cardiology represent mutual threats and mutual opportunities for each other. On the one hand, nuclear cardiology represents a cost center with HMOs exerting tremendous financial pressure on nuclear cardiology programs. On the other hand, nuclear cardiology can act as a sage gatekeeper to the cardiac catheterization laboratory and help HMOs effectively control the health care of an increasing percentage of the population. Through the process of negotiation, of determining each other's needs, an accommodation can take place between the two. The ability to correlate scan results with coronary angiography provides individual nuclear cardiology programs with the opportunity to demonstrate their accuracy. A Nuclear Cardiology Report Card based on these data can be developed for use, with HMOs creating the opportunity to compete not only on price but also on value. Carved out capitation rates for nuclear cardiology can be estimated on the basis of actual experience with an HMO population and by extrapolation from test frequency of the U.S. population. The financial disincentives of capitation and of managed care challenge the physician-patient relationship. Advocacy of the role of nuclear cardiology and an understanding of negotiation strategies can aid nuclear cardiologists in their attempts to provide quality care with commensurate compensation.

  6. Nuclear Cardiology: 2014 Innovations and Developments

    PubMed Central

    Mahmarian, John J.; Chang, SuMin; Nabi, Faisal

    2014-01-01

    Nuclear cardiac imaging is acknowledged as a robust technique for clinically assessing patients with a wide spectrum of cardiac illnesses. Recent technical, radiotracer, and stressor advancements continue to expand the role of nuclear cardiology for the accurate diagnosis and prognostication of patients with known or suspected coronary artery disease. The introduction of I-123 MIBG represents another advance for assessing risk in patients with congestive heart failure and depressed left ventricular (LV) function. Software and hardware innovations and recent shifts in acquisition protocols have greatly improved image quality, reduced cost and radiation exposure, and continue to promote patient and physician satisfaction. The following article will highlight recent achievements in the field that continue to foster a patient-centered imaging approach. PMID:25574344

  7. A survey of nuclear cardiological practice in Great Britain. The British Nuclear Cardiology Group.

    PubMed

    Underwood, R; Gibson, C; Tweddel, A; Flint, J

    1992-03-01

    There is little information on the practice of nuclear cardiology in Great Britain. On behalf of the British Nuclear Cardiology Group in October 1988 we sent a postal questionnaire to 143 hospitals with nuclear medicine facilities (at least 70% of such hospitals). Sixty nine replies were received (48%), of which 23 (33%) were from teaching hospitals and 46 (39%) non-teaching. In these hospitals 147,904 isotope investigations were performed annually (mean 2311 per centre) of which 17,298 (12%) (mean 254 per centre) were cardiac studies. Of these, 59% were equilibrium radionuclide ventriculograms, 14% first pass ventriculograms, and 27% thallium-201 scans. Rest studies were performed more commonly by radiographers or technicians (63%) than by doctors (20%), but doctors were more commonly involved in stress studies (48%). Radiologists reported the studies more often (28%) than they performed them (6%). Methods of acquisition and analysis were varied and, for instance, the lower limit of normal left ventricular ejection fraction ranged from 35% to 75% (mean 49%). For thallium imaging 42% of centres used dipyridamole in some patients and 24% used tomography. These data show that nuclear cardiology techniques are used much less frequently in Great Britain than in countries such as the United States and Germany, that the ratio of blood pool to myocardial perfusion imaging is much higher than elsewhere, and that methods are poorly standardised. They may provide the impetus to improve the service and serve as a baseline for future surveys.

  8. Occupational eye dose in interventional cardiology procedures.

    PubMed

    Haga, Yoshihiro; Chida, Koichi; Kaga, Yuji; Sota, Masahiro; Meguro, Taiichiro; Zuguchi, Masayuki

    2017-04-03

    It is important to measure the radiation dose [3-mm dose equivalent, Hp(3)] in the eye. This study was to determine the current occupational radiation eye dose of staff conducting interventional cardiology procedures, using a novel direct eye dosimeter. We measured the occupational eye dose [Hp(3)] in physicians and nurses in a catheterization laboratory for 6-months. The eye doses [Hp(3)] of 12 physicians (9 with Pb glasses, 3 without), and 11 nurses were recorded using a novel direct eye dosimeter, the DOSIRIS(TM). We placed dosimeters above and under the glasses. We also estimated the eye dose [0.07-mm dose equivalent] using a neck personal dosimeter. The eye doses among interventional staff ranked in the following order: physicians without Pb glasses > physicians with Pb glasses > nurses. The shielding effect of the glasses (0.07-mm Pb) in a clinical setting was approximately 60%. In physicians who do not wear Pb glasses, the eye dose may exceed the new regulatory limit for IR staff. We found good correlations between the neck dosimeter dose and eye dosimeter dose (inside or outside glasses, R(2) = 0.93 and R(2) = 0.86, respectively) in physicians. We recommend that interventional physicians use an eye dosimeter for correct evaluation of the lens dose.

  9. Gender Differences in Radiation Dose from Nuclear Cardiology Studies Across the World: Findings from the International Atomic Energy Agency Nuclear Cardiology Protocols Study (INCAPS) Registry

    PubMed Central

    Shi, Lynn; Dorbala, Sharmila; Paez, Diana; Shaw, Leslee J.; Zukotynski, Katherine A.; Pascual, Thomas N. B.; Karthikeyan, Ganesan; Vitola, João V.; Better, Nathan; Bokhari, Nadia; Rehani, Madan M.; Kashyap, Ravi; Dondi, Maurizio; Mercuri, Mathew; Einstein, Andrew J.

    2016-01-01

    OBJECTIVES The aim of this study was to investigate gender-based differences in nuclear cardiology practice, globally, with particular focus on laboratory volume, radiation dose, protocols, and best practices. BACKGROUND It is unclear if gender-based differences exist in radiation exposure for nuclear cardiology procedures. METHODS In a large multicenter observational cross-sectional study encompassing 7911 patients in 65 countries, radiation effective dose was estimated for each examination. Patient-level best practices relating to radiation exposure were compared between genders. Analysis of covariance was utilized to determine any difference in radiation exposure according to gender, region, and the interaction between gender and region. Linear, logistic, and hierarchical regression models were developed to evaluate gender-based differences in radiation exposure and laboratory adherence to best practices. We also included the United Nations’ gender inequality and human development indices as covariates in multivariable models. RESULTS The proportion of MPI studies performed in women varied between countries, however there was no significant correlation with gender inequality index. Globally, mean effective dose for nuclear cardiology procedures was only slightly lower in women (9.6±4.5 mSv) than in men (10.3±4.5 mSv men, p<0.001), with a difference of only 0.3 mSv in a multivariable model adjusting for patient age and weight. Stress-only imaging was performed more frequently in women (12.5% vs. 8.4%, p<0.001), however camera-based dose-reduction strategies were used less frequently in women (58.6% vs. 65.5%, p<0.001). CONCLUSIONS Despite significant worldwide variation in best practice use and radiation doses from nuclear cardiology procedures, only small differences were observed between genders worldwide. Regional variations noted in MPI use and radiation dose offer potential opportunities to address gender-related differences in delivery of nuclear

  10. Molecular imaging. A new approach to nuclear cardiology.

    PubMed

    Dobrucki, L W; Sinusas, A J

    2005-03-01

    Nuclear cardiology has historically played an important role in detection of cardiovascular disease as well as risk stratification. With the growth of molecular biology have come new therapeutic interventions and the requirement for new diagnostic imaging approaches. Noninvasive targeted radiotracer based as well as transporter gene imaging strategies are evolving to meet these new needs, but require the development of an interdisciplinary approach which focuses on molecular processes, as well as the pathogenesis and progression of disease. This progress has been made possible with the availability of transgenic animal models along with many technological advances. Future adaptations of the developing experimental procedures and instrumentation will allow for the smooth translation and application to clinical practice. This review is intended as a brief overview on the subject molecular imaging. Basic concepts and historical perspective of molecular imaging will be reviewed first, followed by description of current technology, and concluding with current applications in cardiology. The emphasis will be on the use of both single photon emission computed tomography (SPECT) and positron emission tomography (PET) radiotracers, although other imaging modalities will be also briefly discussed. The specific approaches presented here will include receptor-based and reporter gene imaging of natural and therapeutic angiogenesis.

  11. [Nuclear cardiology: the present functions and future perspectives].

    PubMed

    Mei, Xiaoli; Fan, Chengzhong

    2013-02-01

    For the past decade, the diagnosis and treatment of coronary artery disease (CAD) has shifted from the traditional model by evaluating coronary artery stenosis with morphological imaging methods to a novel model by focusing on the detection of ischemia for risk stratification. The myocardial perfusion imaging (MPI) using stress single photon emission computed tomography (SPECT) has become the most commonly used stress imaging technique for the diagnosis and treatment of patients with suspected or known CAD. It has got strong supports, including those of the American College of Cardiology, American Heart Association, American Society of Nuclear Cardiology (ACC/AHA/ASNC) and other numerous clinical guidelines. They all stressed that the SPECT MPI is recommended to be used as the "gate keeper" to coronary angiography in order to prevent unnecessary intervention test and save the cost. However, in China the introduction and application of nuclear cardiology was late and highly unbalanced. This leads to the lack of understanding of nuclear cardiology in some clinicians, and there often is misunderstanding on correct selection of coronary angiography, cardiac CT, CT coronary angiography and others for diagnosis and treatment of CAD which results in a trend of over-application of these traditional techniques. In this article, we will focus on the status of nuclear cardiology, including SPECT, positron emission tomography (PET) MPI in the patients with CAD for the diagnosis of ischemia, risk stratification and management decision-making, and also compare it with the traditional morphological imaging techniques. In addition, we will briefly introduce the recent advances in cardiac hybrid imaging and molecular imaging. The aim of this paper is to popularize the knowledge of nuclear cardiology, and promote the rational application of nuclear cardiology in China.

  12. Nuclear cardiology core syllabus of the European Association of Cardiovascular Imaging (EACVI).

    PubMed

    Gimelli, Alessia; Neglia, Danilo; Schindler, Thomas H; Cosyns, Bernard; Lancellotti, Patrizio; Kitsiou, Anastasia

    2015-04-01

    The European Association of Cardiovascular Imaging (EACVI) Core Syllabus for Nuclear Cardiology is now available online. The syllabus lists key elements of knowledge in nuclear cardiology. It represents a framework for the development of training curricula and provides expected knowledge-based learning outcomes to the nuclear cardiology trainees.

  13. COMPARING MEASURED AND CALCULATED DOSES IN INTERVENTIONAL CARDIOLOGY PROCEDURES.

    PubMed

    Oliveira da Silva, M W; Canevaro, L V; Hunt, J; Rodrigues, B B D

    2017-03-16

    Interventional cardiology requires complex procedures and can result in high doses and dose rates to the patient and medical staff. The many variables that influence the dose to the patient and staff include the beam position and angle, beam size, kVp, filtration, kerma-area product and focus-skin distance. A number of studies using the Monte Carlo method have been undertaken to obtain prospective dose assessments. In this paper, detailed irradiation scenarios were simulated mathematically and the resulting dose estimates were compared with real measurements made previously under very similar irradiation conditions and geometries. The real measurements and the calculated doses were carried out using or simulating an interventional cardiology system with a flat monoplane detector installed in a dedicated room with an Alderson phantom placed on the procedure table. The X-ray spectra, beam angles, focus-skin distance, measured kerma-area product and filtration were simulated, and the real dose measurements and calculated doses were compared. It was shown that the Monte Carlo method was capable of reproducing the real dose measurements within acceptable levels of uncertainty.

  14. Emerging role of nuclear cardiology in heart failure.

    PubMed

    Flotats, A; Carrió, I

    2010-04-01

    The management of patients with heart failure requires the integration of clinical skills and accurate complementary tests for the correct diagnosis, treatment and estimation of individual prognosis. Identification of those patients most at risk of death, and those most likely to benefit from currently available treatment technologies, remains a challenge. Although the basic characterization of patients with heart failure is supported primarily by the assessment of the left ventricular function, there are several nuclear cardiology techniques and tracers, either available or under development, which can provide important noninvasive imaging insights into the pathophysiology, prognosis and management of patients with heart failure. Nuclear techniques for molecular imaging of the myocardium such as those involved in the processes of myocardial perfusion, metabolism and viability, cellular injury, dyssynchrony, intersticial dysregulation and neurohormonal receptor function may facilitate better clinical outcomes for patients with heart failure. This review mainly focuses on cardiac sympathetic imaging, as other modalities of nuclear cardiology in the assessment of patients with HF are reviewed more extensively in other sections of this issue.

  15. Highlights of the 12th International Conference on Nuclear Cardiology and Cardiac CT.

    PubMed

    Kitsiou, Anastasia; Dorbala, Sharmila; Scholte, Arthur J H A

    2015-09-01

    The 12th International Conference on Nuclear Cardiology and Cardiac CT was held from 3 to 5 May 2015 in Madrid, Spain. In this article, the three Congress Program Committee Chairs summarize selected highlights of the presented abstracts.

  16. Sample size considerations for clinical research studies in nuclear cardiology.

    PubMed

    Chiuzan, Cody; West, Erin A; Duong, Jimmy; Cheung, Ken Y K; Einstein, Andrew J

    2015-12-01

    Sample size calculation is an important element of research design that investigators need to consider in the planning stage of the study. Funding agencies and research review panels request a power analysis, for example, to determine the minimum number of subjects needed for an experiment to be informative. Calculating the right sample size is crucial to gaining accurate information and ensures that research resources are used efficiently and ethically. The simple question "How many subjects do I need?" does not always have a simple answer. Before calculating the sample size requirements, a researcher must address several aspects, such as purpose of the research (descriptive or comparative), type of samples (one or more groups), and data being collected (continuous or categorical). In this article, we describe some of the most frequent methods for calculating the sample size with examples from nuclear cardiology research, including for t tests, analysis of variance (ANOVA), non-parametric tests, correlation, Chi-squared tests, and survival analysis. For the ease of implementation, several examples are also illustrated via user-friendly free statistical software.

  17. Radiation-Induced Noncancer Risks in Interventional Cardiology: Optimisation of Procedures and Staff and Patient Dose Reduction

    PubMed Central

    Khairuddin Md Yusof, Ahmad

    2013-01-01

    Concerns about ionizing radiation during interventional cardiology have been increased in recent years as a result of rapid growth in interventional procedure volumes and the high radiation doses associated with some procedures. Noncancer radiation risks to cardiologists and medical staff in terms of radiation-induced cataracts and skin injuries for patients appear clear potential consequences of interventional cardiology procedures, while radiation-induced potential risk of developing cardiovascular effects remains less clear. This paper provides an overview of the evidence-based reviews of concerns about noncancer risks of radiation exposure in interventional cardiology. Strategies commonly undertaken to reduce radiation doses to both medical staff and patients during interventional cardiology procedures are discussed; optimisation of interventional cardiology procedures is highlighted. PMID:24027768

  18. Reporting nuclear cardiology: a joint position paper by the European Association of Nuclear Medicine (EANM) and the European Association of Cardiovascular Imaging (EACVI).

    PubMed

    Trägårdh, Elin; Hesse, Birger; Knuuti, Juhani; Flotats, Albert; Kaufmann, Philipp A; Kitsiou, Anastasia; Hacker, Marcus; Verberne, Hein J; Edenbrandt, Lars; Delgado, Victoria; Donal, Erwan; Edvardsen, Thor; Galderisi, Maurizio; Habib, Gilbert; Lancellotti, Patrizio; Nieman, Koen; Rosenhek, Raphael; Agostini, Denis; Gimelli, Alessia; Lindner, Oliver; Slart, Riemert; Ubleis, Christopher

    2015-03-01

    The report of an imaging procedure is a critical component of an examination, being the final and often the only communication from the interpreting physician to the referring or treating physician. Very limited evidence and few recommendations or guidelines on reporting imaging studies are available; therefore, an European position statement on how to report nuclear cardiology might be useful. The current paper combines the limited existing evidence with expert consensus, previously published recommendations as well as current clinical practices. For all the applications discussed in this paper (myocardial perfusion, viability, innervation, and function as acquired by single photon emission computed tomography and positron emission tomography or hybrid imaging), headings cover laboratory and patient demographics, clinical indication, tracer administration and image acquisition, findings, and conclusion of the report. The statement also discusses recommended terminology in nuclear cardiology, image display, and preliminary reports. It is hoped that this statement may lead to more attention to create well-written and standardized nuclear cardiology reports and eventually lead to improved clinical outcome.

  19. Advances in image reconstruction software in nuclear cardiology: Is all that glitters gold?

    PubMed

    Marcassa, Claudio; Zoccarato, Orazio

    2017-02-01

    The cornerstone results of nuclear cardiology in the last 25 years were obtained with the Filtered Back Projection as the preferred reconstruction method for tomographic studies. Recently, evolution of the OSEM iterative reconstruction algorithms was implemented by different vendors. The value and limitations of the new methods are briefly addressed.

  20. Current status of nuclear cardiology in Japan: Ongoing efforts to improve clinical standards and to establish evidence.

    PubMed

    Yoshinaga, Keiichiro; Tamaki, Nagara

    2015-08-01

    Nuclear cardiology imaging tests are widely performed in Japan as clinical practice. The Japanese nuclear cardiology community has developed new diagnostic imaging tests using (123)I-beta-methyl-p-iodophenyl-pentadecanoic acid, (123)I-metaiodobenzylguanidine, and (18)F-fluorodeoxyglucose PET for detecting cardiac involvement in sarcoidosis. These tests have become popular worldwide. The Japanese Circulation Society and the Japanese Society of Nuclear Cardiology have published clinical imaging guidelines showing indications and standards for the new imaging tests. JSNC is currently striving to improve the standard of clinical practice and is promoting research activities.

  1. Subacute radiation dermatitis following an interventional cardiology procedure.

    PubMed

    Cunha, Nélia; Cardoso, Pedro; Cabete, Joana

    2016-11-23

    Although radiation dermatitis is a widely known complication of radiotherapy, its association with fluoroscopy-guided interventional procedures is yet under recognized. We present a case of a 66-year-old man with a left scapular cutaneous lesion, initially diagnosed as a fixed drug eruption. The subsequent knowledge of a previous percutaneous aortic paravalvular leak closure procedure allowed a correct clinicopathological correlation and the final diagnosis of subacute radiodermatitis associated with fluoroscopy. Many of the patients with skin injury associated with fluoroscopic procedures do not associate both and seek physicians other than the one who performed the procedure. Besides interventional physicians, dermatologists and other physicians should be aware of this form of radiation injury and its manifestations. Suspicion and active search for a history of previous fluoroscopic procedures in patients with figurate cutaneous lesions in allusive locations may allow the diagnosis of this potentially serious complication that should have long follow-up due to the possibility of long-term side effects.

  2. Robotic surgery in Cardiology: a safe and effective procedure

    PubMed Central

    Poffo, Robinson; Toschi, Alisson Parrilha; Pope, Renato Bastos; Celullare, Alex Luiz; Benício, Anderson; Fischer, Claudio Henrique; Vieira, Marcelo Luiz Campos; Teruya, Alexandre; Hatanaka, Dina Mie; Rusca, Gabriel Franzin; Makdisse, Marcia

    2013-01-01

    ABSTRACT Objective: To evaluate the short and medium-term outcomes of patients undergoing robotic-assisted minimally invasive cardiac surgery. Methods: From March 2010 to March 2013, 21 patients underwent robotic-assisted cardiac surgery. The procedures performed were: mitral valve repair, mitral valve replacement, surgical correction of atrial fibrillation, surgical correction of atrial septal defect, intracardiac tumor resection, totally endoscopic coronary artery bypass surgery and pericardiectomy. Results: The mean age was 48.39±18.05 years. The mean cardiopulmonary bypass time was 151.7±99.97 minutes, and the mean aortic cross-clamp time was 109.94±81.34 minutes. The mean duration of intubation was 7.52±15.2 hours, and 16 (76.2%) patients were extubated in the operating room immediately after the procedure. The mean length of intensive care unit stay was 1.67±1.46 days. There were no conversions to sternotomy. There was no in-hospital death or deaths during the medium-term follow-up. Patients mean follow up time was 684±346 days, ranging from 28 to 1096 days. Conclusion: Robotic-assisted cardiac surgery proved to be feasible, safe and effective and can be applied in the correction of various intra and extracardiac pathologies. PMID:24136755

  3. Skin dosimetry of patients during interventional cardiology procedures in the Czech Republic

    NASA Astrophysics Data System (ADS)

    Sukupova, Lucie; Novak, Leos

    2008-01-01

    The aim of the study is to determine distribution of air kerma-area product, fluoro time and number of frames values for the two most frequent procedures in the interventional cardiology, to reconstruct skin dose distributions for some patients undergoing coronarography and percutaneous transluminal coronary angioplasty procedures. Patient dose data were obtained from X-ray unit dose monitoring software report from one hospital and the reconstructions were performed in MATLAB. Dependence of maximum skin dose on air kerma-area product, fluoro time and number of frames was determined to assess trigger levels of these quantities, which can indicate possible exceeding of the 2 Gy skin dose threshold.

  4. Occupational dose constraints in interventional cardiology procedures: the DIMOND approach

    NASA Astrophysics Data System (ADS)

    Tsapaki, Virginia; Kottou, Sophia; Vano, Eliseo; Komppa, Tuomo; Padovani, Renato; Dowling, Annita; Molfetas, Michael; Neofotistou, Vassiliki

    2004-03-01

    Radiation fields involved in angiographic suites are most uneven with intensity and gradient varying widely with projection geometry. The European Commission DIMOND III project addressed among others, the issues regarding optimization of staff doses with an attempt to propose preliminary occupational dose constraints. Two thermoluminescent dosemeters (TLD) were used to assess operators' extremity doses (left shoulder and left foot) during 20 coronary angiographies (CAs) and 20 percutaneous transluminal coronary angioplasties (PTCAs) in five European centres. X-ray equipment, radiation protection measures used and the dose delivered to the patient in terms of dose-area product (DAP) were recorded so as to subsequently associate them with operator's dose. The range of staff doses noted for the same TLD position, centre and procedure type emphasizes the importance of protective measures and technical characteristics of x-ray equipment. Correlation of patient's DAP with staff shoulder dose is moderate whereas correlation of patient's DAP with staff foot dose is poor in both CA and PTCA. Therefore, it is difficult to predict operator's dose from patient's DAP mainly due to the different use of protective measures. A preliminary occupational dose constraint value was defined by calculating cardiologists' annual effective dose and found to be 0.6 mSv.

  5. Status of radiation protection in various interventional cardiology procedures in the Asia Pacific region

    PubMed Central

    Tsapaki, Virginia; Faruque Ghulam, Mohammed; Lim, Soo Teik; Ngo Minh, Hung; Nwe, Nwe; Sharma, Anil; Sim, Kui-Hian; Srimahachota, Suphot; Rehani, Madan Mohan

    2011-01-01

    Objective Increasing use of interventional procedures in cardiology with unknown levels of radiation protection in many countries of Asia-Pacific region necessitates the need for status assessment. The study was part of an International Atomic Energy Agency (IAEA) project for achieving improved radiation protection in interventional cardiology (IC) in developing countries. Design The survey covers 18 cardiac catheterisation laboratories in seven countries (Bangladesh, India, Malaysia, Myanmar, Singapore, Thailand and Vietnam). An important step was the creation of the ‘Asian network of Cardiologists in Radiation Protection’ and a newsletter. Data were collected on: radiation protection tools, number of IC laboratories, and annual number of various IC paediatric and adult procedures in the hospital and in the country. Patient radiation dose data were collected in terms of Kerma Area Product (KAP) and cumulative dose (CD). Results It is encouraging that protection devices for staff are largely used in the routine practice. Only 39% of the angiographic machines were equipped with a KAP meter. Operators' initial lack of awareness on radiation-protection optimisation improved significantly after participation in IAEA radiation-protection training. Only two out of five countries reporting patient percutaneous coronary intervention radiation-dose data were fully within the international guidance levels. Data from 51 patients who underwent multiple therapeutic procedures (median 2–3) indicated a total KAP reaching 995 Gy.cm2 (range 10.1–995) and CD 15.1 Gy (range 0.4–15.1), stressing the importance of dose monitoring and optimisation. Conclusions There is a need for interventional cardiology societies to play an active role in training actions and implementation of radiation protection. PMID:27325974

  6. [The clinical management guidelines of the Sociedad Española de Cardiología. Nuclear cardiology: the technical bases and clinical applications].

    PubMed

    Candell Riera, J; Castell Conesa, J; Jurado López, J A; López de Sá, E; Nuño de la Rosa, J A; Ortigosa Aso, F J; Valle Tudela, V

    1999-11-01

    Although the role of nuclear cardiology is currently well consolidated, the addition of new radiotracers and modern techniques prompt us to permanently update the requirements, equipment and clinical applications of these isotopic tests. Radioisotopic drugs, instrumentation and characteristics of radionuclide tests that are presently used are explained in the first part of this text. In the second part, diagnostic and prognostic indications of these tests are presented in detail.

  7. Current status of nuclear cardiology practice in Latin America and the Caribbean.

    PubMed

    Paez, Diana; Peix, Amalia; Orellana, Pilar; Vitola, Joao; Mut, Fernando; Gutiérrez, Claudia; Plaza, Crosby; Becic, Tarik; Dondi, Maurizio; Estrada, Enrique

    2017-02-01

    The burden of cardiovascular diseases (CVDs) in the world is ever growing. They represent the first cause of death worldwide and in Latin America. Nuclear cardiology has a well-established role in the management of patient with CVDs and is being increasingly integrated into the healthcare systems in the region. However, there remains variability as to the infrastructure available across the countries, in terms of existing technology, radiopharmaceuticals, and human resources. The approximate number of gamma (γ) cameras in the region is 1348, with an average of 2.25 per million population; Argentina and Brazil having the largest number. Nearly 80% of the existing cameras are single-photon emission tomography (SPECT), of which 8% are hybrid SPECT-CT systems. Positron emission tomography technology is steadily increasing, and currently, there is an average of 0.25 scanners per million inhabitants, indicating that there is a potential to expand the capacities in order to cover the needs. Four countries have nuclear reactors for research purposes, which allow the production of technetium-99 m (Argentina, Chile, Mexico and Peru), while four (Argentina, Brazil, Cuba, and Mexico) assemble (99)Mo-(99m)Tc generators. As for the nuclear cardiology studies, about 80% of studies performed are gated SPECT myocardial perfusion imaging; less than 10% are multi-gated acquisition (mainly for evaluation of cardiac toxicity in cancer patients), and the other 10% correspond to other types of studies, such as viability detection, and adrenergic innervation studies with (123)I-MIBG. Physical stress is preferred, when possible, based on the clinical condition of the patient. Regarding human resources, there is an average of 1.1 physicians and 1.3 technologists per γ camera, with 0.1 medical physicists and 0.1 radiopharmacists per center in the region. The future of nuclear cardiology in Latin America and the Caribbean is encouraging, with great potential and possibilities for growth

  8. Recent developments of cyclotron produced radionuclides for nuclear cardiology

    NASA Astrophysics Data System (ADS)

    Kulkarni, P. V.; Jansen, D. E.; Corbett, J. R.

    1987-04-01

    For over a decade myocardial perfusion imaging with thallium-201, a cyclotron product, has been routinely used in clinical medicine. Recent advances have allowed the efficient production of very high purity (> 99.8%) iodine-123. New metabolically active 123I labeled radiopharmaceuticals, including alkyl and phenyl fatty acids, and norepinephrine analogs, have been developed and are undergoing clinical trials. Fab' fragments of monoclonal antibodies to cardiac myosin have been labeled with indium-111 ( 111In) and are undergoing clinical evaluation for imaging myocardial infarcts. Monoclonal antibodies to platelets, fibrin, and the thrombolytic agent, tissue plasminogen activator (TPA), have recently been labeled with 111In. Together these developments in radiotracers and instrumentation should have a significant impact on the future of cardiovascular nuclear medicine. This manuscript will discuss developments in single photon emitting radiotracers for myocardial imaging.

  9. Overall measurements of dose to patients in common interventional cardiology procedures.

    PubMed

    Wang, Weipeng; Zhang, Menglong; Zhang, Yi

    2013-12-01

    This study was designed to measure peak skin dose (PSD), dose-area product (DAP), cumulative dose (CD) and fluoroscopy time (FT) for interventional cardiology procedures and to evaluate whether patient doses were higher than that in other published data. Three cardiac procedure types, including coronary angiography (CAG), percutaneous transluminal coronary angioplasty (PTCA) and radio frequency (RF) ablation, were entered into the study. Data of four special metrics (PSD, DAP, CD and FT) for these procedures were collected and measured. A total of 238 patients who underwent interventional radiology procedures participated in this study. For every procedure, data about PSD were resulted from six TLD arrays and DAP, CD and FT were collected from the displayed monitor. The mean, standard deviation (SD), range and third quartile of the distribution of PSD, DAP, CD and FT recorded and measured on spot were calculated for all procedures. High-dose cases were specifically recorded. There was wide variation in the doses observed for different instances of the same procedure. PSD for PTCA and RF ablation ranged from 0.1 Gy to more than 3 Gy. Of 238 instances, there were 22 (9.2 %) with PSDs greater than 2 Gy and 4 (1.7 %) than 3 Gy. The third quartile of the distribution for PTCA had exceeded the DIMOND preliminary reference levels by 41.1 % in DAP and 25.0 % in FT. Mean DAP was in the range of reported values for CAG procedure, but higher than all data obtained in literatures for PTCA. Data from this study are in the range of most reported values for CAG and RF ablation procedure, while higher than that obtained in some literatures for PTCA. In case of a constant delivering of high doses to patient and physician himself, thorough training of interventionalists and staff is necessary, and the legislation has to be revised and set dose constrains especially for the interventional high-dose procedures.

  10. Estimation of staff lens doses during interventional procedures. Comparing cardiology, neuroradiology and interventional radiology.

    PubMed

    Vano, E; Sanchez, R M; Fernandez, J M

    2015-07-01

    The purpose of this article is to estimate lens doses using over apron active personal dosemeters in interventional catheterisation laboratories (cardiology IC, neuroradiology IN and radiology IR) and to investigate correlations between occupational lens doses and patient doses. Active electronic personal dosemeters placed over the lead apron were used on a sample of 204 IC procedures, 274 IN and 220 IR (all performed at the same university hospital). Patient dose values (kerma area product) were also recorded to evaluate correlations with occupational doses. Operators used the ceiling-suspended screen in most cases. The median and third quartile values of equivalent dose Hp(10) per procedure measured over the apron for IC, IN and IR resulted, respectively, in 21/67, 19/44 and 24/54 µSv. Patient dose values (median/third quartile) were 75/128, 83/176 and 61/159 Gy cm(2), respectively. The median ratios for dosemeters worn over the apron by operators (protected by the ceiling-suspended screen) and patient doses were 0.36; 0.21 and 0.46 µSv Gy(-1) cm(-2), respectively. With the conservative approach used (lens doses estimated from the over apron chest dosemeter) we came to the conclusion that more than 800 procedures y(-1) and per operator were necessary to reach the new lens dose limit for the three interventional specialties.

  11. Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS)

    PubMed Central

    Einstein, Andrew J.; Pascual, Thomas N. B.; Mercuri, Mathew; Karthikeyan, Ganesan; Vitola, João V.; Mahmarian, John J.; Better, Nathan; Bouyoucef, Salah E.; Hee-Seung Bom, Henry; Lele, Vikram; Magboo, V. Peter C.; Alexánderson, Erick; Allam, Adel H.; Al-Mallah, Mouaz H.; Flotats, Albert; Jerome, Scott; Kaufmann, Philipp A.; Luxenburg, Osnat; Shaw, Leslee J.; Underwood, S. Richard; Rehani, Madan M.; Kashyap, Ravi; Paez, Diana; Dondi, Maurizio

    2015-01-01

    Aims To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing ‘best practices’ worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose. Methods and results We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March–April 2013. Eight ‘best practices’ relating to radiation exposure were identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory. Patient radiation effective dose (ED) ranged between 0.8 and 35.6 mSv (median 10.0 mSv). Average laboratory ED ranged from 2.2 to 24.4 mSv (median 10.4 mSv); only 91 (30%) laboratories achieved the median ED ≤ 9 mSv recommended by guidelines. Laboratory QIs ranged from 2 to 8 (median 5). Both ED and QI differed significantly between laboratories, countries, and world regions. The lowest median ED (8.0 mSv), in Europe, coincided with high best-practice adherence (mean laboratory QI 6.2). The highest doses (median 12.1 mSv) and low QI (4.9) occurred in Latin America. In hierarchical regression modelling, patients undergoing MPI at laboratories following more ‘best practices’ had lower EDs. Conclusion Marked worldwide variation exists in radiation safety practices pertaining to MPI, with targeted EDs currently achieved in a minority of laboratories. The significant relationship between best-practice implementation and lower doses indicates numerous opportunities to reduce radiation exposure from MPI globally. PMID:25898845

  12. Can diagnostic and procedural skills required to practice cardiology as a specialist be mastered in 3 years?

    PubMed

    Yu, Eric H C; Nair, Parvathy; Sibbald, Matthew G; Lee, Douglas S; Dorian, Paul

    2015-01-01

    Cognitive and procedural skills required of cardiologists have increased in the past 10 years. What is unknown is whether residents consistently meet recommended volumes during training and what their own subjective assessments of their competency are after training. The purpose of this study was to (1) determine whether current training provides residents with opportunities to develop skills to function independently and (2) identify whether residents perceive gaps in their skills. We surveyed current and recent graduates of adult cardiology programs in Canada. One hundred ten responses from 425 surveys were received. Procedural and diagnostic test interpretation volumes were recorded, as were the optimum number the respondents believed were important to complete to function independently. These volumes were compared with the 2008 American College of Cardiology Core Cardiology Training Symposium (COCATS 3) and the Canadian Cardiovascular Society (CCS) recommendations for training. The proportion of residents meeting recommended volumes for diagnostic test interpretation ranged from 7% (Holter monitors) to 91% (echocardiograms). For procedures, the range was from 71% (echocardiography) to 100% (cardioversion). The ratio of residents' perceived minimum numbers believed to be required for proficiency for diagnostic test interpretation to those recommended ranged from 14% (electrocardiograms) to 116% (echocardiograms), and for procedures, the ratio was 66% (temporary pacemaker placement) to 116% (echocardiography). Recent graduates' perception of minimum required numbers to achieve competency is underestimated compared with COCATS 3 and CCS recommendations. Few graduates achieved the recommended volume targets suggested for diagnostic test interpretation.

  13. Cardiovascular imaging in the diagnosis and monitoring of cardiotoxicity: cardiovascular magnetic resonance and nuclear cardiology.

    PubMed

    Pepe, Alessia; Pizzino, Fausto; Gargiulo, Paola; Perrone-Filardi, Pasquale; Cadeddu, Christian; Mele, Donato; Monte, Ines; Novo, Giuseppina; Zito, Concetta; Di Bella, Gianluca

    2016-05-01

    Chemotherapy-induced cardiotoxicity (CTX) is a determining factor for the quality of life and mortality of patients administered potentially cardiotoxic drugs and in long-term cancer survivors. Therefore, prevention and early detection of CTX are highly desirable, as is the exploration of alternative therapeutic strategies and/or the proposal of potentially cardioprotective treatments. In recent years, cardiovascular imaging has acquired a pivotal role in this setting. Although echocardiography remains the diagnostic method most used to monitor cancer patients, the need for more reliable, reproducible and accurate detection of early chemotherapy-induced CTX has encouraged the introduction of second-line advanced imaging modalities, such as cardiac magnetic resonance (CMR) and nuclear techniques, into the clinical setting. This review of the Working Group on Drug Cardiotoxicity and Cardioprotection of the Italian Society of Cardiology aims to afford an overview of the most important findings from the literature about the role of CMR and nuclear techniques in the management of chemotherapy-treated patients, describe conventional and new parameters for detecting CTX from both diagnostic and prognostic perspectives and provide integrated insight into the role of CMR and nuclear techniques compared with other imaging tools and versus the positions of the most important international societies.

  14. Simulation-based training for cardiology procedures: Are we any further forward in evidencing real-world benefits?

    PubMed

    Harrison, Christopher M; Gosai, Jivendra N

    2017-04-01

    Simulation-based training as an educational tool for healthcare professionals continues to grow in sophistication, scope, and usage. There have been a number of studies demonstrating the utility of the technique, and it is gaining traction as part of the training curricula for the next generation of cardiologists. In this review, we focus on the recent literature for the efficacy of simulation for practical procedures specific to cardiology, focusing on transesophageal echocardiography, cardiac catheterization, coronary angioplasty, and electrophysiology. A number of studies demonstrated improved performance by those trained using SBT when compared to other methods, although evidence of this leading to an improvement in patient outcomes remains scarce. We discuss this evidence, and the implications for practice for training in cardiology.

  15. Radiation Safety in Nuclear Medicine Procedures.

    PubMed

    Cho, Sang-Geon; Kim, Jahae; Song, Ho-Chun

    2017-03-01

    Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

  16. [Glycaemic management in type 1 and 2 diabetes patients undergoing interventional cardiology procedures. Heart and Diabetes Working Group. Sociedad Espan˜ola de Cardiologı´a. Sociedad Espan˜ola de Diabetes].

    PubMed

    Alonso-García, Angeles; Moreno Gómez, Raúl; Miranda Guardiola, Faustino; Artola-Menéndez, Sara; Lisbona-Gil, Arturo

    2012-03-03

    Despite the growing number of therapeutic alternatives available as well as general reviews and treatment guidelines for the treatment of diabetes, physicians are often left without a clear pathway of therapy to follow in specific clinical contexts such as interventional cardiology. The present document proposes a consensus treatment algorithm, based both on a critical appraisal of evidence from recent clinical trials and on value judgements supported by the authors' collective clinical knowledge and experience, in an attempt to guide practitioners when choosing the most appropriate alternatives in the context of glycemic management in type 1 and 2 diabetic patients scheduled to undergo interventional cardiology procedures in a haemodynamic laboratory.

  17. Review of cardiovascular imaging in the journal of nuclear cardiology in 2016: Part 2 of 2-myocardial perfusion imaging.

    PubMed

    Hage, Fadi G; AlJaroudi, Wael A

    2017-04-06

    In 2016, the Journal of Nuclear Cardiology published many high-quality articles. Similar to previous years, we will summarize here a selection of the articles that were published in the Journal in 2016 to provide a concise review of the main advancements that have recently occurred in the field. In the first article of this two-part series we focused on publications dealing with positron emission tomography, computed tomography, and magnetic resonance. This review will place emphasis on myocardial perfusion imaging using single-photon emission-computed tomography summarizing advances in the field including in diagnosis, prognosis, and appropriate use.

  18. The contribution of interventional cardiology procedures to the population radiation dose in a 'health-care level I' representative region.

    PubMed

    Peruzzo Cornetto, Andrea; Aimonetto, Stefania; Pisano, Francesco; Giudice, Marcello; Sicuro, Marco; Meloni, Teodoro; Tofani, Santi

    2016-02-01

    This study evaluates per-procedure, collective and per capita effective dose to the population by interventional cardiology (IC) procedures performed during 2002-11 at the main hospital of Aosta Valley Region that can be considered as representative of the health-care level I countries, as defined by the UNSCEAR, based on its socio-demographic characteristics. IC procedures investigated were often multiple procedures in patients older than 60 y. The median extreme dose-area product values of 300 and 22 908 cGycm(2) were found for standard pacemaker implantation and coronary angioplasty, respectively, while the relative mean per-procedure effective dose ranged from 0.7 to 47 mSv. A 3-fold increase in frequency has been observed together with a correlated increase in the delivered per capita dose (0.05-0.27 mSv y(-1)) and the collective dose (5.8-35 man Sv y(-1)). Doses increased particularly from 2008 onwards mainly because of the introduction of coronary angioplasty procedures in the authors' institution. IC practice contributed remarkably in terms of effective dose to the population, delivering ∼10% of the total dose by medical ionising radiation examination categories.

  19. Changing from image intensifier to flat detector technology for interventional cardiology procedures: a practical point of view.

    PubMed

    Bokou, C; Schreiner-Karoussou, A; Breisch, R; Beissel, J

    2008-01-01

    A small-scale internal audit has been used to evaluate the impact of the use of a dynamic flat panel detector in the clinical routine in the National Interventional Cardiology Centre in Luxembourg. The parameters tested during commissioning and constancy control of an X-ray system, the introduction of new clinical protocols, the patient and the personal staff dosimetry were considered. The technical parameters tested by the hospital physicist stay the same as for the image intensifier. No innovative protocols have been adopted due to the existence of the flat panel detector. A reduction in dose was noted after the installation of a flat detector, due mostly to the continuing education of the interventional cardiologists as well as the initial calibration of the radiological system. The understanding of the X-ray system and its possibilities is vital for the optimisation of clinical procedures in patient and staff exposure.

  20. An overview of nuclear medicine imaging procedures.

    PubMed

    Hogg, Peter; Lawson, Richard

    2015-11-25

    Nuclear medicine imaging is not generally well understood by nurses who work outside this area. Consequently, nurses can find themselves unable to answer patients' questions about nuclear medicine imaging procedures or give them proper information before they attend for a test. This article aims to explain what is involved in some common diagnostic nuclear medicine imaging procedures so that nurses are able to discuss this with patients. It also addresses some common issues about radiation protection that nurses might encounter in their usual working routine. The article includes links to videos showing some typical nuclear medicine imaging procedures from a patient's point of view and links to an e-Learning for Healthcare online resource that provides detailed information for nurses.

  1. Review of cardiovascular imaging in The Journal of Nuclear Cardiology in 2014: Part 1 of 2: Positron emission tomography, computed tomography, and neuronal imaging.

    PubMed

    AlJaroudi, Wael A; Hage, Fadi G

    2015-06-01

    The year 2014 has been an exciting year for the cardiovascular imaging community with significant advances in the realm of nuclear and multimodality cardiac imaging. In this new feature of the Journal of Nuclear Cardiology, we will summarize some of the breakthroughs that were published in the Journal in 2014 in 2 sister articles. This first article will concentrate on publications dealing with cardiac positron emission tomography (PET), computed tomography (CT), and neuronal imaging.

  2. CHARACTERIZATION AND EXPERIMENTAL MEASUREMENTS OF SCATTER DOSE AT CARDIOLOGIST'S EYES DURING PAEDIATRIC INTERVENTIONAL CARDIOLOGY PROCEDURES IN COSTA RICA.

    PubMed

    Ubeda, Carlos; Salazar, Luisa; Retana, Viviana; Santos, Freddy; Salvador, Lourdes; Sáenz, Carlos; Quesada, Cristhian; Gavarrete, Manuel; Picado, Marcela; Arce, Luis

    2017-03-21

    This paper presents the results of the first characterization and experimental measurements of scatter dose at cardiologist's eyes for the only X-ray system that performs all paediatric Interventional cardiology procedures in Costa Rica. Entrance surface air kerma (ESAK) and the scatter dose values were measured on phantoms of 4-20 cm thicknesses of polymethyl methacrylate slabs. Image quality was evaluated using DICOM images of a test object Leeds TOR 18-FG, through the numerical parameters signal-to-noise ratio (SNR), high-contrast spatial resolution (HCSR) and figure of merit (FOM). When PMMA thickness is increased and during a move from low fluoroscopy to cine modes, ESAK, SNR, HCSR and FOM values range from 0.44 to 391.0 μGy fr-1; 2.8 to 14.89; 3.17 to 15.54 and 0.51 to 79.94, respectively. The highest scattered dose rates recorded during the simulations were 1.79 and 8.04 mSv h-1 for the high fluoroscopy and cine modes, respectively.

  3. Radiopharmaceuticals in cardiology.

    PubMed

    Mikołajczak, Renata; Garnuszek, Piotr

    2012-04-24

    Myocardial perfusion studies are among the most often performed investigations in Nuclear Medicine. However, the development of radiopharmaceuticals for cardiology is an emerging discipline and several other radiotracers have been proven to be useful. Although the myocardial perfusion studies have a well established role in the management of cardiac disorders, still a number of radiopharmaceuticals are under development for a variety of specific cardiac indications and their eventual clinical role remains to be seen. The paper provides a short overview of currently used radiopharmaceuticals and potential molecular imaging radiotracers applicable in cardiology.

  4. [Cardiology 2001].

    PubMed

    Jerie, P

    2002-09-01

    A review of the most important topics published during 2001 is presented. The Writing Committee of the American College of Cardiology and the American Heart Association decided to take a new approach to the classification of heart failure that emphasizes both the evolution and the progression of the disease, using potential risk factors and structural disorders as criteria to identify the severity of a heart failure syndrome. Similarly, an ACC/AHA Clinical Competence Statement on electrocardiography and ambulatory electrocardiography was published with a special emphasis on the computer interpretation of the electrocardiogram. Since various drugs were shown to induce electrocardiographic abnormalities as e.g. QT prolongation associated with ventricular tachycardias, the FDA decided to introduce higher regulatory requirements on the cardiac safety of novel drugs. In cardiovascular surgery Octopus off-pump bypass was demonstrated to be a safe procedure for carefully selected patients with multivessel coronary heart disease. Because of the extensive progress made in cardiovascular surgery, the management of severe heart failure has to be improved and early effective preventive measures have to be introduced to reduce the risk of intractable heart failure. The "New guidelines for evaluating acute coronary syndrome" stress the importance of early identifying and early treatment, including invasive strategy as PTCA with stenting.

  5. Reducing radiation to patients and improving image quality in a real-world nuclear cardiology laboratory.

    PubMed

    Bloom, Stephen A; Meyers, Karen

    2017-03-22

    In part because of aging equipment and reduced reimbursement for imaging services in the last several years, nuclear cardiologists who remain in private practice face challenges in maintaining high quality and in reducing radiation exposure to patients. We review patient-centered approaches and affordable software solutions employed in our practice combined with supine-prone myocardial perfusion imaging to achieve increased interpretive confidence with reduced radiation exposure to patients.

  6. Avian cardiology.

    PubMed

    Strunk, Anneliese; Wilson, G Heather

    2003-01-01

    The field of avian cardiology is continually expanding. Although a great deal of the current knowledge base has been derived from poultry data, research and clinical reports involving companion avian species have been published. This article will present avian cardiovascular anatomy and physiology, history and physical examination considerations in the avian cardiac disease patient, specific diagnostic tools, cardiovascular disease processes, and current therapeutic modalities.

  7. Nuclear cardiology and CVD in the developing world: Are we applying our scarce resources appropriately? Why is our mortality rate so high?

    PubMed

    Vitola, João V

    2016-10-01

    While mortality rates from cardiovascular diseases have progressively decreased in developed nations, this has not been observed to the same extent in the developing world. Nuclear Cardiology utilization remains low or non-existent for most of those living in the low-to-middle-income countries. How much of the decline in mortality observed in the developed world has to do with advanced cardiac imaging? Are we applying our scarce resources appropriately for myocardial perfusion imaging? Are myocardial revascularizations being guided by appropriate use criteria? Is more imaging necessary to reduce the mortality rates further in the developing world?

  8. Review of Cardiovascular Imaging in the Journal of Nuclear Cardiology in 2016. Part 1 of 2: Positron Emission Tomography, Computed Tomography and Magnetic Resonance.

    PubMed

    AlJaroudi, Wael; Hage, Fadi G

    2017-02-13

    Several original articles and editorials have been published in the Journal of Nuclear Cardiology last year. It has become a tradition at the beginning of each year to summarize some of these key articles (AlJaroudi and Hage in J Nucl Cardiol 22:507-512, 2015, 23:122-130, 2016; Hage and AlJaroudi in J Nucl Cardiol 22:714-719, 2015; 23:493-498, 2016). In this part one, we will discuss some of the progress made in patients with infiltrative disease, cardiomyopathies (non-ischemic, ischemic, and diabetic), hybrid and molecular imaging, using advancement in positron emission tomography, computed tomography, and magnetic resonance imaging.

  9. Cardiology Mannequin

    NASA Technical Reports Server (NTRS)

    1979-01-01

    Education of medical students in cardiology requires access to patients having a variety of different forms of heart disease. But bringing together student, instructor and patient is a difficult and expensive process that does not benefit the patient. An alternate approach is substitution of a lifelike mannequin capable of simulating many conditions of heart disease. The mannequin pictured below, together with a related information display, is an advanced medical training system whose development benefited from NASA visual display technology and consultative input from NASA's Kennedy Space Center. The mannequin system represents more than 10 years of development effort by Dr. Michael S. Gordon, professor of cardiology at the University of Miami (Florida) School of Medicine.

  10. Normal values and standardization of parameters in nuclear cardiology: Japanese Society of Nuclear Medicine working group database.

    PubMed

    Nakajima, Kenichi; Matsumoto, Naoya; Kasai, Tokuo; Matsuo, Shinro; Kiso, Keisuke; Okuda, Koichi

    2016-04-01

    As a 2-year project of the Japanese Society of Nuclear Medicine working group activity, normal myocardial imaging databases were accumulated and summarized. Stress-rest with gated and non-gated image sets were accumulated for myocardial perfusion imaging and could be used for perfusion defect scoring and normal left ventricular (LV) function analysis. For single-photon emission computed tomography (SPECT) with multi-focal collimator design, databases of supine and prone positions and computed tomography (CT)-based attenuation correction were created. The CT-based correction provided similar perfusion patterns between genders. In phase analysis of gated myocardial perfusion SPECT, a new approach for analyzing dyssynchrony, normal ranges of parameters for phase bandwidth, standard deviation and entropy were determined in four software programs. Although the results were not interchangeable, dependency on gender, ejection fraction and volumes were common characteristics of these parameters. Standardization of (123)I-MIBG sympathetic imaging was performed regarding heart-to-mediastinum ratio (HMR) using a calibration phantom method. The HMRs from any collimator types could be converted to the value with medium-energy comparable collimators. Appropriate quantification based on common normal databases and standard technology could play a pivotal role for clinical practice and researches.

  11. Nuclear Weapon Accident Response Procedures (NARP)

    DTIC Science & Technology

    2005-02-22

    Fast, reliable, and accurate communications are essential for nuclear weapon accident response operations. Moreover, securing adequate internal ...activities near the scene of a nuclear weapon accident to speed the flow of information to the public and the internal audience. Although it is 183...Departments and Agencies in a nuclear weapon accident. Inherent in this event are the relationships between international , national, State, and

  12. University cardiology clinic.

    PubMed

    Borozanov, V

    2013-01-01

    In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original

  13. Assessing Competence in Pediatric Cardiology

    ERIC Educational Resources Information Center

    Johnson, Apul E.; And Others

    1976-01-01

    In response to the need to assure physician competence, a rating scale was developed at the University of Minnesota Medical School for use in evaluating clinical competence in pediatric cardiology. It was tested on first- and second-year specialists. Development and testing procedures are described. (JT)

  14. Nuclear Medicine Procedures in Children: Special Considerations.

    PubMed

    Gelfand, Michael J; Clements, Crysta; MacLean, Joseph R

    2017-03-01

    Nuclear medicine imaging in children is best accomplished when a child-friendly environment is provided for patients and parents. An approach that minimizes patient anxiety and fear is described. International guidelines for administered activity should be used to minimize absorbed radiation doses from radiopharmaceuticals. CT exposure parameters may be reduced to pediatric best practice for diagnostic CT and further reduced when CT images are needed only for localization purposes.

  15. Llama cardiology.

    PubMed

    Boon, J A; Knight, A P; Moore, D H

    1994-07-01

    Auscultatory, ECG, and echocardiographic data have been presented for healthy llamas. The literature, however, contains little information on the incidence of congenital and acquired heart disease in the llama. Data compiled from the medical records at CSU-VTH and the VMDB provide an indication of the types of cardiac disease to be found in llamas in North America. A wide variety of congenital cardiac defects are found in llamas, the most prevalent defect of which is VSD. Llamas tend to do well with this defect but are unlikely to be useful pack animals. Acquired heart disease primarily involved inflammatory processes of the pericardium, endocardium, epicardium, and myocardium, and pericardial effusion without documented inflammatory disease. Although not every cardiac murmur necessitates a complete cardiac work-up, every effort should be made to compile accurate medical histories and physical findings related to the cardiac disease in llamas in order to advance our knowledge of these disorders. There also is a need to use available technologies to better define cardiac abnormalities in the llama and accurately report these findings in the literature before cardiology of llamas is fully understood.

  16. Determination of efficacy of nuclear medicine procedures

    SciTech Connect

    Saenger, E.L.; Buncher, C.R.; Specker, B.; McDevitt, R.A.

    1984-01-01

    Nuclear medicine, a high technology field, is evaluated as to its usefulness. This paper describes the SNM study of 2023 patients comparing two methods evaluating efficacy for lung scanning (LS). Only the referring physicians determined the probabilities of the most important (MI) and most likely (ML) diagnoses and management before and after lung scanning. A logistic regression model was developed for probability of a signout diagnosis of PE. Equal patient groups tested the validity of the regression equations for the probability of PE as MI or ML. The models developed on Group I (G-I) and used on Group II (G-II) gave similar results. This shows that LS classifies PE and NOT PE categories where PE was considered both MI and ML. Entropy minimax pattern detection (EMPD) attempts prediction of signout diagnosis and management from prior patient attributes. In 2023 cases, attributes alone could not eliminate the use of LS for all patients. Comparing the two methods, the predictive values, sensitivity and specificity of each method are similar. EMPD predicts on a relatively small percent (40% before LS, 71% post LS) while the logistic equation predicts on 100% of the cases. An advantage of EMPD is that it does not require estimates of prior probability. However, LR, uses this estimate, thus incorporating intuitive knowledge not evaluated by EMPD. These methods are unique in showing that LS can direct the referring physician toward or away from anticoagulant therapy based on findings of the lung scan.

  17. [Use of radionuclide isotopes by cardiologists. Results of a French survey. Study group: "Nuclear Cardiology" of the French Society of Cardiology and the Society of Nuclear Medicine and Biophysics].

    PubMed

    Pézard, P; Karcher, G

    1995-03-01

    The authors report the results of an enquiry carried out amongst French cardiologists to determine their opinion about radionuclide investigations in cardiological practice. Of the 5,050 cardiologists contacted, 1,431 (28.3%) replied. The cardiologists were attracted by the non-invasive nature (84%) of radionuclide techniques and their complementarity with other methods of investigation (74%) but regretted their cost (55%), their lick of availability in emergencies (35%) and, in general, their difficult of access (30%). Only 38% of the cardiologists who replied used radionuclide investigation on an everyday basis, this being impossible for some because of the distance to the nearest centre with these facilities (on average 32 km but exceeding 50 km in 29% of cases, and the delay before obtaining an appointment (average 13 days) which was often excessive, especially for myocardial scintigraphy (thallium or equivalent). Each cardiologist prescribed an average of 5 myocardial scintigraphies, 3 pulmonary scintigraphies and 2 radioisotopic ventriculography per month. These results seem to be an overestimation; in fact, radionuclide investigations are relatively underemployed, probably more because of the factors cited above than because of lack interest or quality, these latter two points being generally judged positively by the majority of cardiologists. Cardiologists require more from the conclusions of the investigation than a simple description of the images obtained. As with all other investigations that they perform themselves, the interpretation of the results must take the clinical context into consideration and form part of the diagnostic and therapeutic management of the patient.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Computer diagnosis in cardiology

    PubMed Central

    Ewing, Graham Wilfred; Ewing, Elena Nikolayevna

    2009-01-01

    This article reports upon the emergence of a novel cognitive, computer-based technology which may lead to significantly improved methods of cardiological diagnosis and a rapid and inexpensive method of cardiological screening. The technology ‘Virtual Scanning’ illustrates how, in blood, the reaction of proteins and their reactive substrates releases light; that the colour and intensity of this bioluminescence is unique to each reaction and it's rate; and that the development of pathologies influence cognition and visual perception. This illustrates that the function of the autonomic nervous system is linked to that of the physiological systems and that the rate of biochemical reactions, and the progression of disease, can be measured by a cognitive test procedure and used as an indication of the disease(s) affecting heart function. The article discusses the limitations of the conventional biomarker technique, and the potential value of non-invasive cognitive techniques, such as Virtual Scanning, to the medical practitioner. Finally, it discusses how the ability of Virtual Scanning to diagnose disease from its presymptomatic origins may lead to improved diagnostic accuracy and significantly reduced costs. PMID:22666689

  19. Automating Nuclear-Safety-Related SQA Procedures with Custom Applications

    SciTech Connect

    Freels, James D.

    2016-01-01

    Nuclear safety-related procedures are rigorous for good reason. Small design mistakes can quickly turn into unwanted failures. Researchers at Oak Ridge National Laboratory worked with COMSOL to define a simulation app that automates the software quality assurance (SQA) verification process and provides results in less than 24 hours.

  20. [Over diagnostic imaging in cardiology].

    PubMed

    Carpeggiani, Clara

    2014-03-01

    Medical imaging is one of the major cause of rising health care costs. Diagnostic imaging has increased more rapidly than any other component of medical care. About 5 billion imaging tests are performed worldwide each year. According to recent estimates, at least one-third of all examinations are partially or totally inappropriate. Two out of 3 imaging tests employ ionizing radiations with radiology or nuclear medicine. The medical use of radiation is the largest man-made source of radiation exposure. Medical X-rays and γ-rays are a proven human carcinogen. The attributable long-term extra-risk of cancer due to diagnostic testing is around 10% in industrialized countries. Cardiologists prescribe and/or directly perform >50% of all imaging examinations, accounting for about two-thirds of the total effective dose given to patients. The dose of common cardiological examinations may be significant: 500 chest X-rays= a stress scintigraphy with sestamibi, 750 chest X-rays= a Multislice Computed Tomography, 1,000 chest X-rays= a coronary angiography and stenting. Unfortunately, few doctors are aware of the level of radiation their patients are exposed to during radiological tests and more intensive use of ionizing testing was not associated with greater awareness. Also as a consequence of unawareness, the rate of inappropriate examinations is unacceptably high in cardiology, even for procedures with high radiation load. Higher exposure doses correspond to higher long-term risks; there are no safe doses, and all doses add up in determining the cumulative risks over a lifetime. Doctors should make every effort so that «each patient should get the right imaging exam, at the right time, with the right radiation dose», as suggested by US Food and Drug Administration in the 2010 initiative to reduce unnecessary radiation exposure from medical imaging. This is best obtained through a systematic implementation of the "3 A's strategy" proposed by the International Atomic Energy

  1. Supporting the future nuclear workforce with computer-based procedures

    DOE PAGES

    Oxstrand, Johanna; Le Blanc, Katya

    2016-05-01

    Here we see that computer-based tools have dramatically increased ease and efficiency of everyday tasks. Gone are the days of paging through a paper catalog, transcribing product numbers, and calculating totals. Today, a consumer can find a product online with a simple search engine, and then purchase it in a matter of a few clicks. Paper catalogs have their place, but it is hard to imagine life without on-line shopping sites. All tasks conducted in a nuclear power plant are guided by procedures, which helps ensure safe and reliable operation of the plants. One prominent goal of the nuclear industrymore » is to minimize the risk of human errors. To achieve this goal one has to ensure tasks are correctly and consistently executed. This is partly achieved by training and by a structured approach to task execution, which is provided by procedures and work instructions. Procedures are used in the nuclear industry to direct workers' actions in a proper sequence. The governing idea is to minimize the reliance on memory and choices made in the field. However, the procedure document may not contain sufficient information to successfully complete the task. Therefore, the worker might have to carry additional documents such as turnover sheets, operation experience, drawings, and other procedures to the work site. The nuclear industry is operated with paper procedures like paper catalogs of the past. A field worker may carry a large stack of documents needed to complete a task to the field. Even though the paper process has helped keep the industry safe for decades, there are limitations to using paper. Paper procedures are static (i.e., the content does not change after the document is printed), difficult to search, and rely heavily on the field worker’s situational awareness and ability to consistently meet the high expectation of human performance excellence. With computer-based procedures (CBPs) that stack of papers may be reduced to the size of a small tablet or even

  2. Supporting the future nuclear workforce with computer-based procedures

    SciTech Connect

    Oxstrand, Johanna; Le Blanc, Katya

    2016-05-01

    Here we see that computer-based tools have dramatically increased ease and efficiency of everyday tasks. Gone are the days of paging through a paper catalog, transcribing product numbers, and calculating totals. Today, a consumer can find a product online with a simple search engine, and then purchase it in a matter of a few clicks. Paper catalogs have their place, but it is hard to imagine life without on-line shopping sites. All tasks conducted in a nuclear power plant are guided by procedures, which helps ensure safe and reliable operation of the plants. One prominent goal of the nuclear industry is to minimize the risk of human errors. To achieve this goal one has to ensure tasks are correctly and consistently executed. This is partly achieved by training and by a structured approach to task execution, which is provided by procedures and work instructions. Procedures are used in the nuclear industry to direct workers' actions in a proper sequence. The governing idea is to minimize the reliance on memory and choices made in the field. However, the procedure document may not contain sufficient information to successfully complete the task. Therefore, the worker might have to carry additional documents such as turnover sheets, operation experience, drawings, and other procedures to the work site. The nuclear industry is operated with paper procedures like paper catalogs of the past. A field worker may carry a large stack of documents needed to complete a task to the field. Even though the paper process has helped keep the industry safe for decades, there are limitations to using paper. Paper procedures are static (i.e., the content does not change after the document is printed), difficult to search, and rely heavily on the field worker’s situational awareness and ability to consistently meet the high expectation of human performance excellence. With computer-based procedures (CBPs) that stack of papers may be reduced to the size of a small tablet or even a smart

  3. COMPUTERIZATION OF NUCLEAR POWER PLANT EMERGENCY OPERATING PROCEDURES.

    SciTech Connect

    OHARA,J.M.; HIGGINS,J.; STUBLER,W.

