The Role of Vegetation in Mitigating Urban Land Surface Temperatures: A Case Study of Munich, Germany during the Warm Season

Directory of Open Access Journals (Sweden)

Sadroddin Alavipanah

2015-04-01

Full Text Available The Urban Heat Island (UHI is the phenomenon of altered increased temperatures in urban areas compared to their rural surroundings. UHIs grow and intensify under extreme hot periods, such as during heat waves, which can affect human health and also increase the demand for energy for cooling. This study applies remote sensing and land use/land cover (LULC data to assess the cooling effect of varying urban vegetation cover, especially during extreme warm periods, in the city of Munich, Germany. To compute the relationship between Land Surface Temperature (LST and Land Use Land Cover (LULC, MODIS eight-day interval LST data for the months of June, July and August from 2002 to 2012 and the Corine Land Cover (CLC database were used. Due to similarities in the behavior of surface temperature of different CLCs, some classes were reclassified and combined to form two major, rather simplified, homogenized classes: one of built-up area and one of urban vegetation. The homogenized map was merged with the MODIS eight-day interval LST data to compute the relationship between them. The results revealed that (i the cooling effect accrued from urban vegetation tended to be non-linear; and (ii a remarkable and stronger cooling effect in terms of LST was identified in regions where the proportion of vegetation cover was between seventy and almost eighty percent per square kilometer. The results also demonstrated that LST within urban vegetation was affected by the temperature of the surrounding built-up and that during the well-known European 2003 heat wave, suburb areas were cooler from the core of the urbanized region. This study concluded that the optimum green space for obtaining the lowest temperature is a non-linear trend. This could support urban planning strategies to facilitate appropriate applications to mitigate heat-stress in urban area.

The Munich Parasomnia Screening in Psychiatry

NARCIS (Netherlands)

Bosch, M.P.C.; Luijtelaar, E.L.J.M. van; Noort, M.W.M.L. van den; Groetelaers, L.; Lim, S.; Egger, J.I.M.; Coenen, A.M.L.

2012-01-01

Background The aim was to investigate the subjective experience of parasomnias and other nocturnal behaviors in depression and schizophrenia. Materials and methods Using the Munich Parasomnia Screening (MUPS), 21 parasomnias and other nocturnal behaviors were assessed in 85 participants; 27 were

Pediatric nuclear cardiology

International Nuclear Information System (INIS)

Gelfand, M.J.; Hannon, D.W.

1987-01-01

Nuclear cardiology methods have had less impact upon pediatric cardiology than upon adult cardiology. Most pediatric heart disease results from congenital malformations of the heart and great vessels, which is usually discovered in infancy, and is most often treated definitively in infancy or early childhood. Unfortunately, nuclear medicine techniques are limited in their spatial resolution - structures that overlie each other are separated with difficulty. As a result, nuclear cardiology is usually of limited value in the anatomic characterization of the congenital heart abnormalities. Nevertheless, it has been useful in the detection and quantification of the pathophysiologic consequences of many congenital cardiac malformations. The authors review application of nuclear medicine in pediatric cardiology, and attempt to assess each in terms of its clinical utility

EMAS in Germany. Evaluation 2012; EMAS in Deutschland. Evaluierung 2012

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-03-15

Since the 1990ies, the Eco-Management and Audit Scheme (EMAS) is established in the European Union. Arqum GmbH (Munich, Germany) and Infra dimap (Berlin, Germany) performed the survey ''EMAS in Germany - Evaluation 2012'' at 573 EMAS organizations in the period between March 2012 and July 2012 in order to gain insight into the current EMAS practice in German organizations and to identify potentials for the future development of the EMAS system. The survey covered the following topics: (1) Reasons for participation of the companies and organizations with the EMAS system; (2) Cost-effectiveness of EMAS at the site of the organization; (3) Experiences with the environmental statement; (4) Experiences after the last EMAS amendment (EMAS III); (5) Experience with the environmental verifier and the validation process; (6) Evaluation of the continuation of the EMAS system; (7) Requests to the environmental policy. The main results of this survey are presented in the contribution under consideration.

Patterns of suicidal behaviour in a metro subway system: a study of 306 cases injured by the Munich subway, 1980-1999.

Science.gov (United States)

Ladwig, Karl-Heinz; Baumert, Jens J

2004-09-01

As a basis for preventive strategies to reduce subway suicides, an investigation was undertaken to determine if there was a distinct pattern of subway suicidal behaviour. Data were taken from the Municipal Munich Subway System case registry (southern Germany) for all suicidal incidents on the track: purposely inflicted; date, time and location of incident, sex of victim, outcome. The analysis covered a 20 year observation period between 1980 and 1999, for which the Munich Municipal Office for Statistics also provided data of all deaths due to suicides within the city area of Munich. Suicide mortality was classified by the International Classification of Diseases, Ninth revision (codes E950-E959). A total of 306 incidents were documented with an annual mean of 16.5 cases. Case fatality was 66% (n=202). It was highest in winter and in higher aged groups. No significant time trend for incidences was observed. Median age of suicide attempters was 38 years. Most incidences (24.2%) were recorded for persons aged 20-29 years. The male: female ratio was 1.15 : 1. The peak time of day for incidences in women was during the late morning hours while significantly more men committed subway suicides during evening hours (p=0.001). No consistent seasonal variation was observed. In comparison to average suicide attempters, subjects committing subway suicides are markedly younger and they follow to a lesser extent established seasonal or circadian time patterns. More women are involved in subway suicides than would be expected. However, similarities to reports on behavioural patterns of subway suicides in other communities are striking.

Health-resource use and costs associated with fibromyalgia in France, Germany, and the United States

Directory of Open Access Journals (Sweden)

Chandran A

2013-04-01

Full Text Available Tyler Knight,1 Caroline Schaefer,1 Arthi Chandran,2 Gergana Zlateva,2 Andreas Winkelmann,3 Serge Perrot4 1Health Economics and Outcomes Research, Covance Market Access Services, Gaithersburg, MD, USA; 2Primary Care Health Economics and Outcomes Research, Pfizer Global Health Economics, New York, NY, USA; 3Department of Physical Medicine and Rehabilitation, University Hospital Munich, Munich, Germany; 4Service de Médecine Interne et Thérapeutique, Université Paris Descartes, Paris, France Background: Fibromyalgia (FM is a chronic disorder characterized by widespread, persistent pain. Prospective and retrospective studies have demonstrated substantial health-care costs associated with FM in a number of countries. This study evaluated and compared health-resource use (HRU and associated costs related to FM in routine clinical practice across the US, France, and Germany. Methods: Two separate, cross-sectional, observational studies of subjects with FM were conducted: one in the US and one in France and Germany. HRU related to prescription medication, physician office visits, diagnostic tests, and hospitalizations was abstracted from chart review; patient out-of-pocket costs and lost productivity were collected via subject self-report. Costs were assigned to HRU based on standard algorithms. Direct and indirect costs were evaluated and compared by simple linear regression. Results: A total of 442 subjects (203 US, 70 France, 169 Germany with FM were analyzed. The mean (standard deviation age in the US, France, and Germany was 47.9 (10.9, 51.2 (9.5, and 49.2 (9.8, respectively (P = 0.085. Most subjects were female (95% US, 83% France, 80% Germany (P < 0.001. Adjusted annual direct costs per subject for FM were significantly higher in the US ($7087 than in France ($481, P < 0.001 or Germany ($2417, P < 0.001. Adjusted mean annual indirect costs per subject for FM were lower in the US ($6431 than in France ($8718 or Germany ($10,001, but represented

Acute coronary syndrome patients admitted to a cardiology vs non-cardiology service: variations in treatment & outcome.

Science.gov (United States)

O'Neill, Deirdre E; Southern, Danielle A; Norris, Colleen M; O'Neill, Blair J; Curran, Helen J; Graham, Michelle M

2017-05-16

Specialized cardiology services have contributed to reduced mortality in acute coronary syndromes (ACS).  We sought to evaluate the outcomes of ACS patients admitted to non-cardiology services in Southern Alberta. Retrospective chart review performed on all troponin-positive patients in the Calgary Health Region identified those diagnosed with ACS by their attending team. Patients admitted to non-cardiology and cardiology services were compared, using linked data from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry and the Strategic Clinical Network for Cardiovascular Health and Stroke. From January 1, 2007 to December 31, 2008, 2105 ACS patients were identified, with 1636 (77.7%) admitted to cardiology and 469 (22.3%) to non-cardiology services. Patients admitted to non-cardiology services were older, had more comorbidities, and rarely received cardiology consultation (5.1%). Cardiac catheterization was underutilized (5.1% vs 86.4% in cardiology patients (p cardiology vs. cardiology services (49.1% vs. 11.0% respectively at 4-years, p cardiology services. These patients had worse outcomes, despite adjustment for baseline risk factor differences. Although many patients were appropriately admitted to non-cardiology services, the low use of investigations and secondary prevention medications may contribute to poorer patient outcome. Further research is required to identify process of care strategies to improve outcomes and lessen the burden of illness for patients and the health care system.

["Why visit a medical congress?" : Knowledge transfer between Germany and Sweden using the example of the 1929 DGU meeting in Munich].

Science.gov (United States)

Hansson, N; Uvelius, B; Halling, T; Moll, F H

2018-02-01

Drawing on contemporary publications in German and Swedish/Scandinavian journals and biographies as well as conference proceedings of the German Society of Urology (DGU), this paper examines the Swedish impressions of the 1929 DGU meeting in Munich. It focusses on why the Swedish delegates visited the congress and how they evaluated their congress experiences for their Scandinavian peers. Finally, the article shows to what extent a knowledge transfer from the DGU Congress to Sweden took place.

Experiences with publicly promoted solar plants in Munich, the capital of Bavaria

International Nuclear Information System (INIS)

Schmalschlaeger, T.; Sammueller, K.

1994-01-01

The purpose of the present study was to prepare, execute, and evaluate a poll among all the operators of solar heating plants promoted by the 'Foerderprogramm Energieeinsparung der Landeshauptstadt Muenchen' (Energy Conservation Promotion Programme for Munich). In the period from 1989 to April 1992 grants of upto 30% of investment costs were accorded by the city administration of Munich for solar heating plants and the technical energy conserving measures, notably high-efficiency boilers and some photovoltaic plants. The principal upper limit for grants was 25,000 DM per one or two-family house plus another 4.000 DM in certain borderline cases. Until early 1992 more than 350 households had made use of the grants offered by the Munich administration through this programme to finance thir solar heating plant. (orig.) [de

Patient Dose Considerations in Interventional Cardiology

International Nuclear Information System (INIS)

Ciraj-Bjelac, O.; Rafajlovic, S.; Arandjic, D.; Kosutic, D.

2011-01-01

Interventional cardiology procedures are classified as high-dose procedures, owing to increased risk for radiation skin injuries and stochastic effects, such as cancer. European MED Directive 97/43 requires special consideration and dose evaluation for this kind of procedures . Dose received by a patient, in general, depends on the radiological equipment, examination protocol, the way it is implemented, the patient's body weight and nature of disease. Long-term fluoroscopy of certain parts of the body, a significant body mass, high-value dose intensity, continuous rather than pulsed fluoroscopy, small focus-skin distance and repeated procedure on the same patient, are among the factors that can lead to radiation skin injuries. A particular challenge is the fact that the radiation damage of the skin is difficult to detect and connect to the previously conducted cardiologic procedures. The fact that such injuries do not have immediate manifestation is very often reason that many of them remain undetected. The purpose of this work is to assess the level of radiation dose to patients in percutaneous coronary interventions (PCI) and to investigate possibility for setting of a practical trigger value if dose quantities exceed certain levels in terms of dose descriptors available at display of interventional cardiology unit. Two dedicated interventional cardiology units in a large teaching cardiac centre (Clinical Centre of Serbia, Belgrade, Serbia) were included in the survey. Both rooms (D and F) were equipped with X-ray units of the identical model: Siemens Axiom Artis (Siemens, Erlangen, Germany) with the flat panel detector and integrated ionization chamber to measure air kerma-area product (P K A) and air kerma in international reference point (K I RP). Patient doses were assessed in terms of P K A, K I RP and maximum-skin dose (MSD). P K A and K I RP were assessed using a built-in, in situ calibrated dosimeters, while MSD was estimated using radiochromic films

Career Preferences and Perceptions of Cardiology Among US Internal Medicine Trainees: Factors Influencing Cardiology Career Choice.

Science.gov (United States)

Douglas, Pamela S; Rzeszut, Anne K; Bairey Merz, C Noel; Duvernoy, Claire S; Lewis, Sandra J; Walsh, Mary Norine; Gillam, Linda

2018-05-30

Few data exist on internal medicine trainees' selection of cardiology training, although this is important for meeting future cardiology workforce needs. To discover trainees' professional development preferences and perceptions of cardiology, and their relationship to trainees' career choice. We surveyed trainees to discover their professional development preferences and perceptions of cardiology and the influence of those perceptions and preferences on the trainees' career choices. Participants rated 38 professional development needs and 19 perceptions of cardiology. Data collection took place from February 2009, through January 2010. Data analysis was conducted from May 2017 to December 2017. Multivariable models were used to determine the association of demographics and survey responses with prospective career choice. A total of 4850 trainees were contacted, and 1123 trainees (of whom 625 [55.7%] were men) in 198 residency programs completed surveys (23.1% response; mean [SD] age, 29.4 [3.5] years). Principal component analysis of survey responses resulted in 8-factor and 6-factor models. Professional development preferences in descending order of significance were stable hours, family friendliness, female friendliness, the availability of positive role models, financial benefits, professional challenges, patient focus, and the opportunity to have a stimulating career. The top perceptions of cardiology in descending order of significance were adverse job conditions, interference with family life, and a lack of diversity. Women and future noncardiologists valued work-life balance more highly and had more negative perceptions of cardiology than men or future cardiologists, who emphasized the professional advantages available in cardiology. Professional development factors and cardiology perceptions were strongly associated with a decision to pursue or avoid a career in cardiology in both men and women. Alignment of cardiology culture with trainees' preferences

Instituto de bioquímica Munich - Alemania Federal

Directory of Open Access Journals (Sweden)

Beckert, -

1975-05-01

Full Text Available This building, situated in Martinsried, Munich, was awarded the first prize in an international contest. It consists of 15 departments, basically meant for education and research. The complex occupies a large ground, with extensive green zones and covered passages that connect the different blocks, all of them very low: class rooms, testing rooms, electronic microscopy, library, social centre, restaurant auditorium, housing, etc.Este edificio, situado en Martinsried, Munich, fue seleccionado, con el primer premio, en un concurso internacional convocado al efecto. Comprende 15 departamentos destinados, fundamentalmente, a la enseñanza e investigación. El conjunto ocupa una amplia parcela, con profusión de zonas verdes y pasos cubiertos que enlazan los diferentes bloques, todos ellos de poca altura: clases, salas de ensayos, microscopía electrónica, biblioteca, centro social, restaurante, salón de actos, viviendas, etcétera.

Artificial Intelligence in Cardiology.

Science.gov (United States)

Johnson, Kipp W; Torres Soto, Jessica; Glicksberg, Benjamin S; Shameer, Khader; Miotto, Riccardo; Ali, Mohsin; Ashley, Euan; Dudley, Joel T

2018-06-12

Artificial intelligence and machine learning are poised to influence nearly every aspect of the human condition, and cardiology is not an exception to this trend. This paper provides a guide for clinicians on relevant aspects of artificial intelligence and machine learning, reviews selected applications of these methods in cardiology to date, and identifies how cardiovascular medicine could incorporate artificial intelligence in the future. In particular, the paper first reviews predictive modeling concepts relevant to cardiology such as feature selection and frequent pitfalls such as improper dichotomization. Second, it discusses common algorithms used in supervised learning and reviews selected applications in cardiology and related disciplines. Third, it describes the advent of deep learning and related methods collectively called unsupervised learning, provides contextual examples both in general medicine and in cardiovascular medicine, and then explains how these methods could be applied to enable precision cardiology and improve patient outcomes. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

History of pediatric cardiology in India

OpenAIRE

Anita Saxena

2015-01-01

In India, the discipline of cardiology started in the late 1950s and at that time pediatric cardiology was practiced as a part of cardiology specialty. This article traces the history of pediatric cardiology in India. Dr. S. Padmawati and Dr. Kamala Vytilingam underwent training in pediatric cardiology at international centers in the early 1950s and early 1960s. Dr. N. Gopinath successfully closed a ventricular septal defect using a pump oxygenator at Christian Medical College, Vellore. Open ...

A measurement based analysis of the spatial distribution, temporal variation and chemical composition of particulate matter in Munich and Augsburg

Directory of Open Access Journals (Sweden)

Klaus Schäfer

2011-02-01

Full Text Available The objective of the studies presented in this paper is to present an analysis of spatial distribution and temporal variation of particulate matter in Munich and Augsburg, Germany, and to identify and discuss the factors determining the aerosol pollution in both areas. Surface-based in-situ and remote sensing measurements of particle mass and particle size distribution have been performed in, around, and above the two cities. Two measurement campaigns were conducted in Munich, one in late spring and one in winter 2003. Another campaign has been on-going in Augsburg since 2004. Spatial and temporal variations are analyzed from this data (PM10, PM2.5, and PM1. There are higher particle mass concentrations at the urban site than at the surrounding rural sites, especially in winter. No significant difference in the major ionic composition of the particles between the urban and the rural site was detected. This is considered to be related to the spatial distribution of secondary inorganic aerosol that is more homogeneous than aerosol resulting from other sources like traffic or urban releases in general. During the measurement campaigns mixing layer heights were determined continuously by remote sensing (SODAR, ceilometer, RASS. Significant dependence of particle size distribution and particle mass concentration on mixing layer height was found. This finding paves the way to new applications of satellite remote sensing products.

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

Science.gov (United States)

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. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

The upgraded Munich linear heavy ion postaccelerator

International Nuclear Information System (INIS)

Ratzinger, U.; Nolte, E.; Geier, R.; Gartner, N.; Morinaga, H.

1987-01-01

The Munich heavy ion postaccelerator was extended, consisting of two cavities with an interdigital H-type structure now. The frequency is doubled in the second section. A special kind of beam dynamics for O 0 -synchronous particle structures was developed, which results in good particle transmission though only one compact quadrupole-doublet is installed over the length of both linacs. Beamtime experience confirms the transport calculations

History of pediatric cardiology in India

Directory of Open Access Journals (Sweden)

Anita Saxena

2015-01-01

Full Text Available In India, the discipline of cardiology started in the late 1950s and at that time pediatric cardiology was practiced as a part of cardiology specialty. This article traces the history of pediatric cardiology in India. Dr. S. Padmawati and Dr. Kamala Vytilingam underwent training in pediatric cardiology at international centers in the early 1950s and early 1960s. Dr. N. Gopinath successfully closed a ventricular septal defect using a pump oxygenator at Christian Medical College, Vellore. Open heart surgery program kicked off in the 1960s with the tireless efforts of many other surgeons. Dr. Rajendra Tandon, trained for 2 years at Boston Children Hospital under Dr. Alexander Nadas, joined the Department of Cardiology at the All India Institute of Medical Sciences, New Delhi in 1963. This and many other stories are described.

Nuclear cardiology - its current status

International Nuclear Information System (INIS)

Khanna, C.M.

1983-01-01

Nuclear cardiology has been an exciting new field of nuclear medicine. Few examples of the dynamism and excitement of nuclear medicine demonstrate this field's vitality in the way that nuclear cardiology does. Recent new developments in radiopharmaceuticals and instrumentation have established this field as an extremely useful clinical tool and provide a new dimension to the evaluation of a cardiac patient, more so being nonivasive in nature. An attempt has been made to focus the attention on some of the recent advances in nuclear cardiology with a special reference to its clinical application in the field of cardiology. Nuclear cardiology is the most important field of nuclear medicine which has shown most promising results and has opened a new horizon in the field of diagnostic noninvasive cardiac technique. Now it has come of age in concept, instrument development and clinical application. It is very rapidly growing into a subspeciality. (author)

Comparison of Urban and Suburban Rail Transport in Germany and in the Czech Republic

Directory of Open Access Journals (Sweden)

Seidenglanz Daniel

2014-06-01

Full Text Available Rail transport is an environmentally friendly form of passenger transport which can be utilized effectively also in urban and suburban transport systems. The paper describes the urban and suburban rail transport system including comparison of selected Czech (Prague, Brno and Ostrava and German metropolitan regions (Munich, Nuremberg and Dresden. Its aim is to analyze the importance of various factors influencing the differences between the situation in Germany and in the Czech Republic. Therefore, the research question is whether these differences are primarily caused by a different liberalization stage, or whether they are a result of other factors such as available infrastructure, investment level, rail transport services budget, structure and activity of ordering bodies and coordinators or geographical context. The supply of city and suburban rail transport is quite good in Germany and in the Czech Republic, although trains in Munich, Nuremberg and Dresden run more frequently, faster and are better interconnected with car transport. German rail transport sector is at a higher stage of liberalization, and tendering procedures are the preferred selection method for contractor carriers. However, a degree of liberalization of the railway sector is not the key marker indicating a better standard of urban and suburban rail transport in Germany because it is the high standard which is achieved as the consequence of the professional activity of the ordering bodies and train service coordinators in combination with geographical conditions, available financial sources and effective transport infrastructure. On the other hand, the importance of liberalization cannot be totally overlooked as tenders are a tool for the ordering bodies to strongly affect the price and quality of transport services in their area. The supply of better quality and attractive transport to passengers could increase the usage of rail transport in metropolitan regions and could

Partner, workplace, and stranger abuse during pregnancy in Germany.

Science.gov (United States)

Stöckl, Heidi; Hertlein, Linda; Friese, Klaus; Stöckl, Doris

2010-11-01

To investigate the prevalence, perpetrators, sociodemographic correlates, and health impacts of psychological, physical, and sexual abuse during pregnancy among women attending a maternity ward in Germany. A written questionnaire was given to pregnant women in a maternity ward of a university hospital in Munich. Abuse during pregnancy was assessed using the Abuse Assessment Screen. Of 552 women, 401 completed the questionnaire for a response rate of 72.6%. The prevalence of psychological, physical, or sexual abuse during pregnancy by any perpetrator was 6.7% (n = 27); the main perpetrators were women's partners and work colleagues. After controlling for the effect of age, psychological, physical, or sexual abuse during pregnancy was significantly associated with a history of abuse, low education level of the woman and the father of her child, short relationship duration, unintended pregnancy, financial problems caused by the pregnancy, having more than 3 children, and insufficient social support. Women who reported abuse during pregnancy were significantly more likely to smoke and to have adverse maternal health outcomes. Psychological, physical, or sexual abuse during pregnancy was experienced by 1 in 15 women who attended a maternity ward in Munich and adversely affected maternal health outcomes. Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

How to Practice Sports Cardiology: A Cardiology Perspective.

Science.gov (United States)

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. Copyright © 2015 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

Nuclear cardiology in Iran

International Nuclear Information System (INIS)

Zakavi, R.

2002-01-01

Nuclear cardiology is one of the most active branches of nuclear medicine and plays important role in diagnosis in treatment of CAD patients. Few nuclear cardiology surveys were published in the literature, mostly from developed countries. A nuclear cardiology survey in Iran and analysis of the findings in comparison with other countries may lead to better decision making and improve practice in our country. A questionnaire was sent by mail or e-mail to all nuclear medicine centers in Iran asking for details of nuclear cardiology practice. Also ownership of the centers, number of gamma cameras and number of cardiac studies in each week were recorded. Some centers were studied using telephone interview. From 79 nuclear medicine centers in Iran, 55 centers (69.6%) filled the questionnaire including 28 centers in Tehran and 27 centers in other cities. There was 69 Gamma cameras in these centers, 62.3% with SPECT capability. It is estimated that we may have 100 gamma cameras in Iran. This study showed that about 68287 cardiac studies were done in Iran each year with Myocardial perfusion scan accounting for about 99 2% of the studies. Considering population of the country nuclear cardiology activity will be about 1.05 study/1000/year. Regarding radiotracers used, about 13.5% of studies were done with T I-201, with some centers using only Tc- 99 m-M I B I

Nuclear cardiology

International Nuclear Information System (INIS)

Bashore, T.M.; Shaffer, P.B.

1985-01-01

The birth of nuclear cardiology has generally been attributed to a 1927 experiment during which a radium salt was injected in one arm vein and the circulation time calculated by recording the arrival of the radioactivity in the opposite arm. This simple experiment lead to the radiocardiogram in the late 1940s that was used to measure left ventricular function and, later, cardiac output. This chapter provides a brief overview of nuclear cardiology. Methodology is presented when it is important for the understanding of test results. The use of these studies in the diagnosis and evaluation of patients with suspected cardiovascular disease is emphasized

The role of Germany in resolving the ukrainian crisis

Directory of Open Access Journals (Sweden)

Olena L. Hilchenko

2016-02-01

Full Text Available The article analyzes the participation of Germany in the matter of the Ukrainian crisis 2013-2015 and presents some approaches to the definition of the term «Ukrainian crisis». Reveals the reasons that lead Germany to take an active position in solving the Ukrainian question. Characterized the evolution of German-Russian relations from 90s to 2014, within which examined the St. Petersburg dialogue, «Pact of Putin-Schroeder», «Weimar triangle», «Partnership for modernization», Russian-Georgian conflict 2008. Available analysis of the new strategy of German foreign policy in 2012 «to support globalization – develop partnerships to share responsibility» and a new paradigm of German foreign policy presented in 2014 in the framework of the Munich conference on security policy. Examines the role of Germany in the European integration process of Ukraine during the Euromaidan events, the signing of the Association Agreement of Ukraine with the EU, ratification and future prospects of the enlargement of the European Union through the Eastern partnership countries. Presents the results of the public opinion of the population of Germany on this issue. Analyzes the position of the Germany government regarding the annexation of Crimea, the illegal referendum in Donetsk and Lugansk regions and the military aggression of Russian Federation against Ukraine. Presents description of the Germany role in the process of the diplomatic settlement of the military conflict in the East Ukraine in the framework of Norman four. On the example of polls are considered the public opinion of the population of Germany concerning possible ways of settlement the Ukrainian crisis. Presents the official position of the President of the Federal Republic of Germany. J. Gauck, Chancellor Merkel, Foreign Minister Frank-V. Steinmeier and Minister of Finance Schaeuble on certain issues of the Ukrainian crisis and the prolongations of sanctions against the Russian Federation

Diagnostic procedures in cardiology: A clinician's guide

International Nuclear Information System (INIS)

Warren, J.V.; Lewis, R.P.

1985-01-01

This book contains 31 papers. Some of the titles are: Cardiovascular radiology; Nuclear cardiology; echocardiography; The use and conduct of exercise tests; Lipid studies in cardiology; and The practice of cardiology in an era of high technology

Current trends in Nuclear Cardiology. Cuban scenario

International Nuclear Information System (INIS)

Peix González, Amalia

2016-01-01

The study concludes with the following recommendations. Nuclear Cardiology extend to the entire country. Conduct cost-effectiveness studies comparing different imaging techniques in cardiology. Develop metabolic studies and coronary flow by PET. Introducing the study of adrenergic innervation. Develop hybrid imaging in cardiology. Establish committees of experts to analyze the value of different imaging techniques in Cardiology According to our possibilities and resources, toward implementation of a medicine individualized for our patients

Big Data for cardiology: novel discovery?

Science.gov (United States)

Mayer-Schönberger, Viktor

2016-03-21

Big Data promises to change cardiology through a massive increase in the data gathered and analysed; but its impact goes beyond improving incrementally existing methods. The potential of comprehensive data sets for scientific discovery is examined, and its impact on the scientific method generally and cardiology in particular is posited, together with likely consequences for research and practice. Big Data in cardiology changes how new insights are being discovered. For it to flourish, significant modifications in the methods, structures, and institutions of the profession are necessary. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Cardiology Mannequin

Science.gov (United States)

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.

Geriatric Cardiology: An Emerging Discipline.

Science.gov (United States)

Dodson, John A; Matlock, Daniel D; Forman, Daniel E

2016-09-01

Given changing demographics, patients with cardiovascular (CV) disease in developed countries are now older and more complex than even a decade ago. This trend is expected to continue into the foreseeable future; accordingly, cardiologists are encountering patients with a greater number of comorbid illnesses as well as "geriatric conditions," such as cognitive impairment and frailty, which complicate management and influence outcomes. Simultaneously, technological advances have widened the therapeutic options available for patients, including those with the most advanced CV disease. In the setting of these changes, geriatric cardiology has recently emerged as a discipline that aims to adapt principles from geriatric medicine to everyday cardiology practice. Accordingly, the tasks of a "geriatric cardiologist" may include both traditional evidence-based CV management plus comprehensive geriatric assessment, medication reduction, team-based coordination of care, and explicit incorporation of patient goals into management. Given that the field is still in its relative infancy, the training pathways and structure of clinical programs in geriatric cardiology are still being delineated. In this review, we highlight the rationale behind geriatric cardiology as a discipline, several current approaches by geriatric cardiology programs, and future directions for the field. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Advance of nuclear cardiology in clinical application

International Nuclear Information System (INIS)

Shi Hongcheng

2007-01-01

Nuclear cardiology has make a little bit progress in the past year. Both nuclear cardiology and other cardiac imaging have its own advantage and disadvantage in the diagnostic of coronary artery disease. And the relationship of them is complementary but not instead of each other. Nuclear cardiology provides a one-stop shop for diagnosis, risk stratification, and management of coronary artery disease. Nuclear cardiology plays a very important role in the diagnostic of coronary artery disease in early stage in the special group of people. (authors)

Transradial access: lessons learned from cardiology.

Science.gov (United States)

Snelling, Brian M; Sur, Samir; Shah, Sumedh Subodh; Marlow, Megan M; Cohen, Mauricio G; Peterson, Eric C

2018-05-01

Innovations in interventional cardiology historically predate those in neuro-intervention. As such, studying trends in interventional cardiology can be useful in exploring avenues to optimise neuro-interventional techniques. One such cardiology innovation has been the steady conversion of arterial puncture sites from transfemoral access (TFA) to transradial access (TRA), a paradigm shift supported by safety benefits for patients. While neuro-intervention has unique anatomical challenges, the access itself is identical. As such, examining the extensive cardiology literature on the radial approach has the potential to offer valuable lessons for the neuro-interventionalist audience who may be unfamiliar with this body of work. Therefore, we present here a report, particularly for neuro-interventionalists, regarding the best practices for TRA by reviewing the relevant cardiology literature. We focused our review on the data most relevant to our audience, namely that surrounding the access itself. By reviewing the cardiology literature on metrics such as safety profiles, cost and patient satisfaction differences between TFA and TRA, as well as examining the technical nuances of the procedure and post-procedural care, we hope to give physicians treating complex cerebrovascular disease a broader data-driven understanding of TRA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A universal model of giftedness - adaptation of the Munich Model

NARCIS (Netherlands)

Jessurun, J.H.; Shearer, C.B.; Weggeman, M.C.D.P.

2016-01-01

The Munich Model of Giftedness (MMG) by Heller and his colleagues, developed for the identification of gifted children, is adapted and expanded, with the aim of making it more universally usable as a model for the pathway from talents to performance. On the side of the talent-factors, the concept of

Pediatric Cardiology Boot Camp: Description and Evaluation of a Novel Intensive Training Program for Pediatric Cardiology Trainees.

Science.gov (United States)

Ceresnak, Scott R; Axelrod, David M; Motonaga, Kara S; Johnson, Emily R; Krawczeski, Catherine D

2016-06-01

The transition from residency to subspecialty fellowship in a procedurally driven field such as pediatric cardiology is challenging for trainees. We describe and assess the educational value of a pediatric cardiology "boot camp" educational tool designed to help prepare trainees for cardiology fellowship. A two-day intensive training program was provided for pediatric cardiology fellows in July 2015 at a large fellowship training program. Hands-on experiences and simulations were provided in: anatomy, auscultation, echocardiography, catheterization, cardiovascular intensive care (CVICU), electrophysiology (EP), heart failure, and cardiac surgery. Knowledge-based exams as well as surveys were completed by each participant pre-training and post-training. Pre- and post-exam results were compared via paired t tests, and survey results were compared via Wilcoxon rank sum. A total of eight participants were included. After boot camp, there was a significant improvement between pre- and post-exam scores (PRE 54 ± 9 % vs. POST 85 ± 8 %; p ≤ 0.001). On pre-training survey, the most common concerns about starting fellowship included: CVICU emergencies, technical aspects of the catheterization/EP labs, using temporary and permanent pacemakers/implantable cardiac defibrillators (ICDs), and ECG interpretation. Comparing pre- and post-surveys, there was a statistically significant improvement in the participants comfort level in 33 of 36 (92 %) areas of assessment. All participants (8/8, 100 %) strongly agreed that the boot camp was a valuable learning experience and helped to alleviate anxieties about the start of fellowship. A pediatric cardiology boot camp experience at the start of cardiology fellowship can provide a strong foundation and serve as an educational springboard for pediatric cardiology fellows.

Mobile apps in cardiology: review.

Science.gov (United States)

Martínez-Pérez, Borja; de la Torre-Díez, Isabel; López-Coronado, Miguel; Herreros-González, Jesús

2013-07-24

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. 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. 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. 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 cardiac condition, and there were no

“Inspired by real events”—Media (and Memory in Steven Spielberg’s MUNICH (2005

Directory of Open Access Journals (Sweden)

Thomas Nachreiner

2016-02-01

Full Text Available Steven Spielberg’s 2005 film Munich tells the story of an Israeli counter-terrorist team in the aftermath of the hijacking and massacre at the Olympic Games in 1972. The film spawned broad discussion about its historical accuracy and its political standpoint. While criticism primarily focused on the historiographical representation of the actions depicted, this paper analyzes in two steps the genuinely filmic mode of historical representation ofMunich. First, the analysis discusses the interplay of two conflicting narrative strategies that negotiate the character development with the political struggle. And second, analysis focuses on the two formal devices at the core of the narrative conflict: The reflexive framing of television in the depiction of the Munich massacre as a traumatic media event and the excessive transformation of its memory in a series of flashbacks. Such elaboration of the narrative and formal strategies reveals the implicit historiographical structures of the film and suggests that the notion of ‘cultural trauma’ serves as the preferential—but problematic—template in telling the history of terrorism and violence.

A Cryogenic Detector Characterization Facility in the Shallow Underground Laboratory at the Technical University of Munich

Science.gov (United States)

Langenkämper, A.; Defay, X.; Ferreiro Iachellini, N.; Kinast, A.; Lanfranchi, J.-C.; Lindner, E.; Mancuso, M.; Mondragón, E.; Münster, A.; Ortmann, T.; Potzel, W.; Schönert, S.; Strauss, R.; Ulrich, A.; Wawoczny, S.; Willers, M.

2018-04-01

The Physics Department of the Technical University of Munich operates a shallow underground detector laboratory in Garching, Germany. It provides ˜ 160 {m^2} of laboratory space which is shielded from cosmic radiation by ˜ 6 m of gravel and soil, corresponding to a shielding of ˜ 15 {m.w.e.} . The laboratory also houses a cleanroom equipped with work- and wetbenches, a chemical fumehood as well as a spin-coater and a mask-aligner for photolithographic processing of semiconductor detectors. Furthermore, the shallow underground laboratory runs two high-purity germanium detector screening stations, a liquid argon cryostat and a ^3 He-^4 He dilution refrigerator with a base temperature of ≤ 12-14 mK . The infrastructure provided by the shallow laboratory is particularly relevant for the characterization of CaWO_4 target crystals for the CRESST-III experiment, detector fabrication and assembly for rare event searches. Future applications of the laboratory include detector development in the framework of coherent neutrino nucleus scattering experiments (ν -cleus) and studying its potential as a site to search for MeV-scale dark matter with gram-scale cryogenic detectors.

The localization of marbles from busts of the Residence at Munich

International Nuclear Information System (INIS)

Riederer, J.; Hoefs, J.

1980-01-01

51 Greek, Roman and Renaissance marble busts from the Antiquarium of the Residence in Munich were studied for their C- and O-isotopic composition. Apart from some overlapping values, this technique permits - contrary to microscopic and chemical methods - localization of different Turkish, Greek and Italian marbel deposits. (orig.) [de

Recent advances in nuclear cardiology

DEFF Research Database (Denmark)

Gutte, H.; Petersen, C. Leth; Kjaer, A.

2008-01-01

Nuclear cardiology is an essential part of functional, non-invasive, cardiac imaging. Significant advances have been made in nuclear cardiology since planar (201)thallium ((201)TI) scintigraphy was introduced for the evaluation of left ventricular (LV) perfusion nearly 40 years ago. The use...... of nuclear cardiology has been steadily increasing over the last 20 years with important steps being the introduction of (99m)technetium- ((99m)Tc)-labelled perfusion radiotracers, the change from only planar to now much more single photon emission computed tomography (SPECT) and positron emission tomography...... (PET), electrocardiogram gating of nuclear perfusion imaging, and finally introducing nuclear hybrid imaging using either SPECT or PET together with either computed tomography or magnetic resonance imaging. The indications have extended from nearly only coronary artery diseases to several non...

Artificial intelligence in cardiology.

Science.gov (United States)

Bonderman, Diana

2017-12-01

Decision-making is complex in modern medicine and should ideally be based on available data, structured knowledge and proper interpretation in the context of an individual patient. Automated algorithms, also termed artificial intelligence that are able to extract meaningful patterns from data collections and build decisions upon identified patterns may be useful assistants in clinical decision-making processes. In this article, artificial intelligence-based studies in clinical cardiology are reviewed. The text also touches on the ethical issues and speculates on the future roles of automated algorithms versus clinicians in cardiology and medicine in general.

On the evaluation of the Munich-Frascati Werber-type experiment

International Nuclear Information System (INIS)

Kafka, Peter

1974-01-01

The theory of optimal evaluation is sketched and applied to the case of short pulses of gravitational radiation. The concepts of one-detector and multi-detector sensitivity are clarified. Comparison of the equivalent circuits of various detectors and tests with artificial pulses show that the pulses reported by Weber should be detectable in coincidence between Munich and Frascati. First negative results are presented

Nuclear cardiology in Cuba present and perspectives

International Nuclear Information System (INIS)

Peix González, Amalia

2016-01-01

Heart Diseases represent the first cause of death worldwide (WHO, 2011); 80% of these deaths in developing countries (WHO, 2011); Coronary Heart Disease is responsible of 69% of all cardiovascular deaths. In Cuba, National programs have been developed to control the most important associated coronary risk factors; Research projects have been also carried out as part of the Ministry of Public Health’s program on non-transmissible chronic diseases; Strengthening of Nuclear Cardiology in Cuba, as well as its adequate integration in a diagnosis algorithm, focusing on improving the quality of medical care, in accordance with the principles of evidence-based medicine. Recommendations: Extend Nuclear Cardiology throughout the country; Conduct cost-effectiveness studies comparing different imaging techniques in cardiology; Develop coronary flow and metabolic studies with PET; Introducing studying adrenergic innervation; Develop hybrid imaging in cardiology; Set up committees of experts to analyze the value of different imaging techniques in cardiology in accordance with the possibilities and resources of Cuba, aimed at the implementation of a medicine individualized for patients. (author)

Cardiology

OpenAIRE

Fahey, Tom; Schroeder, Knut

2004-01-01

This article describes recent developments in cardiology and cardiovascular disease that are likely to be relevant to primary healthcare professionals and their patients. The following subject areas are covered: Primary prevention: recent developments in pharmacological interventions, drug interactions, and drugs that are likely to cause harm; cardiovascular risk estimation and shared decision making with patients; and new developments in 24-hour ambulatory blood pressure monitoring.Second...

Knowledge discovery in cardiology: A systematic literature review.

Science.gov (United States)

Kadi, I; Idri, A; Fernandez-Aleman, J L

2017-01-01

Data mining (DM) provides the methodology and technology needed to transform huge amounts of data into useful information for decision making. It is a powerful process employed to extract knowledge and discover new patterns embedded in large data sets. Data mining has been increasingly used in medicine, particularly in cardiology. In fact, DM applications can greatly benefit all those involved in cardiology, such as patients, cardiologists and nurses. The purpose of this paper is to review papers concerning the application of DM techniques in cardiology so as to summarize and analyze evidence regarding: (1) the DM techniques most frequently used in cardiology; (2) the performance of DM models in cardiology; (3) comparisons of the performance of different DM models in cardiology. We performed a systematic literature review of empirical studies on the application of DM techniques in cardiology published in the period between 1 January 2000 and 31 December 2015. A total of 149 articles published between 2000 and 2015 were selected, studied and analyzed according to the following criteria: DM techniques and performance of the approaches developed. The results obtained showed that a significant number of the studies selected used classification and prediction techniques when developing DM models. Neural networks, decision trees and support vector machines were identified as being the techniques most frequently employed when developing DM models in cardiology. Moreover, neural networks and support vector machines achieved the highest accuracy rates and were proved to be more efficient than other techniques. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The REX-ISOLDE-project and the Munich Accelerator for Fission Fragments MAFF

CERN Document Server

Habs, D; Assmann, R W; Emhofer, S; Engels, O; Gross, M; Kester, O; Maier, H J; Reiter, P; Sieber, T; Thirolf, P G

2001-01-01

After a general discussion of ISOL-facilities in Europe we focus on the present status of the REX-ISOLDE facility at CERN and the Munich Accelerator for Fission Fragments MAFF. At REX-ISOLDE in 2001 radioactive beams of ISOLDE will be accelerated to (0.8-2.4) MeV/u. At the new Munich high-flux reactor FRM-II a production target of MAFF with 10$^{14}$ fissions/s is under design. Probably in 2003 intense low-energy beams ( approximately=10$^{11}$/s) of very neutron-rich fission fragments will be available. For MAFF a linac is being developed, which will accelerate the ions after charge breeding to energies between 3.7 and 5.9 MeV/u. In the long term a recycling ring with large momentum acceptance will further increase the radioactive beam intensities by a factor of 10$^{2}$-10$^{3}$ for specific experiments. (33 refs).

Evaluation of cardiology consultations sought from the anaesthesia clinic

International Nuclear Information System (INIS)

Minai, F.N.; Kamal, R.S.

2004-01-01

Objective: To evaluate the criteria for cardiology referrals and to assess the perioperative relevance of the cardiology advice given in patients evaluated for non-cardiac surgery. Materials and Methods: A review of case files of 70 patients, scheduled for non-cardiac surgery, who were referred for cardiology consultations from the Anaesthesia Clinic at AKUH during the study period. The clinical criteria for seeking cardiology advice, the cardiology advice given, its influence on patient management, as well as number of adverse cardiac events in the perioperative period were documented. Results: A history of hypertension, ischemic heart disease, and ECG abnormalities were the major criteria for seeking opinion on cardiac status. Cardiology advice frequently resulted in the ordering of extensive cardiac investigations. Among the patients identified for further tests by the cardiologists, 75% had no evidence of ischemic heart disease or myocardial dysfunction; none of them were monitored invasively intraoperatively or had adverse cardiac events in the perioperative period requiring intensive care or prolonged hospital stay. Conclusion: No definite criteria or pattern for referrals was identified. Most of the referrals did not fall within the AHA guidelines. Cardiology advice given had very little influence on the perioperative management. (author)

Zoning and workstation analysis in interventional cardiology

International Nuclear Information System (INIS)

Degrange, J.P.

2009-01-01

As interventional cardiology can induce high doses not only for patients but also for the personnel, the delimitation of regulated areas (or zoning) and workstation analysis (dosimetry) are very important in terms of radioprotection. This paper briefly recalls methods and tools for the different steps to perform zoning and workstation analysis. It outlines the peculiarities of interventional cardiology, presents methods and tools adapted to interventional cardiology, and then discusses the same issues but for workstation analysis. It also outlines specific problems which can be met, and their possible adapted solutions

Nuclear cardiology in Iran in 2002

International Nuclear Information System (INIS)

Zakavi, S. R.

2004-01-01

Aim: few nuclear cardiology surveys, were published in the literature, mostly from developed countries. the aim of this study is to perform a nuclear cardiology survey in iran. This may lead to better decision making and programming. Methods and materials: a questionnaire was sent by mail or e- mail to all nuclear medicine centers in iran asking for details of nuclear cardiology practice in year 2002. Also ownership of the center were studied using telephone interviews. Results: from 79 nuclear medicine centers in Iran, 55 centers (69.6%) filled the questionnaire including 28 centers in Tehran and 27 centers in other cities. Among them, 27 centers were private clinics. There was 69 gamma cameras in these centers, 62.3 % with SPECT capabilities. it is estimated that we may have 100 gamma cameras in Iran. About 85.5 % of centers perform cardiac studies routinely. Tc-99m-MIBI is used in more than 85.7% of the studies and some centers do not use Tl-201. Pharmacological stress with infusion of Dipyridamole is used in 56.7% of the studies and treadmill is the main type of physical exercise (40.2%). SPECT technique was used in 93% of studies including 2.5% of gated SPECT. About 64.3% of centers used two day protocol for imaging.Our study showed that about 65594 cardiac studies were done in Iran each year with myocardial perfusion scan accounting for about 99.2% of the studies. Considering population of the country(about 65 millions) nuclear cardiology activity will be about 1.01 study/1000/year. For viability assessment, Tl-201 with rest redistribution technique is used in 10.7 % of cases while re-injection is used in 29.8% of cases and TNG augmented Tc-99m-MIBI injection at rest in 59.5%. Discussion: Activity of nuclear cardiology is about 15 studies/1000 population/year is USA and 2.2 studies/1000/year in Europe. Although it is not uniformly practiced in different countries of Europe, however the numbers indicate that nuclear cardiology is under utilized in Iran ( less

Meaningful, entertaining, popular and ‘Bavarian’: art into design in nineteenth century Munich

Directory of Open Access Journals (Sweden)

Stefan Muthesius

2014-12-01

Full Text Available Among European regional stereotypes few come across as strongly and consistently as ‘Bavaria’. Its strength is derived from the ways in which it appears to be firmly and comprehensively grounded in its land and its people. This article traces the way in which some of the stereotype’s associated forms and images, principally those related to the domestic environment, were first conceived during the nineteenth century. The principal claim is that it was the nineteenth century artists, architects and designers in the Kunststadt Munich, who, helped by the critics, arrived at very specific valorisations of their designs, which could then be applied in an essentialist way to all artefacts of the region, old or new. The article divides the Munich design activities into two phases. During the 1850s designers aimed for a poetic and ‘volkstümlich / popular’ kind of decoration of common objects, including scenes from Bavarian ‘folk’ poetry. In the second phase, during the 1870s and 1880s, interest turned more directly to the domestic environment of Alpine houses, valorising a plain wooden character. Clearly, an absolute belief in in a primeval and unchanging ‘Bavaria’ cannot be entertained any more. But neither should one classify it all as modern kitsch. The latter attitude must be the reason why the subject has hardly been touched on in the copious art histories of Munich so far.

Development of Quality Metrics in Ambulatory Pediatric Cardiology.

Science.gov (United States)

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. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Current Status and Future Perspective of Nuclear Cardiology

International Nuclear Information System (INIS)

Chung, June Key

2009-01-01

Coronary artery disease is on the rise over the world. Myocardial perfusion SPECT is a well established technique to detect coronary artery disease and to assess left ventricular function. In addition, it has the unique ability to predict the prognosis of the patients. Moreover, the application of ECG-gated images provided the quantitative data and improved the accuracy. This approach has been proved to be cost-effective and suitable for the emerging economies as well as developed countries. However, the utilization of nuclear cardiology procedures vary widely considering the different countries and region of the world. Korea exits 2-3 times less utilization than Japan, and 20 times than the United States. Recently, with the emerging of new technology, namely cardiac CT, cardiac MR and stress echocardiography, the clinical usefulness of nuclear cardiology has been called in question and its role has been redefined. For the proper promotion of nuclear cardiology, special educations should be conducted since the nuclear cardiology has the contact points between nuclear medicine and cardiology. Several innovations are in horizon which will impact the diagnostic accuracy as well as imaging time and cost savings. Development of new tracers, gamma camera technology and hybrid systems will open the new avenue in cardiac imaging. The future of nuclear cardiology based on molecular imaging is very exciting. The newly defined biologic targets involving atherosclerosis and vascular vulnerability will allow the answers for the key clinical questions. Hybrid techniques including SPECT/CT indicate the direction in which clinical nuclear cardiology may be headed in the immediate future. To what extent nuclear cardiology will be passively absorbed by other modalities, or will actively incorporate other modalities, is up to the present and next generation of nuclear cardiologists

Current Status and Future Perspective of Nuclear Cardiology

Energy Technology Data Exchange (ETDEWEB)

Chung, June Key [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2009-06-15

Coronary artery disease is on the rise over the world. Myocardial perfusion SPECT is a well established technique to detect coronary artery disease and to assess left ventricular function. In addition, it has the unique ability to predict the prognosis of the patients. Moreover, the application of ECG-gated images provided the quantitative data and improved the accuracy. This approach has been proved to be cost-effective and suitable for the emerging economies as well as developed countries. However, the utilization of nuclear cardiology procedures vary widely considering the different countries and region of the world. Korea exits 2-3 times less utilization than Japan, and 20 times than the United States. Recently, with the emerging of new technology, namely cardiac CT, cardiac MR and stress echocardiography, the clinical usefulness of nuclear cardiology has been called in question and its role has been redefined. For the proper promotion of nuclear cardiology, special educations should be conducted since the nuclear cardiology has the contact points between nuclear medicine and cardiology. Several innovations are in horizon which will impact the diagnostic accuracy as well as imaging time and cost savings. Development of new tracers, gamma camera technology and hybrid systems will open the new avenue in cardiac imaging. The future of nuclear cardiology based on molecular imaging is very exciting. The newly defined biologic targets involving atherosclerosis and vascular vulnerability will allow the answers for the key clinical questions. Hybrid techniques including SPECT/CT indicate the direction in which clinical nuclear cardiology may be headed in the immediate future. To what extent nuclear cardiology will be passively absorbed by other modalities, or will actively incorporate other modalities, is up to the present and next generation of nuclear cardiologists.

A Universal Model of Giftedness--An Adaptation of the Munich Model

Science.gov (United States)

Jessurun, J. H.; Shearer, C. B.; Weggeman, M. C. D. P.

2016-01-01

The Munich Model of Giftedness (MMG) by Heller and his colleagues, developed for the identification of gifted children, is adapted and expanded, with the aim of making it more universally usable as a model for the pathway from talents to performance. On the side of the talent-factors, the concept of multiple intelligences is introduced, and the…

Conference scene: DGVS spring conference 2009.

Science.gov (United States)

Kolligs, Frank Thomas

2009-10-01

The 3rd annual DGVS Spring Conference of the German Society for Gastroenterology (Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten) was held at the Seminaris Campus Hotel in Berlin, Germany, on 8-9 May, 2009. The conference was organized by Roland Schmid and Matthias Ebert from the Technical University of Munich, Germany. The central theme of the meeting was 'translational gastrointestinal oncology: towards personalized medicine and individualized therapy'. The conference covered talks on markers for diagnosis, screening and surveillance of colorectal cancer, targets for molecular therapy, response prediction in clinical oncology, development and integration of molecular imaging in gastrointestinal oncology and translational research in clinical trial design. Owing to the broad array of topics and limitations of space, this article will focus on biomarkers, response prediction and the integration of biomarkers into clinical trials. Presentations mentioned in this summary were given by Matthias Ebert (Technical University of Munich, Germany), Esmeralda Heiden (Epigenomics, Berlin, Germany), Frank Kolligs (University of Munich, Germany), Florian Lordick (University of Heidelberg, Germany), Hans Jorgen Nielsen (University of Copenhagen, Denmark), Anke Reinacher-Schick (University of Bochum, Germany), Christoph Röcken (University of Berlin, Germany), Wolff Schmiegel (University of Bochum, Germany) and Thomas Seufferlein (University of Halle, Germany).

Recent advances in nuclear cardiology

International Nuclear Information System (INIS)

Lee, Won Woo

2016-01-01

Nuclear cardiology is one of the major fields of nuclear medicine practice. Myocardial perfusion studies using single-photon emission computed tomography (SPECT) have played a crucial role in the management of coronary artery diseases. Positron emission tomography (PET) has also been considered an important tool for the assessment of myocardial viability and perfusion. However, the recent development of computed tomography (CT)/magnetic resonance imaging (MRI) technologies and growing concerns about the radiation exposure of patients remain serious challenges for nuclear cardiology. In response to these challenges, remarkable achievements and improvements are currently in progress in the field of myocardial perfusion imaging regarding the applicable software and hardware. Additionally, myocardial perfusion positron emission tomography (PET) is receiving increasing attention owing to its unique capability of absolute myocardial blood flow estimation. An F-18-labeled perfusion agent for PET is under clinical trial with promising interim results. The applications of F-18 fluorodeoxyglucose (FDG) and F-18 sodium fluoride (NaF) to cardiovascular diseases have revealed details on the basic pathophysiology of ischemic heart diseases. PET/MRI seems to be particularly promising for nuclear cardiology in the future. Restrictive diseases, such as cardiac sarcoidosis and amyloidosis, are effectively evaluated using a variety of nuclear imaging tools. Considering these advances, the current challenges of nuclear cardiology will become opportunities if more collaborative efforts are devoted to this exciting field of nuclear medicine

Cardiological-interventional therapy of coronary artery disease today

International Nuclear Information System (INIS)

Reynen, K.; Henssge, R.

1999-01-01

The current importance of the interventional therapy of coronary artery disease may be deduced from the exponential increase in procedures performed in Germany in the last decade - at least 125,840 in 1996. Today, by improved catheter and balloon materials as well as by growing experience of the cardiologists, even complex lesions may be treated. Limitations of balloon angioplasty include acute vessel closure and restenosis - newer angioplasty devices like directional or rotational atherectomy or excimer-laser angioplasty did not overcome these limitations; only by coronary stenting, acute vessel closure could be managed and the likelihood of restenosis - at least in particular groups of patients - could be reduced. For a few years, intracoronary brachytherapy of the segments dilated with beta- or gamma-emitters has been seeking to reduce restenosis rate; the department of cardiology of the Dresden Cardiovascular Institute is participating in such a multicentre study using the beta-emitter 188 renium. Further main topics of our department represent primary angioplasty in patients with acute myocardial infarction and invasive diagnostic or interventional procedures by the transradial approach. (orig.)

Major maintenance of the Munich MP-tandem

International Nuclear Information System (INIS)

Muenzer, H.; Carli, W.; Hartung, P.; Jakob, H.; Nocker, H.; Rohrer, L.; Schnitter, H.; Assmann, W.; Maier, H.J.; Machlitt, N.; Steffens, H.

1988-01-01

Several measures have been taken to restore the voltage performance of the Munich tandem. 1. All accelerator tubes were reconditioned by sandblasting, new electrodes and diaphragms were inserted and preassembled groups of tubes were baked in high vacuum. 2. All other vacuum components were cleaned, baked in high vacuum and partly pressure leak tested outside the tandem. 3. High voltage tests were performed with tubes. Without portico voltages up to 16 MV were obtained, with portico up to 17.5 MV. 4. Some modifications (e.g. infrared light links) were introduced. The shutdown lasted 6 months. In March 1987 beam operation was resumed at moderate terminal voltages, interrupted by intervals of soft conditioning. (orig.)

Motion and landscape : Otl Aicher, Günther Grzimek and the graphic and garden designs of the 1972 Munich Olympics.

OpenAIRE

Schiller, Kay; Young, Christopher

2010-01-01

This article focuses on Otl Aicher's design and Günther Grzimek's garden architecture for the 1972 Munich Olympics. We argue that the functionalist aesthetics of the Munich Olympic site should be interpreted as a translation into graphic and landscape design of 1960s progressivism in West German society and democracy. In the process Aicher and Grzimek somewhat paradoxically drew on the tradition of the Olympic Gesamtkunstwerk inaugurated in Berlin in 1936.

Radiographic Morphometry of the Lumbar Spine in Munich Miniature Pigs†

Science.gov (United States)

Engelke, Elisabeth C; Post, Christina; Pfarrer, Christiane D; Sager, Martin; Waibl, Helmut R

2016-01-01

The incidence of human spinal column disease remains high, and animal models still play important roles in prophylactic, diagnostic, and therapeutic research. Because of their similar size to humans, pigs remain an important spine model. For pigs to serve as a model for the human spine, basic similarities and differences must be understood. In this study, morphometric data of the lumbar spine of Munich miniature pigs (Troll) were recorded radiologically, evaluated, and compared with recorded human data. Whereas humans have a constant number of 5 lumbar vertebrae, Munich minipigs had 5 or 6 lumbar vertebrae. Compared with their human counterparts, the lumbar vertebral bodies of the minipigs were remarkably larger in the craniocaudal (superior–inferior) direction and considerably smaller in the dorsoventral and laterolateral directions. The porcine vertebral canal was smaller than the human vertebral canal. The spinal cord extended into the caudal part of the porcine lumbar vertebral canal and thus did not terminate as cranial, as seen in humans. The lumbar intervertebral spaces of the pig were narrower in craniocaudal direction than human intervertebral spaces. These differences need to be considered when planning surgical actions, not only to avoid pain and irreversible damage to the minipigs but also to achieve accurate scientific results. PMID:27177570

Integrating cardiology for nuclear medicine physicians. A guide to nuclear medicine physicians

International Nuclear Information System (INIS)

Movahed, Assad; Gnanasegaran, Gopinath; Buscombe, John R.; Hall, Margaret

2009-01-01

Nuclear cardiology is no longer a medical discipline residing solely in nuclear medicine. This is the first book to recognize this fact by integrating in-depth information from both the clinical cardiology and nuclear cardiology literature, and acknowledging cardiovascular medicine as the fundamental knowledge base needed for the practice of nuclear cardiology. The book is designed to increase the practitioner's knowledge of cardiovascular medicine, thereby enhancing the quality of interpretations through improved accuracy and clinical relevance.The text is divided into four sections covering all major topics in cardiology and nuclear cardiology: -Basic Sciences and Cardiovascular Diseases; -Conventional Diagnostic Modalities; -Nuclear Cardiology; -Management of Cardiovascular Diseases. (orig.)

Career choices for cardiology: cohort studies of UK medical graduates

Science.gov (United States)

2013-01-01

Background Cardiology is one of the most popular of the hospital medical specialties in the UK. It is also a highly competitive specialty in respect of the availability of higher specialty training posts. Our aims are to describe doctors’ early intentions about seeking careers in cardiology, to report on when decisions about seeking a career in cardiology are made, to compare differences between men and women doctors in the choice of cardiology, and to compare early career choices with later specialty destinations. Methods Questionnaire surveys were sent to all UK medical graduates in selected qualification years from 1974–2009, at 1, 3, 5, 7 and 10 years after graduation. Results One year after graduation, the percentage of doctors specifying cardiology as their first choice of long-term career rose from the mid-1990s from 2.4% (1993 cohort) to 4.2% (2005 cohort) but then fell back to 2.7% (2009 cohort). Men were more likely to give cardiology as their first choice than women (eg 4.1% of men and 1.9% of women in the 2009 cohort). The percentage of doctors who gave cardiology as their first choice of career declined between years one and five after qualification: the fall was more marked for women. 34% of respondents who specified cardiology as their sole first choice of career one year post-graduation were later working in cardiology. 24% of doctors practising as cardiologists several years after qualification had given cardiology as their sole first choice in year one. The doctors’ ‘domestic circumstances’ were a relatively unimportant influence on specialty choice for aspiring cardiologists, while ‘enthusiasm/commitment’, ‘financial prospects’, ‘experiences of the job so far’ and ‘a particular teacher/department’ were important. Conclusions Cardiology grew as a first preference one year after graduation to 2005 but is now falling. It consistently attracts a higher percentage of men than women doctors. The correspondence between early

The 2017 Seventh World Congress of Pediatric Cardiology & Cardiac Surgery: week in review - ambulatory pediatric cardiology.

Science.gov (United States)

Chowdhury, Devyani

2017-12-01

The Seventh World Congress of Pediatric Cardiology was held in Barcelona in July, 2017. The central philosophy of the congress was "bridging together" all major specialties in the field. This article summarises the highlights of the meeting as it relates to ambulatory paediatric cardiology. There is a now a more unified approach to children with CHD, including assessment of neuro-developmental outcomes. The new World Heart Foundation criteria for the diagnosis of rheumatic fever remain controversial.

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

Science.gov (United States)

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.

The practice of paediatric cardiology in Nigeria: A Review | Chinawa ...

African Journals Online (AJOL)

Background: The practice of Paediatric cardiology in Nigeria is at its early phase and it is being choked in an environment overwhelmed with economic, ethnic and political issues. Paediatric cardiology covers a broad area of medicine. This includes diagnosis, medical treatment, interventional cardiology, prenatal diagnosis ...

Management of suspected acute coronary syndrome patients admitted to cardiology or non-cardiology services at Auckland City Hospital: implications for future national data collection.

Science.gov (United States)

Wang, Tom Kai Ming; Chow, Kok-Lam; Lin, Aaron; Chataline, Alexei; White, Harvey; Dawes, Matthew; Gamble, Greg; Ellis, Chris

2018-03-09

To review the number, characteristics and clinical management of suspected ACS patients admitted to cardiology and non-cardiology services at Auckland City Hospital, to assess differences between these services and to assess the number who would potentially be enrolled in the All New Zealand Acute Coronary Syndrome (ACS) Quality Improvement Programme (ANZACS-QI) database. Auckland City Hospital patient data was extracted from the Australia and New Zealand ACS 'SNAPSHOT' audit, performed over 14 days in May 2012. There were 121 suspected ACS admissions to Auckland City hospital during the audit period, with 45 (37%) patients directly managed by the cardiology service, and 76 (63%) patients cared for by non-cardiology services. Based on the subsequent discharge diagnosis, the cardiology service had more patients with definite ACS than the non-cardiology services; 27/45 (60%) compared to 16/76 (21%), difference (95%CI) 39% (22-56), P<0.0001). Cardiology ACS patients were more likely to undergo echocardiography; 15/27 (56%) compared to 2/16 (13%), difference 42% (18-68), P=0.0089), coronary angiography; 21/27 (78%) compared to 3/16 (19%), difference (95%CI) 59% (34-84), P=0.0003), coronary revascularisation; 18/27 (67%) compared to 3/16 (19%), difference (95%CI) 48% (22-74), P=0.004, and be discharged on two antiplatelet agents; 18/26 (69%) compared to 3/15 (20%), difference (95%CI) 49% (22-76), P=0.0036, or an ACEI/ARB; 20/26 (77%) compared to 5/15 (33%), difference (95%CI) 44% (15-72), P=0.0088. In patients with a discharge diagnosis of definite ACS, those managed by non-cardiology services were less likely to receive guideline-recommended investigations, and management, in this relatively small cohort study. About one-third of all ACS patients are managed by non-cardiology services and would not be recorded by the ANZACS-QI database.

Clinical cardiology consultation at non-cardiology departments: stepchild of patient care?

NARCIS (Netherlands)

Schellings, D.A.; Symersky, T.; Ottervanger, J.P.; Ramdat Misier, A.R.; Boer, M.J. de

2012-01-01

BACKGROUND: Although patient care in cardiology departments may be of high quality, patients with cardiac disease in other departments tend to receive less attention from cardiologists. Driven by the shorter duration of admission nowadays and the fact that consultations are often performed in

Measures of Knowledge and Attitude Toward Preventive Cardiology.

Science.gov (United States)

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)

Population exposure due to nuclear medical diagnosis and therapy in the Munich and Rottal/Inn regions in 1978

International Nuclear Information System (INIS)

Beer, C.

1983-01-01

The cases are systematically evaluated with a view to the number of examinations, applied activities, gonadal doses and genetically significant dose. sup(99m)Tc-pertechnetate was applied in more than 50% of the cases. 131 I-iodide examinations were carried out only in Munich. sup(99m)Tc-pertechnetate and sup(99m)Tc-methylen disphosphonate account for 3/4 of the total GSD. Of the organ examinations, bone scintiscanning contributes most to the GSD. The Munich region has the highest total GSD value (0.907 mrem). (DG) [de

Radiation safety among cardiology fellows.

Science.gov (United States)

Kim, Candice; Vasaiwala, Samip; Haque, Faizul; Pratap, Kiran; Vidovich, Mladen I

2010-07-01

Cardiology fellows can be exposed to high radiation levels during procedures. Proper radiation training and implementation of safety procedures is of critical importance in lowering physician health risks associated with radiation exposure. Participants were cardiology fellows in the United States (n = 2,545) who were contacted by e-mail to complete an anonymous survey regarding the knowledge and practice of radiation protection during catheterization laboratory procedures. An on-line survey engine, SurveyMonkey, was used to distribute and collect the results of the 10-question survey. The response rate was 10.5%. Of the 267 respondents, 82% had undergone formal radiation safety training. Only 58% of the fellows were aware of their hospital's pregnancy radiation policy and 60% knew how to contact the hospital's radiation safety officer. Although 52% of the fellows always wore a dosimeter, 81% did not know their level of radiation exposure in the previous year and only 74% of fellows knew the safe levels of radiation exposure. The fellows who had received formal training were more likely to be aware of their pregnancy policy, to know the contact information of their radiation safety officer, to be aware of the safe levels of radiation exposure, to use dosimeters and RadPad consistently, and to know their own level of radiation exposure in the previous year. In conclusion, cardiology fellows have not been adequately educated about radiation safety. A concerted effort directed at physician safety in the workplace from the regulatory committees overseeing cardiology fellowships should be encouraged. Published by Elsevier Inc.

Practical application of natriuretic peptides in paediatric cardiology

DEFF Research Database (Denmark)

Smith, Julie; Goetze, Jens Peter; B. Andersen, Claus

2010-01-01

It is still uncertain if cardiac natriuretic peptides are useful biomarkers in paediatric cardiology. In this review we identify four clinical scenarios in paediatric cardiology, where clinical decision-making can be difficult, and where we feel the paediatric cardiologists need additional...

Slovak Economy in the Years 1938/1939

Directory of Open Access Journals (Sweden)

Peter Mičko

2011-12-01

Full Text Available Slovak economy was significantly influenced by the change of geopolitical situation in Europe – pressure of Nazi Germany ended in Munich Agreement (Munich Dictate which determined political and economic future of Slovakia.

A Pediatric Cardiology Fellowship Boot Camp improves trainee confidence.

Science.gov (United States)

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. The PCBC curriculum was designed by core faculty in cardiac pathology, echocardiography, electrophysiology, interventional cardiology, exercise physiology, and cardiac intensive care. Individual faculty contributed learning objectives, which were refined by fellowship directors and used to build a programme of didactics, hands-on/simulation-based activities, and self-guided learning opportunities. A total of 16 incoming fellows participated in the 4-week boot camp, with no concurrent clinical responsibilities, over 2 years. On the basis of pre- and post-PCBC surveys, 80% of trainees strongly agreed that they felt more prepared for clinical responsibilities, and a similar percentage felt that PCBC should be offered to future incoming fellows. Fellows showed significant increase in their confidence in all specific knowledge and skills related to the learning objectives. Fellows rated hands-on learning experiences and simulation-based exercises most highly. We describe a novel 4-week-long boot camp designed to expose incoming paediatric cardiology fellows to the broad spectrum of knowledge and skills required for the practice of paediatric cardiology. The experience increased trainee confidence and sense of preparedness to begin fellowship-related responsibilities. Given that highly interactive activities were rated most highly, boot camps in paediatric cardiology should strongly emphasise these elements.

Investigation of the transition from forced to natural convection in the research reactor Munich II

International Nuclear Information System (INIS)

Skreba, S.; Adamek, J.; Unger, H.

1999-01-01

The new research reactor Munich II (FRM-II), which is under construction at the Technical University Munich, Germany, makes use of a newly developed compact reactor core consisting of a single fuel element, which is assembled of two concentric pipes. Between the fuel element's inner and outer pipe 113 involutely bent fuel plates are placed rotationally symmetric, forming 113 cooling channels of a constant width of 2.2 mm. After a shut down of the reactor, battery supported cooling pumps are started by the reactor safety system in order to remove the decay heat by a downwards directed forced flow. Three hours after they have been started, the cooling pumps are shut down and so-called 'natural convection flaps' are opened by their own weight. Through a flow path, which is provided by the opening of the natural convection flaps, the decay heat is given off to the water in the reactor pool after the direction of the flow has changed and an upwards directed natural convection flow has developed. At the Department for Nuclear and New Energy Systems of the Ruhr-University Bochum, Germany, a test facility has been built in order to confirm the concept of the decay heat removal in the FRM-II, to acquire data of single and two phase natural convection flows and to detect the dry out in a narrow channel. The thermohydraulics of the FRM-II are simulated by an electrically heated test section, which represents one cooling channel of the fuel element. At first experiments have been performed, which simulated the transition from forced to natural convection in the core of the FRM-II, both at normal operation and at a complete loss of the decay heat removal pumps. In case of normal operation, the transition from forced to natural convection takes place single phased. If a complete loss of the active decay heat removal system occurs, the decay heat removal is ensured by a quasi-steady two phase flow. In a second test series minimum heat flux densities leading to pressure pulsations

International medical graduates and the cardiology workforce.

Science.gov (United States)

Kostis, John B; Ahmad, Busharat

2004-09-15

Recent publications have expressed the view that there is a shortage of cardiologists and it is growing worse. Both an increasing demand and a diminishing supply of cardiologists have been projected. An increase in the number of international medical graduates (IMGs) who enter cardiology practice has been proposed as a remedy for a projected shortage. The IMGs have to overcome challenges including clinical practice, language proficiency, and cultural differences before they are incorporated into the fabric of U.S. cardiology. With hard work, perseverance, excellence,compassionate care and support and mentoring, many have contributed to scientific and clinical cardiology in the U.S. Whether in the absence of a present crisis the projected shortage of cardiologists necessitates change in U.S. immigration policy is an open question.

Nuclear Cardiology: An Overview

International Nuclear Information System (INIS)

Al Nahhas, Adil

2006-01-01

Full text: Nuclear Cardiology has maintained a prominent position in the assessment of CAD and has become the end-point in Clinical Trials for the following reasons: Non-invasive assessment of CAD, Assessment of presence, localisation and severity, Widely available, feasible and reproducible, Visualisation of blood flow and pumping. The main areas of cardiology that are amenable to assessment with nuclear cardiology include: Stable and unstable CAD, Acute and post MI, Cardiomyopathy, Valvular disease and shunts, Cardiotoxicity, Aneurysms, Transplants The application of nuclear cardiology in these conditions will help in the management of patients by providing information relating to: Diagnosis and prognosis, Risk stratification, Medical Vs surgical treatment, Haemodynamic significance, Efficiency of management The main application in practical terms is in the assessment of CAD at variable stages: Before, during and after an incident: Before Incident: -Enhancing diagnosis and prognosis in patients with CAD, Providing functional data for changes on angiography. During Incident: -Assessing criteria for admission and further tests. After Incident: -Identifying hibernating myocardium, - Risk stratification. Risk Stratification highlights the outcome following nonfatal MI as the patients may be split into 2 categories: Low-risk group -Comprise 50-66% of patients, -Can be managed with medical treatment High-risk group, -Comprise (34-50%), -Prone to future complications within 3 months (Death, reinfarction, CCF and unstable angina). Viability: Is a spectrum of overlapping clinical states following an incident. Assessment is increasingly requested for evaluation of revascularisation vs cardiac transplant as the outcome will improve regional and global function, CCF symptoms and improve quality of life and survival Why assess viability? Persistent LVD have bad prognosis with EF 50% 10-year survival of 90% LVD due to viable tissue have worse prognosis than scars with annual

[Cardiology update in 2015].

Science.gov (United States)

Pascale, Patrizio; Regamey, Julien; Iglesias, Juan F; Gabus, Vincent; Clair, Mathieu; Yerly, Patrick; Hullin, Roger; Müller, Olivier; Eeckhout, Éric; Vogt, Pierre

2016-01-13

The present review provides a selected choice of clinical trials and therapeutic advances in the field of cardiology in 2015. A new treatment option in heart failure will become available this year in Switzerland. In interventional cardiology, new trials have been published on the duration of dual antiplatelet therapy, the new stents with bioresorbable scaffold and the long-term results of TAVR in patients who are not surgical candidates or at high surgical risk. RegardingAF the BRIDGE trial provides new evidences to guide the management of patients during warfarin interruption for surgery. Recent publications are changing the paradigm of AF treatment by showing a major impact of the management of cardiometabolic risk factors. Finally, refined criteria for ECG interpretation in athletes have been recently proposed to reduce the burden of false-positive screening.

Start from scratch: the prospect of nuclear cardiology

Energy Technology Data Exchange (ETDEWEB)

Lee, Won Woo [Dept. of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

2016-06-15

The future is always hard to forecast but the prospect of nuclear cardiology has never been more unobtainable than these days. Myocardial perfusion single-photon emission computed tomography (MPS) has been one of the major nuclear medicine studies for decades, but the annual number of MPS is stagnant or steadily decreasing in Korea and other countries. The challenge from coronary computed tomography (CCT) and the concern of radiation exposure of MPS were the main reasons for the stalemate of nuclear cardiology. Compared to the rapid technological progress of CCT, enabling greater image resolution in conjunction with lower radiation exposure to the patients, development of new radiopharmaceuticals or scintillation imaging techniques has been at a relatively slow pace. Therefore, the future of nuclear cardiology is really dependent on the application of the genuine nuclear medicine principle to patient's management. The review for current update of nuclear cardiology will ensue in the next issue of Nuclear Medicine and Molecular Imaging.

Status of the Munich compact core reactor project

International Nuclear Information System (INIS)

Boening, K.; Glaeser, W.; Meier, J.; Rau, G.; Roehrmoser, A.; Steichele, E.

1991-01-01

A new national, high performance research reactor is being planned in Munich which shall provide an unperturbed thermal neutron flux of about 8.10 14 cm -2 s -1 at only 20 MW power. This object can be achieved with the concept of a small, light water cooled 'compact core' situated in the center of a large heavy water moderator tank. In the first part of this paper an overview is given on the status of the necessary fuel enrichment is discussed. In becomes clear that the potential of the compact core concept can only be developed without compromises when using highly enriched uranium in combination with the new high density fuel. (orig.)

Present state of nuclear cardiology

International Nuclear Information System (INIS)

Krause, T.; Moser, E.

1994-01-01

Unlike other techniques, nuclear cardiologic imaging enables evaluation of cardiac function employing radioactive tracers. This procedure can be used to assess myocardial blood flow, metabolism, viability, cardiac innervation and receptor status. Therefore, this noninvasive imaging modality can be regarded as supplementary to the screening methods in cardiology and also to angiography. General clinical use was not possible until the rapid development of nuclear medicine in the fifties began. With increasing wide-spread of positron emission tomography more detailed information on metabolic tissue characterization can be expected and will be of enormous relevance in clinical decision making and in selecting patients for interventions. (orig.) [de

Review of paediatric cardiology services in district general hospitals in the United Kingdom.

Science.gov (United States)

Andrews, Hannah; Singh, Yogen

2016-03-01

Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

Mind the Gap: Representation of Medical Education in Cardiology-Related Articles and Journals.

Science.gov (United States)

Allred, Clint; Berlacher, Kathryn; Aggarwal, Saurabh; Auseon, Alex J

2016-07-01

Cardiology fellowship programs are at the interface of medical education and the care of patients suffering from the leading cause of mortality in the United States, yet there is an apparent lack of research guiding the effective education of fellows. We sought to quantify the number of publications in cardiology journals that pertained to the education of cardiology trainees and the number of cardiologists participating in education research. For the period between January and December 2012, we cataloged cardiology-specific and general medical/medical education journals and sorted them by impact factor. Tables of content were reviewed for articles with an educational focus, a cardiology focus, or both. We recorded the authors' areas of medical training, and keywords from each cardiology journal's mission statement were reviewed for emphasis on education. Twenty-six cardiology journals, containing 6645 articles, were reviewed. Only 4 articles had education themes. Ten general medical and 15 medical education journals contained 6810 articles. Of these, only 7 focused on medical education in cardiology, and none focused on cardiology fellowship training. Among the 4887 authors of publications in medical education journals, 25 were cardiologists (less than 1%), and among the 1036 total words in the mission statements of all cardiology journals, the term "education" appeared once. Published educational research is lacking in cardiology training, and few cardiologists appear to be active members of the education scholarship community. Cardiology organizations and academic journals should support efforts to identify target areas of study and publish scholarship in educational innovation.

Retail fuel price adjustment in Germany: A threshold cointegration approach

International Nuclear Information System (INIS)

Asane-Otoo, Emmanuel; Schneider, Jan

2015-01-01

Consumers in Germany often complain that retail fuel prices usually adjust quickly to crude oil price increases than decreases and characterize this pricing pattern as market power exploitation. In this paper, we use both weekly national and daily city-specific (Berlin, Hamburg, Munich and Cologne) data to investigate the extent to which retail fuel prices in Germany adjust to changes in the international crude oil price. At the national level with weekly prices, we find positive asymmetries for both gasoline and diesel within the period 2003–2007, reflecting that retail prices react more swiftly to crude oil price increases than decreases. In contrast, for 2009–2013, we observe symmetric adjustment and negative asymmetry for retail diesel and gasoline prices, respectively. The city level analysis supports our findings in the latter time period. Thus, regulatory measures aimed at the retail fuel market over recent years seem to have been effective, and, contrary to consumers' perception, we find no evidence for excessive market power or collusion. - Highlights: • The paper examines the adjustment of German retail fuel (gasoline and diesel) prices to international crude oil price changes. • An error correction model with threshold cointegration is used to investigate the price dynamics. • The findings generally point to a competitive retail fuel pricing, notwithstanding the oligopolistic market structure

Advances in Clinical Cardiology 2016: A Summary of the Key Clinical Trials.

Science.gov (United States)

Gray, Alastair; McQuillan, Conor; Menown, Ian B A

2017-07-01

The findings of many new cardiology clinical trials over the last year have been published or presented at major international meetings. This paper aims to describe and place in context a summary of the key clinical trials in cardiology presented between January and December 2016. The authors reviewed clinical trials presented at major cardiology conferences during 2016 including the American College of Cardiology (ACC), European Association for Percutaneous Cardiovascular Interventions (EuroPCR), European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD), Transcatheter Cardiovascular Therapeutics (TCT), and the American Heart Association (AHA). Selection criteria were trials with a broad relevance to the cardiology community and those with potential to change current practice. A total of 57 key cardiology clinical trials were identified for inclusion. Here we describe and place in clinical context the key findings of new data relating to interventional and structural cardiology including delayed stenting following primary angioplasty, contrast-induced nephropathy, management of jailed wires, optimal duration of dual antiplatelet therapy (DAPT), stenting vs bypass for left main disease, new generation stents (BioFreedom, Orsiro, Absorb), transcatheter aortic valve implantation (Edwards Sapien XT, transcatheter embolic protection), and closure devices (Watchman, Amplatzer). New preventative cardiology data include trials of bariatric surgery, empagliflozin, liraglutide, semaglutide, PCSK9 inhibitors (evolocumab and alirocumab), and inclisiran. Antiplatelet therapy trials include platelet function monitoring and ticagrelor vs clopidogrel for peripheral vascular disease. New data are also presented in fields of heart failure (sacubitril/valsartan, aliskiren, spironolactone), atrial fibrillation (rivaroxaban in patients undergoing coronary intervention, edoxaban in DC cardioversion), cardiac devices (implantable cardioverter

Occupational dose measurement in interventional cardiology, dosimetry comparison study

International Nuclear Information System (INIS)

Ahmad, A.M.A.

2008-05-01

The number of cardiology interventional procedures has significantly increased recently. This is due to the reliability of the diagnostic equipment to diagnose many heart disease. In the procedures the x-ray used results in increasing radiation doses to the staff. The cardiologists and other staff members in interventional cardiology are usually working close to the area under examination and receive the dose primarily from scattered radiation from the patient. Therefore workers in interventional cardiology are expected to receive high doses. This study overviews the status of occupational exposure at the three cardiology centers at three different hospitals in Khartoum compared with that received by workers at other medical practices (radiotherapy, nuclear medicine and diagnostic radiology) in the Institute of Nuclear and Technology (INMO) at El Gezira. The TLD Harshaw 6600 reader was used in the assessment of effective dose for Hp (10). Two TLDs were used by each worker at the three cardiology centres, one worn under a protective apron and the other worn outside and above the apron as specified by the ICRP. Each worker at the other sections was facilitated with one dosimeter to be worn on the chest. The annual doses received by 14 cardiologists, 13 nurses and 9 technologists at the three cardiology centres were in the range: (0.84-4.77), (0.15-2.08), (0.32-1.10) mSv respectively. In the INMO the annual doses received by 7 doctors, 5 nurses and 14 technologists were in the range: (0.12-0.51), (0.11-0.65), (0.03-1.39) mSv respectively. The results showed that the annual doses received by the workers do not exceed 20 mSv. The study also indicated that doses received by workers in interventional cardiology, in particular the cardiologists are high compared to that received at the other medical sections.(Author)

Electrocardiographic interpretation skills of cardiology residents: are they competent?