    2000-07-30

    Emergency operating procedures (EOPs) in nuclear plants guide operators in handling significant process disturbances. Historically these procedures have been paper-based. More recently, computer-based procedure (CBP) systems have been developed to improve the usability of EOPs. The objective of this study was to establish human factors review guidance for CBP systems based on a technically valid methodology. First, a characterization of CBPs was developed for describing their key design features, including both procedure representation and functionality. Then, the research on CBPs and related areas was reviewed. This information provided the technical basis on which the guidelines were developed. For some aspects of CBPs the technical basis was insufficient to develop guidance; these aspects were identified as issues to be addressed in future research.

  4. Hybrid cardiac imaging: SPECT/CT and PET/CT. A joint position statement by the European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC).

    PubMed

    Flotats, Albert; Knuuti, Juhani; Gutberlet, Matthias; Marcassa, Claudio; Bengel, Frank M; Kaufmann, Philippe A; Rees, Michael R; Hesse, Birger

    2011-01-01

    Improvements in software and hardware have enabled the integration of dual imaging modalities into hybrid systems, which allow combined acquisition of the different data sets. Integration of positron emission tomography (PET) and computed tomography (CT) scanners into PET/CT systems has shown improvement in the management of patients with cancer over stand-alone acquired CT and PET images. Hybrid cardiac imaging either with single photon emission computed tomography (SPECT) or PET combined with CT depicts cardiac and vascular anatomical abnormalities and their physiologic consequences in a single setting and appears to offer superior information compared with either stand-alone or side-by-side interpretation of the data sets in patients with known or suspected coronary artery disease (CAD). Hybrid systems are also advantageous for the patient because of the single short dual data acquisition. However, hybrid cardiac imaging has also generated controversy with regard to which patients should undergo such integrated examination for clinical effectiveness and minimization of costs and radiation dose, and if software-based fusion of images obtained separately would be a useful alternative. The European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC) in this paper want to present a position statement of the institutions on the current roles of SPECT/CT and PET/CT hybrid cardiac imaging in patients with known or suspected CAD.

  5. Hammersmith cardiology workshop series. Volume 3

    SciTech Connect

    Maseri, A.; Sobel, B.E.; Chierchia, S.

    1987-01-01

    This book contains over 40 selections. Some of the titles are: Nuclear Cardiology: A Decade of Clinical Use for the Detection of Coronary Artery Disease; Characterization of Ischemic Myocardium with Positron Emission Tomography; Postmortem Findings in Acute Myocardial Infarction; Mechanisms of Coronary Obstructions; and Correlation Between Exercise Stress Testing and Coronary Angiography.

  6. [Perspectives in cardiological research].

    PubMed

    Kübler, W

    2004-08-01

    German cardiological research is confronted with increasing difficulties. Clinical research is restricted by regulations, such as the working hours protecting law, the revised version of the legal articles against corruption and acceptance of advantage as well as by many parts of law for the general frame of the university structures. In addition more and more administrative duties are tranferred to doctors engaged in research. Furthermore cardiology is at a disadvantage as only part of the net profits for cardiological services are tranferred to the responsible clinic. Likewise the facilities for cooperation are increasingly restricted, as basic science institutions originally allocated to cardiological research, are now devoted to other subjects and as many pharmaceutical firms have left the country. Cardiology in our country is practically not supported by private research organizations. Research projects are, therefore, predominantly financed by grants from the Bundeministerium für Bildung und Forschung and by the Deutsche Forschungsgemeinschaft. The financial resources for research in our country are declining and much smaller compared, e. g., to the USA. As a consequence of the shortage of resources not only are the weak projects turned down; it is feared that also the very innovative projects are likewise excluded for entering unknown territory. In periods of financial restrictions the central office and the experts evaluating the projects have a special responsibility, which cannot be met by technical objections, such as e. g., an "unsufficient impact factor". In order to improve the conditions for cardiological research the net profits for cardiological services should be transferred unrestricted to the responsible clinic. The acceptance rate of cardiologcal projects may be increased by more intensive cooperation. At the end, the principle of help by self-help also applies to cardiological research; the British Heart Foundation has developed into an

  7. [Radiation protection in interventional cardiology].

    PubMed

    Durán, Ariel

    2015-01-01

    INTERVENTIONAL: cardiology progress makes each year a greater number of procedures and increasing complexity with a very good success rate. The problem is that this progress brings greater dose of radiation not only for the patient but to occupationally exposed workers as well. Simple methods for reducing or minimizing occupational radiation dose include: minimizing fluoroscopy time and the number of acquired images; using available patient dose reduction technologies; using good imaging-chain geometry; collimating; avoiding high-scatter areas; using protective shielding; using imaging equipment whose performance is controlled through a quality assurance programme; and wearing personal dosimeters so that you know your dose. Effective use of these methods requires both appropriate education and training in radiation protection for all interventional cardiology personnel, and the availability and use of appropriate protective tools and equipment. Regular review and investigation of personnel monitoring results, accompanied as appropriate by changes in how procedures are performed and equipment used, will ensure continual improvement in the practice of radiation protection in the interventional suite.

  8. 2014 update on interventional cardiology.

    PubMed

    Hernández Hernández, Felipe; de la Torre Hernández, José M; Rumoroso Cuevas, José R; García del Blanco, Bruno; Martínez-Sellés, Manuel; Trillo Nouche, Ramiro

    2015-04-01

    This article reviews the most relevant publications and studies in the field of interventional cardiology in 2014. In the area of coronary interventional procedures, integrated treatment of acute coronary syndrome continues to be the subject of numerous studies that evaluate different devices and pharmacological and mechanical strategies that can be used without increasing the risk of hemorrhage or the need for reintervention. Certain anatomical substrates continue to generate a considerable number of publications, both on the outcomes with different stents and on the use of specific techniques. Bioabsorbable drug-eluting stents are used in increasingly complex lesions with promising results. The development of interventional procedures for structural heart disease continues to advance, with new evidence on percutaneously placed aortic valve prostheses, the outcome of percutaneous mitral valve repair, and the safety and efficacy of left atrial appendage occlusion. Finally, renal denervation has generated one of the major debates of the year.

  9. Women in interventional cardiology: Is there a problem?

    PubMed

    Safian, Robert D

    2016-03-01

    In the United States, women account for 4% of interventional cardiologists and perform 3% of interventional procedures. Male and female cardiology fellows share concerns that dissuade them from careers in interventional cardiology; unique issues for women include professional isolation and childbearing. Interventional fellowships should enhance female mentorship and develop friendly policies regarding maternity leave; other issues require comprehensive solutions to medical school debt, duration of training, and balancing professional goals with lifestyle.

  10. 48 CFR 1450.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Special procedures for unusually hazardous or nuclear risks. 1450.104-3 Section 1450.104-3 Federal Acquisition Regulations System... Extraordinary Contractual Actions 1450.104-3 Special procedures for unusually hazardous or nuclear risks. The...

  11. 48 CFR 1850.403 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Special procedures for unusually hazardous or nuclear risks. 1850.403 Section 1850.403 Federal Acquisition Regulations System... Residual Powers 1850.403 Special procedures for unusually hazardous or nuclear risks....

  12. 48 CFR 1850.403 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Special procedures for unusually hazardous or nuclear risks. 1850.403 Section 1850.403 Federal Acquisition Regulations System... Residual Powers 1850.403 Special procedures for unusually hazardous or nuclear risks....

  13. 48 CFR 1450.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Special procedures for unusually hazardous or nuclear risks. 1450.104-3 Section 1450.104-3 Federal Acquisition Regulations System... Extraordinary Contractual Actions 1450.104-3 Special procedures for unusually hazardous or nuclear risks. The...

  14. 48 CFR 1450.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Special procedures for unusually hazardous or nuclear risks. 1450.104-3 Section 1450.104-3 Federal Acquisition Regulations System... Extraordinary Contractual Actions 1450.104-3 Special procedures for unusually hazardous or nuclear risks. The...

  15. 48 CFR 1450.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Special procedures for unusually hazardous or nuclear risks. 1450.104-3 Section 1450.104-3 Federal Acquisition Regulations System... Extraordinary Contractual Actions 1450.104-3 Special procedures for unusually hazardous or nuclear risks. The...

  16. 48 CFR 1450.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Special procedures for unusually hazardous or nuclear risks. 1450.104-3 Section 1450.104-3 Federal Acquisition Regulations System... Extraordinary Contractual Actions 1450.104-3 Special procedures for unusually hazardous or nuclear risks. The...

  17. 48 CFR 50.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... unusually hazardous or nuclear risks. 50.104-3 Section 50.104-3 Federal Acquisition Regulations System... Extraordinary Contractual Actions 50.104-3 Special procedures for unusually hazardous or nuclear risks. (a... nuclear risks should be submitted to the contracting officer and shall include the following...

  18. 48 CFR 50.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... unusually hazardous or nuclear risks. 50.104-3 Section 50.104-3 Federal Acquisition Regulations System... Extraordinary Contractual Actions 50.104-3 Special procedures for unusually hazardous or nuclear risks. (a... nuclear risks should be submitted to the contracting officer and shall include the following...

  19. 48 CFR 50.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... unusually hazardous or nuclear risks. 50.104-3 Section 50.104-3 Federal Acquisition Regulations System... Extraordinary Contractual Actions 50.104-3 Special procedures for unusually hazardous or nuclear risks. (a... nuclear risks should be submitted to the contracting officer and shall include the following...

  20. 48 CFR 50.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... unusually hazardous or nuclear risks. 50.104-3 Section 50.104-3 Federal Acquisition Regulations System... Extraordinary Contractual Actions 50.104-3 Special procedures for unusually hazardous or nuclear risks. (a... nuclear risks should be submitted to the contracting officer and shall include the following...

  1. Radiation monitoring in interventional cardiology: a requirement

    NASA Astrophysics Data System (ADS)

    Rivera, T.; Uruchurtu, E. S.

    2017-01-01

    The increasing of procedures using fluoroscopy in interventional cardiology procedures may increase medical and patients to levels of radiation that manifest in unintended outcomes. Such outcomes may include skin injury and cancer. The cardiologists and other staff members in interventional cardiology are usually working close to the area under examination and they receive the dose primarily from scattered radiation from the patient. Mexico does not have a formal policy for monitoring and recording the radiation dose delivered in hemodynamic establishments. Deterministic risk management can be improved by monitoring the radiation delivered from X-ray devices. The objective of this paper is to provide cardiologist, techniques, nurses, and all medical staff an information on DR levels, about X-ray risks and a simple a reliable method to control cumulative dose.

  2. Routine quality control of clinical nuclear medicine instrumentation: a brief review.

    PubMed

    Zanzonico, Pat

    2008-07-01

    This article reviews routine quality-control (QC) procedures for current nuclear medicine instrumentation, including the survey meter, dose calibrator, well counter, intraoperative probe, organ ("thyroid") uptake probe, gamma-camera, SPECT and SPECT/CT scanner, and PET and PET/CT scanner. It should be particularly useful for residents, fellows, and other trainees in nuclear medicine, nuclear cardiology, and radiology. The procedures described and their respective frequencies are presented only as general guidelines.

  3. Routine Quality Control of Clinical Nuclear Medicine Instrumentation: A Brief Review*

    PubMed Central

    Zanzonico, Pat

    2009-01-01

    This article reviews routine quality-control (QC) procedures for current nuclear medicine instrumentation, including the survey meter, dose calibrator, well counter, intraoperative probe, organ (“thyroid”) uptake probe, γ-camera, SPECT and SPECT/CT scanner, and PET and PET/CT scanner. It should be particularly useful for residents, fellows, and other trainees in nuclear medicine, nuclear cardiology, and radiology. The procedures described and their respective frequencies are presented only as general guidelines. PMID:18587088

  4. [Technique and humanization in invasive cardiology].

    PubMed

    Tambone, V; Fagioli, V; Ragusa, V

    2001-01-01

    The technique used in invasive cardiology, in special way in the PTCA, is here considered technique of first and second order (Donati's classification). This kind of technique is a chance to improve the physician-nurse relationship with patient and the knowledge of the patient on his/her own body. We must use this technique in order to get better the relation with the patient trough an excellent information during all the procedure.

  5. Building a cardiology practice.

    PubMed

    Greenberg, David I; Blonder, Ronald D; Eastburn, Ted E; Smith, G Scott; Schwartz, David J; Miller, James B; Glass, James M; Lee, Joseph R; Ascarelli, E David; Rosenbaum, David A; Harris, Nita G; Mantia, William; Keledjian, Laura M

    2004-01-01

    This study was designed to quantify the clinical and marketing effectiveness of the Pocket EKG Clinical Based Marketing Program by measuring its impact on new patient visits, patient satisfaction, payor negotiations, and patient management at Pikes Peak Cardiology (PPC), Colorado Springs, Colorado. New patient visits were found to increase by 22% for 6.5 consecutive years. Ninety-two percent of patients surveyed found that the Pocket EKG Card promoted loyalty to the cardiology practice. The Pocket EKG Patient Satisfaction Survey was proven to satisfy Health Plan Employer Data and Information Set (HEDIS) guidelines as required in payor contracting. Finally, access to a baseline electrocardiogram contributed to a 54% reduction in unnecessary hospitalization. The Pocket EKG Clinical Based Marketing Program proved to successfully market PPC to its three customers: patients, payors, and primary care physicians.

  6. [Gender differences in cardiology].

    PubMed

    Hochleitner, Margarethe; Bader, Angelika

    2003-01-01

    Frequent reports of gender differences in cardiology prompted us to study the cardiological situation in Tyrol, Austria, from 1995 to 2000. Mortality statistics for heart deaths 1995: women 1008 (53.5%), men 875 (46.5%); 2000: women 1104 (58.2%), men 792 (41.8%). Coronary heart deaths 1995: women 572 (50.0%), men 571 (50.0%); 2000: women 634 (54.4%), men 531 (45.6%). Angiograms 1995: women 332 (33.9%), men 646 (66.1%); 2000: women 688 (32.5%), men 1429 (67.5%). Bypass surgery 1995: women 54 (33.0%), men 156 (67.0%); 2000: women 42 (27.5%), men 157 (72.5%). Heart deaths 1995-2000: women +9.5%, men -9.5%; coronary heart deaths 1995-2000: women +10.8%, men -7.0%. By (welcome) contrast, coronary angiograms 1995-2000: women +107.2%, men +121.2%. Bypass operations 1995-2000: women -22.2%, men +0.6%. Life expectancy 1995-2000: women +0.6%, men +0.6%. Patient age at heart death 1995-2000: women +1.8%, men +2.5%. In aggregate, we see that for decades more women than men have died a heart death, but that cardiac mortalities remain a typically "male bastion" with persistent gender differences in access to clinical cardiology. The worsening trend for women begs for awareness programs and corresponding preventive measures.

  7. Cardiology Still a Man's Field, Survey Finds

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_162700.html Cardiology Still a Man's Field, Survey Finds Women less ... Dr. Claire Duvernoy, chair of the Women in Cardiology Council at the American College of Cardiology (ACC). ...

  8. 48 CFR 250.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Special procedures for unusually hazardous or nuclear risks. 250.104-3 Section 250.104-3 Federal Acquisition Regulations System... unusually hazardous or nuclear risks....

  9. 48 CFR 1850.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Special procedures for unusually hazardous or nuclear risks. 1850.104-3 Section 1850.104-3 Federal Acquisition Regulations System... nuclear risks. (a) Indemnification requests. (1) Contractor indemnification requests must be submitted...

  10. 48 CFR 250.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Special procedures for unusually hazardous or nuclear risks. 250.104-3 Section 250.104-3 Federal Acquisition Regulations System... unusually hazardous or nuclear risks....

  11. 48 CFR 250.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Special procedures for unusually hazardous or nuclear risks. 250.104-3 Section 250.104-3 Federal Acquisition Regulations System... unusually hazardous or nuclear risks....

  12. 48 CFR 1850.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Special procedures for unusually hazardous or nuclear risks. 1850.104-3 Section 1850.104-3 Federal Acquisition Regulations System... nuclear risks. (a) Indemnification requests. (1) Contractor indemnification requests must be submitted...

  13. 48 CFR 250.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Special procedures for unusually hazardous or nuclear risks. 250.104-3 Section 250.104-3 Federal Acquisition Regulations System... unusually hazardous or nuclear risks....

  14. 48 CFR 250.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Special procedures for unusually hazardous or nuclear risks. 250.104-3 Section 250.104-3 Federal Acquisition Regulations System... unusually hazardous or nuclear risks....

  15. Update on interventional cardiology 2013.

    PubMed

    Hernández Hernández, Felipe; Rumoroso Cuevas, José Ramón; García Del Blanco, Bruno; Trillo Nouche, Ramiro

    2014-04-01

    The present article reviews the most important publications and studies in the field of interventional cardiology in 2013. Coronary interventions for ST-segment elevation myocardial infarction are among the most important, with studies that assess different devices and pharmacologic and mechanical strategies in primary angioplasty. Increasingly large groups of patients (with diabetes, of advanced age) and the best coronary revascularization strategy are also the focus of exhaustive research. Percutaneous procedures in the left main coronary artery continue to give rise to a significant number of publications, both because of the results of using different types of stent and because of the intravascular imaging techniques used to guide procedures and the results of their use. New bioabsorbable polymer-coated drug-eluting stents or bioresorbable drug-eluting scaffolds are being compared with second-generation drug-eluting stents to show their efficacy in preventing restenosis and reducing incidence of late thrombosis. Percutaneous treatment of structural heart disease continues to produce many publications, especially regarding percutaneous aortic prostheses, but also on closure of foramen ovale and of left atrial appendage. Finally, renal denervation continues to arouse much interest in the medical literature.

  16. Nuclear cardiac

    SciTech Connect

    Slutsky, R.; Ashburn, W.L.

    1982-01-01

    The relationship between nuclear medicine and cardiology has continued to produce a surfeit of interesting, illuminating, and important reports involving the analysis of cardiac function, perfusion, and metabolism. To simplify the presentation, this review is broken down into three major subheadings: analysis of myocardial perfusion; imaging of the recent myocardial infarction; and the evaluation of myocardial function. There appears to be an increasingly important relationship between cardiology, particularly cardiac physiology, and nuclear imaging techniques. (KRM)

  17. Japanese consensus guidelines for pediatric nuclear medicine. Part 1: Pediatric radiopharmaceutical administered doses (JSNM pediatric dosage card). Part 2: Technical considerations for pediatric nuclear medicine imaging procedures.

    PubMed

    Koizumi, Kiyoshi; Masaki, Hidekazu; Matsuda, Hiroshi; Uchiyama, Mayuki; Okuno, Mitsuo; Oguma, Eiji; Onuma, Hiroshi; Kanegawa, Kimio; Kanaya, Shinichi; Kamiyama, Hiroshi; Karasawa, Kensuke; Kitamura, Masayuki; Kida, Tetsuo; Kono, Tatsuo; Kondo, Chisato; Sasaki, Masayuki; Terada, Hitoshi; Nakanishi, Atsushi; Hashimoto, Teisuke; Hataya, Hiroshi; Hamano, Shin-ichiro; Hirono, Keishi; Fujita, Yukihiko; Hoshino, Ken; Yano, Masayuki; Watanabe, Seiichi

    2014-06-01

    The Japanese Society of Nuclear Medicine has recently published the consensus guidelines for pediatric nuclear medicine. This article is the English version of the guidelines. Part 1 proposes the dose optimization in pediatric nuclear medicine studies. Part 2 comprehensively discusses imaging techniques for the appropriate conduct of pediatric nuclear medicine procedures, considering the characteristics of imaging in children.

  18. Methods in molecular cardiology

    PubMed Central

    de Theije, C.C.; de Windt, L.J.; Doevendans, P.A.

    2002-01-01

    Sequencing is one the major breakthroughs in molecular cardiology. The development of this technique has made it possible to determine the exact order of the nucleotides in DNA. The exact order is relevant for the formation of proteins, through the genetic code. Sequencing is even more important for the identification of genetic variation and disease-causing mutations. The elucidation of the human genome is based on the continuous improvement of this technique, reducing the cost and increasing efficiency. Initially, complex chemical reactions were performed using isotopes to unravel the base sequence in genes. Nowadays, fluorescent capillary-based techniques are available to determine the genetic information. Here, the historical development of the technique is described. In addition, examples are provided on how sequencing is used in clinical medicine. ImagesFigure 2Figure 3Figure 8Figure 9 PMID:25696079

  19. Avicenna's contribution to cardiology.

    PubMed

    Chamsi-Pasha, Mohammed A R; Chamsi-Pasha, Hassan

    2014-01-01

    Ibn Sina, known in the West as Avicenna, was the most famous and influential of all the Islamic philosopher-scientists. His most important medical works are the Canon of Medicine medical encyclopedia and a treatise on cardiac drugs. His Canon of Medicine remained the standard text in both the East and West until the 16(th) century. Avicenna's description of cardiac diseases was logically presented perhaps for the first time in the history of medicine. Avicenna was the first to describe carotid sinus hypersensitivity, which presents with vasovagal syncope. He was a pioneer in pulsology and the first correct explanation of pulsation was given by Avicenna, after he refined Galen's theory of the pulse. Besides, he discussed the action of available drugs on the heart in details and mentioned their indications and contraindications. In conclusion, Avicenna made important contributions to cardiology. This article describes some of his contributions in this field.

  20. Improvement of canine somatic cell nuclear transfer procedure.

    PubMed

    Jang, G; Oh, H J; Kim, M K; Fibrianto, Y H; Hossein, M S; Kim, H J; Kim, J J; Hong, S G; Park, J E; Kang, S K; Lee, B C

    2008-01-15

    The purpose of the present study on canine somatic cell nuclear transfer (SCNT) was to evaluate the effects of fusion strength, type of activation, culture media and site of transfer on developmental potential of SCNT embryos. We also examined the potential of enucleated bovine oocytes to serve as cytoplast recipients of canine somatic cells. Firstly, we evaluated the morphological characteristics of in vivo-matured canine oocytes collected by retrograde flushing of the oviducts 72 h after ovulation. Secondly, the effectiveness of three electrical strengths (1.8, 2.3 and 3.3 kV/cm), used twice for 20 micros, on fusion of canine cytoplasts with somatic cells were compared. Then, we compared: (1) chemical versus electrical activation (a) after parthenogenetic activation or (b) after reconstruction of canine oocytes with somatic cells; (2) culture of resulting intergeneric (IG) embryos in either (a) mSOF or (b) TCM-199. The exposure time to 6-DMAP was standardized by using bovine oocytes reconstructed with canine somatic cells. Bovine oocytes were used for SCNT after a 22 h in vitro maturation interval. The fusion rate was significantly higher in the 3.3 kV/cm group than in the 1.8 and 2.3 kV/cm treatment groups. After parthenogenesis or SCNT with chemical activation, 3.4 and 5.8%, respectively, of the embryos developed to the morula stage, as compared to none of the embryos produced using electrical activation. Later developmental stages (8-16 cells) were transferred to the uterine horn of eight recipients, but no pregnancy was detected. However, IG cloned embryos (bovine cytoplast/canine somatic cell) were capable of in vitro blastocyst development. In vitro developmental competence of IG cloned embryos was improved after exposure to 6-DMAP for 4 h as compared to 0, 2 or 6h exposure, although the increase was not significantly different among culture media. In summary, for production of canine SCNT embryos, we recommend fusion at 3.3 kV/cm, chemical activation

  1. Pediatric Cardiology in India: Onset of a New Era.

    PubMed

    Kumar, Dinesh; Bagri, Narendra

    2015-07-01

    Pediatric cardiology is outgrowing from the shadows of adult cardiology and cardiac surgery departments in India. It promises to be an attractive and sought-after subspeciality of Pediatrics, dealing with not only congenital cardiac diseases but also metabolic, rheumatic and host of other cardiac diseases. The new government policy shall provide more training avenues for the budding pediatric cardiologists, pediatric cardiac surgeons, pediatric anesthetists, pediatric cardiac intensivists, neonatologists and a host of supportive workforce. The proactive role of Indian Academy of Pediatrics and Pediatric Cardiac Society of India, towards creating a political will at the highest level for framing policies towards building infrastructure, training of workforce and subsidies for pediatric cardiac surgeries and procedures shall fuel the development of multiple tertiary cardiac centers in the country, making pediatric cardiology services accessible to the needy population.

  2. Guidelines and procedures for design of Class 1 elevated temperature nuclear system components

    SciTech Connect

    Not Available

    1986-09-01

    This standard provides guidelines and procedures which may be used by the manufacturer in satisfying the requirements given for design of class 1 elevated temperature nuclear system components. Guidance is given regarding planning and control of design analysis. A sequence for calculations is recommended. Methods of analysis, including procedures to account for environmental effects, are given which are acceptable in principle to the owner. A format is provided for use in documentation of design analyses.

  3. Computer-Based Procedures for Field Workers in Nuclear Power Plants: Development of a Model of Procedure Usage and Identification of Requirements

    SciTech Connect

    Katya Le Blanc; Johanna Oxstrand

    2012-04-01

    The nuclear industry is constantly trying to find ways to decrease the human error rate, especially the human errors associated with procedure use. As a step toward the goal of improving procedure use performance, researchers, together with the nuclear industry, have been looking at replacing the current paper-based procedures with computer-based procedure systems. The concept of computer-based procedures is not new by any means; however most research has focused on procedures used in the main control room. Procedures reviewed in these efforts are mainly emergency operating procedures and normal operating procedures. Based on lessons learned for these previous efforts we are now exploring a more unknown application for computer based procedures - field procedures, i.e. procedures used by nuclear equipment operators and maintenance technicians. The Idaho National Laboratory and participants from the U.S. commercial nuclear industry are collaborating in an applied research effort with the objective of developing requirements and specifications for a computer-based procedure system to be used by field workers. The goal is to identify the types of human errors that can be mitigated by using computer-based procedures and how to best design the computer-based procedures to do so. This paper describes the development of a Model of Procedure Use and the qualitative study on which the model is based. The study was conducted in collaboration with four nuclear utilities and five research institutes. During the qualitative study and the model development requirements and for computer-based procedures were identified.

  4. Roles of nuclear cardiology, cardiac computed tomography, and cardiac magnetic resonance: Noninvasive risk stratification and a conceptual framework for the selection of noninvasive imaging tests in patients with known or suspected coronary artery disease.

    PubMed

    Berman, Daniel S; Hachamovitch, Rory; Shaw, Leslee J; Friedman, John D; Hayes, Sean W; Thomson, Louise E J; Fieno, David S; Germano, Guido; Wong, Nathan D; Kang, Xingping; Rozanski, Alan

    2006-07-01

    This review deals with noninvasive imaging for risk stratification and with a conceptual approach to the selection of noninvasive tests in patients with suspected or known chronic coronary artery disease (CAD). Already widely acknowledged with SPECT, there is an increasing body of literature data demonstrating that CT coronary calcium assessment is also of prognostic value. The amount of coronary atherosclerosis, as can be extrapolated from CT coronary calcium score, has been shown to be highly predictive of cardiac events. The principal difference between myocardial perfusion SPECT (MPS) and CT coronary calcium for prognostic application appears to be that the former is an excellent tool for assessing short-term risk, thus effectively guiding decisions regarding revascularization. In contrast, the atherosclerosis imaging methods are likely to provide greater long-term risk assessment and, thus, are more useful in determination of the need for aggressive medical prevention measures. Although the more recent development of CT coronary angiography is promising for diagnosis, there has been no information to date regarding the prognostic value of the CT angiographic data. Similarly, cardiac MRI has not yet been adequately studied for its prognostic content. The selection of the most appropriate test for a given patient depends on the specific question being asked. In patients with a very low likelihood of CAD, no imaging test may be required. In screening the remaining asymptomatic patients, atherosclerosis imaging may be beneficial. In symptomatic patients, MPS, CT coronary angiography, and cardiac MRI play important roles. We consider it likely that, with an increased emphasis on prevention and a concomitant aging of the population, many forms of noninvasive cardiac imaging will continue to grow, with nuclear cardiology continuing to grow.

  5. Triggering radiation alarm at security checks. Patients should be informed even after diagnostic nuclear medicine procedures.

    PubMed

    Palumbo, Barbara; Neumann, Irmgard; Havlik, Ernst; Palumbo, Renato; Sinzinger, Helmut

    2009-01-01

    During the last few years an increasing number of nuclear medicine patients in various countries evoked a radiation alarm after therapeutic or diagnostic procedures, and even after passive exposure. A prospective calculation of activity retention in the patient's body is difficult due to extremely high variation of uptake and kinetics. Furthermore, different sensitivities and distances of the detectors make a prospective calculation even more difficult. In this article a number of cases are being reported, related problems are discussed and the surprisingly very limited literature reviewed. In order to minimize problems after eventually triggering alarms, we strongly recommend that each patient receives a certificate providing personal data, tracer, dose, half-life of the radionuclide, type and date of procedure applied as well as the nuclear medicine unit to contact for further information. Furthermore, a closer cooperation and exchange of information between the authorities and local nuclear medicine societies, would be welcome.

  6. [Fetus radiation doses from nuclear medicine and radiology diagnostic procedures. Potential risks and radiation protection instructions].

    PubMed

    Markou, Pavlos

    2007-01-01

    Although in pregnancy it is strongly recommended to avoid diagnostic nuclear medicine and radiology procedures, in cases of clinical necessity or when pregnancy is not known to the physician, these diagnostic procedures are to be applied. In such cases, counseling based on accurate information and comprehensive discussion about the risks of radiation exposure to the fetus should follow. In this article, estimations of the absorbed radiation doses due to nuclear medicine and radiology diagnostic procedures during the pregnancy and their possible risk effects to the fetus are examined and then discussed. Stochastic and detrimental effects are evaluated with respect to other risk factors and related to the fetus absorbed radiation dose and to the post-conception age. The possible termination of a pregnancy, due to radiation exposure is discussed. Special radiation protection instructions are given for radiation exposures in cases of possible, confirmed or unknown pregnancies. It is concluded that nuclear medicine and radiology diagnostic procedures, if not repeated during the pregnancy, are rarely an indication for the termination of pregnancy, because the dose received by the fetus is expected to be less than 100 mSv, which indicates the threshold dose for having deterministic effects. Therefore, the risk for the fetus due to these diagnostic procedures is low. However, stochastic effects are still possible but will be minimized if the radiation absorbed dose to the fetus is kept as low as possible.

  7. A probabilistic seismic risk assessment procedure for nuclear power plants: (I) Methodology

    USGS Publications Warehouse

    Huang, Y.-N.; Whittaker, A.S.; Luco, N.

    2011-01-01

    A new procedure for probabilistic seismic risk assessment of nuclear power plants (NPPs) is proposed. This procedure modifies the current procedures using tools developed recently for performance-based earthquake engineering of buildings. The proposed procedure uses (a) response-based fragility curves to represent the capacity of structural and nonstructural components of NPPs, (b) nonlinear response-history analysis to characterize the demands on those components, and (c) Monte Carlo simulations to determine the damage state of the components. The use of response-rather than ground-motion-based fragility curves enables the curves to be independent of seismic hazard and closely related to component capacity. The use of Monte Carlo procedure enables the correlation in the responses of components to be directly included in the risk assessment. An example of the methodology is presented in a companion paper to demonstrate its use and provide the technical basis for aspects of the methodology. ?? 2011 Published by Elsevier B.V.

  8. Collective effective dose in Europe from X-ray and nuclear medicine procedures.

    PubMed

    Bly, R; Jahnen, A; Järvinen, H; Olerud, H; Vassileva, J; Vogiatzi, S

    2015-07-01

    Population doses from radiodiagnostic (X-ray and nuclear medicine) procedures in Europe were estimated based on data collected from 36 European countries. For X-ray procedures in EU and EFTA countries (except Liechtenstein) the collective effective dose is 547,500 man Sv, resulting in a mean effective dose of 1.06 mSv per caput. For all European countries included in the survey the collective effective dose is 605,000 man Sv, resulting in a mean effective dose of 1.05 mSv per caput. For nuclear medicine procedures in EU countries and EFTA (except Liechtenstein) countries the collective effective dose is 30,700 man Sv, resulting in a mean effective dose of 0.06 mSv per caput. For all European countries included in the survey the collective effective dose is 31,100 man Sv, resulting in a mean effective dose of 0.05 mSv per caput.

  9. How to Practice Sports Cardiology: A Cardiology Perspective.

    PubMed

    Lawless, Christine E

    2015-07-01

    The rigorous cardiovascular (CV) demands of sport, combined with training-related cardiac adaptations, render the athlete a truly unique CV patient and sports cardiology a truly unique discipline. Cardiologists are advised to adopt a systematic approach to the CV evaluation of athletes, taking into consideration the individual sports culture, sports-specific CV demands, CV adaptations and their appearance on cardiac testing, any existing or potential interaction of the heart with the internal and external sports environment, short- and long-term CV risks, and potential effect of performance-enhancing agents and antidoping regulations. This article outlines the systematic approach, provides a detailed example, and outlines contemporary sports cardiology core competencies.

  10. Graphic user interface-based nuclear medicine reporting system.

    PubMed

    Sanger, J J

    1993-03-01

    A graphically based, computerized report generation program has been developed and deployed at a dozen nuclear medicine facilities. The system is based on the Macintosh graphical user interface (GUI) and has been designed to be easy to learn and use. The system allows the nuclear medicine practitioner to generate reports for any nuclear medicine or nuclear cardiology procedure without transcriptionist support, dramatically decreasing report turnaround time. The system includes a relational database engine that allows cost-effective storage and rapid retrieval of final reports and also supports facsimile transmission of reports directly to referring clinicians' offices.

  11. Recent Advances in Invasive Cardiology

    PubMed Central

    Garbe, George J.

    1987-01-01

    This paper describes recent advances in invasive cardiology that enable the primary-care physician to offer his/her patient a wider range of effective treatments. Major developments in the investigation and management of the acute coronary syndromes, unstable angina and myocardial infarction, have revolutionized the care of patients with these conditions. The primary-care physician must be aware of the treatment modalities, the lines of referral, and strategies for management available in his/her clinical setting to allow prompt application of these modalities. A sampling of exciting advances in other areas of invasive cardiology are also described. PMID:21263906

  12. Sources and magnitude of occupational and public exposures from nuclear medicine procedures

    SciTech Connect

    1996-03-11

    This Report addresses the sources of exposures incurred in the practice of nuclear medicine and provides the necessary data to evaluate the magnitude of exposures to those directly associated with that practice and to those who provide nursing care to the patients containing radiopharmaceuticals. Exposure to members of the public are also addressed. The primary emphasis of this Report is on these individuals and not on the patient, since the patient receives the direct benefit from the nuclear medicine procedure. It is recognized that the patient also receives the bulk of any potential radiation decrement.

  13. Computer–Based Procedures for Nuclear Power Plant Field Workers: Preliminary Results from Two Evaluation Studies

    SciTech Connect

    Katya L Le Blanc; Johanna H Oxstrand

    2013-10-01

    The Idaho National Laboratory and participants from the U.S. nuclear industry are collaborating on a research effort aimed to augment the existing guidance on computer-based procedure (CBP) design with specific guidance on how to design CBP user interfaces such that they support procedure execution in ways that exceed the capabilities of paper-based procedures (PBPs) without introducing new errors. Researchers are employing an iterative process where the human factors issues and interface design principles related to CBP usage are systematically addressed and evaluated in realistic settings. This paper describes the process of developing a CBP prototype and the two studies conducted to evaluate the prototype. The results indicate that CBPs may improve performance by reducing errors, but may increase the time it takes to complete procedural tasks.

  14. Procedure for conducting a human-reliability analysis for nuclear power plants. Final report

    SciTech Connect

    Bell, B.J.; Swain, A.D.

    1983-05-01

    This document describes in detail a procedure to be followed in conducting a human reliability analysis as part of a probabilistic risk assessment when such an analysis is performed according to the methods described in NUREG/CR-1278, Handbook for Human Reliability Analysis with Emphasis on Nuclear Power Plant Applications. An overview of the procedure describing the major elements of a human reliability analysis is presented along with a detailed description of each element and an example of an actual analysis. An appendix consists of some sample human reliability analysis problems for further study.

  15. Using cost/risk procedures to establish recovery criteria following a nuclear reactor accident.

    PubMed

    Tawil, J J; Strenge, D L

    1987-02-01

    In the event of a major accidental release of radionuclides at a nuclear power plant, large populated areas could become seriously contaminated. Local officials would be responsible for establishing radiation recovery criteria that would permit the evacuated population to return safely to their jobs and homes. The range of acceptable criteria could imply variations in property losses in the billions of dollars. Given the likely public concern over the health consequences and the enormity of the potential property losses, a cost/risk analysis can provide important input to establishing the recovery criteria. This paper describes procedures for conducting a cost/risk analysis of a site radiologically contaminated by a nuclear power plant accident. The procedures are illustrated by analyzing a hypothetically contaminated site, using software developed for determining the property and health effects of major reactor accidents.

  16. Computer-based procedure for field activities: Results from three evaluations at nuclear power plants

    SciTech Connect

    Oxstrand, Johanna; bly, Aaron; LeBlanc, Katya

    2014-09-01

    Nearly all activities that involve human interaction with the systems of a nuclear power plant are guided by procedures. The paper-based procedures (PBPs) currently used by industry have a demonstrated history of ensuring safety; however, improving procedure use could yield tremendous savings in increased efficiency and safety. One potential way to improve procedure-based activities is through the use of computer-based procedures (CBPs). Computer-based procedures provide the opportunity to incorporate context driven job aids, such as drawings, photos, just-in-time training, etc into CBP system. One obvious advantage of this capability is reducing the time spent tracking down the applicable documentation. Additionally, human performance tools can be integrated in the CBP system in such way that helps the worker focus on the task rather than the tools. Some tools can be completely incorporated into the CBP system, such as pre-job briefs, placekeeping, correct component verification, and peer checks. Other tools can be partly integrated in a fashion that reduces the time and labor required, such as concurrent and independent verification. Another benefit of CBPs compared to PBPs is dynamic procedure presentation. PBPs are static documents which limits the degree to which the information presented can be tailored to the task and conditions when the procedure is executed. The CBP system could be configured to display only the relevant steps based on operating mode, plant status, and the task at hand. A dynamic presentation of the procedure (also known as context-sensitive procedures) will guide the user down the path of relevant steps based on the current conditions. This feature will reduce the user’s workload and inherently reduce the risk of incorrectly marking a step as not applicable and the risk of incorrectly performing a step that should be marked as not applicable. As part of the Department of Energy’s (DOE) Light Water Reactors Sustainability Program

  17. Physician Requirements-1990. For Cardiology.

    ERIC Educational Resources Information Center

    Tracy, Octavious; Birchette-Pierce, Cheryl

    Professional requirements for physicians specializing in cardiology were estimated to assist policymakers in developing guidelines for graduate medical education. The determination of physician requirements was based on an adjusted needs rather than a demand or utilization model. For each illness, manpower requirements were modified by the…

  18. [Problems in cardiology specialty training in Turkey].

    PubMed

    Altun, Armağan

    2012-04-01

    Cardiology Specialty Training in our country should be made in accordance with the law numbered 1219 on the Practice of Medicine and Related Arts, and according to the Medical and Dental Specialist Training Regulation which is published according to the 9th article of this law. The duration of Cardiology Specialist Training has been defined as 4 years in our country. The European Society of Cardiology (ESC), European Union of Medical Specialists (UEMS), and the European Cardiology Section Foundation (ECSF) define the duration of Cardiology Specialist Training as 6 years. Therefore, insufficient Cardiology residency training occurs in our country due to the shortened length of time. In this report, the problems of the Cardiology Specialist Training in Turkey will be addressed under different headings.

  19. Mobile Apps in Cardiology: Review

    PubMed Central

    2013-01-01

    Background Cardiovascular diseases are the deadliest diseases worldwide, with 17.3 million deaths in 2008 alone. Among them, heart-related deaths are of the utmost relevance; a fact easily proven by the 7.25 million deaths caused by ischemic heart disease alone in that year. The latest advances in smartphones and mHealth have been used in the creation of thousands of medical apps related to cardiology, which can help to reduce these mortality rates. Objective The aim of this paper is to study the literature on mobile systems and applications currently available, as well as the existing apps related to cardiology from the leading app stores and to then classify the results to see what is available and what is missing, focusing particularly on commercial apps. Methods Two reviews have been developed. One is a literature review of mobile systems and applications, retrieved from several databases and systems such as Scopus, PubMed, IEEE Xplore, and Web of Knowledge. The other is a review of mobile apps in the leading app stores, Google play for Android and Apple’s App Store for iOS. Results Search queries up to May 2013 located 406 papers and 710 apps related to cardiology and heart disease. The most researched section in the literature associated with cardiology is related to mobile heart (and vital signs) monitoring systems and the methods involved in the classification of heart signs in order to detect abnormal functions. Other systems with a significant number of papers are mobile cardiac rehabilitation systems, blood pressure measurement, and systems for the detection of heart failure. The majority of apps for cardiology are heart monitors and medical calculators. Other categories with a high number of apps are those for ECG education and interpretation, cardiology news and journals, blood pressure tracking, heart rate monitoring using an external device, and CPR instruction. There are very few guides on cardiac rehabilitation and apps for the management of the

  20. Procedure and information displays in advanced nuclear control rooms: experimental evaluation of an integrated design.

    PubMed

    Chen, Yue; Gao, Qin; Song, Fei; Li, Zhizhong; Wang, Yufan

    2017-02-13

    In the main control rooms of nuclear power plants, operators frequently have to switch between procedure displays and system information displays. In this study, we proposed an operation-unit-based integrated design, which combines the two displays to facilitate the synthesis of information. We grouped actions that complete a single goal into operation units and showed these operation units on the displays of system states. In addition, we used different levels of visual salience to highlight the current unit and provided a list of execution history records. A laboratory experiment, with 42 students performing a simulated procedure to deal with unexpected high pressuriser level, was conducted to compare this design against an action-based integrated design and the existing separated-displays design. The results indicate that our operation-unit-based integrated design yields the best performance in terms of time and completion rate and helped more participants to detect unexpected system failures. Practitioner Summary: In current nuclear control rooms, operators frequently have to switch between procedure and system information displays. We developed an integrated design that incorporates procedure information into system displays. A laboratory study showed that the proposed design significantly improved participants' performance and increased the probability of detecting unexpected system failures.

  1. Current global and Korean issues in radiation safety of nuclear medicine procedures.

    PubMed

    Song, H C

    2016-06-01

    In recent years, the management of patient doses in medical imaging has evolved as concern about radiation exposure has increased. Efforts and techniques to reduce radiation doses are focussed not only on the basis of patient safety, but also on the fundamentals of justification and optimisation in cooperation with international organisations such as the International Commission on Radiological Protection, the International Atomic Energy Agency, and the World Health Organization. The Image Gently campaign in children and Image Wisely campaign in adults to lower radiation doses have been initiated in the USA. The European Association of Nuclear Medicine paediatric dosage card, North American consensus guidelines, and Nuclear Medicine Global Initiative have recommended the activities of radiopharmaceuticals that should be administered in children. Diagnostic reference levels (DRLs), developed predominantly in Europe, may be an important tool to manage patient doses. In Korea, overexposure to radiation, even from the use of medical imaging, has become a public issue, particularly since the accident at the Fukushima nuclear power plant. As a result, the Korean Nuclear Safety and Security Commission revised the technical standards for radiation safety management in medical fields. In parallel, DRLs for nuclear medicine procedures have been collected on a nationwide scale. Notice of total effective dose from positron emission tomography-computed tomography for cancer screening has been mandatory since mid-November 2014.

  2. A Procedure to Obtain the Effective Nuclear Charge from the Atomic Spectrum of Sodium

    NASA Astrophysics Data System (ADS)

    Sala*, O.; Araki, Koiti; Noda, L. K.

    1999-09-01

    The penetration of the valence electron orbitals of the alkali metals into their inner shells and its effect on the energy levels can be considered through two methods that take into account modifications of the hydrogen formula (one-electron system). One of them considers the quantum defect, modifying the quantum number n; the other considers the effective nuclear charge Z* replacing the nuclear charge Z. The method using the quantum defect is widely used because this quantity is practically constant for a given angular momentum quantum number l. However, the method using effective nuclear charge is more realistic because it explains many atomic and molecular properties - but the effective nuclear charge depends on l as well as on the principal quantum number n. This article describes a relatively simple graphical procedure to calculate the effective nuclear charges experienced by the sodium valence electron from its atomic spectrum. A relation of Z* with n for a given l is obtained and the Z* values for all states of the valence electron are found; the energy terms can also be determined. The calculations can be performed by using common spreadsheet software.

  3. Nuclear cardiology: Myocardial perfusion and function

    SciTech Connect

    Seldin, D.W. )

    1991-08-01

    Myocardial perfusion studies continue to be a major focus of research, with new investigations of the relationship of exercise-redistribution thallium imaging to diagnosis, prognosis, and case management. The redistribution phenomenon, which seemed to be fairly well understood a few years ago, is now recognized to be much more complex than originally thought, and various strategies have been proposed to clarify the meaning of persistent defects. Pharmacologic intervention with dipyridamole and adenosine has become available as an alternative to exercise, and comparisons with exercise imaging and catheterization results have been described. Thallium itself is no longer the sole single-photon perfusion radiopharmaceutical; two new technetium agents are now widely available. In addition to perfusion studies, advances in the study of ventricular function have been made, including reports of studies performed in conjunction with technetium perfusion studies, new insights into cardiac physiology, and the prognostic and case-management information that function studies provide. Finally, work has continued with monoclonal antibodies for the identification of areas of myocyte necrosis. 41 references.

  4. Improving Performance in a Nuclear Cardiology Department

    ERIC Educational Resources Information Center

    LaFleur, Doug; Smalley, Karolyn; Austin, John

    2005-01-01

    Improving performance in the medical industry is an area that is ideally suited for the tools advocated by the International Society of Performance Improvement (ISPI). This paper describes an application of the tools that have been developed by Dale Brethower and Geary Rummler, two pillars of the performance improvement industry. It allows the…

  5. [What's new in pediatric cardiology?].

    PubMed

    Bonnet, D; Sidi, D

    1999-07-01

    In recent years, close collaborations have been established between pediatric cardiology, medical and molecular genetics, fetal cardiology and pediatric radiology. As a consequence, several congenital heart defects and syndromes including cardiovascular malformations have been related to microdeletions such as 22q11 in Di George syndrome and 7q in Williams syndrome. Prenatal detection of heart malformations has become a crucial part of the management of life-threatening malformations of the neonate such as the transposition of the great arteries or the coarctation of the aorta. We are at the dawn of a new era of the development of preventive cardiovascular medicine starting from childhood thanks to new techniques of echo-tracking. Finally, three-dimensional reconstruction of heart defects by using ultrasound, X-ray or MRI have dramatically improved the diagnosis and the therapeutic strategies of cardiac diseases.

  6. REVIEW Of COMPUTERIZED PROCEDURE GUIDELINES FOR NUCLEAR POWER PLANT CONTROL ROOMS

    SciTech Connect

    David I Gertman; Katya Le Blanc; Ronald L Boring

    2011-09-01

    Computerized procedures (CPs) are recognized as an emerging alternative to paper-based procedures for supporting control room operators in nuclear power plants undergoing life extension and in the concept of operations for advanced reactor designs. CPs potentially reduce operator workload, yield increases in efficiency, and provide for greater resilience. Yet, CPs may also adversely impact human and plant performance if not designed and implemented properly. Therefore, it is important to ensure that existing guidance is sufficient to provide for proper implementation and monitoring of CPs. In this paper, human performance issues were identified based on a review of the behavioral science literature, research on computerized procedures in nuclear and other industries, and a review of industry experience with CPs. The review of human performance issues led to the identification of a number of technical gaps in available guidance sources. To address some of the gaps, we developed 13 supplemental guidelines to support design and safety. This paper presents these guidelines and the case for further research.

  7. History of Cardiology in India.

    PubMed

    Das, Mrinal Kanti; Kumar, Soumitra; Deb, Pradip Kumar; Mishra, Sundeep

    2015-01-01

    History as a science revolves around memories, travellers' tales, fables and chroniclers' stories, gossip and trans-telephonic conversations. Medicine itself as per the puritan's definition is a non-exact science because of the probability-predictability-sensitivity-specificity factors. Howsoever, the chronicles of Cardiology in India is quite interesting and intriguing. Heart and circulation was known to humankind from pre-Vedic era. Various therapeutics measures including the role of Yoga and transcendental meditation in curing cardiovascular diseases were known in India. Only recently there has been resurgence of the same globally. There have been very few innovations in Cardiology in India. The cause of this paucity possibly lie in the limited resources. This has a vicious effect on the research mentality of the population who are busy in meeting their daily requirements. This socio-scientific aspect needs a thorough study and is beyond the scope of the present documentation. Present is the future of past and so one must not forget the history which is essentially past that give the present generation the necessary fulcrum to stand in good stead. The present article essentially aims to pay tribute to all the workers and pioneers in the field of Cardiology in India, who in spite of limited resources ventured in an unchartered arena.

  8. History of Cardiology in India

    PubMed Central

    Das, Mrinal Kanti; Kumar, Soumitra; Deb, Pradip Kumar; Mishra, Sundeep

    2015-01-01

    History as a science revolves around memories, travellers' tales, fables and chroniclers' stories, gossip and trans-telephonic conversations. Medicine itself as per the puritan's definition is a non-exact science because of the probability-predictability-sensitivity-specificity factors. Howsoever, the chronicles of Cardiology in India is quite interesting and intriguing. Heart and circulation was known to humankind from pre-Vedic era. Various therapeutics measures including the role of Yoga and transcendental meditation in curing cardiovascular diseases were known in India. Only recently there has been resurgence of the same globally. There have been very few innovations in Cardiology in India. The cause of this paucity possibly lie in the limited resources. This has a vicious effect on the research mentality of the population who are busy in meeting their daily requirements. This socio-scientific aspect needs a thorough study and is beyond the scope of the present documentation. Present is the future of past and so one must not forget the history which is essentially past that give the present generation the necessary fulcrum to stand in good stead. The present article essentially aims to pay tribute to all the workers and pioneers in the field of Cardiology in India, who in spite of limited resources ventured in an unchartered arena. PMID:26071301

  9. [Sustainability of medical imaging in cardiology].

    PubMed

    Picano, Eugenio; Lombardi, Massimo; Neglia, Danilo; Lazzeri, Mauro

    2006-11-01

    Every year, 5 billion imaging testing are performed worldwide, and about 1 out of 2 are cardiovascular examinations. According to recent estimates, 30 to 50% of all examinations are partially or totally inappropriate. This represents a potential damage for patient undergoing imaging (who takes the acute risks of a stress procedure and/or a contrast study without a commensurable benefit), an exorbitant cost for the society and an excessive delay in the waiting lists for other patients needing the examination. Economic induction, medico-legal concern, and specialist guidelines, which do not quantitate the potential benefits against the risks of a given procedure, boost inappropriateness of all imaging techniques. In case of ionizing tests, the reduction of useless imaging testing would improve the quality of care also through abatement of long-term risks, which are linked to the dose employed. The radiation dose equivalent of common cardiological imaging examinations corresponds to more than 1000 chest x rays for a thallium scan and to more than 500 chest x-rays for a multislice computed tomography. Although a direct evaluation of incidence of cancer in patients submitted to these procedures is not available, the estimated risk (often ignored by cardiologists) of cancer according to the latest 2005 Biological Effects of Ionizing Radiation Committee VII is about one in 500 exposed patients for a Thallium scintigraphy scan, and one in 750 for a CT scan. Such a risk is probably not acceptable when a scintigraphic or radiological procedure is applied for mass screening (when the risk side of the risk-benefit balance is not considered) or when a similar information can be obtained by other means. By contrast, it is fully acceptable in appropriately selected groups as a filter to more invasive, risky and costly procedures (for instance, coronary angiography and anatomy-driven revascularization). At this point, the cardiological community, that faces the reality of limited

  10. 10 CFR 770.7 - What procedures are to be used to transfer real property at defense nuclear facilities for...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false What procedures are to be used to transfer real property at defense nuclear facilities for economic development? 770.7 Section 770.7 Energy DEPARTMENT OF ENERGY TRANSFER OF REAL PROPERTY AT DEFENSE NUCLEAR FACILITIES FOR ECONOMIC DEVELOPMENT § 770.7...

  11. 10 CFR 770.7 - What procedures are to be used to transfer real property at defense nuclear facilities for...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false What procedures are to be used to transfer real property at defense nuclear facilities for economic development? 770.7 Section 770.7 Energy DEPARTMENT OF ENERGY TRANSFER OF REAL PROPERTY AT DEFENSE NUCLEAR FACILITIES FOR ECONOMIC DEVELOPMENT § 770.7...

  12. 10 CFR 770.7 - What procedures are to be used to transfer real property at defense nuclear facilities for...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false What procedures are to be used to transfer real property at defense nuclear facilities for economic development? 770.7 Section 770.7 Energy DEPARTMENT OF ENERGY TRANSFER OF REAL PROPERTY AT DEFENSE NUCLEAR FACILITIES FOR ECONOMIC DEVELOPMENT § 770.7...

  13. A summary of recommendations for occupational radiation protection in interventional cardiology.

    PubMed

    Durán, Ariel; Hian, Sim Kui; Miller, Donald L; Le Heron, John; Padovani, Renato; Vano, Eliseo

    2013-02-01

    The radiation dose received by cardiologists during percutaneous coronary interventions, electrophysiology procedures, and other interventional cardiology procedures can vary by more than an order of magnitude for the same type of procedure and for similar patient doses. There is particular concern regarding occupational dose to the lens of the eye. This document provides recommendations for occupational radiation protection for physicians and other staff in the interventional suite. Simple methods for reducing or minimizing occupational radiation dose include minimizing fluoroscopy time and the number of acquired images; using available patient dose reduction technologies; using good imaging-chain geometry; collimating; avoiding high-scatter areas; using protective shielding; using imaging equipment whose performance is controlled through a quality assurance program; and wearing personal dosimeters so that you know your dose. Effective use of these methods requires both appropriate education and training in radiation protection for all interventional cardiology personnel, and the availability of appropriate protective tools and equipment. Regular review and investigation of personnel monitoring results, accompanied as appropriate by changes in how procedures are performed and equipment used, will ensure continual improvement in the practice of radiation protection in the interventional suite. These recommendations for occupational radiation protection in interventional cardiology and electrophysiology have been endorsed by the Asian Pacific Society of Interventional Cardiology, the European Association of Percutaneous Cardiovascular Interventions, the Latin American Society of Interventional Cardiology, and the Society for Cardiovascular Angiography and Interventions.

  14. Activity based costing of diagnostic procedures at a nuclear medicine center of a tertiary care hospital

    PubMed Central

    Hada, Mahesh Singh; Chakravarty, Abhijit; Mukherjee, Partha

    2014-01-01

    Context: Escalating health care expenses pose a new challenge to the health care environment of becoming more cost-effective. There is an urgent need for more accurate data on the costs of health care procedures. Demographic changes, changing morbidity profile, and the rising impact of noncommunicable diseases are emphasizing the role of nuclear medicine (NM) in the future health care environment. However, the impact of emerging disease load and stagnant resource availability needs to be balanced by a strategic drive towards optimal utilization of available healthcare resources. Aim: The aim was to ascertain the cost of diagnostic procedures conducted at the NM Department of a tertiary health care facility by employing activity based costing (ABC) method. Materials and Methods: A descriptive cross-sectional study was carried out over a period of 1 year. ABC methodology was utilized for ascertaining unit cost of different diagnostic procedures and such costs were compared with prevalent market rates for estimating cost effectiveness of the department being studied. Results: The cost per unit procedure for various procedures varied from Rs. 869 (USD 14.48) for a thyroid scan to Rs. 11230 (USD 187.16) for a meta-iodo-benzyl-guanidine (MIBG) scan, the most cost-effective investigations being the stress thallium, technetium-99 m myocardial perfusion imaging (MPI) and MIBG scan. The costs obtained from this study were observed to be competitive when compared to prevalent market rates. Conclusion: ABC methodology provides precise costing inputs and should be used for all future costing studies in NM Departments. PMID:25400363

  15. Integrating sleep medicine into a cardiology practice.

    PubMed

    Lee, Joseph R

    2005-01-01

    The sequelae of sleep-disordered breathing is encountered on a daily basis by the general cardiology practitioner. This includes arterial and pulmonary hypertension, congestive heart failure, atrial arrhythmias, and possibly vascular disease. Recognition, diagnosis, and treatment of sleep-disordered breathing is relatively straightforward and can be smoothly incorporated into an existing cardiology practice.

  16. Nobel prizes: contributions to cardiology.

    PubMed

    Mesquita, Evandro Tinoco; Marchese, Luana de Decco; Dias, Danielle Warol; Barbeito, Andressa Brasil; Gomes, Jonathan Costa; Muradas, Maria Clara Soares; Lanzieri, Pedro Gemal; Gismondi, Ronaldo Altenburg

    2015-08-01

    The Nobel Prize was created by Alfred Nobel. The first prize was awarded in 1901 and Emil Adolf von Behring was the first laureate in medicine due to his research in diphtheria serum. Regarding cardiology, Nobel Prize's history permits a global comprehension of progress in pathophysiology, diagnosis and therapeutics of various cardiac diseases in last 120 years. The objective of this study was to review the major scientific discoveries contemplated by Nobel Prizes that contributed to cardiology. In addition, we also hypothesized why Carlos Chagas, one of our most important scientists, did not win the prize in two occasions. We carried out a non-systematic review of Nobel Prize winners, selecting the main studies relevant to heart diseaseamong the laureates. In the period between 1901 and 2013, 204 researches and 104 prizes were awarded in Nobel Prize, of which 16 (15%) studies were important for cardiovascular area. There were 33 (16%) laureates, and two (6%) were women. Fourteen (42%) were American, 15 (45%) Europeans and four (13%) were from other countries. There was only one winner born in Brazil, Peter Medawar, whose career was all in England. Reviewing the history of the Nobel Prize in physiology or medicine area made possible to identify which researchers and studies had contributed to advances in the diagnosis, prevention and treatment of cardiovascular diseases. Most winners were North Americans and Europeans, and male.

  17. The history of veterinary cardiology.

    PubMed

    Buchanan, James W

    2013-03-01

    Throughout civilization, animals have played a pivotal role in the advancement of science and medicine. From as early as 400 BC when Hippocrates recognized that diseases had natural causes, the steadfast advances made by biologists, scientists, physicians and scholars were fueled by timely and important facts and information- much of it gained through animal observations that contributed importantly to understanding anatomy, physiology, and pathology. There have been many breakthroughs and historic developments. For example, William Harvey in the 16th and 17th centuries clarified the importance of the circulatory system, aided by observations in dogs and pigs, which helped to clarify and confirm his concepts. The nineteenth century witnessed advances in physical examination techniques including auscultation and percussion. These helped create the basis for enhanced proficiency in clinical cardiology. An explosion of technologic advances that followed in the 20th century have made possible sophisticated, accurate, and non-invasive diagnostics. This permitted rapid patient assessment, effective monitoring, the development of new cardiotonic drugs, clinical trials to assess efficacy, and multi-therapy strategies. The latter 20th century has marshaled a dizzying array of advances in medical genetics and molecular science, expanding the frontiers of etiologies and disease mechanisms in man, with important implications for animal health. Veterinary medicine has evolved during the last half century, from a trade designed to serve agrarian cultures, to a diverse profession supporting an array of career opportunities ranging from private, specialty practice, to highly organized, specialized medicine and subspecialty academic training programs in cardiology and allied disciplines.

  18. [Circulatory assist devices in cardiology].

    PubMed

    Ferrari, M; Figulla, H R

    2005-03-24

    One out of 13 patients with an acute myocardial infarction is endangered of cardiogenic shock. In addition, acute valvular leakage, shunt vitiae, and acute myocarditis can lead to acute myocardial failure. As a therapeutic option, mechanical assist devices offer cardiac support and hemodynamic stabilization under these circumstances. The following minimal-invasive devices are used in cardiology and intensive care medicine: intra-aortic balloon pulsation (IABP), intra-vascular axial screw pumps, extra-corporal centrifugal pumps with and without additional membrane oxygenator. The IABP improves left ventricular function by a systolic reduction of the after-load, and an increase of diastolic blood pressure dependent on myocardial function. In contrast, axial screw pumps and centrifugal pumps can provide circulatory support independently of myocardial function. Mechanical assist devices can prevent irreversible damage not only by offering a reduction of myocardial work load, but also by improving organ perfusion in cardiogenic shock situations. Another indication for mechanical circulatory support depicts high-risk coronary angioplasty if the left ventricular ejection fraction is severely reduced or the target vessel supplies more than 50 % of vital myocardium. In case of irreversible heart failure, turbine pumps or centrifugal pumps offer a stabilization for the patient's transfer to a cardiac surgery center. They can also be used for bridging to heart transplantation in acute situations. Technical improvements will enhance the use of mechanical assist devices in the near future. Especially the development of portable emergency devices will enrich therapeutic possibilities in cardiology and intensive care medicine.

  19. Nobel Prizes: Contributions to Cardiology

    PubMed Central

    Mesquita, Evandro Tinoco; Marchese, Luana de Decco; Dias, Danielle Warol; Barbeito, Andressa Brasil; Gomes, Jonathan Costa; Muradas, Maria Clara Soares; Lanzieri, Pedro Gemal; Gismondi, Ronaldo Altenburg

    2015-01-01

    The Nobel Prize was created by Alfred Nobel. The first prize was awarded in 1901 and Emil Adolf von Behring was the first laureate in medicine due to his research in diphtheria serum. Regarding cardiology, Nobel Prize’s history permits a global comprehension of progress in pathophysiology, diagnosis and therapeutics of various cardiac diseases in last 120 years. The objective of this study was to review the major scientific discoveries contemplated by Nobel Prizes that contributed to cardiology. In addition, we also hypothesized why Carlos Chagas, one of our most important scientists, did not win the prize in two occasions. We carried out a non-systematic review of Nobel Prize winners, selecting the main studies relevant to heart diseaseamong the laureates. In the period between 1901 and 2013, 204 researches and 104 prizes were awarded in Nobel Prize, of which 16 (15%) studies were important for cardiovascular area. There were 33 (16%) laureates, and two (6%) were women. Fourteen (42%) were American, 15 (45%) Europeans and four (13%) were from other countries. There was only one winner born in Brazil, Peter Medawar, whose career was all in England. Reviewing the history of the Nobel Prize in physiology or medicine area made possible to identify which researchers and studies had contributed to advances in the diagnosis, prevention and treatment of cardiovascular diseases. Most winners were North Americans and Europeans, and male. PMID:25945466

  20. A probabilistic seismic risk assessment procedure for nuclear power plants: (II) Application

    USGS Publications Warehouse

    Huang, Y.-N.; Whittaker, A.S.; Luco, N.

    2011-01-01

    This paper presents the procedures and results of intensity- and time-based seismic risk assessments of a sample nuclear power plant (NPP) to demonstrate the risk-assessment methodology proposed in its companion paper. The intensity-based assessments include three sets of sensitivity studies to identify the impact of the following factors on the seismic vulnerability of the sample NPP, namely: (1) the description of fragility curves for primary and secondary components of NPPs, (2) the number of simulations of NPP response required for risk assessment, and (3) the correlation in responses between NPP components. The time-based assessment is performed as a series of intensity-based assessments. The studies illustrate the utility of the response-based fragility curves and the inclusion of the correlation in the responses of NPP components directly in the risk computation. ?? 2011 Published by Elsevier B.V.

  1. Processes and Procedures for Application of CFD to Nuclear Reactor Safety Analysis

    SciTech Connect

    Richard W. Johnson; Richard R. Schultz; Patrick J. Roache; Ismail B. Celik; William D. Pointer; Yassin A. Hassan

    2006-09-01

    Traditionally, nuclear reactor safety analysis has been performed using systems analysis codes such as RELAP5, which was developed at the INL. However, goals established by the Generation IV program, especially the desire to increase efficiency, has lead to an increase in operating temperatures for the reactors. This increase pushes reactor materials to operate towards their upper temperature limits relative to structural integrity. Because there will be some finite variation of the power density in the reactor core, there will be a potential for local hot spots to occur in the reactor vessel. Hence, it has become apparent that detailed analysis will be required to ensure that local ‘hot spots’ do not exceed safety limits. It is generally accepted that computational fluid dynamics (CFD) codes are intrinsically capable of simulating fluid dynamics and heat transport locally because they are based on ‘first principles.’ Indeed, CFD analysis has reached a fairly mature level of development, including the commercial level. However, CFD experts are aware that even though commercial codes are capable of simulating local fluid and thermal physics, great care must be taken in their application to avoid errors caused by such things as inappropriate grid meshing, low-order discretization schemes, lack of iterative convergence and inaccurate time-stepping. Just as important is the choice of a turbulence model for turbulent flow simulation. Turbulence models model the effects of turbulent transport of mass, momentum and energy, but are not necessarily applicable for wide ranges of flow types. Therefore, there is a well-recognized need to establish practices and procedures for the proper application of CFD to simulate flow physics accurately and establish the level of uncertainty of such computations. The present document represents contributions of CFD experts on what the basic practices, procedures and guidelines should be to aid CFD analysts to obtain accurate

  2. The Paediatric Cardiology Hall of Fame – Donald Nixon Ross.

    PubMed

    Somerville, Jane

    2015-10-01

    Donald Nixon Ross, FRCS (4 October 1922 to 7 July 2014) was a South African-born British cardiothoracic surgeon, who developed the pulmonary autograft, known as the Ross procedure, for the treatment of aortic valve disease, and also performed the first heart transplant in the United Kingdom in 1968. This paper, written by Jane Somerville, Professor of Cardiology [Retired], Imperial College London, London, United Kingdom, provides the personal recollections about Donald Ross from Jane Somerville, and thus provides a unique snapshot of cardiac surgical history.

  3. 10 CFR 770.7 - What procedures are to be used to transfer real property at defense nuclear facilities for...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false What procedures are to be used to transfer real property... ENERGY TRANSFER OF REAL PROPERTY AT DEFENSE NUCLEAR FACILITIES FOR ECONOMIC DEVELOPMENT § 770.7 What... congressional defense committees through the Secretary of Energy. (d) Transfer. After the...

  4. Current status of preventive cardiology training among United States cardiology fellowships and comparison to training guidelines.

    PubMed

    Pack, Quinn R; Keteyian, Steven J; McBride, Patrick E; Weaver, W Douglas; Kim, Henry E

    2012-07-01

    We evaluated preventive cardiology education in United States cardiology fellowship programs and their adherence to Core Cardiovascular Training Symposium training guidelines, which recommend 1 month of training, faculty with expertise, and clinical experience in cardiac rehabilitation, lipid disorder management, and diabetes management as a part of the prevention curricula. We sent an anonymous survey to United States cardiology program directors and their chief fellow. The survey assessed the program curricula, rotation structure, faculty expertise, obstacles, and recommended improvements. The results revealed that 24% of surveyed programs met the Core Cardiovascular Training Symposium guidelines with a dedicated 1-month rotation in preventive cardiology, 24% had no formalized training in preventive cardiology, and 30% had no faculty with expertise in preventive cardiology, which correlated with fewer rotations in prevention than those with specialized faculty (p = 0.009). Fellows rotated though the following experiences (% of programs): cardiac rehabilitation, 71%; lipid management, 37%; hypertension, 15%; diabetes, 7%; weight management/obesity, 6%; cardiac nutrition, 6%; and smoking cessation, 5%. The program directors cited "lack of time" as the greatest obstacle to providing preventive cardiology training and the chief fellows reported "lack of a developed curriculum" (p = 0.01). The most recommended improvement was for the American College of Cardiology to develop a web-based curriculum/module. In conclusion, most surveyed United States cardiology training programs currently do not adhere to basic preventive cardiovascular medicine Core Cardiovascular Training Symposium recommendations. Additional attention to developing curricular content and structure, including the creation of an American College of Cardiology on-line knowledge module might improve fellowship training in preventive cardiology.

  5. Eye lens dose in interventional cardiology.

    PubMed

    Principi, S; Delgado Soler, C; Ginjaume, M; Beltran Vilagrasa, M; Rovira Escutia, J J; Duch, M A

    2015-07-01

    The ICRP has recently recommended reducing the occupational exposure dose limit for the lens of the eye to 20 mSv y(-1), averaged over a period of 5 y, with no year exceeding 50 mSv, instead of the current 150 mSv y(-1). This reduction will have important implications for interventional cardiology and radiology (IC/IR) personnel. In this work, lens dose received by a staff working in IC is studied in order to determine whether eye lens dose monitoring or/and additional radiological protection measures are required. Eye lens dose exposure was monitored in 10 physicians and 6 nurses. The major IC procedures performed were coronary angiography and percutaneous transluminal coronary angioplasty. The personnel were provided with two thermoluminescent dosemeters (TLDs): one calibrated in terms of Hp(3) located close to the left ear of the operator and a whole-body dosemeter calibrated in terms of Hp(10) and Hp(0.07) positioned on the lead apron. The estimated annual eye lens dose for physicians ranged between 8 and 60 mSv, for a workload of 200 procedures y(-1). Lower doses were collected for nurses, with estimated annual Hp(3) between 2 and 4 mSv y(-1). It was observed that for nurses the Hp(0.07) measurement on the lead apron is a good estimate of eye lens dose. This is not the case for physicians, where the influence of both the position and use of protective devices such as the ceiling shield is very important and produces large differences among doses both at the eyes and on the thorax. For physicians, a good correlation between Hp(3) and dose area product is shown.

  6. An overview of radioactive waste disposal procedures of a nuclear medicine department.

    PubMed

    Ravichandran, R; Binukumar, J P; Sreeram, Rajan; Arunkumar, L S

    2011-04-01

    Radioactive wastes from hospitals form one of the various types of urban wastes, which are managed in developed countries in a safe and organized way. In countries where growth of nuclear medicine services are envisaged, implementations of existing regulatory policies and guidelines in hospitals in terms of handling of radioactive materials used in the treatment of patients need a good model. To address this issue, a brief description of the methods is presented. A designed prototype waste storage trolley is found to be of great help in decaying the I-131 solid wastes from wards before releasing to waste treatment plant of the city. Two delay tanks with collection time of about 2 months and delay time of 2 months alternately result in 6 releases of urine toilet effluents to the sewage treatment plant (STP) of the hospital annually. Samples of effluents collected at releasing time documented radioactive releases of I-131 much below recommended levels of bi-monthly release. External counting of samples showed good statistical correlation with calculated values. An overview of safe procedures for radioactive waste disposal is presented.

  7. Potential uses, limitations, and basic procedures of micronuclei and nuclear abnormalities in buccal cells.

    PubMed

    Torres-Bugarín, Olivia; Zavala-Cerna, María Guadalupe; Nava, Arnulfo; Flores-García, Aurelio; Ramos-Ibarra, María Luisa

    2014-01-01

    The use of biomarkers as tools to evaluate genotoxicity is increasing recently. Methods that have been used previously to evaluate genomic instability are frequently expensive, complicated, and invasive. The micronuclei (MN) and nuclear abnormalities (NA) technique in buccal cells offers a great opportunity to evaluate in a clear and precise way the appearance of genetic damage whether it is present as a consequence of occupational or environmental risk. This technique is reliable, fast, relatively simple, cheap, and minimally invasive and causes no pain. So, it is well accepted by patients; it can also be used to assess the genotoxic effect derived from drug use or as a result of having a chronic disease. Furthermore the beneficial effects derived from changes in life style or taking additional supplements can also be evaluated. In the present paper, we aim to focus on the explanation of MN test and its usefulness as a biomarker; we further give details about procedures to perform and interpret the results of the test and review some factors that could have an influence on the results of the technique.

  8. Simulation of beta radiator handling procedures in nuclear medicine by means of a movable hand phantom.

    PubMed

    Blunck, Ch; Becker, F; Urban, M

    2011-03-01

    In nuclear medicine therapies, people working with beta radiators such as (90)Y may be exposed to non-negligible partial body doses. For radiation protection, it is important to know the characteristics of the radiation field and possible dose exposures at relevant positions in the working area. Besides extensive measurements, simulations can provide these data. For this purpose, a movable hand phantom for Monte Carlo simulations was developed. Specific beta radiator handling scenarios can be modelled interactively with forward kinematics or automatically with an inverse kinematics procedure. As a first investigation, the dose distribution on a medical doctor's hand injecting a (90)Y solution was measured and simulated with the phantom. Modelling was done with the interactive method based on five consecutive frames from a video recorded during the injection. Owing to the use of only one camera, not each detail of the radiation scenario is visible in the video. In spite of systematic uncertainties, the measured and simulated dose values are in good agreement.

  9. Potential Uses, Limitations, and Basic Procedures of Micronuclei and Nuclear Abnormalities in Buccal Cells

    PubMed Central

    Torres-Bugarín, Olivia; Zavala-Cerna, María Guadalupe; Nava, Arnulfo; Flores-García, Aurelio; Ramos-Ibarra, María Luisa

    2014-01-01

    The use of biomarkers as tools to evaluate genotoxicity is increasing recently. Methods that have been used previously to evaluate genomic instability are frequently expensive, complicated, and invasive. The micronuclei (MN) and nuclear abnormalities (NA) technique in buccal cells offers a great opportunity to evaluate in a clear and precise way the appearance of genetic damage whether it is present as a consequence of occupational or environmental risk. This technique is reliable, fast, relatively simple, cheap, and minimally invasive and causes no pain. So, it is well accepted by patients; it can also be used to assess the genotoxic effect derived from drug use or as a result of having a chronic disease. Furthermore the beneficial effects derived from changes in life style or taking additional supplements can also be evaluated. In the present paper, we aim to focus on the explanation of MN test and its usefulness as a biomarker; we further give details about procedures to perform and interpret the results of the test and review some factors that could have an influence on the results of the technique. PMID:24778463

  10. Light Water Reactor Sustainability Program: Computer-Based Procedures for Field Activities: Results from Three Evaluations at Nuclear Power Plants

    SciTech Connect

    Oxstrand, Johanna; Le Blanc, Katya; Bly, Aaron

    2014-09-01

    The Computer-Based Procedure (CBP) research effort is a part of the Light-Water Reactor Sustainability (LWRS) Program, which is a research and development (R&D) program sponsored by Department of Energy (DOE) and performed in close collaboration with industry R&D programs that provides the technical foundations for licensing and managing the long-term, safe, and economical operation of current nuclear power plants. One of the primary missions of the LWRS program is to help the U.S. nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. One area that could yield tremendous savings in increased efficiency and safety is in improving procedure use. Nearly all activities in the nuclear power industry are guided by procedures, which today are printed and executed on paper. This paper-based procedure process has proven to ensure safety; however, there are improvements to be gained. Due to its inherent dynamic nature, a CBP provides the opportunity to incorporate context driven job aids, such as drawings, photos, and just-in-time training. Compared to the static state of paper-based procedures (PBPs), the presentation of information in CBPs can be much more flexible and tailored to the task, actual plant condition, and operation mode. The dynamic presentation of the procedure will guide the user down the path of relevant steps, thus minimizing time spent by the field worker to evaluate plant conditions and decisions related to the applicability of each step. This dynamic presentation of the procedure also minimizes the risk of conducting steps out of order and/or incorrectly assessed applicability of steps.

  11. Procedures for using expert judgment to estimate human-error probabilities in nuclear power plant operations. [PWR; BWR

    SciTech Connect

    Seaver, D.A.; Stillwell, W.G.

    1983-03-01

    This report describes and evaluates several procedures for using expert judgment to estimate human-error probabilities (HEPs) in nuclear power plant operations. These HEPs are currently needed for several purposes, particularly for probabilistic risk assessments. Data do not exist for estimating these HEPs, so expert judgment can provide these estimates in a timely manner. Five judgmental procedures are described here: paired comparisons, ranking and rating, direct numerical estimation, indirect numerical estimation and multiattribute utility measurement. These procedures are evaluated in terms of several criteria: quality of judgments, difficulty of data collection, empirical support, acceptability, theoretical justification, and data processing. Situational constraints such as the number of experts available, the number of HEPs to be estimated, the time available, the location of the experts, and the resources available are discussed in regard to their implications for selecting a procedure for use.

  12. Measures of Knowledge and Attitude Toward Preventive Cardiology.

    ERIC Educational Resources Information Center

    Allred, Charlene A.; And Others

    1985-01-01

    The development and validation of an inventory of preventive cardiology at the University of Virginia is described. The inventory contains two instruments designed to measure medical students' preinstructional and postinstructional knowledge of and attitude toward preventive cardiology. (Author/MLW)

  13. The National Cardiac Societies of the European Society of Cardiology.

    PubMed

    Atar, Dan

    2015-06-01

    The National Cardiac Societies are one of the Constituent Bodies of the European Society of Cardiology (ESC). They are the backbone of the ESC and together form the "Cardiology of Europe" in 56 European and Mediterranean countries.

  14. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Ronan, Grace; Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M; Brindis, Ralph G; Kramer, Christopher M; Shaw, Leslee J; Cerqueira, Manuel D; Chen, Jersey; Dean, Larry S; Fazel, Reza; Hundley, W Gregory; Itchhaporia, Dipti; Kligfield, Paul; Lockwood, Richard; Marine, Joseph Edward; McCully, Robert Benjamin; Messer, Joseph V; O'Gara, Patrick T; Shemin, Richard J; Wann, L Samuel; Wong, John B; Patel, Manesh R; Kramer, Christopher M; Bailey, Steven R; Brown, Alan S; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Lindsay, Bruce D; Min, James K; Shaw, Leslee J; Stainback, Raymond F; Wann, L Samuel; Wolk, Michael J; Allen, Joseph M

    2014-02-01

    The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1-9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram (ECG

  15. Introduction to methods in molecular cardiology.

    PubMed

    Sun, Zhongjie

    2005-01-01

    Molecular cardiology is a new area of cardiovascular medicine that aims to apply molecular biological techniques for the mechanistic investigation, diagnosis, prevention, and treatment of cardiovascular disease. As an emerging discipline, it has changed our conceptual thinking of cardiovascular development, disease etiology, and pathophysiology. Although molecular cardiology is still at a very early stage, it has opened a promising avenue for understanding and controlling cardiovascular disease. With the rapid development and application of molecular biological techniques, scientists and clinicians are closer to curing heart diseases that were thought to be incurable 20 yr ago. There clearly is a need for a more thorough understanding of the molecular mechanisms of cardiovascular diseases to promote the advancement of cell and gene therapy for heart diseases. This chapter briefly reviews state-of-the-art techniques in the area of molecular cardiology.

  16. [Sports cardiology - a general practice oriented update].

    PubMed

    Schmied, Christian

    2014-08-06

    As a sub-speciality, Sports Cardiology focuses on sport and physical training interacting with cardiac issues. Particularly, Sports Cardiology deals with the so-called "Sports Paradox", which implicates the fact the on one side regular physical training leads to a multitude of relevant health benefits. But on the other hand, exercise can also be a trigger for sudden cardiac death, particularly in case of an underlying cardiac disease. However, health benefits by regular training outweigh potential risks by far, but only if an adequate cardiac screening and individual recommendations for sports participation have been provided. This review highlights various aspects of Sports Cardiology like strategies to prevent sudden cardiac death in sports and training recommendations in patients with an underlying cardiovascular disease.

  17. A Pediatric Cardiology Fellowship Boot Camp improves trainee confidence.

    PubMed

    Allan, Catherine K; Tannous, Paul; DeWitt, Elizabeth; Farias, Michael; Mansfield, Laura; Ronai, Christina; Schidlow, David; Sanders, Stephen P; Lock, James E; Newburger, Jane W; Brown, David W

    2016-12-01

    Introduction New paediatric cardiology trainees are required to rapidly assimilate knowledge and gain clinical skills to which they have limited or no exposure during residency. The Pediatric Cardiology Fellowship Boot Camp (PCBC) at Boston Children's Hospital was designed to provide incoming fellows with an intensive exposure to congenital cardiac pathology and a broad overview of major areas of paediatric cardiology practice.

  18. Hippocrates, cardiology, Confucius and the Yellow Emperor.

    PubMed

    Cheng, T O

    2001-12-01

    Although Hippocrates (460-c.375 BC) has been traditionally recognized as the Father of Medicine, the fact that he was seminal in the development of cardiology is much less well known. Evidence is presented to support the notion that Hippocrates could also be considered the Father of Cardiology. Hippocrates also had many of the teachings and practices in common with Confucius (c.551-c.479 BC) and the Yellow Emperor of China (2695-2589 BC). Whereas Confucius was not a physician, the Yellow Emperor was an ancient Chinese physician whose Huang Di Neijing, the Yellow Emperor's Canon of Internal Medicine, is the oldest known treatise of medicine in existence.

  19. Ionizing radiation exposure in interventional cardiology: current radiation protection practice of invasive cardiology operators in Lithuania.

    PubMed

    Valuckiene, Zivile; Jurenas, Martynas; Cibulskaite, Inga

    2016-09-01

    Ionizing radiation management is among the most important safety issues in interventional cardiology. Multiple radiation protection measures allow the minimization of x-ray exposure during interventional procedures. Our purpose was to assess the utilization and effectiveness of radiation protection and optimization techniques among interventional cardiologists in Lithuania. Interventional cardiologists of five cardiac centres were interviewed by anonymized questionnaire, addressing personal use of protective garments, shielding, table/detector positioning, frame rate (FR), resolution, field of view adjustment and collimation. Effective patient doses were compared between operators who work with and without x-ray optimization. Thirty one (68.9%) out of 45 Lithuanian interventional cardiologists participated in the survey. Protective aprons were universally used, but not the thyroid collars; 35.5% (n  =  11) operators use protective eyewear and 12.9% (n  =  4) wear radio-protective caps; 83.9% (n  =  26) use overhanging shields, 58.1% (n  =  18)-portable barriers; 12.9% (n  =  4)-abdominal patient's shielding; 35.5% (n  =  11) work at a high table position; 87.1% (n  =  27) keep an image intensifier/receiver close to the patient; 58.1% (n  =  18) reduce the fluoroscopy FR; 6.5% (n  =  2) reduce the fluoro image detail resolution; 83.9% (n  =  26) use a 'store fluoro' option; 41.9% (N  =  13) reduce magnification for catheter transit; 51.6% (n  =  16) limit image magnification; and 35.5% (n  =  11) use image collimation. Median effective patient doses were significantly lower with x-ray optimization techniques in both diagnostic and therapeutic interventions. Many of the ionizing radiation exposure reduction tools and techniques are underused by a considerable proportion of interventional cardiology operators. The application of basic radiation protection tools and

  20. Business process re-engineering a cardiology department.

    PubMed

    Bakshi, Syed Murtuza Hussain

    2014-01-01

    The health care sector is the world's third largest industry and is facing several problems such as excessive waiting times for patients, lack of access to information, high costs of delivery and medical errors. Health care managers seek the help of process re-engineering methods to discover the best processes and to re-engineer existing processes to optimize productivity without compromising on quality. Business process re-engineering refers to the fundamental rethinking and radical redesign of business processes to achieve dramatic improvements in critical, contemporary measures of performance, such as cost, quality and speed. The present study is carried out at a tertiary care corporate hospital with 1000-plus-bed facility. A descriptive study and case study method is used with intensive, careful and complete observation of patient flow, delays, short comings in patient movement and workflow. Data is collected through observations, informal interviews and analyzed by matrix analysis. Flowcharts were drawn for the various work activities of the cardiology department including workflow of the admission process, workflow in the ward and ICCU, workflow of the patient for catheterization laboratory procedure, and in the billing and discharge process. The problems of the existing system were studied and necessary suggestions were recommended to cardiology department module with an illustrated flowchart.

  1. The increasing impact of laboratory medicine on clinical cardiology.

    PubMed

    Clerico, Aldo

    2003-07-01

    The practice of cardiology continues to evolve along with a better understanding of the pathophysiology of cardiovascular disease and the development of new therapeutic procedures. Consequently, new demands are being made on the in vitro diagnostics industry to improve the performance of existing cardiac markers and to develop novel markers for new cardiac disease indications. Indeed, in the last 20 years there has been a progressive increase in new laboratory tests for markers of cardiac diseases. Several highly sensitive and/or specific assays for the detection of myocardial ischemic damage as well as some immunoassays for cardiac natriuretic hormones, now considered a reliable marker of myocardial function, have become commercially available. In parallel, a growing number of some novel risk factors, which can be assessed and monitored by laboratory methods, have been added to the classical risk factors for cardiovascular disease. Finally, the recent explosion of genetic analysis may soon place at the clinical cardiologist's disposal many laboratory tests for defining the diagnosis at the molecular level, assessing new risk factors, and better targeting the pharmaceutical approaches in patients with cardiovascular disease. In the present article, after a brief description of the analytical tests included in these four groups, each group's impact on clinical cardiology is discussed in detail.

  2. Optimization and surgical design for applications in pediatric cardiology

    NASA Astrophysics Data System (ADS)

    Marsden, Alison; Bernstein, Adam; Taylor, Charles; Feinstein, Jeffrey

    2007-11-01

    The coupling of shape optimization to cardiovascular blood flow simulations has potential to improve the design of current surgeries and to eventually allow for optimization of surgical designs for individual patients. This is particularly true in pediatric cardiology, where geometries vary dramatically between patients, and unusual geometries can lead to unfavorable hemodynamic conditions. Interfacing shape optimization to three-dimensional, time-dependent fluid mechanics problems is particularly challenging because of the large computational cost and the difficulty in computing objective function gradients. In this work a derivative-free optimization algorithm is coupled to a three-dimensional Navier-Stokes solver that has been tailored for cardiovascular applications. The optimization code employs mesh adaptive direct search in conjunction with a Kriging surrogate. This framework is successfully demonstrated on several geometries representative of cardiovascular surgical applications. We will discuss issues of cost function choice for surgical applications, including energy loss and wall shear stress distribution. In particular, we will discuss the creation of new designs for the Fontan procedure, a surgery done in pediatric cardiology to treat single ventricle heart defects.

  3. Update for 2014 on clinical cardiology, geriatric cardiology, and heart failure and transplantation.

    PubMed

    Barón-Esquivias, Gonzalo; Manito, Nicolás; López Díaz, Javier; Martín Santana, Antonio; García Pinilla, José Manuel; Gómez Doblas, Juan José; Gómez Bueno, Manuel; Barrios Alonso, Vivencio; Lambert, José Luis

    2015-04-01

    In the present article, we review publications from the previous year in the following 3 areas: clinical cardiology, geriatric cardiology, and heart failure and transplantation. Among the new developments in clinical cardiology are several contributions from Spanish groups on tricuspid and aortic regurgitation, developments in atrial fibrillation, syncope, and the clinical characteristics of heart disease, as well as various studies on familial heart disease and chronic ischemic heart disease. In geriatric cardiology, the most relevant studies published in 2014 involve heart failure, degenerative aortic stenosis, and data on atrial fibrillation in the geriatric population. In heart failure and transplantation, the most noteworthy developments concern the importance of multidisciplinary units and patients with preserved systolic function. Other notable publications were those related to iron deficiency, new drugs, and new devices and biomarkers. Finally, we review studies on acute heart failure and transplantation, such as inotropic drugs and ventricular assist devices.

  4. Evaluation of Cardiology Training and Manpower Requirements.

    ERIC Educational Resources Information Center

    Adams, Forrest H., Ed.; Mendenhall, Robert C., Ed.

    Begun in June, 1971 and completed in October 1973, the study had the following specific goals: to define the cardiologist's role; to determine cardiology training program objectives; to determine manpower needs for cardiologists; and to determine the educational needs of cardiologists. The major information was sought from all active cardiologists…

  5. An Evaluation of a Clerkship In Cardiology

    ERIC Educational Resources Information Center

    Edson, John N.; and others

    1969-01-01

    Evaluation of the clinical clerkship in Cardiology for general practitioners proves there is an urgent need for continuing post graduate medical education for general practitioners. Clerkship was offered jointly by the Long Island College Hospital and the State University of New York Downstate Medical Center, Brooklyn, New York. (IR)

  6. [The best of interventional cardiology in 2006].

    PubMed

    Blanchard, D; Eltchaninoff, H; Berland, J; Carrie, D; Dupouy, P; Funck, F; Gilard, M; Louvard, Y

    2007-01-01

    The year 2006 was a landmark in interventional cardiology. Confirmations of results of large-scale trials and meta analyses, the commercialisation of new drug-elution stents, discussions about well established methods, questions about long-term outcomes of dilated patients, have made 2006 a particularly rich year in controversy, especially during its last three months.

  7. [Aquapheresis, an innovative technique in cardiology].

    PubMed

    Armand, Patricia; Boutarin, David; Gerbaaï, Raphaëlle

    2015-03-01

    Used in France for the last two years, aquapheresis is a technique to remove excess water from patients with heart failure resistant to diuretics. The therapy is delivered during the patient's hospitalisation in a cardiology intensive care unit to ensure optimal monitoring and the prevention of potential complications. A team from Grenoble shares its experience.

  8. Diagnostic cardiology: Noninvasive imaging techniques

    SciTech Connect

    Come, P.C.

    1985-01-01

    This book contains 23 chapters. Some of the chapter titles are: The chest x-ray and cardiac series; Computed tomographic scanning of the heart, coronary arteries, and great vessels; Digital subtraction angiography in the assessment of cardiovascular disease; Magnetic resonance: technique and cardiac applications; Basics of radiation physics and instrumentation; and Nuclear imaging: the assessment of cardiac performance.

  9. Requirements for Computer Based-Procedures for Nuclear Power Plant Field Operators Results from a Qualitative Study

    SciTech Connect

    Katya Le Blanc; Johanna Oxstrand

    2012-05-01

    Although computer-based procedures (CBPs) have been investigated as a way to enhance operator performance on procedural tasks in the nuclear industry for almost thirty years, they are not currently widely deployed at United States utilities. One of the barriers to the wide scale deployment of CBPs is the lack of operational experience with CBPs that could serve as a sound basis for justifying the use of CBPs for nuclear utilities. Utilities are hesitant to adopt CBPs because of concern over potential costs of implementation, and concern over regulatory approval. Regulators require a sound technical basis for the use of any procedure at the utilities; without operating experience to support the use CBPs, it is difficult to establish such a technical basis. In an effort to begin the process of developing a technical basis for CBPs, researchers at Idaho National Laboratory are partnering with industry to explore CBPs with the objective of defining requirements for CBPs and developing an industry-wide vision and path forward for the use of CBPs. This paper describes the results from a qualitative study aimed at defining requirements for CBPs to be used by field operators and maintenance technicians.

  10. 48 CFR 50.104-3 - Special procedures for unusually hazardous or nuclear risks.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...' compensation insurance coverage. (iv) The controlling or limiting factors for determining the amount of... a corporate official with binding contractual authority, of all insurance coverage applicable to the risks to be defined in the contract as unusually hazardous or nuclear, including— (A) Names of...

  11. [Management control of cardiology: the experience of a departmental unit].

    PubMed

    Boccanelli, A; Spandonaro, F

    2000-01-01

    In most Italian hospitals, sanitary reform is being applied, while at the same time a new organization of the National Health System is being planned. The director of the medical hospital (head doctor) is becoming more and more involved in management and this aspect has modified his professional attributes. Cardiology is a branch of medicine that, through its scientific preparatory work consisting in debates, management courses, ethics, and production of managerial software, is closer to applying the reform without risking improper administrative aspects. This, obviously, comes about after thoroughly reviewing past work methods and the need to have an administrative organization, which allocates efficient use of manpower and materials, helping to eliminate any sources of inefficiency. The logical procedure foresees an actual analysis in terms of sanitary needs and availability of resources, and so attempting to better balance and harmonize both aspects of the problem. Certainly, the acquisition of theoretical norms and practices, which today are present because of the upsurge in training courses for doctors, is not enough to guarantee the achievement of optimal results. Furthermore, we find that theoretical models need to be validated and adapted to real work situations in the public hospital sector. This paper proposes, therefore, to explain the managerial experiences achieved in actual work situations at the Cardiology Department Unit of the San Giovanni Addolorata Hospital in Rome. In particular, it shows that in order to reach its clinical and economical objectives, it is essential to make available correct informative support for strategic and operational decisions. We can observe that there is a continuing lack of computer support systems being integrated into the present organization of most cardiology units. The use of software distributed to cardiology units from the Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) has enabled us to partially

  12. Comparison between Cystatin C- and Creatinine-Estimated Glomerular Filtration Rate in Cardiology Patients

    PubMed Central

    Åkerblom, Axel; Helmersson-Karlqvist, Johanna; Flodin, Mats; Larsson, Anders

    2015-01-01

    Objective Estimation of the glomerular filtration rate (GFR) is essential for identification, evaluation and risk prediction in patients with kidney disease. Estimated GFR (eGFR) is also needed for the correct dosing of drugs eliminated by the kidneys and to identify high-risk individuals in whom coronary angiography or other procedures may lead to kidney failure. Both cystatin C and creatinine are used for the determination of GFR, and we aimed to investigate if eGFR by the two methods differ in cardiology patients. Methods We compared cystatin C and creatinine (CKD-EPI) eGFR calculated from the same request from a cardiology outpatient unit (n = 2,716), a cardiology ward (n = 980), a coronary care unit (n = 1,464), and an advanced coronary care unit (n = 518) in an observational, cross-sectional study. Results The median creatinine eGFR results are approximately 10 ml/min/1.73 m2 higher than the median cystatin C eGFR that is up to 90 ml/min/1.73 m2, irrespective of the level of care. Creatinine eGFR resulted in a less advanced eGFR category in the majority of patients with a cystatin C eGFR <60 ml/min/1.73 m2. Conclusions Our study demonstrates a difference between creatinine and cystatin C eGFR in cardiology patients. It is important to be aware of which marker is used for the reported eGFR to minimize erroneous interpretations of the test results, as this could lead to under- or overmedication. Further studies are needed to determine the best method of estimating the GFR in cardiology units. PMID:26648945

  13. Behavioral cardiology: current advances and future directions.

    PubMed

    Rozanski, Alan

    2014-07-08

    Growing epidemiological evidence identifies key domains relevant to behavioral cardiology, including health behaviors, emotions, mental mindsets, stress management, social connectedness, and a sense of purpose. Each of these domains exists along a continuum, ranging from positive factors that promote health, to negative factors, which are pathophysiological. To date, there has been relatively little translation of this growing knowledge base into cardiology practice. Four initiatives are proposed to meet this challenge: 1) promulgating greater awareness of the potency of psychosocial risks factors; 2) overcoming a current "artificial divide" between conventional and psychosocial risk factors; 3) developing novel cost-effective interventions using Internet and mobile health applications, group-based counseling, and development of tiered-care behavioral management; and 4) in recognition that "one size does not fit all" with respect to behavioral interventions, developing specialists who can counsel patients in multidisciplinary fashion and use evidence-based approaches for promoting patient motivation and execution of health goals.

  14. Use of smartphone technology in cardiology.

    PubMed

    Nguyen, Hoang H; Silva, Jennifer N A

    2016-05-01

    Smartphone-based technologies along with broadband connectivity are changing the way modern cardiology is practiced. The ever broadening connectivity and increasing capabilities of smartphone-based technologies can better monitor, diagnose, and prevent cardiovascular diseases. Researchers can leverage the ubiquitous use of smartphone-based technologies and their constant stream of biometric data to establish large community-based clinical research studies. Patient engagement is enhanced with constant and on-demand access to physicians, daily self-monitoring, and expanding social networks. On the other hand, the exponential growth of smartphone-based technologies invariably disrupts the traditional healthcare model and leaves a vacuum in the infrastructure, medico-legal apparatus, and reimbursement systems that need to be addressed. In this review, we present a comprehensive discussion of the various applications utilizing smartphone-based technologies in cardiology.

  15. [Sports cardiology : Overview of relevant clinical topics].

    PubMed

    Laszlo, R; Scharhag, J; Burgstahler, C; Striegel, H; Steinacker, J M

    2017-01-23

    Physical activity is nowadays an established therapeutic principle concerning primary and secondary prevention of cardiovascular diseases; therefore, in internal sports medicine various aspects go beyond basic cardiological knowledge and require special medical expertise (sports cardiology). Acute cardiac risk is increased during physical activity; therefore, physical activity should be individually phased under consideration of the whole clinical situation. Physical training results in a functional adaptation of the cardiovascular system. Moreover, a structural adaptation can also be observed in competitive athletes but a differentiation between athlete's heart and cardiomyopathy is sometimes challenging. Preparticipation screening verifiably reduces the incidence of sudden cardiac death in athletes. Respective recommendations for the required diagnostics have been published and statutory health insurances are increasingly more willing to bear the incurred costs. Statistically, doping is more frequent in performance-orientated leisure time sports than in competitive sports. Drugs which are relevant for doping have partially irreversible cardiac side effects.

  16. Evaluation of drug information for cardiology patients.

    PubMed Central

    Baker, D; Roberts, D E; Newcombe, R G; Fox, K A

    1991-01-01

    1. Cardiologists and pharmacists at the University Hospital of Wales collaborated to write 20 individual leaflets incorporating guidelines for a range of drugs used in the treatment of cardiology patients. The Plain English Campaign advised on the intelligibility and presentation of the information. 2. One hundred and twenty-five patients from the Regional Cardiology Unit, University Hospital of Wales were randomly allocated to receive usual verbal counselling about their drug treatment with or without an individualised drug information wallet. Two weeks after discharge from hospital patients completed a postal questionnaire to determine their satisfaction with the information about their drug treatment and their understanding of it. Forty-nine questionnaires were returned from the leaflet group and 52 from the control group. 3. The provision of written guidelines resulted in significant improvements in patients' satisfaction with their drug treatment (chi 2 = 33.3, P less than 0.001) and their understanding of it (P less than 0.001, Mann-Whitney test). Overall, patients who received leaflets were more likely to be aware of the potential side effects of their drugs but less likely to be apprehensive about them. Succinct guidelines concerning drug therapy can be assimilated by cardiology patients and provide them with a permanent record for future reference. PMID:1888619

  17. Training residents/fellows in paediatric cardiology: the Emory experience.

    PubMed

    Campbell, Robert M

    2016-12-01

    Pediatric cardiology fellowship is a very busy time, with new responsibilities, new knowledge, new technology and fast pace. Above and beyond the science and art of pediatric cardiology, we emphasize that our cardiology fellows are in the middle of the "people business", with additional roles and responsibilities as they serve their patients and communities. This manuscript provides insight into these opportunities for our pediatric cardiac professionals.

  18. [Informed consent in cardiology. The Committee on Informed Consent of the Commission on Professional Matters of the Sociedad Española de Cardiología].

    PubMed

    de los Reyes López, M; Iñíguez Romo, A; Goicolea de Oro, A; Funes López, B; Castro Beiras, A

    1998-10-01

    In the last thirty years, the clinical relationship between physicians and patients has been rather modified. There are several factors that have contributed to this change: a) New ways to execute medical practises, specially referred to the development of new techniques; b) Cultural changes in our western society, mainly in the mediterranean area, where there has been progress in the recognition of patients' autonomy to decide about their own lives, health and their own bodies; c) The increasing number of lawsuits, complaints and judgements about the problems that clinical information involves, particularly the informed consent in clinical practise. We consider it necessary to make an extensive and deep discussion from all of the areas in Medicine and Law, to analyze the different ethical and legal parts of the informed consent. For that reason the Spanish Society of Cardiology offers their members a basic document in order to reflect about these facts, developing arguments, justifications and supports. This document has also considered models, conditions to their applicability according to Spanish law, and the experience we have had. Finally, there is a list of diagnostic procedures and interventional practises in cardiology that might be preceded by a written informed consent document. We considered them by the name of Spanish Society of Cardiology recommendations.

  19. Nuclear cardiograph and scintigraphy

    NASA Technical Reports Server (NTRS)

    Mclaughlin, P.

    1975-01-01

    Extensive advances in the technology of detectors, data analysis systems, and tracers used have resulted in greatly expanded applications of radioisotopes to the assessment of cardiac function and disease. The development of nuclear cardiology has proceeded along four lines: (1) radionuclide angiography, (2) myocardial perfusion imaging, (3) intracoronary microsphere imaging, and (4) regional myocardial blood flow determination using inert gases.

  20. ENDF-102 DATA FORMATS AND PROCEDURES FOR THE EVALUATION NUCLEAR DATA FILE ENDF-6.

    SciTech Connect

    MCLANE,V.

    2001-05-15

    The Evaluated Nuclear Data File (ENDF) formats and libraries are decided by the Cross Section Evaluation Working Group (CSEWG), a cooperative effort of national laboratories, industry, and universities in the U.S. and Canada, and are maintained by the National Nuclear Data Center (NNDC). Earlier versions of the ENDF format provided representations for neutron cross sections and distributions, photon production from neutron reactions, a limited amount of charged-particle production from neutron reactions, photo-atomic interaction data, thermal neutron scattering data, and radionuclide production and decay data (including fission products). Version 6 (ENDF-6) allows higher incident energies, adds more complete descriptions of the distributions of emitted particles, and provides for incident charged particles and photonuclear data by partitioning the ENDF library into sub-libraries. Decay data, fission product yield data, thermal scattering data, and photo-atomic data have also been formally placed in sub-libraries. In addition, this rewrite represents an extensive update to the Version V manual.

  1. Design and evaluation of computerized operating procedures in nuclear power plants.

    PubMed

    Hwang, Fei-Hui; Hwang, Sheue-Ling

    2003-01-15

    A small-scale virtual system has been developed in this study to enhance operators' understanding and operating performance. For this, a computerized graphical interface based on Dynamic Work Causality Equation (DWCE) has been designed to transform the operating procedure into a flowchart. Furthermore, the Programmable Logic Controller (PLC) was installed to connect the signboard (proposed system) with the computerized graphical interface. An experiment was conducted to verify the effect of computerized graphic interface, indicating that the computerized system significantly decreases learning time and improves operational performance.

  2. Hanford spent nuclear fuel cold vacuum drying proof of performance test procedure

    SciTech Connect

    McCracken, K.J.

    1998-06-10

    This document provides the test procedure for cold testing of the first article skids for the Cold Vacuum Drying (CVD) process at the Facility. The primary objective of this testing is to confirm design choices and provide data for the initial start-up parameters for the process. The current scope of testing in this document includes design verification, drying cycle determination equipment performance testing of the CVD process and MCC components, heat up and cool-down cycle determination, and thermal model validation.

  3. ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 Appropriate Use Criteria for Coronary Revascularization in Patients With Acute Coronary Syndromes : A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and the Society of Thoracic Surgeons.

    PubMed

    Patel, Manesh R; Calhoon, John H; Dehmer, Gregory J; Grantham, James Aaron; Maddox, Thomas M; Maron, David J; Smith, Peter K

    2017-03-06

    The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and American Association for Thoracic Surgery, along with key specialty and subspecialty societies, have completed a 2-part revision of the appropriate use criteria (AUC) for coronary revascularization. In prior coronary revascularization AUC documents, indications for revascularization in acute coronary syndromes (ACS) and stable ischemic heart disease were combined into 1 document. To address the expanding clinical indications for coronary revascularization, and in an effort to align the subject matter with the most current American College of Cardiology/American Heart Association guidelines, the new AUC for coronary artery revascularization were separated into 2 documents addressing ACS and stable ischemic heart disease individually. This document presents the AUC for ACS. Clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, presence of clinical instability or ongoing ischemic symptoms, prior reperfusion therapy, risk level as assessed by noninvasive testing, fractional flow reserve testing, and coronary anatomy. This update provides a reassessment of clinical scenarios that the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document but employs the recent modifications in the methods for developing AUC, most notably, alterations in the nomenclature for appropriate use categorization. A separate, independent rating panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate for the clinical scenario presented. Scores of 1 to 3 indicate that revascularization is considered rarely appropriate for the clinical scenario, whereas scores in the mid-range (4 to 6

  4. A case study of technology transfer: Cardiology

    NASA Technical Reports Server (NTRS)

    Schafer, G.

    1974-01-01

    Research advancements in cardiology instrumentation and techniques are summarized. Emphasis is placed upon the following techniques: (1) development of electrodes which show good skin compatibility and wearer comfort; (2) contourography - a real time display system for showing the results of EKGs; (3) detection of arteriosclerosis by digital computer processing of X-ray photos; (4) automated, noninvasive systems for blood pressure measurement; (5) ultrasonoscope - a noninvasive device for use in diagnosis of aortic, mitral, and tricuspid valve disease; and (6) rechargable cardiac pacemakers. The formation of a biomedical applications team which is an interdisciplinary team to bridge the gap between the developers and users of technology is described.

  5. Molecular cardiology and genetics in the 21st century--a primer.

    PubMed

    Roberts, Robert; Gollob, Michael

    2006-10-01

    The terminology and technology of molecular genetics and recombinant DNA have become an essential part of academic cardiology and will soon be applied at the bedside. The treatise includes a brief summary of the essentials of the DNA molecule, the more common techniques, and their application to genetics and molecular cardiology. It is written to be understood by physicians, scientists, and paramedical personnel who would not necessarily have a background in molecular biology. Inherent in the DNA molecule are three properties fundamental to all of the diagnostic and therapeutic applications, namely, the ability of DNA to separate into single strands, recombine (annealment or hybridization), and the presence of the negative charge enables DNA fragments to be separated easily by electrophoresis. Genetic linkage analysis of a family with an inherited disease enables one to identify the gene without knowing its protein product. Over 50 diseases in cardiology due to single-gene disorders have been identified and multiple mutations have been detected. The new therapeutic frontier will be stem cells and nuclear transfer. Identification of genes responsible for coronary artery disease made possible by genome-wide single nucleotide polymorphism (SNP) mapping techniques paves the way for personalized medicine.

  6. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D; Kramer, Christopher M; Berman, Daniel; Brown, Alan; Chaudhry, Farooq A; Cury, Ricardo C; Desai, Milind Y; Einstein, Andrew J; Gomes, Antoinette S; Harrington, Robert; Hoffmann, Udo; Khare, Rahul; Lesser, John; McGann, Christopher; Rosenberg, Alan; Schwartz, Robert; Shelton, Marc; Smetana, Gerald W; Smith, Sidney C

    2010-11-23

    The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research.

  7. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D

    2010-01-01

    The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research.

  8. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D

    2010-11-23

    The American College of Cardiology Foundation, along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research.

  9. Nuclear medicine practices in the 1950s through the mid-1970s and occupational radiation doses to technologists from diagnostic radioisotope procedures.

    PubMed

    Drozdovitch, Vladimir; Brill, Aaron B; Mettler, Fred A; Beckner, William M; Goldsmith, Stanley J; Gross, Milton D; Hays, Marguerite T; Kirchner, Peter T; Langan, James K; Reba, Richard C; Smith, Gary T; Bouville, André; Linet, Martha S; Melo, Dunstana R; Lee, Choonsik; Simon, Steven L

    2014-10-01

    Data on occupational radiation exposure from nuclear medicine procedures for the time period of the 1950s through the 1970s is important for retrospective health risk studies of medical personnel who conducted those activities. However, limited information is available on occupational exposure received by physicians and technologists who performed nuclear medicine procedures during those years. To better understand and characterize historical radiation exposures to technologists, the authors collected information on nuclear medicine practices in the 1950s, 1960s, and 1970s. To collect historical data needed to reconstruct doses to technologists, a focus group interview was held with experts who began using radioisotopes in medicine in the 1950s and the 1960s. Typical protocols and descriptions of clinical practices of diagnostic radioisotope procedures were defined by the focus group and were used to estimate occupational doses received by personnel, per nuclear medicine procedure, conducted in the 1950s to 1960s using radiopharmaceuticals available at that time. The radionuclide activities in the organs of the reference patient were calculated using the biokinetic models described in ICRP Publication 53. Air kerma rates as a function of distance from a reference patient were calculated by Monte Carlo radiation transport calculations using a hybrid computational phantom. Estimates of occupational doses to nuclear medicine technologists per procedure were found to vary from less than 0.01 μSv (thyroid scan with 1.85 MBq of administered I-iodide) to 0.4 μSv (brain scan with 26 MBq of Hg-chlormerodin). Occupational doses for the same diagnostic procedures starting in the mid-1960s but using Tc were also estimated. The doses estimated in this study show that the introduction of Tc resulted in an increase in occupational doses per procedure.

  10. [The origins of the Czech Society of Cardiology and of Czech cardiology].

    PubMed

    Widimský, J

    2013-06-01

    The paper presents the origins of the Czech Society of Cardiology on the one hand, and the origins of Czech cardiology on the other. The Czech Society of Cardiology is the third oldest in the world (after the American and German Societies). It was founded in 1929 by Prof. Libenský. As early as in 1933, the Society organised the first international congress of cardiologists in Prague, which was attended by 200 doctors, out of which 50 were from abroad. The most participants came from France and Poland. Other participants came from England, Argentina, Belgium, the Netherlands, Italy, Romania, Spain and Switzerland. The worldwide importance of this congress is apparent from the fact that both the World Society of Cardiology and the European Society of Cardiology (EKS) were founded after World War II in the years 1950 and 1952, i.e. almost 20 years after the first international congress of cardiology in Prague. In 1964, the Fourth Congress of European Society of Cardiology was held in Prague with the participation of 1,500 specialists from 31 countries and chaired by Prof. Pavel Lukl, the later president of EKS (1964- 1968). The paper also presents the work of our specialists in WHO and the history of the international journal Cor et Vasa issued by the Avicenum publishing house in Prague in English and Russian in the years 1958- 1992. An important role in the development of our cardiology was played by certain departments and clinics. In 1951, the Institute for Cardiovascular Research (ÚCHOK) was founded in PrahaKrč, thanks to the initiative of MU Dr. František Kriegl, the Deputy Minister of Health. Its first director was Klement Weber, who published, as early as in 1929, a monograph on arrhythmias -  50 years earlier than arrhythmias started to be at the centre of attention of cardiologists. Klement Weber was one of the doctors of President T. G. Masaryk during his serious disease towards the end of his life. Jan Brod was the deputy of Klement Weber in the

  11. Genomic translational research: Paving the way to individualized cardiac functional analyses and personalized cardiology.

    PubMed

    Pasipoularides, Ares

    2017-03-01

    For most of Medicine's past, the best that physicians could do to cope with disease prevention and treatment was based on the expected response of an average patient. Currently, however, a more personalized/precise approach to cardiology and medicine in general is becoming possible, as the cost of sequencing a human genome has declined substantially. As a result, we are witnessing an era of precipitous advances in biomedicine and bourgeoning understanding of the genetic basis of cardiovascular and other diseases, reminiscent of the resurgence of innovations in physico-mathematical sciences and biology-anatomy-cardiology in the Renaissance, a parallel time of radical change and reformation of medical knowledge, education and practice. Now on the horizon is an individualized, diverse patient-centered, approach to medical practice that encompasses the development of new, gene-based diagnostics and preventive medicine tactics, and offers the broadest range of personalized therapies based on pharmacogenetics. Over time, translation of genomic and high-tech approaches unquestionably will transform clinical practice in cardiology and medicine as a whole, with the adoption of new personalized medicine approaches and procedures. Clearly, future prospects far outweigh present accomplishments, which are best viewed as a promising start. It is now essential for pluridisciplinary health care providers to examine the drivers and barriers to the clinical adoption of this emerging revolutionary paradigm, in order to expedite the realization of its potential. So, we are not there yet, but we are definitely on our way.

  12. [Fundamental bases of digital information processing in nuclear cardiology (III)].

    PubMed

    Cuarón, A; González, C; García Moreira, C

    1984-01-01

    This article describes the transformation of the gamma-camera images into digital form. The incidence of a gamma photon on the detector, produces two voltage pulses, which are proportional to the coordinates of the incidence points, and a digital pulse, indicative of the occurrence of the event. The coordinate pulses passes through a analog-digital converter, that is activated by the pulse. The result is the appearance of a digital number at the out-put of the converter, which is proportional to the voltage at its in-put. This number, is stored on the accumulation memory of the system, either on a list mode or on a matrix mode. Static images can be stored on a single matrix. Dynamic data can be stored on a series of matrixes, each representing a different period of acquisition. It is also possible to capture information on a series of matrixes syncronized with the electrocardiogram of the patient. In this instance, each matrix represents a distinct period of the cardiac cycle. Data stored on the memory, can be used to process and display images and quantitative histograms on a video screen. In order to do that, it is necessary to translate the digital data on the memory to voltage levels, and to transform these on light levels on the screen. This, is achieved through a digital analog converter. The reading of the digital memory must be syncronic with the electronic scanning of the video screen.

  13. Function Allocation in Complex Socio-Technical Systems: Procedure usage in nuclear power and the Context Analysis Method for Identifying Design Solutions (CAMIDS) Model

    NASA Astrophysics Data System (ADS)

    Schmitt, Kara Anne

    This research aims to prove that strict adherence to procedures and rigid compliance to process in the US Nuclear Industry may not prevent incidents or increase safety. According to the Institute of Nuclear Power Operations, the nuclear power industry has seen a recent rise in events, and this research claims that a contributing factor to this rise is organizational, cultural, and based on peoples overreliance on procedures and policy. Understanding the proper balance of function allocation, automation and human decision-making is imperative to creating a nuclear power plant that is safe, efficient, and reliable. This research claims that new generations of operators are less engaged and thinking because they have been instructed to follow procedures to a fault. According to operators, they were once to know the plant and its interrelations, but organizationally more importance is now put on following procedure and policy. Literature reviews were performed, experts were questioned, and a model for context analysis was developed. The Context Analysis Method for Identifying Design Solutions (CAMIDS) Model was created, verified and validated through both peer review and application in real world scenarios in active nuclear power plant simulators. These experiments supported the claim that strict adherence and rigid compliance to procedures may not increase safety by studying the industry's propensity for following incorrect procedures, and when it directly affects the outcome of safety or security of the plant. The findings of this research indicate that the younger generations of operators rely highly on procedures, and the organizational pressures of required compliance to procedures may lead to incidents within the plant because operators feel pressured into following the rules and policy above performing the correct actions in a timely manner. The findings support computer based procedures, efficient alarm systems, and skill of the craft matrices. The solution to

  14. Radiation exposure to nuclear medicine staffs during 18F-FDG PET/CT procedures at Ramathibodi Hospital

    NASA Astrophysics Data System (ADS)

    Donmoon, T.; Chamroonrat, W.; Tuntawiroon, M.

    2016-03-01

    The aim of this study is to estimate the whole body and finger radiation doses per study received by nuclear medicine staff involved in dispensing, administration of 18F-FDG and interacting with radioactive patients during PET/CT imaging procedures in a PET/CT facility. The whole-body doses received by radiopharmacists, technologists and nurses were measured by electronic dosimeter and the finger doses by ring dosimeter during a period of 4 months. In 70 PET/CT studies, the mean whole-body dose per study to radiopharmacist, technologist, and nurse were 1.07±0.09, 1.77±0.46, μSv, and not detectable respectively. The mean finger doses per study received by radiopharmacist, technologist, and nurse were 265.65±107.55, 4.84±1.08 and 19.22±2.59 μSv, respectively. The average time in contact with 18F-FDG was 5.88±0.03, 39.06±1.89 and 1.21±0.02 minutes per study for radiopharmacist, technologist and nurse respectively. Technologists received highest mean effective whole- body dose per study and radiopharmacist received the highest finger dose per study. When compared with the ICRP dose limit, each individual worker can work with many more 18F- FDG PET/CT studies for a whole year without exceeding the occupational dose limits. This study confirmed that low levels of radiation does are received by our medical personnel involved in 18F-FDG PET/CT procedures.

  15. Tracking patient radiation exposure: challenges to integrating nuclear medicine with other modalities

    PubMed Central

    Mercuri, Mathew; Rehani, Madan M.; Einstein, Andrew J.

    2013-01-01

    The cumulative radiation exposure to the patient from multiple radiological procedures can place some individuals at significantly increased risk for stochastic effects and tissue reactions. Approaches, such as those in the International Atomic Energy Agency’s Smart Card program, have been developed to track cumulative radiation exposures to individuals. These strategies often rely on the availability of structured dose reports, typically found in the DICOM header. Dosimetry information is currently readily available for many individual x-ray based procedures. Nuclear medicine, of which nuclear cardiology constitutes the majority of the radiation burden in the U.S., currently lags behind x-ray based procedures with respect to reporting of radiation dosimetric information. This paper discusses qualitative differences between nuclear medicine and x-ray based procedures, including differences in the radiation source and measurement of its strength, the impact of biokinetics on dosimetry, and the capability of current scanners to record dosimetry information. These differences create challenges in applying monitoring and reporting strategies used in x-ray based procedures to nuclear medicine, and integrating dosimetry information across modalities. A concerted effort by the medical imaging community, dosimetry specialists and manufacturers of imaging equipment is required to develop strategies to improve the reporting of radiation dosimetry data in nuclear medicine. Some ideas on how to address this issue are suggested. PMID:22695788

  16. Advances in cardiology: clinical trial update.

    PubMed

    Howe, Andrew J; Shand, James A; Menown, Ian B A

    2011-05-01

    Multiple key cardiology trials have been presented or published over recent months, several with the potential to change clinical practice. In this article, we summarize and place in clinical context new trial findings regarding anticoagulation in the cardiac catheterization laboratory (enoxaparin, fondaparinux and unfractionated heparin), the implications of genetic polymorphisms and functional testing for antiplatelet therapy (clopidogrel and ticagrelor), new oral anticoagulants for use in atrial fibrillation (apixiban and rivaroxaban), optimal pacing strategies and pharmacological agents in heart failure (ivabradine, eplerenone, cardiac resynchronization therapy, telemonitoring and intracoronary bone marrow stem cell infusion). Clinical trials in percutaneous structural intervention (transcatheter aortic valve implantation, MONARC™ mitral annular implant, STARFlex(®) patent foramen ovale device) and advanced percutaneous coronary intervention (everolimus-eluting stents, biodegradable polymer/polymer-free technologies and contemporary use of intravascular ultrasound) are also discussed.

  17. [Genetics and molecular medicine in cardiology].

    PubMed

    Rojas Martínez, A; Ortiz López, R; Delgado Enciso, I

    2001-01-01

    The discoveries on molecular aspects of cellular function are changing the concepts of health and disease. All medical fields, including cardiology, have been enriched with several diagnostic test to determine predisposition and to detect molecular dysfunctions. This review on the genetic and molecular aspects of cardiovascular diseases is written at the Centenary of the rediscovery of Mendel's principles on heredity and at the time of the announcement of the end of the human genome sequencing task. The review starts with considerations on the pluricellular constitution of the human body, and the principles of genetics with their molecular bases; including a short description of the methods for gene mapping. The following sections give a historic synopsis on the concepts of medical genetics, molecular medicine, and the Human Genome Project. The review ends with a brief description of the spectrum of genetic diseases, using examples of cardiovascular diseases.

  18. Teaching preventive cardiology through community programs.

    PubMed

    Davidson, D M

    1990-01-01

    Entering medical students currently report positive attitudes toward the concept of preventive cardiology but express a lack of confidence in the physician's ability to change unhealthful habits of their patients. One approach to this problem has been the involvement of medical students and house staff physicians in cardiovascular health programs offered in the community. With the goal of enhancing the knowledge, attitudes, and skills of the trainees, these programs have been carried out in educational institutions at all levels, in churches, and at work sites, shopping malls, and health fairs. Informal assessment of these programs suggests that medical trainees develop an increased sense of confidence in their ability to influence positively the health habits of children and adults.

  19. [Takotsubo cardiomyopathy in a cardiology department].

    PubMed

    Cesário, Vera; Loureiro, Maria José; Pereira, Hélder

    2012-09-01

    Takotsubo cardiomyopathy, also known as transient left ventricular apical ballooning syndrome, stress-induced cardiomyopathy and broken heart syndrome, is characterized by transient left ventricular dysfunction in the absence of obstructive coronary artery disease. It was first described in 1990 in Japan, and gained worldwide recognition following the publication of several series of case reports. Its prevalence is estimated to be 1.7-2.2% of suspected acute coronary syndromes. Although takotsubo cardiomyopathy has been progressively better characterized, certain aspects remain to be clarified, and it is still under study. In this article, we report a series of ten cases of takotsubo cardiomyopathy admitted to a cardiology department, and compare the clinical, laboratory, electrocardiographic and imaging characteristics, therapeutic regimens and follow-up of these patients with those described in the latest scientific reviews.

  20. [Cardiology in the Morgagni's anatomo pathological work].

    PubMed

    de Micheli, Alfredo; Iturralde, Pedro; Aranda Fraustro, Alberto

    2015-01-01

    In the XVIII century, under the influence of the "systematic spirit", characteristic of the Enlightenment age, pathological anatomy was systematized in the Morgagni's fundamental treatise De sedibus et causis morborum per anatomen indagatis, published as letters in 1761. Certain biographical data of the author are reported here as well as some his more important contributions to cardiology such as the Morgagni's, Adams', Stokes' syndrome. His points of view on sudden death and his observations on post-infarct myocardial rupture, are related also. In his global evaluation of these facts, the speculative approach always predominates. Indeed, in these anatomist's works, we find a good example of the application of epistemologic principles to the medical field.

  1. Patient doses and dosimetric evaluations in interventional cardiology.

    PubMed

    Bor, Dogan; Olğar, Turan; Toklu, Türkay; Cağlan, Ayça; Onal, Elif; Padovani, Renato

    2009-03-01

    Interventional cardiological examinations may be associated with excessive radiation exposures which may cause skin injuries and higher probabilities of stochastic effects. Dose-area product (DAP) and skin doses of 325 patients were measured using alternative dosimetric techniques for different cardiological examinations. Data were collected from five different systems with the involvement of 11 cardiologists. All these dosimetric information has been collected separately for each of 10 projections together with the exposure parameters of X-ray systems. Mean DAP values measured with a transparent ion chamber were 49.1 Gy cm(2), 66.8 Gy cm(2), 106.9 Gy cm(2) and 124.7 Gy cm(2), respectively, for coronary angiography (CA), percutaneous transluminal coronary angioplasty (PTCA) or stent (PT-SI), coronary angiography and/or PTCA and/or stent (CA-PT-SI), and ablation examinations. Radiochromic films, thermoluminescent dosimeters (TLD) and point measurement of air kerma (AK) were carried out for skin dose assessments. Skin doses of 23 patients measured with radiochromic films were found to be between 2 Gy and 6 Gy. Although the complexity of the procedures was the major reason for these excessive doses, considerable contributions of high X-ray output of some fluoroscopy units were also noticed. In addition to the direct measurement of DAP, alternative DAP values were also determined from the skin dose measurement techniques; exposed areas were summed on digitized radiochromic films in one technique, The product of AK reading with X-ray field size measured at the patient entrance using slow X-ray films was taken as another DAP. Good correlations were found among the DAP results and also between the entrance skin doses calculated from AK measurements and direct DAP readings (R(2)=0.91). A trigger DAP value of 130 Gy cm(2) for the 2 Gy of skin doses was derived from this relationship. Collection of dosimetric data for each projection was also investigated regarding a

  2. Computational cardiology: how computer simulations could be used to develop new therapies and advance existing ones

    PubMed Central

    Trayanova, Natalia A.; O'Hara, Thomas; Bayer, Jason D.; Boyle, Patrick M.; McDowell, Kathleen S.; Constantino, Jason; Arevalo, Hermenegild J.; Hu, Yuxuan; Vadakkumpadan, Fijoy

    2012-01-01

    This article reviews the latest developments in computational cardiology. It focuses on the contribution of cardiac modelling to the development of new therapies as well as the advancement of existing ones for cardiac arrhythmias and pump dysfunction. Reviewed are cardiac modelling efforts aimed at advancing and optimizing existent therapies for cardiac disease (defibrillation, ablation of ventricular tachycardia, and cardiac resynchronization therapy) and at suggesting novel treatments, including novel molecular targets, as well as efforts to use cardiac models in stratification of patients likely to benefit from a given therapy, and the use of models in diagnostic procedures. PMID:23104919

  3. [Role of new oral anticoagulants in interventional cardiology].