Science.gov (United States)

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. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

The Munich MIDY Pig Biobank – A unique resource for studying organ crosstalk in diabetes

Directory of Open Access Journals (Sweden)

Andreas Blutke

2017-08-01

Conclusions: The broad spectrum of well-defined biosamples in the Munich MIDY Pig Biobank that will be available to the scientific community provides a unique resource for systematic studies of organ crosstalk in diabetes in a multi-organ, multi-omics dimension.

History of Cardiology in India

Directory of Open Access Journals (Sweden)

Mrinal Kanti Das

2015-03-01

Full Text Available 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.

Recommendation on measures to safeguard freedom of expression and undistorted competition in EU trade mark law

DEFF Research Database (Denmark)

Minssen, Timo

2015-01-01

, University of Oxford, United Kingdom Christophe Geiger Associate Professor, Director General and Director of the Research Department, Centre for International Intellectual Property Studies, University of Strasbourg, France Gustavo Ghidini Professor of Intellectual Property and Competition Law, University...... Institute for Innovation and Competition, Munich, Germany Paul van der Kooij Associate Professor of Intellectual Property Law, Leiden Law School, University of Leiden, The Netherlands Annette Kur Senior Researcher, Max Planck Institute for Innovation and Competition, Munich, and Honorary Professor...... Professor of Commercial Law, University of Parma, Italy Timo Minssen Associate Professor, Centre for Information and Innovation Law, University of Copenhagen, Denmark Ansgar Ohly Professor of Civil Law, Intellectual Property and Competition Law, University of Munich, Germany Alexander Peukert Professor...

ITER EDA newsletter. V. 4, no.12

International Nuclear Information System (INIS)

1995-12-01

This issue of the ITER EDA (Engineering Design Activities) Newsletter contains a report on the ninth ITER council meeting held December 12 - 13, 1995 in Garching near Munich, Germany (by Dr. E. Canobbio), a report on the status of the ITER EDA (by Dr. R. Aymar, ITER Director) and a report on the ninth meeting of the ITER Technical Advisory Committee (by Professor P. Rutherford, TAC Chair) held 27 - 29 November 1995, in Garching near Munich, Germany

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

Science.gov (United States)

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. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

A history of cardiology in Jamaica.

Science.gov (United States)

Denbow, C E

2004-06-01

The history of cardiology in Jamaica is conveniently considered in decades beginning in the 1950s. The decade of the 1950s was characterized by early descriptions of the pattern of cardiac disease in adults and children in Jamaica, the establishment of a cardiac clinic at the University Hospital of the West Indies and early cardiac surgical landmarks. Extensive preparatory experimental work in the canine laboratory with respect to cardiopulmonary bypass in the early to mid-1960s culminated in the successful completion of the first open heart surgical procedure in April, 1968. Cardiac catheterization was also increasingly developed in the decade of the 1960s. A highlight of the decade of the 1970s was the establishment of the Heart Foundation of Jamaica which began contributing greatly to preventive cardiology in Jamaica by providing a variety of programmes of prevention. In the decade of the 1980s, non-invasive cardiac diagnostic facilities in Jamaica were considerably enhanced by the introduction and development of echocardiography, treadmill exercise testing and ambulatory electrocardiography. In addition, the very important National Rheumatic Fever prevention programme was established. The cardiac catheterization laboratory was re-opened in the 1990s, thus allowing the performance of coronary arteriography in Jamaica for the first time, and interventional cardiology procedures soon followed. The Jamaica Foundation for Cardiac disease was also established in this decade. The vision for the new millennium of "A heart healthy Jamaica in the 21st century" is achievable, but will require appropriate emphasis on expanded preventive and curative cardiology programmes.

[Current situation of the organisation, resources and activity in paediatric cardiology in Spain].

Science.gov (United States)

Sánchez Ferrer, Francisco; Castro García, Francisco José; Pérez-Lescure Picarzo, Javier; Roses Noguer, Ferrán; Centeno Malfaz, Fernándo; Grima Murcia, María Dolores; Brotons, Dimpna Albert

2018-04-26

The results are presented on the «current situation of the organisation, resources and activity in paediatric cardiology in Spain». It was promoted by the Spanish Society of Paediatric Cardiology and Congenital Heart disease. An analysis was carried out on the results obtained from a specifically designed questionnaire, prepared by the Spanish Society of Paediatric Cardiology and Congenital Heart disease, that was sent to all hospitals around the country that offer the speciality of paediatric cardiology. A total of 86 questionnaires were obtained, including 14 hospitals that perform cardiac surgery on children. A total of 190 paediatric cardiology consultants, 40 cardiac surgeons, and 27 middle grade doctors performing their paediatric residency (MIR program) were identified. All hospitals had adequate equipment to perform an optimal initial evaluation of any child with a possible cardiac abnormality, but only tertiary centres could perform complex diagnostic procedures, interventional cardiology, and cardiac surgery. In almost all units around the country, paediatric cardiology consultants were responsible for outpatient clinics and hospital admissions, whereas foetal cardiology units were still mainly managed by obstetricians. The number of diagnostic and therapeutic procedures was similar to those reported in the first survey, except for a slight decrease in the total number of closed cardiac surgery procedures, and a proportional increase in the number of therapeutic catheterisations. Paediatric Cardiology in Spain is performed by paediatric cardiology consultants that were trained initially as general paediatricians, and then completed a paediatric cardiology training period. Almost all units have adequate means for diagnosis and treatment. Efforts should be directed to create a national registry that would not only allow a prospective quantification of diagnostic and therapeutic procedures, but also focus on their clinical outcomes. Copyright © 2018

History of Cardiology in India.

Science.gov (United States)

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. Copyright © 2015. Published by Elsevier B.V.

Comparison of the Munich Chronotype Questionnaire with the Horne-Östberg’s Morningness-Eveningness Score

NARCIS (Netherlands)

Zavada, Andrei; Gordijn, Marijke C.M.; Beersma, Domien G.M.; Daan, Serge; Roenneberg, Till

2005-01-01

We report on results from an Internet survey of sleeping habits in a Dutch population using the Munich Chronotype Questionnaire (MCTQ), supplemented with the Horne-Östberg Morningness-Eveningness Questionnaire (MEQ). The MCTQ was completed by 5,055 responders, of which 2,481 also completed the MEQ.

Data Sharing and Cardiology: Platforms and Possibilities.

Science.gov (United States)

Dey, Pranammya; Ross, Joseph S; Ritchie, Jessica D; Desai, Nihar R; Bhavnani, Sanjeev P; Krumholz, Harlan M

2017-12-19

Sharing deidentified patient-level research data presents immense opportunities to all stakeholders involved in cardiology research and practice. Sharing data encourages the use of existing data for knowledge generation to improve practice, while also allowing for validation of disseminated research. In this review, we discuss key initiatives and platforms that have helped to accelerate progress toward greater sharing of data. These efforts are being prompted by government, universities, philanthropic sponsors of research, major industry players, and collaborations among some of these entities. As data sharing becomes a more common expectation, policy changes will be required to encourage and assist data generators with the process of sharing the data they create. Patients also will need access to their own data and to be empowered to share those data with researchers. Although medicine still lags behind other fields in achieving data sharing's full potential, cardiology research has the potential to lead the way. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The National Cardiac Societies of the European Society of Cardiology.

Science.gov (United States)

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.

Comparison of nuclear cardiology in the United States and Europe

International Nuclear Information System (INIS)

Iskandrian, A.; Giubbini, R.

1996-01-01

Nuclear Cardiology is a widely available and a widely accepted tool for diagnosis and management of coronary artery disease both in the US and in Europe. Although the most common indications for nuclear studies are similar in the US and Europe, different social and economical environments may affect the practice of Nuclear Cardiology. The aim of this paper is to identify key issues and to provide some information on the similarities and differences which characterize the practice of Nuclear Cardiology in the US and Europe. This paper takes into account the training requirements, the relationships between different professional societies, the accessibility, the choice of imaging protocols, tracers and stressors, the impact of managed care and the role of cardiologists, nuclear physicians and technologists in nuclear labs. The economical differences which may affect the field of high technology, imply a wide range of variability concerning the availability of nuclear cardiology studies in different countries (1:1/10). Moreover the legislation which regulates the practice of nuclear medicine may differ from country. Thus in our opinion there are several important factors both in the US and Europe limiting the development of nuclear cardiology independently of its intrinsic clinical value

Toxicity and elemental composition of particulate matter from outdoor and indoor air of elementary schools in Munich, Germany.

Science.gov (United States)

Oeder, S; Dietrich, S; Weichenmeier, I; Schober, W; Pusch, G; Jörres, R A; Schierl, R; Nowak, D; Fromme, H; Behrendt, H; Buters, J T M

2012-04-01

Outdoor particulate matter (PM(10)) is associated with detrimental health effects. However, individual PM(10) exposure occurs mostly indoors. We therefore compared the toxic effects of classroom, outdoor, and residential PM(10). Indoor and outdoor PM(10) was collected from six schools in Munich during teaching hours and in six homes. Particles were analyzed by scanning electron microscopy and X-ray spectroscopy (EDX). Toxicity was evaluated in human primary keratinocytes, lung epithelial cells and after metabolic activation by several human cytochromes P450. We found that PM(10) concentrations during teaching hours were 5.6-times higher than outdoors (117 ± 48 μg/m(3) vs. 21 ± 15 μg/m(3), P particle number), organic (29%, probably originating from human skin), and Ca-carbonate particles (12%, probably originating from paper). Outdoor PM contained more Ca-sulfate particles (38%). Indoor PM at 6 μg/cm(2) (10 μg/ml) caused toxicity in keratinocytes and in cells expressing CYP2B6 and CYP3A4. Toxicity by CYP2B6 was abolished with the reactive oxygen species scavenger N-acetylcysteine. We concluded that outdoor PM(10) and indoor PM(10) from homes were devoid of toxicity. Indoor PM(10) was elevated, chemically different and toxicologically more active than outdoor PM(10). Whether the effects translate into a significant health risk needs to be determined. Until then, we suggest better ventilation as a sensible option. Indoor air PM(10) on an equal weight base is toxicologically more active than outdoor PM(10). In addition, indoor PM(10) concentrations are about six times higher than outdoor air. Thus, ventilation of classrooms with outdoor air will improve air quality and is likely to provide a health benefit. It is also easier than cleaning PM(10) from indoor air, which has proven to be tedious. © 2011 John Wiley & Sons A/S.

Radionuclide methods in pediatric cardiology

International Nuclear Information System (INIS)

Reich, O.; Ruth, C.; Samanek, M.

1990-01-01

The use of radionuclide methods in pediatric cardiology is discussed for non-invasive evaluation of myocardial function and perfusion, regional lung perfusion and ventilation, and for measuring central and peripheral hemodynamics. (H.W.). 16 refs

Computers in cardiology

International Nuclear Information System (INIS)

1983-01-01

The present abstract book contains the abstracts of 90 lectures and 29 posters presented at the conference. They are dealing with the following themes: Echocardiography, databases, ECG interpretation, wall motion, arrhythmia processing systems, electrophysiological models, ECG-mapping, intensive care and hemodynamic monitoring, digital subtraction angiography, clinical electrophysiology, mechanical properties of the cardiovascular system, coronary artery measurements, arrythmia analysis, arrhytmia monitoring techniques, ECG waveform recognition and nuclear cardiology. (MG)

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

Science.gov (United States)

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.

Evaluating the benefits of nuclear cardiology

International Nuclear Information System (INIS)

Maisey, M.

1996-01-01

This paper reviews the role of nuclear cardiology in the context of health care evaluation and resource utilisation. Nuclear cardiology procedures are used to detect disease, to define the extent of disease, to predict the outcome of therapy and to monitor the response to treatment. The evaluation of effectiveness will depend on the role for which the tests are being used. The evaluation of diagnostic tests most commonly follows the five level Fineberg classification. I) Technical capacity; II) diagnostic accuracy; III) diagnostic impact; IV) therapeutic impact; V) patient outcome. Tests may succeed or fail at each of these hierarchical levels. In addition to the clinical impact which is evaluated, the appropriate use of health care resources has to be considered , i.e. the cost effectiveness of the investigation. For this the costs of diagnosis and treatment in the resources used, together with the direct cost on the patient and patient carers needs to be considered. In addition to these direct costs to the community and to the patient and the carers the secondary downstream costs and opportunity costs have to be taken into account. The common methods for assessing the costs and benefits include cost minimization, cost effectiveness, cost utility, and cost benefit studies. The advantage and appropriate use of these methods are reviewed. There are seven clinical methods for evaluating diagnostics tests in nuclear cardiology which are: I) Case reports; II) consensus studies; III) databases; IV) management impact studies; V)modeling techniques; VI) management impact studies; VII) randomized control trial. Each of these has a role with advantages and disadvantages which are reviewed. It is no long sufficient to investigate the usefulness of a diagnostic test used in nuclear cardiology in isolation but it as to be within the context of the health care system and the resource used

Static and dynamic scintigraphy in radioisotope cardiology diagnostics

International Nuclear Information System (INIS)

Waligorski, M.; Zolna, J.; Strzelecki, A.; Pasyk, S.

1981-01-01

A review of the applications of scintigraphy in cardiac diagnosis is given. The principle of operation of the gamma-camera and of the scintigraphic system, the handling of data and the so-called gated scintigraphy are discussed. Characteristics of some radioisotopes applied in nuclear cardiology are given. The most frequent clinical states are discussed in which isotope diagnostics may be useful. Attention is drawn to the advantages of nuclear cardiology methods over conventional diagnostics. (author)

Diverse perspectives and training paths in cardiology: An analysis of authorship in the Journal of the American College of Cardiology.

Science.gov (United States)

Danek, Barbara A; Karatasakis, Aris; Karacsonyi, Judit; Rangan, Bavana V; Abdullah, Shuaib; Sorajja, Paul; Banerjee, Subhash; Brilakis, Emmanouil S

2018-03-15

The role of women and foreign medical graduates (FMGs) in cardiology research published in the United States has received limited study. We examined the characteristics of the first and last authors of all original contributions and review articles published in the Journal of the American College of Cardiology from October 1, 2015, to October 1, 2016. A total of 345 articles were identified, with 687 first and last authors originating from ≥50 different countries. Overall, 17% of authors were women (20% of the first and 14% of the last authors). Overall, 86% of authors held a medical degree (MD) or equivalent, and 25% of those also held another advanced degree (PhD, MPH, and/or MBA). The proportion of authors with an advanced degree in addition to an MD/equivalent was higher among foreign graduates and international contributors as compared with American graduates (31% vs. 30% vs. 17%, respectively, p < 0.0001). Of US-based authors with an MD/equivalent, 67% were American medical graduates (AMGs) and 33% were FMGs. Women authors represented 11% of FMGs, 16% of AMGs, and 12% of international physicians as contributors (p = 0.23). Foreign graduates and international researchers contribute substantially to cardiology research in the US, but women authors remain under-represented. Copyright © 2018 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.

Accurate diagnosis of CHD by Paediatricians with Expertise in Cardiology.

Science.gov (United States)

Jacob, Hannah C; Massey, Hannah; Yates, Robert W M; Kelsall, A Wilfred

2017-08-01

Introduction Paediatricians with Expertise in Cardiology assess children with a full history, examination, and often perform an echocardiogram. A minority are then referred to an outreach clinic run jointly with a visiting paediatric cardiologist. The accuracy of the echocardiography diagnosis made by the Paediatrician with Expertise in Cardiology is unknown. Materials and methods We conducted a retrospective review of clinic letters for children seen in the outreach clinic for the first time between March, 2004 and March, 2011. Children with CHD diagnosed antenatally or elsewhere were excluded. We recorded the echocardiography diagnosis made by the paediatric cardiologist and previously by the Paediatrician with Expertise in Cardiology. The Paediatrician with Expertise in Cardiology referred 317/3145 (10%) children seen in the local cardiac clinics to the outreach clinic over this period, and among them 296 were eligible for inclusion. Their median age was 1.5 years (range 1 month-15.1 years). For 244 (82%) children, there was complete diagnostic agreement between the Paediatrician with Expertise in Cardiology and the paediatric cardiologist. For 29 (10%) children, the main diagnosis was identical with additional findings made by the paediatric cardiologist. The abnormality had resolved in 17 (6%) cases by the time of clinic attendance. In six (2%) patients, the paediatric cardiologist made a different diagnosis. In total, 138 (47%) patients underwent a surgical or catheter intervention. Discussion Paediatricians with Expertise in Cardiology can make accurate diagnoses of CHD in children referred to their clinics. This can allow effective triage of children attending the outreach clinic, making best use of limited specialist resources.

Behavioral cardiology: current advances and future directions.

Science.gov (United States)

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. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Examples of successful architectural integration of PV: Germany

International Nuclear Information System (INIS)

Hagemann, I.B.

2004-01-01

In Germany building-integrated photovoltaics (BIPV) are developing rapidly, and much progress has been achieved in the past five years. BIPV can be used today in different ways on both existing and new buildings. Architects and designers are discovering BIPV. With the help of custom-made products available on the German market they are beginning to explore the technical limits of an aesthetic and structural integration of PV in buildings. As a result some exciting high-profile building projects with PV have been built, for example, the small service pavilion Meereslauschen in Steinhude or the new headquarters building of the Wood Trade Association in Munich. These projects show that the use of PV is very varied and offers opportunities for creative architects. However non-technical problems still need to be solved to allow a meaningful and widespread application of PV in the built environment. To decrease costs it is essential to develop further standard BIPV components. The aim of such developments should be to replace standard PV modules by products in which PV and structural building elements are melded into one design and structural unit. (author)

Regional Income and Employment Effects of the 1972 Munich Olympic Summer Games

OpenAIRE

Stephanie Jasmand; Wolfgang Maennig

2007-01-01

Abstract Olympic Games may have impacts on income and employment in the host city, but no ex post study has been carried out for European Olympic host cities to date. The present study closes this gap using the 1972 Munich Olympic Games. The data period examined in this study allows for analysis of long-term effects. In addition, the methodology avoids overestimating the significance of the effects. Finally, we report results for all possible combinations of pre- and post-Olympic p...

Systematic Reviews and Meta-analyses for Cardiology Fellows.

Science.gov (United States)

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. © 2016 Wiley Periodicals, Inc.

Organizational aspects of the handling of radiation accidents in the Federal Republic of Germany

International Nuclear Information System (INIS)

Fliedner, T.M.

1977-01-01

In the Federal Republic of Germany it is a legal requirement that persons exposed to ionizing radiation as a consequence of their employment in radiation facilities should be monitored. Some 90000 persons constitute the population 'at risk' for occupational radiation exposure. The actual radiation accident rate has been very low indeed. Nevertheless, precautions must be taken. Four radiation accident categories may be distinguished: uncomplicated, complicated, contamination and incorporation accidents. In the Federal Republic, the 'Berufsgenossenschaften' (BGS) are required to organize radiation accident care if necessary and take all measures to prevent them. The BGS has issued a pamphlet 'First Aid in case of Increased Exposure to Ionizing Radiation' as a guide to all personnel concerned. The BGS has also organized 5 'Regional Radiation Protection Centres' available to give advice 7 days a week, 24 hours a day in Hamburg, Homburg (Saar), Juelich, Karlsruhe und Munich. These centres are all equipped to provide first aid and decontamination and to cater for a short term stay until a decision is reached as to how to handle a particular accident. The special burns hospital of the BGS in Ludwigshafen is equipped with sterile rooms to handle 'complicated accidents', in particular when skin burns are involved. Two mobile 'radiation protection units' are available in Karlsruhe and Munich to provide help in all problems of dosimetry and health physics. A medical advisory team has been formed to supplement local physicians in dealing with special problems in the handling of radiation accident victims. (author)

Nuclear Medicine in Pediatric Cardiology.

Science.gov (United States)

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

Contributions to the 11. Geoengineering Congress in Munich. Geoengineering and energy; Beitraege zum 11. Geotechnik-Tag in Muenchen. Geotechnik und Energie

Energy Technology Data Exchange (ETDEWEB)

Vogt, Norbert (ed.)

2012-11-01

Within the eleventh geotechnics conference at 09th March, 2012 in Munich (Federal Republic of Germany), the following lectures were held: (1) New construction of the highway A44 on a new open pit dump (N. Vogt); (2) Soil liquefaction issues at mining dumps in the Lausitz (Wolfram Kudla); (3) Underfloor pumped-storage power plants in facilities of hard coal minings (Eugen Perau); (4) Geothermal energy power plant trademark (H. Haemmerle); (5) Surface settlements during the tunnel heading in the loose rock - prognosis, measurement and impact (J. Fillibeck); (6) Ring wall storages - an essential contribution to geotechnics for energy storage (M. Popp); (7) Storage basins and their geotechnical challenges (S. Messerklinger); (8) Energy from the Andes: The hydroelectric power plant La Confluencia in Chile (M. Mueller); (9) Particularities of geotechnical verifications for flat foundations of offshore wind power plants (U. Hartwig); (10) Dimensioning of piles for the foundation of offshore wind power plants (M. Achmus); (11) Offshore wind power fundaments: Practical experiences from the projects London Array and Dan Tysk (M. Horn); (12) Installation of a mono pile as a foundation structure for a tide turbine (S. Schmitz); (13) Carbon footprint - International comparison of assessment approaches at specialist foundation engineering techniques (A. Zoehrer); (14) Geotechnical assessments of upgrading power transmission lines (A. Smith).

[Cardiology update in 2016].

Science.gov (United States)

Gabus, Vincent; Tran, Van Nam; Regamey, Julien; Pascale, Patrizio; Monney, Pierre; Hullin, Roger; Vogt, Pierre

2017-01-11

In 2016 the European Society of Cardiology (ESC) published new guidelines. These documents update the knowledge in various fields such as atrial fibrillation, heart failure, cardiovascular prevention and dyslipidemia. Of course it is impossible to summarize these guidelines in detail. Nevertheless, we decided to highlight the major modifications, and to emphasize some key points that are especially useful for the primary care physician.

[The QuIK-Registry of the German Society of Cardiologists in private practice: countrywide and benchmarking quality assurance in invasive cardiology].

Science.gov (United States)

Albrecht, A; Levenson, B; Göhring, S; Haerer, W; Reifart, N; Ringwald, G; Troger, B

2009-10-01

QuIK is the German acronym for QUality Assurance in Invasive Cardiology. It describes the continuous project of an electronic data collection in Cardiac catheterization laboratories all over Germany. Mainly members of the German Society of Cardiologists in Private Practice (BNK) participate in this computer based project. Since 1996 data of diagnostic and interventional procedures are collected and send to a registry-center where a regular benchmarking analysis of the results is performed. Part of the project is a yearly auditing process including an on-site visit to the cath lab to guarantee for the reliability of information collected. Since 1996 about one million procedures have been documented. Georg Thieme Verlag KG Stuttgart , New York.

Quantitative Nuclear Cardiology: How objective?

International Nuclear Information System (INIS)

Crawley, J.C.W.; Raval, U.; Soman, P.; Lahiri, A.

1997-01-01

The object of this study was to establish the accuracy required from the operator in indicating the centre and axis the left ventricle, and in placing regions of interest (ROIs), whilst using the MYO TOMO and MYO QUANT software to analyze tomographic data from nuclear cardiology

Assessing Competence in Pediatric Cardiology

Science.gov (United States)

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)

Physician Requirements-1990. For Cardiology.

Science.gov (United States)

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…

Hippocrates, cardiology, Confucius and the Yellow Emperor.

Science.gov (United States)

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.

Energy in a dialog. The challenges facing Germany's power industry as a result of the energy turnaround

International Nuclear Information System (INIS)

Gueldner, Ralf

2012-01-01

The challenges posed by the energy turnaround in Germany to the power industry and the national economy after the Fukushima events were the topic of the ''Energy in a Dialog'' meeting organized by the Deutsches Atomforum in Berlin on December 14, 2011. Dr. Ralf Gueldner, President of the Deutsches Atomforum, opened the conference by drawing attention to the real purposes of the energy turnaround, namely to prevent severe climate changes and, thus, also carbon emissions. Both nationally in Germany and worldwide, nuclear power made major contributions to achieving these goals. Referring to developments in many neighboring countries, he underlined that opting out of the use of nuclear power in Germany was not tantamount to the end of nuclear power. Reality in energy policy had to be accepted, however, namely that nuclear power played, and would go on playing, an important role in Europe. Other contributions by Dr. Juergen Grossmann (Chief Executive Officer of RWE AG), Stefan Kohler (Chairman of the Board of Management of the German Energy Agency - dena), and Prof.Dr. Felix Muesgens (Brandenburg Technical University of Cottbus, Chair of Power Economics) dealt with political and other boundary conditions required for the energy turnaround, and with the consequences and burdens on the power industry and the national economy. A final panel discussion chaired by Henning Krumrey (Wirtschaftswoche) was attended by F. Muesgens and Prof. Dr. Hans-Werner Sinn (President of the Munich-based Info Institute) and Prof. Dr. Michael Huether (German Business Institute). (orig.)

What to Expect From the Evolving Field of Geriatric Cardiology.

Science.gov (United States)

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. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Equipment standards for interventional cardiology

International Nuclear Information System (INIS)

Dowling, A.; Gallagher, A.; Walsh, C.; Malone, J.

2005-01-01

Interventional radiology has seen rapid growth in cardiology and represents an alternative to hazardous surgery. Recently there has been a substantial growth in the number of procedures being performed and interventional cardiology (IC) procedures are the most common interventional procedures in Europe. Advances in imaging technology have facilitated the development of increasingly complex radiological IC equipment. Currently, the technology is developing at a rate ahead of supporting research, equipment standards and a regulatory framework. International standards play a key role in the design, manufacture and performance of radiological IC equipment. A survey of 12 IC systems (15 imaging chains) was conducted in Irish hospitals. The aim of the study was to assess the imbalance between rapidly advancing technology and existing standards and to propose recommendations for new IC equipment standards. The results demonstrate the need for definitive equipment requirements and standardisation in the design, manufacture, acceptance and maintenance of IC equipment. (authors)

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

Science.gov (United States)

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.

Ground depositions and air concentrations of Chernobyl fallout radionuclides at Munich-Neuherberg

Energy Technology Data Exchange (ETDEWEB)

Hoetzl, H.; Rosner, G.; Winkler, R.

1987-01-01

Southern Bavaria has received a comparatively high deposition of fallout radionuclides from the reactor accident at Chernobyl. As a result, in addition to the measurement of numerous gamma emitting nuclides and of strontium isotopes, the determination of several actinides, including isotopes of uranium, neptunium, plutonium and curium was possible. The observed radionuclide composition of the fallout and the time course of ground deposition and air concentration at the site of the Gesellschaft fuer Strahlen- und Umweltforschung (GSF) at Neuherberg, 10 km north of Munich, are reported and discussed.

Ground depositions and air concentrations of Chernobyl fallout radionuclides at Munich-Neuherberg

International Nuclear Information System (INIS)

Hoetzl, H.; Rosner, G.; Winkler, R.

1987-01-01

Southern Bavaria has received a comparatively high deposition of fallout radionuclides from the reactor accident at Chernobyl. As a result, in addition to the measurement of numerous gamma emitting nuclides and of strontium isotopes, the determination of several actinides, including isotopes of uranium, neptunium, plutonium and curium was possible. The observed radionuclide composition of the fallout and the time course of ground deposition and air concentration at the site of the Gesellschaft fuer Strahlen- und Umweltforschung (GSF) at Neuherberg, 10 km north of Munich, are reported and discussed. (orig.)

Cubierta para naves de grandes dimensiones en hormigón, Munich (Alemania Federal

Directory of Open Access Journals (Sweden)

Bomhard, H.

1972-05-01

Full Text Available This article describes the study, design and building of wide span concrete halls which, at present, are greatly influenced by the advances made in pre-stressed concrete, préfabrication and the development of modern building methods, as well as the new techniques in building with light concrete. The influence which gave origin to these halls is also described. Chosen as an example is the hall, with a span of 150 metres and a maximum hight of 27.30 metres, for the Munich goods station, showing the importance of this type of construction.El artículo describe el estudio, proyecto y construcción de naves de gran luz en hormigón que, en el momento actual, están decisivamente influenciadas por los adelantos en hormigón pretensado, en prefabricación y por el desarrollo de los modernos métodos de construcción, así como por las nuevas técnicas de la construcción en hormigones ligeros. Se detalla igualmente la influencia que originan estas naves de grandes dimensiones. Se toma como ejemplo la nave, de 150 m de luz y 27,30 m de altura máxima, para la estación de mercancías de Munich, haciendo patente su gran importancia en este tipo de construcciones.

Cardiac transplantation: 15 years experience Cardiology Institute of Child

International Nuclear Information System (INIS)

Ceruti, B; Chiesa, P.; Tambasco, J.; Anzibar, R.; Gutierrez, C.; Barboza, S.; Manfredi, A.; Leone, R.

2012-01-01

The cardiac transplant is the treatment of choice for the cardiac insufficiency when there is not another therapeutic alternative that prolongs the life expectancy. On December 1996 The Cardiology Institute of child begin the program of Cardiac Insufficiency and Transplants of the Institute of Pediatric Cardiology, achieving the first cardiac transplant in a 14-year-old child in Uruguay. Three years later they put in practice the program of cardiac transplant in adults

Radiobiological experiments at the Munich ion microbeam SNAKE

Energy Technology Data Exchange (ETDEWEB)

Friedl, A.A.; Drexler, G.A.; Loewe, R. [Strahlenbiologisches Inst., Ludwig-Maximilians-Univ. Muenchen (Germany); Dollinger, G.; Hauptner, A.; Hable, V.; Greubel, C.; Kruecken, R. [Physik Dept. E12, Technische Univ. Muenchen, Garching (Germany); Cremer, T.; Dietzel, S. [Dept. Biologie II, Ludwig-Maximilians-Univ. Muenchen, Planegg-Martinsried (Germany)

2005-07-01

The ion microbeam SNAKE at the Munich 14 MV tandem accelerator was recently adapted for irradiation of cells and is now routinely used for radiobiological experiments. Several features, including ion-optical beam focussing to achieve a targeting accuracy of about 500 nm, fast movement of the beam by electrostatic deflection and single ion preparation make SNAKE an excellent tool for localized irradiation with a defined number of ions. The ion spectrum available ranges from 20 MeV protons to 200 MeV gold ions, thus allowing to vary the LET over four orders of magnitude and to conduct low and high LET irradiation in a single experimental set-up. This offers the possibility of a systematic analysis of the cellular response mechanisms in their dependence on dose and LET. Other current lines of research include analysis of the spatio-temporal dynamics of protein recruitment at damaged chromatin sites and determination of the mobility of damaged chromatin regions in the interphase nucleus. (orig.)

Multi-scale modeling of urban air pollution: development and application of a Street-in-Grid model (v1.0) by coupling MUNICH (v1.0) and Polair3D (v1.8.1)

Science.gov (United States)

Kim, Youngseob; Wu, You; Seigneur, Christian; Roustan, Yelva

2018-02-01

A new multi-scale model of urban air pollution is presented. This model combines a chemistry-transport model (CTM) that includes a comprehensive treatment of atmospheric chemistry and transport on spatial scales down to 1 km and a street-network model that describes the atmospheric concentrations of pollutants in an urban street network. The street-network model is the Model of Urban Network of Intersecting Canyons and Highways (MUNICH), which consists of two main components: a street-canyon component and a street-intersection component. MUNICH is coupled to the Polair3D CTM of the Polyphemus air quality modeling platform to constitute the Street-in-Grid (SinG) model. MUNICH is used to simulate the concentrations of the chemical species in the urban canopy, which is located in the lowest layer of Polair3D, and the simulation of pollutant concentrations above rooftops is performed with Polair3D. Interactions between MUNICH and Polair3D occur at roof level and depend on a vertical mass transfer coefficient that is a function of atmospheric turbulence. SinG is used to simulate the concentrations of nitrogen oxides (NOx) and ozone (O3) in a Paris suburb. Simulated concentrations are compared to NOx concentrations measured at two monitoring stations within a street canyon. SinG shows better performance than MUNICH for nitrogen dioxide (NO2) concentrations. However, both SinG and MUNICH underestimate NOx. For the case study considered, the model performance for NOx concentrations is not sensitive to using a complex chemistry model in MUNICH and the Leighton NO-NO2-O3 set of reactions is sufficient.

Multi-scale modeling of urban air pollution: development and application of a Street-in-Grid model (v1.0 by coupling MUNICH (v1.0 and Polair3D (v1.8.1

Directory of Open Access Journals (Sweden)

Y. Kim

2018-02-01

Full Text Available A new multi-scale model of urban air pollution is presented. This model combines a chemistry–transport model (CTM that includes a comprehensive treatment of atmospheric chemistry and transport on spatial scales down to 1 km and a street-network model that describes the atmospheric concentrations of pollutants in an urban street network. The street-network model is the Model of Urban Network of Intersecting Canyons and Highways (MUNICH, which consists of two main components: a street-canyon component and a street-intersection component. MUNICH is coupled to the Polair3D CTM of the Polyphemus air quality modeling platform to constitute the Street-in-Grid (SinG model. MUNICH is used to simulate the concentrations of the chemical species in the urban canopy, which is located in the lowest layer of Polair3D, and the simulation of pollutant concentrations above rooftops is performed with Polair3D. Interactions between MUNICH and Polair3D occur at roof level and depend on a vertical mass transfer coefficient that is a function of atmospheric turbulence. SinG is used to simulate the concentrations of nitrogen oxides (NOx and ozone (O3 in a Paris suburb. Simulated concentrations are compared to NOx concentrations measured at two monitoring stations within a street canyon. SinG shows better performance than MUNICH for nitrogen dioxide (NO2 concentrations. However, both SinG and MUNICH underestimate NOx. For the case study considered, the model performance for NOx concentrations is not sensitive to using a complex chemistry model in MUNICH and the Leighton NO–NO2–O3 set of reactions is sufficient.

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

Science.gov (United States)

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, pnuclear 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 cardiology care. PMID:27056156

Longer-term impact of cardiology e-consults.

Science.gov (United States)

Wasfy, Jason H; Rao, Sandhya K; Kalwani, Neil; Chittle, Melissa D; Richardson, Calvin A; Gallen, Kathleen M; Isselbacher, Eric M; Kimball, Alexandra B; Ferris, Timothy G

2016-03-01

Cardiac e-consults may be an effective way to deliver value-oriented outpatient cardiology care in an accountable care organization. Initial results of cardiac e-consults have demonstrated high satisfaction among both patients and referring providers, no known adverse events, and low rates of diagnostic testing. Nevertheless, differences between e-consults and traditional consults, effects of e-consults on traditional consult volume, and whether patients seek traditional consults after e-consults are unknown. We established a cardiac e-consult program on January 13, 2014. We then conducted detailed medical record reviews of all patients with e-consults to detect any adverse clinical events and detect subsequent traditional visits to cardiologists. We also performed 2 comparisons. First, we compared age, gender, and referral reason for e-consults vs traditional consults. Second, we compared changes in volume of referrals to cardiology vs other medical specialties that did not have e-consults. From January 13 to December 31, 2014, 1,642 traditional referrals and 165 e-consults were requested. The proportion of e-consults of all evaluations requested over that period was 9.1%. Gender balance was similar among traditional consults and e-consults (44.8% male for e-consults vs 45.0% for traditional consults, P = .981). E-consult patients were younger than traditional consult patients (55.3 vs 60.4 years, P cardiology visit during the follow-up period. E-consults are an effective and safe mechanism to enhance value in outpatient cardiology care, with low rates of bounceback to traditional consults. E-consults can account for nearly one-tenth of total outpatient consultation volume at 1 year within an accountable care organization and are associated with a reduction in traditional referrals to cardiologists. Copyright © 2015 Elsevier Inc. All rights reserved.

Nuclear cardiology in the UK: activity and practice 1997

International Nuclear Information System (INIS)

Prvulovich, Elizabeth; Metcalfe, Malcolm J.

2002-01-01

A questionnaire was sent to 251 nuclear medicine centres asking for details of nuclear medicine activity, and nuclear cardiology activity and practice in 1997. One hundred and seventy-one (68%) centres replied. Nuclear medicine activity was estimated at 11.8 studies/1,000 population/year, and 9.5% of these studies were within cardiology (1.12 studies/1,000/year). Myocardial perfusion imaging (MPI) studies accounted for 77% and radionuclide ventriculography (RNV) for 22% of all nuclear cardiology. On a national basis this represents activity levels of 0.86 and 0.25 studies/1,000/year for MPI and RNV, respectively. Of the 171 responding centres, 102 (60%) performed MPI studies and 81 (79%) of these reported that activity was increasing. However, MPI activity was unevenly distributed between hospitals. Two centres accounted for 13% of total MPI; others had far lower activity rates, and 51/102 (50%) centres performed less than 200 MPI studies/year. Comparison with previous surveys showed that nuclear medicine activity had almost doubled since 1990 (it was 6.0 studies/1,000 population in 1990, 9.3 studies/1,000 in 1994 and 11.8 studies/1,000 in 1997). Over the same period, nuclear cardiology activity had also risen, the greatest increase being seen for the last 3 years (it was 0.7 studies/1,000 population in 1990, 0.82 studies/1,000 in 1994 and 1.12 studies/1,000 in 1997). Despite these encouraging figures, MPI activity for 1997 remained well below that recommended by the British Cardiac Society in 1994 (2.6 studies/1,000/year) as adequate to serve the needs of patients with cardiac disease in the UK; it was also below the European average activity for the same year (2.2 studies/1,000/year). The anticipated increased workload for nuclear cardiology is encouraging despite the wide and varied practice of nuclear cardiology around the UK. The nuclear medicine community now needs to address the issues that will prevent it keeping up with demand, such as restricted camera

Use of smartphone technology in cardiology.

Science.gov (United States)

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. Copyright © 2016 Elsevier Inc. All rights reserved.

Nuclear cardiology practice and associated radiation doses in Europe: results of the IAEA Nuclear Cardiology Protocols Study (INCAPS) for the 27 European countries.

Science.gov (United States)

Lindner, Oliver; Pascual, Thomas N B; Mercuri, Mathew; Acampa, Wanda; Burchert, Wolfgang; Flotats, Albert; Kaufmann, Philipp A; Kitsiou, Anastasia; Knuuti, Juhani; Underwood, S Richard; Vitola, João V; Mahmarian, John J; Karthikeyan, Ganesan; Better, Nathan; Rehani, Madan M; Kashyap, Ravi; Dondi, Maurizio; Paez, Diana; Einstein, Andrew J

2016-04-01

Nuclear cardiology is widely used to diagnose coronary artery disease and to guide patient management, but data on current practices, radiation dose-related best practices, and radiation doses are scarce. To address these issues, the IAEA conducted a worldwide study of nuclear cardiology practice. We present the European subanalysis. In March 2013, the IAEA invited laboratories across the world to document all SPECT and PET studies performed in one week. The data included age, gender, weight, radiopharmaceuticals, injected activities, camera type, positioning, hardware and software. Radiation effective dose was calculated for each patient. A quality score was defined for each laboratory as the number followed of eight predefined best practices with a bearing on radiation exposure (range of quality score 0 - 8). The participating European countries were assigned to regions (North, East, South, and West). Comparisons were performed between the four European regions and between Europe and the rest-of-the-world (RoW). Data on 2,381 European patients undergoing nuclear cardiology procedures in 102 laboratories in 27 countries were collected. A cardiac SPECT study was performed in 97.9 % of the patients, and a PET study in 2.1 %. The average effective dose of SPECT was 8.0 ± 3.4 mSv (RoW 11.4 ± 4.3 mSv; P cardiology is lower and the average quality score is higher than in the RoW. There is regional variation in effective dose in relation to the best practice quality score. A possible reason for the differences between Europe and the RoW could be the safety culture fostered by actions under the Euratom directives and the implementation of diagnostic reference levels. Stress-only imaging and weight-adjusted activity might be targets for optimization of European nuclear cardiology practice.