    PubMed

    Brasselet, C; Duval, S

    2012-12-01

    New oral anticoagulants constitute an important breakthrough for cardiologists and their patients. After reviewing their mechanism of action, their role in the context of interventional cardiology, particularly for patients with acute coronary syndromes, is discussed.

  4. Development of Quality Metrics in Ambulatory Pediatric Cardiology.

    PubMed

    Chowdhury, Devyani; Gurvitz, Michelle; Marelli, Ariane; Anderson, Jeffrey; Baker-Smith, Carissa; Diab, Karim A; Edwards, Thomas C; Hougen, Tom; Jedeikin, Roy; Johnson, Jonathan N; Karpawich, Peter; Lai, Wyman; Lu, Jimmy C; Mitchell, Stephanie; Newburger, Jane W; Penny, Daniel J; Portman, Michael A; Satou, Gary; Teitel, David; Villafane, Juan; Williams, Roberta; Jenkins, Kathy

    2017-02-07

    The American College of Cardiology Adult Congenital and Pediatric Cardiology (ACPC) Section had attempted to create quality metrics (QM) for ambulatory pediatric practice, but limited evidence made the process difficult. The ACPC sought to develop QMs for ambulatory pediatric cardiology practice. Five areas of interest were identified, and QMs were developed in a 2-step review process. In the first step, an expert panel, using the modified RAND-UCLA methodology, rated each QM for feasibility and validity. The second step sought input from ACPC Section members; final approval was by a vote of the ACPC Council. Work groups proposed a total of 44 QMs. Thirty-one metrics passed the RAND process and, after the open comment period, the ACPC council approved 18 metrics. The project resulted in successful development of QMs in ambulatory pediatric cardiology for a range of ambulatory domains.

  5. Systematic Reviews and Meta-analyses for Cardiology Fellows.

    PubMed

    Fares, Munes; Alahdab, Fares; Alsaied, Tarek

    2016-07-01

    Participating in a scholarly activity is one of the training requirements for cardiology fellows. However, it can be very challenging to complete a research project during such a busy period of clinical training. To help the cardiology fellows in choosing and starting off a research project, a light has been shed on the process of conducting a systematic review, and the importance of this research activity, as well as its limitations.

  6. The ten advances that have defined modern cardiology.

    PubMed

    Braunwald, Eugene

    2014-07-01

    Modern cardiology was born early in the twentieth century. Here I list and review what I believe to be the ten most important advances in the twentieth century in this field. They are as follows: electrocardiography, cholesterol-induced atherosclerosis, cardiac catheterization, cardiovascular surgery, coronary angiography and percutaneous coronary angioplasty, the coronary care unit, the development of new cardiovascular drugs, preventive cardiology, cardiac imaging, and implanted cardiac pacemakers/defibrillators.

  7. [Guideline for the education of the specialist in cardiology in Spain. Comisión Nacional de la Especialidad de Cardiología].

    PubMed

    Cosín Aguilar, J; Plaza Celemín, L; Martín Durán, R; Zarco Gutiérrez, P; López Merino, V; Cortina Llosa, A; Ferreira Montero, I; García-Cosío Mir, F; Castro Beiras, A; Martínez Monzonís, A

    2000-02-01

    This article presents the program for training in cardiology. The document was elaborated by the National Committee of the Specialty of Cardiology, from the Ministry of Health and Ministry of Education, and describes the theoretical and practical aspects of training in cardiology prevailing at present in Spain.

  8. Is patient size important in dose determination and optimization in cardiology?

    NASA Astrophysics Data System (ADS)

    Reay, J.; Chapple, C. L.; Kotre, C. J.

    2003-12-01

    Patient dose determination and optimization have become more topical in recent years with the implementation of the Medical Exposures Directive into national legislation, the Ionising Radiation (Medical Exposure) Regulations. This legislation incorporates a requirement for new equipment to provide a means of displaying a measure of patient exposure and introduces the concept of diagnostic reference levels. It is normally assumed that patient dose is governed largely by patient size; however, in cardiology, where procedures are often very complex, the significance of patient size is less well understood. This study considers over 9000 cardiology procedures, undertaken throughout the north of England, and investigates the relationship between patient size and dose. It uses simple linear regression to calculate both correlation coefficients and significance levels for data sorted by both room and individual clinician for the four most common examinations, left ventrical and/or coronary angiography, single vessel stent insertion and single vessel angioplasty. This paper concludes that the correlation between patient size and dose is weak for the procedures considered. It also illustrates the use of an existing method for removing the effect of patient size from dose survey data. This allows typical doses and, therefore, reference levels to be defined for the purposes of dose optimization.

  9. Electrocardiographic interpretation skills of cardiology residents: are they competent?

    PubMed

    Sibbald, Matthew; Davies, Edward G; Dorian, Paul; Yu, Eric H C

    2014-12-01

    Achieving competency at electrocardiogram (ECG) interpretation among cardiology subspecialty residents has traditionally focused on interpreting a target number of ECGs during training. However, there is little evidence to support this approach. Further, there are no data documenting the competency of ECG interpretation skills among cardiology residents, who become de facto the gold standard in their practice communities. We tested 29 Cardiology residents from all 3 years in a large training program using a set of 20 ECGs collected from a community cardiology practice over a 1-month period. Residents interpreted half of the ECGs using a standard analytic framework, and half using their own approach. Residents were scored on the number of correct and incorrect diagnoses listed. Overall diagnostic accuracy was 58%. Of 6 potentially life-threatening diagnoses, residents missed 36% (123 of 348) including hyperkalemia (81%), long QT (52%), complete heart block (35%), and ventricular tachycardia (19%). Residents provided additional inappropriate diagnoses on 238 ECGs (41%). Diagnostic accuracy was similar between ECGs interpreted using an analytic framework vs ECGs interpreted without an analytic framework (59% vs 58%; F(1,1333) = 0.26; P = 0.61). Cardiology resident proficiency at ECG interpretation is suboptimal. Despite the use of an analytic framework, there remain significant deficiencies in ECG interpretation among Cardiology residents. A more systematic method of addressing these important learning gaps is urgently needed.

  10. European Society of Cardiology Congress 2013 highlights.

    PubMed

    Fox, Keith A A

    2014-01-01

    The European Society of Cardiology (ESC) Congress in 2013 met in Amsterdam (The Netherlands) as an innovative and interactive congress involving more than 30,000 participants. There were 10,490 abstract submissions and a total of 227 hotline, basic science hotline and trial update submissions. Participants were involved from more than 150 countries. To make the congress manageable for participants, related topics were grouped together in ‘villages’ and a smart electronic application allowed the participants to guide their way through the congress and choose the sessions of interest. The innovative new program was initiated by the ESC Congress Programme Committee and the Congress Chair (Keith AA Fox, Chair 2012–2014) has responsibility for the design and delivery of the scientific program. The spotlight of the congress was ‘the heart interacting with systemic organs’, chosen because of the importance of cardiovascular disease conditions crossing conventional boundaries. In all 572 abstracts, the work involved an interaction between the heart and another organ, such as the brain, lungs, kidney, vasculature or inflammation system. In addition, innovative new approaches linked basic science and clinical science and the new ‘hubs of the congress’ allowed excellent interaction and exchange of ideas.

  11. The contributions of Carl Ludwig to cardiology.

    PubMed

    Zimmer, H G

    1999-03-01

    The basic instruments for measuring functional cardiovascular parameters and the most important discoveries made by Carl Ludwig and his disciples in cardiovascular physiology are described and put into perspective in regard to the further development of his methods and ideas. The most important apparatus was the kymograph, which, for the first time, made recording and documenting of functional parameters possible. This instrument was also used for the functional evaluation of the isolated perfused frog heart that was developed by Elias Cyon in Ludwig's Leipzig Physiological Institute. In the isolated frog heart, important phenomena were discovered such as the staircase ('Treppe'), the absolute refractory period and the all-or-none law of the heart. The isolated dog heart was used to determine the origin of the first heart sound, which was characterized as a muscle tone. To measure regional blood flow and eventually cardiac output, a flowmeter ('Stromuhr') was designed. Precise measurements of cardiac output became possible only when Adolf Fick had developed his principle, which served as the basis for the modern indicator methods. Cyon and Ludwig also discoverd the depressor nerve, which constitutes the basis of the baroreceptor reflex. Finally, the precise localization of the vasomotor centre in the ventrolateral medulla was achieved in Ludwig's Leipzig Physiological Institute. This was confirmed more than 100 years later with modern neuroanatomical methods making use of retrograde axonal transport. Thus, Ludwig and his scholars made major substantial contributions to cardiovascular knowledge that can be considered to constitute the basis of modern cardiology.

  12. Metabolomics: a new era in cardiology?

    PubMed

    Mercuro, Giuseppe; Bassareo, Pier P; Deidda, Martino; Cadeddu, Christian; Barberini, Luigi; Atzori, Luigi

    2011-11-01

    The metabolome represents the collection of all metabolites in a biological cell, tissue, organ or organism, which are the end-products of cellular processes. Metabolomics is the systematic study of small-molecule metabolite profiles that specific cellular processes leave behind. RNA messenger gene expression data and proteomic analyses do not tell the whole story of what might be happening in a cell. Metabolic profiling, in turn, amplifies changes both in the proteome and the genome, and represents a more accurate approximation to the phenotype of an organism in health and disease. In this article, we have provided a description of metabolomics, in the presence of other, more familiar 'omics' disciplines, such as genomics and proteomics. In addition, we have reviewed the current rationale for metabolomics in cardiology, its basic methodology and the data actually available in human studies in this discipline. The discussed topics highlight the importance of being able to use the metabolomics information in order to understand disease mechanisms from a systems biology perspective as a noninvasive approach to diagnose, grade and treat cardiovascular diseases.

  13. Speculative Considerations about Some Cardiology Enigmas.

    PubMed

    Evora, Paulo Roberto Barbosa; Schmidt, Andre; Arcêncio, Livia; Marin-Neto, José Antonio

    2017-03-17

    Write a review text or point-of-view that takes into account the interests, if not of all, but of most readers of a scientific journal is an arduous task. The editorial can be grounded in published articles, even in a single article of undeniable importance and, it can also represent a trend of specialty. Therefore, especially for the sake of the reader's motivation, the present text was freely designed to discuss some cardiology enigmas in the context of the heart valve and coronary artery disease (CAD). Concerning the CAD five well-known enigmas will be considered: 1) The absence of arteriosclerosis in intramyocardial coronary arteries; 2) The unique and always confirmed superior evolution of the left internal thoracic artery as a coronary graft; 3) The prophylactic left internal thoracic artery graft in mildly-stenosed coronary lesions, and; 4) The high incidence of perioperative atrial fibrillation (AF) in patients with CAD, and; 5) The handling of disease-free saphenous vein graft at the time of reoperation. Concerning the cardiac valve disease these enigmas topics will be discussed: 1) Why some young patients present acute pulmonary edema as the first sign of mitral stenosis, and other patients with significant hemodynamic changes are mildly symptomatic or asymptomatic, and; 2) The enigma of aortic stenosis protection against CAD.

  14. Improving Access to Pediatric Cardiology in Cape Verde via a Collaborative International Telemedicine Service.

    PubMed

    Lapão, Luís Velez; Correia, Artur

    2015-01-01

    This paper addresses the role of international telemedicine services in supporting the evacuation procedures from Cape Verde to Portugal, enabling better quality and cost reductions in the management of the global health system. The Cape Verde, as other African countries, health system lacks many medical specialists, like pediatric cardiologists, neurosurgery, etc. In this study, tele-cardiology shows good results as diagnostic support to the evacuation decision. Telemedicine services show benefits while monitoring patients in post-evacuation, helping to address the lack of responsive care in some specialties whose actual use will help save resources both in provision and in management of the evacuation procedures. Additionally, with tele-cardiology collaborative service many evacuations can be avoided whereas many cases will be treated and followed locally in Cape Verde with remote technical support from Portugal. This international telemedicine service enabled more efficient evacuations, by reducing expenses in travel and housing, and therefore contributed to the health system's improvement. This study provides some evidence of how important telemedicine really is to cope with both the geography and the shortage of physicians.

  15. Role Of The Bureau Of Radiological Health In Assessment Of Risks From Clinical Nuclear Magnetic Resonance (NMR) Procedures

    NASA Astrophysics Data System (ADS)

    Anderson, Mary P.; Athey, T. W.; Phillips, Robert A.

    1982-12-01

    The 1976 Medical Device Amendments to the Federal Food, Drug, and Cosmetic Act provide for the classification of a medical device intended for human use into one of three regulatory classes based on the extent of control necessary to ensure safety and effectiveness: Class I, General Controls; Class II, Performance Standards; Class III, Premarket Approval. Class III devices are those for which there is insufficient information available to ensure safety and effectiveness through General Controls and Performance Standards alone. New devices such as Nuclear Magnetic Resonance Imaging systems fall under Class III because they were developed after the date of the law's enactment (28 May 1976). Investigational studies involving human subjects undertaken to develop safety and effectiveness data for a post-enactment Class III device come under the Investigational Device Exemption (IDE) Regulation (21 CFR 812). This regulation distinguishes between investigations of devices that pose a significant risk to the human subject and those that do not. A significant risk investigation "presents a potential for serious risk to the health, safety, or welfare of a subject." Procedures for obtaining an IDE differ if the device does or does not pose a significant risk. The sponsor of a clinical trial, and ultimately the Institutional Review Board (IRB), have the primary responsibility to determine whether a certain clinical use of the investigational device represents a significant risk to the subject of the investigation. A finding of significant risk does not mean that a device is too hazardous for clinical studies, but it does mean that a formal application for an IDE must be made to and approved by the Food and Drug Administration (FDA) before a clinical trial can begin. If the device is deemed not to pose a significant risk, unless otherwise notified by FDA, the sponsor is not required to submit an IDE application to FDA. Instead, the sponsor and investigators must satisfy only

  16. Radiation dose and image quality for paediatric interventional cardiology.

    PubMed

    Vano, E; Ubeda, C; Leyton, F; Miranda, P

    2008-08-07

    Radiation dose and image quality for paediatric protocols in a biplane x-ray system used for interventional cardiology have been evaluated. Entrance surface air kerma (ESAK) and image quality using a test object and polymethyl methacrylate (PMMA) phantoms have been measured for the typical paediatric patient thicknesses (4-20 cm of PMMA). Images from fluoroscopy (low, medium and high) and cine modes have been archived in digital imaging and communications in medicine (DICOM) format. Signal-to-noise ratio (SNR), figure of merit (FOM), contrast (CO), contrast-to-noise ratio (CNR) and high contrast spatial resolution (HCSR) have been computed from the images. Data on dose transferred to the DICOM header have been used to test the values of the dosimetric display at the interventional reference point. ESAK for fluoroscopy modes ranges from 0.15 to 36.60 microGy/frame when moving from 4 to 20 cm PMMA. For cine, these values range from 2.80 to 161.10 microGy/frame. SNR, FOM, CO, CNR and HCSR are improved for high fluoroscopy and cine modes and maintained roughly constant for the different thicknesses. Cumulative dose at the interventional reference point resulted 25-45% higher than the skin dose for the vertical C-arm (depending of the phantom thickness). ESAK and numerical image quality parameters allow the verification of the proper setting of the x-ray system. Knowing the increases in dose per frame when increasing phantom thicknesses together with the image quality parameters will help cardiologists in the good management of patient dose and allow them to select the best imaging acquisition mode during clinical procedures.

  17. Radiation dose and image quality for paediatric interventional cardiology

    NASA Astrophysics Data System (ADS)

    Vano, E.; Ubeda, C.; Leyton, F.; Miranda, P.

    2008-08-01

    Radiation dose and image quality for paediatric protocols in a biplane x-ray system used for interventional cardiology have been evaluated. Entrance surface air kerma (ESAK) and image quality using a test object and polymethyl methacrylate (PMMA) phantoms have been measured for the typical paediatric patient thicknesses (4-20 cm of PMMA). Images from fluoroscopy (low, medium and high) and cine modes have been archived in digital imaging and communications in medicine (DICOM) format. Signal-to-noise ratio (SNR), figure of merit (FOM), contrast (CO), contrast-to-noise ratio (CNR) and high contrast spatial resolution (HCSR) have been computed from the images. Data on dose transferred to the DICOM header have been used to test the values of the dosimetric display at the interventional reference point. ESAK for fluoroscopy modes ranges from 0.15 to 36.60 µGy/frame when moving from 4 to 20 cm PMMA. For cine, these values range from 2.80 to 161.10 µGy/frame. SNR, FOM, CO, CNR and HCSR are improved for high fluoroscopy and cine modes and maintained roughly constant for the different thicknesses. Cumulative dose at the interventional reference point resulted 25-45% higher than the skin dose for the vertical C-arm (depending of the phantom thickness). ESAK and numerical image quality parameters allow the verification of the proper setting of the x-ray system. Knowing the increases in dose per frame when increasing phantom thicknesses together with the image quality parameters will help cardiologists in the good management of patient dose and allow them to select the best imaging acquisition mode during clinical procedures.

  18. Development of pediatric cardiology in latin america: accomplishments and remaining challenges.

    PubMed

    Capelli, Horacio; Kreutzer, Christian; Kreutzer, Guillermo

    2011-01-01

    Until the first quarter of the 20th century, most physicians were more than happy to differentiate congenital heart lesions from rheumatic heart disease, which then was rampant. As early as 1932, Dr Rodolfo Kreutzer, from Buenos Aires, Argentina, was already involved in the study of congenital heart defects. He started off assessing children with a stethoscope and with Einthoven electrocardiography equipment. The cardiac unit at the Buenos Aires Children's Hospital was created in 1936. It established the onset of pediatric cardiology in Argentina and fueled its development in South America. Nearly at the same time, Agustin Castellanos from Cuba also became a pioneer in the assessment of congenital heart disease. He described the clinical applications of intravenous angiocardiography in 1937. Meanwhile in Mexico, Dr Ignacio Chavez founded the National Institute of Cardiology in 1944 in Mexico City. It was the first center in the world to be exclusively devoted to cardiology. From this center, Victor Rubio and Hugo Limon performed the first therapeutic cardiac catheterization in 1953. Meanwhile, Professor Euriclydes Zerbini from Sao Paulo, Brazil, built the largest and most important school of cardiac surgeons in South America. In Santiago, Chile, the Calvo Makenna Hospital was the center where Helmut Jaegger operated on the first infant with extracorporeal circulation in Latin America in 1956. The patient was a 1-month-old baby, with complete transposition of the great arteries, who underwent an Albert procedure. Currently, there are many fully equipped centers all over the region, capable of dealing with most lesions and of providing excellent medical, interventional, and surgical treatment. Outcomes have improved substantially over the last 20 years. These achievements have gone beyond our pioneers' dreams. However, many neonates and young infants die prior to surgery because referral centers are overburdened and have long surgical waiting lists. Clearly, we still

  19. What to Expect From the Evolving Field of Geriatric Cardiology.

    PubMed

    Bell, Susan P; Orr, Nicole M; Dodson, John A; Rich, Michael W; Wenger, Nanette K; Blum, Kay; Harold, John Gordon; Tinetti, Mary E; Maurer, Mathew S; Forman, Daniel E

    2015-09-15

    The population of older adults is expanding rapidly, and aging predisposes to cardiovascular disease. The principle of patient-centered care must respond to the preponderance of cardiac disease that now occurs in combination with the complexities of old age. Geriatric cardiology melds cardiovascular perspectives with multimorbidity, polypharmacy, frailty, cognitive decline, and other clinical, social, financial, and psychological dimensions of aging. Although some assume that a cardiologist may instinctively cultivate some of these skills over the course of a career, we assert that the volume and complexity of older cardiovascular patients in contemporary practice warrants a more direct approach to achieve suitable training and a more reliable process of care. We present a rationale and vision for geriatric cardiology as a melding of primary cardiovascular and geriatrics skills, thereby infusing cardiology practice with expanded proficiencies in diagnosis, risks, care coordination, communications, end-of-life, and other competences required to best manage older cardiovascular patients.

  20. What to Expect from the Evolving Field of Geriatric Cardiology

    PubMed Central

    Bell, Susan P.; Orr, Nicole M.; Dodson, John A.; Rich, Michael W.; Wenger, Nanette K.; Blum, Kay; Harold, John Gordon; Tinetti, Mary; Maurer, Mathew S.; Forman, Daniel E.

    2016-01-01

    The population of older adults is expanding rapidly and aging predisposes to cardiovascular disease. The principle of patient-centered care must respond to the preponderance of cardiac disease that now occurs in combination with complexities of old age. Geriatric cardiology melds cardiovascular perspectives with multimorbidity, polypharmacy, frailty, cognitive decline, and other clinical, social, financial, and psychological dimensions of aging. While some assume a cardiologist may instinctively cultivate some of these skills over the course of a career, we assert that the volume and complexity of older cardiovascular patients in contemporary practice warrants a more direct approach to achieve suitable training and a more reliable process of care. We present a rationale and vision for geriatric cardiology as a melding of primary cardiovascular and geriatrics skills, and thereby infusing cardiology practice with expanded proficiencies in diagnosis, risks, care coordination, communications, end-of-life, and other competences required to best manage older cardiovascular patients. PMID:26361161

  1. The value of independent specialty designation for interventional cardiology.

    PubMed

    Blankenship, James C; Powell, Wayne A; Gray, Dawn R; Duffy, Peter L

    2017-01-01

    Interventional cardiology has finally completed, after 26 years of advocacy, a professional hat trick: independent board certification, membership as a unique specialty in the American Medical Association House of Delegates (AMA HOD), and recognition by the Centers for Medicaid and Medicare Services (CMS) as a separate medical specialty. This article points out how these distinctions for interventional cardiology and its professional society, the Society for Cardiovascular Angiography and Interventions (SCAI), have led to clear and definite benefits for interventional cardiologists and their patients. We focus on the least understood of these three-recognition by CMS and its implications for reimbursement and quality assessment for interventional cardiologists. © 2016 Wiley Periodicals, Inc.

  2. [The Sociedad Española de Cardiología on the Internet: current resources and future prospects. The Internet Committee of the Sociedad Española de Cardiología].

    PubMed

    Arribas, F; Elízaga, J; Bosch, X

    1998-10-01

    The Internet can help physicians to identify needed clinical information quickly providing continued medical education. Internet also improves medical information of the non-medical population. Researchers have quick access to library catalogs, Medline and other important databases from the most recognized research centers. Furthermore, it can put physicians in ready contact with other specialists for communication and consultation, facilitates administrative procedures of multicenter studies and accelerates editorial processes of biomedical journals. Since its creation, the website of the Spanish Society of Cardiology has evolved rapidly to the present model, providing different kinds of services to its members including faster communication, information from national and international societies and congresses, earlier access to the full content of Revista Española de Cardiología and to a variety of graphic resources and of continuing education. Nowadays, the website of the Spanish Society of Cardiology is consulted by one thousand visitors a week, even at weekends. The degree of activity increases from 3 h P.M. with a peak from 11 h P.M. to 1 h A.M. In the near future, our website will incorporate its own courses of continuing medical education with on-line evaluation and credit granting, will give support to multicenter studies and will initiate the publication and discussion of clinical cases of interest.

  3. Interoperable computerized smart card based system for health insurance and health services applied in cardiology.

    PubMed

    Cocei, Horia-Delatebea; Stefan, Livia; Dobre, Ioana; Croitoriu, Mihai; Sinescu, Crina; Ovricenco, Eduard

    2002-01-01

    In 1999 Romania started its health care reform by promulgating the Health Insurance Law. A functional and efficient health care system needs procedures for monitoring and evaluation of the medical services, communication between different service providers and entities involved in the system, integration and availability of the information. The final goal is a good response to the needs and demands of the patients and of the real life. For this project we took into account, on one hand, the immediate need for computerized systems for the health care providers and, on the other hand, the large number of trials and experiments with health smart cards across Europe. Our project will implement a management system based on electronic patient records to be used in all cardiology clinics and will experiment the health smart cards, will promote and demonstrate the capabilities of the smart card technology. We focused our attention towards a specific and also critical category of patients, those with heart diseases, and also towards a critical sector of the health care system--the emergency care. The patient card was tested on a number of 150 patients at a cardiology clinic in Bucharest. This was the first trial of a health smart card in Romania.

  4. Update on heart failure, heart transplant, congenital heart disease, and clinical cardiology.

    PubMed

    Almenar, Luis; Zunzunegui, José Luis; Barón, Gonzalo; Carrasco, José Ignacio; Gómez-Doblas, Juan José; Comín, Josep; Barrios, Vivencio; Subirana, M Teresa; Díaz-Molina, Beatriz

    2013-04-01

    In the year 2012, 3 scientific sections-heart failure and transplant, congenital heart disease, and clinical cardiology-are presented together in the same article. The most relevant development in the area of heart failure and transplantation is the 2012 publication of the European guidelines for heart failure. These describe new possibilities for some drugs (eplerenone and ivabradine); expand the criteria for resynchronization, ventricular assist, and peritoneal dialysis; and cover possibilities of percutaneous repair of the mitral valve (MitraClip(®)). The survival of children with hypoplastic left heart syndrome in congenital heart diseases has improved significantly. Instructions for percutaneous techniques and devices have been revised and modified for the treatment of atrial septal defects, ostium secundum, and ventricular septal defects. Hybrid procedures for addressing structural congenital heart defects have become more widespread. In the area of clinical cardiology studies have demonstrated that percutaneous prosthesis implantation has lower mortality than surgical implantation. Use of the CHA2DS2-VASc criteria and of new anticoagulants (dabigatran, rivaroxaban and apixaban) is also recommended. In addition, the development of new sequencing techniques has enabled the analysis of multiple genes.

  5. Potential and Limitations of Cochrane Reviews in Pediatric Cardiology: A Systematic Analysis.

    PubMed

    Poryo, Martin; Khosrawikatoli, Sara; Abdul-Khaliq, Hashim; Meyer, Sascha

    2017-02-27

    Evidence-based medicine has contributed substantially to the quality of medical care in pediatric and adult cardiology. However, our impression from the bedside is that a substantial number of Cochrane reviews generate inconclusive data that are of limited clinical benefit. We performed a systematic synopsis of Cochrane reviews published between 2001 and 2015 in the field of pediatric cardiology. Main outcome parameters were the number and percentage of conclusive, partly conclusive, and inconclusive reviews as well as their recommendations and their development over three a priori defined intervals. In total, 69 reviews were analyzed. Most of them examined preterm and term neonates (36.2%), whereas 33.3% included also non-pediatric patients. Leading topics were pharmacological issues (71.0%) followed by interventional (10.1%) and operative procedures (2.9%). The majority of reviews were inconclusive (42.9%), while 36.2% were conclusive and 21.7% partly conclusive. Although the number of published reviews increased during the three a priori defined time intervals, reviews with "no specific recommendations" remained stable while "recommendations in favor of an intervention" clearly increased. Main reasons for missing recommendations were insufficient data (n = 41) as well as an insufficient number of trials (n = 22) or poor study quality (n = 19). There is still need for high-quality research, which will likely yield a greater number of Cochrane reviews with conclusive results.

  6. Sample collection, preservation and submittal procedures for 10 CFR 50 and 10 CFR 50 and 10 CFR 61 nuclear power plant matrices

    SciTech Connect

    Banavali, A.D.; Moreno, E.M.; McCurdy, D.E.

    1994-12-31

    Sample collection, preservation and submittal procedures are described here for nuclear power plant 10 CFR 50 and 10 CFR 61 samples. While sample collection procedures should ensure that a sample reflects the true media type from a homogeneity standpoint, sample preservation is absolutely necessary to prevent the adsorption of analytes occurring on the walls of the container. After sample collection and preservation, the samples should be shipped to the radioanalytical laboratory as soon as possible to reduce the magnitude of analyte adsorption on the walls of the container. When samples are shipped for analysis, sample transmittal forms should be properly filled out to ensure that instructions are clear as to the isotopic analysis requested and the weight/volume of sample shipped, minimum detectable concentration (MDC) required, station code, etc.

  7. Patient and staff doses in paediatric interventional cardiology derived from experimental measurements with phantoms.

    PubMed

    Ubeda, Carlos; Vano, Eliseo; Miranda, Patricia; Aguirre, Daniel; Riquelme, Nemorino; Dalmazzo, Dandaro; Galaz, Sergio

    2016-01-01

    The aim of this paper was to determine experimentally the entrance surface air kerma (ESAK) and kerma-area product (KAP) levels to patients and scatter doses at the cardiologist's eyes during paediatric interventional cardiology (IC) procedures for Chile, on the basis of measurements taken from X-ray systems characterization for different thicknesses of polymethyl methacrylate, together with the average values of fluoroscopy time and number of cine frames for ten paediatric IC procedures. The range of cumulative ESAK values when the different clinical procedures were simulated was from 2 to 1100 mGy. KAP values ranged from 0.30 to 150 Gy cm(2). Scatter doses at cardiologist's eyes for the simulated procedures ranged from 0.20 to 116 µSv per procedure. Large differences between the X-ray systems were found in our study. Standardized guidelines in terms of X-ray system setting and protocols should be developed for hospitals that perform paediatric IC procedures in Chile.

  8. [From myocardium to the atherosclerotic plaque: new perspectives in cardiologic imaging].

    PubMed

    Gargiulo, Paola; D'Amore, Carmen; Dellegrottaglie, Santo; Leosco, Dario; Rengo, Giuseppe; Musella, Francesca; Pirozzi, Elisabetta; Mosca, Susanna; Casaretti, Laura; Formisano, Roberto; Bologna, Ada; Parente, Antonio; Conte, Sirio; Perrone-Filardi, Pasquale

    2011-06-01

    Molecular imaging is an innovative and promising approach in cardiology for functional characterization of atherosclerosis. Nuclear, ultrasound and magnetic resonance imaging have been used for assessment of atherosclerosis of large and small arteries in several clinical and experimental studies. Positron Emission Tomography with fluorodeoxyglucose can measure metabolic activity and vulnerability of atherosclerotic plaques, identifying individuals at risk of future cardiovascular events. Magnetic resonance imaging can quantify carotid artery inflammation using iron oxide nanoparticles as contrast agent. In addition, macrophage accumulation of iron particles in atherosclerotic plaques may allow monitoring of inflammation during drug therapy, whereas contrast-enhanced ultrasound imaging may detect plaque neovascularization. Currently, technical factors, including cardiac and diaphragmatic motion and small size of coronary vessels, limit routine application of these techniques for coronary imaging. Purpose of this review is to describe state of the art and potential areas of clinical applications of molecular imaging of atherosclerosis.

  9. Population radiation dose from diagnostic nuclear medicine procedures in the Tehran population in 1999-2003: striking changes in only one decade.

    PubMed

    Tabeie, Faraj; Mohammadi, Hooshang; Asli, Isa Neshandar

    2013-02-01

    Use of unsealed radiopharmaceuticals in Iran's nuclear medicine centers has expanded rapidly in the last decade. As part of a nationwide survey, this study was undertaken to estimate the radiation risk due to the diagnostic nuclear medicine procedures performed in Tehran in 1999-2003. During the five years of the study, the data of 101,540 yearly examinations of diagnostic nuclear medicine were obtained for 34 (out of 40) active nuclear medicine centers in Tehran. The patients studied were aged 1 y, 5 y, 10 y, 15 y, and adults (>15 y). Compared to an earlier investigation in 1989 (which was published in 1995), striking changes were found to be occurring in the trends of nuclear medicine in Tehran in a matter of a decade. The frequency of cardiac examinations increased from less than 1% in 1989 to 43.2% (mean of 5 y) in 2003; thyroid examinations, with the relative frequency of higher than 80% in 1989, decreased to 26.7% in the current investigation (averaged for 2001); and the number of overall examinations per 1,000 population of Tehran increased from 1.9 in 1989 to 8.8 in this study (about fourfold). The decrease in relative frequency of thyroid examinations could be attributed to the lower referral policy (mainly by specialists), decreased incidence of goiter due to implementation of programs for iodine enrichment diets, introduction of fine needle aspiration (FNA), and sonography techniques for diagnosis of thyroid disease. The large increase in relative frequency of cardiac examinations could be due to the increase in the number of single photon emission computerized tomography (SPECT) systems in recent years as compared to 1989 in Tehran. The collective effective dose increased from 400 (person-Sv) in 1999 to 529 (person-Sv) in 2003, and the effective dose per capita increased from 34.80 μSv in 1999 to 44.06 μSv in 2003 (average, 35.60 μSv).

  10. Comparison of Two Educational Strategies in Teaching Preventive Cardiology.

    ERIC Educational Resources Information Center

    Stroup-Benham, Christine A.; And Others

    This study assessed the impact of two educational strategies: text only versus text plus small group discussion, among two groups of third-year internal medicine clerkship students in a preventive cardiology course. The course was a required, 12-week Internal Medical clerkship at the University of Texas Medical Branch. The first group reviewed…

  11. Weekly Interdisciplinary Colloquy on Cardiology: A Decade of Experiment.

    ERIC Educational Resources Information Center

    Wehrmacher, William H.; And Others

    1981-01-01

    An experimental, continuing, weekly interdisciplinary colloquy on cardiology is described. It is organized between the departments of medicine and physiology of Loyola University Medical Center to promote interaction between basic scientists and practicing physicians in the medical school. (Author/MLW)

  12. Burnout, Perceived Stress, and Depression among Cardiology Residents in Argentina

    ERIC Educational Resources Information Center

    Waldman, Silvina V.; Diez, Juan Cruz Lopez; Arazi, Hernan Cohen; Linetzky, Bruno; Guinjoan, Salvador; Grancelli, Hugo

    2009-01-01

    Objective: Because medical residency is a stressful time for training physicians, placing residents at increased risk for psychological distress, the authors studied the prevalence of burnout, perceived stress, and depression in cardiology residents in Argentina and examined the association between sociodemographic characteristics and these…

  13. [Pediatric cardiology and congenital heart disease: from fetus to adult].

    PubMed

    Subirana, M Teresa; Oliver, José M; Sáez, José M; Zunzunegui, José L

    2012-01-01

    This article contains a review of some of the most important publications on congenital heart disease and pediatric cardiology that appeared in 2010 and up until September 2011. Of particular interest were studies on demographic changes reported in this patient population and on the need to manage the patients' transition from the pediatric to the adult cardiology department. This transition has given rise to the appearance of new areas of interest: for example, pregnancy in women with congenital heart disease, and the effect of genetic factors on the etiology and transmission of particular anomalies. In addition, this review considers some publications on fetal cardiology from the perspective of early diagnosis and, if possible, treatment. There follows a discussion on new contributions to Eisenmenger's syndrome and arrhythmias, as well as on imaging techniques, interventional catheterization and heart transplantation. Finally, there is an overview of the new version of clinical practice guidelines on the management of adult patients with congenital heart disease and of recently published guidelines on pregnancy in women with heart disease, both produced by the European Society of Cardiology.

  14. Report from The International Society for Nomenclature of Paediatric and Congenital Heart Disease: cardiovascular catheterisation for congenital and paediatric cardiac disease (Part 2 - Nomenclature of complications associated with interventional cardiology).

    PubMed

    Bergersen, Lisa; Giroud, Jorge Manuel; Jacobs, Jeffrey Phillip; Franklin, Rodney Cyril George; Béland, Marie Josée; Krogmann, Otto Nils; Aiello, Vera Demarchi; Colan, Steven D; Elliott, Martin J; Gaynor, J William; Kurosawa, Hiromi; Maruszewski, Bohdan; Stellin, Giovanni; Tchervenkov, Christo I; Walters, Henry Lane; Weinberg, Paul; Everett, Allen Dale

    2011-06-01

    Interventional cardiology for paediatric and congenital cardiac disease is a relatively young and rapidly evolving field. As the profession begins to establish multi-institutional databases, a universal system of nomenclature is necessary for the field of interventional cardiology for paediatric and congenital cardiac disease. The purpose of this paper is to present the results of the efforts of The International Society for Nomenclature of Paediatric and Congenital Heart Disease to establish a system of nomenclature for cardiovascular catheterisation for congenital and paediatric cardiac disease, focusing both on procedural nomenclature and the nomenclature of complications associated with interventional cardiology. This system of nomenclature for cardiovascular catheterisation for congenital and paediatric cardiac disease is a component of The International Paediatric and Congenital Cardiac Code. This manuscript is the second part of the two-part series. Part 1 covered the procedural nomenclature associated with interventional cardiology as treatment for paediatric and congenital cardiac disease. Part 2 will cover the nomenclature of complications associated with interventional cardiology as treatment for paediatric and congenital cardiac disease.

  15. ENDF-102 data formats and procedures for the evaluated nuclear data file ENDF-6. Revision November 1995

    SciTech Connect

    McLane, V.; Dunford, C.L.; Rose, P.F.

    1995-11-01

    The ENDF formats and libraries are decided by the Cross Section Evaluation Working Group (CSEWG), a cooperative effort of national laboratories, industry, and universities in the US and Canada, and are maintained by the National Nuclear Data Center (NNDC). Earlier versions of the ENDF format provided representations for neutron cross sections and distributions, photon production from neutron reactions, a limited amount of charged-particle production from neutron reactions, photo-atomic interaction data, thermal neutron scattering data, and radionuclide production and decay data (including fission products). Version 6 (ENDF-6) allows higher incident energies, adds more complete descriptions of the distributions of emitted particles, and provides for incident charged particles and photo-nuclear data by partitioning the ENDF library into sublibraries. Decay data, fission product yield data, thermal scattering data, and photo-atomic data have also been formally placed in sublibraries. In addition, this rewrite represents an extensive update to the Version V manual.

  16. Applications of CdTe to nuclear medicine. Final report

    SciTech Connect

    Entine, G.

    1985-05-07

    Uses of cadmium telluride (CdTe) nuclear detectors in medicine are briefly described. They include surgical probes and a system for measuring cerebral blood flow in the intensive care unit. Other uses include nuclear dentistry, x-ray exposure control, cardiology, diabetes, and the testing of new pharmaceuticals. (ACR)

  17. The Next Step in Deployment of Computer Based Procedures For Field Workers: Insights And Results From Field Evaluations at Nuclear Power Plants

    SciTech Connect

    Oxstrand, Johanna; Le Blanc, Katya L.; Bly, Aaron

    2015-02-01

    The paper-based procedures currently used for nearly all activities in the commercial nuclear power industry have a long history of ensuring safe operation of the plants. However, there is potential to greatly increase efficiency and safety by improving how the human operator interacts with the procedures. One way to achieve these improvements is through the use of computer-based procedures (CBPs). A CBP system offers a vast variety of improvements, such as context driven job aids, integrated human performance tools (e.g., placekeeping, correct component verification, etc.), and dynamic step presentation. The latter means that the CBP system could only display relevant steps based on operating mode, plant status, and the task at hand. A dynamic presentation of the procedure (also known as context-sensitive procedures) will guide the operator down the path of relevant steps based on the current conditions. This feature will reduce the operator’s workload and inherently reduce the risk of incorrectly marking a step as not applicable and the risk of incorrectly performing a step that should be marked as not applicable. The research team at the Idaho National Laboratory has developed a prototype CBP system for field workers, which has been evaluated from a human factors and usability perspective in four laboratory studies. Based on the results from each study revisions were made to the CBP system. However, a crucial step to get the end users' (e.g., auxiliary operators, maintenance technicians, etc.) acceptance is to put the system in their hands and let them use it as a part of their everyday work activities. In the spring 2014 the first field evaluation of the INL CBP system was conducted at a nuclear power plant. Auxiliary operators conduct a functional test of one out of three backup air compressors each week. During the field evaluation activity, one auxiliary operator conducted the test with the paper-based procedure while a second auxiliary operator followed

  18. Advances in software for faster procedure and lower radiotracer dose myocardial perfusion imaging.

    PubMed

    Piccinelli, Marina; Garcia, Ernest V

    2015-01-01

    The American Society of Nuclear Cardiology has recently published documents that encourage laboratories to take all the appropriate steps to greatly decrease patient radiation dose and has set the goal of 50% of all myocardial perfusion studies performed with an associated radiation exposure of 9mSv by 2014. In the present work, a description of the major software techniques readily available to shorten procedure time and decrease injected activity is presented. Particularly new reconstruction methods and their ability to include means for resolution recovery and noise regularization are described. The use of these improved reconstruction algorithms results in a consistent reduction in acquisition time, injected activity and consequently in the radiation dose absorbed by the patient. The clinical implications to the use of these techniques are also described in terms of maintained and even improved study quality, accuracy and sensitivity for the detection of heart disease.

  19. [Spanish Registry on Cardiac Catheterization Interventions. 11th official report of the Working Group on Cardiac Catheterization and Interventional Cardiology of the Spanish Society of Cardiology (years 1990-2001)].

    PubMed

    Hernández, José M; Goicolea, Javier; Durán, Juan M; Augé, José M

    2002-11-01

    The results of the Spanish Registry of the Working Group on cardiac catheterization and Interventional Cardiology of the Spanish Society of Cardiology (years 1990-2001) are presented. One-hundred-and-three centers contributed data, all the cardiac catheterization laboratories in Spain; 97 centers performed mainly adult catheterization and 6 carried out only pediatric procedures. In 2001, 95,430 diagnostic catheterization procedures were performed, with 79,607 coronary angiograms, representing a total increase of 8.4% over 2000. The population-adjusted incidence was 1947 coronary angiograms per 106 inhabitants. Coronary interventions increased by 15.4% compared with 2000, with a total of 31,290 procedures and an incidence of coronary interventions of 761 per 106 inhabitants. Coronary stents were the most frequently used devices with 39,356 implanted in 2001, and increase of 33.4% over 2000. Stenting accounted for 88.2% of procedures. Direct stenting was done in 11,280 procedures (40.9%). IIb-IIIa glycoprotein inhibitors were given in 7,012 procedures (22.4%). Multivessel percutaneous coronary interventions were performed in 8,445 cases (27%) and interventions were performed ad hoc during diagnostic study in 23,144 cases (74 %).A total of 3,845 percutaneous coronary interventions were carried out in patients with acute myocardial infarction, an increase of 22.9% over 2000 and 12.3% of all interventional procedures. Among non-coronary interventions, atrial septal defect closure was performed more often (161 cases, a 60% increase over 2000). Pediatric interventions increased by 15.4% (from 817 to 943 cases).Lastly, we would like to underline the high rate of reporting by laboratories, which allowed the Registry to compile data that are highly representative of hemodynamic interventions in Spain.

  20. A Procedure for Determination of Degradation Acceptance Criteria for Structures and Passive Components in Nuclear Power Plants

    SciTech Connect

    Nie, J.; Braverman, J.; Hofmayer, C.; Choun, Y-S.; Hahm, D.; Choi, I-K.

    2012-01-30

    The Korea Atomic Energy Research Institute (KAERI) has been collaborating with Brookhaven National Laboratory since 2007 to develop a realistic seismic risk evaluation system which includes the consideration of aging of structures and components in nuclear power plants (NPPs). This collaboration program aims at providing technical support to a five-year KAERI research project, which includes three specific areas that are essential to seismic probabilistic risk assessment: (1) probabilistic seismic hazard analysis, (2) seismic fragility analysis including the effects of aging, and (3) a plant seismic risk analysis. The understanding and assessment of age-related degradations of structures, systems, and components and their impact on plant safety is the major goal of this KAERI-BNL collaboration. Four annual reports have been published before this report as a result of the collaboration research.

  1. A practical method for skin dose estimation in interventional cardiology based on fluorographic DICOM information.

    PubMed

    Matthews, Lucy; Dixon, Matthew; Rowles, Nick; Stevens, Greg

    2016-03-01

    A practical method for skin dose estimation for interventional cardiology patients has been developed to inform pre-procedure planning and post-procedure patient management. Absorbed dose to the patient skin for certain interventional radiology procedures can exceed thresholds for deterministic skin injury, requiring documentation within the patient notes and appropriate patient follow-up. The primary objective was to reduce uncertainty associated with current methods, particularly surrounding field overlap. This was achieved by considering rectangular field geometry incident on a spherical patient model in a polar coordinate system. The angular size of each field was quantified at surface of the sphere, i.e. the skin surface. Computer-assisted design software enabled the modelling of a sufficient dataset that was subsequently validated with radiochromic film. Modelled overlap was found to agree with overlap measured using film to within 2.2° ± 2.0°, showing that the overall error associated with the model was < 1 %. Mathematical comparison against exposure data extracted from procedural Digital Imaging and Communication in Medicine files was used to generate a graphical skin dose map, demonstrating the dose distribution over a sphere centred at the interventional reference point. Dosimetric accuracy of the software was measured as between 3.5 and 17 % for different variables.

  2. A framework for clinical reasoning in adult cardiology

    PubMed Central

    de la Calzada, Carlos S

    2015-01-01

    It is well known that an expert clinician formulates a diagnostic hypothesis with little clinical data. In comparison, students have difficulties in doing so. The mental mechanism of diagnostic reasoning is almost unconscious and therefore difficult to teach. The purpose of this essay (devoted to 2nd-year medical students) is to present an integrating framework to teach clinical reasoning in cardiology. By analyzing cardiology with a synthetic mind, it becomes apparent that although there are many diseases, the heart, as an organ, reacts to illness with only six basic responses. The clinical manifestations of heart diseases are the direct consequence of these cardiac responses. Considering the six cardiac responses framework, diagnostic reasoning is done in three overlapping steps. With the presented framework, the process of reasoning becomes more visual and needs less clinical data, resembling that of the expert clinician. PMID:26203294

  3. Safety of pharmacotherapy of osteoporosis in cardiology patients.

    PubMed

    Zapolski, Tomasz; Wysokiński, Andrzej

    2010-01-01

    The commonest medical conditions following menopause are osteoporosis and atherosclerotic disease. This review considers the safety of pharmacotherapy of osteoporosis in cardiology patients. Drugs used for osteoporosis treatment may have adverse effects on the cardiovascular system. This article has detailed analysed of current drug classes, such as the bisphosphonates and strontium ranelate, as well as reviewed of the controversy surrounding hormone replacement therapy (HRT) and the selective estrogen receptor modulators (SERMs). Additionally, we discuss the adverse effects on the heart of calcium and drugs influencing calcium metabolism such as vitamin D, parathormone and calcitonin. We look at the interference between osteoporosis treatment and the drugs used for atherosclerosis. Moreover, the side effects on bones of cardiology drugs are analysed. Lastly, the possible advantages of selected drugs used for cardiovascular diseases in terms of osteoporosis prevention are evaluated.

  4. European Society of Cardiology (ESC) Congress Report from London 2015.

    PubMed

    Nishiguchi, Tsuyoshi; Akasaka, Takashi

    2015-01-01

    The Annual Congress of the European Society of Cardiology (ESC) was held in London from 29 August to 2 September 2015. It is the leading conference in cardiology in the world, with presentations on the latest scientific discoveries, innovations, technology, education, and clinical practices. More than 32,000 delegates and 5,000 exhibitors from 140 countries participated, sharing a number of scientific presentations, including 28 clinical hot lines, 18 clinical trial updates, 20 registry studies, 12 basic and translational science hot line studies, and 4,533 abstract studies. Japan had the highest number of accepted abstracts at the Congress, indicating the great contribution of Japanese scientists and the Japanese Circulation Society.

  5. Year in review 2007: Critical Care – cardiology

    PubMed Central

    2008-01-01

    This review summarises key research papers in the fields of cardiology and intensive care published during 2007 in Critical Care. To create a context and for comparison with the papers described in the review, we cite studies on the same subject published in other journals. The papers have been grouped into four categories: venous oximetry, cardiac surgery, perioperative fluid optimisation, and haemodynamic monitoring. PMID:18983703

  6. Phosphoproteomics and molecular cardiology: techniques, applications and challenges.

    PubMed

    Sun, Zeyu; Hamilton, Karyn L; Reardon, Kenneth F

    2012-09-01

    Protein phosphorylation has been widely documented as a key regulatory and signaling mechanism associated with many cardiac diseases. Recent advances in phosphoproteomic technologies such as phosphopeptide enrichment, novel mass spectrometry applications, and bioinformatic tools have resulted in high-throughput identification and quantitation of protein phosphorylation in a global manner. This review summarizes mainstream phosphoproteomic workflows and highlights the most recent applications of phosphoproteomics used in a range of molecular cardiology research.

  7. Interventional pediatric cardiology: state of the art and future directions.

    PubMed

    Rao, P S

    1998-01-01

    Although the interventional pediatric cardiology began in the early 1950s, it was not until the mid-1980s that a full spectrum of transcatheter interventions in children could be undertaken including balloon atrial septostomy which has been in usage since 1966. Enormous developments have occurred even from the mid-1980s to date. In this review, current state-of-the-art for each broad area of therapeutic catheterization is presented. A large variety of lesions could be opened-up or closed, as the case may be and the results of these interventions were either similar to or better than those reported for the alternative surgical therapy. Indeed, therapeutic catheterization techniques have replaced the conventional surgery for many lesions and are threatening to do so for others. However, long-term follow-up results are scanty and are needed. Further miniaturization of catheters/sheaths used in interventional pediatric cardiology and development of new technology for the lesions which are not amenable to currently available transcatheter methods are awaited. The future seems to be bright for interventional pediatric cardiology.

  8. Aspirin and clopidogrel: a sweeping combination in cardiology.

    PubMed

    Manolis, Antonis S; Tzeis, Stylianos; Andrikopoulos, George; Koulouris, Spyros; Melita, Helen

    2005-07-01

    important large-scale clinical trials currently ongoing. Newer data are being accumulated from studies where indications for the use of clopidogrel and aspirin continue to expand into other patient groups, rendering this dual antiplatelet drug therapy a sweeping combination in Cardiology. However, important issues remain to be further and more thoroughly explored about the benefit of this antiplatelet drug combination in these other patient groups, such as in patients with heart failure, where preliminary data indicate a favorable effect on thrombotic vascular events, in patients with atrial fibrillation, where there is hope that this combination may replace or be an alternative treatment modality to coumadin in certain subpopulations, in patients undergoing demanding catheter ablation procedures, where data point to a protective effect from thromboembolic events. Another pertaining issue to be further investigated is the occurrence of drug-resistance observed in some patients for both these antithrombotic agents. This article is a comprehensive review of all these data and the landmark trials on the two antiplatelet agents, the issues involved and the current recommendations for their use in patients with atherosclerotic heart disease and other cardiovascular disorders and procedures.

  9. Position paper: proposal for a core curriculum for a European Sports Cardiology qualification.

    PubMed

    Heidbuchel, Hein; Papadakis, Michael; Panhuyzen-Goedkoop, Nicole; Carré, François; Dugmore, Dorian; Mellwig, Klaus-Peter; Rasmusen, Hanne Kruuse; Solberg, Erik E; Borjesson, Mats; Corrado, Domenico; Pelliccia, Antonio; Sharma, Sanjay

    2013-10-01

    Sports cardiology is a new and rapidly evolving subspecialty. It aims to elucidate the cardiovascular effects of regular exercise and delineate its benefits and risks, so that safe guidance can be provided to all individuals engaging in sports and/or physical activity in order to attain the maximum potential benefit at the lowest possible risk. The European Society of Cardiology (ESC) advocates systematic preparticipation cardiovascular screening in an effort to identify competitive athletes at risk of exercise-related cardiovascular events and sudden cardiac death. However, the implementation of preparticipation screening is hindered because of lack of structured training and as a result lack of sufficient expertise in the field of sports cardiology. In 2008 the European Society of Cardiology published a core curriculum for the general cardiologist, in which sports cardiology was incorporated within the topic 'Rehabilitation and Exercise Physiology'. However, the exponential rise in knowledge and the growing demand for expertise in the field of sports cardiology dictates the need to systematically structure the knowledge base of sports cardiology into a detailed curriculum. We envisage that the curriculum would facilitate more uniform training and guideline implementation throughout Europe, and safeguard that evaluation and guidance of competitive athletes or individuals who wish to engage in leisure-time sports activities is performed by physicians with expertise in the field. The current manuscript provides a comprehensive curriculum for sports cardiology, which may serve as a framework upon which universities and national and international health authorities will develop the training, evaluation and accreditation in sports cardiology.

  10. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision.

    PubMed

    Verberne, Hein J; Acampa, Wanda; Anagnostopoulos, Constantinos; Ballinger, Jim; Bengel, Frank; De Bondt, Pieter; Buechel, Ronny R; Cuocolo, Alberto; van Eck-Smit, Berthe L F; Flotats, Albert; Hacker, Marcus; Hindorf, Cecilia; Kaufmann, Philip A; Lindner, Oliver; Ljungberg, Michael; Lonsdale, Markus; Manrique, Alain; Minarik, David; Scholte, Arthur J H A; Slart, Riemer H J A; Trägårdh, Elin; de Wit, Tim C; Hesse, Birger

    2015-11-01

    Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/publications/guidelines/2015_07_EANM_FINAL_myocardial_perfusion_guideline.pdf .

  11. [Results of a structural diagnosis of patients with chronic dyspnoea recruited from two cardiological practices].

    PubMed

    Ewert, R; Obst, A; Bahr, C; Weirich, C; Henschel, F; Rink, A

    2013-01-01

    While well validated algorithms exist for the diagnosis of patients with acute dyspnoea, such generally valid procedural instructions are lacking for patients with chronic dyspnoea. The diagnostic approach presented here is based on investigations of 246 patients with chronic dyspnoea recruited from two cardiological practices using a self-developed multi-level procedure. Besides anamnestic and clinical examinations, different diagnostic procedures, available in the ambulant range, are included. The results suggest that in over 50 % of the cases the cause of chronic dyspnoea can be determined from anamnestic and clinical examinations as well as from electrocardiogram and echocardiography. Additional inclusion of lung function and capillary blood gas analysis permitted a sufficient clarification in over 80 % of the cases. In a further step, cardiopulmonary exercise testing clarified the reasons for chronic dyspnoea in approximately 10 % of the remaining patients. Threshold values of lung function parameters as used for the differentiation of acute dyspnoea, do not seem suitable for the diagnosis of patients with chronic dyspnoea. By means of a simple step-wise diagnostic algorithm, applicable under ambulant conditions, the cause of chronic dyspnoea could sufficiently be clarified in more than 95 % of the cases.

  12. [Transradial approach in interventional cardiology: "quod licet femoralisti, non licet radialisti"].

    PubMed

    Lukenda, Josip

    2012-01-01

    Transradial approach has been used in invasive cardiology since 1989 and since 1995 for PCI. Croatia is late in using this technique for about one whole decade. The advantage of transradial approach over femoral approach are serious local complications of (2.6-2.8%), more frequent with modem therapy (7.4%), occasionally requiring surgical repair (2.4%). Major adverse cardiovascular events are significantly more occurring with femoral (3.8-6.55%) compared to transradial approach (2.5-3.7%), while in the MORTAL study total mortality is higher as well. Patients prefer transradial approach due to it being less painful and uncomfortable, and also because of greater mobility after the procedure. Time spent for patient care by nurses is shortened by half than what it used to be, and the final savings per patient is $290. An unfavorable aspect of transradial approach is clinically insignificant radial artery occlusion (0.6%-1.4%), as well as higher radiation exposure, for 12% in practice. Procedural time is similar, but it could take up to 3 minutes longer. Access site crossover is more often with transradial (4.7-7.6%), compared to femoral procedure (1.4-2.0%), but PCI failure is independent of approach. All unfavorable aspects are diminishing with experience of a cardiologist. Now, some of the Croatian centers, such as General Hospital Zadar, use transradial approach in 67% of catheterizations, 64% of PCI, and 38% of all primary PCIs.

  13. Scatter and staff dose levels in paediatric interventional cardiology: a multicentre study.

    PubMed

    Ubeda, Carlos; Vano, Eliseo; Gonzalez, Luciano; Miranda, Patricia; Valenzuela, Edith; Leyton, Fernando; Oyarzun, Carlos

    2010-06-01

    Interventional cardiology procedures usually imply high doses to the staff, as paediatric cardiologists need to stay closer to the patient than during adult procedures. Also, biplane systems are used that imply an additional source of staff doses. The objective of this paper is to measure scatter doses in four X-ray systems, using polymethyl methacrylate phantoms with thicknesses ranging from 4 to 16 cm to simulate paediatric patients, for the different acquisition modes. Scatter dose rates measured at the position of cardiologist's eyes ranged from 0.8 to 12 mSv h(-1), and about twice the above values at lower extremities, as a linear function of the surface air kerma at the phantom, keeping the irradiated area constant. Therefore, the respective personal dose equivalent for the lens of the eyes may be around 0.5 and 1 mSv throughout the procedure, if additional protection is not used. Simultaneous cine acquisition in biplane systems yielded scatter doses to cardiologists, increased by factors from 5 to 21, compared with a single C-arm acquisition case and depending on geometry. Knowledge of scatter doses for different operation modes, patient thicknesses and the biplane operation should help paediatric cardiologists to adopt conservative attitudes in respect of their occupational radiation risks.

  14. The new European Society of Cardiology guidelines on myocardial revascularisation: an appraisal.

    PubMed

    Nauta, Sjoerd T; Gaspersz, Marcia; Deckers, Jaap W

    2012-01-01

    The latest European Society of Cardiology (ESC) guidelines on myocardial revascularisation are reviewed. The nearly 300 recommendations make it difficult to apply them in their totality. The authors would propose 20-30 recommendations per guideline based on sound clinical evidence. Also, the scope of the current guidelines is very wide as it includes topics already incorporated in other guidelines, such as strategies for pre-intervention diagnosis and imaging as well as on secondary prevention. Some recommendations in the new guidelines are sensible and will not be disputed. In particular, the encouragement of a balanced multidisciplinary decision process (the 'heart team') is welcome. Although coronary revascularisation in unstable high risk patients is well accepted, this is less the case for the low risk patient with chest pain. This issue is controversial and a balanced discussion of the pros and cons of percutaneous coronary intervention is missing. Despite convincing evidence indicating lack of benefit of percutaneous coronary intervention for chronic total occlusion, this procedure is not discouraged. Lastly, most committee members were interventional cardiologists or cardiac surgeons. Guideline committees should be representative of the whole group of professionals as the interpretation of the evidence by specialists may be biased. There may be a role for procedure oriented guidelines but, in that case, the items at issue should remain confined to matters directly related to technical aspects of the procedure.

  15. Nuclear reprogramming.

    PubMed

    Halley-Stott, Richard P; Pasque, Vincent; Gurdon, J B

    2013-06-01

    There is currently particular interest in the field of nuclear reprogramming, a process by which the identity of specialised cells may be changed, typically to an embryonic-like state. Reprogramming procedures provide insight into many mechanisms of fundamental cell biology and have several promising applications, most notably in healthcare through the development of human disease models and patient-specific tissue-replacement therapies. Here, we introduce the field of nuclear reprogramming and briefly discuss six of the procedures by which reprogramming may be experimentally performed: nuclear transfer to eggs or oocytes, cell fusion, extract treatment, direct reprogramming to pluripotency and transdifferentiation.

  16. NMR clinical imaging and spectroscopy: Its impact on nuclear medicine

    SciTech Connect

    Not Available

    1990-02-02

    This is a collection of four papers describing aspects of past and future use of nuclear magnetic resonance as a clinical diagnostic tool. The four papers are entitled (1) What Does NMR Offer that Nuclear Medicine Does Not by Jerry W. Froelich, (2) Oncological Imaging: Now, Future and Impact Jerry W. Froelich, (3) Magnetic Resonance Spectroscopy/Spectroscopic Imaging and Nuclear Medicine: Past, Present and Future by H. Cecil Charles, and (4) MR Cardiology: Now, Future and Impact by Robert J. Herfkens.

  17. NMR clinical imaging and spectroscopy: Its impact on nuclear medicine

    SciTech Connect

    Not Available

    1990-02-02

    This is a collection of four papers describing aspects of past and future use of nuclear magnetic resonance as a clinical diagnostic tool. The four papers are entitled (1) What Does NMR Offer that Nuclear Medicine Does Not? by Jerry W. Froelich, (2) Oncological Imaging: Now, Future and Impact Jerry W. Froelich, (3) Magnetic Resonance Spectroscopy/Spectroscopic Imaging and Nuclear Medicine: Past, Present and Future by H. Cecil Charles, and (4) MR Cardiology: Now, Future and Impact by Robert J. Herfkens.