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

Science.gov (United States)

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. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Bernhard von Gudden, neuro-ophthalmology and the Munich School of Neuroanatomy and Psychiatry.

Science.gov (United States)

Danek, Adrian

2006-12-01

Bernhard von Gudden, psychiatrist to the Royal House of Bavaria (1824-1886), had studied ocular torsion by means of self-observation in the mirror and with the help of after-images for his dissertation of 1848, but later turned to experimental neuroanatomy. Several findings are connected with his name, among them the transverse peduncular tract, part of the accessory optic system. August Forel, Emil Kraepelin and Franz Nissl belonged to his Munich school that took neuroanatomical research as a guiding principle for scientific psychiatry.

Patient doses in interventional cardiology

International Nuclear Information System (INIS)

Carrera, F.; Ojeda, C.; Ruiz-Cruces, R.; Francisco Diaz, J.; Sanchez, A.; Tort, I.

2001-01-01

Cardiovascular diseases are the first cause of death in Spain. The most usual procedures in interventional cardiology are coronariography and PTCA. The first is a diagnostic technique, and the second one is interventional. Our goal has been to study procedures made during the first six months in the Interventional Cardiology Unit of the Juan Ramon Jimenez Hospital (Huelva-Spain), taking into account radiation protection issues. We have studied 178 patients; 145 of them underwent coronariography, and 33 of the patients had PTCA too. Every case was analyzed taking into account technical and dosimetric parameters. We show parameters values gathered: Diagnostic techniques (valvular and non-valvular patients), and interventional techniques (coronariography and PTCA in different or in the same intervention). Higher doses were obtained with valvular patients, although the number of frames was similar. Attending to therapeutic procedures, the highest values were gotten with the 'double' interventions. Interventional procedures exceed in 60% doses gotten in diagnostic studies: this is because of the number of series and number of frames per series. Similar values obtained by other authors have been gotten. (author)

Site matters: winning the hearts and minds of patients in a cardiology clinic.

Science.gov (United States)

Annunziato, Rachel A; Rubinstein, David; Sheikh, Saqib; Maurer, Martin; Cotter, Gad; McKay, Mary M; Milo-Cotter, Olga; Gorman, Jack M; Shemesh, Eyal

2008-01-01

In medical care settings, mental health symptoms of depression and distress are associated with poor medical outcomes, yet they are often underrecognized. Authors sought to examine the effect of having immediate mental-health screening in the cardiology clinic. The Patient Health Questionnaire and the Impact of Event Scale were used to screen for depression and distress in 316 patients at an urban cardiology clinic. Because of poor follow-up rates, a psychiatrist was placed on the premises of the cardiology clinic to facilitate referrals. Placing a psychiatrist within the cardiology clinic significantly improved the rate of successful referrals. Because 45 patients (14%) endorsed suicidal thoughts, authors conclude that mental health screening programs should include an immediate evaluation by a clinician.

Dose to patients and professionals in cardiology interventional: Progress of multicenter group Doccaci

International Nuclear Information System (INIS)

Sanchez, R. M.; Vano, E.; Fernandez, J. M.; Goicolea Ruigomez, J.; Pifarre, X.; Escaned, J.; Rovira, J. J.; Garcia del Blanco, B.; Carrera, F.; Diaz, J. F.; Ordiales, J. M.; Nogales, J. M.; Hernandez, J.; Bosa, F.; Rosales, F.; Saez, J. R.; Soler, M. M.; Romero, M. A.

2013-01-01

The multidisciplinary group and multicenter DOCCACI (dosimetry and quality assurance in interventional cardiology), sponsored by the section of haemodynamics of the Spanish society of Cardiology, is intended to propose reference levels to doses received by patients in interventional cardiology procedures such as recommended by the International Commission on radiological protection It also investigates the doses received by professionals, in particular dose in Crystallyne whose recommended limit dose has been reduced recently from 150 to 20 mSv/year. (Author)

Nuclear cardiology: Part 1

International Nuclear Information System (INIS)

Berger, H.J.; Zaret, B.L.

1981-01-01

A review of recent developments and future directions in nuclear cardiology is presented. Myocardial perfusion imaging is discussed with special emphasis on thallium-201 methods. Infarct-avid imaging is also discussed with emphasis on technetium-99m labelled in diagnosis, and emission computed tomography is briefly reviewed. In addition, new biologically based radiotracers such as indium-111-labeled blood cells, gallium-67 citrate, and new positron- and gamma-emittng radiotracers are reviewed

Quality control in nuclear medicine. Addendum to 'Quality assurance in nuclear medicine', World Health Organization, 1982. Following a training workshop in Neuherberg, Munich, Federal Republic of Germany, November 23-30, 1983

International Nuclear Information System (INIS)

Cradduck, T.D.; Busemann Sokole, E.

2006-01-01

Based on the results of a workshop, sponsored by the German Federal Ministry of the Interior (BMI) and the World Health Organization (WHO), held in Neuherberg, Munich, 1983, a revised concept of quality control (QC) in nuclear medicine is proposed. In a previous document published by the WHO in 1982, a set of rigorous daily, weekly, monthly, quarterly and half-quarterly QC protocols was recommended. The revised concept suggested by the 1983 workshop participants is that of a simple, total system, QC test that can be applied on a frequent, probably daily, basis. Any deviation of the results of such a test from the accepted norm will require further investigation and decision trees can then be applied to localize faults

Emergency planning of the city of Munich with reference to nuclear facilities, especially the nuclear power stations Isar I and II, resp. the reactor in Garching

International Nuclear Information System (INIS)

1990-01-01

During the hearing of Munich's city council of 13.7.1990 thirteen experts were heard on the following subjects: Hazard potential of Isar reactors and FRM reactor and appropriate radioactive waste transports; responsibilities in emergency planning. Some of the experts cannot visualize a major accident and propose not to cater for it. Shelters and evacuation are not planned for Munich, both solutions not being realizable for all inhabitants. Nuclear phaseout is seen by some as a measure of prevention. (HSCH) [de

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

Science.gov (United States)

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.

The Adult Congenital and Pediatric Cardiology Section: increasing the opportunities for the congenital heart disease community within the American College of Cardiology.

Science.gov (United States)

Martin, Gerard R; Mitchell, Stephanie; Beekman, Robert H; Feinstein, Jeffrey A; Jenkins, Kathy J; Landzberg, Michael; Webb, Gary

2012-01-03

The Adult Congenital and Pediatric Cardiology (AC/PC) Section was established to develop a clear voice within the American College of Cardiology and address the myriad issues facing the congenital heart disease profession. The Section is governed by the AC/PC Council, which includes pediatric cardiologists, adult congenital cardiologists, a cardiac care associate, and a fellow-in-training member. The Council is responsible for bidirectional communication between the College's Board of Trustees and the AC/PC Section members. Since its founding in 2004, Section objectives have been defined by the College's mission: to advocate for quality cardiovascular care through education, research promotion, and the development and application of standards and guidelines and to influence health care policy. The pillars of the College-advocacy, quality, education, and member engagement-serve as the defining template for the Section's strategy. The Section has developed work groups in advocacy, clinical practice, education and training, quality, and publications. A separate leadership group has been developed for adult congenital heart disease. Work groups are open to all Section members. Recognition of the importance of lifelong care in congenital heart disease led Section leaders to incorporate pediatric cardiology and adult congenital heart disease content into each of the work groups. There are more than 1,200 Section members, with nearly 400 members actively contributing to Section activities. This article outlines Section efforts to date and highlights significant successes to date. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Radiation monitoring in interventional cardiology: a requirement

Science.gov (United States)

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.

Status of Early-Career Academic Cardiology: A Global Perspective.

Science.gov (United States)

Tong, Carl W; Madhur, Meena S; Rzeszut, Anne K; Abdalla, Marwah; Abudayyeh, Islam; Alexanderson, Erick; Buber, Jonathan; Feldman, Dmitriy N; Gopinathannair, Rakesh; Hira, Ravi S; Kates, Andrew M; Kessler, Thorsten; Leung, Steve; Raj, Satish R; Spatz, Erica S; Turner, Melanie B; Valente, Anne Marie; West, Kristin; Sivaram, Chittur A; Hill, Joseph A; Mann, Douglas L; Freeman, Andrew M

2017-10-31

Early-career academic cardiologists, who many believe are an important component of the future of cardiovascular care, face myriad challenges. The Early Career Section Academic Working Group of the American College of Cardiology, with senior leadership support, assessed the progress of this cohort from 2013 to 2016 with a global perspective. Data consisted of accessing National Heart, Lung, and Blood Institute public information, data from the American Heart Association and international organizations, and a membership-wide survey. Although the National Heart, Lung, and Blood Institute increased funding of career development grants, only a small number of early-career American College of Cardiology members have benefited as funding of the entire cohort has decreased. Personal motivation, institutional support, and collaborators continued to be positive influential factors. Surprisingly, mentoring ceased to correlate positively with obtaining external grants. The totality of findings suggests that the status of early-career academic cardiologists remains challenging; therefore, the authors recommend a set of attainable solutions. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

Environmental effect studies on a forest ecosystem in Germany

International Nuclear Information System (INIS)

Yamamoto, Masayoshi; Bunzl, K.

1993-01-01

Long-term acid deposition on a forest ecosystem can have serious impacts on many physicochemical processes in the soil. Since 1984 extensive studies have been carried out in the 'Hoglwald', an old Norway spruce stand near Munich, Germany. In 1986 a variety of radionuclides were deposited in the canopy and on the forest floor of the Hoglwald following the reactor accident at Chernobyl. The amount of 137 Cs from Chernobyl was about 10 times larger than that present in the soil before Chernobyl. Six experimental plots were established in order to study the potential disturbances caused by artificial acid irrigation and compensative liming. Using these fields, investigations on the interception and retention of radionuclides by a coniferous woodland have been done together with the deposition and vertical migration of the radionuclides in the forest. One of the most important results obtained was that 134 Cs deposition velocity in the spruce stand was as high as 5.5 mm/s, and thus higher by a factor of 10 than the corresponding value for the grassland. By evaluating the depth profiles of the Chernobyl-derived 137 Cs in the soil with a compartment model. The fixation of radiocesium in the forest soil was found to be a rather slow process. (author)

Myocardial scintigraphy. Clinical use and consequence in a non-invasive cardiological department

DEFF Research Database (Denmark)

Dümcke, Christine Elisabeth; Graff, J; Rasmussen, SPL

2006-01-01

to analyse the clinical use of MPI in a university hospital without invasive cardiological laboratory. MATERIAL AND METHODS: In the period 01.01.2002 to 31.12.2003, 259 patients (141 women, 118 men) were referred to MPI from our department of cardiology. RESULTS: Normal MPI was seen in 111 patients (43...

Why Do Model Tropical Cyclones Intensify More Rapidly at Low Latitudes?

Science.gov (United States)

2015-05-01

University of Munich, Munich, Germany MICHAEL T. MONTGOMERY Department of Meteorology, Naval Postgraduate School , Monterey, California (Manuscript...WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate School ,Department of Meteorology,Monterey,CA,93943 8...Roy.Meteor. Soc., 135, 839–850, doi:10.1002/qj.390. Willoughby, H. E., 1979: Forced secondary circulations in hurri- canes . J. Geophys. Res., 84, 3173

Women in interventional cardiology: The French experience.

Science.gov (United States)

Vautrin, E; Marlière, S; Bellemain-Appaix, A; Gilard, M; Manzo-Silberman, S

2016-12-01

Exploring the discrepancy in sex-ratio among interventional cardiologists by analysing the population of the female interventionalist. Despite an increase number of women who graduate from medical school in France during the last generation today, women represent only 24% of all cardiologists and 3% are interventional cardiologists. To face this international gender-based issue of interventional cardiology, committees were established in US (WIN) and recently within the EAPCI: the Women EAPCI chaired by Drs Mehilli and Mauri. In France, the Intervention'Elles committee emerged in order to participate in this concern. As a first initiative, the Intervention'Elles group launched an e-survey to obtain information on the population of French female interventional cardiologists, focused on demography, work patterns, maternity and radiation exposure. Mean age is 40 years old (±7,4), 68% are working in large volume center, 28% have also structural interventional activity. Only 40% have left arm coverage. Despite 80% of French female interventional cardiologists wear personal dosimeters only 45% of them have a dosimetry feedback. Interestingly, even if 54% of women have children (mean: 1.9±1) 28% of them report that childbearing had interfered with their career plan. This questionnaire identifies for the first time the women population in interventional cardiology in France and highlights some of the issues encountered in more detail. This first descriptive step would help to develop strategies for attaining gender equality in interventional cardiology. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Screening for mental disorders in cardiology outpatients

DEFF Research Database (Denmark)

Birket-Smith, M.; Rasmussen, A.

2008-01-01

The objective of the study was to compare the frequency of mental disorders in cardiology outpatients to the number of patients with psychological problems identified by cardiologists. In a cardiology outpatient service, 103 consecutive patients were asked to participate in the study. Of these 86...... were included and screened for mental disorder with the Primary Care Evaluation of Mental Disorders (PRIME-MD), Structured Clinical Interview for DSM-IV (SCID) psychosis screening, the Clock Drawing Test, and the WHO-5 Well-being Index. The cardiologists were asked to rate the severity of somatic...... and mental problems in each patient on visual analogue scales (VAS-som and VAS-men). The current treatments, including psychiatric and psychological treatments, were noted, and the survival was followed for 3 years. Of the 86 patients included, 34 (40%) had a diagnosis of mental disorder. Eleven (12.8%) had...

Radiation-induced eye lens changes and risk for cataract in interventional cardiology.

Science.gov (United States)

Ciraj-Bjelac, O; Rehani, M; Minamoto, A; Sim, K H; Liew, H B; Vano, E

2012-01-01

Recent studies have reported a significant increase in eye lens opacities among staff in the cardiac catheterization laboratory but indicated further studies are needed to confirm the findings. To evaluate the prevalence of opacities in eyes of cardiologists, radiographers and nurses working in interventional cardiology. The eyes of 52 staff in interventional cardiology facilities and 34 age- and sex-matched unexposed controls were screened in a cardiology conference held in Kuala Lumpur by dilated slit-lamp examination, and posterior lens changes were graded. Individual cumulative lens X-ray exposures were calculated from responses to a questionnaire in terms of workload and working practice. The prevalence of posterior lens opacities among interventional cardiologists was 53%, while in nurses and radiographers it was 45%. Corresponding relative risks were 2.6 (95% CI: 1.2-5.4) and 2.2 (95% CI: 0.98-4.9), for interventional cardiologists and support staff, respectively. This study confirms a statistically significant increase in radiation-associated posterior lens changes in the eyes of interventional cardiology staff. Copyright © 2012 S. Karger AG, Basel.

What to Expect from the Evolving Field of Geriatric Cardiology

Science.gov (United States)

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

Nuclear Cardiology. Guidance and Recommendations for Implementation in Developing Countries

International Nuclear Information System (INIS)

2012-01-01

Nuclear cardiology represents one of the most widely used non-invasive techniques for the assessment of coronary artery disease and other cardiovascular conditions. It has been proven as a cost effective tool for the management of cardiac patients and usually has a decisive role in diagnosis, prognosis and risk stratification, as well as in evaluation of therapy. Clinical scenarios in which nuclear cardiology can be helpful are continuously expanding, with the identification of special subgroups of patients as potential beneficiaries of these methods and the emergence of technological developments in instrumentation and software that tend to enhance the cost-benefit ratio and the reliability of results. Many developing countries have introduced nuclear cardiology, with increasing use of this technique in view of the epidemic of cardiovascular disease that is taking place in most low to middle income countries. Longer life expectancies, changes in lifestyle, diabetes, overweight and obesity are thought to be some of the factors underlying the rapidly growing incidence of this life threatening condition. Today, cardiovascular diseases are the most common cause of death in adults in most, if not all, countries of the world, although specific diseases show different relative weights according to local socioeconomic conditions. Thus, proper utilization of available resources such as nuclear cardiology and other imaging methods is essential to effectively combat these diseases. The practice of nuclear cardiology, however, is not homogeneous worldwide, owing to differences in technological capabilities, availability of consumables, education and training of human resources, and access to evidence based medicine, among other factors. Evidence based medicine is the judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available

A survey for the evaluation of the training period of cardiology specialists in Turkey.

Science.gov (United States)

Yıldız, Bekir Serhat; Alkan, Mustafa Beyazıt; Güngör, Hasan; Gül, Ilker; Bilgin, Murat; Akın, Mustafa; Nalbantgil, Sanem; Zoghi, Mehdi

2011-12-01

To evaluate postgraduate training period, social life and problems of cardiology residents in Turkey by using a questionnaire form and to compare with the core curriculum of European Society of Cardiology for general cardiology. Overall, 529 residents of cardiology ages in range of 24-35 years (mean age: 26.5±2.0 years, 81.4% male) participated as volunteers in this cross-sectional survey study. An 86-item questionnaire form was used to evaluate the education process, capacity of knowledge and skill and social effectiveness level of participants. The questionnaire were composed both closed- and open-ended questions. The questionnaire form was filled in with the face-to-face communication method. The data of survey were compared with the core curriculum of European Society of Cardiology for general cardiology training period. Chi-square or Fischer exact test was used for statistical analysis. The participants were working in various university hospitals (70.3%) and training-research (state) hospitals in 31 different provinces in Turkey (40.8% in Marmara region). They visited 40±10 outpatients and 10±5 hospitalized pts daily in the clinics. The 3-5 residents worked at the clinic on night shifts and mostly (89%) 8 or more night shifts per month were held in their first training years. During first three-years of training 76% of residents have performed echocardiography, 40.8%-transesophageal echocardiography and 10% - intraoperative echocardiography. The 84.3% of them evaluated exercise tests, 76.4%-Holter electrocardiography and 53.3%-tilt-table tests. The rate of residents working in coronary angiography laboratories was 54.3%. The 53.7% of residents performed coronary angiography and 64%-only in the 4th year of their training. The number of coronary angiography performance was under expected when compared with European Society of Cardiology curriculum. The 18.5% of residents were participated as assistant researcher in an international multi-center study and

MEMS - Munich Energy Management System. FIA Project: Exchange of research information; MEMS - Muenchner Energiemanagement-System. FIA-Projekt - Forschungs-Informations-Austausch

Energy Technology Data Exchange (ETDEWEB)

Funk, H.; Fries, W.

2001-10-01

The City of Munich developed the project 'Munich Energy-Management-Systems (MEMS)' with financial support from the Federal Ministry of Economy and Technology. The project is based on a system of building automation using as many standard elements of hardware and software as possible. This will guarantee a high degree of independence from suppliers and subcontractors. The project has led to a reliable working base for the evaluation, measuring and control for ca. 150 municipal buildings. (orig.) [German] Mit dem Projekt 'Muenchner Energie-Management-System (MEMS)' erstellte die Landeshauptstadt Muenchen mit finanzieller Unterstuetzung des Bundesministeriums fuer Wirtschaft und Technologie ein auf der Leitzentrale Haustechnik (LZH) basierendes zentrales Energiemanagementsystem. Die Verwendung moeglichst vieler Standards in Hard- und Software ist dabei ein wesentlicher Gesichtspunkt. Dadurch wurde eine weitgehende Unabhaengigkeit von einem einzelnen Hersteller erreicht. Damit wurde ein Erfassungs-, Auswerte- und Steuerungssystem fuer derzeit rund 150 staedtische Gebaeude geschaffen. (orig.)

The Clinical Impact of Cardiology Consultation Prior to Major Vascular Surgery.

Science.gov (United States)

Davis, Frank M; Park, Yeo June; Grey, Scott F; Boniakowski, Anna E; Mansour, M Ashraf; Jain, Krishna M; Nypaver, Timothy; Grossman, Michael; Gurm, Hitinder; Henke, Peter K

2018-01-01

To understand statewide variation in preoperative cardiology consultation prior to major vascular surgery and to determine whether consultation was associated with differences in perioperative myocardial infarction (poMI). Medical consultation prior to major vascular surgery is obtained to reduce perioperative risk. Despite perceived benefit of preoperative consultation, evidence is lacking specifically for major vascular surgery on the effect of preoperative cardiac consultation. Patient and clinical data were obtained from a statewide vascular surgery registry between January 2012 and December 2014. Patients were risk stratified by revised cardiac risk index category and compared poMI between patients who did or did not receive a preoperative cardiology consultation. We then used logistic regression analysis to compare the rate of poMI across hospitals grouped into quartiles by rate of preoperative cardiology consultation. Our study population comprised 5191 patients undergoing open peripheral arterial bypass (n = 3037), open abdominal aortic aneurysm repair (n = 332), or endovascular aneurysm repair (n = 1822) at 29 hospitals. At the patient level, after risk-stratification by revised cardiac risk index category, there was no association between cardiac consultation and poMI. At the hospital level, preoperative cardiac consultation varied substantially between hospitals (6.9%-87.5%, P 66%) had a reduction in poMI (OR, 0.52; confidence interval: 0.28-0.98; P cardiology consultation for vascular surgery varies greatly between institutions, and does not appear to impact poMI at the patient level. However, reduction of poMI was noted at the hospitals with the highest rate of preoperative cardiology consultation as well as a variety of medical services, suggesting that other hospital culture effects play a role.

History of Cardiology in India

OpenAIRE

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 a...

Cholelithiasis in adult bearded dragons: retrospective study of nine adult bearded dragons (Pogona vitticeps) with cholelithiasis between 2013 and 2015 in southern Germany.

Science.gov (United States)

Gimmel, A; Kempf, H; Öfner, S; Müller, D; Liesegang, A

2017-06-01

With an increased number of pet reptiles, many diseases occur due to nutritional disorders. Between 2013 and 2015, irregular gallbladder contents (sludge/choleliths) in adult bearded dragons (Pogona vitticeps) were recorded in many of the routinely conducted necropsies at the reptile rescue station in Munich (Auffangstation für Reptilien, München e.V., Munich, Germany). Nine animals, six from the rescue station and three from an associated veterinary practice (Tierärztliche Praxis für Exoten, Augsburg, Germany), were studied. Gallbladder contents from all animals were analysed at the Institute for Clinical Chemistry in Zurich, Switzerland. In three of nine animals, one cholelith composed of 100% calcium carbonate (CaCO 3 ) was detected and it precipitated either as pure calcite or as a calcite:vaterite combination. In the remaining six animals, analyses suggested a protein-based material. The detection of choleliths/sludge was not anticipated at necropsy or surgery in eight of nine animals. The diet of the six animals from the rescue station was retrospectively described as mainly insects, whereas the diet of the three animals from the veterinary practice also contained little plant matter. Fed insect species were mealworm larva (Tenebrio molitor), house cricket (Acheta domestica), migratory locust (Locusta migratoria) and zophobas larva (Zophobas morio), all high in protein and fat. In other species, a nidus must be present for CaCO 3 to precipitate. As a protein-based sludge was detected in six gallbladders, it is possible that a high-protein diet could lead to such a nidus and subsequently to cholelith formation. Cholelithiasis seems to be a rising problem in adult bearded dragons and is likely underdiagnosed, as many choleliths were found at necropsy. This rise in cholelithiasis may correlate with an unnatural high-protein, high-fat insect-based diet instead of a balanced plant-based diet. Journal of Animal Physiology and Animal Nutrition © 2017 Blackwell

Analysis of the frequency of interventional cardiology in various European countries

International Nuclear Information System (INIS)

Faulkner, K.; Werduch, A.

2008-01-01

The contribution of interventional cardiology procedures to the population dose in Europe is poorly known. The estimation of the population dose from these procedures requires knowledge of both the typical dose received by patients and an estimate of the number of procedures undertaken annually. Data on the number of cardiology procedures in various European countries are available on the internet for a number of countries. However, this data set is incomplete or out of date. This paper describes the statistical analysis undertaken to estimate the number of interventional cardiology procedures in a number of European countries for 2007. Estimates of the number of procedures are given. On average, the number of cardiac catheterizations per million population is 5346, percutaneous transluminal coronary angioplasty is 1599 and 1214 stent procedures. In addition, there are an estimated 973 pacemaker insertions per million population. (authors)

Cardiological-interventional therapy of coronary artery disease today; Kardiologisch-interventionelle Therapie der koronaren Herzerkrankung heute

Energy Technology Data Exchange (ETDEWEB)

Reynen, K.; Henssge, R. [Technische Univ. Dresden (Germany). Klinik fuer Kardiologie

1999-07-01

The current importance of the interventional therapy of coronary artery disease may be deduced from the exponential increase in procedures performed in Germany in the last decade - at least 125,840 in 1996. Today, by improved catheter and balloon materials as well as by growing experience of the cardiologists, even complex lesions may be treated. Limitations of balloon angioplasty include acute vessel closure and restenosis - newer angioplasty devices like directional or rotational atherectomy or excimer-laser angioplasty did not overcome these limitations; only by coronary stenting, acute vessel closure could be managed and the likelihood of restenosis - at least in particular groups of patients - could be reduced. For a few years, intracoronary brachytherapy of the segments dilated with beta- or gamma-emitters has been seeking to reduce restenosis rate; the department of cardiology of the Dresden Cardiovascular Institute is participating in such a multicentre study using the beta-emitter {sup 188}renium. Further main topics of our department represent primary angioplasty in patients with acute myocardial infarction and invasive diagnostic or interventional procedures by the transradial approach. (orig.)

Enabling Precision Cardiology Through Multiscale Biology and Systems Medicine

Directory of Open Access Journals (Sweden)

Kipp W. Johnson, BS

2017-06-01

Full Text Available Summary: The traditional paradigm of cardiovascular disease research derives insight from large-scale, broadly inclusive clinical studies of well-characterized pathologies. These insights are then put into practice according to standardized clinical guidelines. However, stagnation in the development of new cardiovascular therapies and variability in therapeutic response implies that this paradigm is insufficient for reducing the cardiovascular disease burden. In this state-of-the-art review, we examine 3 interconnected ideas we put forth as key concepts for enabling a transition to precision cardiology: 1 precision characterization of cardiovascular disease with machine learning methods; 2 the application of network models of disease to embrace disease complexity; and 3 using insights from the previous 2 ideas to enable pharmacology and polypharmacology systems for more precise drug-to-patient matching and patient-disease stratification. We conclude by exploring the challenges of applying a precision approach to cardiology, which arise from a deficit of the required resources and infrastructure, and emerging evidence for the clinical effectiveness of this nascent approach. Key Words: cardiology, clinical informatics, multi-omics, precision medicine, translational bioinformatics

Munich Re konsultant Gerhard Berz : katastroofid on meie ärile kasulikud / Gerhard Berz ; interv. Ulrich Schnabel, tõlk. Erik Aru

Index Scriptorium Estoniae

Berz, Gerhard

2005-01-01

Intervjuu meteoroloogiga, kes on kolm aastakümmet arvutanud edasikindlustusfirma Munich Re heaks loodusõnnetuste riske ja viibinud ligi viiekümnes katastroofipiirkonnas. Vaatamata sellele, et 2004. aasta oli kõige kulukamate looduskatastroofide aasta, saavutas firma läbi aegade parimad majandustulemused. Lisa: Meeletu kahju

Munich case, some decisions make great stories: Business Model innovation by means of Social Media

OpenAIRE

Rodríguez Donaire, Silvia; Olivé Tomàs, Antoni

2012-01-01

The main objective of this article is to identify how Social Media influences the way the business is managed and/or innovated. To evaluate this Business Model Innovation we have conducted a case study that assesses how strategic choices made by managers, due to the implementation of Social Media, influences Business Model Innovation. The contribution of this article throughout the company’s history, Munich case, allows us to see how Munich’s Business Model has been innovated, and how Social ...

Nuclear cardiology

Energy Technology Data Exchange (ETDEWEB)

Cuaron, A

1993-12-31

Today, nuclear medicine techniques are routinely used in cardiological practice. They include procedures for the atraumatic investigation of different physiological processes in the various structures included in the central circulation: pericardium, myocardium, myocardial adrenergic innervation, cardiac chambers and valves, coronary microcirculation, and great vessels. Beside these in-Vivo procedures, they also comprise of in-Vitro methods for the detection and measurement in blood of various biological molecules of significance in the management of cardiac diseases. A common feature in this collection of in-Vivo and in-Vitro techniques is their ability to provide helpful clinical information for the diagnosis, prognosis and management of cardiac diseases. Their simplicity and safety for the patient allow their repeated use in the follow up of the progress of disease and in the assessment of the efficacy of the therapeutic measures 15 figs, 14 tabs

Nuclear cardiology

International Nuclear Information System (INIS)

Cuaron, A.

1992-01-01

Today, nuclear medicine techniques are routinely used in cardiological practice. They include procedures for the atraumatic investigation of different physiological processes in the various structures included in the central circulation: pericardium, myocardium, myocardial adrenergic innervation, cardiac chambers and valves, coronary microcirculation, and great vessels. Beside these in-Vivo procedures, they also comprise of in-Vitro methods for the detection and measurement in blood of various biological molecules of significance in the management of cardiac diseases. A common feature in this collection of in-Vivo and in-Vitro techniques is their ability to provide helpful clinical information for the diagnosis, prognosis and management of cardiac diseases. Their simplicity and safety for the patient allow their repeated use in the follow up of the progress of disease and in the assessment of the efficacy of the therapeutic measures

Artificial intelligence in cardiology

Directory of Open Access Journals (Sweden)

Srishti Sharma

2017-01-01

Full Text Available Artificial intelligence (AI provides machines with the ability to learn and respond the way humans do and is also referred to as machine learning. The step to building an AI system is to provide the data to learn from so that it can map relations between inputs and outputs and set up parameters such as “weights”/decision boundaries to predict responses for inputs in the future. Then, the model is tested on a second data set. This article outlines the promise this analytic approach has in medicine and cardiology.

Embedding patient simulation in a pediatric cardiology rotation: a unique opportunity for improving resident education.

Science.gov (United States)

Mohan, Shaun; Follansbee, Christopher; Nwankwo, Ugonna; Hofkosh, Dena; Sherman, Frederick S; Hamilton, Melinda F

2015-01-01

High-fidelity patient simulation (HFPS) has been used in medical education to bridge gaps in medical knowledge and clinical skills. Few studies have analyzed the impact of HFPS in subspecialty rotations for pediatric residents. We hypothesized that pediatric residents exposed to HFPS with a structured content curriculum would perform better on a case quiz than residents without exposure to HFPS. Prospective randomized controlled Tertiary-care free standing children's hospital During a cardiology rotation, senior pediatric residents completed an online pediatric cardiology curriculum and a cardiology quiz. After randomization into two groups, the study group participated in a fully debriefed HFPS session. The control group had no HFPS. Both groups completed a case quiz. Confidence surveys pre- and postsimulation were completed. From October 2010 through March 2013, 55 residents who rotated through the pediatric cardiology rotation were used in the final analysis (30 control, 25 in the study group). There was no significant difference between groups on the initial cardiology quiz. The study group scored higher on the case quiz compared with the control group (P = .024). Based on pre- and postsimulation questionnaires, residents' confidence in approaching a pediatric cardiology patient improved from an average Likert score of 5.1 to 7.5 (on scale of 0-10) (P cardiology rotation was feasible and well received. Our study suggests that simulation promotes increased confidence and may modestly improve clinical reasoning compared to traditional educational techniques. Targeted simulation sessions may readily be incorporated into pediatric subspecialty rotations. © 2014 Wiley Periodicals, Inc.

On the Existence of the Logarithmic Surface Layer in the Inner Core of Hurricanes

Science.gov (United States)

2012-01-01

characteristics of eyewall boundary layer of Hurricane Hugo (1989). Mon. Wea. Rev., 139, 1447-1462. Zhang, JA, Montgomery MT. 2012 Observational...the inner core of hurricanes Roger K. Smitha ∗and Michael T. Montgomeryb a Meteorological Institute, University of Munich, Munich, Germany b Dept. of...logarithmic surface layer”, or log layer, in the boundary layer of the rapidly-rotating core of a hurricane . One such study argues that boundary-layer

Major achievements in cardiology in the past century : influence on Dutch cardiovascular medicine

NARCIS (Netherlands)

van der Wall, E. E.; de Boer, M-J; Doevendans, P. A.; Wilde, A. A.; Zijlstra, F.

At the occasion of the 75th anniversary of the Netherlands Society of Cardiology, it is interesting to look back on the major scientific achievements in cardiovascular medicine of the last century, and to pail attention to the impact of these achievements on Dutch Cardiology. It might be a nice

Quantifying the impact of human activity on temperatures in Germany

Science.gov (United States)

Benz, Susanne A.; Bayer, Peter; Blum, Philipp

2017-04-01

and surface air temperature, groundwater temperatures are elevated in cultivated areas as well. At the surface of Germany, the highest anthropogenic heat intensity with 4.5 K is found at an open-pit lignite mine near Jülich, followed by three large cities (Munich, Düsseldorf and Nuremberg) with annual mean anthropogenic heat intensities > 4 K. Overall, surface anthropogenic heat intensities > 0 K and therefore urban heat islands are observed in communities down to a population of 5,000.

The EDP data base as a marketing instrument in the supply industry. Methods and experiences in natural gas customer acquisition of the Munich municipal utilities

International Nuclear Information System (INIS)

Wind, F.; Disser, U.

1994-01-01

The natural gas marketing concept of the Munich municipal utilities describes the aims and objectives for the acquisition of new customers beyond the year 2000. One target is to extend the grids into new areas but also activate natural gas clients in densely populated areas. The marketing strategies concentrate on extensive advice and consulting co-ordinated by the customer service representatives with the support of electronic data processing. The following report shows how modern database systems were integrated into marketing activities by the Munich municipal utility company and describes the strategies selected in new areas and areas with a high customer population. (orig.) [de

The RECALCAR Project. Healthcare in the Cardiology Units of the Spanish National Health System, 2011 to 2014.

Science.gov (United States)

Íñiguez Romo, Andrés; Bertomeu Martínez, Vicente; Rodríguez Padial, Luis; Anguita Sánchez, Manuel; Ruiz Mateas, Francisco; Hidalgo Urbano, Rafael; Bernal Sobrino, José Luis; Fernández Pérez, Cristina; Macaya de Miguel, Carlos; Elola Somoza, Francisco Javier

2017-07-01

The RECALCAR project (Spanish acronym for Resources and Quality in Cardiology Units) uses 2 data sources: a survey of cardiology units and an analysis of the Minimum Basic Data set of all hospital discharges of the Spanish National Health System. From 2011 to 2014, there was marked stability in all indicators of the availability, utilization, and productivity of cardiology units. There was significant variability between units and between the health services of the autonomous communities. There was poor implementation of process management (only 14% of the units) and scarce development of health care networks (17%). Structured cardiology units tended to have better results, in terms of both quality and efficiency. No significant differences were found between the different types of unit in the mean length of stay (5.5±1.1 days) or the ratio between successive and first consultations (2:1). The mean discharge rate was 5/1000 inhabitants/y and the mean rate of initial consultations was 16±4/1000 inhabitants/y. No duty or on-call cardiologist was available in 30% of cardiology units with 24 or more beds; of these, no critical care beds were available in 45%. Our findings support the recommendation to regionalize cardiology care and to promote the development of cardiology unit networks. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

e-Teaching in pediatric cardiology: A paradigm shift.

Science.gov (United States)

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

2015-01-01

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. 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. 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. 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. 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 branches of specialist and super-specialist medical training in

An overview of Smorn V-Munich

International Nuclear Information System (INIS)

Kryter, R.C.; La Wanda, E. Klobe; Hendrix, S.P.

1988-03-01

At the recent fifth Symposium on Reactor Noise (SMORN V), over half the participants represented power utilities, and thirteen out of ninety papers covered practical experience of plant monitoring by noise analysis. In 1986 the Nuclear Energy Agency published a State of the Art Report on Reactor Noise Analysis providing an assessment of the applicability of noise techniques to power reactor operations, which was drawn up by a working group of the NEA Committee on Reactor Physics in the aftermath of the 1984 SMORN IV symposium in Dijon. Since that time, the practical applications of noise analysis techniques to plant surveillance have become more widespread, in particular in the areas of loose part detection and vibration monitoring. Theoretical understanding of the methods has continued to improve. These advances were presented at the SMORN V symposium, held in Munich from 12th - 16th October 1987. The meeting also recommended that the 1986 State of the Art report should be updated, and the present overview is intended, like its predecessor, for a wide audience including national safety authorities and managers in the nuclear industry. The full proceedings of the symposium, to be published in 1988 by Pergamon Press, will include all the papers presented at the meeting. This document was assembled and edited at Oak Ridge National Laboratory from the summaries of each session provided by the session chairmen. Topics which were divided into multiple sessions for the purpose of the conference have been regrouped into single chapters. A complete list of the papers presented at the conference is included in the appendix

Palliative Care Training in Cardiology Fellowship: A National Survey of the Fellows.

Science.gov (United States)

Dabbouseh, Noura M; Kaushal, Shivtej; Peltier, Wendy; Johnston, Fabian M

2018-02-01

To address perspectives of cardiology fellows on the current state of palliative education and palliative and hospice resource utilization within their fellowship experiences. We conducted an online national survey of cardiology fellows during the 2015 to 2016 academic year. Survey questions aimed to assess perceived importance of palliative care education, level of palliative care education during fellowship, and the structure of palliative care support at respondent institutions. Responses were collected anonymously. A total of 519 programs, including subspecialty programs, were contacted. We received 365 responses, a number that represents roughly 14% of all cardiology fellows nationwide during the 2015 to 2016 academic year. Fellows reported discordance in the quality of education between general cardiology and palliative care principles as it relates to care of the patient approaching the end of life. Fellows infrequently received explicit training nor were observed or mentored in delivering end-of-life discussions. Respondents reported an underutilization of palliative care and hospice resources during fellowship training and also a perception that attending faculty were not routinely addressing goals of care. Our survey results highlight a need for enhanced palliative care and end-of-life training experiences for cardiology fellows and also suggest underutilization of hospice and palliative care resources for patients with advanced cardiac diseases. These findings create a platform for future work that might: (1) confirm this training deficit, (2) lead to exploration of educational models that could reconcile this deficit, and (3) potentially help improve palliative care support for patients and families facing advanced heart disease.

TUM Critical Zone Observatory, Germany

Science.gov (United States)

Völkel, Jörg; Eden, Marie

2014-05-01

Founded 2011 the TUM Critical Zone Observatory run by the Technische Universität München and partners abroad is the first CZO within Germany. TUM CZO is both, a scientific as well as an education project. It is a watershed based observatory, but moving behind this focus. In fact, two mountainous areas are integrated: (1) The Ammer Catchment area as an alpine and pre alpine research area in the northern limestone Alps and forelands south of Munich; (2) the Otter Creek Catchment in the Bavarian Forest with a crystalline setting (Granite, Gneiss) as a mid mountainous area near Regensburg; and partly the mountainous Bavarian Forest National Park. The Ammer Catchment is a high energy system as well as a sensitive climate system with past glacial elements. The lithology shows mostly carbonates from Tertiary and Mesozoic times (e.g. Flysch). Source-to-sink processes are characteristic for the Ammer Catchment down to the last glacial Ammer Lake as the regional erosion and deposition base. The consideration of distal depositional environments, the integration of upstream and downstream landscape effects are characteristic for the Ammer Catchment as well. Long term datasets exist in many regards. The Otter Creek catchment area is developed in a granitic environment, rich in saprolites. As a mid mountainous catchment the energy system is facing lower stage. Hence, it is ideal comparing both of them. Both TUM CZO Catchments: The selected catchments capture the depositional environment. Both catchment areas include historical impacts and rapid land use change. Crosscutting themes across both sites are inbuilt. Questions of ability to capture such gradients along climosequence, chronosequence, anthroposequence are essential.

Energy efficiency. A constant challenge to science and practice. Proceedings. 2. ed.; Energieeffizienz. Eine stete Herausforderung an Wissenschaft und Praxis. Tagungsband

Energy Technology Data Exchange (ETDEWEB)

Wagner, Ulrich (ed.)