  18. Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values

    SciTech Connect

    Ubeda, Carlos; Miranda, Patricia; Vano, Eliseo

    2015-02-15

    Purpose: To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Methods: Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Results: Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for <1 yr; 213 for 1 to <5 yr; 82 for 5 to <10 yr; and 102 for 10 to <16 yr. The third quartile values obtained for DAP by diagnostic and therapeutic procedures and age range were 1.17 and 1.11 Gy cm{sup 2} for <1 yr; 1.74 and 1.90 Gy cm{sup 2} for 1 to <5 yr; 2.83 and 3.22 Gy cm{sup 2} for 5 to <10 yr; and 7.34 and 8.68 Gy cm{sup 2} for 10 to <16 yr, respectively. The third quartile value obtained for the DAP/body weight ratio for the full sample of procedures was 0.17 (Gy cm{sup 2}/kg) for diagnostic and therapeutic procedures. Conclusions: The data presented in this paper are an initial attempt at establishing local DRLs in pediatric interventional cardiology, from a large sample of procedures for the standard age bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there

  19. Impact of a Preventive Cardiology Curriculum on Knowledge and Attitudes of First-Year Medical Students.

    ERIC Educational Resources Information Center

    Veitia, Marie C.; And Others

    1993-01-01

    A study of 54 first-year Marshall University (West Virginia) medical students found that a preventive cardiology curriculum improved both knowledge of and attitudes about preventive cardiology in general and on all 4 subscales (epidemiological evidence, risk factor characteristics, pathophysiology, primary interventions). (Author/MSE)

  20. Linux thin-client conversion in a large cardiology practice: initial experience.

    PubMed

    Echt, Martin P; Rosen, Jordan

    2004-01-01

    Capital Cardiology Associates (CCA) is a single-specialty cardiology practice with offices in New York and Massachusetts. In 2003, CCA converted its IT system from a Microsoft-based network to a Linux network employing Linux thin-client technology with overall positive outcomes.

  1. [Analysis of the safety culture in a Cardiology Unit managed by processes].

    PubMed

    Raso-Raso, Rafael; Uris-Selles, Joaquín; Nolasco-Bonmatí, Andreu; Grau-Jornet, Guillermo; Revert-Gandia, Rosa; Jiménez-Carreño, Rebeca; Sánchez-Soriano, Ruth M; Chamorro-Fernández, Carlos I; Marco-Francés, Elvira; Albero-Martínez, José V

    2017-04-03

    The safety culture is one of the requirements to prevent the occurrence of adverse effects, however has not been studied in the field of cardiology. The objective is to evaluate the safety culture in a cardiology unit has implemented and certified an integrated quality and risk management for patient safety system.

  2. Monitoring Device Safety in Interventional Cardiology

    PubMed Central

    Matheny, Michael E.; Ohno-Machado, Lucila; Resnic, Frederic S.

    2006-01-01

    Objective: A variety of postmarketing surveillance strategies to monitor the safety of medical devices have been supported by the U.S. Food and Drug Administration, but there are few systems to automate surveillance. Our objective was to develop a system to perform real-time monitoring of safety data using a variety of process control techniques. Design: The Web-based Data Extraction and Longitudinal Time Analysis (DELTA) system imports clinical data in real-time from an electronic database and generates alerts for potentially unsafe devices or procedures. The statistical techniques used are statistical process control (SPC), logistic regression (LR), and Bayesian updating statistics (BUS). Measurements: We selected in-patient mortality following implantation of the Cypher drug-eluting coronary stent to evaluate our system. Data from the University of Michigan Consortium Bare-Metal Stent Study was used to calculate the event rate alerting boundaries. Data analysis was performed on local catheterization data from Brigham and Women's Hospital from July 1, 2003, shortly after the Cypher release, to December 31, 2004, including 2,270 cases with 27 observed deaths. Results: The single-stratum SPC had alerts in months 4 and 10. The multistrata SPC had alerts in months 5, 10, and 18 in the moderate-risk stratum, and months 1, 4, 7, and 10 in the high-risk stratum. The only cumulative alerts were in the first month for the high-risk stratum of the multistrata SPC. The LR method showed no monthly or cumulative alerts. The BUS method showed an alert in the first month for the high-risk stratum. Conclusion: The system performed adequately within the Brigham and Women's Hospital Intranet environment based on the design goals. All three cumulative methods agreed that the overall observed event rates were not significantly higher for the new medical device than for a closely related medical device and were consistent with the observation that the initial concerns about this

  3. [Criteria catalogue for Integrated Health Care in cardiology].

    PubMed

    Frantz, E

    2006-01-01

    This paper comprises criteria for projects of Integrated Health Care in cardiology. With these criteria, projects can be assessed for their congruence with essentials that have been assigned by the German Cardiac Society, the Association of German Hospital Cardiologists and the Association of German Practice Cardiologists. The main purpose is to ensure that evidence-based medicine is the basis for the contracts and that all valid guidelines have been observed when services have been agreed. Possibly this paper may be the basis to award an approval to projects that meet all the criteria. This paper is no model contract.

  4. The role of exercise testing in pediatric cardiology.

    PubMed

    Massin, Martial M

    2014-05-01

    Exercise testing for cardiac disease in children differs in many aspects from the tests performed in adults; their cardiovascular response to exercise presents different characteristics, which are essential for the interpretation of hemodynamic data. Moreover, diseases that are associated with myocardial ischemia are very rare in young patients, and the main indications for exercise testing are evaluation of exercise capacity and identification of exercise-induced arrhythmias. This article describes the specificity of exercise testing in pediatric cardiology, in terms of techniques, indications and interpretation of data.

  5. [Methods of the elaboration of data of the cardiological importance].

    PubMed

    Marchesi, C; Taddei, A; Varanini, M

    1987-12-01

    This paper deals with some introductory topics of signal processing and decision making in cardiology. In both instances the matter is referred to general schemes well suited to host different applications. Signal processing is divided in some phases: acquisition, storing, analysis and each of them is described with applications to specific signals. In a similar manner the methods for decision making have been simplified to a scheme including a "knowledge base" and an "inference method". The scheme is used to classify various implementations. Bayes analysis and expert systems have been introduced with some details.

  6. e-Teaching in pediatric cardiology: A paradigm shift

    PubMed Central

    Maheshwari, Sunita; Zheleva, Bistra; Rajasekhar, Veeralakshmi; Batra, Bipin

    2015-01-01

    Background: Training of postgraduate students has traditionally been done in person in a hospital setting with hands-on training with each faculty member imparting knowledge to 2 to 4 students per year. Supplementing their practical education with online instruction could make a significant difference in standardizing pediatric cardiology education in India. Objective: To present the rationale, methods and survey results of a live e-Teaching methodology implemented for Pediatric cardiology trainees in association with the National Board of Examinations, India. Materials and Methods: Between March 2010 and March 2014, 310 e-classes were conducted in the Pediatric cardiac sciences by 24 e-teachers. Content of the e-Learning program was based on a 2-year pediatric cardiology curriculum and included twice-weekly live online video training sessions, a library of recorded sessions and online test quizzes for the students. A total of 231 students accessed the program at various times over the 4-year period. Results: In our study, requests for access to the e-lectures increased from 10/year the first year to 100/year by the fourth year with feedback surveys conveying a high satisfaction level from the students and a high need for this knowledge. The advantages of virtual live e-Learning included the fact that one teacher can teach multiple students in multiple geographic locations at the same time, obviating the issue of quality teacher shortage and the same content can be disseminated to all students undergoing specialist training so there is a national consensus on diagnostic and management approach among all trainees. Additionally, the e-classes can be recorded and replayed so they can be viewed repeatedly by the same group or new trainees. Conclusion: This is the first sustained use of e-Teaching in a medical super-specialty in India. We believe that e-Teaching is an innovative solution that can be applied, not just to Pediatric Cardiology as we have done, but to all

  7. [Spanish Society of Cardiology ethical framework (executive summary)].

    PubMed

    de los Reyes López, Manuel; Martín Luengo, Cándido; Brugada Terradellas, Josep; Sanz Romero, Ginés; Lidón Corbí, Rosa María; Martín Burrieza, Fernando

    2006-12-01

    The Spanish Society of Cardiology (SEC) has produced an Ethical Framework Document. This document is divided into two distinct parts that deal, respectively, with the responsibilities of the SEC as an organization and the responsibilities of its professional members. The SEC makes recommendations on how its members should carry out their daily clinical practice, provides a professional perspective on public commitments as a scientific association, and aims to ensure that any views, recommendations, and advice expressed provide the basis for an informed debate on ethical problems in our field of work.

  8. [Heart catheterization in Mexico. Results of the 1996 census of heart catheterization services by the Mexican Society of Cardiology].

    PubMed

    Gaspar H, J; Guadalajara Boo, J F; de la Llata Romero, M

    1996-01-01

    The findings of the 1996 Cardiac Catheterization Laboratory Survey of the Sociedad Mexicana de Cardiología are presented. There are 52 cardiac catheterization laboratory departments distributed in 16 cities of which Mexico City has 20, Guadalajara 6 and Monterrey 5. Ninety-six percent are in hospitals where heart surgery can be performed and 8 (17%) have a training program in cardiac catheterization. Only two (3.8%) are exclusively dedicated to pediatric cardiac catheterization. In 1995, 19,214 diagnostic procedures and 2,429 PTCAs were done. A total of 270 physicians were reported to have privileges to perform cardiac catheterization. The geographical distribution of the cath labs, procedure volumes and number of physicians performing catheterization are discussed.

  9. DOSE MEASUREMENTS TO THE LENS IN NUCLEAR MEDICINE AND IN FLUOROSCOPY-GUIDED INTERVENTIONAL PROCEDURES: ANALYSIS OF THE RESULTS AND ASSESSMENT OF THE EFFECTIVENESS OF PROTECTIVE EYEWEAR ANTI-X.

    PubMed

    Sarti, G; Busca, F; Carpano, L; Dottore, F Del; Dall'ara, D; Sanniti, S

    2016-09-01

    The new limit of 20 mSv to the lens raises the need for further assessment of the equivalent dose to the lens for nuclear medicine and interventional radiology operators. (a) A measurement campaign was performed in nuclear medicine, (b) a routine monitoring was organised in interventional procedures and (c) the effectiveness of protective eyewear was assessed. In nuclear medicine, for photon fields, the adequacy of Hp(0.07) of dosemeter worn on the trunk is confirmed; with (90)Y, the annual values of Hp(3) measured in therapeutic session are <5 mSv. In interventional procedures, routine monitoring of the dose to the lens must be maintained where the values of Hp(0.07) dosemeter worn on the trunk are higher than one-third of the new limits. The measures carried out have shown that the attenuation factor mean of the protective glasses is equal to ∼4 (range 1.7-11.4).

  10. Patient radiation doses in interventional cardiology in the U.S.: Advisory data sets and possible initial values for U.S. reference levels

    SciTech Connect

    Miller, Donald L.; Hilohi, C. Michael; Spelic, David C.

    2012-10-15

    Purpose: To determine patient radiation doses from interventional cardiology procedures in the U.S and to suggest possible initial values for U.S. benchmarks for patient radiation dose from selected interventional cardiology procedures [fluoroscopically guided diagnostic cardiac catheterization and percutaneous coronary intervention (PCI)]. Methods: Patient radiation dose metrics were derived from analysis of data from the 2008 to 2009 Nationwide Evaluation of X-ray Trends (NEXT) survey of cardiac catheterization. This analysis used deidentified data and did not require review by an IRB. Data from 171 facilities in 30 states were analyzed. The distributions (percentiles) of radiation dose metrics were determined for diagnostic cardiac catheterizations, PCI, and combined diagnostic and PCI procedures. Confidence intervals for these dose distributions were determined using bootstrap resampling. Results: Percentile distributions (advisory data sets) and possible preliminary U.S. reference levels (based on the 75th percentile of the dose distributions) are provided for cumulative air kerma at the reference point (K{sub a,r}), cumulative air kerma-area product (P{sub KA}), fluoroscopy time, and number of cine runs. Dose distributions are sufficiently detailed to permit dose audits as described in National Council on Radiation Protection and Measurements Report No. 168. Fluoroscopy times are consistent with those observed in European studies, but P{sub KA} is higher in the U.S. Conclusions: Sufficient data exist to suggest possible initial benchmarks for patient radiation dose for certain interventional cardiology procedures in the U.S. Our data suggest that patient radiation dose in these procedures is not optimized in U.S. practice.

  11. Assessment of radiation dose in nuclear cardiovascular imaging using realistic computational models

    PubMed Central

    Xie, Tianwu; Lee, Choonsik; Bolch, Wesley E.; Zaidi, Habib

    2015-01-01

    Purpose: Nuclear cardiology plays an important role in clinical assessment and has enormous impact on the management of a variety of cardiovascular diseases. Pediatric patients at different age groups are exposed to a spectrum of radiation dose levels and associated cancer risks different from those of adults in diagnostic nuclear medicine procedures. Therefore, comprehensive radiation dosimetry evaluations for commonly used myocardial perfusion imaging (MPI) and viability radiotracers in target population (children and adults) at different age groups are highly desired. Methods: Using Monte Carlo calculations and biological effects of ionizing radiation VII model, we calculate the S-values for a number of radionuclides (Tl-201, Tc-99m, I-123, C-11, N-13, O-15, F-18, and Rb-82) and estimate the absorbed dose and effective dose for 12 MPI radiotracers in computational models including the newborn, 1-, 5-, 10-, 15-yr-old, and adult male and female computational phantoms. Results: For most organs, 201Tl produces the highest absorbed dose whereas 82Rb and 15O-water produce the lowest absorbed dose. For the newborn baby and adult patient, the effective dose of 82Rb is 48% and 77% lower than that of 99mTc-tetrofosmin (rest), respectively. Conclusions: 82Rb results in lower effective dose in adults compared to 99mTc-labeled tracers. However, this advantage is less apparent in children. The produced dosimetric databases for various radiotracers used in cardiovascular imaging, using new generation of computational models, can be used for risk-benefit assessment of a spectrum of patient population in clinical nuclear cardiology practice. PMID:26127049

  12. Assessment of radiation dose in nuclear cardiovascular imaging using realistic computational models

    SciTech Connect

    Xie, Tianwu; Lee, Choonsik; Bolch, Wesley E.; Zaidi, Habib

    2015-06-15

    Purpose: Nuclear cardiology plays an important role in clinical assessment and has enormous impact on the management of a variety of cardiovascular diseases. Pediatric patients at different age groups are exposed to a spectrum of radiation dose levels and associated cancer risks different from those of adults in diagnostic nuclear medicine procedures. Therefore, comprehensive radiation dosimetry evaluations for commonly used myocardial perfusion imaging (MPI) and viability radiotracers in target population (children and adults) at different age groups are highly desired. Methods: Using Monte Carlo calculations and biological effects of ionizing radiation VII model, we calculate the S-values for a number of radionuclides (Tl-201, Tc-99m, I-123, C-11, N-13, O-15, F-18, and Rb-82) and estimate the absorbed dose and effective dose for 12 MPI radiotracers in computational models including the newborn, 1-, 5-, 10-, 15-yr-old, and adult male and female computational phantoms. Results: For most organs, {sup 201}Tl produces the highest absorbed dose whereas {sup 82}Rb and {sup 15}O-water produce the lowest absorbed dose. For the newborn baby and adult patient, the effective dose of {sup 82}Rb is 48% and 77% lower than that of {sup 99m}Tc-tetrofosmin (rest), respectively. Conclusions: {sup 82}Rb results in lower effective dose in adults compared to {sup 99m}Tc-labeled tracers. However, this advantage is less apparent in children. The produced dosimetric databases for various radiotracers used in cardiovascular imaging, using new generation of computational models, can be used for risk-benefit assessment of a spectrum of patient population in clinical nuclear cardiology practice.

  13. Radiation dose and image quality for paediatric interventional cardiology systems. A national survey in Chile.

    PubMed

    Ubeda, Carlos; Vano, Eliseo; Miranda, Patricia; Leyton, Fernando; Martinez, Luis Carlos; Oyarzun, Carlos

    2011-11-01

    Radiation dose and image quality for paediatric protocols in all five X-ray fluoroscopy systems used for interventional cardiology procedures existing in Chile have been evaluated. Entrance surface air kerma (ESAK) and image quality using a test object (TO) and polymethyl methacrylate (PMMA) phantoms have been measured for the typical paediatric patient thicknesses (4-16 cm of PMMA). Images from fluoroscopy (low (FL), medium and high) and cine (CI) modes have been archived in DICOM format. Signal-to-noise ratio (SNR), figure of merit (FOM) and high-contrast spatial resolution (HCSR) have been computed from the images. The ratio between the maximum and the minimum value of ESAK per frame for a given fluoroscopy mode between the five systems ranges from 2 to 5 and from 14 to 38 for CI mode. SNR, FOM and HCSR showed a great variability for the different acquisition modes (AMs) and PMMA thickness. In the near future, it is urgent to upgrade Chilean legislation on radiation protection to incorporate quality assurance programmes that will allow us to evaluate and optimise the X-ray systems used in medical applications. Increments in doses per frame when increasing phantom thickness and when used CI runs instead of FL runs can be considered by the cardiologist in the good management of patient dose and allow them to select the best imaging AM during clinical procedures.

  14. The current and future state of interventional cardiology: a critical appraisal.

    PubMed

    Meier, Bernhard

    2006-01-01

    After 75 years of invasive and over 50 years of interventional cardiology, cardiac catheter-based procedures have become the most frequently used interventions of modern medicine. Patients undergoing a percutaneous coronary intervention (PCI) outnumber those with coronary artery bypass surgery by a factor of 2 to 4. The default approach to PCI is the implantation of a (drug-eluting) stent, in spite of the fact that it improves the results of balloon angioplasty only in about 25% of cases. The dominance of stenting over conservative therapy or balloon angioplasty on one hand and bypass surgery on the other hand is a flagrant example of how medical research is digested an applied in real life. Apart from electrophysiological interventions, closure ot the patent foramen ovale and percutaneous replacement of the aortic valve in the elderly have the potential of becoming daily routine procedures in catheterization laboratories around the world. Stem cell regeneration of vessels or heart muscle, on the other hand, may remain a dream never to come true.

  15. Patient-centered imaging: shared decision making for cardiac imaging procedures with exposure to ionizing radiation.

    PubMed

    Einstein, Andrew J; Berman, Daniel S; Min, James K; Hendel, Robert C; Gerber, Thomas C; Carr, J Jeffrey; Cerqueira, Manuel D; Cullom, S James; DeKemp, Robert; Dickert, Neal W; Dorbala, Sharmila; Fazel, Reza; Garcia, Ernest V; Gibbons, Raymond J; Halliburton, Sandra S; Hausleiter, Jörg; Heller, Gary V; Jerome, Scott; Lesser, John R; Raff, Gilbert L; Tilkemeier, Peter; Williams, Kim A; Shaw, Leslee J

    2014-04-22

    The current paper details the recommendations arising from an NIH-NHLBI/NCI-sponsored symposium held in November 2012, aiming to identify key components of a radiation accountability framework fostering patient-centered imaging and shared decision-making in cardiac imaging. Symposium participants, working in 3 tracks, identified key components of a framework to target critical radiation safety issues for the patient, the laboratory, and the larger population of patients with known or suspected cardiovascular disease. The use of ionizing radiation during an imaging procedure should be disclosed to all patients by the ordering provider at the time of ordering, and reinforced by the performing provider team. An imaging protocol with effective dose ≤3 mSv is considered very low risk, not warranting extensive discussion or written informed consent. However, a protocol effective dose >20 mSv was proposed as a level requiring particular attention in terms of shared decision-making and either formal discussion or written informed consent. Laboratory reporting of radiation dosimetry is a critical component of creating a quality laboratory fostering a patient-centered environment with transparent procedural methodology. Efforts should be directed to avoiding testing involving radiation, in patients with inappropriate indications. Standardized reporting and diagnostic reference levels for computed tomography and nuclear cardiology are important for the goal of public reporting of laboratory radiation dose levels in conjunction with diagnostic performance. The development of cardiac imaging technologies revolutionized cardiology practice by allowing routine, noninvasive assessment of myocardial perfusion and anatomy. It is now incumbent upon the imaging community to create an accountability framework to safely drive appropriate imaging utilization.

  16. Patient-Centered Imaging: Shared Decision Making for Cardiac Imaging Procedures with Exposure to Ionizing Radiation

    PubMed Central

    Einstein, Andrew J.; Berman, Daniel S.; Min, James K.; Hendel, Robert C.; Gerber, Thomas C.; Carr, J. Jeffrey; Cerqueira, Manuel D.; Cullom, S. James; DeKemp, Robert; Dickert, Neal; Dorbala, Sharmila; Garcia, Ernest V.; Gibbons, Raymond J.; Halliburton, Sandra S.; Hausleiter, Jörg; Heller, Gary V.; Jerome, Scott; Lesser, John R.; Fazel, Reza; Raff, Gilbert L.; Tilkemeier, Peter; Williams, Kim A.; Shaw, Leslee J.

    2014-01-01

    Objective To identify key components of a radiation accountability framework fostering patient-centered imaging and shared decision-making in cardiac imaging. Background An NIH-NHLBI/NCI-sponsored symposium was held in November 2012 to address these issues. Methods Symposium participants, working in three tracks, identified key components of a framework to target critical radiation safety issues for the patient, the laboratory, and the larger population of patients with known or suspected cardiovascular disease. Results Use of ionizing radiation during an imaging procedure should be disclosed to all patients by the ordering provider at the time of ordering, and reinforced by the performing provider team. An imaging protocol with effective dose ≤3mSv is considered very low risk, not warranting extensive discussion or written consent. However, a protocol effective dose <20mSv was proposed as a level requiring particular attention in terms of shared decision-making and either formal discussion or written informed consent. Laboratory reporting of radiation dosimetry is a critical component of creating a quality laboratory fostering a patient-centered environment with transparent procedural methodology. Efforts should be directed to avoiding testing involving radiation, in patients with inappropriate indications. Standardized reporting and diagnostic reference levels for computed tomography and nuclear cardiology are important for the goal of public reporting of laboratory radiation dose levels in conjunction with diagnostic performance. Conclusions The development of cardiac imaging technologies revolutionized cardiology practice by allowing routine, noninvasive assessment of myocardial perfusion and anatomy. It is now incumbent upon the imaging community to create an accountability framework to safely drive appropriate imaging utilization. PMID:24530677

  17. Possible helio-geomagnetic activity influence on cardiological cases

    NASA Astrophysics Data System (ADS)

    Katsavrias, Christos

    Eruptive solar events as flares and coronal mass ejections (CMEs) occur during solar activ-ity periods. Energetic particles, fast solar wind plasma and electromagnetic radiation pass through interplanetary space, arrive on Earth's ionosphere-magnetosphere and produce various disturbances. It is well known the negative influence of geomagnetic substorms on the human technological applications on geospace. During the last 25 years, many studies concerning the possible influence on the human health are published. Increase of the Acute Coronary Syn-dromes and disorders of the Cardiac Rhythm, increase of accidents as well as neurological and psychological disorders (e.g. increase of suicides) during or near to the geomagnetic storms time interval are reported. In this study, we research the problem in Greece, focusing on patients with Acute Myocardial Infraction, hospitalized in the 2nd Cardiological Department of the General Hospital of Nikaea (Piraeus City), for the time interval 1997-2007 (23rd solar cycle) and also to the arrival of emergency cardiological cases to Emergency Department of two greek hospitals, the General Hospital of Lamia City and the General Hospital of Veria City during the selected months, with or without helio-geomagnetic activity, of the 23rd solar cycle. Increase of cases is recorded during the periods with increase helio-geomagnetic activity. The necessity of continuing the research for a longer period and with a bigger sample is high; so as to exact more secure conclusions.

  18. Simulation based planning of surgical interventions in pediatric cardiology

    PubMed Central

    Marsden, Alison L.

    2013-01-01

    Hemodynamics plays an essential role in the progression and treatment of cardiovascular disease. However, while medical imaging provides increasingly detailed anatomical information, clinicians often have limited access to hemodynamic data that may be crucial to patient risk assessment and treatment planning. Computational simulations can now provide detailed hemodynamic data to augment clinical knowledge in both adult and pediatric applications. There is a particular need for simulation tools in pediatric cardiology, due to the wide variation in anatomy and physiology in congenital heart disease patients, necessitating individualized treatment plans. Despite great strides in medical imaging, enabling extraction of flow information from magnetic resonance and ultrasound imaging, simulations offer predictive capabilities that imaging alone cannot provide. Patient specific simulations can be used for in silico testing of new surgical designs, treatment planning, device testing, and patient risk stratification. Furthermore, simulations can be performed at no direct risk to the patient. In this paper, we outline the current state of the art in methods for cardiovascular blood flow simulation and virtual surgery. We then step through pressing challenges in the field, including multiscale modeling, boundary condition selection, optimization, and uncertainty quantification. Finally, we summarize simulation results of two representative examples from pediatric cardiology: single ventricle physiology, and coronary aneurysms caused by Kawasaki disease. These examples illustrate the potential impact of computational modeling tools in the clinical setting. PMID:24255590

  19. Simulation-based planning of surgical interventions in pediatric cardiology

    NASA Astrophysics Data System (ADS)

    Marsden, Alison

    2012-11-01

    Hemodynamics plays an essential role in the progression and treatment of cardiovascular disease. This is particularly true in pediatric cardiology, due to the wide variation in anatomy observed in congenital heart disease patients. While medical imaging provides increasingly detailed anatomical information, clinicians currently have limited knowledge of important fluid mechanical parameters. Treatment decisions are therefore often made using anatomical information alone, despite the known links between fluid mechanics and disease progression. Patient-specific simulations now offer the means to provide this missing information, and, more importantly, to perform in-silico testing of new surgical designs at no risk to the patient. In this talk, we will outline the current state of the art in methods for cardiovascular blood flow simulation and virtual surgery. We will then present new methodology for coupling optimization with simulation and uncertainty quantification to customize treatments for individual patients. Finally, we will present examples in pediatric cardiology that illustrate the potential impact of these tools in the clinical setting.

  20. Training fellows in paediatric cardiology: the Harvard experience.

    PubMed

    Brown, David W; Allan, Catherine K; Newburger, Jane W

    2016-12-01

    The Fellowship Program of the Department of Cardiology at Boston Children's Hospital seeks to train academically oriented leaders in clinical care and laboratory and clinical investigation of cardiovascular disease in the young. The core clinical fellowship involves 3 years in training, comprising 24 months of clinical rotations and 12 months of elective and research experience. Trainees have access to a vast array of research opportunities - clinical, basic, and translational. Clinical fellows interested in basic science may reverse the usual sequence and start their training in the laboratory, deferring clinical training for 1 or more years. An increasing number of clinical trainees apply to spend a fourth year as a senior fellow in one of the subspecialty areas of paediatric cardiology. From the founding of the Department to the present, we have maintained a fundamental and unwavering commitment to training and education in clinical care and research in basic science and clinical investigation, as well as to the training of outstanding young clinicians and investigators.

  1. [Cardiological follow-up in patients with Fabry disease].

    PubMed

    Pieruzzi, Federico; Pieroni, Maurizio; Chimenti, Cristina; Frustaci, Andrea; Sarais, Cristiano; Cecchi, Franco

    2010-01-01

    Fabry disease is a rare tesaurismosis due to a deficit of the lysosomal enzyme activity of alpha-galactosidase, needed for the normal catabolism of globotriaosylceramides (GL3). Fabry cardiac involvement has several clinical manifestations: concentric left ventricular hypertrophy without left ventricular dilation and severe loss of left ventricular systolic function, mitral and aortic valvulopathy, disorders of the atrioventricular conduction or repolarization, and compromised diastolic function. Differentiating Fabry disease from similar conditions is often quite straightforward, e.g., cardiac amyloidosis is often associated with low electrocardiographic voltages, and systemic symptoms are usually associated with hemochromatosis and sarcoidosis. However, sometimes second-level (genetic analysis, alpha-galactosidase levels) or invasive investigations are required, which can include endomyocardial biopsy. Diagnostic imaging techniques have been described, but they lack specificity. Echocardiographic imaging with tissue Doppler analysis and/or strain rate analysis can allow diagnosis of Fabry disease even before left ventricular hypertrophy becomes apparent. This review illustrates the techniques for staging cardiac involvement and damage in Fabry disease and for the long-term follow-up of Fabry patients with or without cardiac involvement. Careful cardiac monitoring is especially important in elderly female carriers, who often develop renal disorders and/or left ventricular hypertrophy as the only manifestations of their late Fabry disease. In some clinical series, Fabry disease was diagnosed in 12% of women with adult-onset hypertrophic cardiomyopathy. Cardiological problems and outcomes of enzyme replacement therapy, associated with or without other cardiological treatments, are also discussed.

  2. European Society of Cardiology (ESC) congress report from Barcelona 2014.

    PubMed

    Muramatsu, Takashi; Ozaki, Yukio

    2014-01-01

    The Annual Congress of the European Society of Cardiology (ESC) was held in Barcelona from 30th August to 3rd September 2014. More than 30,300 attendees from around the world shared the latest original research, including 27 clinical Hot Line studies, 12 basic science Hot Lines, 15 clinical trial updates, 19 registry studies, and 4,597 abstracts. Many important issues were presented, including novel treatment strategies for heart failure, acute coronary syndrome, interventional treatment for structural heart disease, renal denervation, novel anticoagulant therapies, atrial fibrillation and so on. In addition, 5 new ESC clinical practice guidelines (ie, myocardial revascularization, non-cardiac surgery, acute pulmonary embolism, hypertrophic cardiomyopathy, and aortic disease) were launched. It should be noted that Japan has recently been ranked in the top position in terms of the number of abstract submissions. Based on these activities, the ESC Congress has been recognized as the dominant scientific and educational forum for healthcare professionals in cardiology. We report the highlights and several key presentations of the ESC Congress 2014. The scientific activities and growing contributions of Japanese cardiologists or cardiovascular surgeons enhance the favorable relationship between the ESC and the Japanese Circulation Society.

  3. [Scientific evidence-based cardiology: the principles and practice].

    PubMed

    Carneiro, A V

    2000-09-01

    Every clinical cardiologist, no matter what the clinical work (invasive or non-invasive), has to face several problems concerning clinical knowledge and medical information in everyday practice. Diagnostic and therapeutic advances in cardiology are occurring at an increasing pace and every cardiologist responsible for patient care in hospitals, clinics or emergency rooms needs to be up-to-date in order to provide the best possible medical care. On the other hand, society is increasingly making doctors accountable for the provision of good quality care in a cost-effective way. In the context of scarce resources, this situation requires a rigorous and rational approach by the individual cardiologist. These apparent contradictions can be solved by practicing evidence-based cardiology (EBC). This review introduces the concept of EBC, its principles, practice, and methodological steps: 1) formulation of a structured clinical activity; 2) scientific evidence; 3) critical appraisal of this evidence using explicit methods; and 4) synthesis and practical application of this evidence. In this sense, EBC arises from the patient, and after the best possible scientific evidence is selected, it is applied to the individual case. EBC allows the individual cardiologist to keep up with the medical literature while improving reading habits and the form in which relevant clinical information is selected. It also increases confidence in the clinical decisions, reducing practice variation as well as improving doctor-patient communication. Lastly EBC can be used as a powerful tool for pre, post and continuous medical education.

  4. Simulation based planning of surgical interventions in pediatric cardiology.

    PubMed

    Marsden, Alison L

    2013-10-01

    Hemodynamics plays an essential role in the progression and treatment of cardiovascular disease. However, while medical imaging provides increasingly detailed anatomical information, clinicians often have limited access to hemodynamic data that may be crucial to patient risk assessment and treatment planning. Computational simulations can now provide detailed hemodynamic data to augment clinical knowledge in both adult and pediatric applications. There is a particular need for simulation tools in pediatric cardiology, due to the wide variation in anatomy and physiology in congenital heart disease patients, necessitating individualized treatment plans. Despite great strides in medical imaging, enabling extraction of flow information from magnetic resonance and ultrasound imaging, simulations offer predictive capabilities that imaging alone cannot provide. Patient specific simulations can be used for in silico testing of new surgical designs, treatment planning, device testing, and patient risk stratification. Furthermore, simulations can be performed at no direct risk to the patient. In this paper, we outline the current state of the art in methods for cardiovascular blood flow simulation and virtual surgery. We then step through pressing challenges in the field, including multiscale modeling, boundary condition selection, optimization, and uncertainty quantification. Finally, we summarize simulation results of two representative examples from pediatric cardiology: single ventricle physiology, and coronary aneurysms caused by Kawasaki disease. These examples illustrate the potential impact of computational modeling tools in the clinical setting.

  5. Simulation based planning of surgical interventions in pediatric cardiology

    NASA Astrophysics Data System (ADS)

    Marsden, Alison L.

    2013-10-01

    Hemodynamics plays an essential role in the progression and treatment of cardiovascular disease. However, while medical imaging provides increasingly detailed anatomical information, clinicians often have limited access to hemodynamic data that may be crucial to patient risk assessment and treatment planning. Computational simulations can now provide detailed hemodynamic data to augment clinical knowledge in both adult and pediatric applications. There is a particular need for simulation tools in pediatric cardiology, due to the wide variation in anatomy and physiology in congenital heart disease patients, necessitating individualized treatment plans. Despite great strides in medical imaging, enabling extraction of flow information from magnetic resonance and ultrasound imaging, simulations offer predictive capabilities that imaging alone cannot provide. Patient specific simulations can be used for in silico testing of new surgical designs, treatment planning, device testing, and patient risk stratification. Furthermore, simulations can be performed at no direct risk to the patient. In this paper, we outline the current state of the art in methods for cardiovascular blood flow simulation and virtual surgery. We then step through pressing challenges in the field, including multiscale modeling, boundary condition selection, optimization, and uncertainty quantification. Finally, we summarize simulation results of two representative examples from pediatric cardiology: single ventricle physiology, and coronary aneurysms caused by Kawasaki disease. These examples illustrate the potential impact of computational modeling tools in the clinical setting.

  6. Accidental nuclear war: Modifications to superpower arsenals and to procedures for handling them could substantially reduce the risk of unintended Armageddon

    SciTech Connect

    Blair, B.G.; Kendall, H.W.

    1990-12-01

    If nuclear war breaks out in the coming decade or two, it will probably be by accident. The threat of a cold-blooded, calculated first strike is vanishing, but beneath the calm surface of constructive diplomacy among the traditional nuclear rivals lurks the danger of unpremeditated use of nuclear weapons. The accidental, unauthorized or inadvertent use of these weapons has become the most plausible path to nuclear war. Both superpowers, as well as France, Great Britain and China - long-standing members of the nuclear club - are potential sources of accidental missile launch. The emergence of fledgling nuclear powers such as India, Pakistan and Israel - some armed with ballistic missiles - pushes nuclear safeguards even closer to the top of the international security agenda. The chances of unwanted nuclear war would be reduced significantly if tamper proof, coded locks were installed on all nuclear weapons and if methods were put in place to disarm nuclear forces even after launch. In addition, the US and the Soviet Union should reduce their reliance on the dangerous policy of launch on warning and reduce the launch readiness of their nuclear forces. The social and political upheavals in the Soviet Union underscore fears of unintended nuclear war. Civil turmoil raises the possibility that rebellious ethnic groups or splinter organizations could capture nuclear weapons. Other, deeper fault lines run through the whole of Soviet society and may be capable of cracking the foundations of its nuclear command system. Although the US faces no such civil unrest, the country's system of nuclear command carries some risk that nuclear weapons might be used contrary to the intentions of legitimate authorities.

  7. Comparing spatial expression dynamics of bovine blastocyst under three different procedures: in-vivo, in-vitro derived, and somatic cell nuclear transfer embryos.

    PubMed

    Nagatomo, Hiroaki; Akizawa, Hiroki; Sada, Ayari; Kishi, Yasunori; Yamanaka, Ken-ichi; Takuma, Tetsuya; Sasaki, Keisuke; Yamauchi, Nobuhiko; Yanagawa, Yojiro; Nagano, Masashi; Kono, Tomohiro; Takahashi, Masashi; Kawahara, Manabu

    2015-11-01

    There has been no work on spatiotemporal transcriptomic differences of blastocysts using in vivo- and in vitro-derived, and somatic cell nuclear transfer (SCNT) embryos. Here, we first compared the lineage-differentially transcriptomic profiles of in vivo- and in vitro-derived embryos by microarray analysis using divided into inner cell mass (ICM)-and trophectoderm (TE)-side samples, as well as those derived from SCNT in order to explore lineage-differentially expressed genes that are associated with preimplantation development in cattle. The transcriptomic profiles of the ICM-specific and TE-specific genes were similar between in vitro-derived embryos and in vivo-derived embryos, whereas SCNT embryos exhibited unusual lineage-differentially gene expression regulation at the blastocyst stage. The genes expressed in a spatiotemporal manner between developmentally normal in-vivo derived blastocysts and developmentally abnormal SCNT blastocysts might play critical roles for preimplantation development. Comparing spatial expression dynamics of bovine blastocyst under three different procedures revealed that CIITA was expressed in ICM-side samples of all the embryo types. CIITA is known as the master regulator of major histocompatibility complexes (MHC) class II genes that express in antigen-presenting cells but its biological function in preimplantation embryo is still unknown in mammals. Knockdown of CIITA expression in in vitro-derived embryos did not affect cleavage, but disrupted development of embryos into the blastocyst stage. These findings provide the novel transcriptomic information on blastocyst formation, raising the possibility that immune function-related gene directly plays important roles in bovine preimplantation development.

  8. Variable-target-function and build-up procedures for the calculation of protein conformation. Application to bovine pancreatic trypsin inhibitor using limited simulated nuclear magnetic resonance data.

    PubMed

    Vásquez, M; Scheraga, H A

    1988-02-01

    An implementation of the variable-target-function procedure, first introduced by Braun and Go [W. Braun and N. Go, J. Mol. Biol. 186, 611-626 (1985)], has been used to generate conformations of the small protein bovine pancreatic trypsin inhibitor (BPTI), given a limited set of simulated data that could be obtained by nuclear magnetic resonance (NMR) techniques. A hybrid strategy was also used to calculate conformations of BPTI, given the same information. In the hybrid strategy, low-energy structures of medium-size fragments (decapeptides) of BPTI were generated using the variable-target-function method, followed by restrained energy optimization. The low-energy conformations were used as a basis to build up the complete fifty-eight-residue BPTI molecule. By using the variable-target-function approach, in which energy considerations were not introduced until full conformations of the entire BPTI molecule had been generated, it was not possible to obtain calculated structures with rms deviations from the X-ray conformation of less than 1.6 A for the alpha-carbons. On the other hand, with the hybrid strategy, which involved the consideration of realistic energy terms in the early stages of the calculations, it was possible to calculate low-energy conformations of BPTI with rms deviations from the X-ray structure of 1.06 to 1.50 A for the alpha-carbons. When the rms deviations were computed along the amino acid sequence, it was found that there was a good correlation between deviations among the calculated structures and deviations from the X-ray structure.

  9. Highlights of the annual meeting of the Association for European Paediatric and Congenital Cardiology.

    PubMed

    Konta, Laura; Hayes, Nicholas; Qureshi, Shakeel A

    2013-09-01

    The 47th annual meeting of the Association for European Paediatric and Congenital Cardiology was held on 22-25th May 2013 in London, UK. This is one of the largest scientific meetings in Europe within the field of congenital cardiac disease and was held in association with the Japanese Society of Pediatric Cardiology and Cardiac Surgery, and Asia Pacific Pediatric Cardiology Society. There were 900 submitted abstracts and over 1000 delegates from 57 countries attended. We have summarized some of the highlights of the meeting below.

  10. Report of the American College of Cardiology (ACC) Scientific Sessions 2016, Chicago.

    PubMed

    Mano, Toshiaki; Yamamoto, Kazuhiro

    2016-05-25

    The 65(th)Annual Scientific Sessions of the American College of Cardiology (ACC) were held at McCormick Place, Chicago, from April 2-4, 2016. The ACC Scientific Sessions are one of the 2 major scientific cardiology meetings in the USA and one of the major scientific meetings of cardiology in the world. It had an attendance of 18,769 and over 2,000 oral and poster abstracts, including 8 late-breaking clinical trials. This report presents the key presentations and the highlights from the ACC Scientific Sessions 2016 in Chicago. (Circ J 2016; 80: 1308-1313).

  11. Open source cardiology electronic health record development for DIGICARDIAC implementation

    NASA Astrophysics Data System (ADS)

    Dugarte, Nelson; Medina, Rubén.; Huiracocha, Lourdes; Rojas, Rubén.

    2015-12-01

    This article presents the development of a Cardiology Electronic Health Record (CEHR) system. Software consists of a structured algorithm designed under Health Level-7 (HL7) international standards. Novelty of the system is the integration of high resolution ECG (HRECG) signal acquisition and processing tools, patient information management tools and telecardiology tools. Acquisition tools are for management and control of the DIGICARDIAC electrocardiograph functions. Processing tools allow management of HRECG signal analysis searching for indicative patterns of cardiovascular pathologies. Telecardiology tools incorporation allows system communication with other health care centers decreasing access time to the patient information. CEHR system was completely developed using open source software. Preliminary results of process validation showed the system efficiency.

  12. Task Force on Sudden Cardiac Death, European Society of Cardiology.

    PubMed

    Priori, S G; Aliot, E; Blømstrom-Lundqvist, C; Bossaert, L; Breithardt, G; Brugada, P; Camm, J A; Cappato, R; Cobbe, S M; Di, Mario C; Maron, B J; McKenna, W J; Pedersen, A K; Ravens, U; Schwartz, P J; Trusz-Gluza, M; Vardas, P; Wellens, H J J; Zipes, D P

    2002-01-01

    The European Society of Cardiology has convened a Task Force on Sudden Cardiac Death in order to provide a comprehensive, educational document on this important topic. The main document has been published in the European Heart Journal in August 2001. The Task Force has now summarized the most important clinical issues on sudden cardiac death and provided tables with recommendations for risk stratification and for prophylaxis of sudden cardiac death. The present recommendations are specifically intended to encourage the development and revision of national guidelines on prevention of sudden cardiac death. The common challenge for cardiologists, physicians of other medical specialties and health professionals throughout Europe is to realize the potential for sudden cardiac death prevention and to contribute to public health efforts to reduce its burden.

  13. Role and importance of biochemical markers in clinical cardiology.

    PubMed

    Panteghini, Mauro

    2004-07-01

    This paper reviews the current contribution of the biochemical marker determination to clinical cardiology and discusses some important developments in this field. Biochemical markers play a pivotal role in the diagnosis and management of patients with acute coronary syndrome (ACS), as witnessed by the incorporation of cardiac troponins into new international guidelines for patients with ACS and in the re-definition of myocardial infarction. Despite the success of cardiac troponins, there is still a need for the development of early markers that can reliably rule out ACS from the emergency room at presentation and also detect myocardial ischaemia in the absence of irreversible myocyte injury. Under investigation are two classes of indicators: markers of early injury/ischaemia and markers of inflammation and coronary plaque instability and disruption. Finally, with the characterisation of the cardiac natriuretic peptides, Laboratory Medicine is also assuming a role in the assessment of cardiac function.

  14. [One-stop outpatient cardiology clinics: 10 years' experience].

    PubMed

    Falces, Carlos; Sadurní, Josep; Monell, Joan; Andrea, Rut; Ylla, Miquel; Moleiro, Angels; Cantillo, Jordi

    2008-05-01

    A one-stop outpatient cardiology clinic was set up at the Vic General Hospital in Spain in 1996. The aims were to provide patients with a rapid response, and to ensure that, on the same day, they saw a specialist and were referred for any relevant investigations required, primarily echocardiography, exercise testing, and Holter monitoring. We report experience from 10 years of follow-up, involving 19,515 consultations. The mean waiting time for a consultation was 3 days. We analyzed the reasons for the consultations, the investigations carried out, and the reductions in follow-up visits and hospital admissions. Primary care physicians' level of satisfaction was increased by this approach. The one-stop clinic proved feasible in clinical practice and proved robust during the follow-up period. This clinical model was beneficial for patients, was highly acceptable to primary care physicians, reduced the need for patients to contact the hospital, and, possibly, reduced hospital admissions.

  15. A cooperative model for integration in a cardiology outpatient clinic.

    PubMed Central

    Cornet, R.; van Mulligen, E. M.; Timmers, T.

    1994-01-01

    With the increasing amount of digitally stored patient information, such as images and findings, the possibility and need arise for a system which is able to both store and display this information in a structured, user-friendly way. In the common situation where different information systems are used within one department, this means that the various information systems have to be integrated. However, integration requires more complex management of data, processes and windows. This management can be handled by a Workspace Manager, which controls inter-application tasks, and interaction with the user. Furthermore, this Workspace Manager supports the user with the definition of complex tasks such as collecting problem-related patient information from the various remote systems. In an outpatient clinic for cardiology this architecture is used to achieve cooperative integration of an open Computer Patient Record with a range of information-specific services. Images Figure 4 PMID:7949997

  16. Medication Reconciliation in Patients Hospitalized in a Cardiology Unit

    PubMed Central

    Magalhães, Gabriella Fernandes; Santos, Gláucia Beisl Noblat de Carvalho; Rosa, Mário Borges; Noblat, Lúcia de Araújo Costa Beisl

    2014-01-01

    Objectives To compare drugs prescribed on hospital admission with the list of drugs taken prior to admission for adult patients admitted to a cardiology unit and to identify the role of a pharmacist in identifying and resolving medication discrepancies. Method This study was conducted in a 300 bed university hospital in Brazil. Clinical pharmacists taking medication histories and reconciling medications prescribed on admission with a list of drugs used prior to admission. Discrepancies were classified as justified (e.g., based on the pharmacotherapeutic guidelines of the hospital studied) or unintentional. Treatments were reviewed within 48 hours following hospitalization. Unintentional discrepancies were further classified according to the categorization of medication error severity. Pharmacists verbally contacted the prescriber to recommend actions to resolve the discrepancies. Results A total of 181 discrepancies were found in 50 patients (86%). Of these discrepancies, 149 (82.3%) were justified changes to the patient's home medication regimen; however, 32 (17.7%) discrepancies found in 24 patients were unintentional. Pharmacists made 31 interventions and 23 (74.2%) were accepted. Among unintentional discrepancies, the most common was a different medication dose on admission (42%). Of the unintentional discrepancies 13 (40.6%) were classified as error without harm, 11 (34.4%) were classified as error without harm but which could affect the patient and require monitoring, 3 (9.4%) as errors could have resulted in harm and 5 (15.6%) were classified as circumstances or events that have the capacity to cause harm. Conclusion The results revealed a high number of unintentional discrepancies and the pharmacist can play an important role by intervening and correcting medication errors at a hospital cardiology unit. PMID:25531902

  17. Platelet function tests in clinical cardiology: unfulfilled expectations.

    PubMed

    Gorog, Diana A; Fuster, Valentin

    2013-05-28

    This review is a critical evaluation of publications in the past decade on the usefulness of platelet function tests (PFTs) in clinical cardiology, in aiding diagnosis, predicting risk, and monitoring therapy. The ideal PFT should: 1) detect baseline platelet hyperreactivity; 2) allow individualization of antiplatelet medication; 3) predict thrombotic risk; and 4) predict bleeding risk. The practicalities of clinical cardiology demand rapid, accurate, and reliable tests that are simple to operate at the bedside and available 24 h a day, 7 days a week. Point-of-care PFTs most widely evaluated clinically include PFA-100 and VerifyNow. None of these tests can reliably detect platelet hyperreactivity and thus identify a prothrombotic state. Identification of antiplatelet nonresponsiveness or hyporesponsiveness is highly test specific, and does not allow individualization of therapy. The power of PFTs in predicting thrombotic events for a given individual is variable and often modest, and alteration of antithrombotic treatment on the basis of the results of PFTs has not been shown to alter clinical outcome. PFTs in current mainstream use cannot reliably assess bleeding risk. These tests have been in use for over a decade, but the hopes raised by PFTs in clinical practice remain unfulfilled. Although physiologically relevant measurement of platelet function now is more important than ever, a critical reappraisal of available techniques in light of clinical requirements is needed. The use of native blood, global stimulus instead of individual agonists, contribution of thrombin generation by activated platelets to the test results, and establishment of a PFT therapeutic range for each antiplatelet drug should be considered and is discussed.

  18. On New Spain and Mexican medicinal botany in cardiology.

    PubMed

    de Micheli-Serra, Alfredo Alessandro; Izaguirre-Ávila, Raúl

    2014-01-01

    Towards the middle of the XVI century, the empirical physician Martín de la Cruz, in New Spain, compiled a catalogue of the local medicinal herbs and plants, which was translated into Latin by Juan Badiano, professor at the Franciscan college of Tlatelolco. On his side, Dr. Francisco Hernández, the royal physician (protomédico) from 1571 until 1577, performed a systematic study of the flora and fauna in this period. His notes and designs were not published at that time, but two epitomes of Hernández' works appeared, respectively, in 1615 in Mexico and in 1651 in Rome. During the XVIII century, two Spanish scientific expeditions arrived to these lands. They were led, respectively, by the Spanish naturalist Martín Sessé and the Italian seaman, Alessandro Malaspina di Mulazzo, dependent from the Spanish Government. These expeditions collected and carried rich scientific material to Spain. At the end of that century, the Franciscan friar Juan Navarro depicted and described several Mexican medicinal plants in the fifth volume of his botanic work. In the last years of the colonial period, the fundamental works of Humboldt and Bonpland on the geographic distribution of the American plants were published. In the modern age, the first research about the Mexican medicinal botany was performed in the laboratory of the Instituto Médico Nacional [National Medical Institute] under the leadership of Dr. Fernando Altamirano, who started pharmacological studies in this country. Later, trials of cardiovascular pharmacology were performed in the small laboratories of the cardiological unit at the General Hospital of Mexico City, on Dr. Ignacio Chávez' initiative. The Mexican botanical-pharmacological tradition persists alive and vigorous at the Instituto Nacional de Cardiología and other scientific institutions of the country.

  19. 3D-Printing in Congenital Cardiology: From Flatland to Spaceland

    PubMed Central

    Deferm, Sébastien; Meyns, Bart; Vlasselaers, Dirk; Budts, Werner

    2016-01-01

    Medical imaging has changed to a great extent over the past few decades. It has been revolutionized by three-dimensional (3D) imaging techniques. Despite much of modern medicine relying on 3D imaging, which can be obtained accurately, we keep on being limited by visualization of the 3D content on two-dimensional flat screens. 3D-printing of graspable models could become a feasible technique to overcome this gap. Therefore, we printed pre- and postoperative 3D-models of a complex congenital heart defect. With this example, we intend to illustrate that these models hold value in preoperative planning, postoperative evaluation of a complex procedure, communication with the patient, and education of trainees. At this moment, 3D printing only leaves a small footprint, but makes already a big impression in the domain of cardiology and cardiovascular surgery. Further studies including more patients and more validated applications are needed to streamline 3D printing in the clinical setting of daily practice. PMID:27195174

  20. Multimedia platform for authoring and presentation of clinical rounds in cardiology

    NASA Astrophysics Data System (ADS)

    Ratib, Osman M.; Allada, Vivekanand; Dahlbom, Magdalena; Lapstra, Lorelle

    2003-05-01

    We developed a multimedia presentation platform that allows retrieving data from any digital and analog modalities and to prepare a script of a clinical presentation in an XML format. This system was designed for cardiac multi-disciplinary conferences involving different cardiology specialists as well as cardiovascular surgeons. A typical presentation requires preparation of summary reports of data obtained from the different investigations and imaging techniques. An XML-based scripting methodology was developed to allow for preparation of clinical presentations. The image display program uses the generated script for the sequential presentation of different images that are displayed on pre-determined presentation settings. The ability to prepare and present clinical conferences electronically is more efficient and less time consuming than conventional settings using analog and digital documents, films and videotapes. The script of a given presentation can further be saved as part of the patient record for subsequent review of the documents and images that supported a given medical or therapeutic decision. This also constitutes a perfect documentation method for surgeons and physicians responsible of therapeutic procedures that were decided upon during the clinical conference. It allows them to review the relevant data that supported a given therapeutic decision.

  1. 3D-Printing in Congenital Cardiology: From Flatland to Spaceland.

    PubMed

    Deferm, Sébastien; Meyns, Bart; Vlasselaers, Dirk; Budts, Werner

    2016-01-01

    Medical imaging has changed to a great extent over the past few decades. It has been revolutionized by three-dimensional (3D) imaging techniques. Despite much of modern medicine relying on 3D imaging, which can be obtained accurately, we keep on being limited by visualization of the 3D content on two-dimensional flat screens. 3D-printing of graspable models could become a feasible technique to overcome this gap. Therefore, we printed pre- and postoperative 3D-models of a complex congenital heart defect. With this example, we intend to illustrate that these models hold value in preoperative planning, postoperative evaluation of a complex procedure, communication with the patient, and education of trainees. At this moment, 3D printing only leaves a small footprint, but makes already a big impression in the domain of cardiology and cardiovascular surgery. Further studies including more patients and more validated applications are needed to streamline 3D printing in the clinical setting of daily practice.

  2. [The GIPSY-RECPAM model: a versatile approach for integrated evaluation in cardiologic care].

    PubMed

    Carinci, F

    2009-01-01

    Tree-structured methodology applied for the GISSI-PSICOLOGIA project, although performed in the framework of earliest GISSI studies, represents a powerful tool to analyze different aspects of cardiologic care. The GISSI-PSICOLOGIA project has delivered a novel methodology based on the joint application of psychometric tools and sophisticated statistical techniques. Its prospective use could allow building effective epidemiological models relevant to the prognosis of the cardiologic patient. The various features of the RECPAM method allow a versatile use in the framework of modern e-health projects. The study used the Cognitive Behavioral Assessment H Form (CBA-H) psychometrics scales. The potential for its future application in the framework of Italian cardiology is relevant and particularly indicated to assist planning of systems for integrated care and routine evaluation of the cardiologic patient.

  3. How will 2014 European Society of Cardiology Congress influence our daily practice?

    PubMed

    Yılmaz, M Birhan

    2014-12-01

    European Cardiology Congress which was held in Barcelona in this year; was a meeting with striking results of the presented scientific studies. Herein, a brief overview of congress highlights is presented.

  4. Waist circumference as a vital sign in cardiology 20 years after its initial publication in the American Journal of Cardiology.

    PubMed

    Després, Jean-Pierre

    2014-07-15

    In 1994, we reported in The American Journal of Cardiology that a simple anthropometric measurement, waist circumference, was related to the amount of abdominal visceral adipose tissue measured by computed tomography. An elevated waist circumference was also found to be associated with several features of the cardiometabolic risk profile such as glucose intolerance, hyperinsulinemia, and an atherogenic dyslipidemic profile that included hypertriglyceridemia and reduced high-density lipoprotein cholesterol levels. Although a linear relation was found between waist circumference and these metabolic alterations, we reported that a waist circumference value of about 100 cm was associated with a high probability of finding diabetogenic and atherogenic abnormalities. The present short report provides a brief update of issues that have been raised regarding the measurement of waist circumference and its clinical use over a period of 20 years since the original publication.

  5. Occupational cataracts and lens opacities in interventional cardiology (O'CLOC study): are X-Rays involved?

    PubMed Central

    2010-01-01

    Background The eye is well known to be sensitive to clearly high doses (>2 Gy) of ionizing radiation. In recent years, however, cataracts have been observed in populations exposed to lower doses. Interventional cardiologists are repeatedly and acutely exposed to scattered ionizing radiation (X-rays) during the diagnostic and therapeutic procedures they perform. These "low" exposures may cause damage to the lens of the eye and induce early cataracts, known as radiation-induced cataracts. The O'CLOC study (Occupational Cataracts and Lens Opacities in interventional Cardiology) was designed to test the hypothesis that interventional cardiologists, compared with an unexposed reference group of non-interventional cardiologists, have an increased risk of cataracts. Method/Design The O'CLOC study is a cross-sectional study that will include a total of 300 cardiologists aged at least 40 years: one group of exposed interventional cardiologists and another of non-interventional cardiologists. The groups will be matched for age and sex. Individual information, including risk factors for cataracts (age, diabetes, myopia, etc.), will be collected during a telephone interview. A specific section of the questionnaire for the exposed group focuses on occupational history, including a description of the procedures (type, frequency, radiation protection tool) used. These data will be used to classify subjects into "exposure level" groups according to cumulative dose estimates. Eye examinations for all participants will be performed to detect cataracts, even in the early stages (lens opacities, according to LOCS III, the international standard classification). The analysis will provide an estimation of the cataract risk in interventional cardiology compared with the unexposed reference group, while taking other risk factors into account. An analysis comparing the risks according to level of exposure is also planned. Discussion This epidemiological study will provide further evidence

  6. [The practical clinical guidelines of the Sociedad Española de Cardiología on interventional cardiology: coronary angioplasty and other technics].

    PubMed

    Esplugas, E; Alfonso, F; Alonso, J J; Asín, E; Elizaga, J; Iñiguez, A; Revuelta, J M

    2000-02-01

    Interventional cardiology has had an extraordinary expansion in last years. This clinical guideline is a review of the scientific evidence of the techniques in relation to clinical and anatomic findings. The review includes: 1. Coronary arteriography. 2. Coronary balloon angioplasty. 3. Coronary stents. 4. Other techniques: directional atherectomy, rotational atherectomy, transluminal extraction atherectomy, cutting balloon, laser angioplasty and transmyocardial laser and endovascular radiotherapy. 5. Platelet glycoprotein IIb/IIIa inhibitors. 6. New diagnostic techniques: intravascular ultrasound, coronary angioscopy, Doppler and pressure wire. For the recommendations we have used the classification system: class I, IIa, IIb, III like in the guidelines of the American College of Cardiology and the American Heart Association.

  7. Association of Physician Certification in Interventional Cardiology with In-Hospital Outcomes of Percutaneous Coronary Intervention

    PubMed Central

    Fiorilli, Paul N.; Minges, Karl E.; Herrin, Jeph; Messenger, John C.; Ting, Henry H.; Nallamothu, Brahmajee K.; Lipner, Rebecca S.; Hess, Brian J.; Holmboe, Eric S.; Brennan, Joseph J.; Curtis, Jeptha P.

    2015-01-01

    Background The value of American Board of Internal Medicine (ABIM) certification has been questioned. We evaluated the association of interventional cardiology (ICARD) certification with in-hospital outcomes of patients undergoing percutaneous coronary intervention (PCI) in 2010. Methods and Results We identified physicians who performed ≥10 PCIs in 2010 in the CathPCI Registry and determined ICARD status using ABIM data. We compared in-hospital outcomes of patients treated by certified and non-certified physicians using hierarchical multivariable models adjusted for differences in patient characteristics and PCI volume. Primary endpoints were all-cause in-hospital mortality and bleeding complications. Secondary endpoints included emergency coronary artery bypass grafting, vascular complications, and a composite of any adverse outcome. With 510,708 PCI procedures performed by 5,175 physicians, case mix and unadjusted outcomes were similar among certified and non-certified physicians. The adjusted risks of in-hospital mortality (OR 1.10, 95% CI 1.02-1.19) and emergency CABG (OR 1.32, 95% CI 1.12-1.56) were higher in the non-ICARD certified group, but the risks of bleeding, vascular complications, and the composite endpoint were not statistically significantly different between groups. Conclusions We did not observe a consistent association between ICARD certification and the outcomes of PCI procedures. Although there was a significantly higher risk of mortality and emergency CABG in patients treated by non-ICARD certified physicians, the risks of vascular complications and bleeding were similar. Our findings suggest that ICARD certification status alone is not a strong predictor of patient outcomes, and indicate a need to enhance the value of subspecialty certification. PMID:26384518

  8. Nuclear telemedicine

    NASA Astrophysics Data System (ADS)

    Morrison, R. T.; Szasz, I. J.

    1990-06-01

    Diagnostic nuclear medicine patient images have been transniitted for 8 years from a regional conununity hospital to a university teaching hospital 700 kiloinetres away employing slow scan TV and telephone. Transruission and interpretation were done at the end of each working day or as circumstances required in cases of emergencies. Referring physicians received the nuclear medicine procedure report at the end of the completion day or within few minutes of completion in case of emergency procedures. To date more than 25 patient studies have been transmitted for interpretation. Blinded reinterpretation of the original hard copy data of 350 patient studies resulted in 100 agreement with the interpretation of transmitted data. This technique provides high quality diagnostic and therapeutic nuclear medicine services in remote hospitals where the services of an on-site nuclear physician is not available. 2. HISTORY Eight years ago when the nuclear medicine physician at Trail Regional Hospital left the Trail area and an other could not be recruited we examined the feasibility of image transmission by phone for interpretation since closing the department would have imposed unacceptable physical and financial hardship and medical constraints on the patient population the nearest nuclear medicine facility was at some 8 hours drive away. In hospital patients would have to be treated either based purely on physical findings or flown to Vancouver at considerable cost to the health care system (estimated cost $1500.

  9. Report from The International Society for Nomenclature of Paediatric and Congenital Heart Disease: cardiovascular catheterisation for congenital and paediatric cardiac disease (Part 1 - Procedural nomenclature).