2011-07-01

Within the meeting ''Energy efficiency'' of the Research Center for Energy Economics (Munich, Federal Republic of Germany) from 12th to 13th May, 2011, at the Munich Residenz (Munich, Federal Republic of Germany) the following lectures were presented: (1) Innovation and research for an enhanced energy efficiency - New accents in the energy research politics of the Federal Government (Knut Kuebler); (2) Revolution of efficiency in the monastery St. Ottilien (Wolfgang Mauch); (3) From the maser plan to the local plan of energy utilization (Tobias Schmid); (4) The life cycle approach as a driver for innovative energy contracting (Alfred Gayer); (5) Energy efficiency networks (Anna Gruber); (6) Grid expansion for an enhanced utilization of renewable energies (Martin Fuchs); (7) Storage requirement in the electrical grid; (8) Scenarios for the development of the electromobility in Munich (Stephan Brunnert); (9) Li ion batteries for electrified automobiles - Demands and status (Peter Lamp); (10) Marketing of wind power (Serafin von Roon); (11) Demand side management in non-residential buildings (Johannes Jungwirth); (12) Energy future 2050 (Ulrich Wagner); (13) Decentral and renewable power generation (Ulli Arndt); (14) Electromobility - is that the future? (Markus Lienkamp); (14) Electric power - Reason or solution of the climate problem? (Harald Lesch).

Energy efficiency. A constant challenge to science and practice. Proceedings. 2. ed.; Energieeffizienz. Eine stete Herausforderung an Wissenschaft und Praxis. Tagungsband

Energy Technology Data Exchange (ETDEWEB)

Wagner, Ulrich [ed.

2011-07-01

Within the meeting ''Energy efficiency'' of the Research Center for Energy Economics (Munich, Federal Republic of Germany) from 12th to 13th May, 2011, at the Munich Residenz (Munich, Federal Republic of Germany) the following lectures were presented: (1) Innovation and research for an enhanced energy efficiency - New accents in the energy research politics of the Federal Government (Knut Kuebler); (2) Revolution of efficiency in the monastery St. Ottilien (Wolfgang Mauch); (3) From the maser plan to the local plan of energy utilization (Tobias Schmid); (4) The life cycle approach as a driver for innovative energy contracting (Alfred Gayer); (5) Energy efficiency networks (Anna Gruber); (6) Grid expansion for an enhanced utilization of renewable energies (Martin Fuchs); (7) Storage requirement in the electrical grid; (8) Scenarios for the development of the electromobility in Munich (Stephan Brunnert); (9) Li ion batteries for electrified automobiles - Demands and status (Peter Lamp); (10) Marketing of wind power (Serafin von Roon); (11) Demand side management in non-residential buildings (Johannes Jungwirth); (12) Energy future 2050 (Ulrich Wagner); (13) Decentral and renewable power generation (Ulli Arndt); (14) Electromobility - is that the future? (Markus Lienkamp); (14) Electric power - Reason or solution of the climate problem? (Harald Lesch).

The value of independent specialty designation for interventional cardiology.

Science.gov (United States)

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. © 2016 Wiley Periodicals, Inc.

An Evaluation of a Clerkship In Cardiology

Science.gov (United States)

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)

Status of the compact core design for the Munich research reactor

International Nuclear Information System (INIS)

Boening, K.; Glaeser, W.; Meier, J.; Rau, G.; Roehrmoser, A.; Zhang, L.

1985-01-01

A novel 'compact core' has been proposed for our project of substantially modernizing the research reactor FRM at Munich. This core has about 20 cm diameter and 70 cm height, is cooled by H 2 O and surrounded by a large D 2 O moderator tank. It makes essential use of the new U 3 Si/Al dispersion fuel with very high Uranium density now available. We present the results of new, two-dimensional neutronic calculations and give an estimate of the probable burnup and reactivity behaviour of the compact core. We expect that this core can be effectively operated with an unperturbed multiplication factor of about 1.22, and that a maximum thermal neutron flux of 7 to 8·10 14 cm- ,2 s -1 can be achieved in the D 2 O tank at 20 MW reactor power. (author)

Sensitivity of Tropical Cyclone Models to the Surface Drag Coefficient in Different Boundary-Layer Schemes

Science.gov (United States)

2011-10-20

altitude of about 500 m in Hurricanes Allen (1980) and Hugo (1989) by Zhang et al. (2010). In Hugo these were about 110 m2 s−1 beneath the eyewall...Marks FD Montgomery MT Lorsolo S. 2010 Estimation of turbulence characteristics of eyewall boundary layer of Hurricane Hugo (1989) Mon. Wea. Rev., in...University of Munich, Munich, Germany b Dept. of Meteorology, Naval Postgraduate School, Monterey, CA & NOAA’s Hurricane Research Division ∗Correspondence

Predictability of the individual clinical outcome of extracorporeal shock wave therapy for cellulite

OpenAIRE

Schlaudraff, Kai-Uwe; Kiessling, Maren C; Császár, Nikolaus BM; Schmitz, Christoph

2014-01-01

Kai-Uwe Schlaudraff,1 Maren C Kiessling,2 Nikolaus BM Császár,2 Christoph Schmitz21Concept Clinic, Geneva, Switzerland; 2Department of Anatomy II, Ludwig-Maximilians-University of Munich, Munich, GermanyBackground: Extracorporeal shock wave therapy has been successfully introduced for the treatment of cellulite in recent years. However, it is still unknown whether the individual clinical outcome of cellulite treatment with extracorporeal shock wave therapy can be predict...

New ADAC centre cools and heats environmental-friendly. Concrete core tempering; Neue ADAC-Zentrale kuehlt und heizt umweltvertraeglich. Betonkerntemperierung

Energy Technology Data Exchange (ETDEWEB)

Anon,

2010-12-15

At present, the new centre of the General German Automobile Association (ADAC) arises in Munich's suburb Sendling/Westpark. In summer 2011, nearly 2,400 coworkers of ADAC so far distributed over six locations in Munich shall work together in the new office building. So that they feel well in this new building, Rehau AG (Rehau, Federal Republic of Germany) supplies an environmental-friendly heating and cooling of the building by means of concrete core tempering.

Nobel Prizes: Contributions to Cardiology

International Nuclear Information System (INIS)

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

Nobel Prizes: Contributions to Cardiology

Energy Technology Data Exchange (ETDEWEB)

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, E-mail: ronaldo@floralia.com.br [Universidade Federal Fluminense, Niterói, RJ (Brazil)

2015-08-15

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.

[Quality assurance in interventional cardiology].

Science.gov (United States)

Gülker, H

2009-10-01

Quality assurance in clinical studies aiming at approval of pharmaceutical products is submitted to strict rules, controls and auditing regulations. Comparative instruments to ensure quality in diagnostic and therapeutic procedures are not available in interventional cardiology, likewise in other fields of cardiovascular medicine. Quality assurance simply consists of "quality registers" with basic data not externally controlled. Based on the experiences of clinical studies and their long history of standardization it is assumed that these data may be severely flawed thus being inappropriate to set standards for diagnostic and therapeutic strategies. The precondition for quality assurance are quality data. In invasive coronary angiography and intervention medical indications, the decision making process interventional versus surgical revascularization, technical performance and after - care are essential aspects affecting quality of diagnostics and therapy. Quality data are externally controlled data. To collect quality data an appropriate infrastructure is a necessary precondition which is not existent. For an appropriate infrastructure investments have to be done both to build up as well as to sustain the necessary preconditions. As long as there are no infrastructure and no investments there will be no "quality data". There exist simply registers of data which are not proved to be a basis for significant assurance and enhancement in quality in interventional coronary cardiology. Georg Thieme Verlag KG Stuttgart, New York.

78 FR 49768 - Notice Pursuant to the National Cooperative Research and Production Act of 1993-Joint Task-Force...

Science.gov (United States)

2013-08-15

...; Ciena, Kanata, Ontario, CANADA; Cinegy, Munich, GERMANY; Cisco, San Jose, CA; Cobalt Digital Inc... speed-up content time-to-market. Patricia A. Brink, Director of Civil Enforcement, Antitrust Division...

Evaluation of Cardiology Training and Manpower Requirements.

Science.gov (United States)

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…

Specialty Payment Model Opportunities and Assessment: Gastroenterology and Cardiology Model Design Report.

Science.gov (United States)

Mulcahy, Andrew W; Chan, Chris; Hirshman, Samuel; Huckfeldt, Peter J; Kofner, Aaron; Liu, Jodi L; Lovejoy, Susan L; Popescu, Ioana; Timbie, Justin W; Hussey, Peter S

2015-07-15

Gastroenterology and cardiology services are common and costly among Medicare beneficiaries. Episode-based payment, which aims to create incentives for high-quality, low-cost care, has been identified as a promising alternative payment model. This article describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS). The authors analyzed Medicare claims data to describe the frequency and characteristics of gastroenterology and cardiology index procedures, the practices that delivered index procedures, and the patients that received index procedures. The results of these analyses can help inform CMS decisions about the definition of episodes in an episode-based payment model; payment adjustments for service setting, multiple procedures, or other factors; and eligibility for the payment model.

Identifying anthropogenic anomalies in air, surface and groundwater temperatures in Germany.

Science.gov (United States)

Benz, Susanne A; Bayer, Peter; Blum, Philipp

2017-04-15

Human activity directly influences ambient air, surface and groundwater temperatures. The most prominent phenomenon is the urban heat island effect, which has been investigated particularly in large and densely populated cities. This study explores the anthropogenic impact on the thermal regime not only in selected urban areas, but on a countrywide scale for mean annual temperature datasets in Germany in three different compartments: measured surface air temperature, measured groundwater temperature, and satellite-derived land surface temperature. Taking nighttime lights as an indicator of rural areas, the anthropogenic heat intensity is introduced. It is applicable to each data set and provides the difference between measured local temperature and median rural background temperature. This concept is analogous to the well-established urban heat island intensity, but applicable to each measurement point or pixel of a large, even global, study area. For all three analyzed temperature datasets, anthropogenic heat intensity grows with increasing nighttime lights and declines with increasing vegetation, whereas population density has only minor effects. While surface anthropogenic heat intensity cannot be linked to specific land cover types in the studied resolution (1km×1km) and classification system, both air and groundwater show increased heat intensities for artificial surfaces. Overall, groundwater temperature appears most vulnerable to human activity, albeit the different compartments are partially influenced through unrelated processes; unlike land surface temperature and surface air temperature, groundwater temperatures are elevated in cultivated areas as well. At the surface of Germany, the highest anthropogenic heat intensity with 4.5K is found at an open-pit lignite mine near Jülich, followed by three large cities (Munich, Düsseldorf and Nuremberg) with annual mean anthropogenic heat intensities >4K. Overall, surface anthropogenic heat intensities >0K and

Vaccination: Developing and implementing a competency-based-curriculum at the Medical Faculty of LMU Munich

Directory of Open Access Journals (Sweden)

Vogel, B.

2016-02-01

Full Text Available Background: In Germany medical students should gain proficiency and specific skills in the vaccination field. Especially important is the efficient communication of scientific results about vaccinations to the community, in order to give professional counseling with a complete overview about therapeutic options.Aim of the project: The aim of this project is to set up a vaccination-related curriculum in the Medical Faculty at the Ludwig-Maximilians-University in Munich. The structure of the curriculum is based on the National catalogue for competency-based learning objectives in the field of vaccination (Nationaler Kompetenzbasierter Lernzielekatalog Medizin NKLM. Through this curriculum, the students will not only acquire the classical educational skills concerning vaccination in theory and practice, but they will also learn how to become independent in the decision-making process and counseling. Moreover, the students will become aware of consequences of action related to this specific topic.Methods: According to defined guidelines, an analysis was performed on courses, which are currently offered by the university. A separate analysis of the NKLM was carried out. Both analyses identified the active courses related to the topic of vaccination as well as the NKLM learning objectives. The match between the topics taught in current courses and the NKLM learning objectives identified gaps concerning the teaching of specific content. Courses were modified in order to implement the missing NKLM learning objectives.Results: These analyses identified 24 vaccination-related courses, which are currently taught at the University. Meanwhile, 35 learning objectives on vaccination were identified in the NKLM catalogue. Four of which were identified as not yet part of the teaching program. In summary, this interdisciplinary work enabled the development of a new vaccination-related curriculum, including 35 learning objectives, which are now implemented in

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

Science.gov (United States)

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. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com. This article is being published concurrently in the Journal of Nuclear Cardiology (10.1007/s12350-015-0260-y) and European Heart Journal – Cardiovascular Imaging (10.1093/ehjci/jev179). The articles are identical except for minor stylistic and spelling differences in keeping with each journal’s style. Either citation can be used when citing this article.

Comparison of EuroMISE Minimal Data Model for Cardiology and HL7 V3 DAM: Cardiology Rel. 2

Czech Academy of Sciences Publication Activity Database

Seidl, Libor; Hanzlíček, Petr

2011-01-01

Roč. 7, č. 1 (2011), s. 33-36 ISSN 1801-5603 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : data model * EuroMISE MDMC * HL7 V3 DAM cardiology * comparison Subject RIV: IN - Informatics, Computer Science http://www.ejbi.eu/images/2011-1/Seidl_en.pdf

Update protocols for evaluating nuclear cardiology and management of coronary heart disease. Chilean Society of Cardiology and Cardiovascular Surgery

International Nuclear Information System (INIS)

Massardo, Teresa; Jaimovich, Rodrigo; Canessa, Jose; Castro, Gabriel; Soto, Juan Ramon

2010-01-01

Protocols are reviewed nuclear cardiology present, with emphasis on imaging studies Single photon ( S PECT ) myocardial perfusion mainly in assessment of coronary heart disease (EC). The indications and protocols used are detailed as well as the literature review relevant both to clinical use as a quality control and interpretation of studies

Impact of Nuclear Laboratory Personnel Credentials & Continuing Education on Nuclear Cardiology Laboratory Quality Operations.

Science.gov (United States)

Malhotra, Saurabh; Sobieraj, Diana M; Mann, April; Parker, Matthew W

2017-12-22

Background/Objectives: The specific credentials and continuing education (CME/CE) of nuclear cardiology laboratory medical and technical staff are important factors in the delivery of quality imaging services that have not been systematically evaluated. Methods: Nuclear cardiology accreditation application data from the Intersocietal Accreditation Commission (IAC) was used to characterize facilities performing myocardial perfusion imaging by setting, size, previous accreditation and credentials of the medical and technical staff. Credentials and CME/CE were compared against initial accreditation decisions (grant or delay) using multivariable logistic regression. Results: Complete data were available for 1913 nuclear cardiology laboratories from 2011-2014. Laboratories with initial positive accreditation decisions had a greater prevalence of Certification Board in Nuclear Cardiology (CBNC) certified medical directors and specialty credentialed technical directors. Certification and credentials of the medical and technical directors, respectively, staff CME/CE compliance, and assistance of a consultant with the application were positively associated with accreditation decisions. Conclusion: Nuclear cardiology laboratories directed by CBNC-certified physicians and NCT- or PET-credentialed technologists were less likely to receive delay decisions for MPI. CME/CE compliance of both the medical and technical directors was associated with accreditation decision. Medical and technical directors' years of experience were not associated with accreditation decision. Copyright © 2017 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

2013 update on congenital heart disease, clinical cardiology, heart failure, and heart transplant.

Science.gov (United States)

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. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Using a statewide survey methodology to prioritize pediatric cardiology core content.

Science.gov (United States)

Neal, Ashley E; Lehto, Elizabeth; Miller, Karen Hughes; Ziegler, Craig; Davis, Erin

2018-01-01

Although pediatrician-reported relevance of Canadian cardiology-specific objectives has been studied, similar data are not available for the 2016 American Board of Pediatrics (ABP) cardiology-specific objectives. This study asked Kentucky trainees, pediatricians, and pediatric cardiologists to identify "most important" content within these objectives. This cross-sectional study used an original, online survey instrument based on the 2016 ABP cardiology-specific objectives. We collected quantitative data (numerical indications of importance) and qualitative data (open-ended replies regarding missing content and difficulty in teaching and learning). Respondents indicated the top two choices of most important items within eight content areas. Descriptive statistics (frequencies and percentages) and chi-square analysis were calculated. Content within categories was organized using naturally occurring "clusters" and "gaps" in scores. Common themes among open-ended qualitative responses were identified using Pandit's version of Glaser and Strauss Grounded theory (constant comparison). Of the 136 respondents, 23 (17%) were residents, 15 (11%) fellows, 85 (62%) pediatricians, and 13 (10%) pediatric cardiologists. Of attendings, 80% reported faculty/gratis faculty status. Naturally occurring clusters in respondent-designated importance resulted in ≤3 "most selected" objectives per content area. Objectives in "most selected" content pertained to initial diagnosis (recognition of abnormality/disease) (n = 16), possible emergent/urgent intervention required (n = 14), building a differential (n = 8), and planning a workup (n = 4). Conversely, themes for "least selected" content included comanagement with subspecialist (n = 15), knowledge useful in patient-family communication (n = 9), knowledge that can be referenced (as needed) (n = 7), and longitudinal/follow-up concerns (n = 5). This study demonstrated the utility of an online survey

Clinical - cardiologic data of 170 dogs - general aspects of diagnosis and therapy

International Nuclear Information System (INIS)

Bohn, F.K.

1994-01-01

The paper presents an actual continuous cardiologic follow up study on 170 unselected dogs. Each proband underwent a complete cardiologic examination (history, auscultation, ECG, radiologic examination, in some cases also echocardiography). Data were grouped by age, sex, breed, congenital and acquired cardiac diseases, and by therapy. 81 (47.65 percent) of the 170 dogs were suffering from an acquired, 25 (14.70 percent) from a congenital cardiac disease. 64 dogs (37.65 percent) showedno clinical signs of heart disease

Advanced Imaging of Intracranial Atherosclerosis: Lessons from Interventional Cardiology

Directory of Open Access Journals (Sweden)

Davor Pavlin-Premrl

2017-08-01

Full Text Available Intracranial atherosclerosis is a major cause of ischemic stroke. Patients with a high degree of stenosis have a significant rate of stroke despite medical therapy. Two randomized trials of stenting have failed to show benefit. Improving periprocedural complication rates and patient selection may improve stenting outcomes. Fractional flow reserve (FFR, intravascular ultrasound (IVUS, and optical coherence tomography (OCT are intravascular imaging techniques employed to improve patient selection and stent placement in interventional cardiology. FFR has been shown to improve cardiovascular outcomes when used in patient selection for intervention. Studies of FFR in intracranial atherosclerosis show that the measure may predict which plaques lead to stroke. IVUS is used in cardiology to quantify stenosis and assist with stent placement. Comparisons with histology show that it can reliably characterize plaques. Several case reports of IVUS in intracranial arteries show the technique to be feasible and indicate it may improve stent placement. Plaque characteristics on IVUS may help identify vulnerable plaques. In interventional cardiology, OCT provides excellent visualization of vessel geometry and is useful periprocedurally. Images reliably identify thin-capped fibroatheromas and other plaque features. Case reports indicate that OCT is safe for use in intracranial arteries. OCT can be used to identify perforator vessels and so may be useful in avoiding perforator strokes, a common complication of stenting. Plaque characteristics on OCT may be useful in patient selection.

The use of MR in cardiological diagnostics

International Nuclear Information System (INIS)

Smith, Hans-Joergen

2004-01-01

Image diagnostics is playing an important role in cardiology, and magnetic resonance tomography (MR) is one of many methods used in examinations of the heart. Based on studies of the literature and his own experience the author surveys the potential of MR in today's and tomorrow's diagnostics of heart diseases. Among the image diagnostic methods MR is the one that can give the most extensive information about the heart's anatomy and function. In a non-invasive way and without the use of ionizing radiation, MR can represent the anatomy in selectable planes, visualize and quantify the heart's pumping function and functioning of the cardiac valves, and give detailed information about the regional contractility, blood flow and viability of myocard. MR is capable of giving important and to some extent unique contributions to heart diseases, both congenital and contracted heart disease. Because of failing availability and competence MR is still little used in cardiological diagnostics, but the method undoubtedly has the potential to play a very important role in the future

Lifelong learning in aviation and medicine; Comments and suggestions

NARCIS (Netherlands)

Boshuizen, Els

2011-01-01

Boshuizen, H. P. A. (2010, 25-27 August). Lifelong learning in aviation and medicine; Comments and suggestions. Discussion at the 5th EARLI-SIG14 Learning and Professional Development, Munich, Germany.

Characteristics of Highly Cited Articles in Interventional Cardiology.

Science.gov (United States)

Khan, Muhammad Shahzeb; Usman, Muhammad Shariq; Fatima, Kaneez; Hashmani, Nauman; Siddiqi, Tariq Jamal; Riaz, Haris; Khan, Abdur Rahman; Khosa, Faisal

2017-12-01

Citation classics have been published in many fields of medicine; however, none have focused on interventional cardiology. The goal of this study was to identify the top 100 articles in the field of interventional cardiology and highlight their important trends and characteristics. The Scopus database was used by 2 independent reviewers to extract the top 100 articles using a variety of keywords. We found articles published between 1953 and 2012. Majority (n = 78) of the top 100 articles were published between 1996 and 2010, and the United States was affiliated with the highest number of articles in our list (n = 68). Over half (n = 54) the articles were funded. Private funding was correlated with higher citations (p = 0.036). A third (n = 33) of the papers had authors with conflicts of interest; however, conflict of interest had no effect on citations (p = 0.837). Majority (n = 57) of the articles studied coronary angioplasty and stenting; followed by coronary angiography (n = 14). Women were underrepresented, with only 11 female first authors in the top 100 papers, and only 1 female in the list of top authors who had 5 or more publications. In conclusion, the following features define the typical highly cited article in interventional cardiology-a clinical trial conducted in the United States, which studies angioplasty, and has been published relatively recently in a high-impact journal by a male first author. Copyright © 2017 Elsevier Inc. All rights reserved.

The role of computerized diagnostic proposals in the interpretation of the 12-lead electrocardiogram by cardiology and non-cardiology fellows.

Science.gov (United States)

Novotny, Tomas; Bond, Raymond; Andrsova, Irena; Koc, Lumir; Sisakova, Martina; Finlay, Dewar; Guldenring, Daniel; Spinar, Jindrich; Malik, Marek

2017-05-01

Most contemporary 12-lead electrocardiogram (ECG) devices offer computerized diagnostic proposals. The reliability of these automated diagnoses is limited. It has been suggested that incorrect computer advice can influence physician decision-making. This study analyzed the role of diagnostic proposals in the decision process by a group of fellows of cardiology and other internal medicine subspecialties. A set of 100 clinical 12-lead ECG tracings was selected covering both normal cases and common abnormalities. A team of 15 junior Cardiology Fellows and 15 Non-Cardiology Fellows interpreted the ECGs in 3 phases: without any diagnostic proposal, with a single diagnostic proposal (half of them intentionally incorrect), and with four diagnostic proposals (only one of them being correct) for each ECG. Self-rated confidence of each interpretation was collected. Availability of diagnostic proposals significantly increased the diagnostic accuracy (p<0.001). Nevertheless, in case of a single proposal (either correct or incorrect) the increase of accuracy was present in interpretations with correct diagnostic proposals, while the accuracy was substantially reduced with incorrect proposals. Confidence levels poorly correlated with interpretation scores (rho≈2, p<0.001). Logistic regression showed that an interpreter is most likely to be correct when the ECG offers a correct diagnostic proposal (OR=10.87) or multiple proposals (OR=4.43). Diagnostic proposals affect the diagnostic accuracy of ECG interpretations. The accuracy is significantly influenced especially when a single diagnostic proposal (either correct or incorrect) is provided. The study suggests that the presentation of multiple computerized diagnoses is likely to improve the diagnostic accuracy of interpreters. Copyright © 2017 Elsevier B.V. All rights reserved.

Telemedicine: Its Importance in Cardiology Practice. Experience in Chile

Directory of Open Access Journals (Sweden)

Edgardo Escobar, MD, FACC, FAHA

2017-05-01

Full Text Available There is a growing need worldwide to take medical care to distant locations far from the main urban centers, particularly to rural areas. Furthermore, there is the ethical imperative to provide equal access to medical care to all patients, regardless of their place of residence, so as to satisfy an increasingly demanding population. A widespread problem, from which cardiology is not excepted, is the insufficient number of specialists and their uneven distribution. The upsurge in information and communications technology has made available a large collection of tools, mainly computers, smartphones, e-mail, and the Internet, to name just a few, to meet the needs of communication between individuals and organizations. This article defines telemedicine and describes its application in the practice of cardiology and its impact in Chile.

The establishment of local diagnostic reference levels for paediatric interventional cardiology

International Nuclear Information System (INIS)

McFadden, S.; Hughes, C.; D'Helft, C.I.; McGee, A.; Rainford, L.; Brennan, P.C.; McCrum-Gardner, E.; Winder, R.J.

2013-01-01

Background: There is a paucity of information worldwide on radiation exposure in paediatric interventional cardiology. At present Nationally established Diagnostic Reference Levels exist for adult interventional cardiology procedures in the UK but little data is available for paediatrics. In addition, interventional cardiology has been identified as one the highest contributors to medical exposure to ionising radiation and children are more radiosensitive than adults. Objective: This study sought to determine current radiation dose levels in paediatric interventional cardiology (IC) with a view to establishing local diagnostic reference levels (LDRL). Methods: Radiation dose and examination details were recorded for 354 paediatric patients examined by IC in a specialised paediatric centre in Europe. Radiation doses were recorded using a Dose Area Product meter along with examination details. Procedures were categorised as either diagnostic (A) or therapeutic (B). Data was further sub-divided into five age ranges; (1) newborn <1 year (2) 1 <5 years (3) 5 <10 years (4) 10 <15 years (5) 15 years and over. Proposed LDRL were calculated from the mean dose area product readings. Results: The mean patient age was 2.6 years (range 0.0 days–16 years) and weight was 14.9 kg (range 2.4–112 kg). LDRL for the five age groupings were calculated as 190, 421, 582, 1289 and 1776 cGycm² respectively. Conclusion: Local dose reference levels have been proposed for paediatric IC and can be used as a benchmark for other hospitals to compare against their own radiation doses

Speculative Considerations about Some Cardiology Enigmas.

Science.gov (United States)

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

2017-01-01

Enigmas often lead to hypotheses and speculations. For this reason, especially for the sake of the reader's motivation, we opted for the plain discussion of some cardiology enigmas. The present text was aimed to discuss speculatively some cardiology enigmas. Text was freely designed in the context of coronary artery and heart valve diseases. The results were presented as the combination enigma/hypothesis. 1) The absence of arteriosclerosis in intramyocardial coronary arteries/ endothelium-myocardial interaction (crosstalk); 2) The unique and always confirmed superior evolution of the internal thoracic artery as coronary graft/ higher NO basal release 3) The prophylactic left internal thoracic artery graft in mildlystenosed coronary lesions/need of more accurate functional imaging techniques; 4) The high incidence of perioperative atrial fibrillation in patients with coronary artery disease/atrial ischemia associated to left circumflex coronary lesions; 5) The handling of disease-free saphenous vein grafts at the time of reoperation/biological serendipity with graft vein segments; 6) The possible aortic stenosis protection against coronary artery disease/ endothelium-myocardium interaction (crosstalk) improving NO release. The discussed topics associated with their respective speculative hypothesis remain as enigmas, but would become motivations for investigations. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Cardiological aspects of carbon monoxide poisoning.

Science.gov (United States)

Marchewka, Jakub; Gawlik, Iwona; Dębski, Grzegorz; Popiołek, Lech; Marchewka, Wojciech; Hydzik, Piotr

2017-01-01

The aim of this study was to assess cardiological manifestations of carbon monoxide (CO) poisoning. Background/introduction: Carbon monoxide intoxication is one of the most important toxicological causes of morbidity and mortality worldwide. Early clinical manifestation of CO poisoning is cardiotoxicity. We enrolled 75 patients (34 males and 41 females, mean age 37.6 ± 17.7 y/o) hospitalized due to CO poisoning. Laboratory tests including troponin I, blood pressure measurements, HR and electrocardiograms (ECG) were collected. Pach's scale scoring and grading system was used to establish severity of poisoning. Grade of poisoning is positively correlated with troponin I levels and systolic blood pressure. Moreover, troponin levels are significantly correlated with exposition time, lactates and are higher in tachycardiac, hypertensive and positive ECG subpopulations. COHb levels are indicative of exposure but do not correlate with grade of poisoning. The main cause of CO poisoning were bathroom heaters - 83%, only 11% of examined intoxicated population were equipped with CO detectors. Complex cardiological screening covering troponin levels, ECG, blood pressure and heart rate measurements as well as complete blood count with particular attention to platelet parameters should be performed in each case where CO intoxication is suspected. More emphasis on education on CO poisoning is needed.

Providing Cardiology Care in Rural Areas Through Visiting Consultant Clinics.

Science.gov (United States)

Gruca, Thomas S; Pyo, Tae-Hyung; Nelson, Gregory C

2016-06-30

Workforce experts predict a future shortage of cardiologists that is expected to impact rural areas more severely than urban areas. However, there is little research on how rural patients are currently served through clinical outreach. This study examines the impact of cardiology outreach in Iowa, a state with a large rural population, on participating cardiologists and on patient access. Outreach clinics are tracked annually in the Office of Statewide Clinical Education Programs Visiting Medical Consultant Database (University of Iowa Carver College of Medicine). Data from 2014 were analyzed. In 2014, an estimated 5460 visiting consultant clinic days were provided in 96 predominantly rural cities by 167 cardiologists from Iowa and adjoining states. Forty-five percent of Iowa cardiologists participated in rural outreach. Visiting cardiologists from Iowa and adjoining states drive an estimated 45 000 miles per month. Because of monthly outreach clinics, the average driving time to the nearest cardiologist falls from 42.2±20.0 to 14.7±11.0 minutes for rural Iowans. Cardiology outreach improves geographic access to office-based cardiology care for more than 1 million Iowans out of a total population of 3 million. Direct travel costs and opportunity costs associated with physician travel are estimated to be more than $2.1 million per year. Cardiologists in Iowa and adjoining states have expanded access to office-based cardiology care from 18 to 89 of the 99 counties in Iowa. In these 71 counties without a full-time cardiologist, visiting consultant clinics can accommodate more than 50% of office visits in the patients' home county. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Development of quality metrics for ambulatory pediatric cardiology: Infection prevention.

Science.gov (United States)

Johnson, Jonathan N; Barrett, Cindy S; Franklin, Wayne H; Graham, Eric M; Halnon, Nancy J; Hattendorf, Brandy A; Krawczeski, Catherine D; McGovern, James J; O'Connor, Matthew J; Schultz, Amy H; Vinocur, Jeffrey M; Chowdhury, Devyani; Anderson, Jeffrey B

2017-12-01

In 2012, the American College of Cardiology's (ACC) Adult Congenital and Pediatric Cardiology Council established a program to develop quality metrics to guide ambulatory practices for pediatric cardiology. The council chose five areas on which to focus their efforts; chest pain, Kawasaki Disease, tetralogy of Fallot, transposition of the great arteries after arterial switch, and infection prevention. Here, we sought to describe the process, evaluation, and results of the Infection Prevention Committee's metric design process. The infection prevention metrics team consisted of 12 members from 11 institutions in North America. The group agreed to work on specific infection prevention topics including antibiotic prophylaxis for endocarditis, rheumatic fever, and asplenia/hyposplenism; influenza vaccination and respiratory syncytial virus prophylaxis (palivizumab); preoperative methods to reduce intraoperative infections; vaccinations after cardiopulmonary bypass; hand hygiene; and testing to identify splenic function in patients with heterotaxy. An extensive literature review was performed. When available, previously published guidelines were used fully in determining metrics. The committee chose eight metrics to submit to the ACC Quality Metric Expert Panel for review. Ultimately, metrics regarding hand hygiene and influenza vaccination recommendation for patients did not pass the RAND analysis. Both endocarditis prophylaxis metrics and the RSV/palivizumab metric passed the RAND analysis but fell out during the open comment period. Three metrics passed all analyses, including those for antibiotic prophylaxis in patients with heterotaxy/asplenia, for influenza vaccination compliance in healthcare personnel, and for adherence to recommended regimens of secondary prevention of rheumatic fever. The lack of convincing data to guide quality improvement initiatives in pediatric cardiology is widespread, particularly in infection prevention. Despite this, three metrics were

Psychosocial risk factors and personality disorders in outpatient cardiology setting

Directory of Open Access Journals (Sweden)

Mariana Suárez-Bagnasco

2015-01-01

Psychological risk factors and personality disorders comorbidities are more frequent than psychological risk factors only or personality disorders only in outpatient cardiology setting without cardiovascular diseases.

POSITIONS OF CALCIUM CHANNEL BLOCKER LERCANIDIPINE ACCORDING TO EVIDENCE BASED CARDIOLOGY

Directory of Open Access Journals (Sweden)

Yu. V. Lukina

2010-01-01

Full Text Available Data of evidence based cardiology including results of international clinical trials on efficacy and safety of the modern calcium channel blocker (CCB, lercanidipine, are presented. Results of these trials show the firm position of lercanidipine in the modern cardiology and confirm that treatment with lercanidipine leads to significant reduction of systolic and diastolic blood pressure (BP with no effect on heart rate (HR. Peripheral edema (the common side effect of CCBs occurs rarer with lercanidipine treatment than this with any other CCB treatment. Lercanidipine can be recommended to patients with concomitant diseases due to its additional features.

Nuclear cardiology practice and associated radiation doses in Europe: results of the IAEA Nuclear Cardiology Protocols Study (INCAPS) for the 27 European countries

International Nuclear Information System (INIS)

Lindner, Oliver; Burchert, Wolfgang; Pascual, Thomas N.B.; Kashyap, Ravi; Dondi, Maurizio; Paez, Diana; Mercuri, Mathew; Acampa, Wanda; Flotats, Albert; Kaufmann, Philipp A.; Kitsiou, Anastasia; Knuuti, Juhani; Underwood, S.R.; Vitola, Joao V.; Mahmarian, John J.; Karthikeyan, Ganesan; Better, Nathan; Rehani, Madan M.; Einstein, Andrew J.

2016-01-01

Nuclear cardiology is widely used to diagnose coronary artery disease and to guide patient management, but data on current practices, radiation dose-related best practices, and radiation doses are scarce. To address these issues, the IAEA conducted a worldwide study of nuclear cardiology practice. We present the European subanalysis. In March 2013, the IAEA invited laboratories across the world to document all SPECT and PET studies performed in one week. The data included age, gender, weight, radiopharmaceuticals, injected activities, camera type, positioning, hardware and software. Radiation effective dose was calculated for each patient. A quality score was defined for each laboratory as the number followed of eight predefined best practices with a bearing on radiation exposure (range of quality score 0 - 8). The participating European countries were assigned to regions (North, East, South, and West). Comparisons were performed between the four European regions and between Europe and the rest-of-the-world (RoW). Data on 2,381 European patients undergoing nuclear cardiology procedures in 102 laboratories in 27 countries were collected. A cardiac SPECT study was performed in 97.9 % of the patients, and a PET study in 2.1 %. The average effective dose of SPECT was 8.0 ± 3.4 mSv (RoW 11.4 ± 4.3 mSv; P < 0.001) and of PET was 2.6 ± 1.5 mSv (RoW 3.8 ± 2.5 mSv; P < 0.001). The mean effective doses of SPECT and PET differed between European regions (P < 0.001 and P = 0.002, respectively). The mean quality score was 6.2 ± 1.2, which was higher than the RoW score (5.0 ± 1.1; P < 0.001). Adherence to best practices did not differ significantly among the European regions (range 6 to 6.4; P = 0.73). Of the best practices, stress-only imaging and weight-adjusted dosing were the least commonly used. In Europe, the mean effective dose from nuclear cardiology is lower and the average quality score is higher than in the RoW. There is regional variation in effective dose in

Nuclear cardiology practice and associated radiation doses in Europe: results of the IAEA Nuclear Cardiology Protocols Study (INCAPS) for the 27 European countries

Energy Technology Data Exchange (ETDEWEB)

Lindner, Oliver; Burchert, Wolfgang [University Hospital of the Ruhr University, Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine-Westphalia Bochum, Bad Oeynhausen (Germany); Pascual, Thomas N.B.; Kashyap, Ravi; Dondi, Maurizio; Paez, Diana [International Atomic Energy Agency, Section of Nuclear Medicine and Diagnostic Imaging, Division of Human Health, Vienna (Austria); Mercuri, Mathew [Columbia University Medical Center and New York-Presbyterian Hospital, Division of Cardiology, Department of Medicine, New York, NY (United States); Acampa, Wanda [National Council of Research, Institute of Biostructures and Bioimaging, Naples (Italy); Flotats, Albert [Universitat Autonoma de Barcelona, Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain); Kaufmann, Philipp A. [University Hospital Zurich, Department of Nuclear Medicine and Cardiac Imaging, Zurich (Switzerland); Kitsiou, Anastasia [Sismanoglio Hospital, Department of Cardiology, Athens (Greece); Knuuti, Juhani [University of Turku, and Turku University Hospital, Turku PET Centre, Turku (Finland); Underwood, S.R. [Imperial College London, National Heart and Lung Institute, London (United Kingdom); Royal Brompton and Harefield Hospitals, Department of Nuclear Medicine, London (United Kingdom); Vitola, Joao V. [Quanta Diagnostico and Terapia, Curitiba (Brazil); Mahmarian, John J. [Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology, Houston, TX (United States); Karthikeyan, Ganesan [All India Institute of Medical Sciences, Department of Cardiology, New Delhi (India); Better, Nathan [Royal Melbourne Hospital and University of Melbourne, Department of Nuclear Medicine, Melbourne (Australia); Rehani, Madan M. [International Atomic Energy Agency, Radiation Protection of Patients Unit, Vienna (Austria); Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Einstein, Andrew J. [Columbia University Medical Center and New York-Presbyterian Hospital, Division of Cardiology, Department of Medicine, New York, NY (United States); Columbia University Medical Center and New York-Presbyterian Hospital, Department of Radiology, New York, NY (United States); Collaboration: for the INCAPS Investigators Group

2016-04-15

Nuclear cardiology is widely used to diagnose coronary artery disease and to guide patient management, but data on current practices, radiation dose-related best practices, and radiation doses are scarce. To address these issues, the IAEA conducted a worldwide study of nuclear cardiology practice. We present the European subanalysis. In March 2013, the IAEA invited laboratories across the world to document all SPECT and PET studies performed in one week. The data included age, gender, weight, radiopharmaceuticals, injected activities, camera type, positioning, hardware and software. Radiation effective dose was calculated for each patient. A quality score was defined for each laboratory as the number followed of eight predefined best practices with a bearing on radiation exposure (range of quality score 0 - 8). The participating European countries were assigned to regions (North, East, South, and West). Comparisons were performed between the four European regions and between Europe and the rest-of-the-world (RoW). Data on 2,381 European patients undergoing nuclear cardiology procedures in 102 laboratories in 27 countries were collected. A cardiac SPECT study was performed in 97.9 % of the patients, and a PET study in 2.1 %. The average effective dose of SPECT was 8.0 ± 3.4 mSv (RoW 11.4 ± 4.3 mSv; P < 0.001) and of PET was 2.6 ± 1.5 mSv (RoW 3.8 ± 2.5 mSv; P < 0.001). The mean effective doses of SPECT and PET differed between European regions (P < 0.001 and P = 0.002, respectively). The mean quality score was 6.2 ± 1.2, which was higher than the RoW score (5.0 ± 1.1; P < 0.001). Adherence to best practices did not differ significantly among the European regions (range 6 to 6.4; P = 0.73). Of the best practices, stress-only imaging and weight-adjusted dosing were the least commonly used. In Europe, the mean effective dose from nuclear cardiology is lower and the average quality score is higher than in the RoW. There is regional variation in effective dose in

Meniscectomy: indications, procedure, outcomes, and rehabilitation

Directory of Open Access Journals (Sweden)

Anetzberger H

2013-12-01

Full Text Available Hermann Anetzberger,1 Christof Birkenmaier,2 Stephan Lorenz3 1Orthopädische Gemeinschaftspraxis am OEZ, Munich, Germany; 2Department of Orthopedics, Ludwig-Maximilian-University Munich, Munich, Germany; 3Department of Orthopedic Sports Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany Abstract: Meniscal injuries are among the most frequent reasons for knee problems. The goal of this manuscript is to review the biomechanical relevance of the human knee's menisci in relation to surgical indications, surgical techniques, rehabilitation, and outcomes. In order to identify the relevant literature, we performed a PubMed search for the years ranging from 1980–2013 using the following search terms: meniscus; biomechanical function; meniscectomy; meniscal repair; and clinical outcome. The meniscus helps to distribute the forces between the tibial and femoral articular cartilage layers in a load-sharing capacity. Meniscus damage or meniscectomy intuitively leads to an overloading of the cartilage and, hence, to the development of osteoarthrosis. Precise knowledge of meniscal shape and function, of the type of injury, of surgical techniques, as well as of postsurgical rehabilitative care are of decisive importance for an individually-adjusted treatment strategy. Other underlying coexisting knee pathologies also need to be considered. The diagnosis of a meniscal injury is based upon clinical history, physical examination, and imaging studies. The treatment of a meniscal lesion includes conservative, as well as operative, procedures. The goals of surgery are to reduce pain and disability, as well as to preserve meniscal function without causing additional cartilage damage. The resection of meniscal tissue should be restricted to as much as is necessary, and as little as is reasonably possible. Postoperative rehabilitation serves the purpose of improving functional deficits and pain, as well as of restoring a good range of

Training fellows in paediatric cardiology: the Harvard experience.