    PubMed

    Bergersen, Lisa; Everett, Allen Dale; Giroud, Jorge Manuel; Martin, Gerard R; Franklin, Rodney Cyril George; Béland, Marie Josée; Krogmann, Otto Nils; Aiello, Vera Demarchi; Colan, Steven D; Elliott, Martin J; Gaynor, J William; Kurosawa, Hiromi; Maruszewski, Bohdan; Stellin, Giovanni; Tchervenkov, Christo I; Walters, Henry Lane; Weinberg, Paul; Jacobs, Jeffrey Phillip

    2011-06-01

    Interventional cardiology for paediatric and congenital cardiac disease is a relatively young and rapidly evolving field. As the profession begins to establish multi-institutional databases, a universal system of nomenclature is necessary for the field of interventional cardiology for paediatric and congenital cardiac disease. The purpose of this paper is to present the results of the efforts of The International Society for Nomenclature of Paediatric and Congenital Heart Disease to establish a system of nomenclature for cardiovascular catheterisation for congenital and paediatric cardiac disease, focusing both on procedural nomenclature and on the nomenclature of complications associated with interventional cardiology. This system of nomenclature for cardiovascular catheterisation for congenital and paediatric cardiac disease is a component of The International Paediatric and Congenital Cardiac Code. This manuscript is the first part of a two-part series. Part 1 will cover the procedural nomenclature associated with interventional cardiology as treatment for paediatric and congenital cardiac disease. This procedural nomenclature of The International Paediatric and Congenital Cardiac Code will be used in the IMPACT Registry™ (IMproving Pediatric and Adult Congenital Treatment) of the National Cardiovascular Data Registry® of The American College of Cardiology. Part 2 will cover the nomenclature of complications associated with interventional cardiology as treatment for paediatric and congenital cardiac disease.

  10. Nuclear imaging in pediatrics

    SciTech Connect

    Siddiqui, A.R.

    1985-01-01

    The author's intent is to familiarize practicing radiologists with the technical aspects and interpretation of nuclear medicine procedures in children and to illustrate the indications for nuclear medicine procedures in pediatric problems. Pediatric doses, dosimetry, sedation, and injection techniques, organ systems, oncology and infection, testicular scanning and nuclear crystography, pediatric endocrine and skeletal systems, ventilation and perfusion imaging of both congenital and acquired pediatric disorders, cardiovascular problems, gastrointestinal, hepatobiliary, reticuloendothelial studies, and central nervous system are all topics which are included and discussed.

  11. Interprofessional teamwork in Swedish pediatric cardiology: a national exploratory study.

    PubMed

    Birkeland, Anna-Lena; Hägglöf, Bruno; Dahlgren, Lars; Rydberg, Annika

    2013-07-01

    This paper aims to describe the nature of pediatric cardiology teams (PCTs) based in Sweden through the use of a mixed methods approach. Questionnaires examining issues about the organization/ways of working, functions/tasks and attitudes were answered by 30 PCTs. Focus group interviews were conducted with six PCTs, selected purposefully by size and location, and information on experiences and attitudes on interprofessional teamwork was explored in depth. Results from the quantitative indicated that in 17 of the teams, where the nurse acted as the central coordinator, there was a positive attitude to the value of teamwork. In the interviews, different problems and needs of improvements were mentioned regarding structure, leadership, presence of physicians in the team as well as the team's mandate. All of the participants, however, agreed that interprofessional teams were required to manage the complexity of the children's care. In conclusion, this study suggests that PCTs need further support to develop structure, leadership and coordination of resources to function in a more effective manner. National plans or recommendations that mandate the organization and working methods of PCTs would be helpful for the ongoing development of PCTs in Sweden.

  12. DICOM media interchange standards for cardiology: initial interoperability demonstration.

    PubMed Central

    Elion, J. L.

    1995-01-01

    The first multi-vendor demonstration of digital exchange of cardiac image data was held in conjunction with the annual scientific sessions of the American College of Cardiology (ACC) in March, 1995. This was the culmination of several years of effort by the ACC to help extend the DICOM standard to be suitable for cardiac images exchanged on removeable media. The software was designed to help system implementors with little or no DICOM experience quickly acquire this technology. File content can be specified and manipulated in human-readable form, and converted as needed to its binary equivalent. Images were selected from those submitted from a variety of sources, and a recordable CD (CD-R) created with 30 echocardiograms and 30 angiograms). A prototype display program was created that reads the DICOM directory ("DICOMDIR"), allows user interaction, and decompresses the image files. This paper describes the ACC's interoperability demonstration with 29 vendors, the CD-R of images that was used, and the software used by the participants. PMID:8563354

  13. The potential role of MRI in veterinary clinical cardiology.

    PubMed

    Gilbert, Stephen H; McConnell, Fraser J; Holden, Arun V; Sivananthan, Mohan U; Dukes-McEwan, Joanna

    2010-02-01

    Over the last decade, magnetic resonance imaging (MRI) has become established as a useful referral diagnostic method in veterinary medicine that is widely used in small animal brain and spinal diseases, aural, nasal and orbital disorders, planning soft tissue surgery, oncology and small animal and equine orthopaedics. The use of MRI in these disciplines has grown due to its unparalleled capability to image soft tissue structures. This has been exploited in human cardiology where, despite the inherent difficulties in imaging a moving, contractile structure, cardiac MRI (CMRI) has become the optimal technique for the morphological assessment and quantification of ventricular function. Both CMRI hardware and software systems have developed rapidly in the last 10 years but although several preliminary veterinary CMRI studies have been reported, the technique's growth has been limited and is currently used primarily in clinical research. A review of published studies is presented with a description of CMRI technology and the potential of CMRI is discussed along with some of the reasons for its limited usage.

  14. Update: Innovation in cardiology (II). Telecardiology: past, present and future.

    PubMed

    Sørensen, Jacob Thorsted; Clemmensen, Peter; Sejersten, Maria

    2013-03-01

    Technological advances over the past decades have allowed improved diagnosis and monitoring of patients with acute coronary syndromes as well as patients with advanced heart failure. High-quality digital recordings transmitted wirelessly by cellular telephone networks have augmented the prehospital use of transportable electrocardiogram machines as well as implantable devices for arrhythmia monitoring and therapy. The impact of prehospital electrocardiogram recording and interpretation in patients suspected of acute myocardial infarction should not be underestimated. It enables a more widespread access to rapid reperfusion therapy, thereby reducing treatment delay, morbidity and mortality. Further, continuous electrocardiogram monitoring has improved arrhythmia diagnosis and dynamic ST-segment changes have been shown to provide important prognostic information in patients with acute ST-elevation myocardial infarction. Likewise, remote recording or monitoring of arrhythmias and vital signs seem to improve outcome and reduce the necessity of re-admissions or outpatient contacts in patients with heart failure or arrhythmias. In the future telemonitoring and diagnosis is expected to further impact the way we practice cardiology and provide better care for the patient with cardiovascular disease.

  15. [Innovations in cardiology. We are too fast with new methods].

    PubMed

    Diegeler, A

    2016-03-01

    Cardiology is rapidly developing on many levels. New treatment methods are introduced at ever decreasing intervals. Against the background of economization of other areas in medicine, dangers are lurking here for patients if safety, usefulness and sustainability of the treatment methods cannot be sufficiently proven. The German Federal Ministry of Health (Bundesministerium für Gesundheit, BMG) aims to adjust the regulatory framework for the approval of new medical products to the legal requirements of the European Union. With the establishment of the Institute for Quality Assessment and Transparency in Health Care (Institut für Qualitätssicherung und Transparenz im Gesundheitswesen, IQTIG) more precise quality controls should be carried out. Implantation registers will be soon implemented and the routinely performed quality control of different interventions will be coordinated across different healthcare sectors in order to achieve a better understanding of long-term results. Medicine in general and the safety of patients in particular, ultimately benefit from more stringent controls, neutrality and transparency in the assessment of new methods.

  16. The initial Trinidad experience with Cine MRI in clinical cardiology.

    PubMed

    Thomas, C N; Maharaj, P; Bodapati, S; John, R; Rahaman, R; Henry, R; Brann, S

    2002-03-01

    We describe the initial Trinidad experience with Magnetic Resonance Imaging (MRI) and Cine MRI as a diagnostic tool in clinical cardiology. Six patients from the following categories were referred for Cine MRI evaluation: congenital heart disease, valvular heart disease, aortic diseases, cardiomyopathy and intracardiac mass. All patients underwent echocardiography. MRI and Cine MRI were performed on all patients using a Siemens Magnetom 1.0 Tesla MR system at MRI Trinidad and Tobago Ltd. Selected patients underwent Angiography and/or computed tomography (CT) scanning. Clinical data and images of the six patients evaluated are described. MRI and Cine MRI provided excellent anatomical and functional details of the heart and aorta in five patients with dissection of the aorta, aneurysm of the ascending aorta, suspected left ventricular apical thrombus, infiltrative cardiomyopathy and arrhythmogenic right ventricular dysplasia. Technical difficulty was experienced with one patient who had a congenital defect (common atrium). In this study, Cine MRI provided excellent images in all but one patient. This new noninvasive technique enhanced diagnostic capabilities and facilitated management in patients with certain cardiovascular diseases.

  17. Tomsk Cardiology Center program on lasers in cardiovascular: first results

    NASA Astrophysics Data System (ADS)

    Gordov, Eugeni P.; Karpov, Rostislav S.; Dudko, Victor A.; Shipulin, Vladimir M.

    1994-12-01

    Recent progress in biomedical optics resulted in increased activity in this area at a number of different centers. Reported are the first results of the program directed to incorporate at Tomsk Cardiology Center experience gained in Tomsk optical profile research institutions in areas of light-matter interaction, high resolution spectroscopy, laser physics and relevant software and their usage in cardiac therapy, surgery, and diagnostics. To coordinate research work in this direction the special unit-laboratory of laser medicine is organized at the Center. Laboratory activity goes in the following directions: study of spectral properties of vessel walls in norm and atherosclerosis, comparative study of different wavelength laser radiation action on normal and atherosclerotically damaged tissues, novel approach to intravascular imaging, and usage of high sensitive laser spectroscopy for early diagnosis of cardiac diseases. The spectroscopic study of AP and normal tissue is aimed at understanding of differences in internal energy structures and ways of energy migration which are of critical importance for reaching selective laser action on normal and deceased tissues. To compare thermal, mechanical, and photo-chemical variations of tissues caused by laser radiation the XeCl excimer laser with Raman shifting cell and Nd:YAG laser with second, third, and fourth harmonic converters are employed. Fine influence of pulse duration, intensity, and repetition rates on AP removal is considered in laboratory experiments with vessel samples. Preliminary results on theoretical consideration for determination of spectroscopically detectable markers of some cardiac diseases are reported as well.

  18. Motivation and frustration in cardiology trial participation: The patient perspective

    PubMed Central

    Meneguin, Silmara; César, Luiz Antônio Machado

    2012-01-01

    OBJECTIVE: The participation of humans in clinical cardiology trials remains essential, but little is known regarding participant perceptions of such studies. We examined the factors that motivated participation in such studies, as well as those that led to participant frustration. METHODS: Patients who had participated in hypertension and coronary arterial disease (phases II, III, and IV) clinical trials were invited to answer a questionnaire. They were divided into two groups: Group I, which included participants in placebo-controlled clinical trials after randomization, and Group II, which included participants in clinical trials in which the tested treatment was compared to another drug after randomization and in which a placebo was used in the washout period. RESULTS: Eighty patients (47 patients in Group I and 33 patients in Group II) with different socio-demographic characteristics were interviewed. Approximately 60% of the patients were motivated to participate in the trial with the expectation of personal benefit. Nine participants (11.2%) expressed the desire to withdraw, which was due to their perception of risk during the testing in the clinical trial (Group I) and to the necessity of repeated returns to the institution (Group II). However, the patients did not withdraw due to fear of termination of hospital treatment. CONCLUSIONS: Although this study had a small patient sample, the possibility of receiving a benefit from the new tested treatment was consistently reported as a motivation to participate in the trials. PMID:22760899

  19. [About the origin, evolution and irradiation of Mexican cardiology].

    PubMed

    de Micheli, Alfredo

    2014-01-01

    The Mexican cardioangiology started in the nineteen century thanks to first endeavors of surgeons and physicians related to local academies and to School of Medicine, established in 1833 by Dr. Valentin Gómez Farías. Dr. Manuel Carpio, the future first head of department of physiology in this school, translated to Spanish language and published, in 1823, the article On pectoriloquo of the French physician Marat and later performed some experiments on the heart' motion. During the Secont Empire (1864-1867), the physician Samuel von Basch performed studies to define the arterial hypertension, called by him "latent atherosclerosis", i.e. the "essential hypertension". Once he had returned to his country, he invented in 1880, a sphygmomanometer of mercury column, that was the model for the instrument constructed by the Italian physician Scipione Riva-Rocci and presented in 1896. In our time, Dr. Demetrio Sodi Pallares systematized a metabolic therapy called "polarizing therapy", i.e. capable of repolarizing the heart's cells partly depolarized due to hypoxia or direct aggressions. These were the first steps in Mexico on the way to a promising medicine starting and the great adventure of Mexican cardiology.

  20. Does digital flat detector technology tip the scale towards better image quality or reduced patient dose in interventional cardiology?

    PubMed

    Bogaert, E; Bacher, K; Lapere, R; Thierens, H

    2009-11-01

    As dynamic flat-panel detectors (FD) are introduced in interventional cardiology (IC), the relation between patient dose and image quality (IQ) needs to be reconsidered for this type of image receptor. On one hand this study investigates IQ of a FD system by means of a threshold contrast-detail analysis and compares it to an image intensifier (II) system on a similar X-ray setup. On the other hand patient dose for coronary angiography (CA) procedures on both systems is compared by Dose-Area Product (DAP)-registration of a patient population. The comparative IQ study was performed for a range of entrance dose rates (EDR) covering the fluoroscopy and cinegraphy working mode. In addition the IQ investigation was extended to a similar study under automatic brightness control (ABC). As well the systematic study of IQ as a function of EDR as the study performed under ABC point to a better IQ for FD in cinegraphy mode and no difference between both systems in fluoroscopy mode. The patient population study resulted in mean DAP values of 31Gycm(2) (II system) and 33Gycm(2) (FD system) (p=0.68) for CA procedures. As well total DAP as contributions of fluoroscopy and cinegraphy on both systems are not significantly different. To conclude, we could state that profit was taken from the intrinsic better performance of the FD for cinegraphy mode in producing higher quality images in this mode but without any effect on patient dose for CA procedures.

  1. Redesigning the nuclear medicine reading room.

    PubMed

    Zemariame, Nigist; Knight, Nancy; Siegel, Eliot L

    2011-11-01

    The process of image review and interpretation has become increasingly complex and challenging for today's nuclear medicine physician from many perspectives, especially with regard to workstation integration and reading room ergonomics. With the recent proliferation of hybrid imaging systems, this complexity has increased rapidly, along with the number of studies performed. At the same time, clinicians throughout the health care enterprise are expecting remote access to nuclear medicine images whereas nuclear medicine physicians require reliable access at the point of care to the electronic medical record and to medical images from radiology and cardiology. The authors discuss the background and challenges related to integration of nuclear medicine into the health care enterprise and provide a series of recommendations for advancing successful integration efforts. Also addressed are unique characteristics of the nuclear medicine environment as well as ergonomic, lighting, and environmental considerations in the design and redesign of the modern reading room.

  2. A review on the Avicenna's contribution to the field of cardiology.

    PubMed

    Zarshenas, Mohammad M; Zargaran, Arman

    2015-03-01

    The cardiology and field of cardiovascular approaches are often mentioned as of the earliest concerns throughout the history of mankind civilization. During the golden ages of Islamic era, 9th to 12th centuries A.D., medical knowledge from various fields including cardiology was flourished by prominent Persian physicians and scholars. Among those outstanding physicians and scientists of the Islamic golden era, Avicenna is known as a famous and pioneer character. To outline the cardiovascular knowledge and contribution of Avicenna, current review compiled all his evidence-based concepts of cardiovascular findings from current medical literatures as well as those mentioned in his important medical encyclopedia, the Canon of Medicine. In this review, Avicenna's findings on cardiovascular anatomy such as his description of Willis circle, capillary circulation and arterial and ventricular contractions in the cardiovascular system have been mentioned. Also, his books and manuscripts on cardiology as well as findings and theories on cardiovascular and allied diseases were discussed. These findings are included in his descriptions on cardiac tamponade, stroke, palpitation, atherosclerosis, hypertension, association of the cardiovascular complications with erection and ejaculation, interaction between the heart and emotions as well as some of his mentioned drugs for cardiological disorders and the early concepts of drug targeting. These results can show Avicenna's great contribution to improve the sciences of cardiology in early medieval era.

  3. Assessment of the occupational eye lens dose for clinical staff in interventional radiology, cardiology and neuroradiology.

    PubMed

    Omar, Artur; Kadesjö, Nils; Palmgren, Charlotta; Marteinsdottir, Maria; Segerdahl, Tony; Fransson, Annette

    2017-03-20

    In accordance with recommendations by the International Commission on Radiological Protection, the current European Basic Safety Standards has adopted a reduced occupational eye lens dose limit of 20 mSv yr(-1). The radiation safety implications of this dose limit is of concern for clinical staff that work with relatively high dose x-ray angiography and interventional radiology. Presented in this work is a thorough assessment of the occupational eye lens dose based on clinical measurements with active personal dosimeters worn by staff during various types of procedures in interventional radiology, cardiology and neuroradiology. Results are presented in terms of the estimated equivalent eye lens dose for various medical professions. In order to compare the risk of exceeding the regulatory annual eye lens dose limit for the widely different clinical situations investigated in this work, the different medical professions were separated into categories based on their distinct work pattern: staff that work (a) regularly beside the patient, (b) in proximity to the patient and (c) typically at a distance from the patient. The results demonstrate that the risk of exceeding the annual eye lens dose limit is of concern for staff category (a), i.e. mainly the primary radiologist/cardiologist. However, the results also demonstrate that the risk can be greatly mitigated if radiation protection shields are used in the clinical routine. The results presented in this work cover a wide range of clinical situations, and can be used as a first indication of the risk of exceeding the annual eye lens dose limit for staff at other medical centres.

  4. Dose assessment during the commissioning of flat detector imaging systems for cardiology.

    PubMed

    Vano, Eliseo; Ubeda, Carlos; Fernandez, Jose Miguel; Sanchez, Roberto M; Prieto, Carlos

    2009-08-01

    Incident air kerma (IAK) and entrance surface air kerma (ESAK) have been measured for a range of copper (Cu) absorbers (1-10 mm) and polymethylmethacrylate (PMMA) slabs (12-28 cm) with kilovolt values ranging from 61 to 120 during the commissioning of an X-ray system equipped with a flat detector used in interventional cardiology procedures. Numerical parameters on image quality have also been measured for different X-ray beam qualities using the plastic wall of the ionisation chamber. When moving from 1 to 10 mm of Cu, IAK per frame increased to a factor of 38 for cine and 27 for fluoroscopy. A cine frame requires 60-116 times more IAK than a fluoroscopy frame. As for PMMA, when the backscatter factor is included (simulating real conditions with patients), and when moving from 12 to 28 cm, the increases in ESAK are 16 times for cine and 10 times for fluoroscopy. Because of the differences in X-ray beam quality for cine and fluoroscopy modes, the Cu thicknesses necessary to drive the generator to equivalent kilovolts resulted in the following values (cine and fluoroscopy, respectively): 12 cm of PMMA (1 and 1.5 mm Cu), 20 PMMA (2.5 and 3.5 mm Cu) and 28 cm PMMA (4.5 and 8.5 mm Cu). With the analysis of IAK, ESAK and image quality, one can verify the appropriate settings of the X-ray system and obtain baseline information for constancy checks and help cardiologists in the management of patient doses by knowing the dose increase factors and image quality changes when increasing patient thickness or using different C-arm projections.

  5. A new experimental procedure for determination of photoelectric efficiency of a NaI(Tl) detector used for nuclear medicine liquid waste monitoring with traceability to a reference standard radionuclide calibrator.

    PubMed

    Ceccatelli, A; Campanella, F; Ciofetta, G; Marracino, F M; Cannatà, V

    2010-02-01

    To determine photopeak efficiency for (99m)Tc of the NaI(Tl) detector used for liquid waste monitoring at the Nuclear Medicine Unit of IRCCS Paediatric Hospital Bambino Gesù in Rome, a specific experimental procedure, with traceability to primary standards, was developed. Working with the Italian National Institute for Occupational Prevention and Safety, two different calibration source geometries were employed and the detector response dependence on geometry was investigated. The large percentage difference (almost 40%) between the two efficiency values obtained showed that geometrical effects cannot be neglected.

  6. [New pharmaceuticals in cardiology. Heart failure, anticoagulation, dyslipidemia].

    PubMed

    Czepluch, F S; Hasenfuß, G; Jacobshagen, C

    2014-04-01

    Three innovative pharmaceuticals which might play an important role in the field of cardiology in the near future were recently tested in large clinical studies. Serelaxin, a vasoactive hormone peptide that is produced during pregnancy, reduces vessel resistance, increases cardiac output, and improves renal function. Lately, it was demonstrated that serelaxin significantly reduces congestion symptoms in patients with acute heart failure. As a secondary endpoint the mortality at day 180 was reduced. Therefore, serelaxin seems to be a promising new drug for the treatment of acute heart failure which might have a prognostic impact. Edoxaban is a selective factor Xa inhibitor, which inhibits thrombin production and thrombus formation. Two recently published studies reported that edoxaban is at least as effective as the vitamin K antagonist warfarin in prevention and treatment of venous thromboembolism and in the prevention of stroke and systemic embolism due to nonvalvular atrial fibrillation. Compared to warfarin, edoxaban significantly exhibited less frequent severe bleeding complications. Edoxaban will probably soon be the fourth new oral anticoagulant available for patients. The serine protease proprotein convertase subtilisin/kexin 9 (PCSK9) reduces the ability of the liver to bind low-density lipoprotein cholesterol (LDL-C) and to remove it from the circulation. Recently, a monoclonal antibody for PCSK9 was developed which induces a LDL-C plasma level reduction up to 73 % and also decreases lipoprotein(a) and apolipoprotein B. PCSK9 inhibition is a promising new mechanism for LDL-C reduction and the corresponding drug will be presumably approved soon by the regulatory authorities.

  7. The Use of Continuous Electrocardiographic Holter Monitoring in Pediatric Cardiology

    PubMed Central

    Begic, Zijo; Begic, Edin; Mesihovic-Dinarevic, Senka; Masic, Izet; Pesto, Senad; Halimic, Mirza; Kadic, Almira; Dobraca, Amra

    2016-01-01

    Objective: To show the place and role of continuous electrocardiographic twenty-four-hour ECG monitoring in daily clinical practice of pediatric cardiologists. Methods: According to protocol, 2753 patients underwent dynamic continuous ECG Holter monitoring (data collected from the “Register of ECG Holter monitoring” of Pediatric Clinic, UCC Sarajevo in period April 2003- April 2015). Results: There were 50,5% boys and 49,5% girls, aged from birth to 19 years (1,63% - neonates and infants, 2,6% - toddlers, 9,95% - preschool children, 35,5% - gradeschoolers and 50,3% children in puberty and adolescence). In 68,1% of patients Holter was performed for the first time. Indications for conducting Holter were: arrhythmias in 42,2% cases, precordial pain in 23,5%, suspicion of pre-excitation and/or pre-excitation in 10%, crisis of consciousness in 8%, uncorrected congenital/acquired heart defects in 4,2%, operated heart defects in 3,7%, hypertension in 3,1% cases, control of the pacemaker in 1,63% and other causes in 3,5% cases. Discharge diagnosis after ECG Holter monitoring were: insignificant arrhythmias in 47,1% cases, wandering pacemaker in 21,3%, pre-excitation in 16,2%, benign ventricular premature beats in 6,3%, atrioventricular block in 3%, sinus pause in 2.2% cases and other arrhythmias in 3,5%. In mentioned period 57 cases of Wolf Parkinson White syndrome were registered, in 4,5% of patients antiarrhythmic therapy was administered. Radiofrequent ablation was performed in 23 cases. Conclusion: The development of pediatric cardiac surgery has initiated development of pediatric arrhythmology as imperative segment of pediatric cardiology. Continuous ECG Holter monitoring has become irreplaceable method in everyday diagnostics and therapy of arrhythmias in children. PMID:27708487

  8. [National and international impact factor of Revista Española de Cardiología].

    PubMed

    Aleixandre Benavent, Rafael; Valderrama Zurián, Juan C; Castellano Gómez, Miguel; Miguel-Dasit, Alberto; Simó Meléndez, Raquel; Navarro Molina, Carolina

    2004-12-01

    The aim of this paper is to present the bibliometric indicators for Revista Española de Cardiologíathat were obtained from the "Potential impact factor of Spanish medical journals in 2001" study financed by the Spanish Ministerio de Educacion, Cultura y Deporte. Citations to Revista Española de Cardiología, its national and international impact factor, and its immediacy index were calculated with methods similar to those used by the Institute for Scientific Information. National indicators were based only on citations from 87 Spanish journals considered source journals, whereas international indicators were calculated on the basis of citations from both national journals and foreign source journals in the Science Citation Index. Revista Española de Cardiologíaobtained a national impact factor of 0.719 and an international impact factor of 0.837, placing it at the head of the ranking of Spanish medical journals.

  9. The search of the best mode of the reserve power supply consumption during the nuclear reactor’s emergency shutdown procedures in case of force majeure circumstances

    NASA Astrophysics Data System (ADS)

    Zagrebaev, A. M.; Trifonenkov, A. V.

    2017-01-01

    This article deals with the problem of the control mode choice for a power supply system in case of force majeure circumstances. It is not known precisely, when a force majeure incident occurs, but the threatened period is given, when the incident is expected. It is supposed, that force majeure circumstances force nuclear reactor shutdown at the moment of threat coming. In this article the power supply system is considered, which consists of a nuclear reactor and a reserve power supply, for example, a hydroelectric pumped storage power station. The reserve power supply has limited capacity and it doesn’t undergo the threatened incident. The problem of the search of the best reserve supply time-distribution in case of force majeure circumstances is stated. The search is performed according to minimization of power loss and damage to the infrastructure. The software has been developed, which performs automatic numerical search of the approximate optimal control modes for the reserve power supply.

  10. Report of the American College of Cardiology (ACC) Scientific Sessions 2015, San Diego.

    PubMed

    Murohara, Toyoaki

    2015-01-01

    The 64th Annual Scientific Sessions and Exposition of the American College of Cardiology (ACC) were held at the San Diego Convention Center from March 14-16, 2015. The ACC Scientific Sessions are 1 of 2 major scientific cardiology meetings in the United States, with nearly 20,000 attendees, including 15,000 cardiovascular professionals. There were over 2,100 oral and poster abstracts, and more than 15 late-breaking clinical trials (LBCTs) abstructs. This report presents the highlights and several key presentations, especially the LBCTs, from the ACC Scientific Sessions 2015. I hope this review will help cardiologists update to the latest information.

  11. Cardiology in the young : where we have been. Where we are. Where we are going.

    PubMed

    Jacobs, Jeffrey P

    2014-12-01

    Cardiology in the Young is devoted to cardiovascular issues affecting the young, and older patients with congenital heart disease, or with other cardiac diseases acquired during childhood. The journal serves the interests of all professionals concerned with these topics. By design, the journal is international and multidisciplinary in its approach, and members of the editorial board take an active role in its mission, helping to make it an indispensable reference for paediatric and congenital cardiac care. All aspects of paediatric and congenital cardiac care are covered within the journal. The content includes original articles, brief reports, editorials, reviews, and papers devoted to continuing professional development. High-quality colour figures are published on a regular basis, and without charge to the authors. Regular supplements are published containing the abstracts of the annual meetings of the Association for European Paediatric and Congenital Cardiology, along with other occasional supplements. These supplements are supplied free to subscribers. The vision of Cardiology in the Young is to use print and electronic media to improve paediatric and congenital cardiac care. The mission of Cardiology in the Young is to be a premier global journal for paediatric and congenital cardiac care - an essential journal that spans the domains of patient care, research, education, and advocacy, and also spans geographical, temporal, and subspeciality boundaries. Cardiology in the Young was officially launched in December, 1990. The late Lucio Parenzan was Editor-in-Chief from 1990 through Volume 4, Number 1, January 1994. Professor Robert Anderson and Giancarlo Crupi then shared the Editor-in-Chief position until the end of 1995. Then, from 1995 through 2007, Professor Robert Anderson served as the sole Editor-in-Chief of Cardiology in the Young . Edward Baker, MD, FRCP, FRCPCH, served as Editor-in-Chief of Cardiology in the Young from 2007 to 2013. In January, 2014

  12. A report from the European Society of Cardiology Congress 2014 (August 30-September 3 - Barcelona, Spain).

    PubMed

    Dulsat, C

    2014-09-01

    The European Society of Cardiology (ESC) Annual Congress is the largest cardiology conference in the world and this year ran in Barcelona from August 30 to September 3. During the meeting, more than 30,000 cardiologists from over 100 countries met to share their knowledge in all cardiovascular fields, from basic science to management and prevention of cardiovascular diseases. Apart from more than 4,500 interesting abstracts presented in posters and oral sessions, five new ESC Clinical Practice Guidelines were presented among the latest clinical trial results, updates and registries.

  13. Online educational tools developed by Heart improve the knowledge and skills of hospital doctors in cardiology.

    PubMed

    Walsh, Kieran; Rafiq, Isma; Hall, Roger

    2007-07-01

    We conducted this study to find out if online learning packages in cardiology enabled users to increase their knowledge and skills. We also looked at how acceptable users found these packages. The journal Heart in association with BMJ Learning produced a series of modules on common cardiology problems. The modules involved a pre-test, a number of interactive cases and a post-test. A total of 1786 users completed these modules. Doing the modules enabled users to improve their score from the pre-test to the post-test by a significant amount (p<0.001). Feedback to the modules was very positive.

  14. SPECT attenuation correction: an essential tool to realize nuclear cardiology's manifest destiny.

    PubMed

    Garcia, Ernest V

    2007-01-01

    Single photon emission computed tomography (SPECT) myocardial perfusion imaging has attained widespread clinical acceptance as a standard of care for cardiac patients. Yet, physical phenomena degrade the accuracy of how our cardiac images are visually interpreted or quantitatively analyzed. This degradation results in cardiac images in which brightness or counts are not necessarily linear with tracer uptake or myocardial perfusion. Attenuation correction (AC) is a methodology that has evolved over the last 30 years to compensate for this degradation. Numerous AC clinical trials over the last 10 years have shown increased diagnostic accuracy over non-AC SPECT for detecting and localizing coronary artery disease, particularly for significantly increasing specificity and normalcy rate. This overwhelming evidence has prompted our professional societies to issue a joint position statement in 2004 recommending the use of AC to maximize SPECT diagnostic accuracy and clinical usefulness. Phantom and animal studies have convincingly shown how SPECT AC recovers the true regional myocardial activity concentration, while non-AC SPECT does not. Thus, AC is also an essential tool for extracting quantitative parameters from all types of cardiac radionuclide distributions, and plays an important role in establishing cardiac SPECT for flow, metabolic, innervation, and molecular imaging, our manifest destiny.

  15. Performance evaluation of D-SPECT: a novel SPECT system for nuclear cardiology

    NASA Astrophysics Data System (ADS)

    Erlandsson, Kjell; Kacperski, Krzysztof; van Gramberg, Dean; Hutton, Brian F.

    2009-05-01

    D-SPECT (Spectrum Dynamics, Israel) is a novel SPECT system for cardiac perfusion studies. Based on CZT detectors, region-centric scanning, high-sensitivity collimators and resolution recovery, it offers potential advantages over conventional systems. A series of measurements were made on a β-version D-SPECT system in order to evaluate its performance in terms of energy resolution, scatter fraction, sensitivity, count rate capability and resolution. Corresponding measurements were also done on a conventional SPECT system (CS) for comparison. The energy resolution of the D-SPECT system at 140 keV was 5.5% (CS: 9.25%), the scatter fraction 30% (CS: 34%), the planar sensitivity 398 s-1 MBq-1 per head (99mTc, 10 cm) (CS: 72 s-1 MBq-1), and the tomographic sensitivity in the heart region was in the range 647-1107 s-1 MBq-1 (CS: 141 s-1 MBq-1). The count rate increased linearly with increasing activity up to 1.44 M s-1. The intrinsic resolution was equal to the pixel size, 2.46 mm (CS: 3.8 mm). The average reconstructed resolution using the standard clinical filter was 12.5 mm (CS: 13.7 mm). The D-SPECT has superior sensitivity to that of a conventional system with similar spatial resolution. It also has excellent energy resolution and count rate characteristics, which should prove useful in dynamic and dual radionuclide studies.

  16. The development of iodine-123-methyl-branched fatty acids and their applications in nuclear cardiology

    SciTech Connect

    Knapp, F.F. Jr.; Ambrose, K.R.; Kropp, J.; Biersack, H.J.; Goodman, M.M.; Franken, P.; Reske, S.N.; Som, P.; Sloof, G.W.; Visser, F.C.

    1993-06-01

    Continued Interest in the use of iodine-1 23-labeled fatty acids for myocardial Imaging results from observations from a variety of studies that in many types of cardiac disease, regional fatty acid myocardial uptake patterns are often different than regional distribution of flow tracers. These differences may reflect alterations in important parameters of metabolism which can be useful for patient management or therapeutic strategy decision making. In addition, use of iodine-I 23-labeled fatty acid distribution may represent a unique metabolic probe to relate some aspects of the metabolism of these substrates with the regional viability of cardiac tissue. The use of such viability markers could provide important prognostic information on myocardial salvage, helping to identify patients for revascularization or angioplasty. Clinical studies are currently in progress with the iodine-123-labeled 1 5-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) fatty acid analogue at several institutions. The goals of this paper are to discuss development of the concept of metabolic trapping of fatty acids, to briefly review development and evaluation of various radioiodinated methyl-branched fatty acids and to discuss recent patient studies with iodine-123 (BMIPP) using single photon emission computerized tomography (SPECT).

  17. The development of iodine-123-methyl-branched fatty acids and their applications in nuclear cardiology

    SciTech Connect

    Knapp, F.F. Jr.; Ambrose, K.R. ); Kropp, J.; Biersack, H.J. . Inst. fuer Klinische und Experimentelle Nuklearmedizin); Goodman, M.M. . Dept. of Radiology); Franken, P. . Nuclear Medicine Dept.); Reske, S.N. (Ulm Univ. (Germany

    1993-01-01

    Continued Interest in the use of iodine-1 23-labeled fatty acids for myocardial Imaging results from observations from a variety of studies that in many types of cardiac disease, regional fatty acid myocardial uptake patterns are often different than regional distribution of flow tracers. These differences may reflect alterations in important parameters of metabolism which can be useful for patient management or therapeutic strategy decision making. In addition, use of iodine-I 23-labeled fatty acid distribution may represent a unique metabolic probe to relate some aspects of the metabolism of these substrates with the regional viability of cardiac tissue. The use of such viability markers could provide important prognostic information on myocardial salvage, helping to identify patients for revascularization or angioplasty. Clinical studies are currently in progress with the iodine-123-labeled 1 5-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) fatty acid analogue at several institutions. The goals of this paper are to discuss development of the concept of metabolic trapping of fatty acids, to briefly review development and evaluation of various radioiodinated methyl-branched fatty acids and to discuss recent patient studies with iodine-123 (BMIPP) using single photon emission computerized tomography (SPECT).

  18. The use of nuclear imaging for cardiac resynchronization therapy.

    PubMed

    Chen, Ji; Boogers, Mark J; Boogers, Mark M; Bax, Jeroen J; Soman, Prem; Garcia, Ernest V

    2010-03-01

    Cardiac resynchronization therapy (CRT) has shown benefits in patients with end-stage heart failure, depressed left ventricular (LV) ejection fraction (< or = 35%), and prolonged QRS duration (> or = 120 ms). However, based on the conventional criteria, 20% to 40% of patients fail to respond to CRT. Studies have focused on important parameters for predicting CRT response, such as LV dyssynchrony, scar burden, LV lead position, and site of latest activation. Phase analysis allows nuclear cardiology modalities, such as gated blood-pool imaging and gated myocardial perfusion single photon emission computed tomography (GMPS), to assess LV dyssynchrony. Most importantly, GMPS with phase analysis has the potential of assessing LV dyssynchrony, scar burden, and site of late activation from a single acquisition, so that this technique may provide a one-stop shop for predicting CRT response. This article provides a summary on the role of nuclear cardiology in selecting patients for CRT, with emphasis on GMPS with phase analysis.

  19. Cardiac ablation procedures

    MedlinePlus

    ... of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society ... Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm ...

  20. Computational cardiology and risk stratification for sudden cardiac death: one of the grand challenges for cardiology in the 21st century.

    PubMed

    Hill, Adam P; Perry, Matthew D; Abi-Gerges, Najah; Couderc, Jean-Philippe; Fermini, Bernard; Hancox, Jules C; Knollmann, Bjorn C; Mirams, Gary R; Skinner, Jon; Zareba, Wojciech; Vandenberg, Jamie I

    2016-12-01

    Risk stratification in the context of sudden cardiac death has been acknowledged as one of the major challenges facing cardiology for the past four decades. In recent years, the advent of high performance computing has facilitated organ-level simulation of the heart, meaning we can now examine the causes, mechanisms and impact of cardiac dysfunction in silico. As a result, computational cardiology, largely driven by the Physiome project, now stands at the threshold of clinical utility in regards to risk stratification and treatment of patients at risk of sudden cardiac death. In this white paper, we outline a roadmap of what needs to be done to make this translational step, using the relatively well-developed case of acquired or drug-induced long QT syndrome as an exemplar case.

  1. Computational cardiology and risk stratification for sudden cardiac death: one of the grand challenges for cardiology in the 21st century

    PubMed Central

    Perry, Matthew D.; Abi‐Gerges, Najah; Couderc, Jean‐Philippe; Fermini, Bernard; Hancox, Jules C.; Knollmann, Bjorn C.; Mirams, Gary R.; Skinner, Jon; Zareba, Wojciech; Vandenberg, Jamie I.

    2016-01-01

    Abstract Risk stratification in the context of sudden cardiac death has been acknowledged as one of the major challenges facing cardiology for the past four decades. In recent years, the advent of high performance computing has facilitated organ‐level simulation of the heart, meaning we can now examine the causes, mechanisms and impact of cardiac dysfunction in silico. As a result, computational cardiology, largely driven by the Physiome project, now stands at the threshold of clinical utility in regards to risk stratification and treatment of patients at risk of sudden cardiac death. In this white paper, we outline a roadmap of what needs to be done to make this translational step, using the relatively well‐developed case of acquired or drug‐induced long QT syndrome as an exemplar case. PMID:27060987

  2. Impact of the X-ray system setting on patient dose and image quality; a case study with two interventional cardiology systems.

    PubMed

    Vassileva, J; Vano, E; Ubeda, C; Rehani, M; Zotova, R

    2013-07-01

    This study investigates the influence of the initial X-ray system setting on patient doses and image quality in interventional cardiology procedures. Two dedicated interventional cardiology systems were studied: a system with image intensifier (II) and a flat detector (FD) system. Entrance surface air kerma (ESAK) rates in fluoroscopy and ESAK per frame in the acquisition mode were measured on the surface of a PMMA phantom for the field of views (FOV) of 23 and 17 cm (II system) and 25 and 20 cm (FD system). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were estimated using DICOM images obtained during the measurements. System performances were compared using a figure of merit combining SNR and ESAK. The influence of system setting on patient doses was investigated analysing the information for air kerma area product (KAP) and cumulative dose (CD) at the patient entrance reference point, for a sample of coronary angiography examinations. ESAK rates in fluoroscopy modes were a factor of 2 higher in the FD system for the similar FOVs, resulting in a factor of 1.9 higher median values of KAP and CD for patients with FD system than for the II system. SNR and CNR for the FD system were better than the equivalent FOVs with II. The resulting FOM was better for the FD system in both FOVs. Potential for optimisation was suggested by adjusting system settings.

  3. Designing Inpatient Technology to Meet the Medication Information Needs of Cardiology Patients.

    PubMed

    Wilcox, Lauren; Feiner, Steven; Liu, Andy; Restaino, Susan; Collins, Sarah; Vawdrey, David

    2012-01-28

    As patients are encouraged to become active participants in their own care, recent research has begun to explore the direct sharing of electronic health information with patients during hospital visits. The design of patient-facing views of clinical information is, however, a relatively recent line of inquiry. Research is needed to further understand guidelines for communicating specific types of information to hospital patients. In this work, we focus on cardiology patients' information needs related to their hospital medications. We assessed these needs to inform the design of interactive, electronic views of medication information for cardiology inpatients. We present results of in-situ interviews with 11 inpatients and 6 nurses in a cardiology step-down unit. Our findings suggest that cohesive trends in medication information needs exist across cardiology inpatients. We discuss interview results and their implications for the design of inpatient-facing information technology. We also discuss key ways in which electronic medication information, formatted for inpatient use, differs from that formatted for outpatient or transitional medication-management use.

  4. Test of a Cardiology Patient Simulator with Students in Fourth-Year Electives.

    ERIC Educational Resources Information Center

    Ewy, Gordon A.; And Others

    1987-01-01

    Students at five medical schools participated in an evaluation of a cardiology patient simulator (CPS), a life-size mannequin capable of simulating a wide variety of cardiovascular conditions. The CPS enhances learning both the knowledge and the skills necessary to perform a bedside cardiovascular evaluation. (Author/MLW)

  5. Biological reactions in the heart: what should we do in 'cardiology'?

    PubMed

    Sugishita, Y

    1999-10-01

    Humankind is on a similar evolutionary process to animals. Biological reactions in the human heart will be reviewed, and consideration will be made about what can be done in cardiology, from the viewpoints of basic, clinical and community medicine. Functional reactions of the heart to acute loading (exercise, etc) comprise myocardial contractility, preload, pump function and peripheral factors, and are mobilized step by step in that order, to maintain normal functioning. Morphological reactions to chronic loading (hypertension etc) comprise hypertrophy and dilatation, which are caused by mechanical and nonmechanical factors, but may not always be mobilized to maintain normal functioning. Various neurohumoral factors take part in the mechanisms, and modifications, of these reactions. They act in a complex manner according to the biological conditions, and may not always act to maintain normal functioning. The biological reactions in the heart (ie, Basic Cardiology) should not be interpreted as having purpose; that is, putting a value on humankind, although medical treatment (Clinical Cardiology) and the solution of health problems in the community (Community Cardiology) should be done from this viewpoint.

  6. Comparative study between ultrasonography and optical coherence tomography in interventional cardiology

    NASA Astrophysics Data System (ADS)

    Fanjul-Vélez, Félix; de la Torre-Hernández, José María; Ortega-Quijano, Noé; Zueco-Gil, José Javier; Arce-Diego, José Luis

    2009-07-01

    In this work, we present clinical images of IVUS and OCT in the evaluation of pharmacological stent endothelization. These preliminary imaging results are analyzed and compared in order to determine the ability of these technologies to visualize relevant intravascular features of interest in interventional cardiology. The results enable to compare the performance of both techniques and to evaluate their potential for clinical purposes.

  7. [Devices for visualizing biosignals for the comprehensive equipping of cardiology institutions].

    PubMed

    Kats, B M; Olifer, B M

    1981-01-01

    Purposeful activity of the Scientific-Production Association of Radioelectronic Medical Equipment in the creation, serial tissue and practical mastering of to-day's aids of biosignal visualization allows, in optimal way, realizing complete instrumentation of major links in cardiological service. Further perfection of these facilities is directed to more efficient diagnostic value of visible information, to acceleration of diagnostic process and its simplicity.

  8. The World Congress of Paediatric Cardiology and Cardiac Surgery: "The Olympics of our profession".

    PubMed

    Hugo-Hamman, Christopher; Jacobs, Jeffery Phillip

    2012-12-01

    The first World Congress of Paediatric Cardiology was held in London, United Kingdom, in 1980, organised by Dr. Jane Somerville and Prof. Fergus Macartney. The idea was that of Jane Somerville, who worked with enormous energy and enthusiasm to bring together paediatric cardiologists and surgeons from around the world. The 2nd World Congress of Paediatric Cardiology took place in New York in 1985, organised by Bill Rashkind, Mary Ellen Engle, and Eugene Doyle. The 3rd World Congress of Paediatric Cardiology was held in Bangkok, Thailand, in 1989, organised by Chompol Vongraprateep. Although cardiac surgeons were heavily involved in these early meetings, a separate World Congress of Paediatric Cardiac Surgery was held in Bergamo, Italy, in 1988, organised by Lucio Parenzan. Thereafter, it was recognised that surgeons and cardiologists working on the same problems and driven by a desire to help children should really rather meet together. A momentous decision was taken to initiate a Joint World Congress of Paediatric Cardiology and Cardiac Surgery. A steering committee was established with membership comprising the main organisers of the four separate previous Congresses, and additional members were recruited in an effort to achieve numerical equality of cardiologists and surgeons and a broad geographical representation. The historic 1st "World Congress of Paediatric Cardiology and Cardiac Surgery" took place in Paris in June, 1993, organised by Jean Kachaner. The next was to be held in Japan, but the catastrophic Kobe earthquake in 1995 forced relocation to Hawaii in 1997. Then followed Toronto, Canada (2001, organised by Bill Williams and Lee Benson), Buenos Aires, Argentina (2005, organised by Horatio Capelli and Guillermo Kreutzer), and most recently Cairns, Australia (2009, organised by Jim Wilkinson). Having visited Europe (1993), Asia-Pacific (1997), North America (2001), South America (2005), and Australia (2009), and reflecting the "African Renaissance", the

  9. Nuclear disarmament verification

    SciTech Connect

    DeVolpi, A.

    1993-12-31

    Arms control treaties, unilateral actions, and cooperative activities -- reflecting the defusing of East-West tensions -- are causing nuclear weapons to be disarmed and dismantled worldwide. In order to provide for future reductions and to build confidence in the permanency of this disarmament, verification procedures and technologies would play an important role. This paper outlines arms-control objectives, treaty organization, and actions that could be undertaken. For the purposes of this Workshop on Verification, nuclear disarmament has been divided into five topical subareas: Converting nuclear-weapons production complexes, Eliminating and monitoring nuclear-weapons delivery systems, Disabling and destroying nuclear warheads, Demilitarizing or non-military utilization of special nuclear materials, and Inhibiting nuclear arms in non-nuclear-weapons states. This paper concludes with an overview of potential methods for verification.

  10. ENDF-6 Formats Manual Data Formats and Procedures for the Evaluated Nuclear Data File ENDF/B-VI and ENDF/B-VII

    SciTech Connect

    Herman, M.; Members of the Cross Sections Evaluation Working Group

    2009-06-01

    In December 2006, the Cross Section Evaluation Working Group (CSEWG) of the United States released the new ENDF/B-VII.0 library. This represented considerable achievement as it was the 1st major release since 1990 when ENDF/B-VI has been made publicly available. The two libraries have been released in the same format, ENDF-6, which has been originally developed for the ENDF/B-VI library. In the early stage of work on the VII-th generation of the library CSEWG made important decision to use the same formats. This decision was adopted even though it was argued that it would be timely to modernize the formats and several interesting ideas were proposed. After careful deliberation CSEWG concluded that actual implementation would require considerable resources needed to modify processing codes and to guarantee high quality of the files processed by these codes. In view of this the idea of format modernization has been postponed and ENDF-6 format was adopted for the new ENDF/B-VII library. In several other areas related to ENDF we made our best to move beyond established tradition and achieve maximum modernization. Thus, the 'Big Paper' on ENDF/B-VII.0 has been published, also in December 2006, as the Special Issue of Nuclear Data Sheets 107 (1996) 2931-3060. The new web retrieval and plotting system for ENDF-6 formatted data, Sigma, was developed by the NNDC and released in 2007. Extensive paper has been published on the advanced tool for nuclear reaction data evaluation, EMPIRE, in 2007. This effort was complemented with release of updated set of ENDF checking codes in 2009. As the final item on this list, major revision of ENDF-6 Formats Manual was made. This work started in 2006 and came to fruition in 2009 as documented in the present report.

  11. Inelastic deuteron scattering in the Coulomb nuclear interference region: Procedures for estimating the precision of the extracted B(E2) and B(IS2) values

    SciTech Connect

    Duarte, J.L.; Ukita, G.M.; Borello-Lewin, T.; Horodynski-Matsushigue, L.B.; Gomes, L.C.

    1997-10-01

    Taking {sup 94}Mo(d,d{sup {prime}}){sup 94}Mo(2{sub 1}{sup +}) at 13.2 MeV incident energy as an example, a discussion is made about the influence of known experimental uncertainties in the primary data on the precision of the B(E2) and B(IS2) values, extracted in Coulomb-nuclear interference (CNI) measurements in a correlated way. The reflexes of judicious variations of three optical model parameters (around the global prescription) on the extracted values are also examined. The good quality of the data obtained with the S. Paulo Pelletron-Enge-Spectrograph facility is shown to allow for a 2{endash}3{percent} statistical uncertainty level for these quantities, within a distorted-wave Born approximation-deformed optical model approach. The accuracy of relative values of the ratio B(E2)/B(IS2), which may be linked to the ratio of proton to neutron quadrupole moments, is argued to be of similar order. {copyright} {ital 1997} {ital The American Physical Society}

  12. Procedure of calculation of the spatial distribution of temperatures and heat fluxes in the steam generator of a nuclear power installation with an RBEC fast-neutron reactor

    NASA Astrophysics Data System (ADS)

    Frolov, A. A.; Sedov, A. A.

    2016-08-01

    A method for combined 3D/1D-modeling of thermohydraulics of a once-through steam generator (SG) based on the joint analysis of three-dimensional thermo- and hydrodynamics of a single-phase heating coolant in the intertube space and one-dimensional thermohydraulics of steam-generating channels (tubes) with the use of well-known friction and heat-transfer correlations under various boiling conditions is discussed. This method allows one to determine the spatial distribution of temperatures and heat fluxes of heat-exchange surfaces of SGs with a single-phase heating coolant in the intertube space and with steam generation within tubes. The method was applied in the analytical investigation of typical operation of a once-through SG of a nuclear power installation with an RBEC fast-neutron heavy-metal reactor that is being designed by Kurchatov Institute in collaboration with OKB GIDROPRESS and Leipunsky Institute of Physics and Power Engineering. Flow pattern and temperature fields were obtained for the heavy-metal heating coolant in the intertube space. Nonuniformities of heating of the steam-water coolant in different heat-exchange tubes and nonuniformities in the distribution of heat fluxes at SG heat-exchange surfaces were revealed.

  13. Introduction of nuclear medicine research in Japan.

    PubMed

    Inubushi, Masayuki; Higashi, Tatsuya; Kuji, Ichiei; Sakamoto, Setsu; Tashiro, Manabu; Momose, Mitsuru

    2016-12-01

    There were many interesting presentations of unique studies at the Annual Meeting of the Japanese Society of Nuclear Medicine, although there were fewer attendees from Europe than expected. These presentations included research on diseases that are more frequent in Japan and Asia than in Europe, synthesis of original radiopharmaceuticals, and development of imaging devices and methods with novel ideas especially by Japanese manufacturers. In this review, we introduce recent nuclear medicine research conducted in Japan in the five categories of Oncology, Neurology, Cardiology, Radiopharmaceuticals and Technology. It is our hope that this article will encourage the participation of researchers from all over the world, in particular from Europe, in scientific meetings on nuclear medicine held in Japan.

  14. The history of the German Cardiac Society and the American College of Cardiology and their two founders.

    PubMed

    Lüderitz, Berndt; Holmes, David R; Harold, John

    2013-02-26

    The German Cardiac Society is the oldest national cardiac society in Europe, founded on June 3, 1927, in Bad Nauheim by Dr. Bruno Kisch and Professor Arthur Weber. They were actively supported by Dr. Franz Groedel, who together with Kisch became co-founders of the American College of Cardiology in 1949. Both Groedel and Kisch would be proud to see the fulfillment of their visions and dreams, which was commemorated at the joint session of the two societies held during the 78th annual meeting of the German Cardiac Society in Mannheim, Germany. "It is ironic that their dreadful years in Germany and their loss to German Cardiology helped to contribute to advances in American and international Cardiology," said Dr. Simon Dack, American College of Cardiology president in 1956 and 1957. The legacy of Groedel might be reflected by his own words: "We will meet the future not merely by dreams but by concerned action and inextinguishable enthusiasm".

  15. Trends and different educational pathways for training physicians in nuclear medicine.

    PubMed

    Harolds, Jay A; Smith, Gary T; Baker, Stephen R

    2008-12-01

    The introduction of positron emission tomography/computed tomography (CT), single photon-emission CT/CT, and software packages for multimodality imaging has accelerated the need for nuclear medicine physicians to obtain more training in cross-sectional imaging, especially in CT. In recent years, the Nuclear Regulatory Commission, the Accreditation Council for Graduate Medical Education, the American Board of Radiology, and the American Board of Nuclear Medicine have promulgated new rules and regulations. In addition, the Society of Nuclear Medicine, the American College of Radiology, and the American College of Cardiology Foundation have crafted new guidelines and training requirements. All these changes have consequences for the education of physicians in nuclear medicine. Self-referral and concerns about radiation exposure from nuclear medicine examinations and CT are also affecting the education of physicians practicing nuclear medicine. The authors examine the impact of these developments on training and certification in nuclear medicine and suggest another pathway to train some nuclear medicine physicians.

  16. Nuclear material operations manual

    SciTech Connect

    Tyler, R.P.

    1981-02-01

    This manual provides a concise and comprehensive documentation of the operating procedures currently practiced at Sandia National Laboratories with regard to the management, control, and accountability of nuclear materials. The manual is divided into chapters which are devoted to the separate functions performed in nuclear material operations-management, control, accountability, and safeguards, and the final two chapters comprise a document which is also issued separately to provide a summary of the information and operating procedures relevant to custodians and users of radioactive and nuclear materials. The manual also contains samples of the forms utilized in carrying out nuclear material activities. To enhance the clarity of presentation, operating procedures are presented in the form of playscripts in which the responsible organizations and necessary actions are clearly delineated in a chronological fashion from the initiation of a transaction to its completion.

  17. [Physical training with the use of electrostimulation of skeletal muscles in cardiology].

    PubMed

    Sumin, A N

    2010-01-01

    Conduction of programs of physical rehabilitation is impeded in most severely ill cardiological patients. A method of training with the use of electrostimulation of skeletal muscles (ESM) has been suggested recently for this category of patients. This review contains detailed description of effects of ESM in patients with congestive heart failure - improvements of muscular status, tolerance to physical work, maximal oxygen consumption and quality of life associated with favorable metabolic and morphological changes in muscles. Data on application of ESM in other categories of patients - myocardial infarction, chronic pulmonary heart - during long stay in intensive care units are also presented. ESM is safe and effective mean of physical rehabilitation in most problematic cardiological and deserves both further scientific investigation and introduction into clinical practice.

  18. [Measuring instruments in cardiology adapted into Portuguese language of Brazil: a systematic review].

    PubMed

    Cornélio, Marilia Estevam; Alexandre, Neusa Maria Costa; São-João, Thaís Moreira

    2014-04-01

    This was a systematic review aimed at identifying and characterizing measuring instruments, developed in the context of cardiology, which were adapted into Portuguese language of Brazil. Systematic searches were performed in six databases. Information extracted included cultural adaptation process and measurement properties. To assess the methodological quality of studies, criteria based on international guidelines for cultural adaptation of instruments were used. Among the 114 articles found, 14 were eligible for review. Of these, most evaluated quality of life (35.7%) and health knowledge/learning (28.6%). Most studies followed all stages of the adaptation process recommended in the literature. With respect to measurement properties, internal consistency, verified by Cronbach's alpha, was the property reported in the majority of the studies, as well as construct and criterion validity. This study is expected to provide to the scientific community a critical evaluation of adapted questionnaires available in the context of cardiology.

  19. Concepts of neuroendocrine cardiology and neuroendocrine immunology, chemistry and biology of signal molecules.

    PubMed

    Galoyan, Armen

    2010-12-01

    Discovery of neurosecretion of cardioactive neurohormones produced by hypothalamic nuclei (NSO and NPV), as well as the biosynthesis of several immunomodulators (signal molecules of the neuroendocrine immune system of brain), deciphering of their chemical structure and study of their biological properties led to the foundation of two important trends of neurobiology: neuroendocrine immunology and cardiology. Hormone formation by atrium ganglionary nerve cells and auriculum establishment of neurohumoral interactions between hypothalamic and atrium neurosecretion indicated the existence of the system neuroendocrine hypothalamus--endocrine heart. Study of their biological properties promoted creation of powerful neurohormonal preparations for the treatment of immune, cardio-vascular, neurodegenerative, infectious and tumor diseases. Concepts suggested by us on neuroendocrine cardiology and immunology, create large perspectives for development of the theory and its implementation in medicine.

  20. [The beginning of Mexican cardiology in the springtime of the Mexican National Academy of Medicine].

    PubMed

    de Micheli, Alfredo

    2016-01-01

    The National Academy of Medicine was founded 141 years ago during the French intervention. Under the sponsorship of this brand-new medical association, Mexican cardioangiology took its first steps in the medical and surgical field as well. After the falling of the second empire, the medical and surgical advances of this discipline continued. The corresponding publications appeared in different volumes of the "Gaceta Médica de México"; at present journal of the Academy still published in our time. These steps permitted the development of the true cardiologic speciality during 40s of the twentieth century, due to the vision of Professor Ignacio Chávez, father of Mexican cardiology. Some examples of application are the epistemologic criteria in cardiologycal domains such as the conception of Riva-Rocci's sphygmomanometer in Italy in the nineteenth century and the so-called cardiac metabolic therapy in Mexico of our time, are included.

  1. The Polish Interventional Cardiology TAVI Survey (PICTS): adoption and practice of transcatheter aortic valve implantation in Poland

    PubMed Central

    Parma, Radosław; Dąbrowski, Maciej; Ochała, Andrzej; Witkowski, Adam; Dudek, Dariusz; Siudak, Zbigniew

    2017-01-01

    Introduction Few studies have assessed the development of transcatheter aortic valve implantation (TAVI) in Poland since its introduction in 2008, and data on current TAVI activity or practice are missing. Aim To assess the dynamics of TAVI adoption in Poland and to detect differences among Polish centres in TAVI practice and decision-making. Material and methods The Polish Interventional Cardiology TAVI Survey (PICTS) was approved by the Polish Association of Cardiovascular Interventions and presented to all 21 national TAVI centres. Between 2008 and 2015 the cumulative number of TAVI performed in Poland was 2189. The annual number of TAVI rose from 8 in 2008 to 670 in 2015 (0.21 to 17.4 implants per million inhabitants, respectively). Results The median TAVI experience per centre was 80 procedures (95% CI: 38.1–154.6). In 2015 the TAVI penetration rate reached 5.12% of the estimated eligible Polish population. Inoperable and high-risk patients are treated with TAVI in all centres, with 52% of Heart Teams also qualifying medium-risk patients. The rate of transfemoral implantations increased to 83.2% of all procedures in 2015, while transapical implantations decreased to 12%. The frequency of subclavian, direct aortic or transcarotid routes in 2015 was below 3% each. Conclusions The PICTS survey observed a positive but slow rate of adoption of TAVI in Poland. When compared to Western European countries, our findings highlight a significant treatment gap in high or prohibitive surgical risk patients with severe aortic stenosis. Remarkable variations in TAVI practices among Polish TAVI centres warrant publication of joint national guidelines and recommendations. PMID:28344612

  2. 10 CFR 840.2 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Procedures. 840.2 Section 840.2 Energy DEPARTMENT OF ENERGY EXTRAORDINARY NUCLEAR OCCURRENCES § 840.2 Procedures. (a) DOE may initiate, on its own motion, the making of a determination as to whether or not there has been an extraordinary nuclear occurrence. In...

  3. 10 CFR 840.2 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Procedures. 840.2 Section 840.2 Energy DEPARTMENT OF ENERGY EXTRAORDINARY NUCLEAR OCCURRENCES § 840.2 Procedures. (a) DOE may initiate, on its own motion, the making of a determination as to whether or not there has been an extraordinary nuclear occurrence. In...

  4. 10 CFR 840.2 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Procedures. 840.2 Section 840.2 Energy DEPARTMENT OF ENERGY EXTRAORDINARY NUCLEAR OCCURRENCES § 840.2 Procedures. (a) DOE may initiate, on its own motion, the making of a determination as to whether or not there has been an extraordinary nuclear occurrence. In...

  5. 10 CFR 840.2 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Procedures. 840.2 Section 840.2 Energy DEPARTMENT OF ENERGY EXTRAORDINARY NUCLEAR OCCURRENCES § 840.2 Procedures. (a) DOE may initiate, on its own motion, the making of a determination as to whether or not there has been an extraordinary nuclear occurrence. In...

  6. 10 CFR 840.2 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Procedures. 840.2 Section 840.2 Energy DEPARTMENT OF ENERGY EXTRAORDINARY NUCLEAR OCCURRENCES § 840.2 Procedures. (a) DOE may initiate, on its own motion, the making of a determination as to whether or not there has been an extraordinary nuclear occurrence. In...

  7. 10 CFR 1706.7 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Procedures. 1706.7 Section 1706.7 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.7 Procedures. (a) Pre... the same defense nuclear facility that is the subject of the proposed new work (including...

  8. 10 CFR 1706.7 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Procedures. 1706.7 Section 1706.7 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.7 Procedures. (a) Pre... the same defense nuclear facility that is the subject of the proposed new work (including...

  9. 10 CFR 1706.7 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Procedures. 1706.7 Section 1706.7 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.7 Procedures. (a) Pre... the same defense nuclear facility that is the subject of the proposed new work (including...

  10. Pulmonary Edema Assessed by Ultrasound: Impact in Cardiology and Intensive Care Practice.

    PubMed

    Blanco, Pablo A; Cianciulli, Tomás F

    2016-05-01

    Pulmonary edema is a frequent condition found in adult patients hospitalized in cardiology wards and intensive care units. Ultrasonography is a diagnostic modality with a high sensitivity for the detection of extravascular lung water, visualized as B lines, and usually caused by cardiogenic or noncardiogenic pulmonary edema. This paper highlights a simple method for the assessment of patients with pulmonary edema, which allows for a differential diagnosis of its possible mechanism and contributes to therapeutic intervention guiding and monitoring.

  11. Unexpected deaths in cardiology outpatients – what can we learn from case review?

    PubMed Central

    Kitz, Thomas Michael; Burnand, Nikki; Ortner, Astrid; Rudd, Ian G; Sampson, Rod; Rushworth, Gordon F

    2016-01-01

    Objectives A proportion of cardiac patients managed at a cardiology outpatient clinic will die between clinic visits. This study aimed to identify the cause of death, to determine if case review occurred and if a formal review of such cases might be useful. Design Single-centre retrospective cohort study. Setting A remote regional centre in the North of Scotland. Participants All patients who had been removed from the cardiology outpatient clinic due to death in the community. Main outcome measures Cause of death, comorbidities and treatments were collected from hospital records and the national register of deaths. Chi-squared test and Student’s t-test were used with significance taken at the 5% level. Results Of 10,606 patients who attended the cardiology outpatient clinic, 75 (0.7%) patients died in the community. The majority (57.0%) died from a non-cardiac cause. Eleven patients (14.9%) died due to an unexpected cardiac death. A detailed case note review was undertaken. In only two (18.2%) cases was any note made as to the cause of death in the hospital records and in only one was there details of post mortem discussion between primary and secondary care. Conclusions A small proportion of patients attending a cardiology outpatient clinic died in the community. Documentation of the death in the hospital notes was very poor and evidence of post mortem communication between primary and secondary care was absent in all but one case. Better documentation and communication between primary and secondary care would seem desirable. PMID:27928509

  12. Acceptability and impact of pet visitation on a pediatric cardiology inpatient unit.

    PubMed

    Wu, Adam S; Niedra, Ruta; Pendergast, Lisa; McCrindle, Brian W

    2002-10-01

    We evaluated the effectiveness of a pet visitation program in helping children and their families adjust to hospitalization on a pediatric cardiology ward. Thirty-one pet visits were observed and followed by interviews with patients and parents. Analysis of data suggested that pet visits relieved stress, normalized the hospital milieu, and improved patient and parent morale. The benefit received by the subjects correlated with the amount of physical contact and rapport developed with the visiting animal.

  13. The impact of prenatal diagnosis of congenital heart disease on pediatric cardiology and cardiac surgery.

    PubMed

    Chiappa, Enrico

    2007-01-01

    Since the early 1980s prenatal diagnosis of congenital heart disease (CHD) has progressively impacted on the practice of pediatric cardiology and cardiac surgery. Fetal cardiology today raises special needs in screening programs, training of the involved staff, and allocations of services. Due to the increased detection rate and to the substantial number of terminations, the reduced incidence of CHD at birth can affect the workload of centers of pediatric cardiology and surgery. In utero transportation and competition among centers may change the area of referral in favor of the best centers. Echocardiography is a powerful means to diagnose and to guide lifesaving medical treatment of sustained tachyarrhythmias in the fetus. Prenatal diagnosis not only improves the preoperative conditions in most cases but also postoperative morbidity and mortality in selected types of CHD. Intrauterine transcatheter valvuloplasty in severe outflow obstructive lesions has been disappointing so far and this technique remains investigational, until its benefits are determined by controlled trials. Prenatal diagnosis allows counselling of families which are better prepared for the foreseeable management and outcome of the fetus. These benefits can reduce the risks of litigation for missed ultrasound diagnosis. As increased costs can be expected in institutions dealing with a large number of fetal CHD, the administrators of these institutions should receive protected funds, proportional to their needs.

  14. Preliminary Study of Pet Owner Adherence in Behaviour, Cardiology, Urology, and Oncology Fields.

    PubMed

    Talamonti, Zita; Cassis, Chiara; Brambilla, Paola G; Scarpa, Paola; Stefanello, Damiano; Cannas, Simona; Minero, Michela; Palestrini, Clara

    2015-01-01

    Successful veterinary treatment of animals requires owner adherence with a prescribed treatment plan. The aim of our study was to evaluate and compare the level of adherence of the owners of patients presented for behavioural, cardiological, urological, and oncological problems. At the end of the first examination, each owner completed a questionnaire. Then, the owners were called four times to fill out another questionnaire over the phone. With regard to the first questionnaire, statistically significant data concern behavioral medicine and cardiology. In the first area the owner's worry decreases during the follow-up and the number of owners who would give away the animal increases. In cardiology, owners who think that the pathology harms their animal's quality of life decreased significantly over time. With regard to the 9 additional follow-up questions, in behavioural medicine and urology the owner's discomfort resulting from the animal's pathology significantly decreases over time. Assessment of adherence appears to be an optimal instrument in identifying the positive factors and the difficulties encountered by owners during the application of a treatment protocol.

  15. Italian cardiological guidelines for sports eligibility in athletes with heart disease: part 1.

    PubMed

    Biffi, Alessandro; Delise, Pietro; Zeppilli, Paolo; Giada, Franco; Pelliccia, Antonio; Penco, Maria; Casasco, Maurizio; Colonna, Pierluigi; D'Andrea, Antonello; D'Andrea, Luigi; Gazale, Giovanni; Inama, Giuseppe; Spataro, Antonio; Villella, Alessandro; Marino, Paolo; Pirelli, Salvatore; Romano, Vincenzo; Cristiano, Antonio; Bettini, Roberto; Thiene, Gaetano; Furlanello, Francesco; Corrado, Domenico

    2013-07-01

    In Italy the existence of a law on health protection of competitive sports since 1982 has favored the creation and the revision of these cardiological guidelines (called COCIS), which have reached their fourth edition (1989-2009). The present article is the second English version, which has summarized the larger version in Italian. The experience of the experts consulted in the course of these past 20 years has facilitated the application and the compatibility of issues related to clinical cardiology to the sports medicine field. Such prolonged experience has allowed the clinical cardiologist to acquire knowledge of the applied physiology of exercise and, on the other hand, has improved the ability of sports physicians in cardiological diagnostics. All this work has produced these guidelines related to the judgment of eligibility for competitive sports in the individual clinical situations and in the different cardiovascular abnormalities and/or heart disease. Numerous arguments are debated, such as interpretation of the athlete's ECG, the utility of a preparticipation screening, arrhythmias, congenital heart disease, cardiomyopathies, arterial hypertension, ischemic heart disease and other particular issues.

  16. Italian cardiological guidelines for sports eligibility in athletes with heart disease: part 2.

    PubMed

    Biffi, Alessandro; Delise, Pietro; Zeppilli, Paolo; Giada, Franco; Pelliccia, Antonio; Penco, Maria; Casasco, Maurizio; Colonna, Pierluigi; D'Andrea, Antonello; D'Andrea, Luigi; Gazale, Giovanni; Inama, Giuseppe; Spataro, Antonio; Villella, Alessandro; Marino, Paolo; Pirelli, Salvatore; Romano, Vincenzo; Cristiano, Antonio; Bettini, Roberto; Thiene, Gaetano; Furlanello, Francesco; Corrado, Domenico

    2013-07-01

    In Italy the existence of a law on health protection of competitive sports since 1982 has favored the creation and the revision of these cardiological guidelines (called COCIS), which have reached their fourth edition (1989-2009). The present article is the second English version, which has summarized the larger version in Italian. The experience of the experts consulted in the course of these past 20 years has facilitated the application and the compatibility of issues related to clinical cardiology to the sports medicine field. Such prolonged experience has allowed the clinical cardiologist to acquire knowledge of the applied physiology of exercise and, on the other hand, has improved the ability of sports physicians in cardiological diagnostics. All this work has produced these guidelines related to the judgment of eligibility for competitive sports in the individual clinical situations and in the different cardiovascular abnormalities and/or heart disease. Numerous arguments are debated, such as interpretation of the athlete's ECG, the utility of a preparticipation screening, arrhythmias, congenital heart disease, cardiomyopathies, arterial hypertension, ischemic heart disease and other particular issues.

  17. 2013 update on congenital heart disease, clinical cardiology, heart failure, and heart transplant.

    PubMed

    Subirana, M Teresa; Barón-Esquivias, Gonzalo; Manito, Nicolás; Oliver, José M; Ripoll, Tomás; Lambert, Jose Luis; Zunzunegui, José L; Bover, Ramon; García-Pinilla, José Manuel

    2014-03-01

    This article presents the most relevant developments in 2013 in 3 key areas of cardiology: congenital heart disease, clinical cardiology, and heart failure and transplant. Within the area of congenital heart disease, we reviewed contributions related to sudden death in adult congenital heart disease, the importance of specific echocardiographic parameters in assessing the systemic right ventricle, problems in patients with repaired tetralogy of Fallot and indication for pulmonary valve replacement, and confirmation of the role of specific factors in the selection of candidates for Fontan surgery. The most recent publications in clinical cardiology include a study by a European working group on correct diagnostic work-up in cardiomyopathies, studies on the cost-effectiveness of percutaneous aortic valve implantation, a consensus document on the management of type B aortic dissection, and guidelines on aortic valve and ascending aortic disease. The most noteworthy developments in heart failure and transplantation include new American guidelines on heart failure, therapeutic advances in acute heart failure (serelaxin), the management of comorbidities such as iron deficiency, risk assessment using new biomarkers, and advances in ventricular assist devices.

  18. Web tools for effective retrieval, visualization, and evaluation of cardiology medical images and records

    NASA Astrophysics Data System (ADS)

    Masseroli, Marco; Pinciroli, Francesco

    2000-12-01

    To provide easy retrieval, integration and evaluation of multimodal cardiology images and data in a web browser environment, distributed application technologies and java programming were used to implement a client-server architecture based on software agents. The server side manages secure connections and queries to heterogeneous remote databases and file systems containing patient personal and clinical data. The client side is a Java applet running in a web browser and providing a friendly medical user interface to perform queries on patient and medical test dat and integrate and visualize properly the various query results. A set of tools based on Java Advanced Imaging API enables to process and analyze the retrieved cardiology images, and quantify their features in different regions of interest. The platform-independence Java technology makes the developed prototype easy to be managed in a centralized form and provided in each site where an intranet or internet connection can be located. Giving the healthcare providers effective tools for querying, visualizing and evaluating comprehensively cardiology medical images and records in all locations where they can need them- i.e. emergency, operating theaters, ward, or even outpatient clinics- the developed prototype represents an important aid in providing more efficient diagnoses and medical treatments.

  19. Sports cardiology: lessons from the past and perspectives for the future

    PubMed Central

    Leischik, Roman

    2015-01-01

    The possibility of myocardial damage as a result of endurance sport has been known about since ancient times. According to a leg­end, a soldier named Pheidippides (more likely Philippides) dropped dead after run­ning from war-torn Marathon to Athens with the news of victory. Millennia later, we do not know whether he was a soldier or a courier, or whether he really ran the entire 240 km from Athens to Sparta and then back from Marathon to Athens. What is clear however, is that his death went down in history as the first documented exercise-related death and provides a tangible starting-point for the discipline of sport cardiology. Sports cardiology today covers a broad range of areas; from patients with cardiomyopathies, coronary disease and metabolic syndrome through to fitness fans, high-performance athletes and those with physically demanding professions. The following editorial introduces the primary topics for discussion to be included in the F1000Research channel Sports cardiology with the hope that this will evoke open, controversial and broad discourse in the form of reviews and original research papers in this important field. PMID:26097692

  20. Sports cardiology: lessons from the past and perspectives for the future.

    PubMed

    Leischik, Roman

    2015-01-01

    The possibility of myocardial damage as a result of endurance sport has been known about since ancient times. According to a leg-end, a soldier named Pheidippides (more likely Philippides) dropped dead after run-ning from war-torn Marathon to Athens with the news of victory. Millennia later, we do not know whether he was a soldier or a courier, or whether he really ran the entire 240 km from Athens to Sparta and then back from Marathon to Athens. What is clear however, is that his death went down in history as the first documented exercise-related death and provides a tangible starting-point for the discipline of sport cardiology. Sports cardiology today covers a broad range of areas; from patients with cardiomyopathies, coronary disease and metabolic syndrome through to fitness fans, high-performance athletes and those with physically demanding professions. The following editorial introduces the primary topics for discussion to be included in the F1000Research channel Sports cardiology with the hope that this will evoke open, controversial and broad discourse in the form of reviews and original research papers in this important field.

  1. [Effects of minimum volume regulations on the provision of health care services in cardiology].

    PubMed

    Fürstenberg, T; Heumann, M; Roeder, N

    2005-02-01

    In order to improve the quality of medical care, minimum volumes for services were set. Hospitals are only permitted to continue to provide these services and settle accounts with the health insurance companies if they are able to achieve these minimum annual volumes. This study is based on service data of the year 2002 from 88 neighboring hospitals of the hospital association Cologne, Bonn and region. In the study, the influence of these regulations on the provision of health care services in cardiology were examined. The cases were grouped according to the different examined services, followed by an analysis of the number of cases for each hospital in comparison to four fictitious minimum quantity models. When the hospital's volume remained below the minimum quantity, these cases were assigned to the nearest hospital still able to provide the service. For the services coronary angiography, PTCA, AICD implantation, EPS and ablation, only marginal case redistributions were determined. Depending on the minimum quantity, service concentrations are only expected for pacemaker implantations. Due to the increasing service concentration as a consequence of the DRG-payment system, a bureaucratic regulation of minimum volumes has become superfluous for most cardiological services. Instead of minimum volume regulations, recommendation of minimum volumes should be made in cardiological guidelines.

  2. Minimizing and communicating radiation risk in pediatric nuclear medicine.

    PubMed

    Fahey, Frederic H; Treves, S Ted; Adelstein, S James

    2011-08-01

    The value of pediatric nuclear medicine is well established. Pediatric patients are referred to nuclear medicine from nearly all pediatric specialties including urology, oncology, cardiology, gastroenterology, and orthopedics. Radiation exposure is associated with a potential, small, risk of inducing cancer in the patient later in life and is higher in younger patients. Recently, there has been enhanced interest in exposure to radiation from medical imaging. Thus, it is incumbent on practitioners of pediatric nuclear medicine to have an understanding of dosimetry and radiation risk to communicate effectively with their patients and their families. This article reviews radiation dosimetry for radiopharmaceuticals and also CT given the recent proliferation of PET/CT and SPECT/CT. It also describes the scientific basis for radiation risk estimation in the context of pediatric nuclear medicine. Approaches for effective communication of risk to patients' families are discussed. Lastly, radiation dose reduction in pediatric nuclear medicine is explicated.

  3. Minimizing and communicating radiation risk in pediatric nuclear medicine.

    PubMed

    Fahey, Frederic H; Treves, S Ted; Adelstein, S James

    2012-03-01

    The value of pediatric nuclear medicine is well established. Pediatric patients are referred to nuclear medicine from nearly all pediatric specialties including urology, oncology, cardiology, gastroenterology, and orthopedics. Radiation exposure is associated with a potential, small, risk of inducing cancer in the patient later in life and is higher in younger patients. Recently, there has been enhanced interest in exposure to radiation from medical imaging. Thus, it is incumbent on practitioners of pediatric nuclear medicine to have an understanding of dosimetry and radiation risk to communicate effectively with their patients and their families. This article reviews radiation dosimetry for radiopharmaceuticals and also CT given the recent proliferation of PET/CT and SPECT/CT. It also describes the scientific basis for radiation risk estimation in the context of pediatric nuclear medicine. Approaches for effective communication of risk to patients' families are discussed. Lastly, radiation dose reduction in pediatric nuclear medicine is explicated.

  4. [What has been brought to residents and communities by the nuclear power plant accident? Special and serious disaster relief procedure modification after the 2011 Tohoku earthquake and tsunami in Fukushima].

    PubMed

    Ishikawa, Kazunobu

    2011-01-01

    After the catastrophic 2011 Tohoku earthquake and tsunami which struck cities and towns on the Japanese Pacific coast, Fukushima has been the focus of special and serious disaster relief procedures modification regarding nuclear power plant accidents. To date, the Japanese government has repeatedly issued evacuation orders to more than 100,000 residents. Huge numbers of refugees are still uncertain if they can return home and re-cultivate their farm land. Ambiguous public announcements concerning the radiation risks seem to have aggravated feelings of insecurity, fear and the desire to escape, both at home and abroad. This disaster has seriously undermined trust internationally and locally in Fukushima. Harmful rumors added further difficulties. In response to this disaster, local government, medical institutions, care facilities, police, emergency services and the self-defense forces continue to put their utmost effort into reconstruction. This seismic disaster has reminded us that supplies of water, electricity, gas, gasoline and telephone/communication facilities are essential prerequisites for reconstruction and daily life. Disaster and radiation medical association teams actively participated in the rescue efforts, and a number of organized medical teams cared for about 15,000 refugees in 100 shelters. We also visited home-bound patients, who were unable to evacuate from the 20-30 km inner evacuation area. In this relief role, we need to consider the following; (1) professionals, both healthcare and nuclear engineers, must always be prepared for unexpected circumstances, (2) the daily organic cooperation of individuals and units is closely linked to readiness against sudden risks, and (3) appropriate accountability is essential to assuage the fears of residents and refugees. A sincere learning process may benefit those innocent refugees who may be forced to abandon their homes permanently.

  5. Provision of services for the diagnosis and treatment of heart disease. Fourth report of a Joint Cardiology Committee of the Royal College of Physicians of London and the Royal College of Surgeons of England.

    PubMed Central

    1992-01-01

    The principal conclusions of the fourth report of the Joint Cardiology Committee are: 1 Cardiovascular disease remains a major cause of death and morbidity in the population and of utilisation of medical services. 2 Reduction in the risk of cardiovascular disease is feasible, and better co-ordination is required of strategies most likely to be effective. 3 Pre-hospital care of cardiac emergencies, in particular the provision of facilities for defibrillation, should continue to be developed. 4 There remains a large shortfall in provision of cardiological services with almost one in five district hospitals in England and Wales having no physician with the appropriate training. Few of the larger districts have two cardiologists to meet the recommendation for populations of over 250,000. One hundred and fifty extra consultant posts (in both district and regional centres) together with adequate supporting staff and facilities are urgently needed to provide modest cover for existing requirements. 5 The provision of coronary bypass grafting has expanded since 1985, but few regions have fulfilled the unambitious objectives stated in the Third Joint Cardiology Report. 6 The development of coronary angioplasty has been slow and haphazard. All regional centres should have at least two cardiologists trained in coronary angioplasty and there should be a designated budget. Surgical cover is still required for most procedures and is best provided on site. 7 Advances in the management of arrhythmias, including the use of specialised pacemakers, implantable defibrillators, and percutaneous or surgical ablation of parts of the cardiac conducting system have resulted in great benefit to patients. Planned development of the emerging sub-specialty of arrhythmology is required. 8 Strategies must be developed to limit the increased exposure of cardiologists to ionising radiation which will result from the expansion and increasing complexity of interventional procedures. 9 Supra

  6. Percutaneous interventions in cardiology in Poland in the year 2014. Summary report of the Association of Cardiovascular Interventions of the Polish Cardiac Society AISN PTK

    PubMed Central

    Siudak, Zbigniew; Legutko, Jacek; Parma, Radosław; Chmielak, Zbigniew; Bartuś, Stanisław; Dobrzycki, Sławomir; Grygier, Marek; Moszura, Tomasz; Pawłowski, Tomasz; Dudek, Dariusz

    2015-01-01

    Introduction The Board of the Association of Cardiovascular Interventions of the Polish Cardiac Society (AISN PTK) publishes annual data from the National PCI Registry (ORPKI) operated by the Jagiellonian University Medical College in Krakow. Aim For the first time the AISN PTK report is based on the new electronic database implemented in Poland on January 1st, 2014. Material and methods In 2014, there were 155 invasive cardiology centers registered in the ORPKI database (an increase by 1 center in comparison to 2013) and 92% of them had 24/7 percutaneous (PCI) duty. For the first time the number of catheterization laboratories (cath labs) in Poland remained stable, and even though there was an increase by 1 in absolute numbers, 2 cath labs ceased to admit patients in 2014. This means that the number of active cath labs per 1 million inhabitants is similar to last year and equals 4. Results In comparison to 2013, there was a significant increase in the total number of coronary angiographies. There were 226 713 angiographies in 2014. The total number of PCI procedures was 126 241, which is 5.1% more than in 2013. Conclusions There was a significant increase in the overall number of coronary angiographies and PCIs in Poland in 2014. The use of attributes of modern interventional cardiology such as drug-eluting stents and bioabsorbable vascular stents is growing as well as more frequent choice of a radial access site by PCI operators even in ST-elevation myocardial infarction patients. One should also note a significant rise in the use of additional imaging or diagnostic tools such as fractional flow reserve, intravascular ultrasound and optical coherent tomography. PMID:26677356

  7. Clinical Presentation, Imaging, and Management of Complications due to Neurointerventional Procedures

    PubMed Central

    Davis, Matthew C.; Deveikis, John P.; Harrigan, Mark R.

    2015-01-01

    Neurointervention is a rapidly evolving and complex field practiced by clinicians with backgrounds ranging from neurosurgery to radiology, neurology, cardiology, and vascular surgery. New devices, techniques, and clinical applications create exciting opportunities for impacting patient care, but also carry the potential for new iatrogenic injuries. Every step of every neurointerventional procedure carries risk, and a thorough appreciation of potential complications is fundamental to maximizing safety. This article presents the most frequent and dangerous iatrogenic injuries, their presentation, identification, prevention, and management. PMID:26038618

  8. Nuclear rights - nuclear wrongs

    SciTech Connect

    Paul, E.F.; Miller, F.D.; Paul, J.; Ahrens, J.

    1986-01-01

    This book contains 11 selections. The titles are: Three Ways to Kill Innocent Bystanders: Some Conundrums Concerning the Morality of War; The International Defense of Liberty; Two Concepts of Deterrence; Nuclear Deterrence and Arms Control; Ethical Issues for the 1980s; The Moral Status of Nuclear Deterrent Threats; Optimal Deterrence; Morality and Paradoxical Deterrence; Immoral Risks: A Deontological Critique of Nuclear Deterrence; No War Without Dictatorship, No Peace Without Democracy: Foreign Policy as Domestic Politics; Marxism-Leninism and its Strategic Implications for the United States; Tocqueveille War.

  9. Pediatric nuclear medicine

    SciTech Connect

    Not Available

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.

  10. Computerized operating procedures

    SciTech Connect

    Ness, E.; Teigen, J.

    1994-12-31

    A number of observed and potential problems in the nuclear industry are related to the quality of operating procedures. Many of the problems identified in operating procedure preparation, implementation, and maintenance have a technical nature, which can be directly addressed by developing computerized procedure handling tools. The Halden Reactor Project (HRP) of the Organization for Economic Cooperation and Development has since 1985 performed research work within this field. A product of this effort is the development of a second version of the computerized operation manuals (COPMA) system. This paper summarizes the most important characteristics of the COPMA-II system and discusses some of the experiences in using a system like COPMA-II.

  11. Thoracic ultrasound: A complementary diagnostic tool in cardiology

    PubMed Central

    Trovato, Guglielmo M

    2016-01-01

    Clinical assessment and workup of patients referred to cardiologists may need an extension to chest disease. This requires more in-depth examination of respiratory co-morbidities due to uncertainty or severity of the clinical presentation. The filter and integration of ecg and echocardiographic information, addressing to the clues of right ventricular impairment, pulmonary embolism and pulmonary hypertension, and other less frequent conditions, such as congenital, inherited and systemic disease, usually allow more timely diagnosis and therapeutic choice. The concurrent use of thoracic ultrasound (TUS) is important, because, despite the evidence of the strict links between cardiac and respiratory medicine, heart and chest US imaging approaches are still separated. Actually, available expertise, knowledge, skills and training and equipment’s suitability are not equally fitting for heart or lung examination and not always already accessible in the same room or facility. Echocardiography is useful for study and monitoring of several respiratory conditions and even detection, so that this is nowadays an established functional complementary tool in pulmonary fibrosis and diffuse interstitial disease diagnosis and monitoring. Extending the approach of the cardiologist to lung and pleura will allow the achievement of information on pleural effusion, even minimal, lung consolidation and pneumothorax. Electrocardiography, pulse oximetry and US equipment are the friendly extension of the physical examination, if their use relies on adequate knowledge and training and on appropriate setting of efficient and working machines. Lacking these premises, overshadowing or misleading artefacts may impair the usefulness of TUS as an imaging procedure. PMID:27847557

  12. Nuclear Weapon Accident Response Procedures (NARP) Manual

    DTIC Science & Technology

    1990-09-01

    SUMMARY OF SPECIALIZED CAPABILITIES 20-1 G eneral ............................................................................. 20-1 20-2 Purpose...and Analysis Form ............................... 5-E-17 5-E-7 Weapons Accident Environmental Radiation Alpha Probe Data Form ................. 5-E-19...Emergency Preparedness Responsibilities, 13 Nov 88. (j) JCS Publication 1-03.6, Joint Reporting Structure Event/Incident Report , Nov 80. (k) TP 20-11

  13. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Procedures. 26.127 Section 26.127 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.127 Procedures. (a) Licensee testing facilities shall develop, implement, and maintain clear and well-documented procedures...

  14. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Procedures. 26.127 Section 26.127 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.127 Procedures. (a) Licensee testing facilities shall develop, implement, and maintain clear and well-documented procedures...

  15. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Procedures. 26.127 Section 26.127 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.127 Procedures. (a) Licensee testing facilities shall develop, implement, and maintain clear and well-documented procedures...

  16. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Procedures. 26.127 Section 26.127 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.127 Procedures. (a) Licensee testing facilities shall develop, implement, and maintain clear and well-documented procedures...

  17. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Procedures. 26.127 Section 26.127 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.127 Procedures. (a) Licensee testing facilities shall develop, implement, and maintain clear and well-documented procedures...

  18. 10 CFR 2.1304 - Hearing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Hearing procedures. 2.1304 Section 2.1304 Energy NUCLEAR... for Hearings on License Transfer Applications § 2.1304 Hearing procedures. The procedures in this subpart will constitute the exclusive basis for hearings on license transfer applications for all...

  19. 10 CFR 26.157 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... of standard operating procedures for each assay performed for licensees and other entities for drug... 10 Energy 1 2013-01-01 2013-01-01 false Procedures. 26.157 Section 26.157 Energy NUCLEAR... Services § 26.157 Procedures. (a) HHS-certified laboratories shall develop, implement, and maintain...

  20. 10 CFR 26.157 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... of standard operating procedures for each assay performed for licensees and other entities for drug... 10 Energy 1 2012-01-01 2012-01-01 false Procedures. 26.157 Section 26.157 Energy NUCLEAR... Services § 26.157 Procedures. (a) HHS-certified laboratories shall develop, implement, and maintain...

  1. 10 CFR 26.157 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... of standard operating procedures for each assay performed for licensees and other entities for drug... 10 Energy 1 2014-01-01 2014-01-01 false Procedures. 26.157 Section 26.157 Energy NUCLEAR... Services § 26.157 Procedures. (a) HHS-certified laboratories shall develop, implement, and maintain...

  2. The prevalence and management of angina among patients with chronic coronary artery disease across US outpatient cardiology practices: insights from the Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR) study.

    PubMed

    Kureshi, Faraz; Shafiq, Ali; Arnold, Suzanne V; Gosch, Kensey; Breeding, Tracie; Kumar, Ashwath S; Jones, Philip G; Spertus, John A

    2017-01-01

    Although eliminating angina is a primary goal in treating patients with chronic coronary artery disease (CAD), few contemporary data quantify prevalence and severity of angina across US cardiology practices. The authors hypothesized that angina among outpatients with CAD managed by US cardiologists is low and its prevalence varies by site. Among 25 US outpatient cardiology clinics enrolled in the American College of Cardiology Practice Innovation and Clinical Excellence (PINNACLE) registry, we prospectively recruited a consecutive sample of patients with chronic CAD over a 1- to 2-week period at each site between April 2013 and July 2015, irrespective of the reason for their appointment. Eligible patients had documented history of CAD (prior acute coronary syndrome, prior coronary revascularization procedure, or diagnosis of stable angina) and ≥1 prior office visit at the practice site. Angina was assessed directly from patients using the Seattle Angina Questionnaire Angina Frequency score. Among 1257 patients from 25 sites, 7.6% (n = 96) reported daily/weekly, 25.1% (n = 315) monthly, and 67.3% (n = 846) no angina. The proportion of patients with daily/weekly angina at each site ranged from 2.0% to 24.0%, but just over half (56.3%) were on ≥2 antianginal medications, with wide variability across sites (0%-100%). One-third of outpatients with chronic CAD managed by cardiologists report having angina in the prior month, and 7.6% have frequent symptoms. Among those with frequent angina, just over half were on ≥2 antianginal medications, with wide variability across sites. These findings suggest an opportunity to improve symptom control.

  3. Improving VTE risk assessment at point of admission to a tertiary centre cardiology ward.

    PubMed

    Wilson, Rachel

    2015-01-01

    Cardiology wards are generally high turnover units, which may receive primary PCI, high-risk NSTEMI patients, and other general cardiac admissions from a large geographical area. Many centres also provide national specialist services for rarer cardiac conditions for which admissions may be lengthy. Cardiac patients have significant risk factors for venous thromboembolism (VTE) as immobility may be due to systolic dysfunction, attachment to continuous monitoring and predisposition to chest pain, or cardiac syncope. It is recommended by NICE that an initial VTE risk assessment is undertaken at the time of patient admission, with reassessment within 24 hours. For this purpose a risk assessment tool is featured on the front of many Trust drug charts. It is noted that this risk assessment is electronic in other trusts. We undertook an audit into the drug chart documentation of VTE risk assessment on the cardiology ward and the Coronary Care Unit (CCU) at The Royal Free Hospital. It was evident that documentation of VTE risk assessment was poor. The audit interventions were; a teaching presentation to the cardiology department, an educational poster, several update emails to the department and the identification of a 'VTE risk assessment champion' to audit ongoing compliance. Following these measures the second audit round demonstrated that documentation of initial risk assessment was slightly improved, but significant improvement was seen in documentation of risk assessment at 24 hours post admission. Results from a third audit cycle indicated that the improvement in initial VTE risk assessment was sustained, and that there was a significant sustained improvement in risk assessment at 24 hours (p <0.05). Recommendations for sustained improvement included: redesigning the drug chart so that the VTE risk assessment tool was linked to the VTE prophylaxis prescription box, and designating the responsibility of the initial VTE risk assessment to the on call junior doctor who

  4. Improving VTE risk assessment at point of admission to a tertiary centre cardiology ward

    PubMed Central

    Wilson, Rachel

    2015-01-01

    Cardiology wards are generally high turnover units, which may receive primary PCI, high-risk NSTEMI patients, and other general cardiac admissions from a large geographical area. Many centres also provide national specialist services for rarer cardiac conditions for which admissions may be lengthy. Cardiac patients have significant risk factors for venous thromboembolism (VTE) as immobility may be due to systolic dysfunction, attachment to continuous monitoring and predisposition to chest pain, or cardiac syncope. It is recommended by NICE that an initial VTE risk assessment is undertaken at the time of patient admission, with reassessment within 24 hours. For this purpose a risk assessment tool is featured on the front of many Trust drug charts. It is noted that this risk assessment is electronic in other trusts. We undertook an audit into the drug chart documentation of VTE risk assessment on the cardiology ward and the Coronary Care Unit (CCU) at The Royal Free Hospital. It was evident that documentation of VTE risk assessment was poor. The audit interventions were; a teaching presentation to the cardiology department, an educational poster, several update emails to the department and the identification of a ‘VTE risk assessment champion’ to audit ongoing compliance. Following these measures the second audit round demonstrated that documentation of initial risk assessment was slightly improved, but significant improvement was seen in documentation of risk assessment at 24 hours post admission. Results from a third audit cycle indicated that the improvement in initial VTE risk assessment was sustained, and that there was a significant sustained improvement in risk assessment at 24 hours (p <0.05). Recommendations for sustained improvement included: redesigning the drug chart so that the VTE risk assessment tool was linked to the VTE prophylaxis prescription box, and designating the responsibility of the initial VTE risk assessment to the on call junior doctor

  5. Early cardiology assessment and intervention reduces mortality following myocardial injury after non-cardiac surgery (MINS)

    PubMed Central

    Hua, Alina; Pattenden, Holly; Leung, Maria; Davies, Simon; George, David A.; Raubenheimer, Hilgardt; Niwaz, Zakiyah

    2016-01-01

    Background Myocardial injury after non-cardiac surgery (MINS) is defined as troponin elevation of ≥0.03 ng/mL associated with 3.87-fold increase in early mortality. We sought to determine the impact of cardiology intervention on mortality in patients who developed MINS after general thoracic surgery. Methods A retrospective review was performed in patients over 5 years. Troponin was routinely measured and levels ≥0.04 ng/mL classified as positive. Data acquisition and mortality status was obtained via medical records and NHS tracing systems. Thirty-day mortality was compared on MINS cohort using Fisher’s exact square testing and logistic regression analysis. Results Troponin levels were measured in 491 (96%) of 511 patients. Eighty (16%) patients fulfilled the MINS criteria. Sixty-one (76%) received early cardiology consult and “myocardial infarction” stated in four (5%) patients. Risk assessment (for AMI) was undertaken; 20 (25%) patients were commenced on aspirin, four (5%) on β-blockers and one (1%) underwent percutaneous coronary intervention. Forty-nine (61%) patients received primary risk factor modifications and 26 (33%) had outpatient follow-up. There were no significant differences in the proportion of patients who died within 30 days post-operatively in the MINS group of 2.6% compared to the non-MINS group of 1.6% (P=0.625). The odds ratio for 30-day mortality in the MINS group was 1.69 (95% CI: 0.34 to 8.57, P=0.522). Conclusions MINS is common after general thoracic surgery. Early cardiology intervention reduced the expected hazard ratio of early death from 3.87 to an odds ratio of 1.69 with no significant difference in 30-day mortality for patients who developed MINS. PMID:27162667

  6. The role of psychology in a pediatric outpatient cardiology setting: preliminary results from a new clinical program.

    PubMed

    Brosig, Cheryl; Yang, Kai; Hoffmann, Raymond G; Dasgupta, Mahua; Mussatto, Kathleen

    2014-12-01

    The aim of this study was to provide a descriptive analysis of a new clinical program integrating psychology services within a pediatric outpatient cardiology clinic. Patients with congenital heart disease (CHD) (n = 79) were referred for psychological services by their pediatric cardiologist. Parents completed the child behavior checklist, and the pediatric quality of life inventory generic core scales (PedsQL parent report). Teachers completed the teacher report form. Reasons for referral included: emotional problems (29%); attention problems (25%); learning problems (22%); behavior problems (16%); and developmental delay (8%). Parents and teachers reported higher rates of behavior problems and lower quality of life scores than the general population. Psychological evaluation suggested that incorporating a psychologist within a pediatric cardiology clinic may be beneficial for children with CHD in order to optimize their psychosocial functioning. Practice implications for implementing psychology services within a pediatric outpatient cardiology program are discussed.

  7. Biomarkers in Cardiology – Part 1 – In Heart Failure and Specific Cardiomyopathies

    PubMed Central

    2014-01-01

    Cardiovascular diseases are the leading causes of mortality and morbidity in Brazil. The primary and secondary preventions of those diseases are a priority for the health system and require multiple approaches to increase their effectiveness. Biomarkers are tools used to more accurately identify high-risk individuals, to speed the diagnosis, and to aid in treatment and prognosis determination. This review aims to highlight the importance of biomarkers in clinical cardiology practice, and to raise relevant points of their use and the promises for the coming years. This document was divided into two parts, and this first one discusses the use of biomarkers in specific cardiomyopathies and heart failure. PMID:25590924

  8. [Neuro-cardiology or cardio-neurology - a new specialization of the future?].

    PubMed

    Widimský, Petr; Štětkářová, Ivana

    2015-05-01

    Acute ischemic stroke is a catastrophic cardiovascular disease with frequent cardiac causes and cerebral consequences, thus the close cooperation between neurologists and cardiologists is necessary for the optimal patient management. Furthermore, recent randomized trials demonstrated, that catheter-based thrombectomy (CBT) is the most effective treatment for properly selected patients. Interventional cardiology with its widespread non-stop services for acute myocardial infarction can fill the existing gaps in coverage of population needs with neurointerventional services. Thus, a new future medical subspecialization may emerge: neurocardiology or cardioneurology.

  9. Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals.

    PubMed

    Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

    2012-06-01

    Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed.

  10. Conflict of interest policies and disclosure requirements among European Society of Cardiology national cardiovascular journals.

    PubMed

    Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

    2012-01-01

    Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee the credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed.

  11. [Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals].

    PubMed

    Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

    2012-04-01

    Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed.

  12. Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals.

    PubMed

    Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

    2012-05-01

    Disclosure of potential conflicts of interest is used by biomedical journals to guarantee credibility and transparency of the scientific process. Conflict of interest disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for conflicts of interest disclosure. This paper provides a comprehensive editorial perspective on classical conflict of interest-related issues. New insights into current conflicts of interest policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed.

  13. Ontologies of drug discovery and design for neurology, cardiology and oncology.

    PubMed

    Vázquez-Naya, José M; Martínez-Romero, Marcos; Porto-Pazos, Ana B; Novoa, Francisco; Valladares-Ayerbes, Manuel; Pereira, Javier; Munteanu, Cristian R; Dorado, Julián

    2010-01-01

    The complex diseases in the field of Neurology, Cardiology and Oncology have the most important impact on our society. The theoretical methods are fast and they involve some efficient tools aimed at discovering new active drugs specially designed for these diseases. The ontology of all the items that are linked with the molecule metabolism and the treatment of these diseases gives us the possibility to correlate information from different levels and to discover new relationships between complex diseases such as common drug targets and disease patterns. This review presents the ontologies used to process drug discovery and design in the most common complex diseases.

  14. Patient selection for transcatheter aortic valve implantation: An interventional cardiology perspective.

    PubMed

    Mylotte, Darrren; Martucci, Giuseppe; Piazza, Nicolo

    2012-07-01

    Transcatheter aortic valve implantation (TAVI) has emerged as a highly effective minimally invasive treatment symptomatic for severe calcific aortic stenosis in patients at high or prohibitive surgical risk. The success of TAVI has been determined by a number of factors, but in particular by appropriate patient selection. Appropriate patient selection involves identifying patients with the potential to benefit most from TAVI and individualizing the bioprosthesis type and size, and the vascular access site for each case. We present herein, our critical appraisal on patient selection for TAVI: an interventional cardiology perspective.

  15. Biomarkers in Cardiology - Part 2: In Coronary Heart Disease, Valve Disease and Special Situations

    PubMed Central

    2015-01-01

    Cardiovascular diseases are the main causes of mortality and morbidity in Brazil. Their primary and secondary preventions are a priority for the health system and require multiple approaches for increased effectiveness. Biomarkers are tools used to identify with greater accuracy high-risk individuals, establish a faster diagnosis, guide treatment, and determine prognosis. This review aims to highlight the importance of biomarkers in clinical cardiology practice and raise relevant points regarding their application and perspectives for the next few years. This document was divided into two parts. This second part addresses the application of biomarkers in coronary heart disease, valvular diseases, cardio-oncology, pulmonary embolism, and cardiorenal syndrome. PMID:26083777

  16. [On hi-tech cardiologic care model in medical support of train operation safety].

    PubMed

    Pfaf, V F; Gorokhova, S G; Kotenko, V A

    2015-01-01

    The article covers hi-tech cardiologic care model in system of medical support of train operation safety, with definition of structure blocks in this model. Discussion covers peculiarities of the model functioning in comparison with the governmental system of hi-tech medical care, including its closed cycle principle characteristics, wide patients selection among railway workers, continuous and close cooperation between various medical speicalities, with active involvement of occupational fitness specialists (medical examination committees of various levels, including Central Medical Examination Committee), major extent of interventional rentgenosurgical technologies applied in diseases without significant functional failure.

  17. The radiology informed consent form: recommendations from the European Society of Cardiology position paper.

    PubMed

    Carpeggiani, Clara; Picano, Eugenio

    2016-06-01

    Every radiological and nuclear medicine examination confers a definite long-term risk of cancer, but most patients undergoing such examinations receive no or inaccurate information about radiation dose and corresponding risk related to the dose received. Informed consent is a procedure to support (not substitute) the physician/patient dialogue and relationship, facilitating a free, informed and aware expression of the patient's will in the principle of patient autonomy. Physicians are responsible for providing patients with all the information on risks, benefits and alternatives useful to the patient to make the decision. In current radiological practice the information on the radiation dose and long-term cancer risks is difficult to find and not easy to understand. The form using plain language should spell-out the type of examination, the effective dose (mSv), the effective dose expressed in number of chest radiographs and the risk of cancer. The current practice clashes against the guidelines and the law.

  18. Model Action Plan for Nuclear Forensics and Nuclear Attribution

    SciTech Connect

    Dudder, G B; Niemeyer, S; Smith, D K; Kristo, M J

    2004-03-01

    Nuclear forensics and nuclear attribution have become increasingly important tools in the fight against illegal trafficking in nuclear and radiological materials. This technical report documents the field of nuclear forensics and nuclear attribution in a comprehensive manner, summarizing tools and procedures that have heretofore been described independently in the scientific literature. This report also provides national policy-makers, decision-makers, and technical managers with guidance for responding to incidents involving the interdiction of nuclear and radiological materials. However, due to the significant capital costs of the equipment and the specialized expertise of the personnel, work in the field of nuclear forensics has been restricted so far to a handful of national and international laboratories. In fact, there are a limited number of specialists who have experience working with interdicted nuclear materials and affiliated evidence. Most of the laboratories that have the requisite equipment, personnel, and experience to perform nuclear forensic analysis are participants in the Nuclear Smuggling International Technical Working Group or ITWG (see Section 1.8). Consequently, there is a need to disseminate information on an appropriate response to incidents of nuclear smuggling, including a comprehensive approach to gathering evidence that meets appropriate legal standards and to developing insights into the source and routes of nuclear and radiological contraband. Appendix A presents a ''Menu of Options'' for other Member States to request assistance from the ITWG Nuclear Forensics Laboratories (INFL) on nuclear forensic cases.

  19. Nuclear Medicine.

    ERIC Educational Resources Information Center

    Badawi, Ramsey D.

    2001-01-01

    Describes the use of nuclear medicine techniques in diagnosis and therapy. Describes instrumentation in diagnostic nuclear medicine and predicts future trends in nuclear medicine imaging technology. (Author/MM)

  20. Collected radiochemical and geochemical procedures

    SciTech Connect

    Kleinberg, J

    1990-05-01

    This revision of LA-1721, 4th Ed., Collected Radiochemical Procedures, reflects the activities of two groups in the Isotope and Nuclear Chemistry Division of the Los Alamos National Laboratory: INC-11, Nuclear and radiochemistry; and INC-7, Isotope Geochemistry. The procedures fall into five categories: I. Separation of Radionuclides from Uranium, Fission-Product Solutions, and Nuclear Debris; II. Separation of Products from Irradiated Targets; III. Preparation of Samples for Mass Spectrometric Analysis; IV. Dissolution Procedures; and V. Geochemical Procedures. With one exception, the first category of procedures is ordered by the positions of the elements in the Periodic Table, with separate parts on the Representative Elements (the A groups); the d-Transition Elements (the B groups and the Transition Triads); and the Lanthanides (Rare Earths) and Actinides (the 4f- and 5f-Transition Elements). The members of Group IIIB-- scandium, yttrium, and lanthanum--are included with the lanthanides, elements they resemble closely in chemistry and with which they occur in nature. The procedures dealing with the isolation of products from irradiated targets are arranged by target element.

  1. Understanding appropriate use criteria in nuclear medicine.

    PubMed

    Farrell, Mary Beth; Cerqueira, Manuel D

    2012-06-01

    There has been a significant increase in cardiac radionuclide imaging over the past decade, leading to a corresponding increase in scrutiny from Federal and private health plans questioning the necessity of these tests. In response to efforts by third-party payers to limit all types of cardiovascular imaging studies, the American College of Cardiology Foundation, in conjunction with other professional societies, developed appropriate use criteria. The goal of this article is to explain how the criteria were created and define the 3 categories of indications: appropriate, inappropriate, and uncertain. Tips for using appropriate use criteria and tables, including a definition of several key terms technologists should be familiar with, will be provided. In addition, reimbursement, benchmark data, and practical considerations for implementation will be discussed. Finally, several tools to aid in calculating appropriateness are suggested. With a basic understanding, the appropriate use criteria are relatively easy to apply. It is important for facilities to begin to voluntarily incorporate them into their practice and document levels of appropriateness now as payers are developing 2 trends that are not favorable for nuclear cardiology: preauthorization and denial of payment for inappropriate studies.

  2. Assessing causes of death in the Cardiology Department of Yalgado Ouédraogo University Hospital

    PubMed Central

    Yameogo, Aristide Relwende; Mandi, Germain; Millogo, Georges; Samadoulougou, Andre; Zabsonre, Patrice

    2014-01-01

    Introduction Analysis of the underlying causes of death can develop action plans for prevention of death that could be avoided. The aim of our study was to analyse the causes of cardiovascular deaths in the cardiology department of Yalgado Ouedraogo University Hospital. Methods The study was a descriptive retrospective study over a 24 month period among patients who died in the department. Results Prevalence of death in the cardiology department was of 13.2%. Sex ratio was of 1.2 and 72.7% of patients were residing in Ouagadougou. Mean age of patients was 56.1 years and 59.4% of patients were under 65 years old. Hypertension was the major cardiovascular risk factor (46.1%) and 27.4% of patients had a medical history of dilated cardiomyopathy. Cardiogenic shock was the immediate cause of death in 55.5% of cases and the initial cause of death was hypertension and its complications in 46.1% of cases. Death was not notified in 18% of cases and no death had been medically certified. Conclusion Death statistics are the most reliable data for public health interventions. However, it is necessary to establish an effective method of data gathering according to the WHO standards in order to facilitate international comparison. PMID:25767673

  3. Bionic cardiology: exploration into a wealth of controllable body parts in the cardiovascular system.

    PubMed

    Sugimachi, Masaru; Sunagawa, Kenji

    2009-01-01

    Bionic cardiology is the medical science of exploring electronic control of the body, usually via the neural system. Mimicking or modifying biological regulation is a strategy used to combat diseases. Control of ventricular rate during atrial fibrillation by selective vagal stimulation, suppression of ischemia-related ventricular fibrillation by vagal stimulation, and reproduction of neurally commanded heart rate are some examples of bionic treatment for arrhythmia. Implantable radio-frequency-coupled on-demand carotid sinus stimulators succeeded in interrupting or preventing anginal attacks but were replaced later by coronary revascularization. Similar but fixed-intensity carotid sinus stimulators were used for hypertension but were also replaced by drugs. Recently, however, a self-powered implantable device has been reappraised for the treatment of drug-resistant hypertension. Closed-loop spinal cord stimulation has successfully treated severe orthostatic hypotension in a limited number of patients. Vagal nerve stimulation is effective in treating heart failure in animals, and a small-size clinical trial has just started. Simultaneous corrections of multiple hemodynamic abnormalities in an acute decompensated state are accomplished simply by quantifying fundamental cardiovascular parameters and controlling these parameters. Bionic cardiology will continue to promote the development of more sophisticated device-based therapies for otherwise untreatable diseases and will inspire more intricate applications in the twenty-first century.

  4. Paediatric interventional cardiology: flat detector versus image intensifier using a test object

    NASA Astrophysics Data System (ADS)

    Vano, E.; Ubeda, C.; Martinez, L. C.; Leyton, F.; Miranda, P.

    2010-12-01

    Entrance surface air kerma (ESAK) values and image quality parameters were measured and compared for two biplane angiography x-ray systems dedicated to paediatric interventional cardiology, one equipped with image intensifiers (II) and the other one with dynamic flat detectors (FDs). Polymethyl methacrylate phantoms of different thicknesses, ranging from 8 to 16 cm, and a Leeds TOR 18-FG test object were used. The parameters of the image quality evaluated were noise, signal-difference-to-noise ratio (SdNR), high contrast spatial resolution (HCSR) and three figures of merit combining entrance doses and signal-to-noise ratios or HCSR. The comparisons showed a better behaviour of the II-based system in the low contrast region over the whole interval of thicknesses. The FD-based system showed a better performance in HCSR. The FD system evaluated would need around two times more dose than the II system evaluated to reach a given value of SdNR; moreover, a better spatial resolution was measured (and perceived in conventional monitors) for the system equipped with flat detectors. According to the results of this paper, the use of dynamic FD systems does not lead to an automatic reduction in ESAK or to an automatic improvement in image quality by comparison with II systems. Any improvement also depends on the setting of the x-ray systems and it should still be possible to refine these settings for some of the dynamic FDs used in paediatric cardiology.

  5. Dosemeter readings and effective dose to the cardiologist with protective clothing in a simulated interventional procedure.

    PubMed

    Schultz, F W; Zoetelief, J

    2008-01-01

    A personal dosemeter issued for individual monitoring is calibrated in terms of personal dose equivalent, usually H(P)(10). In general it yields a reasonable estimate of effective dose (E) when the exposed person does not wear protective clothing. In interventional cardiology, however, a lead equivalent apron is worn and often a thyroid collar. A correction factor will then be necessary to convert a dosemeter reading to E. To explore this factor an interventional cardiology procedure is simulated based on exposure conditions typical for a modern hospital in the BENELUX area. The dose to the cardiologist is investigated using Monte Carlo simulation of radiation transport. It is concluded that a personal dosemeter may best be worn outside the apron at a central position high on the chest for least dependence on the beam direction. It will overestimate E by roughly a factor of 20 (apron and thyroid collar of 0.25 mm Pb).

  6. Dental Procedures.

    PubMed

    Ramponi, Denise R

    2016-01-01

    Dental problems are a common complaint in emergency departments in the United States. There are a wide variety of dental issues addressed in emergency department visits such as dental caries, loose teeth, dental trauma, gingival infections, and dry socket syndrome. Review of the most common dental blocks and dental procedures will allow the practitioner the opportunity to make the patient more comfortable and reduce the amount of analgesia the patient will need upon discharge. Familiarity with the dental equipment, tooth, and mouth anatomy will help prepare the practitioner for to perform these dental procedures.

  7. Specified assurance level sampling procedure

    SciTech Connect

    Willner, O.

    1980-11-01

    In the nuclear industry design specifications for certain quality characteristics require that the final product be inspected by a sampling plan which can demonstrate product conformance to stated assurance levels. The Specified Assurance Level (SAL) Sampling Procedure has been developed to permit the direct selection of attribute sampling plans which can meet commonly used assurance levels. The SAL procedure contains sampling plans which yield the minimum sample size at stated assurance levels. The SAL procedure also provides sampling plans with acceptance numbers ranging from 0 to 10, thus, making available to the user a wide choice of plans all designed to comply with a stated assurance level.

  8. [Cardiology for the veterinary practice--information processing with the help of a computer program, with a working example].

    PubMed

    Bohn, F K; Emmerichs, H; Müller, H

    1991-06-01

    Description of a PC-Program "Cardiology for the Veterinary Practice", title "Kardiag", with Illustrations and a report of a congenital heart disease in a one year old, male, Newfoundland dog, with the use of the described PC-Program. After euthanasia an autopsy was performed which verified the clinical diagnosis.

  9. Effectiveness of current teaching methods in Cardiology: the SKILLS (medical Students Knowledge Integration of Lower Level clinical Skills) study

    PubMed Central

    Lavranos, G; Koliaki, C; Briasoulis, A; Nikolaou, A; Stefanadis, C

    2013-01-01

    Introduction: The aim of the study is to assess reported changes in medical students’ capacity to attain five basic cardiological clinical skills, following a one-month intensive cardiology course provisioned in the core curriculum. Materials and Methods: An anonymous questionnaire comprising self reported performance in the five skills, namely 1) arterial blood pressure measurement, 2) cardiac auscultation, 3) electrocardiogram (ECG) carry out, 4) ECG interpretation and 5) defibrillation, was distributed to 177 fifth year students of the Athens Medical School upon initiating the cardiology course (pre-training group) and to 59 students matched for sex, age, year of study and training centre, following completion of the course (post training group). Comparison of pre- and post- training performance was evaluated using the χ2 test. Results: No change was noted with regards to blood pressure measurement, cardiac auscultation or defibrillation. By contrast, a statistically significant improvement was reported for ECG execution (54.3 versus 81.4%; p<0.001) and interpretation (from 33.1 to 89.8%; p<0.001). Conclusions: Improvement in the execution and interpretation of ECGs seems to be among the strengths of the cardiology training program. Further studies including larger samples from multiple medical schools and objective assessment of skill execution might facilitate accurate training evaluation and define opportunities for improvement. PMID:23935341

  10. Reptile cardiology.

    PubMed

    Mitchell, Mark A

    2009-01-01

    Cardiovascular disease in reptiles generally is considered an uncommon finding in captive animals, but no large-scale, cross-sectional studies have been performed to determine its prevalence. It is possible that cardiovascular disease is more common than is generally accepted and that the current belief results from limited clinical and diagnostic experience. This article offers guidance drawn from the author's clinical experience and the available literature. It is important that veterinarians pursue a thorough history, physical examination, and diagnostic work-up when managing cardiovascular disease in a reptile case. Veterinarians working with these cases should document their findings and share them with their colleagues to build an evidence-based foundation for reptile medicine.

  11. Camelid cardiology.

    PubMed

    Margiocco, Marco L; Scansen, Brian A; Bonagura, John D

    2009-07-01

    Cardiovascular disorders, although not thoroughly described in the literature, are frequently diagnosed in South American camelids, causing morbidity, mortality, and loss of production. Definitive confirmation concerning the heritability of cardiac defects in these species is lacking; however, this potential exists and should be taken into account when counseling breeders and owners. This article describes the diagnosis and treatment of cardiovascular diseases in llamas and alpacas and reviews the most recent literature. Unique aspects of the cardiovascular physiology in these species are also reviewed.

  12. Ferret cardiology.

    PubMed

    Wagner, Robert A

    2009-01-01

    Cardiac disease in pet ferrets is common and includes dilated cardiomyopathy, arrhythmias, and acquired valvular disease. Clinical presentation of cardiac disease in ferrets may be similar to dog or cats, although hind limb weakness may be a prominent feature. Radiography, ECG, and ultrasound are all useful tools in the diagnosis of cardiac disease in ferrets. Therapeutics for cardiac disease in ferrets is based on recommendations for dogs and cats. The prognosis for cardiac disease in ferrets varies from fair to guarded, depending on underlying disease.

  13. Sports and exercise cardiology in the United States: cardiovascular specialists as members of the athlete healthcare team.

    PubMed

    Lawless, Christine E; Olshansky, Brian; Washington, Reginald L; Baggish, Aaron L; Daniels, Curt J; Lawrence, Silvana M; Sullivan, Renee M; Kovacs, Richard J; Bove, Alfred A

    2014-04-22

    In recent years, athletic participation has more than doubled in all major demographic groups, while simultaneously, children and adults with established heart disease desire participation in sports and exercise. Despite conferring favorable long-term effects on well-being and survival, exercise can be associated with risk of adverse events in the short term. Complex individual cardiovascular (CV) demands and adaptations imposed by exercise present distinct challenges to the cardiologist asked to evaluate athletes. Here, we describe the evolution of sports and exercise cardiology as a unique discipline within the continuum of CV specialties, provide the rationale for tailoring of CV care to athletes and exercising individuals, define the role of the CV specialist within the athlete care team, and lay the foundation for the development of Sports and Exercise Cardiology in the United States. In 2011, the American College of Cardiology launched the Section of Sports and Exercise Cardiology. Membership has grown from 150 to over 4,000 members in just 2 short years, indicating marked interest from the CV community to advance the integration of sports and exercise cardiology into mainstream CV care. Although the current athlete CV care model has distinct limitations, here, we have outlined a new paradigm of care for the American athlete and exercising individual. By practicing and promoting this new paradigm, we believe we will enhance the CV care of athletes of all ages, and serve the greater athletic community and our nation as a whole, by allowing safest participation in sports and physical activity for all individuals who seek this lifestyle.

  14. Is endocarditis prophylaxis for dental procedures necessary?

    PubMed Central

    Taubert, Kathryn A; Wilson, Walter

    2017-01-01

    Objectives Our purpose is to address whether antimicrobial prophylaxis is necessary before certain dental procedures for patients at increased risk for acquiring infective endocarditis (IE). Methods We reviewed recommendations for IE prophylaxis made by the American Heart Association (AHA) from 1995 to the present time. We also compared and contrasted the current recommendations from the AHA, European Society of Cardiology (ESC), United Kingdom’s National Institute for Health and Care Excellence (NICE) and a consortium of French organisations. We further reviewed recent papers that have observed the incidence of IE since these current recommendations were published. Results Beginning in the 1990s, questions were raised about the advisability of using antimicrobial prophylaxis before certain dental procedures to prevent IE. Various groups in Europe and the US were increasingly aware that there were not any clinical trials showing the effectiveness, or lack thereof, of such prophylaxis. In the early to mid-2000s, the AHA, ESC and French consortium published guidelines recommending restriction of prophylaxis before dental procedures to patients with highest risk for developing IE and/or the highest risk for an adverse outcome from IE. The NICE guidelines eliminated recommendations for prophylaxis before dental procedures. Studies published after these changes were instituted have generally shown that the incidence of IE has not changed, although two recent reports have observed some increased incidence (but not necessarily related to an antecedent dental procedure). Conclusion A multi-national randomised controlled clinical trial that would include individuals from both developed and developing countries around the world is needed to ultimately define whether there is a role for antibiotic prophylaxis administered before certain dental procedures to prevent IE. PMID:28321267

  15. Complementary and alternative medicine: a survey of its use in pediatric cardiology

    PubMed Central

    Adams, Denise; Whidden, Ashley; Honkanen, Meeri; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W. James

    2014-01-01

    Background The use of complementary and alternative medicine is high among children and youth with chronic illnesses, including patients with cardiac conditions. Our goal was to assess the prevalence and patterns of such use among patients presenting to academic pediatric cardiology clinics in Canada. Methods A survey instrument was developed to inquire about current or previous use of complementary and alternative medicine products and practices, including indications, beliefs, sources of information and whether this use was discussed with physicians. Between February and July 2007, the survey was administered to patients (or their parents/guardians) presenting to 2 hospital-based cardiology clinics: the Stollery Children’s Hospital in Edmonton, Alberta, and the Children’s Hospital of Eastern Ontario in Ottawa, Ontario. Results At the Stollery Children’s Hospital, 64.1% of the 145 respondents had used complementary and alternative medicine compared with 35.5% of the 31 respondents at the Children’s Hospital of Eastern Ontario (p = 0.003). Overall, the most common products in current use were multivitamins (70.6%), vitamin C (22.1%), calcium (13.2%), unspecified “cold remedies” (11.8%) and fish oil or omega-3 fatty acids (11.8%). The most common practices in current use were massage (37.5%), faith healing (25.0%), chiropractic (20.0%), aromatherapy (15.0%) and Aboriginal healing (7.5%). Many patients (44.9%) used complementary and alternative medicine products at the same time as conventional prescription drugs. Concurrent use was discussed with physicians or pharmacists by 64.3% and 31.3% of respondents, respectively. Interpretation Use of complementary and alternative medicine products and practices was high among patients seen in the pediatric cardiology clinics in our study. Most respondents believed that the use of these products and practices was helpful; few reported harms and many did not discuss this use with their physicians, increasing the

  16. Evaluation of neurological and cardiological findings in carbonmonoxide poisoning in children

    PubMed Central

    Boztepe, Hatice; Yalaki, Zahide; Bilge, Yıldız Dallar

    2014-01-01

    Aim: The aim of our study was to investigate the relation of blood carboxyhemoglobin level with presentation finding and clinical properties and to demonstrate neurological and cardiological findings which are indicators of tissue hypoxia in patients followed up because of carbonmonoxide (CO) poisoning. Material and Methods: Three hundred and twenty-five patients who were followed up because of carbonmonoxide poisoning between 2011 and 2013 in our pediatric emergency department were evaluated prospectively. Ethics committee approval was obtained for the study on 10.19.2011 (number: 0437). The carbonmonoxide levels, source of intoxication, neurological and cardiological findings and treatment methods were recorded. Blood gases and cardiac enzymes were studied and electrocardiography (ECG) was performed. The data were analysed using SPSS for windows 16.0 package program. Results: One hundred and sixty-eight (51.7%) of the patients were female and the median age was 9 years (11 days–17 years). Two hundred and twenty-eight (70.2%) of the patients were poisoned while using heater and 78.1% presented during winter months. The median carbonmonoxide level of the patients was found to be 24.8%. Cardiac enzymes were found to be increased in 10.5% of the patients, first degree A-V block was found in 0.6% and negative T wave was found in 0.3%. Glasgow coma score was found to be below 14 in 4.6% of the patients. A significant correlation was found between the carboxyhemoglobin levels and neurological findings, cardiological findings and lactate (p<0.05). Normobaric oxygen treatment was given to 76.3% of the patients and hyperbaric oxygen treatment was given to 23.7%. Conclusions: We think that neurological disorders and cardiac findings may be closely related, since systemic involvement may be easier in carbonmonoxide poisoning in children, Glasgow coma score should be assessed in the follow-up of the patients and cardiac enzymes and serum lactate levels should be monitored

  17. [Return to work of the cardiac patient: work fitness evaluation in Occupational Medicine Division including an Occupational Cardiology Unit and Work-Physiology Lab in Bergamo].