Science.gov (United States)

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.

Latest version of the Munich pulsed low energy positron system

International Nuclear Information System (INIS)

Bauer-Kugelmann, W.; Sperr, P.; Koegel, G.; Triftshaeuser, W.

2001-01-01

Further improvements of the Munich pulsed low energy positron system have been performed. A new chopper, configured as a double plate deflection system with an external resonator and a new buncher working like a classical double gap buncher, are implemented. The complete rf-power electronic was redesigned and operates now at an overall master-frequency of 50 MHz for all bunching and chopping components. A new target station with an enlarged Faraday cage is installed. The sample temperature is variable between 30 K and 600 K. Up to ten samples can be stored in a magazine and transferred under vacuum conditions to the measuring position. With a primary source of 30 mCi 22 Na a count rate of up to 4 kHz can be achieved with a peak-to-background ratio of 3000:1. This ratio can be further improved by the use of a Wien filter. A beam diameter of about 2 mm was determined. The total time resolution (pulsing plus detector system) is 250 ps (FWHM). (orig.)

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

Science.gov (United States)

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

The 2017 Seventh World Congress of Paediatric Cardiology and Cardiac Surgery: "The Olympics of our Profession".

Science.gov (United States)

Cohen, Mitchell I; Jacobs, Jeffrey P; Cicek, Sertac

2017-12-01

The 1st 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 would 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; Cairns, Australia, 2009, organised by Jim Wilkinson; Cape Town, South Africa, 2013, organised by Christopher Hugo-Hamman; and Barcelona, Spain, 2017, organised by Sertac Cicek. With stops in Europe (1993), Asia-Pacific (1997), North America

Existing and projected neutron sources and low-temperature irradiation facilities in Germany

International Nuclear Information System (INIS)

Boening, K.

1984-01-01

In this paper, a contribution given at the Kyoto University Research Reactor Institute to the temporal meeting on the design of the facilities for high flux, low temperature irradiation is summarized. The following five subjects were discussed. The project of modernizing the swimming pool type research reactor FRM with 4 MW power at Munich is to achieve relatively high thermal neutron flux, and an extremely compact core is designed. The existing low temperature irradiation facility (LTIF) of the FRM is the most powerful in the world, and has been successfully operated more than 20 years. The fast and thermal neutron fluxes are 2.9 x 10 13 and 3.5 x 10 13 /cm 2 sec, respectively. The experimental techniques in the LTIF of the FRM, such as a measuring cryostat, the mounting of irradiated samples and so on, are described. The installation of new LTIFs in connection with the projects of advanced neutron sources in Germany is likely to be made in the modernized FRM at Garching, in the spallation neutron source SNQ at KFA Juelich and so on. The interesting problems in fundamental and applied researches with LTIFs, and the unusual application of LTIFs are shown. (Kako, I.)

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

Science.gov (United States)

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

2017-04-04

Safety culture is one of the requirements for preventing the occurrence of adverse effects. However, this has not been studied in the field of cardiology. The aim of this study is to evaluate the safety culture in a cardiology unit that has implemented and certified an integrated quality and risk management system for patient safety. A cross-sectional observational study was conducted in 2 consecutive years, with all staff completing the Spanish version of the questionnaire, "Hospital Survey on Patient Safety Culture" of the "Agency for Healthcare Research and Quality", with 42 items grouped into 12 dimensions. The percentage of positive responses in each dimension in 2014 and 2015 were compared, as well as national data and United States data, following the established rules. The overall assessment out of a possible 5, was 4.5 in 2014 and 4.7 in 2015. Seven dimensions were identified as strengths. The worst rated were: staffing, management support and teamwork between units. The comparison showed superiority in all dimensions compared to national data, and in 8 of them compared to American data. The safety culture in a Cardiology Unit with an integrated quality and risk management patient safety system is high, and higher than nationally in all its dimensions and in most of them compared to the United States. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

Nuclear cardiology

International Nuclear Information System (INIS)

Vos, P.H.

1982-01-01

This thesis deals with two topics in nuclear cardiology. In the first, left ventricular wall motion assessment using Fourier transform of local left ventricular time-activity curves in gated blood pool studies is evaluated. In the second, the interpretation of myocardial perfusion scintigrams is assessed which are obtained with thallium-201 or with another radiopharmaceutical with different physical, but identical biological properties. In all these investigations data acquisition and analysis by computer played an essential role. In chapter 1 the desirable properties of a nuclear medicine computer system are given and the computer system used for this work is described. Wall motion analysis of the left ventricle using Fourier transform of local time-activity curves in the left ventricular region in gated blood pool studies is described in chapter 2. In chapter 3 detection of non-perfused lesions in myocardial perfusion scintigraphy with thallium-201 is described. Detection of partly perfused lesions and the influence of scatter and photon energy on myocardial perfusion scintigraphy is described in chapter 4. (Auth.)

Clinical use of nuclear cardiology in the assessment of heart failure

International Nuclear Information System (INIS)

Han Lei; Shi Hongcheng

2011-01-01

Nuclear cardiology is the most commonly performed non-invasive cardiac imaging test in patients with heart failure, and it plays an important role in their assessment and management. Quantitative gated single positron emission computed tomography is used to assess quantitatively cardiac volume, left ventricular ejection fraction, stroke volume, and cardiac diastolic function. Resting and stress myocardial perfusion imaging can not only identify nonischemic heart failure and ischemic heart failure, but also demonstrate myocardial viability. Diastolic heart failure also termed as heart failure with a preserved left ventricular ejection fraction is readily identified by nuclear cardiology techniques and can accurately be estimated by peak filling rate and time to peak filling rate. With newer techniques such as three-dimensional, quantitative gated single positron emission computed tomography can assess movement of the left ventricle, and wall thickening evaluation aids its assessment. Myocardial perfusion imaging is also commonly used to identify candidates for implantable cardiac defibrillator and cardiac resynchronization therapies. Neurotransmitter imaging using 123 I-metaiodobenzylguanidine offers prognostic information in patients with heart failure. Metabolism and function in the heart are closely related, and energy substrate metabolism is a potential target of medical therapies to improve cardiac function in patients with heart failure. Cardiac metabolic imaging using 123 I-15-(p-iodophenyl) 3-R, S-methylpentadecacoic acid is a commonly used tracer in clinical studies to diagnose metabolic heart failure. Nuclear cardiology tests, including neurotransmitter imaging and metabolic imaging, are now easily preformed with new tracers to improve heart failure diagnosis. Nuclear cardiology techniques contribute significantly to identifying patients with heart failure and to guiding their management decisions. (authors)

Evaluation of occupational radiation exposure in cardiology interventional procedures in some Khartoum hospitals

International Nuclear Information System (INIS)

Ibrahim, Doaa Mohammed Ali

2015-12-01

The number of cardiology interventional procedures has significantly increased recently. This is due to the reliability of the diagnostic equipment to diagnose many heart diseases. In the procedures the x-ray used results in increasing radiation doses to the staff. The cardiologists and other staff member in interventional cardiology are usually working close to the area under examination and receive the dose primarily as well as from scattered radiation from the patients. In this study three electronic personal dosimeters (EPDs) were used to measured personal equivalent dose Hp (10) for assessment staff doses were monitoring during interventional cardiology procedure, totally in (100) procedures were performed in two clinical. The procedures was collect in two main hospitals in Khartoum State, the staff workers include cardiologists, technologists and nurses. The EPDs were used by each worker at the two cardiology centers, was one worn under a protective apron attach to chest. The annual doses received by 6 cardiologists, 6 nurses and 2 technologists at the sudan heart center were tn the range: (27.25-33.5) μSv, (3.25-3.66) μSv, (3.25-3.66) μSv, (3.23 and 3.70) μSv respectively. In the royal care hospital the annual doses received by 2 doctors, 4 nurses and 2 technologists were in the range ( 38.375 and 39.375) μSv (12.06-14.125) μSv, (8.5 and 9.25) μSv respectively, estimated for four weeks. The highest doses were received by the cardiologist followed by nurses and the x-ray technicians. The results showed that the annual doses received by the workers do not exceed 20 mSv. Recommendation on how to reduce staff doses in interventional cardiology are presented.(Author)

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

Science.gov (United States)

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

Evaluation of an Antigen-Antibody

African Journals Online (AJOL)

GB

Reduction of costs is important for developing countries where money and personal resources ... 1Max von Pettenkofer Institute for Hygiene and Medical Microbiology - LMU, Munich, Germany ..... Tuke PW, Grant PR, Waite J, Kitchen AD, Eglin.

Recent advances in pediatric interventional cardiology.

Science.gov (United States)

Kim, Seong-Ho

2017-08-01

During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously considered resistant to interventional therapies can now be managed with high success rates. The hybrid approach has enabled the overcoming of limitations inherent to percutaneous access, expanding the application of endovascular therapies as adjunct to surgical interventions to improve patient outcomes and minimize invasiveness. Percutaneous pulmonary valve implantation has become a successful alternative therapy. However, most of the current recommendations about pediatric cardiac interventions (including class I recommendations) refer to off-label use of devices, because it is difficult to study the safety and efficacy of catheterization and transcatheter therapy in pediatric cardiac patients. This difficulty arises from the challenge of identifying a control population and the relatively small number of pediatric patients with congenital heart disease. Nevertheless, the pediatric interventional cardiology community has continued to develop less invasive solutions for congenital heart defects to minimize the need for open heart surgery and optimize overall outcomes. In this review, various interventional procedures in patients with congenital heart disease are explored.

[Structured teaching of surgery the LMU model in Munich].

Science.gov (United States)

Chiapponi, C; Bruns, C J; Pilz, F; Kanz, K-G; Mutschler, W; Jauch, K-W; Siebeck, M

2014-12-01

The medical curriculum (MeCuM) of the Ludwig Maximilian University (LMU) in Munich is a dynamic curriculum aimed to support the learning process of all students with their different learning styles. It is based on interactive, activating teaching methods in order to increase students' interest, and on repetitive evaluation of teaching units to modify the teaching in order to meet students' needs and wishes. In this context the teaching of surgery at our faculty takes place. Besides interdisciplinary lessons where diseases are taught in cooperation with our colleagues from internal medicine, indications for surgery, complications and consequences of surgery for the patients are analysed in PBL tutorials, online cases, bedside teachings and practical teaching on the ward. Surgical skills like suturing are demonstrated in videos, practiced on models or during practical teaching on the ward and they are tested in OSCEs. During the "praktisches Jahr", the students in the last year of their medical studies are supposed to apply their practical skills besides repeating theoretical knowledge in order to pass the final examination. For this purpose they are taught in a revision course called "LMU-StaR" (revision course for the Staatsexamen). In this paper we describe in detail the teaching of surgery at our faculty. Georg Thieme Verlag KG Stuttgart · New York.

Upgrading of the Munich reactor with a compact core

International Nuclear Information System (INIS)

Boening, K.; Glaeser, W.; Meier, J.; Rau, G.; Roehrmoser, A.; Zhang, L.

1985-01-01

An extremely small reactor core has been proposed for the project of substantial modernization of the FRM research reactor at Munich. According to the present status this 'compact core' will be a cylinder with a diameter of about 20 cm and 70 cm high. The new high-density U 3 Si/Al dispersion fuel of about 45% enrichment is contained in 20 concentric fuel plate rings. The compact core is surrounded by a large heavy-water tank which will incorporate the user installations (beam tubes and irradiation channels). However, the primary cooling circuit will contain light water which is not only more economic but also essential for the performance of the small core. An important optimization potential to decrease easily the power density peaks in the core is to reduce further the enrichment in those fuel plate rings where the neutron flux is particularly high. Two-dimensional neutron transport calculations show that such a core, containing about 7.5 kg 235 U, should have an effective multiplication factor of about 1.22 and an unperturbed but realistic maximum thermal neutron flux in the heavy water tank of 7 to 8x10 14 cm -2 .s -1 at 20 MW reactor power. (author)

Nuclear Cardiology: Are We Using the Right Protocols and Tracers the Right Way?

Science.gov (United States)

Dondi, Maurizio; Pascual, Thomas; Paez, Diana; Einstein, Andrew J

2017-12-01

The field of nuclear cardiology has changed considerably over recent years, with greater attention paid to safety and radiation protection issues. The wider usage of technetium-99m (Tc-99m)-labeled radiopharmaceuticals for single-photon emission computed tomography (SPECT) imaging using gamma cameras has contributed to better quality studies and lower radiation exposure to patients. Increased availability of tracers and scanners for positron emission tomography (PET) will help further improve the quality of studies and quantify myocardial blood flow and myocardial flow reserve, thus enhancing the contribution of non-invasive imaging to the management of coronary artery disease. The introduction of new instrumentation such as solid state cameras and new software will help reduce further radiation exposure to patients undergoing nuclear cardiology studies. Results from recent studies, focused on assessing the relationship between best practices and radiation risk, provide useful insights on simple measures to improve the safety of nuclear cardiology studies without compromising the quality of results.

Decision Making in Paediatric Cardiology. Are We Prone to Heuristics, Biases and Traps?

Science.gov (United States)

Ryan, Aedin; Duignan, Sophie; Kenny, Damien; McMahon, Colin J

2018-01-01

Hidden traps in decision making have been long recognised in the behavioural economics community. Yet we spend very limited, if any time, analysing our decision-making processes in medicine and paediatric cardiology. Systems 1 and 2 thought processes differentiate between rapid emotional thoughts and slow deliberate rational thoughts. For fairly clear cut medical decisions, in-depth analysis may not be needed, but in our field of paediatric cardiology it is not uncommon for challenging cases and occasionally 'simple' cases to generate significant debate and uncertainty as to the best decision. Although morbidity and mortality meetings frequently highlight poor outcomes for our patients, they often neglect to analyse the process of thought which underlined those decisions taken. This article attempts to review commonly acknowledged traps in decision making in the behavioural economics world to ascertain whether these heuristics translate to decision making in the paediatric cardiology environment. We also discuss potential individual and collective solutions to pitfalls in decision making.

Nuclear cardiology in Senegal: a luxury or a need?

International Nuclear Information System (INIS)

Mbodj, M.; Seck Gassama, S.; Ndong, B.; Ndoye, O.; Toure Sow, H.; Senghor, S.R.; Diop, S.N.; Solanki, K.K.

2006-01-01

Aim: to sensitize at the same time experts and public authorities on the interest of the establishment of nuclear cardiology in Senegal. Material and method: the radioimmunoassay of micro-albuminuria, early marker of cardiovascular morbid-mortality was carried out in the nuclear medicine department of Dakar on a population of 100 diabetic patients (74 of type 1 and 26 of type 2) presenting one or more traditional cardiovascular risk factors. Out of these patients, 39% had abnormal rest ECG, asymptomatic in half of the cases. Results: prevalence of micro-albuminuria is high (24%). There is no significant difference in distribution between type I and type 2. Micro-albuminuria > 30 mg/24 h exists in 16,3% of patients with lipid abnormalities (ratio: total cholesterol/HDL cholesterol > 5), 30% of obese, 75% of hypertensive patients and 43,6% of patients with abnormal rest ECG, who would benefit from myocardial perfusion imaging (MPI): about 17% of patients involved in this study. No or weak correlation is found between micro-albuminuria and traditional risk factors. Conclusion: From these results and available epidemiological data in 2005, the estimate of the requirements in nuclear cardiology for the Senegalese diabetic population, indicates that 3740 patients should have benefited that year from it. Considering that this figure underestimates the real needs, taking into account the needs brought back to a population of 10 million inhabitants and the expect expansion of the diabetic disease, it appears justified to include the nuclear cardiology in the national programmes of prevention of the public health in Senegal. (author)

Nuclear medicine in cardiology

Energy Technology Data Exchange (ETDEWEB)

Torizuka, K.; Ishii, Y.; Yonekura, Y.; Yamamoto, K.; Tamaki, N. (Kyoto Univ. (Japan). Faculty of Medicine)

1981-02-01

Nuclear medicine in cardiology was reviewed. Electrocardiogram is obtained from the ..gamma..-ray measurement of a tracer by a single detector, which enables a bedsidemonitoring. Resolution and sensitivity are high and nuclear stethoscope with a computer is applicable for a background treatment. Myocardium is imaged by /sup 201/Tl scintigraphy. Relative difference of the perfusion indicates the ischemia which gaives roughly the size and portion of myocardial infarction. For transient ischemia stress myocardial perfusion imaging (SMPI) is also used. sup(99m)Tc pyrophosphate provides a clear image for myocardial infarction. Angiocardiogram is obtained repeatedly, by a single administration, using an equilibrium method. An attempt of three-dimensional display by 7 pin hole collimator and positron CT are also discussed.

Radioisotope evaluation in cardiology

International Nuclear Information System (INIS)

Massardo V, Teresa; Gonzalez E, Patricio; Canessa G, Jose

2002-01-01

The current applications of nuclear cardiology techniques are reviewed. Coronary artery disease is the most important and prevalent cardiovascular problem in most developed countries and also in Chile. Different approaches can be employed for its diagnosis and prognosis, as well as for risk stratification and preoperative evaluation. Myocardial infarction assessment and ischemia recognition with radionuclide perfusion images are also reviewed, including new protocols applying functional parameters addition. Viability detection after myocardial infarction or in patients with ischemic cardiomyopathy are discussed. Stress protocols with the use of exercise or pharmacological action for ischemia production, the diagnostic value of perfusion SPECT and the use of Thallium-201, Tc-99m-Sestamibi and metabolic images with Fluorine18-Fluordeoxyglucose are also mentioned (au)

A framework for clinical reasoning in adult cardiology

Directory of Open Access Journals (Sweden)

de la Calzada CS

2015-07-01

Full Text Available Carlos S de la Calzada Department of Medicine, Universidad Complutense de Madrid, Madrid, SpainAbstract: 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.Keywords: clinical deduction, diagnostic reasoning, education, teaching methods

Biomass in Germany

International Nuclear Information System (INIS)

Chapron, Thibaut

2014-01-01

This document provides, first, an overview of biomass industry in Germany: energy consumption and renewable energy production, the French and German electricity mix, the 2003-2013 evolution of renewable electricity production and the 2020 forecasts, the biomass power plants, plantations, biofuels production and consumption in Germany. Then, the legal framework of biofuels development in Germany is addressed (financial incentives, tariffs, direct electricity selling). Next, a focus is made on biogas production both in France and in Germany (facilities, resources). Finally, the French-German cooperation in the biomass industry and the research actors are presented

Myocardial perfusion scintigraphy in Germany. Results of the 2005 query and current status

International Nuclear Information System (INIS)

Lindner, O.; Burchert, W.; Bengel, F.M.; Zimmermann, R.; Dahl, J. vom; Schaefer, W.; Buell, U.; Schober, O.; Schwaiger, M.; Kluge, R.; Schaefers, M.

2007-01-01

The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine (DGN), in cooperation with the working group Nuclear Cardiology of the German Cardiac Society (DGK), decided to conduct a national survey on myocardial perfusion scintigraphy (MPS). Method: a questionnaire to evaluate MPS for the year 2005 was sent. Results: 346 completed questionnaires had been returned (213 private practices, 99 hospitals and 33 university hospitals). MPS of 112 707 patients were reported with 110 747 stress and 95 878 rest studies. The majority (> 75%) was performed with 99m Tc-MIBI or tetrofosmin. 201 Tl stress-redistribution was used in 22 637 patients (20%). The types of stress were exercise in 78%, vasodilation with adenosine or dipyridamol in 21% and dobutamine in 1%. 99.97% of all MPS were SPECT studies. Gated SPECT was performed in 36% of the stress and in 32% of the rest studies. An attenuation correction was used in 21%. 29 institutions (8%) performed gated SPECT (stress and rest) and attenuation correction. 47% of all MPS were requested by ambulatory care cardiologists, 17% by internists, 12% by primary care physicians, 21% by hospital departments and 2% by others. Conclusion: in Germany, MPS is predominantly performed with 99m Tc-perfusion agents. The common type of stress is ergometry. Gated SPECT and attenuation correction do not yet represent standards of MPS practice in Germany, which indicates some potential of optimization. (orig.)

The effects of preoperative cardiology consultation prior to elective abdominal aortic aneurysm repair on patient morbidity.

Science.gov (United States)

Boniakowski, Anna E; Davis, Frank M; Phillips, Amanda R; Robinson, Adina B; Coleman, Dawn M; Henke, Peter K

2017-08-01

Objectives The relationship between preoperative medical consultations and postoperative complications has not been extensively studied. Thus, we investigated the impact of preoperative consultation on postoperative morbidity following elective abdominal aortic aneurysm repair. Methods A retrospective review was conducted on 469 patients (mean age 72 years, 20% female) who underwent elective abdominal aortic aneurysm repair from June 2007 to July 2014. Data elements included detailed medical history, preoperative cardiology consultation, and postoperative complications. Primary outcomes included 30-day morbidity, consult-specific morbidity, and mortality. A bivariate probit regression model accounting for the endogeneity of binary preoperative medical consult and patient variability was estimated with a maximum likelihood function. Results Eighty patients had preoperative medical consults (85% cardiology); thus, our analysis focuses on the effect of cardiac-related preoperative consults. Hyperlipidemia, increased aneurysm size, and increased revised cardiac risk index increased likelihood of referral to cardiology preoperatively. Surgery type (endovascular versus open repair) was not significant in development of postoperative complications when controlling for revised cardiac risk index ( p = 0.295). After controlling for patient comorbidities, there was no difference in postoperative cardiac-related complications between patients who did and did not undergo cardiology consultation preoperatively ( p = 0.386). Conclusions When controlling for patient disease severity using revised cardiac risk index risk stratification, preoperative cardiology consultation is not associated with postoperative cardiac morbidity.

Letter to the Editor in response to "publication performance of women compared to men in German cardiology" by Boehm et al. (2014).

Science.gov (United States)

Weismann, Constance G; Colson, Eve R; Shapiro, Eugene D

2015-03-01

Based on their review of abstracts submitted to the German Cardiac Society, Boehm et al. (2014) report better success of female vs male cardiologists publishing in journals with an impact factor ≥5. However, only 25% of conference abstracts were submitted by women, perhaps suggesting a paucity of women in academic cardiology. In this 'letter to the editor' we review gender statistics in the medical field using Germany and the US as examples. While women are well represented in early career stages, only fewfull professors are women. This reflects a wasted opportunity to benefit from the best of both genders. Recent gender research has shown that subtle gender bias may play a role. To change the gender statistics in academic medicine a multifaceted approach is necessary. This will ultimately lead to a more equal representation of women in senior roles, and bring science, medical care, and leadership to a new level. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Paediatric cardiology programs in countries with limited resources: how to bridge the gap.

Science.gov (United States)

Sulafa, K M Ali

2010-07-01

Establishing paediatric cardiology service in a country with limited resources like Sudan is a challenging task. A paediatric cardiac team was formed then the services in different disciplines were gradually established. Echocardiography (echo) clinics were founded in tertiary and peripheral hospitals. Cardiac catheterization (cath) was established at the Sudan Heart Centre (SHC) in 2004 and over 400 procedures had been performed including interventional catheterization like pulmonary valve dilatation, patent ductus arteriosus and atrial septal defect device closure. Congenital heart surgery started in 2001, currently 200 cases are done each year including closed procedures as well as open heart procedures for patients weighing more than 8 kg. Cardiology-cardiac surgery as well as adult congenital heart disease meetings were held and contributed positively to the services. The cardiology-cardiac surgery scientific club meeting was founded as a forum for academic discussions. A fellowship program was established in 2004 and included seven candidates trained in paediatric cardiology and intensive care. Two training courses had been established: congenital heart disease echo and paediatric electrocardiogram interpretation. Links with regional and international cardiac centres had important roles in consolidating our program. Significant obstacles face our service due to the small number of trained personnel, high cost of procedures, the lack of regular supplies and lack of cardiac intensive care facilities for young infants. Bridging the huge gap needs extensive official as well as non-governmental efforts, training more staff, supporting families and collaboration with regional and international centres.

CARDIOLOGICAL MANAGEMENT OF PREGNANT WOMEN IN THE UDMURT REPUBLIC

Directory of Open Access Journals (Sweden)

I. R. Gaisin

2009-01-01

Full Text Available Aim. To assess the efficacy of specialized management of pregnant women with cardiovascular diseases (CVD in the Udmurt Republic (UR of Russia.Material and methods. In prospective and retrospective study we investigated pregnancy outcomes in all 17948 women in management system created for pregnant patients with CVD in the UR from 2000 to 2007. The system comprises specialized outpatient and inpatient departments and an obstetric hospital within the regional cardiological centre. Pregnant women had different CVD including hypertension, congenital and rheumatic heart disease, cardiac arrhythmias, noncoronary myocardial disease, disorders and autoimmune diseases of connective tissue, etc.Results. Perinatal mortality decreased by 41,1% from 11,2‰ in 2000 to 6,6‰ in 2007. During 8 years, no one woman died.Conclusion. The management system for pregnant women with CVD within the regional cardiological clinic makes it possible to reduce of maternal and perinatal mortality rates significantly. 

Simulation-based planning of surgical interventions in pediatric cardiology

Science.gov (United States)

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.

Extreme weather events in southern Germany - Climatological risk and development of a large-scale identification procedure

Science.gov (United States)

Matthies, A.; Leckebusch, G. C.; Rohlfing, G.; Ulbrich, U.

2009-04-01

Extreme weather events such as thunderstorms, hail and heavy rain or snowfall can pose a threat to human life and to considerable tangible assets. Yet there is a lack of knowledge about present day climatological risk and its economic effects, and its changes due to rising greenhouse gas concentrations. Therefore, parts of economy particularly sensitve to extreme weather events such as insurance companies and airports require regional risk-analyses, early warning and prediction systems to cope with such events. Such an attempt is made for southern Germany, in close cooperation with stakeholders. Comparing ERA40 and station data with impact records of Munich Re and Munich Airport, the 90th percentile was found to be a suitable threshold for extreme impact relevant precipitation events. Different methods for the classification of causing synoptic situations have been tested on ERA40 reanalyses. An objective scheme for the classification of Lamb's circulation weather types (CWT's) has proved to be most suitable for correct classification of the large-scale flow conditions. Certain CWT's have been turned out to be prone to heavy precipitation or on the other side to have a very low risk of such events. Other large-scale parameters are tested in connection with CWT's to find out a combination that has the highest skill to identify extreme precipitation events in climate model data (ECHAM5 and CLM). For example vorticity advection in 700 hPa shows good results, but assumes knowledge of regional orographic particularities. Therefore ongoing work is focused on additional testing of parameters that indicate deviations of a basic state of the atmosphere like the Eady Growth Rate or the newly developed Dynamic State Index. Evaluation results will be used to estimate the skill of the regional climate model CLM concerning the simulation of frequency and intensity of the extreme weather events. Data of the A1B scenario (2000-2050) will be examined for a possible climate change

Status report of the Triton/Munich

International Nuclear Information System (INIS)

Trinks, U.

1988-01-01

At the Accelerator Laboratory of the Universities of Munich a booster for the existing MP-tandem is under construction. The Tritron project was finally funded in January this year. The Tritron is a cyclotron with separated orbits with both the magnets and cavities superconducting. It will increase the ion energies by a factor of 4.9, so a 12 C 6+ -beam will have a maximum energy of 21 MeV/u e.g. The cryostat has a diameter of 3.6 m. The beam is injected at a radius r 1 = 66 cm and extracted after almost 20 turns at r 2 = 145 cm. The turn separation is δR = 4 cm. The bending is made by 12 flat magnet sectors, each consisting of 20 magnetic channels of window frame type. In each channel the magnetic field (∼ 1.4 T) is adjustable individually, so that the beam always can be guided along the spiral orbit. The gradient is alternating from one sector to the next resulting in strong focusing in both transversal directions. In each second intermediate gap a wedge-shaped accelerating cavity of the reentrant type is installed for the 20 parallel beams. The radial cavity length is 1.2 m, the outside width 0.7 m. The radial length of the accelerating lips is 0.9 m, the gap width at injection radius 6 cm, at extraction radius 13 cm. The rf-frequency is ∼ 170 MHz, the maximum voltage at injection U(r 1 ) ≅ 270 kV, at extraction U(r 2 ) ≅ 540 kV per cavity. If the bunchers cross the cavity at a rf-phase with increasing accelerating voltage, they are focused longitudinally, resulting in ∼ 0.2 synchrotron oscillations per turn. The longitudinal focusing causes the rf-phase to change automatically corresponding to the necessary energy gain and to the radial characteristic of the voltage amplitude along the gap. 2 references, 6 figures, 1 table

Heart Failure Association of the European Society of Cardiology Specialist Heart Failure Curriculum

DEFF Research Database (Denmark)

McDonagh, Theresa A; Gardner, Roy S; Lainscak, Mitja

2014-01-01

Training Curricula. In addition, European Society of Cardiology (ESC) subspecialty curricula exist for Interventional Cardiology and Heart Rhythm Management. The purpose of this heart failure curriculum is to provide a framework which can be used as a blueprint for training across Europe. This blueprint...... mirrors other ESC curricula. Each section has three components: the knowledge required, the skills which are necessary, and the professionalism (attitudes and behaviours) which should be attained. The programme is designed to last 2 years. The first year is devoted to the specialist heart failure module...

Comparison of Rate of Utilization of Medicare Services in Private Versus Academic Cardiology Practice.

Science.gov (United States)

Hovanesyan, Arsen; Rubio, Eduardo; Novak, Eric; Budoff, Matthew; Rich, Michael W

2017-11-15

Cardiovascular services are the third largest source of Medicare spending. We examined the rate of cardiovascular service utilization in the community of Glendale, CA, compared with the nearest academic medical center, the University of Southern California. Publicly available utilization data released by Medicare for the years 2012 and 2013 were used to identify all inpatient and outpatient cardiology services provided in each practice setting. The analysis included 19 private and 17 academic cardiologists. In unadjusted analysis, academic physicians performed half as many services per Medicare beneficiary per year as those in private practice: 2.3 versus 4.8, p cardiology practice settings in southern California, medical service utilization per Medicare beneficiary was nearly 2-fold higher in private practice than in the academic setting, suggesting that there may be opportunity for substantially reducing costs of cardiology care in the community setting. Copyright © 2017 Elsevier Inc. All rights reserved.

Paediatric cardiology fellowship training: effect of work-hour regulations on scholarly activity.

Science.gov (United States)

Ronai, Christina; Lang, Peter

2017-01-01

In 2003, work-hour regulations were implemented by the Accreditation Council for Graduate Medical Education. Much has been published regarding resident rest and quality of life as well as patient safety. There has been no examination on the effect of work-hour restrictions on academic productivity of fellows in training. Paediatric subspecialty fellows have a scholarly requirement mandated by the American Board of Pediatrics. We have examined the impact of work-hour restrictions on the scholarly productivity of paediatric cardiology fellows during their fellowship. We conducted a literature search for all paediatric cardiology fellows between 1998 and 2007 at a single academic institution as first or senior authors on papers published during their 3-year fellowship and 3 years after completion of their categorical fellowship (n=63, 30 fellows before 2003 and 33 fellows after 2003). The numbers of first- or senior-author fellow publications before and after 2003 were compared. We also collected data on final paediatric cardiology subspecialty career choice. There was no difference in the number of fellow first-author publications before and after 2003. Before work-hour restrictions, the mean number of publications per fellow was 2.1 (±2.2), and after work-hour restrictions it was 2.0 (±1.8), (p=0.89). By subspecialty career choice, fellows who select electrophysiology, preventative cardiology, and heart failure always published within the 6-year time period. Since the implementation of work-hour regulations, total number of fellow first-authored publications has not changed. The role of subspecialty choice may play a role in academic productivity of fellows in training.

Development of quality metrics for ambulatory pediatric cardiology: Chest pain.

Science.gov (United States)

Lu, Jimmy C; Bansal, Manish; Behera, Sarina K; Boris, Jeffrey R; Cardis, Brian; Hokanson, John S; Kakavand, Bahram; Jedeikin, Roy

2017-12-01

As part of the American College of Cardiology Adult Congenital and Pediatric Cardiology Section effort to develop quality metrics (QMs) for ambulatory pediatric practice, the chest pain subcommittee aimed to develop QMs for evaluation of chest pain. A group of 8 pediatric cardiologists formulated candidate QMs in the areas of history, physical examination, and testing. Consensus candidate QMs were submitted to an expert panel for scoring by the RAND-UCLA modified Delphi process. Recommended QMs were then available for open comments from all members. These QMs are intended for use in patients 5-18 years old, referred for initial evaluation of chest pain in an ambulatory pediatric cardiology clinic, with no known history of pediatric or congenital heart disease. A total of 10 candidate QMs were submitted; 2 were rejected by the expert panel, and 5 were removed after the open comment period. The 3 approved QMs included: (1) documentation of family history of cardiomyopathy, early coronary artery disease or sudden death, (2) performance of electrocardiogram in all patients, and (3) performance of an echocardiogram to evaluate coronary arteries in patients with exertional chest pain. Despite practice variation and limited prospective data, 3 QMs were approved, with measurable data points which may be extracted from the medical record. However, further prospective studies are necessary to define practice guidelines and to develop appropriate use criteria in this population. © 2017 Wiley Periodicals, Inc.

Nuclear cardiology procedures to diagnose ischemia in coronary artery disease

International Nuclear Information System (INIS)

Kropp, J.

1999-01-01

Nuclear cardiology is equipped with a broad spectrum of diagnostic capabilities which allow the evaluation of ventricular performance, perfusion and metabolism of the heart. The principle of nuclear medicine procedures consists in the administration of free radioisotopes or radiopharmaceuticals to detect their spatial distribution within the body by detecting their y-rays from outside by gamma cameras. Myocardial perfusion scintigraphy is the most important procedure in nuclear cardiology and is performed on a routine basis with 201 Thallium-Chloride ( 201 Tl) since 1975. With the Single-Photon Emission Computerized Tomography (SPECT) technique it is possible to diagnose ischemia of the left ventricle on the basis of coronary artery disease with a sensitivity of 90-95% and a specificity of about 55%. Recently 99m Tc-tracers were developed for this purpose, which have many advantages due to their better physical properties, their easy handling and availability. The diagnostic accuracy is the same compared to ( 201 Tl). Free fatty acids labeled with 123 Iodine like 123 IPPA are alternative tracers to diagnose ischemia by the metabolic alteration and are pathognomonic tracers to diagnose the heart involvement in myopathies or metabolic defects related to fatty acid degradation which are the main fuel of the normal myocytes. Finally we should not forget the radionuclide ventriculography (RNVG) which is one of the oldest nuclear cardiology procedures providing us with very objective, reliable results of ventricular performance. (orig.)

Weimar Germany

DEFF Research Database (Denmark)

Reckendrees, Alfred

The Weimar Republic is analysed within the framework of limited and open access orders. Germany had developed into a mature limited access order before World War I, with rule of law and open economic access but only limited access to politics. After the war, Germany developed toward an open access...... order; this process was, however, not sustainable. Two interpretations are discussed, which both pose a challenge to the limited access-open access framework: (1.) Weimar Germany was the first open access order that failed; (2.) sufficiency conditions of the sustainability of open access are not yet...

Present and future of nuclear cardiology. Where we come from and where we are going

International Nuclear Information System (INIS)

Candell-Riera, J.

2014-01-01

The present of nuclear cardiology techniques with gated-SPECT, positron emission tomography, cardiac magnetic resonance, cardiac mIBG scintigraphy and anatomical and functional images of three-dimensional SPECT-CT fusion may be the future for some centers, a future more or less distant for others. The prediction of the ways that will be followed by the different radioisotope scans in the field of cardiology is to some extent uncertain and depends on the development of other noninvasive techniques and on the possibility of reducing the dose of irradiation, decreasing the undesirable effects of ischemia-inducing drugs, but also on the evolution of macroeconomics in different countries, and of course on the level of experience and excellence in nuclear cardiology laboratories and the confidence generated on clinical cardiologists. (author) [es

The Doktabörse – an innovative online platform for research projects at the medical faculty of the LMU Munich

Directory of Open Access Journals (Sweden)

Nicolai, Leo

2017-08-01

Full Text Available Introduction: One of the most important extracurricular aspects of medical studies in Germany is a research thesis completed by most students. This research project often times conveys relevant competencies for the physician’s role as scientist. Nevertheless, the choice of the right project remains a challenge. Reasons for this are among others, missing structures for a comprehensive overview of research groups and their respective projects.Description of the project: We developed the online platform as an online marketplace for doctoral research projects. The platform enables authorized researchers to create working groups and upload, deactivate and change research projects within their institute. For interested students, a front end with integrated search function displays these projects in a structured and well-arranged way. In parallel, the provides for a comprehensive overview of research at the medical faculty. We evaluated Researchers‘ and students‘ use of the platform. Results: 96,6% of students participating in the evaluation (n=400 were in favor of a centralized research platform at the medical faculty. The platform grew at a steady pace and included 120 research groups in June 2016. The students appreciated the structure and design of the Two thirds of all uploaded projects matched successfully with doctoral students via the platform and over 94% of researchers stated that they did not need technical assistance with uploading projects and handling the platform. Discussion: The represents an innovative and well accepted platform for doctoral research projects. The platform is perceived positively by researchers and students alike. However, students criticized limited extent and timeliness of offered projects.In addition, the platform serves as databank of research at the medical faculty of the LMU Munich. The future potential of this platform is to provide for an integrated management solution of doctoral thesis projects

Profile and scientific production of CNPq researchers in cardiology.

Science.gov (United States)

Oliveira, Eduardo Araujo de; Ribeiro, Antonio Luiz Pinho; Quirino, Isabel Gomes; Oliveira, Maria Christina Lopes; Martelli, Daniella Reis; Lima, Leonardo Santos; Colosimo, Enrico Antonio; Lopes, Thais Junqueira; Silva, Ana Cristina Simões; Martelli, Hercílio

2011-09-01

Systematic assessments of the scientific production can optimize resource allocation and increase research productivity in Brazil. The aim of this study was to evaluate the profile and scientific production of researchers in the field of Cardiology who have fellowship in Medicine provided by the Conselho Nacional de Desenvolvimento Científico e Tecnológico. The curriculum Lattes of 33 researchers with active fellowships from 2006 to 2008 were included in the analysis. The variables of interest were: gender, affiliation, tutoring of undergraduate, masters and PhD students, and scientific production and its impact. : There was predominance of males (72.7%) and of fellowship level 2 (56.4%). Three states of the Federation were responsible for 94% of the researchers: SP (28; 71.8%), RS (4; 10.3%), e RJ (3; 9.1%). Four institutions are responsible for about 82% of researchers: USP (13; 39.4%), UNESP (5; 15.2%), UFRGS (4; 12.1%) e UNIFESP (3; 9.1%). During all academic careers, the researchers published 2.958 journal articles, with a mean of 89 articles per researcher. Of total, 55% and 75% were indexed at Web of Science and Scopus databases, respectively. The researchers received a total of 19648 citations at the database Web of Science, with a median of 330 citations per researcher (IQ = 198-706). The average number of citations per article was 13.5 citations (SD = 11.6). Our study has shown that researchers in the field of cardiology have a relevant scientific production. The knowledge of the profile of researchers in the field of Cardiology will probably enable effective strategies to qualitatively improve the scientific output of Brazilian researchers.

Live cell imaging at the Munich ion microbeam SNAKE - a status report.