    PubMed

    Borleri, D; Seghizzi, P; Manfredini, F; Mosconi, G

    2012-01-01

    Cardiovascular disease in working age still represent a major cause of morbidity and account for a number of fitness to work certificates expressing several limitations and prescriptions. To present the medical assessment conducted in an Occupational Medicine Division including an Occupational Cardiology Unit and work-physiology lab. It is described the history and the structure of the Occupational Cardiology Unit. Our almost forty years long-lasting experience allow us to point out the precious contribution of the Occupational Cardiology Unit to the Occupational Medicine Division, due to a highly specialised and qualified assessment of cardiac patients.

  18. Evaluated Nuclear Data

    SciTech Connect

    Oblozinsky, P.; Oblozinsky,P.; Herman,M.; Mughabghab,S.F.

    2010-10-01

    This chapter describes the current status of evaluated nuclear data for nuclear technology applications. We start with evaluation procedures for neutron-induced reactions focusing on incident energies from the thermal energy up to 20 MeV, though higher energies are also mentioned. This is followed by examining the status of evaluated neutron data for actinides that play dominant role in most of the applications, followed by coolants/moderators, structural materials and fission products. We then discuss neutron covariance data that characterize uncertainties and correlations. We explain how modern nuclear evaluated data libraries are validated against an extensive set of integral benchmark experiments. Afterwards, we briefly examine other data of importance for nuclear technology, including fission yields, thermal neutron scattering and decay data. A description of three major evaluated nuclear data libraries is provided, including the latest version of the US library ENDF/B-VII.0, European JEFF-3.1 and Japanese JENDL-3.3. A brief introduction is made to current web retrieval systems that allow easy access to a vast amount of up-to-date evaluated nuclear data for nuclear technology applications.

  19. A modular informatics platform for effective support of collaborative and multicenter studies in cardiology.

    PubMed

    Marinelli, Martina; Positano, Vincenzo; Lorenzoni, Valentina; Caselli, Chiara; Mangione, Maurizio; Marcheschi, Paolo; Puzzuoli, Stefano; Esposito, Natalia; L'Abbate, Giuseppe Andrea; Neglia, Danilo

    2016-12-01

    Collaborative and multicenter studies permit a large number of patients to be enrolled within a reasonable time and providing the opportunity to collect different data. Informatics platforms play an important role in management, storage, and exchange of data between the participants involved in the study. In this article, we describe a modular informatics platform designed and developed to support collaborative and multicenter studies in cardiology. In each developed module, data management is implemented following local defined protocols. The modular characteristic of the developed platform allows independent transfer of different kinds of data, such as biological samples, imaging raw data, and patients' digital information. Moreover, it offers safe central storage of the data collected during the study. The developed platform was successfully tested during a European collaborative and multicenter study, focused on evaluating multimodal non-invasive imaging to diagnose and characterize ischemic heart disease.

  20. [Pulmonary thromboembolism: Recent experience of 4 years at a cardiology hospital].

    PubMed

    Ramírez-Arias, Erick; Rosas-Peralta, Martin; Borrayo-Sánchez, Gabriela; Moreno-Ruiz, Luis Antonio; Arenas-Fonseca, Jorge Guillermo; Arzola-Covarrubias, Víctor Manuel; Santos-Martínez, Luis Efrén; Arizmendi-Uribe, Efraín

    2017-01-01

    It comprised a series of cases over a period of 4 years, held at the Hospital of Cardiology of the Centro Médico Nacional Siglo XXI, IMSS. From 2008 to 2011, admitted to Emergency 184 patients with suspected pulmonary embolism, of which 41 were removed; of the 143 remaining cases, only 127 patients was diagnosed with PE. The other 16 patients had other diagnoses. In 86% of patients showed electrocardiographic pattern S1Q3T3 and 39% had RBBB, in 17 (13.3%) patients there was hemodynamic instability, and in 94.4% showed enlargement of the right chambers by echocardiography, 55.9% showed paradoxical septal motion, PASP was 66.2+22.8 mm Hg and in 43.3% the Mc Connell sign was positive. A total of 48 patients (37.7%) received thrombolysis, the remaining patients received conventional medical treatment with anticoagulation. Overall mortality was 14%.

  1. Board certification in internal medicine and cardiology: Historical success and future challenges.

    PubMed

    Baron, Richard J; Krumholz, Harlan M; Jessup, Mariell; Brosseau, Jennifer L

    2015-05-01

    Board certification is at a critical juncture. As physicians face increased regulation and pressures from both inside and outside the profession, board certification and Maintenance of Certification (MOC) are coming under increased scrutiny from the public and the medical community. At this challenging time, it is important to remind ourselves what board certification is (and what it is not) and revisit the origins of this tangible expression of professional self-regulation, even as we contemplate how it needs to improve. Board certification has evolved over time and must continue to evolve; it is our collective responsibility as physicians that peer-developed standards meet the needs of both the profession and the public. In this article, we will reflect on the history of the American Board of Internal Medicine (ABIM), especially which related to Cardiology, and describe some of ABIM׳s challenges and new directions.

  2. The World Congress of Paediatric Cardiology and Cardiac Surgery: a short factual history by Jane Somerville.

    PubMed

    Somerville, Jane

    2012-12-01

    The World Congress of Paediatric Cardiology and Cardiac Surgery has survived with minimal assets and simple organisation. Each congress is special, taking on the humour, flavour, and culture of the organising country. It is hard work for a few organisers and money is hard to raise. The steering committee works closely, fairly, and successfully, and even though accused of being secretive and effete that does not matter. It is efficient and produces successful, happy world congresses, where all involved with the speciality are welcome. With so many "grown-ups" with congenital heart disease, it is no longer just a paediatric problem - maybe the name of this congress must change again. Regardless, the flag must fly on.

  3. Cardiovascular Magnetic Resonance in Cardiology Practice: A Concise Guide to Image Acquisition and Clinical Interpretation.

    PubMed

    Valbuena-López, Silvia; Hinojar, Rocío; Puntmann, Valentina O

    2016-02-01

    Cardiovascular magnetic resonance plays an increasingly important role in routine cardiology clinical practice. It is a versatile imaging modality that allows highly accurate, broad and in-depth assessment of cardiac function and structure and provides information on pertinent clinical questions in diseases such as ischemic heart disease, nonischemic cardiomyopathies, and heart failure, as well as allowing unique indications, such as the assessment and quantification of myocardial iron overload or infiltration. Increasing evidence for the role of cardiovascular magnetic resonance, together with the spread of knowledge and skill outside expert centers, has afforded greater access for patients and wider clinical experience. This review provides a snapshot of cardiovascular magnetic resonance in modern clinical practice by linking image acquisition and postprocessing with effective delivery of the clinical meaning.

  4. Tools for assessing quality of life in cardiology and cardiac surgery

    PubMed Central

    Pudlo, Robert; Jaworska, Izabela; Byrczek-Godula, Kamila; Gąsior, Mariusz

    2016-01-01

    The holistic concept of health, popularization of knowledge, as well as social and economic factors have contributed to the growing interest in research concerning quality of life in cardiovascular diseases. The value of direct measurements of the patient's well-being and the extent of their functioning in everyday life (i.e., health-related quality of life; HRQoL) has gained appreciation. Questionnaires are the most popular method of measuring quality of life. On the basis of the literature, we can conclude that the Short-Form Health Survey (SF-36) questionnaire is one of the most widely used tools measuring the quality of life of patients undergoing cardiological treatment and cardiac surgery. PMID:27212988

  5. Constrictive pericarditis. Early experience in 12 patients in light of modern cardiology.

    PubMed

    Finkelstein, Y; Wurzel, M; Vishne, T H; Garty, B Z; Adler, Y

    2000-11-01

    The last several decades have witnessed major advances in the understanding and management of constrictive pericarditis. The aim of the present study was to compare the diagnosis, treatment and outcome of constrictive pericarditis of 40 years ago to today. The study population consisted of 12 patients with a diagnosis of constrictive pericarditis who presented at the Institute of Cardiology of Beilinson Hospital, from 1961 to 1970. Their main physical findings, electrocardiographic and chest X-ray changes, and hemodynamic study results are discussed in relation to the surgical outcome of patients with constrictive pericarditis today. New noninvasive imaging modalities, such as M mode, two-dimensional and Doppler echocardiography, computed tomography and magnetic resonance imaging are presented, and their advantages and disadvantages in the diagnosis of constrictive pericarditis and its differentiation from restrictive cardiomyopathy are explained.

  6. Classification and Quality Standards of Heart Failure Units: Scientific Consensus of the Spanish Society of Cardiology.

    PubMed

    Anguita Sánchez, Manuel; Lambert Rodríguez, José Luis; Bover Freire, Ramón; Comín Colet, Josep; Crespo Leiro, María G; González Vílchez, Francisco; Manito Lorite, Nicolás; Segovia Cubero, Javier; Ruiz Mateas, Francisco; Elola Somoza, Francisco Javier; Íñiguez Romo, Andrés

    2016-10-01

    The prevalence of heart failure remains high and represents the highest disease burden in Spain. Heart failure units have been developed to systematize the diagnosis, treatment, and clinical follow-up of heart failure patients, provide a structure to coordinate the actions of various entities and personnel involved in patient care, and improve prognosis and quality of life. There is ample evidence on the benefits of heart failure units or programs, which have become widespread in Spain. One of the challenges to the analysis of heart failure units is standardization of their classification, by determining which "programs" can be identified as heart failure "units" and by characterizing their complexity level. The aim of this article was to present the standards developed by the Spanish Society of Cardiology to classify and establish the requirements for heart failure units within the SEC-Excellence project.

  7. EXIT procedure: a report of the first three Mississippi cases.

    PubMed

    Brewer, Justin; Liechty, Kenneth W; Bofill, James A

    2012-04-01

    The University of Mississippi Medical Center has initiated a state-of-the-art fetal center. This project involves collaboration between multiple disciplines including anesthesiology, pediatric surgery, maternal-fetal medicine, radiology, neonatology, genetics, pediatric cardiology and other pediatric subspecialties, nursing, and social work. Complicated fetal patients from throughout the southeastern U.S.A. may be referred to this center and benefit from new and innovative interventions that have not been available to this region in the past. The first three EXIT (ex-utero intrapartum treatment) procedures were recently performed at Batson Children's Hospital at the University of Mississippi Medical Center. Our objective is to share our recent experiences with this novel procedure and to detail some of the basics of an EXIT delivery.

  8. The impact of statin therapy on long-term cardiovascular outcomes in an outpatient cardiology practice

    PubMed Central

    Lai, Hoang M.; Aronow, Wilbert S.; Mercando, Anthony D.; Kalen, Phoenix; Desai, Harit V.; Gandhi, Kaushang; Sharma, Mala; Amin, Harshad; Lai, Trung M.

    2011-01-01

    Summary Background Statins reduce coronary events in patients with coronary artery disease. Material/Methods Chart reviews were performed in 305 patients (217 men and 88 women, mean age 74 years) not treated with statins during the first year of being seen in an outpatient cardiology practice but subsequently treated with statins. Based on the starting date of statins use, the long-term outcomes of myocardial infarction (MI), percutaneous coronary intervention (PCI), and coronary artery bypass graft surgery (CABGS) before and after statin use were compared. Results Mean follow-up was 65 months before statins use and 66 months after statins use. MI occurred in 31 of 305 patients (10%) before statins, and in 13 of 305 patients (4%) after statins (p<0.01). PCI had been performed in 66 of 305 patients (22%) before statins and was performed in 41 of 305 patients (13%) after statins (p<0.01). CABGS had been performed in 56 of 305 patients (18%) before statins and was performed in 20 of 305 patients (7%) after statins (p<0.001). Stepwise logistic regression showed statins use was an independent risk factor for MI (odds ratio=0.0207, 95% CI, 0.0082–0.0522, p<0.0001), PCI (odds ratio=0.0109, 95% CI, 0.0038–0.0315, p<0.0001), and CABGS (odds ratio=0.0177, 95% CI=0.0072–0.0431, p<0.0001) Conclusions Statins use in an outpatient cardiology practice reduces the incidence of MI, PCI, and CABGS. PMID:22129898

  9. Reduction in atherosclerotic events: a retrospective study in an outpatient cardiology practice

    PubMed Central

    Mercando, Anthony D.; Lai, Hoang M.; Kalen, Phoenix; Desai, Harit V.; Gandhi, Kaushang; Sharma, Mala; Amin, Harshad; Lai, Trung M.

    2012-01-01

    Introduction Although atherosclerotic disease cannot be cured, risk of recurrent events can be reduced by application of evidence-based treatment protocols involving aspirin, beta blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and statin medications. We studied atherosclerotic event rates in a patient population treated before and after the development of aggressive risk factor reduction treatment protocols. Material and methods We performed a retrospective chart review of patients presenting for follow-up treatment of coronary artery disease in a community cardiology practice, comparing atherosclerotic event rates and medication usage in a 2-year treatment period prior to 2002 and a 2-year period in 2005-2008. Care was provided in both the early and later eras by 7 board-certified cardiologists in a suburban cardiology practice. Medication usage was compared in both treatment eras. The primary outcome was a composite event rate of myocardial infarction, cerebrovascular events, and coronary interventions. Results Three hundred and fifty-seven patients were studied, with a follow-up duration of 12.1 (±3.5) years. There were 132 composite events in 104 patients (29.1%) in the early era compared to 40 events in 33 patients (9.2%) in the later era (p < 0.0001). From the early to the later eras, there was an increase in use of β-blockers (66% to 83%, p < 0.0001), angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (34% to 80%, p < 0.0001), and statins (40% to 90%, p < 0.0001). Conclusions Application of aggressive evidence-based medication protocols for treatment of atherosclerosis is associated with a significant decrease in atherosclerotic events or need for coronary intervention. PMID:22457676

  10. The impact of statin therapy on long-term cardiovascular outcomes in an outpatient cardiology practice

    PubMed Central

    Lai, Hoang M.; Mercando, Anthony D.; Kalen, Phoenix; Desai, Harit V.; Gandhi, Kaushang; Sharma, Mala; Amin, Harshad; Lai, Trung M.

    2012-01-01

    Introduction Statins reduce coronary events in patients with coronary artery disease. Material and methods Chart reviews were performed in 305 patients (217 men and 88 women, mean age 74 years) not treated with statins during the first year of being seen in an outpatient cardiology practice but subsequently treated with statins. Based on the starting date of statins use, the long-term outcomes of myocardial infarction (MI), percutaneous coronary intervention (PCI), and coronary artery bypass graft surgery (CABGs) before and after statin use were compared. Results Mean follow-up was 65 months before statins use and 66 months after statins use. Myocardial infarction occurred in 31 of 305 patients (10%) before statins, and in 13 of 305 patients (4%) after statins (p < 0.01). Percutaneous coronary intervention had been performed in 66 of 305 patients (22%) before statins and was performed in 41 of 305 patients (13%) after statins (p < 0.01). Coronary artery bypass graft surgery had been performed in 56 of 305 patients (18%) before statins and in 20 of 305 patients (7%) after statins (p < 0.001). Stepwise logistic regression showed statins use was an independent risk factor for MI (odds ratio = 0.0207, 95% CI, 0.0082-0.0522, p < 0.0001), PCI (odds ratio = 0.0109, 95% CI, 0.0038-0.0315, p < 0.0001) and CABGs (odds ratio = 0.0177, 95% CI = 0.0072-0.0431, p < 0.0001) Conclusions Statins use in an outpatient cardiology practice reduces the incidence of MI, PCI, and CABGs. PMID:22457675

  11. Heterogeneity in statin indications within the 2013 american college of cardiology/american heart association guidelines.

    PubMed

    Shah, Ravi V; Rubenfire, Melvyn; Brook, Robert D; Lima, João A C; Nallamothu, Brahmajee; Murthy, Venkatesh L

    2015-01-01

    A standard ("core") implementation of American College of Cardiology/American Heart Association 2013 lipid guidelines (based on 10-year risk) dramatically increases the statin-eligible population in older Americans, raising controversy in the cardiovascular community. The guidelines also endorse a more "comprehensive" risk approach based in part on lifetime risk. The impact of this broader approach on statin eligibility remains unclear. We studied the impact of 2 different implementations of the new guidelines ("core" and "comprehensive") using the National Health and Nutrition Examination Survey. Although "core" guidelines led to 72.0 million subjects qualifying for statin therapy, the broader "comprehensive" application led to nearly a twofold greater estimate for statin-eligible subjects (121.2 million), with the greatest impact among those aged 21 to 45 years. Subjects indicated for statin therapy under comprehensive guidelines had a greater burden of cardiovascular risk factors and a higher lifetime risk of cardiovascular disease than those not indicated for statins. In particular, men aged 21 to 45 years had a 3.13-fold increased odds of being eligible for statin therapy only under the "comprehensive" guidelines (vs standard "core" guidelines; 95% confidence interval 2.82 to 3.47, p <0.0001). There were no racial differences. In conclusion, the "comprehensive" approach to statin eligibility espoused by the American College of Cardiology/American Heart Association 2013 guidelines would increase the statin-eligible population to over 120 million Americans, particularly targeting younger men with high-risk factor burden.

  12. A telemedicine network for remote paediatric cardiology services in north-east Brazil

    PubMed Central

    Hazin, Sheila Maria Vieira; Regis, Cláudio Teixeira; Soares de Araújo, Juliana Sousa; Albuquerque, Fernanda Cruz de Lira; Moser, Lúcia Roberta Didier Nunes; Hatem, Thamine de Paula; Gomes de Freitas, Carolina Paim; Mourato, Felipe Alves; Tavares, Thiago Ribeiro; Gomes, Renata Grigório Silva; Severi, Rossana; Santos, Cícera Rocha; Ferreira da Silva, Jailson; Rezende, Juliana Landim; Vieira, Paulo Coelho; Filho, José Luiz de Lima

    2015-01-01

    Abstract Problem Providing health care for children with congenital heart diseases remains a major challenge in low- and middle-income countries. Approach In October 2011, the Government of Paraíba, Brazil, established a paediatric cardiology network in partnership with the nongovernmental organization Círculo do Coração. A cardiology team supervised all network activities, using the Internet to keep in contact with remote health facilities. The network developed protocols for screening heart defects. Echocardiograms were performed by physicians under direct online supervision of a cardiologist; alternatively, a video recording of the examination was subsequently reviewed by a cardiologist. Cardiovascular surgeons came to a paediatric hospital in the state capital once a week to perform heart surgeries. Local setting Until 2011, the State of Paraíba had no structured programme to care for children with heart disease. This often resulted in missed or late diagnosis, with adverse health consequences for the children. Relevant changes From 2012 to 2014, 73 751 babies were screened for heart defects and 857 abnormalities were identified. Detection of congenital heart diseases increased from 4.09 to 11.62 per 1000 live births (P < 0.001). Over 6000 consultations and echocardiograms were supervised via the Internet. Time to diagnosis, transfers and hospital stays were greatly reduced. A total of 330 operations were carried out with 6.7% (22/330) mortality. Lessons learnt Access to an echocardiography machine with remote supervision by a cardiologist improves the detection of congenital heart disease by neonatologists; virtual outpatient clinics facilitate clinical management; the use of Internet technology with simple screening techniques allows resources to be allocated more efficiently. PMID:26668441

  13. Class attendance and cardiology examination performance: a study in problem-based medical curriculum

    PubMed Central

    Bamuhair, Samira S; Al Farhan, Ali I; Althubaiti, Alaa; ur Rahman, Saeed; Al-Kadri, Hanan M

    2016-01-01

    Background and aims Information on the effect of students’ class attendance on examination performance in a problem-based learning medical curriculum is limited. This study investigates the impact of different educational activities on students’ academic performance in a problem-based learning curriculum. Methods This is a retrospective cohort study conducted on the cardiology block at the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. All students who undertook the cardiology block during the academic year 2011–2012 were included. The students’ attendance was measured using their overall attendance percentage. This percentage is a product of their attendance of many activities throughout the block. The students’ performance was assessed by the final mark obtained, which is a product of many assessment elements. Statistical correlation between students’ attendance and performance was established. Results A total of 127 students were included. The average lecture attendance rate for the medical students in this study was found to be 86%. A significant positive correlation was noted between the overall attendance and the accumulated students’ block mark (r=0.52; P<0.001). Students’ attendance to different education activities was correlated to their final mark. Lecture attendance was the most significant predictor (P<0.001), that is, 1.0% increase in lecture attendance has predicted a 0.27 increase in students’ final block mark. Conclusion Class attendance has a positive effect on students’ academic performance with stronger effect for lecture attendance compared to attendance in other teaching modalities. This suggests that lecture attendance is critical for learning even when a problem-based learning medical curriculum is applied. PMID:26929658

  14. End-of-life care in a cardiology department: have we improved?

    PubMed Central

    Ruiz-Garcia, Juan; Diez-Villanueva, Pablo; Ayesta, Ana; Bruña, Vanessa; Figueiras-Graillet, Lourdes M; Gallego-Parra, Laura; Fernández-Avilés, Francisco; Martínez-Sellés, Manuel

    2016-01-01

    Background End-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate (DNR) order protocol. Methods & Results Retrospective analysis of all deaths in a cardiology department in two periods, before and after the introduction of the protocol. Comparison of demographic characteristics, use of DNR orders, and end-of-life care issues between both periods, according to the presence in the second period of the new DNR sheet (Group A), a conventional DNR order (Group B) or the absence of any DNR order (Group C). The number of deaths was similar in both periods (n = 198 vs. n = 197). The rate of patients dying with a DNR order increased significantly (57.1% vs. 68.5%; P = 0.02). Only 4% of patients in both periods were aware of the decision taken about cardiopulmonary resuscitation. Patients in Group A received the DNR order one day earlier, and 24.5% received it within the first 24 h of admission (vs. 2.6% in the first period; P < 0.001). All patients in Group A with an implantable cardioverter defibrillator (ICD) had shock therapies deactivated (vs. 25.0% in the first period; P = 0.02). Conclusions The introduction of a DNR order protocol may improve end-of-life care in cardiac patients by increasing the use and shortening the time of registration of DNR orders. It may also contribute to increase ICD deactivation in patients with these orders in place. However, the introduction of the sheet in late stages of the disease failed to improve patient participation. PMID:27605939

  15. Eighth survey of staffing in cardiology in the United Kingdom 1992.

    PubMed Central

    Chamberlain, D.; Parker, J.; Balcon, R.; Webb-Peploe, M.; Cobbe, S.; Boyle, D.; Tynan, M.; Hunter, S.; Reval, K.

    1994-01-01

    The Eighth Survey of Staffing in Cardiology was conducted with an index date of 30 September 1992. The total number of cardiologists in England and Wales, defined as individuals trained in the specialty and spending at least 40% of their professional time working in it, was 358. Of these 11 were part time, defined as six sessions or less, giving a number in whole time (or near whole time) equivalents of 352.5. The number of individuals increased from 1991 by 18 (5.3%). There were 71 cardiologists in Scotland and Northern Ireland, making a total for the United Kingdom of 429 individuals (423.5 whole time equivalents), which is 7.3 per million population. A total of 44 Districts serving 8.8 million people have no resident cardiologist. There has been little improvement since the 1991 survey. An additional 34 Districts with populations greater than 250,000 have only one cardiologist: we have clear evidence of inadequate provision of care in most of these, a situation that is inevitable within the resources provided. A wider threat to the provision of a satisfactory level of cardiological care throughout the United Kingdom will follow from changes in the organisation of the National Health Service and in the new requirements for training of future cardiologists because these changes will make major new demands on consultant time which cannot be met within existing resources. A crisis will be averted only if a rapid and major expansion of the consultant grade can be achieved. PMID:8011423

  16. Provision of Transition Education and Referral Patterns from Pediatric Cardiology to Adult Cardiac Care.

    PubMed

    Harbison, Anna L; Grady, Stafford; Chi, Kevin; Fernandes, Susan M

    2016-02-01

    ACC/AHA guidelines recommend a structured preparation for and transfer to adult-oriented cardiac care for adult survivors of pediatric onset heart disease (POHD). Given this, we sought to describe the transition and transfer practices for a cohort of young adults with POHD and to determine factors associated with successful transfer to adult-oriented cardiac care. We performed a single-center, retrospective chart review on patients ≥18 years of age, with POHD likely to require lifelong cardiac care, who were seen in outpatient pediatric cardiology (PC) between 2008 and 2011. Successful transfer was defined as the subsequent attendance at adult cardiology (AC) within 2 years of PC visit. We identified 118 patients who met study criteria. Mean age 22.4 ± 2.0 years, 59 % male, 64 % white and 40 % Hispanic. Mean transition education topics noted was 3.3 ± 1.8 out of 20 and covered the underlying cardiac disease (89 %), follow-up and current medications (56 %) and exercise limitations (34 %). Recommendations for follow-up were AC (57 %) and PC (33 %). Of those told to transfer to AC, 79 % successfully transferred. Characteristics of successful transfer included: prior cardiac surgery (p = 0.008), cardiac medication use (p = 0.006) and frequency of follow-up ≤1 year (p = 0.037). One-quarter of all subjects did not follow-up within at least 2 years. Despite published guidelines, transition education appears lacking and the approach to transfer to adult cardiac care is not consistent. Given the increased risk of morbidity and mortality in this patient population, standardization of transition education and transfer processes appear warranted.

  17. 10 CFR 26.157 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Procedures. 26.157 Section 26.157 Energy NUCLEAR... laboratories shall develop, implement, and maintain written procedures for instrument setup and normal... instruments; (2) Tolerance limits for acceptable function checks; and (3) Instructions for...

  18. 77 FR 51943 - Procedures for Safety Investigations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... SAFETY BOARD 10 CFR Part 1708 Procedures for Safety Investigations AGENCY: Defense Nuclear Facilities... Investigations, which published July 27, 2012 in the Federal Register, 77 FR 44174. The comment period expires... Board is extending the comment period on the proposed rule, Procedures for Safety...

  19. 10 CFR 76.33 - Application procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Application procedures. 76.33 Section 76.33 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Application § 76.33 Application procedures. (a) Filing requirements. (1) An application for a certificate of compliance must be tendered...

  20. 10 CFR 76.33 - Application procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Application procedures. 76.33 Section 76.33 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Application § 76.33 Application procedures. (a) Filing requirements. (1) An application for a certificate of compliance must be tendered...

  1. 10 CFR 76.33 - Application procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Application procedures. 76.33 Section 76.33 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Application § 76.33 Application procedures. (a) Filing requirements. (1) An application for a certificate of compliance must be tendered...

  2. 10 CFR 76.33 - Application procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Application procedures. 76.33 Section 76.33 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Application § 76.33 Application procedures. (a) Filing requirements. (1) An application for a certificate of compliance must be tendered...

  3. 10 CFR 76.33 - Application procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Application procedures. 76.33 Section 76.33 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Application § 76.33 Application procedures. (a) Filing requirements. (1) An application for a certificate of compliance must be tendered...

  4. 10 CFR 1045.8 - Procedural exemptions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Procedural exemptions. 1045.8 Section 1045.8 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND DECLASSIFICATION Program Management of the Restricted Data and Formerly Restricted Data Classification System § 1045.8 Procedural...

  5. 10 CFR 1045.8 - Procedural exemptions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Procedural exemptions. 1045.8 Section 1045.8 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND DECLASSIFICATION Program Management of the Restricted Data and Formerly Restricted Data Classification System § 1045.8 Procedural...

  6. 10 CFR 1045.8 - Procedural exemptions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Procedural exemptions. 1045.8 Section 1045.8 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND DECLASSIFICATION Program Management of the Restricted Data and Formerly Restricted Data Classification System § 1045.8 Procedural...

  7. 10 CFR 1045.8 - Procedural exemptions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Procedural exemptions. 1045.8 Section 1045.8 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND DECLASSIFICATION Program Management of the Restricted Data and Formerly Restricted Data Classification System § 1045.8 Procedural...

  8. 10 CFR 1045.8 - Procedural exemptions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Procedural exemptions. 1045.8 Section 1045.8 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND DECLASSIFICATION Program Management of the Restricted Data and Formerly Restricted Data Classification System § 1045.8 Procedural...

  9. Nuclear Scans

    MedlinePlus

    Nuclear scans use radioactive substances to see structures and functions inside your body. They use a special ... images. Most scans take 20 to 45 minutes. Nuclear scans can help doctors diagnose many conditions, including ...

  10. Nuclear Winter.

    ERIC Educational Resources Information Center

    Ehrlich, Anne

    1984-01-01

    "Nuclear Winter" was recently coined to describe the climatic and biological effects of a nuclear war. These effects are discussed based on models, simulations, scenarios, and projections. Effects on human populations are also considered. (JN)

  11. Nuclear Chemistry.

    ERIC Educational Resources Information Center

    Chemical and Engineering News, 1979

    1979-01-01

    Provides a brief review of the latest developments in nuclear chemistry. Nuclear research today is directed toward increased activity in radiopharmaceuticals and formation of new isotopes by high-energy, heavy-ion collisions. (Author/BB)

  12. New Exercise-Dipyridamole Combined Test for Nuclear Cardiology in Insufficient Effort: Appropriate Diagnostic Sensitivity Keeping Exercise Prognosis

    PubMed Central

    Cortinas, Inés Vidal; Beretta, Mario; Alonso, Omar; Mut, Fernando

    2015-01-01

    Background Myocardial perfusion scintigraphy (MPS) in patients not reaching 85% of the maximum predicted heart rate (MPHR) has reduced sensitivity. Objectives In an attempt to maintain diagnostic sensitivity without losing functional exercise data, a new exercise and dipyridamole combined protocol (EDCP) was developed. Our aim was to evaluate the feasibility and safety of this protocol and to compare its diagnostic sensitivity against standard exercise and dipyridamole protocols. Methods In patients not reaching a sufficient exercise (SE) test and with no contraindications, 0.56 mg/kg of dipyridamole were IV administered over 1 minute simultaneously with exercise, followed by 99mTc-MIBI injection. Results Of 155 patients, 41 had MPS with EDCP, 47 had a SE test (≥ 85% MPHR) and 67 underwent the dipyridamole alone test (DIP). They all underwent coronary angiography within 3 months. The three stress methods for diagnosis of coronary lesions had their sensitivity compared. For stenosis ≥ 70%, EDCP yielded 97% sensitivity, SE 90% and DIP 95% (p = 0.43). For lesions ≥ 50%, the sensitivities were 94%, 88% and 95%, respectively (p = 0.35). Side effects of EDCP were present in only 12% of the patients, significantly less than with DIP (p < 0.001). Conclusions The proposed combined protocol is a valid and safe method that yields adequate diagnostic sensitivity, keeping exercise prognostic information in patients unable to reach target heart rate, with fewer side effects than the DIP. PMID:26039661

  13. Nuclear weapons, nuclear effects, nuclear war

    SciTech Connect

    Bing, G.F.

    1991-08-20

    This paper provides a brief and mostly non-technical description of the militarily important features of nuclear weapons, of the physical phenomena associated with individual explosions, and of the expected or possible results of the use of many weapons in a nuclear war. Most emphasis is on the effects of so-called ``strategic exchanges.``

  14. Nuclear Fuels.

    ERIC Educational Resources Information Center

    Nash, J. Thomas

    1983-01-01

    Trends in and factors related to the nuclear industry and nuclear fuel production are discussed. Topics addressed include nuclear reactors, survival of the U.S. uranium industry, production costs, budget cuts by the Department of Energy and U.S. Geological survey for resource studies, mining, and research/development activities. (JN)

  15. The role of commercial nuclear pharmacy in the future practice of nuclear medicine.

    PubMed

    Callahan, R J

    1996-04-01

    It has been estimated that today 70% to 80% of all radiopharmaceutical doses are dispensed through commercial nuclear pharmacy channels. These services are provided by the approximately 250 facilities in the United States, with some multisite corporations dispensing in excess of 20,000 unit-dose prescriptions per day. As pressures mount within health care institutions to reduce manpower, increase cost-effectiveness, increase participation in managed care contracts, and to seek outside vendors for many services that were previously provided in-house, the future role of the commercial nuclear pharmacy in the practice of nuclear medicine will only continue to increase. The essence of nuclear pharmacy practice is the dispensing of a full range of high quality radiopharmaceuticals in patient-specific unit doses. These doses must be delivered in a timely and cost effective manner, without compromising quality or patient safety. Commercial nuclear pharmacies have expanded to provide such varied functions as radiation safety and waste management, as well as consultative and marketing activities directed towards clinicians within a nuclear medicine practitioners own facility. In-service continuing education programs directed towards physicians and technologists are frequently offered by many commercial nuclear pharmacies. Changes in health care economics, merging and down-sizing in the hospital industry, and the overall impact of managed care on the viability of hospitals in general has resulted in slow growth, or even a small decline in the number of institutionally based nuclear pharmacists. As a result, nuclear medicine practitioners will be looking to the commercial nuclear pharmacies to meet a larger portion of their radiopharmaceutical needs, as well as to value added services, such as education and research and development. Specialized practice settings, such as nuclear cardiology and free-standing nuclear medicine clinics, are especially well suited to the services

  16. Procedural knowledge

    NASA Technical Reports Server (NTRS)

    Georgeff, Michael P.; Lansky, Amy L.

    1986-01-01

    Much of commonsense knowledge about the real world is in the form of procedures or sequences of actions for achieving particular goals. In this paper, a formalism is presented for representing such knowledge using the notion of process. A declarative semantics for the representation is given, which allows a user to state facts about the effects of doing things in the problem domain of interest. An operational semantics is also provided, which shows how this knowledge can be used to achieve particular goals or to form intentions regarding their achievement. Given both semantics, the formalism additionally serves as an executable specification language suitable for constructing complex systems. A system based on this formalism is described, and examples involving control of an autonomous robot and fault diagnosis for NASA's Space Shuttle are provided.

  17. [Historic account of infirmary at the Instituto Nacional de Cardiología "Ignacio Chávez"].

    PubMed

    Loredo Díaz, Luz Pérez

    2007-01-01

    The historical process of the infirmary has had great evolution in Mexico its beginnings, in the professional order, have taken to a great height to the National Institute of Cardiology; in the year of 1944, the Dr. Ignacio Chávez had great vision and assertivity when considering to religious nurses to direct different services to it; they have been and are at the moment an essential piece to continue the evolution of infirmary in the National Institute of Cardiology. It is possible to mention that the historical way of the infirmary must to the effort of the group of nuns who have known to guide and to lead to the team of nurses of the Institute, promoting at any moment the quality of attention provided to the patients with cardiovascular affections.

  18. A report from the European Society of Cardiology Congress 2013 (August 31-September 4, 2013 - Amsterdam, the Netherlands).

    PubMed

    Rabasseda, X

    2013-09-01

    Many are the diseases that can affect the heart and the vessels, most of which were discussed during the European Society of Cardiology Congress 2013 in Amsterdam. With an attendance of almost 30,000 delegates buzzing the halls of the RAI convention center, Amsterdam was the capital of cardiologic science this summer, and a big challenge for any attendee trying to get the most out of all the oral and poster sessions missing the minimum of new science being presented. Thomson Reuters Cortellis™ supplements the information for any scientist who missed an important session, with a particular focus on new investigational drugs, many of them still in preclinical research, which will certainly impact how cardiovascular disorders are treated in a foreseeable future. Clinical and preclinical research advance to bring novel therapeutic targets, new drugs and new insight into patient characteristics requiring particular treatment approaches. This report is a sample of the new science discussed during the 5 days of meetings.

  19. How changes to the Medicare Benefits Schedule could improve the practice of cardiology and save taxpayer money.

    PubMed

    Harper, Richard W; Nasis, Arthur; Sundararajan, Vijaya

    2015-09-21

    Rising health care costs above inflation are placing serious strains on the sustainability of the Australian Medicare system in its current structure. The Medicare Benefits Schedule (MBS), which lists rebates payable to patients for private medical services provided on a fee-for-service basis, is the cornerstone of the Australian health care system. Introduced in the 1980s, the MBS has changed little despite major advances in the evidence base for the practice of cardiology. We outline how we believe sensible changes to the MBS listings for four cardiac services--invasive coronary angiography, computed tomography coronary angiography, stress testing and percutaneous coronary intervention--would improve the clinical practice of cardiology and save substantial amounts of taxpayer money.

  20. [Progressive moderate mitral regurgitation in a children with Axenfeld-Rieger syndrome. The importance of cardiologic follow up].

    PubMed

    Sánchez Ferrer, Francisco; Grima Murcia, María D

    2016-12-01

    Axenfeld-Rieger syndrome is a congenital disease with an estimated prevalence of one in 200,000 individuals. This is an ophthalmic disorder related to anterior segment dysgenesis, which may be present from the neonatal period. It is associated with extraocular affectations such as cranial dimorphism, maxillofacial or dental anomalies. Cardiological or pituitary manifestations are less common. The congenital heart disease in Axenfeld-Rieger syndrome has been described in very few cases in the literature. We report a 7-year-old patient with Axenfeld-Rieger syndrome and mild mitral insufficiency since the age of 3 years, which is progressing to moderate mitral regurgitation at the present time. The cardiologic follow up may be indicated in patients with Axenfeld-Rieger syndrome.

  1. Advances in Pediatric Cardiology Boot Camp: Boot Camp Training Promotes Fellowship Readiness and Enables Retention of Knowledge.

    PubMed

    Ceresnak, Scott R; Axelrod, David M; Sacks, Loren D; Motonaga, Kara S; Johnson, Emily R; Krawczeski, Catherine D

    2017-03-01

    We previously demonstrated that a pediatric cardiology boot camp can improve knowledge acquisition and decrease anxiety for trainees. We sought to determine if boot camp participants entered fellowship with a knowledge advantage over fellows who did not attend and if there was moderate-term retention of that knowledge. A 2-day training program was provided for incoming pediatric cardiology fellows from eight fellowship programs in April 2016. Hands-on, immersive experiences and simulations were provided in all major areas of pediatric cardiology. Knowledge-based examinations were completed by each participant prior to boot camp (PRE), immediately post-training (POST), and prior to the start of fellowship in June 2016 (F/U). A control group of fellows who did not attend boot camp also completed an examination prior to fellowship (CTRL). Comparisons of scores were made for individual participants and between participants and controls. A total of 16 participants and 16 control subjects were included. Baseline exam scores were similar between participants and controls (PRE 47 ± 11% vs. CTRL 52 ± 10%; p = 0.22). Participants' knowledge improved with boot camp training (PRE 47 ± 11% vs. POST 70 ± 8%; p < 0.001) and there was excellent moderate-term retention of the information taught at boot camp (PRE 47 ± 11% vs. F/U 71 ± 8%; p < 0.001). Testing done at the beginning of fellowship demonstrated significantly better scores in participants versus controls (F/U 71 ± 8% vs. CTRL 52 ± 10%; p < 0.001). Boot camp participants demonstrated a significant improvement in basic cardiology knowledge after the training program and had excellent moderate-term retention of that knowledge. Participants began fellowship with a larger fund of knowledge than those fellows who did not attend.

  2. Bridging the Gap, Facing the Challenge—the 26th Great Wall International Congress of Cardiology (GW-ICC)

    PubMed Central

    Zhang, Yingmei

    2016-01-01

    The joint venue of the 26th Great Wall International Congress of Cardiology (GW-ICC) & Asia Pacific Heart Congress 2015 (APHC 2015) & International Congress Cardiovascular Prevention and Rehabilitation 2015 (ICCPR 2015) were held from October 29 to November 01, 2015 at the China National Convention Center (CNCC), Beijing, China. This year’s conference focused on cardiovascular disease prevention, health promotion, education and training, as well as disease management and rehabilitation. PMID:26885499

  3. A,B,C`s of nuclear science

    SciTech Connect

    Noto, V.A.; Norman, E.B.; Chan, Yuen-Dat; Dairiki, J.; Matis, H.S.; McMahan, M.A.; Otto, R.

    1995-08-07

    This introductory level presentation contains information on nuclear structure, radioactivity, alpha decay, beta decay, gamma decay, half-life, nuclear reactions, fusion, fission, cosmic rays, and radiation protection. Nine experiments with procedures and test questions are included.

  4. Position paper on the importance of psychosocial factors in cardiology: Update 2013

    PubMed Central

    Ladwig, Karl-Heinz; Lederbogen, Florian; Albus, Christian; Angermann, Christiane; Borggrefe, Martin; Fischer, Denise; Fritzsche, Kurt; Haass, Markus; Jordan, Jochen; Jünger, Jana; Kindermann, Ingrid; Köllner, Volker; Kuhn, Bernhard; Scherer, Martin; Seyfarth, Melchior; Völler, Heinz; Waller, Christiane; Herrmann-Lingen, Christoph

    2014-01-01

    Background: The rapid progress of psychosomatic research in cardiology and also the increasing impact of psychosocial issues in the clinical daily routine have prompted the Clinical Commission of the German Heart Society (DGK) to agree to an update of the first state of the art paper on this issue which was originally released in 2008. Methods: The circle of experts was increased, general aspects were implemented and the state of the art was updated. Particular emphasis was dedicated to coronary heart diseases (CHD), heart rhythm diseases and heart failure because to date the evidence-based clinical knowledge is most advanced in these particular areas. Differences between men and women and over the life span were considered in the recommendations as were influences of cognitive capability and the interactive and synergistic impact of classical somatic risk factors on the affective comorbidity in heart disease patients. Results: A IA recommendation (recommendation grade I and evidence grade A) was given for the need to consider psychosocial risk factors in the estimation of coronary risks as etiological and prognostic risk factors. Furthermore, for the recommendation to routinely integrate psychosocial patient management into the care of heart surgery patients because in these patients, comorbid affective disorders (e.g. depression, anxiety and post-traumatic stress disorder) are highly prevalent and often have a malignant prognosis. A IB recommendation was given for the treatment of psychosocial risk factors aiming to prevent the onset of CHD, particularly if the psychosocial risk factor is harmful in itself (e.g. depression) or constrains the treatment of the somatic risk factors. Patients with acute and chronic CHD should be offered anti-depressive medication if these patients suffer from medium to severe states of depression and in this case medication with selective reuptake inhibitors should be given. In the long-term course of treatment with implanted

  5. Nuclear astrophysics

    SciTech Connect

    Haxton, W.C.

    1992-01-01

    The problem of core-collapse supernovae is used to illustrate the many connections between nuclear astrophysics and the problems nuclear physicists study in terrestrial laboratories. Efforts to better understand the collapse and mantle ejection are also motivated by a variety of interdisciplinary issues in nuclear, particle, and astrophysics, including galactic chemical evolution, neutrino masses and mixing, and stellar cooling by the emission of new particles. The current status of theory and observations is summarized.

  6. Nuclear astrophysics

    SciTech Connect

    Haxton, W.C.

    1992-12-31

    The problem of core-collapse supernovae is used to illustrate the many connections between nuclear astrophysics and the problems nuclear physicists study in terrestrial laboratories. Efforts to better understand the collapse and mantle ejection are also motivated by a variety of interdisciplinary issues in nuclear, particle, and astrophysics, including galactic chemical evolution, neutrino masses and mixing, and stellar cooling by the emission of new particles. The current status of theory and observations is summarized.

  7. Nuclear Fission

    NASA Astrophysics Data System (ADS)

    Denschlag, J. O.

    This chapter first gives a survey on the history of the discovery of nuclear fission. It briefly presents the liquid-drop and shell models and their application to the fission process. The most important quantities accessible to experimental determination such as mass yields, nuclear charge distribution, prompt neutron emission, kinetic energy distribution, ternary fragment yields, angular distributions, and properties of fission isomers are presented as well as the instrumentation and techniques used for their measurement. The contribution concentrates on the fundamental aspects of nuclear fission. The practical aspects of nuclear fission are discussed in http://dx.doi.org/10.1007/978-1-4419-0720-2_57 of Vol. 6.

  8. Nuclear Forensic Materials and Methods

    NASA Astrophysics Data System (ADS)

    Hutcheon, I. D.; Grant, P. M.; Moody, K. J.

    A short history and treatment of the various aspects of nuclear forensic analysis is followed by a discussion of the most common chemical procedures, including applications of tracers, radioisotopic generators, and sample chronometry. Analytic methodology discussed includes sample preparation, radiation detection, various forms of microscopy, and mass-spectrometric techniques. The chapter concludes with methods for the production and treatment of special nuclear materials and with a description of several actual case studies conducted at Livermore.

  9. Designing Flight Deck Procedures

    NASA Technical Reports Server (NTRS)

    Degani, Asaf; Wiener, Earl

    2005-01-01

    Three reports address the design of flight-deck procedures and various aspects of human interaction with cockpit systems that have direct impact on flight safety. One report, On the Typography of Flight- Deck Documentation, discusses basic research about typography and the kind of information needed by designers of flight deck documentation. Flight crews reading poorly designed documentation may easily overlook a crucial item on the checklist. The report surveys and summarizes the available literature regarding the design and typographical aspects of printed material. It focuses on typographical factors such as proper typefaces, character height, use of lower- and upper-case characters, line length, and spacing. Graphical aspects such as layout, color coding, fonts, and character contrast are discussed; and several cockpit conditions such as lighting levels and glare are addressed, as well as usage factors such as angular alignment, paper quality, and colors. Most of the insights and recommendations discussed in this report are transferable to paperless cockpit systems of the future and computer-based procedure displays (e.g., "electronic flight bag") in aerospace systems and similar systems that are used in other industries such as medical, nuclear systems, maritime operations, and military systems.

  10. [Commentary by the German Society for Thoracic and Cardiovascular Surgery on the positions statement by the German Cardiology Society on quality criteria for transcatheter aortic valve implantation (TAVI)].

    PubMed

    Cremer, Jochen; Heinemann, Markus K; Mohr, Friedrich Wilhelm; Diegeler, Anno; Beyersdorf, Friedhelm; Niehaus, Heidi; Ensminger, Stephan; Schlensak, Christian; Reichenspurner, Hermann; Rastan, Ardawan; Trummer, Georg; Walther, Thomas; Lange, Rüdiger; Falk, Volkmar; Beckmann, Andreas; Welz, Armin

    2014-12-01

    Surgical aortic valve replacement is still considered the first-line treatment for patients suffering from severe aortic valve stenosis. In recent years, transcatheter aortic valve implantation (TAVI) has emerged as an alternative for selected high-risk patients. According to the latest results of the German external quality assurance program, mandatory by law, the initially very high mortality and procedural morbidity have now decreased to approximately 6 and 12%, respectively. Especially in Germany, the number of patients treated by TAVI has increased exponentially. In 2013, a total of 10.602 TAVI procedures were performed. TAVI is claimed to be minimally invasive. This is true concerning the access, but it does not describe the genuine complexity of the procedure, defined by the close neighborhood of the aortic valve to delicate intracardiac structures. Hence, significant numbers of life-threatening complications may occur and have been reported. Owing to the complexity of TAVI, there is a unanimous concordance between cardiologists and cardiac surgeons in the Western world demanding a close heart team approach for patient selection, intervention, handling of complications, and pre- as well as postprocedural care, respectively. The prerequisite is that TAVI should not be performed in centers with no cardiac surgery on site. This is emphasized in all international joint guidelines and expert consensus statements. Today, a small number of patients undergo TAVI procedures in German hospitals without a department of cardiac surgery on site. To be noted, most of these hospitals perform less than 20 cases per year. Recently, the German Cardiac Society (DGK) published a position paper supporting this practice pattern. Contrary to this statement and concerned about the safety of patients treated this way, the German Society for Thoracic and Cardiovascular Surgery (DGTHG) still fully endorses the European (ESC/EACTS) and other actual international guidelines and

  11. Graphics and Statistics for Cardiology: Data visualisation for meta-analysis.

    PubMed

    Kiran, Amit; Crespillo, Abel Pérez; Rahimi, Kazem

    2017-01-01

    Graphical displays play a pivotal role in understanding data sets and disseminating results. For meta-analysis, they are instrumental in presenting findings from multiple studies. This report presents guidance to authors wishing to submit graphical displays as part of their meta-analysis to a clinical cardiology journal, such as HeartWhen using graphical displays for meta-analysis, we recommend the following: Use a flow diagram to describe the number of studies returned from the initial search, the inclusion/exclusion criteria applied and the final number of studies used in the meta-analysis.Present results from the meta-analysis using a figure that incorporates a forest plot and underlying (tabulated) statistics, including test for heterogeneity.Use displays such as funnel plot (minimum 10 studies) and Galbraith plot to visually present distribution of effect sizes or associations in order to evaluate small-study effects and publication bias).For meta-regression, the bubble plot is a useful display for assessing associations by study-level factors.Final checks on graphs, such as appropriate use of axis scale, line pattern, text size and graph resolution, should always be performed.

  12. Impact of a Virtual Clinic in a Paediatric Cardiology Network on Northeast Brazil.

    PubMed

    de Araújo, Juliana Sousa Soares; Dias Filho, Adalberto Vieira; Silva Gomes, Renata Grigório; Regis, Cláudio Teixeira; Rodrigues, Klecida Nunes; Siqueira, Nicoly Negreiros; Albuquerque, Fernanda Cruz de Lira; Mourato, Felipe Alves; Mattos, Sandra da Silva

    2015-01-01

    Introduction. Congenital heart diseases (CHD) affect approximately 1% of live births and is an important cause of neonatal morbidity and mortality. Despite that, there is a shortage of paediatric cardiologists in Brazil, mainly in the northern and northeastern regions. In this context, the implementation of virtual outpatient clinics with the aid of different telemedicine resources may help in the care of children with heart defects. Methods. Patients under 18 years of age treated in virtual outpatient clinics between January 2013 and May 2014 were selected. They were divided into 2 groups: those who had and those who had not undergone a screening process for CHD in the neonatal period. Clinical and demographic characteristics were collected for further statistical analysis. Results. A total of 653 children and teenagers were treated in the virtual outpatient clinics. From these, 229 had undergone a neonatal screening process. Fewer abnormalities were observed on the physical examination of the screened patients. Conclusion. The implementation of pediatric cardiology virtual outpatient clinics can have a positive impact in the care provided to people in areas with lack of skilled professionals.

  13. Impact of a Virtual Clinic in a Paediatric Cardiology Network on Northeast Brazil

    PubMed Central

    de Araújo, Juliana Sousa Soares; Dias Filho, Adalberto Vieira; Silva Gomes, Renata Grigório; Regis, Cláudio Teixeira; Rodrigues, Klecida Nunes; Siqueira, Nicoly Negreiros; Albuquerque, Fernanda Cruz de Lira; Mourato, Felipe Alves; Mattos, Sandra da Silva

    2015-01-01

    Introduction. Congenital heart diseases (CHD) affect approximately 1% of live births and is an important cause of neonatal morbidity and mortality. Despite that, there is a shortage of paediatric cardiologists in Brazil, mainly in the northern and northeastern regions. In this context, the implementation of virtual outpatient clinics with the aid of different telemedicine resources may help in the care of children with heart defects. Methods. Patients under 18 years of age treated in virtual outpatient clinics between January 2013 and May 2014 were selected. They were divided into 2 groups: those who had and those who had not undergone a screening process for CHD in the neonatal period. Clinical and demographic characteristics were collected for further statistical analysis. Results. A total of 653 children and teenagers were treated in the virtual outpatient clinics. From these, 229 had undergone a neonatal screening process. Fewer abnormalities were observed on the physical examination of the screened patients. Conclusion. The implementation of pediatric cardiology virtual outpatient clinics can have a positive impact in the care provided to people in areas with lack of skilled professionals. PMID:26265913

  14. European Society of Cardiology (ESC) Annual Congress Report From Rome 2016.

    PubMed

    Mizuno, Hiroya; Otani, Tomohito; Sakata, Yasushi

    2016-10-25

    From August 27th to 31st, the 2016 Annual Congress of the European Society of Cardiology (ESC 2016) was held in Fiera di Roma, Italy. Despite the socially unstable situation, more than 32,000 attendees, including clinical physicians, basic researchers, medical students, and paramedical personnel, as well as 5,000 exhibitors from 106 countries gathered in this historical city to share the latest findings and to discuss the present issues in cardiovascular medicine. There were scientific sessions, including 28 Hot Lines, 26 clinical trial updates, 24 registry studies, and 5 clinical practice guideline sessions. Japan had 1,170 attendees, with 1,743 submitted and 670 accepted abstracts, including the NIPPON trial presented in the hotline session. From 2011 to 2016, Japan has been the first abstract submitter and has had the most abstracts accepted, which indicates the great contribution of Japanese cardiologists and the Japanese Circulation Society. This report briefly introduces the key presentations and highlights from the ESC 2016 Scientific Sessions. (Circ J 2016; 80: 2282-2286).

  15. Radiation dose and image quality for adult interventional cardiology in Chile: a national survey.

    PubMed

    Ubeda, C; Vano, E; Miranda, P; Leyton, F; Valenzuela, E; Oyarzun, C

    2011-09-01

    The aim of this work was to investigate the differences in dose settings and image quality among 10 X-ray systems used for interventional cardiology in Chile. Entrance surface air kerma (ESAK) was measured on a phantom of 20 cm thickness of polymethyl methacrylate slabs. Image quality was evaluated using DICOM images of a test object Leeds TOR 18-FG for cine mode acquisition, through the numerical parameters signal-to-noise ratio (SNR), high-contrast spatial resolution (HCSR) and figure of merit. ESAK rate values for fluoroscopy modes ranged between 7.1 and 121.7 mGy min(-1). For cine mode, ESAK values per frame ranged from 63 to 400 µGy fr(-1). SNR and HCSR parameters for cine mode varied from 4.8 to 8.6 and 0.4 to 10, respectively. FOM values resulted from 6.9 to 64.5 among the different X-ray systems. Results show important differences between systems and point out the need to launch an optimisation programme.

  16. Reperfusion therapy of myocardial infarction in Mexico: A challenge for modern cardiology.

    PubMed

    Martínez-Sánchez, Carlos; Arias-Mendoza, Alexandra; González-Pacheco, Héctor; Araiza-Garaygordobil, Diego; Marroquín-Donday, Luis Alfonso; Padilla-Ibarra, Jorge; Sierra-Fernández, Carlos; Altamirano-Castillo, Alfredo; Álvarez-Sangabriel, Amada; Azar-Manzur, Francisco Javier; Briseño-de la Cruz, José Luis; Mendoza-García, Salvador; Piña-Reyna, Yigal; Martínez-Ríos, Marco Antonio

    2017-02-03

    Mexico has been positioned as the country with the highest mortality attributed to myocardial infarction among the members of the Organization for Economic Cooperation and Development. This rate responds to multiple factors, including a low rate of reperfusion therapy and the absence of a coordinated system of care. Primary angioplasty is the reperfusion method recommended by the guidelines, but requires multiple conditions that are not reached at all times. Early pharmacological reperfusion of the culprit coronary artery and early coronary angiography (pharmacoinvasive strategy) can be the solution to the logistical problem that primary angioplasty rises. Several studies have demonstrated pharmacoinvasive strategy as effective and safe as primary angioplasty ST-elevation myocardial infarction, which is postulated as the choice to follow in communities where access to PPCI is limited. The Mexico City Government together with the National Institute of Cardiology have developed a pharmaco-invasive reperfusion treatment program to ensure effective and timely reperfusion in STEMI. The model comprises a network of care at all three levels of health, including a system for early pharmacological reperfusion in primary care centers, a digital telemedicine system, an inter-hospital transport network to ensure primary angioplasty or early percutaneous coronary intervention after fibrinolysis and a training program with certification of the health care personal. This program intends to reduce morbidity and mortality associated with myocardial infarction.

  17. EVALUATION OF CARDIOLOGIC FUNCTIONS IN CAPTIVE EURASIAN BROWN BEARS (URSUS ARCTOS ARCTOS) IN TURKEY.

    PubMed

    Cihan, Huseyin; Yilmaz, Zeki; Aytug, Nilufer

    2016-03-01

    The aim of this study was to evaluate the cardiac functions in healthy Eurasian brown bears (Ursus arctos arctos) living in a seminatural area during their active season. Twelve clinically healthy brown bears were selected based on their normal physical examination, hematologic, and serum biochemistry results. These bears were divided into two groups based on age; subadult (<5 yr, n = 4) and adult (≥5 yr, n = 8). After the chemical immobilization (ketamine and xylazine), routine clinical and laboratory examinations were performed. Also, cardiologic examinations were performed using electrocardiogram and echocardiogram. There were no significant differences for the clinical parameters between the two groups including for body temperature, heart and respiratory rates, capillary refilling time, and oxygen saturation. The Q, R, and S wave (QRS) complexes and T wave amplitude were higher (P < 0.05) in the subadult group when compared to those of adult bears. Notching of QRS complexes and peaked T wave were also observed in both groups. Left ventricular diameter at systole and diastole in adult bears was wider (P < 0.05) than that of subadult bears. Subadult bears had reduced aortic diameter compared to adult bears (P < 0.05). Doppler variables of mitral, tricuspid, and aortic inflows between groups were similar; however, pulmonary artery variables such as flow velocity integral, mean velocity, and gradient were higher (P < 0.05) in the subadult group. These results suggest that electrocardiographic and echocardiographic parameters should be evaluated based on the age of brown bears.

  18. The PhysioNet/Computing in Cardiology Challenge 2015: Reducing False Arrhythmia Alarms in the ICU.

    PubMed

    Clifford, Gari D; Silva, Ikaro; Moody, Benjamin; Li, Qiao; Kella, Danesh; Shahin, Abdullah; Kooistra, Tristan; Perry, Diane; Mark, Roger G

    2015-09-01

    High false alarm rates in the ICU decrease quality of care by slowing staff response times while increasing patient delirium through noise pollution. The 2015 Physio-Net/Computing in Cardiology Challenge provides a set of 1,250 multi-parameter ICU data segments associated with critical arrhythmia alarms, and challenges the general research community to address the issue of false alarm suppression using all available signals. Each data segment was 5 minutes long (for real time analysis), ending at the time of the alarm. For retrospective analysis, we provided a further 30 seconds of data after the alarm was triggered. A collection of 750 data segments was made available for training and a set of 500 was held back for testing. Each alarm was reviewed by expert annotators, at least two of whom agreed that the alarm was either true or false. Challenge participants were invited to submit a complete, working algorithm to distinguish true from false alarms, and received a score based on their program's performance on the hidden test set. This score was based on the percentage of alarms correct, but with a penalty that weights the suppression of true alarms five times more heavily than acceptance of false alarms. We provided three example entries based on well-known, open source signal processing algorithms, to serve as a basis for comparison and as a starting point for participants to develop their own code. A total of 38 teams submitted a total of 215 entries in this year's Challenge.

  19. Echocardiographic Tests of Left Ventricular Function in Pediatric Cardiology: Are We Searching for the Holy Grail?

    PubMed

    Sandor, George G S

    2016-10-01

    In this article the utility of echocardiographic tests of left ventricular (LV) function in pediatric cardiology is reviewed. These indices are derived from the basic concepts of cardiac physiology, namely the Frank-Starling curve, pressure volume loops, and the force frequency relation and, to some extent, are all governed by these general principles. Thus, they are prone to be load-dependent and their utility variable. Methods that use formulas for calculating LV volume are a problem in congenital heart disease in which LV geometry is frequently abnormal. New indices, such as the TEI index, continue to be developed but they are still load-dependent. The utility of more complex LV function tests such as mean velocity of circumferential fibre shortening corrected for heart rate, mean velocity of circumferential fibre shortening corrected for heart rate/wall stress, end-systolic, and arterial elastance also have limitations. Tissue Doppler and its functional derivatives which test myocardial mechanics are being intensively applied to patients with acquired and congenital heart disease. To apply these tests appropriately, knowledge of the strengths, limitations, and variability of each of these tests is required. Resting echocardiograms may mask limited myocardial reserve. Our experience with semisupine cycle ergometry has unmasked limited myocardial reserve and helped in clinical decision-making. Thus, there is no single echocardiographic test that is perfect for all clinical questions. Clinicians must use the appropriate combination of tests to answer the question relevant to individual patients.

  20. Direct thrombin inhibition with bivalirudin as an antithrombotic strategy in general and interventional cardiology.

    PubMed

    Ahrens, Ingo; Smith, Belinda K; Bode, Christoph; Peter, Karlheinz

    2007-08-01

    Antithrombotic therapy is a crucial component of interventional cardiology and currently involves the administration of both anticoagulant and antiplatelet agents. The implementation of standard dual or triple antiplatelet therapies has allowed percutaneous coronary intervention (PCI) with stent implantation to become the treatment of choice in most patients with acute coronary syndromes (ACS), particularly in patients with ST-segment elevation myocardial infarction. However, the combined use of antithrombotic agents increases the bleeding risk associated with coronary intervention, which is a concern due to the increasing evidence that bleeding complications are associated with a higher risk of ischaemic events and death. The shortcomings of currently available anticoagulant drugs have promoted the ongoing development of new, powerful anticoagulant agents that have both efficacy in the setting of PCI and a reduced risk of bleeding; one of these classes of agents targets the thrombin molecule, a key factor in the coagulation cascade, and belongs to the class of anticoagulants known as direct thrombin inhibitors (DTIs). Bivalirudin, a synthetic peptide, is a DTI with unique, favourable pharmacological properties that include predictable linear pharmacokinetics. Bivalirudin was approved as an anticoagulant in patients undergoing routine PCI in 2000 by the FDA (in 2004 in Europe and Australia) and more recently in patients with ACS undergoing PCI. The pharmacological properties of bivalirudin, along with current indications for its use, are discussed in this review, with a focus on the major completed and ongoing clinical trials with bivalirudin.