Science.gov (United States)

Drexler, Guido A; Siebenwirth, Christian; Drexler, Sophie E; Girst, Stefanie; Greubel, Christoph; Dollinger, Günther; Friedl, Anna A

2015-02-18

Ion microbeams are important tools in radiobiological research. Still, the worldwide number of ion microbeam facilities where biological experiments can be performed is limited. Even fewer facilities combine ion microirradiation with live-cell imaging to allow microscopic observation of cellular response reactions starting very fast after irradiation and continuing for many hours. At SNAKE, the ion microbeam facility at the Munich 14 MV tandem accelerator, a large variety of biological experiments are performed on a regular basis. Here, recent developments and ongoing research projects at the ion microbeam SNAKE are presented with specific emphasis on live-cell imaging experiments. An overview of the technical details of the setup is given, including examples of suitable biological samples. By ion beam focusing to submicrometer beam spot size and single ion detection it is possible to target subcellular structures with defined numbers of ions. Focusing of high numbers of ions to single spots allows studying the influence of high local damage density on recruitment of damage response proteins.

Letter to the Editor

Directory of Open Access Journals (Sweden)

Naber KG

2011-11-01

Full Text Available Kurt G NaberTechnical University of Munich, Munich, GermanyMinardi et al1 have described well-established risk factors for recurrent urinary tract infection (UTI and have emphasized the importance of a clear communication with the patient in order to find out behavior at risk, channel right hygiene recommendations, and suggest necessary changes in life habits to prevent acute UTI episodes. There is general agreement that behavioral modifications and counseling should be attempted first to reduce the rate of acute UTI episodes and their associated discomfort.

Sports and exercise cardiology in the United States: cardiovascular specialists as members of the athlete healthcare team.

Science.gov (United States)

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. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Preliminary Study of Pet Owner Adherence in Behaviour, Cardiology, Urology, and Oncology Fields

Directory of Open Access Journals (Sweden)

Zita Talamonti

2015-01-01

Full Text Available 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.

Preliminary Study of Pet Owner Adherence in Behaviour, Cardiology, Urology, and Oncology Fields.

Science.gov (United States)

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.

Mathematical methods in medicine: neuroscience, cardiology and pathology

Science.gov (United States)

Amigó, José M.

2017-01-01

The application of mathematics, natural sciences and engineering to medicine is gaining momentum as the mutual benefits of this collaboration become increasingly obvious. This theme issue is intended to highlight the trend in the case of mathematics. Specifically, the scope of this theme issue is to give a general view of the current research in the application of mathematical methods to medicine, as well as to show how mathematics can help in such important aspects as understanding, prediction, treatment and data processing. To this end, three representative specialties have been selected: neuroscience, cardiology and pathology. Concerning the topics, the 12 research papers and one review included in this issue cover biofluids, cardiac and virus dynamics, computational neuroscience, functional magnetic resonance imaging data processing, neural networks, optimization of treatment strategies, time-series analysis and tumour growth. In conclusion, this theme issue contains a collection of fine contributions at the intersection of mathematics and medicine, not as an exercise in applied mathematics but as a multidisciplinary research effort that interests both communities and our society in general. This article is part of the themed issue ‘Mathematical methods in medicine: neuroscience, cardiology and pathology’. PMID:28507240

Mathematical methods in medicine: neuroscience, cardiology and pathology.

Science.gov (United States)

Amigó, José M; Small, Michael

2017-06-28

The application of mathematics, natural sciences and engineering to medicine is gaining momentum as the mutual benefits of this collaboration become increasingly obvious. This theme issue is intended to highlight the trend in the case of mathematics. Specifically, the scope of this theme issue is to give a general view of the current research in the application of mathematical methods to medicine, as well as to show how mathematics can help in such important aspects as understanding, prediction, treatment and data processing. To this end, three representative specialties have been selected: neuroscience, cardiology and pathology. Concerning the topics, the 12 research papers and one review included in this issue cover biofluids, cardiac and virus dynamics, computational neuroscience, functional magnetic resonance imaging data processing, neural networks, optimization of treatment strategies, time-series analysis and tumour growth. In conclusion, this theme issue contains a collection of fine contributions at the intersection of mathematics and medicine, not as an exercise in applied mathematics but as a multidisciplinary research effort that interests both communities and our society in general.This article is part of the themed issue 'Mathematical methods in medicine: neuroscience, cardiology and pathology'. © 2017 The Author(s).

Investigation of radiation skin dose in interventional cardiology

International Nuclear Information System (INIS)

Webster, C.M.; Horrocks, J.; Hayes, D.

2001-01-01

Background - The study investigated the radiation skin doses for interventional patients in cardiology; two procedures which have the highest radiation dose are Radiofrequency Catheter Ablation (RFCA) and Percutaneous Transluminal Coronary Angioplasty (PTCA). Methods and Results - 56 patients were randomly selected and investigated; 23 patients in the RFCA group and 33 in the PTCA group. Skin and effective dose were calculated from Dose Area Product (DAP). Thermoluminescent Dosimetry was the second method of dose measurement used. Patients were followed-up for a three month period to check for possible skin reactions resulting from the radiation dose during the procedure. Radiation skin doses in 14 patients were calculated to be more than 1 Gy, including three patients who received more than 2 Gy, the threshold dose for deterministic effects of radiation. 7 patients (12.5%) reported skin reactions as a result of the radiation received to their backs during the procedure. Mean DAP and estimated effective doses were 105 Gycm 2 and 22.5 mSv for RFCA, and 32 Gycm 2 and 6.2 mSv for PTCA procedures respectively. Conclusion - Complex procedures in Interventional Cardiology can exceed the threshold level for deterministic effects in the skin. (author)

Pramana – Journal of Physics | Indian Academy of Sciences

Indian Academy of Sciences (India)

Max-Planck-Institut f ur Physik, Munich, Germany; Joint Institute for Nuclear Research, Dubna, Russia; Rudjer Boskovic Institute, Zagreb, Croatia; KFKI Research Institute for Particle and Nuclear Physics, Budapest, Hungary; Institute of Nuclear Physics, Cracow, Poland; Birmingham University, Birmingham, England ...

Success factors of master of science curricula in business administration

NARCIS (Netherlands)

Bijker, Monique; Van der Klink, Marcel; Boshuizen, Els

2010-01-01

Bijker, M. M., Van der Klink, M. R., & Boshuizen, H. P. A. (2010, 25-27 August). Success factors of master of science curricula in business administration. Paper presented at the 5th EARLI-SIG14, Learning and Professional Development, Munich, Germany.

The quest for self-regulation: A design-based approach with vocational teachers

NARCIS (Netherlands)

Jossberger, Helen; Brand-Gruwel, Saskia; Boshuizen, Els; Van de Wiel, Margje

2010-01-01

Jossberger, H., Brand-Gruwel, S., Boshuizen, H. P. A., & Van de Wiel, M. (2010, August). The quest for self-regulation: A design-based approach with vocational teachers. Poster presentation at the EARLI Learning and Professional Development SIG Conference, Munich, Germany.

The status of pediatric cardiology at a tertiary center in Lebanon.

Science.gov (United States)

Arabi, Mariam; Majdalani, Marianne; El Hajj, Maria Atoui; Nemer, Georges; Sawaya, Fadi; Obeid, Mounir; Bitar, Fadi F

2011-01-01

Cardiac disease, both congenital and acquired, contributes significantly to morbidity and mortality in children. This article describes the status of pediatric cardiology at the Children's Heart Center in the American University of Beirut Medical Center. It addresses the available clinical services as well as the research and educational activities that are present at a tertiary center in Lebanon, a developing country with a population of 4 million. Lebanon has witnessed major developments in the field of pediatric cardiology over the past few years. About 650 babies are born with heart disease every year, with more than 425 needing treatment. Nearly all types of interventional catheterization procedures are currently being performed. About 300 open and closed pediatric cardiac surgeries are performed per year in Lebanon. In 2008, the in-hospital surgical mortality rate at our center was 2.6%, reflecting the good level of care in the treatment of children with congenital heart disease (CHD) in Lebanon. Basic research in the field of pediatric cardiology is emerging at our center. Our team has been studying the effect of chronic hypoxemia on the neonatal myocardium in an animal model of chronic hypoxia, as well as the study of molecular basis of CHD. Appropriate identification of cardiac disease, its epidemiology, and outcome is of utmost importance in guiding adequate care. Centralization of facilities is important to improve results and level of care.

17th European photovoltaic solar energy conference and exhibition, Munich 22.-26.10.2001

International Nuclear Information System (INIS)

Nowak, S.

2002-01-01

This report for the Swiss Federal Office of Energy (SFOE) summarises the photovoltaics (PV) conference and exhibition held in Munich in October 2001 from the Swiss point of view. The contributions made by representatives of Swiss institutions and companies are presented including papers on the progress being made in third generation crystalline and multi-crystalline silicon technology, amorphous and micro-crystalline silicon solar cells, thin film solar cells based on compound semiconductors and thermo-photovoltaics. Further papers deal with PV modules on the market, building-integrated solar power systems and new developments in PV systems technology. The exhibition that accompanied the conference, including the 12 Swiss exhibitors who were present, is reviewed as are international market developments. Contributions concerning the application of photovoltaics in developing countries are also reviewed

Heterogeneity in coverage for measles and varicella vaccination in toddlers - analysis of factors influencing parental acceptance.

Science.gov (United States)

Hagemann, Christine; Streng, Andrea; Kraemer, Alexander; Liese, Johannes G

2017-09-19

In 2004, routine varicella vaccination was introduced in Germany for children aged 11-14 months. Routine measles vaccination had already been introduced in 1973 for the same age group, but coverage is still too low (measles. The present study assessed varicella and measles vaccination coverage and determinants of parental acceptance in two study regions, situated in Northern and Southern Bavaria (Germany). From 2009 to 2011, annual cross-sectional parent surveys were performed on random samples of 600 children aged 18-36 months in the Bavarian regions of both Munich and Würzburg. Logistic regression models were used to identify factors associated with varicella and measles vaccination. In 2009, 2010 and 2011, vaccination coverage was lower in Munich than in Würzburg, for both varicella (Munich 53%, 67%, 69% vs. Würzburg 72%, 81%, 83%) and for measles (Munich 88%, 89%, 91% vs. Würzburg 92%, 93%, 95%). Recommendation by the physician was the main independent factor associated with varicella vaccination in both regions (adjusted odd ratios (OR) with 95% confidence interval (CI): Munich OR 19.7, CI 13.6-28.6; Würzburg OR 34.7, CI 22.6-53.2). Attendance at a childcare unit was positively associated with a higher acceptance of varicella vaccination in Munich (OR 1.5, CI 1.1-2.2). Regarding measles vaccination, attendance at a childcare unit was positively associated in both regions (Munich OR 2.0; CI 1.3-3.0; Würzburg OR 1.8; CI 1.1-3.1), and a higher level of parental school education was negatively associated in Würzburg (OR 0.5, CI 0.3-0.9). Vaccination rates differed between regions, with rates constantly higher in Würzburg. Within each region, vaccination rates were lower for varicella than for measles. Measles vaccination status was mainly dependent upon socio-demographic factors (attendance at a childcare unit, parental school education), whereas for the more recently introduced varicella vaccination recommendation by the physician had the strongest

Comparison of Two Educational Strategies in Teaching Preventive Cardiology.

Science.gov (United States)

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…

Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services.

Science.gov (United States)

Salata, Brian M; Sterling, Madeline R; Beecy, Ashley N; Ullal, Ajayram V; Jones, Erica C; Horn, Evelyn M; Goyal, Parag

2018-05-01

Given high rates of heart failure (HF) hospitalizations and widespread adoption of the hospitalist model, patients with HF are often cared for on General Medicine (GM) services. Differences in discharge processes and 30-day readmission rates between patients on GM and those on Cardiology during the contemporary hospitalist era are unknown. The present study compared discharge processes and 30-day readmission rates of patients with HF admitted on GM services and those on Cardiology services. We retrospectively studied 926 patients discharged home after HF hospitalization. The primary outcome was 30-day all-cause readmission after discharge from index hospitalization. Although 60% of patients with HF were admitted to Cardiology services, 40% were admitted to GM services. Prevalence of cardiovascular and noncardiovascular co-morbidities were similar between patients admitted to GM services and Cardiology services. Discharge summaries for patients on GM services were less likely to have reassessments of ejection fraction, new study results, weights, discharge vital signs, discharge physical examinations, and scheduled follow-up cardiologist appointments. In a multivariable regression analysis, patients on GM services were more likely to experience 30-day readmissions compared with those on Cardiology services (odds ratio 1.43 95% confidence interval [1.05 to 1.96], p = 0.02). In conclusion, outcomes are better among those admitted to Cardiology services, signaling the need for studies and interventions focusing on noncardiology hospital providers that care for patients with HF. Copyright © 2018 Elsevier Inc. All rights reserved.

The Information System on Occupational Exposure in Medicine, Industry and Research (ISEMIR): Interventional Cardiology

International Nuclear Information System (INIS)

2014-02-01

In the last three decades, the use of image guided interventional procedures in cardiology has increased significantly, bringing great benefit to millions of patients around the world. As technology improves, the medical capabilities of these procedures continue to expand, adding further to the armamentarium for diagnosis and treatment of patients with cardiac problems. All of these procedures require health professionals (including interventional cardiologists, electrophysiologists, nurses and medical radiation technologists) to be present in the room and alongside the patient when radiation is being used, which may result in occupational exposure. While it has been long known that there is significant potential for health professionals in attendance during interventional cardiology to receive non-trivial occupational exposures, reported details have been typically limited to a few specific interventional cardiology facilities and situations. A more global perspective has been lacking, as is the availability of a systematic means for improving occupational radiation protection in interventional cardiology facilities throughout the world. In 2006, the IAEA published the Fundamental Safety Principles (IAEA Safety Standards Series No. SF-1), which sets out the fundamental safety objective and principles of protection and safety. In 2011, the IAEA published Radiation Protection and Safety of Sources: International Basic Safety Standards (IAEA Safety Standards Series No. GSR Part 3 (Interim Edition)), which sets out the requirements for meeting the fundamental safety objective and applying the principles specified in the Fundamental Safety Principles. The establishment of safety requirements and provision of guidance on occupational radiation protection is a major component of the support for radiation protection and safety provided by the IAEA to Member States. This publication was developed under the IAEA's statutory responsibility to facilitate worldwide application

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

Science.gov (United States)

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…

Acquisition and processing of multiple functional investigations in cardiology

International Nuclear Information System (INIS)

Baruthio, J.; Constantinesco, A.; Chavas, M.; Meyer, P.; Dumitresco, B.; Chambron, J.; Nikitine, S.; Voegtlin, R.

1978-01-01

This work is based on a acquisition and pretreating Service of data and signals resulting from several types of functional explorations in cardiology. This Service, through a specialised phone-line, is connected to the Medical Centre of Informatic where the different treatments and on occasion the recording of data are carried out. This functions according to the Real Time Executive System and the clinical results are send back to the investigation unit. The main types of cardiologic analysis as studied by the system are envisaged: measure in real time of the cardiac output and analysis of the radiocardiogram, measure and display of the thoracic potentials, spectral analysis of the vectorcardiogram, quantitative cineangiocardiography and analysis of intracardiac pressures. This system is particularly interesting in that it may treat several processes which could ask for a great capacity of storing and an important calculus power, see for instance the study of thoracic potentials. This type of analysis could not be envisaged financially with isolated calculators. The set of results obtained enables us to investigate thoroughly and precisely the cardiac performance [fr

Learning knowledge as an integral part of competencies in higher education: Effects on students' knowledge

NARCIS (Netherlands)

Van Bommel, Marijke; Boshuizen, Els; Kwakman, Kitty

2011-01-01

Van Bommel, M., Boshuizen, H. P. A., & Kwakman, K. (2010, 25-27 August). Learning knowledge as an integral part of competencies in higher education: Effects on students' knowledge. Paper presented at the 5th EARLI-SIG14 Learning and Professional Development, Munich, Germany.

Thermal construction unit activation with supply air gains significance. Ceilings cooling - supply air heating - more than 50 % energy conservation; Thermische Bauteilaktivierung mit Zuluft gewinnt an Bedeutung. Decke kuehlen - Zuluft erwaermen - mehr als 50% Energie einsparen

Energy Technology Data Exchange (ETDEWEB)

Schmid, Wolfgang

2009-05-15

In the year 2001, in Stuttgart (Federal Republic of Germany) the first office building was established which uses a thermal construction unit activation with air as cooling agent. Today, the system ''Concret-cool'' already is installed in more than 40 buildings. Computations show that due to the room heating by means of internally finned ventilation pipes embedded in concrete more than 50 % less energy in comparison to comparable systems can be used. In his Green Building project ''Skyline Tower'' in Munich (Federal Republic of Germany), also star architect Helmut Jahn uses the know-how of the manufacturer of ventilation systems from Stuttgart. As one of the first multi-storied buildings in Munich, ''Skyline Tower'' with its 23 floors was prized with the pre-certificate of the German quality seal ''sustainable building ''in gold.

Clinical applications of nuclear cardiology studies in the reforms epoch of health systems

International Nuclear Information System (INIS)

Mut, Fernando; Beretta, Mario

2003-01-01

The appropriate evaluation of the ischemic heart disease due to it seriousness and high prevalence, limited by the expenses that arise from the illness, constitutes a challenge in our times for the daily practice. At the present time, nuclear cardiology competes with several non invasive techniques in the evaluation of the perfusion and the myocardial viability, being this requested in function of the real necessity of each patient. The applications that nuclear cardiology offers for the study of the myocardial perfusion are multiple. Clinical situations are reviewed in this article, such as the coronary illness, states previous to the non cardiac surgery, states after cardiac catheterization, coronary angioplasty, revascularization surgery, and evaluation of patient under long term medical treatment. The study of the myocardial perfusion allows that the coronary illness can be classified according to a low, intermediate or high probability, providing a wide prognosis information in relation to the extension and severity of the ischemia. In this study there are also remarked practical limits as for the selection of patients in order to achieve that the studies of nuclear cardiology offer an appropriate evaluation of the well-known or suspected coronary illness. (The author)

Engine Response to Distorted Inflow Conditions: Conference Proceedings of the Propulsion and Energetics Specialists’ Meeting (68th) Held in Munich, Germany on 8-9 September 1986.

Science.gov (United States)

1987-03-01

Heisenbergweg 39,8014 Neubiberg, Germany PANEL EXECUTIVE Dr E. Riester AGARD-NATO 7 rue Ancelle 92200 Neuilly sur Seine France ACKNOWLEDGEMENT The...this paper and to Rolls-Royce for permission to present it. The work has been carried out with the support of the Procurement Executive , Ministry of...Pourriez vous presenter ce papier a nouveau dans la partie -B" de cette reunion de specialistes ou de nombreux chercheurs en "ondes de choc " seront

Optimization of Patient Doses in Interventional Radiology and Cardiology

International Nuclear Information System (INIS)

Nikodemova, D.; Boehm, K.

2011-01-01

Interventional radiology and cardiology belongs to the imaging modalities connected with significantly higher radiation exposure of patients and medical staff, compared to the exposure during other diagnostic procedures. The objective of this presentation is to promote typical technical parameters and parameters related to the radiation policy, used during the most frequent endovascular and cardiology procedures, as well as the monitoring of the exposure of patients. The presented study reports the results of collecting the data of monitoring doses received by 318 patients undergoing interventional examinations in 3 various departments of the Slovak National Institute of Cardiology and Vascular Diseases. There were 9 different endovascular and cardiology procedures reviewed. The reported patient's radiation exposures were established by using the KAP values, directly shown on the display of the X-ray equipment. From the measured KAP values the entrance surface doses were calculated. Equivalent doses have been measured on hands, legs and other parts of medical staff body, by using electronic dosimeters or thermoluminescent dosimeters. The presented results have covered a wide range of the measured fluoroscopy time values, different number of acquisitions used in various interventional procedures, various cumulated KAP values and also a wide range of the cumulated entrance surface doses. The occupational doses of the operators, followed during dose measurements on their left hands, covered the range from 0.1 μSv to 1513 μSv for one examination performed. The important contribution of the presented results to the radiation protection policy in the Slovak Republic is the mapping of the current situation of the radiation exposure of patients undergoing the chosen interventional examinations and the professional radiation exposure level of interventional operators, providing the most significant interventional procedures in the Slovak interventional hospitals. The

Present and future use of TRIGA reactors in the Federal Republic of Germany

International Nuclear Information System (INIS)

Menke, H.; Junker, D.; Krauss, O.

1986-01-01

In the Federal Republic of Germany nine research reactors are presently in operation, three of which are TRIGA reactors. These are the TRIGA Mark I reactors at Hannover and Heidelberg with a steady state power of 250 kW and the TRIGA Mark II reactor at Mainz with a steady power of 100 kW and a peak pulsing power of 250 MW. The decommissioning of a number of research reactors, including the TRIGA Mark III reactor at Neuherberg near Munich, is reason enough to think about the present and future use of our reactors. The German TRIGA reactors met a lively interest of scientists, since they went into operation. Presently they are well used especially in biomedical (Hannover, Heidelberg) and basic research (Mainz). In the course of about 20 years of operation the techniques and requirements of experiments changed and consequently the use of the reactors too. Certainly this will be so in the future. But thanks to its versatile experimental facilities, this type of reactor can meet the various experimental demands. So we are looking forward to a good utilisation of our German TRIGA reactors in future and taking into account the low costs for personal, energy and fuel, we are quite confident that they will be in operation still for many years. (author)

Multiculturalism in Germany

Directory of Open Access Journals (Sweden)

Milan Mesić

2010-12-01

Full Text Available The paper starts out from the recent statement by the German Chancellor Angela Merkel that multiculturalism in Germany is dead. The author draws attention to the unfavourable conditions for the development of multiculturalism in Germany. The reasons are historical, especially the experience of Nazism as well as the German social state. Namely, foreign workers in Germany, although without political rights and socially non-integrated, enjoyed a high degree of working and social rights, including high employment security. In this respect their position significantly differed from that of American workers (immigrants, which is why the struggle for civil rights was not in the foreground for German immigrants. Therefore, “the crisis of multiculturalism” appeared with the immigrants’ “second generation” (children, who have been first hit in the current times of crisis and the increasing deregulation of the labour market. They have remained socially non-integrated and without civil and political rights. It is interesting that the churches, particularly the Protestant one, lead in Germany in the efforts to begin to look at immigrants in a cultural (human sense as well, and have thus been the first to acknowledge that Germany has become a multicultural society. But this term and concept in Germany have remained sketchy, both in the theoretical and political sense. However, they have gained certain sympathy, mainly in parts of liberal-democratic circles – the Green Party leading the way – but more in a symbolic sense in countering xenophobia and cultural exclusion in German society. When multiculturalism was accused of developing “parallel society”, both the right and the left renounced it in favour of the (seemingly neutral concept of integration. The author proves that Germany has become and has remained multicultural, although not a multiculturalist country.

Radionuclide investigations in clinical cardiology - 10 years of cooperation in Frankfurt/FRG

International Nuclear Information System (INIS)

Klepzig, H. Jr.; Kaltenbach, M.

1989-01-01

Radionuclide investigations today are an important tool in cardiology. They close the diagnostic gap in cases where non-invasive procedures of cardiological diagnosis such as ecg, exercise-ecg, echocardiography and chest-x-ray remains unrevealing. Further, they are helpful when an exact quantitation of the disease or a precise follow-up is required. Radionuclide techniques are very useful to detect myocardial ischemia in patients with coronary heart disease and to judge myocardial function in patients with aortic or mitral regurgitation. Follow-up investigations after therapy (aortocoronary bypass, PTCA, valve replacement) permit conclusions regarding the benefit of these measures. Results of radionuclide investigations should consider the Bayes' theorem in order to keep false-negative and false-positive reports as low as possible. (orig.) [de

Molecular imaging: a new approach to nuclear cardiology

International Nuclear Information System (INIS)

Dobrucki, L.W.; Sinusas, A.J.

2005-01-01

Nuclear cardiology has historically played an important role in detection of cardiovascular disease as well as risk statification. 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 instrumentations 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 therapeutical angiogenesis

Utility of hand-held echocardiography in outpatient pediatric cardiology management.

Science.gov (United States)

Riley, Alan; Sable, Craig; Prasad, Aparna; Spurney, Christopher; Harahsheh, Ashraf; Clauss, Sarah; Colyer, Jessica; Gierdalski, Marcin; Johnson, Ashley; Pearson, Gail D; Rosenthal, Joanna

2014-12-01

Adult patient series have shown hand-held echocardiography (echo) units (HHE) to be accurate for rapid diagnosis and triage. This is the first study to evaluate the ability of HHE to inform decision making in outpatient pediatric cardiology. New pediatric cardiology patients in outpatient clinics staffed by six pediatric cardiologists (experience 1-17 years) were prospectively enrolled if an echocardiogram (echo) was ordered during their initial visit. After history and physical examination and before a standard echo, the cardiologists performed a bedside HHE examination (GE Vscan 1.7-3.8 MHz), documented findings, and made a clinical decision. Diagnoses and decisions based on HHE were compared with final management after the standard echo. The study enrolled 101 subjects (ages 9 days to 19 years). The cardiologists considered HHE imaging adequate for decision making for 80 of the 101 subjects. For 77 of the 80 subjects with acceptable HHE imaging (68/68 normal and 9/12 abnormal standard echoes), the HHE-based primary diagnoses and decisions agreed with the final management. The sensitivity of HHE was 75 % (95 % confidence interval [CI] 43-94 %) and the positive predictive value 100 % (95 % CI 66-100 %) for pediatric heart disease. The agreement between standard echocardiography and HHE imaging was substantial (κ = 0.82). Excluding one of the least experienced cardiologists, HHE provided the basis for correct cardiac diagnoses and management for all the subjects with acceptable HHE imaging (58/58 normal and 9/9 abnormal echoes). In outpatient pediatric cardiology, HHE has potential as a tool to complement physical examination. Further investigation is needed to evaluate how value improves with clinical experience.

Reanálisis del diagnóstico de alcoholismo en Perú: el test de alcoholismo Munich (malt

Directory of Open Access Journals (Sweden)

Klaus-Dieter Gorené

1992-12-01

Full Text Available El Test de Alcoholismo Munich (MALT fue traducido al español y aplicado a una muestra constituida por 145 probandos peruanos, de los cuales 94 eran alcohólicos. El MALT consta de dos partes: la primera está conformada por siete preguntas que son contestadas por el médico y la segunda sección está formada por 24 preguntas y son contestadas por el paciente. Tanto el coeficiente de validación para toda la prueba (r=0.87 como el coeficiente de confiabilidad de la parte autoadministrable (r=0.93 fueron elevados.

A study of role expansion: a new GP role in cardiology care

Science.gov (United States)

2014-01-01

Background The National Health Service is reconfiguring health care services in order to meet the increasing challenge of providing care for people with long-term conditions and to reduce the demand on specialised outpatient hospital services by enhancing primary care. A review of cardiology referrals to specialised care and the literature on referral management inspired the development of a new GP role in Cardiology. This new extended role was developed to enable GPs to diagnose and manage patients with mild to moderate heart failure or atrial fibrillation and to use a range of diagnostics effectively in primary care. This entailed GPs participating in a four-session short course with on-going clinical supervision. The new role was piloted in a small number of GP practices in one county in England for four months. This study explores the impact of piloting the Extended Cardiology role on the GP’s role, patients’ experience, service delivery and quality. Methods A mixed methods approach was employed including semi-structured interviews with GPs, a patient experience survey, a quality review of case notes, and analysis on activity and referral data. Results The participating GPs perceived the extended GP role as a professional development opportunity that had the potential to reduce healthcare utilisation and costs, through a reduction in referrals, whilst meeting the patient’s wishes for the provision of care closer to home. Patient experience of the new GP service was positive. The standard of clinical practice was judged acceptable. There was a fall in referrals during the study period. Conclusion This new role in cardiology was broadly welcomed as a model of care by the participating GPs and by patients, because of the potential to improve the quality of care for patients in primary care and reduce costs. As this was a pilot study further development and continuing evaluation of the model is recommended. PMID:24885826

Nuclear medicine in cardiology: a position paper for an open debate

International Nuclear Information System (INIS)

Ell, P.J.; Bourguignon, M.H.; Pauwels, E.K.J.; Martin-Comin, J.; Roo, M. de; Dige-Petersen, H.

1995-01-01

The European Union of Medical Specialities (EUMS) is in the process of collecting data on the practice of nuclear medicine in cardiology in Europe in the different European national territories. A report on this practice is expected to become available shortly. (orig.)

Review on Factors Influencing Physician Guideline Adherence in Cardiology.

Science.gov (United States)

Hoorn, C J G M; Crijns, H J G M; Dierick-van Daele, A T M; Dekker, L R C

2018-04-09

Cardiovascular disease is the most common cause of death in Western countries. Physician adherence to guidelines is often suboptimal, resulting in impaired patient outcome and prognosis. Multiple studies have been conducted to evaluate patterns and the influencing factors of patient adherence, but little is known about factors influencing physician guideline adherence. This review aims to identify factors influencing physician guideline adherence relevant to cardiology and to provide insights and suggestions for future improvement. Physician adherence was measured as adherence to standard local medical practice and applicable guidelines. Female gender and older age had a negative effect on physician guideline adherence. In addition, independent of the type of heart disease, physicians without cardiologic specialization were linked to physician noncompliance. Also, guideline adherence in primary care centers was at a lower level compared to secondary or tertiary care centers. The importance of guideline adherence increases as patients age, and complex diseases and comorbidity arise. Appropriate resources and interventions, taking important factors for nonadherence in account, are necessary to improve guideline adoption and adherence in every level of the chain. This in turn should improve patient outcome.

Subsequent full publication of abstracts presented in the annual meetings of the Spanish Society of Cardiology.

Science.gov (United States)

Alonso-Arroyo, Adolfo; Aleixandre-Benavent, Rafael; Vidal-Infer, Antonio; Anguita-Sánchez, Manuel; Chorro-Gascó, Francisco J; Bolaños-Pizarro, Máxima; Castelló-Cogollos, Lourdes; Navarro-Molina, Carolina; Valderrama-Zurián, Juan C

2014-01-01

The Spanish Society of Cardiology holds an annual national meeting with a large number of presentations but the number of full-text publications resulting from these presentations and the journals accepting these manuscripts is unknown. This study aimed to identify the full-text publication rate of accepted abstracts and to analyze the bibliometric features of subsequent publications. We randomly selected a sample of 300 oral presentations at the meetings of the Spanish Society of Cardiology in 2002, 2005 and 2008. Subsequent publications were identified through the Science Citation Index-Expanded, Scopus, Índice Médico Español, and Índice Bibliográfico Español en Ciencias de la Salud. Of 300 abstracts, 115 resulted in 147 full publications, representing a publication rate of 38.33%. The meeting with the highest publication rate (43%) was held in 2005. The subject category with the highest number of publications was Pediatric Cardiology/Congenital Heart Disease (58.8%). Time to full publication was usually 2 years (30.61%). Articles were published in 57 journals. The journals publishing the highest number of articles were Revista Española de Cardiología (n=55; 37.41%) and the European Heart Journal (n=8; 5.44%). The high percentage of articles published in the upper half of journals listed in Journal Citation Reports under the category of cardiac and cardiovascular system (83%) can be taken as an objective quality indicator of the results presented at these meetings. However, more than 60% of the abstracts did not result in full publications, thus depriving the scientific community of potentially interesting results. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Clinical and economic outcomes assessment in nuclear cardiology

International Nuclear Information System (INIS)

Shaw, L.J.; Miller, D.D.; Berman, D.S.; Hachamovitch, R.

2000-01-01

The future of nuclear medicine procedures, as understood within our current economic climate, depends upon its ability to provide relevant clinical information at similar or lower comparative costs. With an ever-increasing emphasis on cost containment, outcome assessment forms the basis of preserving the quality of patient care. Today, outcomes assessment encompasses a wide array of subjects including clinical, economic, and humanistic (i.e., quality of life) outcomes. For nuclear cardiology, evidence-based medicine would require a threshold level of evidence in order to justify the added cost of any test in a patient's work-up. This evidence would include large multicenter, observational series as well as randomized trial data in sufficiently large and diverse patient populations. The new movement in evidence-based medicine is also being applied to the introduction of new technologies, in particular when comparative modalities exist. In the past 5 years, it has seen a dramatic shift in the quality of outcomes data published in nuclear cardiology. This includes the use of statistically rigorous risk-adjusted techniques as well as large populations (i.e., >500 patients) representing multiple diverse medical care settings. This has been the direct result of the development of multiple outcomes databases that have now amassed thousands of patients worth of data. One of the benefits of examining outcomes in large patient datasets is the ability to assess individual endpoints (e.g., cardiac death) as compared with smaller datasets that often assess combined endpoints (e.g., death, myocardial infarction, or unstable angina). New technologies for the diagnosis of coronary artery disease have contributed to the rising costs of care. In the United States and in Europe, costs of care have risen dramatically, consuming an ever-increasing amount of available resources. The overuse of diagnostic angiography often leads to unnecessary revascularization that does not lead to

Discharge planning in a cardiology out-patient clinic: a clinical audit.

Science.gov (United States)

Ingram, Shirley; Khan, Barkat

2014-01-01

The purpose of this paper is to audit the active discharge (DC) planning process in a general cardiology clinic, by pre-assessing patients' medical notes and highlighting those suitable for potential DC to the clinic physician. The cardiology clinical nurse specialist (CNS) identified patients' for nine- to 12-month return visits one week prior to attendance. The previous consultation letter was accessed and information was documented by the CNS in the medical record. The key performance indicator (KPI) used was patient DCs for each clinic visit. The process was audited at three separate times to reflect recommended action carried out. The CNS pre-assessment and presence at the clinics significantly increased total DCs during the first period compared to usual care, 11 vs 34 per cent (p audit period, DCs fell (9 per cent) with a reduction in CNS pre-assessed DCs (10 per cent). Recommendations were implemented. The process was continued by clinic administration staff, colour coding all nine- to 12-month returns, resulted in a 19 per cent DC rate in 2012. CNS pre-assessment and highlighting DC suitability increased the number of patient DCs. As the CNS presence at the clinic reduced so did the rate of DC. Specific personnel need to be responsible for monitoring and reminding staff of the process; this does not always have to be medical or nursing. Implementing positive discharging procedures is aimed at improving quality, increasing efficiency and accessibility of services for patients. This audit describes a process to promote DC planning from cardiology outpatients.

Protection against ionizing radiation by leaded glass googles during interventional cardiology

International Nuclear Information System (INIS)

Zett-Lobos, Claudio; Vera Munoz, Felipe; Arriola Alvarez, Katerina; Diaz Ramos, Oscar; Gamarra, Jorge; Fernandez Palomo, Cristian; Merello, Lorenzo; Mora D, Alex; Gutierrez, Alejandro; Catalan Reyes, Monica; Ramos Avasola, Sergio

2013-01-01

Background: It is not known whether leaded glass goggles with 0.25 mm Pb equivalency, used in interventional cardiology procedures, attenuate radiation below the levels established by the latest recommendation of the International Commission on Radiological Protection (ICRP). Aim: To assess if the degree of attenuation of the secondary ionizing radiation achieved by the use of 0.25 mm Pb leaded glass goggles, in occupationally exposed workers in interventional cardiology procedures, meets the latest ICRP recommendations. Material and Methods : A prospective investigation was carried out to compare the eye exposure to secondary ionizing radiation received by occupationally exposed personnel in a 9 months period. A set of two thermo luminescent dosimeters was arranged in the front and back of leaded glass goggles in a cohort of seven members of an interventional cardiology service, exposed to 1057 consecutive procedures. Results:The monthly dose equivalent measurement performed in front of the goggles ranged between 1.1 and 6.5 mSv,for paramedics and interventional cardiologists. The radiation measured in the back of the glass varied between 0.66 and 2.75 mSv,respectively.The degree of attenuation of the dose at eye level ranged from 40% to 57.7%,respectively. The projected annual exposure would reach 33 mSv for the interventional cardiologist. Conclusions: With a similar load of work and wearing 0.25 mm Pb equivalent glass goggles, interventional cardiologists will exceed the crystalline equivalent dose limit recommended by the ICRP (20 mSv/year averaged over the past 5 years)

[Cardiology: is the smartphone era?

Science.gov (United States)

Mandoli, Giulia Elena; D'Ascenzi, Flavio; Cameli, Matteo; Mondillo, Sergio

2017-12-01

The worldwide spread of smartphones has radically changed the habits of human life, allowing a 24/7 connection with other people. These changes have involved also Medicine with smartphones being able to simplify the clinical practice of physicians. The development of new external devices that can be connected to smartphones has further increased their use with mobile phones converted in portable electrocardiogram or echocardiogram machines. This extraordinary technological improvement seems to be partly in conflict with the classical tools available for the cardiologist, such as the "old" stethoscope that in 2016 had its 200th anniversary. This article focuses on the smartphone as a new tool available for the physicians, describing the most important potential uses and reporting an analysis of pros and cons of the smart-cardiology.

Military Periodicals.

Science.gov (United States)

1983-05-01

4401 Vine Grove Road Fort Knox, Kentucky 40121 Telephone: (502) 942-8624 Editor-in-Chief: MAJ C. R. Steiner , Jr. $10.00 Army (M) Association...Wehrkunde) Verlag Europaische Wehrkunde Gmb H Herzog- Rudolf -Str. 1 8000 Munich 22 West Germany Telephone: (089) 293883 Editor: Ewald Heinrich von

Development of a thermal hydraulic modelling of ground water of the Malm in the Munich metropolitan area; Entwicklung einer thermisch-hydraulischen Grundwassermodellierung des Malm im Grossraum Muenchen

Energy Technology Data Exchange (ETDEWEB)

Dussel, M.; Lueschen, E.; Thomas, R. [Leibniz-Institut fuer Angewandte Geophysik, Hannover (DE)] (and others)

2011-10-24

The mutual potential influence of geothermal duplicates and the scientific investigation of the relationship between seismic and hydraulic parameters are investigated in the joint research project 'Geothermal characterization of fractured karst limestone aquifers in the Munich metropolitan area'. Thirteen doublets and triplets being in production or sunk illustrate the great geothermal potential and provide important data on the development of a thermal-hydraulic modeling of the reservoir. 3D seismic Unterhaching, 3D structural model, hydrogeological model and a high-resolution 3D temperature model form the basis of the numerical modeling. Different seismic signatures, seismic attributes and variations in the interval velocities characterize the ground geophysically, and were interpreted under consideration of geological and hydrogeological background information as well as borehole measurements in terms of hydraulically conductive homogeneous areas. For the Munich metropolitan area, the numerical modeling is a decision aid for the future optimized and sustainable hydrothermal utilization of the Malm aquifer.

Low dose in nuclear cardiology: state of the art in the era of new cadmium-zinc-telluride cameras.

Science.gov (United States)

Acampa, Wanda; Buechel, Ronny R; Gimelli, Alessia

2016-06-01

The use of myocardial perfusion imaging has seen a tremendous growth during the last decade and has become the most commonly used non-invasive imaging tool for risk stratification in patients with suspected and known coronary artery disease. Adherence to radiation safety best practices varied significantly between laboratories but the possibility to use the new cameras in nuclear cardiology can reduce dramatically the radiation dose without losing accuracy. Moreover, the physical characteristics of ultrafast technology could be able to open new doors for the evaluation of old parameters, changing the impact of nuclear cardiology in the diagnostic strategies. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings.

Science.gov (United States)

Jena, Anupam B; Prasad, Vinay; Goldman, Dana P; Romley, John

2015-02-01

Thousands of physicians attend scientific meetings annually. Although hospital physician staffing and composition may be affected by meetings, patient outcomes and treatment patterns during meeting dates are unknown. To analyze mortality and treatment differences among patients admitted with acute cardiovascular conditions during dates of national cardiology meetings compared with nonmeeting dates. Retrospective analysis of 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure, or cardiac arrest from 2002 through 2011 during dates of 2 national cardiology meetings compared with identical nonmeeting days in the 3 weeks before and after conferences (AMI, 8570 hospitalizations during 82 meeting days and 57,471 during 492 nonmeeting days; heart failure, 19,282 during meeting days and 11,4591 during nonmeeting days; cardiac arrest, 1564 during meeting days and 9580 during nonmeeting days). Multivariable analyses were conducted separately for major teaching hospitals and nonteaching hospitals and for low- and high-risk patients. Differences in treatment utilization were assessed. Hospitalization during cardiology meeting dates. Thirty-day mortality, procedure rates, charges, length of stay. Patient characteristics were similar between meeting and nonmeeting dates. In teaching hospitals, adjusted 30-day mortality was lower among high-risk patients with heart failure or cardiac arrest admitted during meeting vs nonmeeting dates (heart failure, 17.5% [95% CI, 13.7%-21.2%] vs 24.8% [95% CI, 22.9%-26.6%]; P cardiology meetings. High-risk patients with heart failure and cardiac arrest hospitalized in teaching hospitals had lower 30-day mortality when admitted during dates of national cardiology meetings. High-risk patients with AMI admitted to teaching hospitals during meetings were less likely to receive PCI, without any mortality effect.

Country report for Germany [Fast reactors in Germany

International Nuclear Information System (INIS)

Knebel, J.

2007-01-01

Full text: The primary energy consumption in Germany in 2005 was about 492.6 MtSKE in total. The distribution on the main energy sources is: mineral oil: 36.4%, natural gas 22.4%, black coal 13.5%, brown coal 11.4%, nuclear energy 12.6%, water and wind 1.2%, others 2.5%. The net electricity production in Germany in 2005 was about 495.9 billion kWh. The distribution is: nuclear energy 32%, lignite coal 28.9%, black coal 23.1%, oil 0.2%, natural gas 9.1%, water 4.7%, others (being biomass, photovoltaics, wind) 2.0%. In 2005, 18 nuclear power plants were in operation in Germany. In May 2005 the KWO Obrigheim was closed due to the new Atomic law which fixes the phase out of nuclear power production. The net installed nuclear power was 20.7GWel, the net nuclear electricity production was 163TWh, the time availability was 88%. Nuclear makes up for about 50% of the base-load electricity production in Germany. In absolute numbers, Germany is number 5 in nuclear electricity production. Among the top ten nuclear power plants world-wide, in 2005 there were 7 German plants including the plant with the highest amount of electricity produced, being NPP Brokdorf with 1440MWel and 11.98TWhel. The net electricity output of the nuclear power plants is constantly increasing due to power upgrading and higher time availabilities. As for the renewable energies, there is no significant absolute increase except for wind. About 50% of the government support for renewable energies from the Environmental Ministry goes to photovoltaics. The Helmholtz-Gemeinschaft (HGF), summarising 15 national research centres, 24.000 employees and a yearly budget of about 2,1 billion Euro is the largest research organisation in Germany. The HGF identifies and works on complex and urgent questions of society, science and economy, especially concentrating on systems of high complexity. There are six research areas, being energy, earth and environment, health, key technologies, structure of matter, traffic and

Oral versus intravenous iron therapy in patients with inflammatory bowel disease and iron deficiency with and without anemia in Germany – a real-world evidence analysis

Directory of Open Access Journals (Sweden)

Stein J

2018-02-01

Full Text Available Jürgen Stein,1,2 Jennifer Scarlet Haas,3 Siew Hwa Ong,4 Kathrin Borchert,3 Thomas Hardt,5 Elmira Lechat,4 Kerry Nip,5 Douglas Foerster,4 Sebastian Braun,3 Daniel C Baumgart6 1Interdisciplinary Crohn Colitis Center Rhein-Main, Frankfurt/Main, Germany; 2Department of Gastroenterology and Clinical Nutrition, DGD Clinics Sachsenhausen, Teaching Hospital of the J.W. Goethe University, Frankfurt/Main, Germany; 3Xcenda GmbH, Hannover, Germany; 4Vifor Pharma Ltd., Glattbrugg, Switzerland; 5Vifor Pharma Deutschland GmbH, Munich, Germany; 6Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada Background: Iron-deficiency anemia and iron deficiency are common comorbidities associated with inflammatory bowel disease (IBD resulting in impaired quality of life and high health care costs. Intravenous iron has shown clinical benefit compared to oral iron therapy. Aim: This study aimed to compare health care outcomes and costs after oral vs intravenous iron treatment for IBD patients with iron deficiency or iron deficiency anemia (ID/A in Germany. Methods: IBD patients with ID/A were identified by ICD-10-GM codes and newly commenced iron treatment via ATC codes in 2013 within the InGef (formerly Health Risk Institute research claims database. Propensity score matching was performed to balance both treatment groups. Non-observable covariates were adjusted by applying the difference-in-differences (DID approach. Results: In 2013, 589 IBD patients with ID/A began oral and 442 intravenous iron treatment. After matching, 380 patients in each treatment group were analyzed. The intravenous group had fewer all-cause hospitalizations (37% vs 48% and ID/A-related hospitalizations (5% vs 14% than the oral iron group. The 1-year preobservation period comparison revealed significant health care cost differences between both groups. After adjusting for cost differences by DID method, total health care cost savings in the intravenous iron group were

Radiological protection in interventional cardiology in Chile

International Nuclear Information System (INIS)

Ramirez, A.; Leyton, F.A.; Farias, E.; Silva, A.M.; Vano, E.; Oyarzun, C.; Gamarra, J.; Ortiz, P.

2001-01-01

In September 2000, an expert mission was assigned to Chile, under the regional project named 'International BBS in Medical Practices Radiation Protection and Quality Assurance In Interventional Radiology' (ARCAL XLIX). The objective of the mission was to evaluate the level of radiation protection (RP) and safety in interventional cardiology ( IC ) installations. A team of local cardiologists, medical physicists and technologists was created for this purpose and during one week, several cardiology laboratories were evaluated and some basic quality controls (QC) were carried out. A basic pilot training course in radiation protection was imparted at the Hospital of the University of Chile in Santiago de Chile and some of the key objectives for a future national quality assurance programme were presented during the national congress of IC. In addition, a national survey on radiation protection aspects was circulated and its results evaluated. These activities enabled the local team to become familiar with the methodology of assessment of the level of protection and the organization of a programme, which was illustrated with the examples of similar European programmes. As result of these actions, several proposals were made to both the local authorities and the IAEA. The most important were: a) to initiate a basic QC programme, b) to organize a training in RP for cardiologists in order to formalize their accreditation, c) to improve personal occupational dosimetry, d) to initiate a programme of patient dosimetry, e) to optimize the technical and clinical protocols, f) to create a national registry of incidents with skin injuries. (author)

Cryptogenic transient ischemic attack after nose blowing: association of huge atrial septal aneurysm with patent foramen ovale as potential cause

OpenAIRE

Lotze, Ulrich; Kirsch, Uwe; Ohlow, Marc-Alexander; Scholle, Thorsten; Leonhardi, Jochen; Lauer, Bernward; Oltmanns, Gerhard; Schmidt, Hendrik

2013-01-01

Ulrich Lotze,1 Uwe Kirsch,1 Marc-Alexander Ohlow,2 Thorsten Scholle,3 Jochen Leonhardi,3 Bernward Lauer,2 Gerhard Oltmanns,4 Hendrik Schmidt5,6 1Department of Internal Medicine, DRK Krankenhaus Sondershausen, Sondershausen, Germany; 2Department of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany; 3Institute of Diagnostic and Interventional Radiology, Zentralklinik Bad Berka, Germany; 4Department of Internal Medicine, DRK Krankenhaus Sömmerda; Sömmerda, Germany; 5Depar...

THE DOPPLER ECHOGRAPHY – FROM GREEK MYTHOLOGY TO MODERN CARDIOLOGY

Directory of Open Access Journals (Sweden)

Diana DĂNIŞOR

2016-10-01

Full Text Available The following pages shall demonstrate how the nature of things is made evident through the science of naming, the structure of designation. Through this extensive analysis, I aim at establishing the connection between Greek mythology and modern cardiology by exploring the origin of the word echography and its modern counterpart the Doppler echography.

Mental disorders and general well-being in cardiology outpatients--6-year survival

DEFF Research Database (Denmark)

Birket-Smith, Morten; Hansen, Baiba H; Hanash, Jamal A

2009-01-01

disorder with the Primary Care Evaluation of Mental Disorders; Structured Clinical Interview for DSM-III-R, Non-Patient Edition, psychosis screening; the Clock Drawing Test; and the WHO-5 Well-Being Index. The cardiologists were asked in each patient to rate the severity of somatic disease and mental......OBJECTIVE: Long-term survival in a sample of cardiology outpatients with and without mental disorders and other psychosocial risk factors. METHODS: In a cardiology outpatient setting, 103 consecutive patients were asked to participate in the study. Of these, 86 were included and screened for mental...... problems on visual analogue scales (VAS-somatic and VAS-mental). Cardiac diagnosis, noncardiac comorbidity, history of mental disorder, and the number of daily social contacts were noted. Survival was followed for 6 years. RESULTS: At baseline, 33 (38.4%) patients had mental disorder, 6 dementia, 11 major...

Empathy without borders? Cross-cultural heart and mind-reading in ...

African Journals Online (AJOL)

Background: This cross-cultural study was designed to examine cultural differences in empathy levels of first-year medical students. Methods: A total of 257 students from the academic year 2010/11, 131 at Jimma University, Ethiopia, and 126 at the Ludwig Maximilian University, Munich, Germany, completed the Balanced ...

Granulopoietic Growth Factor Secretion in Ovarian Carcinoma as a Mechanism for the Emergence of Immune Suppressive Myeloid Subsets

Science.gov (United States)

2014-08-01

on “Biotherapy of Cancer: From Disease to Targeted Treatment” in Munich, Germany . Talk entitled, “Combinatorial Vaccine Strategies Employing...Bardhan, K., Paschall, A. V., Yang, D., Waller, J. L., Park, M. A., Nayak-Kapoor, A., Samuel, T. A., Abrams, S. I., and Liu, K. Deregulation of apoptotic

The Meaning of Avoidance and Aggressive Tax Planning and the BEPS Initiative

NARCIS (Netherlands)

M.F. de Wilde (Maarten); C. Wisman (Ciska)

2016-01-01

markdownabstractThis national report has been prepared as a contribution to the Conference of the European Association of Tax Law Professors entitled ‘Tax Avoidance Revisited: Exploring the Boundaries of Anti-Avoidance Rules in the EU BEPS Context. The conference is to be held in Munich, Germany, on

78 FR 33859 - Notice Pursuant to the National Cooperative Research and Production Act of 1993-DIE Products...

Science.gov (United States)

2013-06-05

... Technologies, AG, Munich, Germany; Freescale Semiconductor, Inc., Austin, TX; Philips Semiconductors, Inc., San... original notification pursuant to Section 6(a) of the Act. The Department of Justice published a notice in... notification was filed with the Department on May 2, 2006. A notice was published in the Federal Register...

Srovnání vybraných burzovních trhů v německy mluvících zemích

OpenAIRE

Horáková, Veronika

2010-01-01

This bachelor thesis compares four regional stock exchanges in Germany. These are stock exchanges in Berlin, Munich, Stuttgart and Frankfurt. The Frankfurt stock exchange is the most important stock market in Germany and it is often used as a benchmark for the whole German market. The goal of this paper is to inform about the system of the German stock market system in general and describe not only the well-known Frankfurt stock exchange but the smaller stock exchanges of regional importace a...

The current status of eye lens dose measurement in interventional cardiology personnel in Thailand.

Science.gov (United States)

Krisanachinda, Anchali; Srimahachota, Suphot; Matsubara, Kosuke

2017-06-01

Workers involved in interventional cardiology procedures receive high eye lens doses if radiation protection tools are not properly utilized. Currently, there is no suitable method for routine measurement of eye dose. In Thailand, the eye lens equivalent doses in terms of Hp(3) of the interventional cardiologists, nurses, and radiographers participating in interventional cardiology procedures have been measured at 12 centers since 2015 in the pilot study. The optically stimulated luminescence (OSL) dosimeter was used for measurement of the occupational exposure and the eye lens dose of 42 interventional cardiology personnel at King Chulalongkorn Memorial Hospital as one of the pilot centers. For all personnel, it is recommended that a first In Light OSL badge is placed at waist level and under the lead apron for determination of Hp(10); a second badge is placed at the collar for determination of Hp(0.07) and estimation of Hp(3). Nano Dots OSL dosimeter has been used as an eye lens dosimeter for 16 interventional cardiology personnel, both with and without lead-glass eyewear. The mean effective dose at the body, equivalent dose at the collar, and estimated eye lens dose were 0.801, 5.88, and 5.70 mSv per year, respectively. The mean eye lens dose measured by the Nano Dots dosimeter was 8.059 mSv per year on the left eye and 3.552 mSv per year on the right eye. Two of 16 interventional cardiologists received annual eye lens doses on the left side without lead glass that were higher than 20 mSv per year, the new eye lens dose limit as recommended by ICRP with the risk of eye lens opacity and cataract.

Common usage of cardiologic anatomical terminology: critical analysis and a trilingual discussion proposal.

Science.gov (United States)

Werneck, Alexandre Lins; Batigália, Fernando

2009-01-01

Terminology and Lexicography have been especially addressed to the Allied Health Sciences regarding discussion of case reports or concerning publication of scientific articles. The knowledge of Human Anatomy enables the understanding of medical terms and the refinement of Medical Terminology makes possible a better anatomicomedical communication in a highly technical level. Most of the scientific publications in both Anatomy and Medicine are found only in English and most of dictionaries or search resources available do not have specificity enough to explain anatomicomedical, terminological, or lexicographical occurrences. To design and produce a multilingual terminological dictionary (Latin-English-Portuguese-Spanish) containing a list of English anatomicomedical terms in common usage in cardiology subspecialties addressed to medical students and professionals, to other allied health sciences professionals, and to translators working in this specific field. Terms, semantical and grammatical components were selected to compose an anatomicocardiological corpus. The adequacy to the thematic terminological research requests and the translation reliability level will be settled from the terminology specificity in contrast to the semantics, as well as from a peer survey of the main terms used by national and international experts in specialized journals, Internet sites, and from text-books on Anatomy and Cardiology. The inclusion criteria will be the terms included in the English, Portuguese, and Spanish Terminologia Anatomica - the official terminology of the anatomical sciences; nonofficial technical commonly used terms which lead to terminology or translation misunderstanding often being a source of confusion. A table with a sample of the 508 most used anatomical cardiologic terms in English language peer-reviewed journals of cardiology and (pediatric and adult) thoracic surgery is shown. The working up of a multilingual terminological dictionary reduces the risk of

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

Science.gov (United States)

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

Web tools for effective retrieval, visualization, and evaluation of cardiology medical images and records

Science.gov (United States)

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.

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

Science.gov (United States)

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

Search for heavy sterile neutrinos with SHiP

CERN Document Server

Jacobsson, Richard

Invited contribution to the White Paper on keV sterile neutrino Dark Matter as proceedings of the v-Dark 2015 international workshop which was held at the Institute for Advanced Study of the Technical University of Munich, Garching, Germany, 7 - 9 December 2015. White Paper will be submitted to JCAP.

Indicators for successful learning in air traffic control training

NARCIS (Netherlands)

Van Meeuwen, Ludo; Brand-Gruwel, Saskia; Van Merriënboer, Jeroen; De Bock, Jeano; Kirschner, Paul A.

2011-01-01

Van Meeuwen, L. W., Brand-Gruwel, S., Van Merriënboer, J. J. G., De Bock, J. J. P. R., & Kirschner, P. A. (2010, August). Indicators for successful learning in air traffic control training. Paper presented at the 5th EARLI SIG 14 Learning and Professional Development Conference. Munich, Germany.

Germany, Russia, and energy

International Nuclear Information System (INIS)

Paillard, Christophe Alexandre

2007-01-01

This article first recalls and comments the objectives defined in March 2007 by the European Council in terms of energy to struggle against climate change. These objectives relate to the reduction of greenhouse gas emissions, to renewable energies, to energy saving, and to the share of biofuels. It outlines that Germany worries about the political situation in Russia and the capacities of this country to supply Europe with hydrocarbons. Figures related to consumption of primary energy and to sources of production of electricity in Germany show that Germany is facing an increased energy dependency. The issues related to the relationship between the EU and Russia in the field of energy are further discussed, notably from the German point of view, but also from a European point of view as the EU expects a stronger reaction of Germany in front of the Russian situation

Competency Testing for Pediatric Cardiology Fellows Learning Transthoracic Echocardiography: Implementation, Fellow Experience, and Lessons Learned.

Science.gov (United States)

Levine, Jami C; Geva, Tal; Brown, David W

2015-12-01

There is currently great interest in measuring trainee competency at all levels of medical education. In 2007, we implemented a system for assessing cardiology fellows' progress in attaining imaging skills. This paradigm could be adapted for use by other cardiology programs. Evaluation consisted of a two-part exercise performed after years 1 and 2 of pediatric cardiology training. Part 1: a directly observed evaluation of technical skills as fellows imaged a normal subject (year 1) and a patient with complex heart disease (year 2). Part 2: fellows interpreted and wrote reports for two echocardiograms illustrating congenital heart disease. These were graded for accuracy and facility with communicating pertinent data. After 5 years of testing, fellows were surveyed about their experience. In 5 years, 40 fellows were tested at least once. Testing identified four fellows who underperformed on the technical portion and four on the interpretive portion. Surveys were completed by 33 fellows (83 %). Most (67 %) felt that intermittent observation by faculty was inadequate for assessing skills and that procedural volume was a poor surrogate for competency (58 %). Posttest feedback was constructive and valuable for 90, and 70 % felt the process helped them set goals for skill improvement. Overall, fellows felt this testing was fair and should continue. Fellow performance and responses identified programmatic issues that were creating barriers to learning. We describe a practical test to assess competency for cardiology fellows learning echocardiography. This paradigm is feasible, has excellent acceptance among trainees, and identifies trainees who need support. Materials developed could be easily adapted to help track upcoming ACGME-mandated metrics.

Drugs in East Germany.

Science.gov (United States)

Dressler, J; Müller, E

1997-09-01

Germany was divided into two parts after World War II. The closed border and a nonconvertible currency in the Eastern part were the factors that did not allow a drug market to develop. Alcohol and medicaments were used as substitute drugs. Since Germany was reunified 5 years ago, there are now the same conditions prevailing for the procurement and sale of drugs in East Germany as there are in the Western German states. This report describes the current state of drug traffic, especially in Saxony, under the new social conditions.

Payment Reform to Enhance Collaboration of Primary Care and Cardiology: A Review.

Science.gov (United States)

Farmer, Steven A; Casale, Paul N; Gillam, Linda D; Rumsfeld, John S; Erickson, Shari; Kirschner, Neil M; de Regnier, Kevin; Williams, Bruce R; Martin, R Shawn; McClellan, Mark B

2018-01-01

The US health care system faces an unsustainable trajectory of high costs and inconsistent outcomes. The fee-for-service payment model has contributed to inefficiency, and new payment methods are a promising approach to improving value. Health reforms are needed to increase patient access, reduce costs, and improve health care quality, and the landmark Medicare Access and CHIP Reauthorization Act presents a roadmap for reform. The product of a collaboration between primary care and cardiology clinicians, this review describes a conceptual approach to delivery and payment reforms that aim to better support primary care-cardiology comanagement of chronic cardiovascular disease (CVD). Few existing alternative payment models specifically address long-term management of CVD. Primary care medical homes and accountable care organizations come closest, but both emphasize primary care, and cardiologists have often not been well engaged. A collaborative care framework should articulate distinct roles and responsibilities for primary care and cardiology in CVD comanagement. Finally, a series of payment models aim to better support clinicians in providing accountable, seamless, and patient-centered cardiac care. Clinical leadership is essential during this time of change in the health care system. Patients often struggle to navigate a fragmented and expensive system, whereas clinicians often practice with incomplete information about tests, treatments, and recommendations by their colleagues. The payment models described in this review offer an opportunity to create more satisfying approaches to patient care while improving value. These models have potential to support more effective coordination and to facilitate broader health care system transformation.

Pediatric cardiology. Clinical and practical experiences with heart diseases of children, juveniles and young adults

International Nuclear Information System (INIS)

Haas, Nikolaus A.

2011-01-01

The book on pediatric cardiology covers the following chapters: (I) Fundamentals and diagnostics: pediatric cardiologic anamnesis, electrocardiograms, thorax X-radiography, MRT and CT of the heart, nuclear medical diagnostics, exercise tests, heart catheter examination, electrophysiological tests. (II) Leading symptoms: Cyanosis, cardiac murmur, thorax pain, palpitation, syncopes. (III) Disease pictures: congenital heart defects, acquired heart defects, cardiomyopathies, heart rhythm disturbances, heart insufficiency, arterial hypertension, pulmonary hypertension, other heart involving syndromes. (IV) Therapy: Catheter interventional therapy, post-surgical pediatric cardiac therapy, surgery involving the life-support machine, mechanical cardiovascular support systems, initial treatment of newborns with critical heart defects, heart transplantation, vaccination of children with heart diseases, medicinal therapy.

Defining pediatric inpatient cardiology care delivery models: A survey of pediatric cardiology programs in the USA and Canada.

Science.gov (United States)

Mott, Antonio R; Neish, Steven R; Challman, Melissa; Feltes, Timothy F

2017-05-01

The treatment of children with cardiac disease is one of the most prevalent and costly pediatric inpatient conditions. The design of inpatient medical services for children admitted to and discharged from noncritical cardiology care units, however, is undefined. North American Pediatric Cardiology Programs were surveyed to define noncritical cardiac care unit models in current practice. An online survey that explored institutional and functional domains for noncritical cardiac care unit was crafted. All questions were multi-choice with comment boxes for further explanation. The survey was distributed by email four times over a 5-month period. Most programs (n = 45, 60%) exist in free-standing children's hospitals. Most programs cohort cardiac patients on noncritical cardiac care units that are restricted to cardiac patients in 39 (54%) programs or restricted to cardiac and other subspecialty patients in 23 (32%) programs. The most common frontline providers are categorical pediatric residents (n = 58, 81%) and nurse practitioners (n = 48, 67%). However, nurse practitioners are autonomous providers in only 21 (29%) programs. Only 33% of programs use a postoperative fast-track protocol. When transitioning care to referring physicians, most programs (n = 53, 72%) use facsimile to deliver pertinent patient information. Twenty-two programs (31%) use email to transition care, and eighteen (25%) programs use verbal communication. Most programs exist in free-standing children's hospitals in which the noncritical cardiac care units are in some form restricted to cardiac patients. While nurse practitioners are used on most noncritical cardiac care units, they rarely function as autonomous providers. The majority of programs in this survey do not incorporate any postoperative fast-track protocols in their practice. Given the current era of focused handoffs within hospital systems, relatively few programs utilize verbal handoffs to the referring pediatric

A case study of technology transfer: Cardiology

Science.gov (United States)

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.

Germany, Pacifism and Peace Enforcement

DEFF Research Database (Denmark)

Dalgaard-Nielsen, Anja

This book is about the transformation of Germany's security and defence policy in the time between the 1991 Gulf War and the 2003 war against Iraq. It traces and explains the reaction of Europe's biggest and potentially most powerful country to the ethnic wars of the 1990s, the emergence of large...... the 1990s. The book debates the implications of Germany's transformation for Germany's partners and neighbours, and explains why Germany said ‘yes’ to the war in Afghanistan, but ‘no’ to the Iraq War. Based on a comprehensive study of the debates of the German Bundestag and actual German policy responses...

研究発表 森鷗外・ドイツ留学最後の一年

OpenAIRE

坂本, 秀次

1982-01-01

From August 1884 to September 1888, Ōgai Rintaro Mori, the most prominent writer in modern Japanese literature, lived in Germany as a military doctor with the Japanese Imperial Army. In the free atmosphere of Leipzig, Dresden, and Munich he had a bright and cheerful life. But his life in Berlin, which he visited last, was darker.At that time, Berlin was the capital of Germany, and Ōgai was thus burdened with the duties of public and private intercourse. He was especially under great strain wh...

War, Medicine, and Cultural Diplomacy in the Americas: Frank Wilson and Brazilian cardiology.

Science.gov (United States)

Kropf, Simone P; Howell, Joel D

2017-10-01

American cultural diplomacy played a key role in the institutionalization of Brazilian cardiology. In 1942, Frank Wilson, an internationally recognized pioneer in electrocardiography, made an extended wartime visit to Rio de Janeiro and São Paulo. The visit was sponsored by the United States Department of State as part of Roosevelt's Good Neighbor Policy and brought Wilson together with a group of physicians who would establish the specialty of cardiology in Brazil. This US cultural and diplomatic initiative strengthened an academic network that was already evolving and would eventually prove to be of benefit to both sides. Latin American physicians began in the 1920s to visit Wilson's laboratory at the University of Michigan, where they established the relationships on which Wilson would build. While affiliation with the "Wilson school" advanced the cause of Brazilian cardiologists who sought to establish themselves as specialists, cooperation with Latin American physicians benefitted Wilson in his pursuit of wider recognition for his innovations in the use of electrocardiography (ECG). Wilson's identity as a scientific ambassador to Latin America helped in legitimating his approach to the clinical application of the ECG. A close examination of Wilson's relationship to Brazilian cardiology demonstrates the role played by science and medicine as a part of wartime cultural diplomacy, as well as the dynamics of the transnational circulation of scientific knowledge and practices. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

Science.gov (United States)

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)

Weimar Germany

DEFF Research Database (Denmark)

Reckendrees, Alfred

2015-01-01

The Weimar Republic is analysed within the concept of limited and open access orders. Before World War I, Imperial Germany had developed into a mature limited access order with rule of law and open economic access but lack of competition in politics. After World War I and inflation, Weimar Germany...... developed toward an open access order; open access was not, however, sustainable and collapsed in 1930–31. This case of a failed open access order suggests refining the framework of limited and open access orders in further work. It shows that the political process of “creative destruction” might result...

Sanatorio para la infancia, en Munich

Directory of Open Access Journals (Sweden)

Haind, Friedrich F.

1964-10-01

Full Text Available The main objects to be met in the design this Children's Building were to provide suitable control and protection of the children, adequate working conditions for the nurses, and develop a pleasant family environment. This clinic is an extension of that run by the Sisters of Saint Benedict in Lechnerstrasse, Munich. It consists of two blocks, of 4 and 5 floor levels. It has a semibasement, housing the services, and some spare rooms and other facilities, described in the enclosed plans. The ground floor provides room for 25 beds, for the older boys. On the second floor there are 30 beds for those recently born, whilst the third floor has space for 30 beds for prematurely born babies. The nurses live in the attic, where there are 15 bedrooms, each with two beds, a kitchen and suitable auxiliary facilities. Much thought has been given to the design of details, the general distribution and circulation system has been planned with much care, and the overall functional efficiency of the building as a children's clinic has been kept a paramount factor. All this makes this building an outstanding one among those of this type.Los objetivos principales perseguidos aquí son: conseguir una eficaz vigilancia y protección de los niños; organizar los puestos de trabajo de las enfermeras para que resulten prácticos y agradables, y crear un ambiente familiar La clínica construida —como ampliación de las instalaciones que las Hermanas de San Benito poseen en la calle Lachner, en Munich— comprende dos cuerpos de edificio unidos, de 4 y 5 plantas de altura, respectivamente, y está distribuida del siguiente modo: el semisótano aloja, además de la zona de servicios, una serie de dependencias, que vienen descritas en la respectiva documentación gráfica. La planta baja alberga 25 camas; está destinada a los niños mayores y colegiales; la planta primera, con 30 camas, a los recién nacidos, y la planta segunda, con 30 camas, a la sección de prematuros

Primer on statistical interpretation or methods report card on propensity-score matching in the cardiology literature from 2004 to 2006: a systematic review.

Science.gov (United States)

Austin, Peter C

2008-09-01

Propensity-score matching is frequently used in the cardiology literature. Recent systematic reviews have found that this method is, in general, poorly implemented in the medical literature. The study objective was to examine the quality of the implementation of propensity-score matching in the general cardiology literature. A total of 44 articles published in the American Heart Journal, the American Journal of Cardiology, Circulation, the European Heart Journal, Heart, the International Journal of Cardiology, and the Journal of the American College of Cardiology between January 1, 2004, and December 31, 2006, were examined. Twenty of the 44 studies did not provide adequate information on how the propensity-score-matched pairs were formed. Fourteen studies did not report whether matching on the propensity score balanced baseline characteristics between treated and untreated subjects in the matched sample. Only 4 studies explicitly used statistical methods appropriate for matched studies to compare baseline characteristics between treated and untreated subjects. Only 11 (25%) of the 44 studies explicitly used statistical methods appropriate for the analysis of matched data when estimating the effect of treatment on the outcomes. Only 2 studies described the matching method used, assessed balance in baseline covariates by appropriate methods, and used appropriate statistical methods to estimate the treatment effect and its significance. Application of propensity-score matching was poor in the cardiology literature. Suggestions for improving the reporting and analysis of studies that use propensity-score matching are provided.

[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].

Science.gov (United States)

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. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Advances in Pediatric Cardiology Boot Camp: Boot Camp Training Promotes Fellowship Readiness and Enables Retention of Knowledge.

Science.gov (United States)

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 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.

A model-based approach to adjust microwave observations for operational applications: results of a campaign at Munich Airport in winter 2011/2012

Directory of Open Access Journals (Sweden)

J. Güldner

2013-10-01

Full Text Available In the frame of the project "LuFo iPort VIS" which focuses on the implementation of a site-specific visibility forecast, a field campaign was organised to offer detailed information to a numerical fog model. As part of additional observing activities, a 22-channel microwave radiometer profiler (MWRP was operating at the Munich Airport site in Germany from October 2011 to February 2012 in order to provide vertical temperature and humidity profiles as well as cloud liquid water information. Independently from the model-related aims of the campaign, the MWRP observations were used to study their capabilities to work in operational meteorological networks. Over the past decade a growing quantity of MWRP has been introduced and a user community (MWRnet was established to encourage activities directed at the set up of an operational network. On that account, the comparability of observations from different network sites plays a fundamental role for any applications in climatology and numerical weather forecast. In practice, however, systematic temperature and humidity differences (bias between MWRP retrievals and co-located radiosonde profiles were observed and reported by several authors. This bias can be caused by instrumental offsets and by the absorption model used in the retrieval algorithms as well as by applying a non-representative training data set. At the Lindenberg observatory, besides a neural network provided by the manufacturer, a measurement-based regression method was developed to reduce the bias. These regression operators are calculated on the basis of coincident radiosonde observations and MWRP brightness temperature (TB measurements. However, MWRP applications in a network require comparable results at just any site, even if no radiosondes are available. The motivation of this work is directed to a verification of the suitability of the operational local forecast model COSMO-EU of the Deutscher Wetterdienst (DWD for the calculation

Simulation based planning of surgical interventions in pediatric cardiology

Science.gov (United States)

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.

A study of the relationship between peak skin dose and cumulative air kerma in interventional neuroradiology and cardiology

International Nuclear Information System (INIS)

Neil, S; Padgham, C; Martin, C J

2010-01-01

A study of peak skin doses (PSDs) during neuroradiology and cardiology interventional procedures has been carried out using Gafchromic XR-RV2 film. Use of mosaics made from squares held in cling film has allowed doses to the head to be mapped successfully. The displayed cumulative air kerma (CAK) has been calibrated in terms of cumulative entrance surface dose (CESD) and results indicate that this can provide a reliable indicator of the PSD in neuroradiology. Results linking PSD to CESD for interventional cardiology were variable, but CAK is still considered to provide the best option for use as an indicator of potential radiation-induced effects. A CESD exceeding 3 Gy is considered a suitable action level for triggering follow-up of patients in neuroradiology and cardiology for possible skin effects. Application of dose action levels defined in this way would affect 8% of neurological embolisation procedures and 5% of cardiology ablation and multiple stent procedures at the hospitals where the investigations were carried out. A close relationship was observed between CESD and dose-area product (DAP) for particular types of procedure, and DAPs of 200-300 Gy cm 2 could be used as trigger levels where CAK readings were not available. The DAP value would depend on the mean field size and would need to be determined for each application.

Hospitalidade em festivais: avaliação comparada das Oktoberfest de Munique (RFA e Blumenau (SC/Brasil

Directory of Open Access Journals (Sweden)

Sérgio Luiz do Amaral Moretti

2016-01-01

Full Text Available The study of hospitality allows the understanding of the human relationships at the time of receiving the other and has become important concept to understand the perception of quality and customer satisfaction. Increased interest in festivals has led organizers to devote more attention to it. This article seeks to examine the subject and to this end we applied a survey in Oktoberfest Munich (Germany with 285 inquiries and, of Blumenau (S / C, Brazil with 432 inquiries based on SERVQUAL using their dimension Perceived Quality of Service, which is an innovative initiative in the research field of festivals. The analysis was performed using structural equation. In all aspects investigated for perceived quality (safety, empathy, reliability, service and tangibility, satisfaction rates were much more positive in Blumenau Oktoberfest, compared to the Oktoberfest in Munich. As in Munich, the beer choices make up the best‑rated item on the tangibility by patrons of the event in Blumenau, leaving extremely satisfied 72.9% of visitors.

Implementation of mild therapeutic hypothermia for post-resuscitation care of sudden cardiac arrest survivors in cardiology units in Poland.

Science.gov (United States)

Kołtowski, Łukasz; Malesa, Karolina; Tomaniak, Mariusz; Stępińska, Janina; Średniawa, Beata; Karolczyk, Paulina; Puchta, Dominika; Kowalik, Robert; Kremis, Elżbieta; Filipiak, Krzysztof J; Banaszewski, Marek; Opolski, Grzegorz; Bagińska, Marta

2017-11-01

The post-cardiac arrest (CA) period is often associated with secondary damage of the brain that leads to severe neurological deficits. The current practice guidelines recommend the use of therapeutic hypothermia (TH) to prevent neurological deficit and improve survival. The aim of the study was to investigate the implementation of medical guidelines in clinical practice and to evaluate the barriers for implementation of TH in cardiology units in Poland. A telephone survey, fax and online inquiry form were used to assess the implementation of TH in cardiology units in the management of unconscious patients after cardiac arrest (CA). The questions addressed the local practice, TH protocol, reasons for not using TH and outcomes of CA patients. We obtained information from 79 units out of 150 asked (53%). At the time of the survey, 24 units (30.8%) were using TH as part of their post-CA management. Of all CA patients, 45% underwent TH in cardiac intensive care units (CICU), 37.5% in the coronary care unit (CCU) and 12.5% in the intensive care unit (ICU). The major barrier for the implementation of TH declared by the non-cooling centers was lack of sufficient knowledge regarding the technique and protocol, as well as experience (37%); access to dedicated equipment was not perceived as an obstacle. The number of cardiology units that provide TH for comatose CA patients is low. The main limiting factor for wider use of TH is lack of knowledge and experience. There is a clear need for urgent educational activities for cardiology units. The benefits of TH still have not reached their potential in cardiology units.

Optimizing cardiology capacity to reduce emergency department boarding: a systems engineering approach.

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Levin, Scott R; Dittus, Robert; Aronsky, Dominik; Weinger, Matthew B; Han, Jin; Boord, Jeffrey; France, Daniel

2008-12-01

Patient safety and emergency department (ED) functionality are compromised when inefficient coordination between hospital departments impedes ED patients' access to inpatient cardiac care. The objective of this study was to determine how bed demand from competing cardiology admission sources affects ED patients' access to inpatient cardiac care. A stochastic discrete event simulation of hospital patient flow predicted ED patient boarding time, defined as the time interval between cardiology admission request to inpatient bed placement, as the primary outcome measure. The simulation was built and tested from 1 year of patient flow data and was used to examine prospective strategies to reduce cardiology patient boarding time. Boarding time for the 1,591 ED patients who were admitted to the cardiac telemetry unit averaged 5.3 hours (median 3.1, interquartile range 1.5-6.9). Demographic and clinical patient characteristics were not significant predictors of boarding time. Measurements of bed demand from competing admission sources significantly predicted boarding time, with catheterization laboratory demand levels being the most influential. Hospital policy required that a telemetry bed be held for each electively scheduled catheterization patient, yet the analysis revealed that 70.4% (95% CI 51.2-92.5) of these patients did not transfer to a telemetry bed and were discharged home each day. Results of simulation-based analyses showed that moving one afternoon scheduled elective catheterization case to before noon resulted in a 20-minute reduction in average boarding time compared to a 9-minute reduction achieved by increasing capacity by one additional telemetry bed. Scheduling and bed management practices based on measured patient transfer patterns can reduce inpatient bed blocking, optimize hospital capacity, and improve ED patient access.

[Structure and career advancement in cardiology in Italy].

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Modena, M G; Molinari, R; Lalla, M

1999-03-01

Women are less present on the labor market and many studies have demonstrated the existence of gender differences regarding participation rate and career advancement of women. The process through which job-, career- and research-related choices are structured within the realm of Italian cardiology, is described in this study emphasizing the effects of productivity, gender and family commitments. In June 1996, a questionnaire was mailed to all members of the Italian societies of cardiology. It included mainly (pre-coded) set-choice questions concerning individual characteristics, career-related data, and information pertaining to teaching, scientific and research activity. Returned questionnaires numbered 1715 (21.4% of the total mailed), 83% were completed by males and 17% by females. For both hospital and academic careers, advancement in rank was influenced by variables denoting productivity, family and individual characteristics. Promotion to the upper ranks of the hierarchy was highly dependent upon time (once the effects of the covariates were eliminated). This is a situation that is typical of the internal labor market, that is, of an institution in which staff members are ranked on a hierarchical scale according to formal criteria that are "rigid" and institutionalized, partially and totally sheltered from competition. Therefore, once a member has gained access to the first level of the hierarchy, his/her professional career is to a certain extent pre-determined and the seniority ends up taking on importance in promotion decisions to an appreciable extent; in this field, the weight of seniority on promotion ranges between 30 and 50%.

Cegelec Germany

International Nuclear Information System (INIS)

2011-01-01

Cegelec is a group of companies acting internationally and one of Europe's biggest plant engineering firms in the fields of power generation and distribution with the focus on engineering and technical services. Cegelec's competences in Germany are mainly in planning, installation and maintenance of plants and facilities in all key industries and for public clients. The main areas of activity are industry, infrastructure and power, for which Cegelec offers comprehensive project and service work. While the Industry business area covers chemistry, steel, paper, automotive, re-engineering, and mining industries, Cegelec's Infrastructure unit performs services to airports, in tunnel construction, for railways and waterways. The Power market segment comprises gas, refuse incineration, power supply, sugar, power plants, and nuclear final storage. Cegelec is represented in Germany on roughly 30 locations with a staff of 1,700. The origins of Cegelec are in Germany, i.e. in AEG founded 1896. The Plant and Automation Technology sector was divested in 1996 and moved to Alstom where, in 2001, a management buyout led to the independent Cegelec group of companies. When the strategic partnership between Qatari Diar and Vinci took shape, Cegelec became a subsidiary of the Vinci group in April 2010. (orig.)

Clinical features and prognosis of patients with acute non-specific chest pain in emergency and cardiology departments after the introduction of high-sensitivity troponins

DEFF Research Database (Denmark)

Ilangkovan, Nivethitha; Mickley, Hans; Diederichsen, Axel

2017-01-01

OBJECTIVES: To determine the incidence of clinical, cardiac-related endpoints and mortality among patients presenting to an emergency or cardiology department with non-specific chest pain (NSCP), and who receive testing with a high-sensitivity troponin. A second objective was to identify risk...... factors for the above-noted endpoints during 12 months of follow-up. DESIGN: A prospective multicentre study. SETTING: Emergency and cardiology departments in Southern Denmark. SUBJECTS: The study enrolled 1027 patients who were assessed for acute chest pain in an emergency or cardiology department...

3. European conference of TRIGA users. Papers and abstracts

International Nuclear Information System (INIS)

1974-01-01

The Third European Conference of TRIGA Users was held October 29-31, 1974, in Neuherberg near Munich, Germany under the sponsorship of the Gesellschaft fur Strahlen and Umweltforschung mbH, Physikalischen-Technische Ableilung. The main topics were: experience in reactor operation, maintenance, measurements, fuel management and fuel performance, neutron physical experiments and other research programs

Live cell imaging at the Munich ion microbeam SNAKE – a status report

International Nuclear Information System (INIS)

Drexler, Guido A; Siebenwirth, Christian; Drexler, Sophie E; Girst, Stefanie; Greubel, Christoph; Dollinger, Günther; Friedl, Anna A

2015-01-01

Ion microbeams are important tools in radiobiological research. Still, the worldwide number of ion microbeam facilities where biological experiments can be performed is limited. Even fewer facilities combine ion microirradiation with live-cell imaging to allow microscopic observation of cellular response reactions starting very fast after irradiation and continuing for many hours. At SNAKE, the ion microbeam facility at the Munich 14 MV tandem accelerator, a large variety of biological experiments are performed on a regular basis. Here, recent developments and ongoing research projects at the ion microbeam SNAKE are presented with specific emphasis on live-cell imaging experiments. An overview of the technical details of the setup is given, including examples of suitable biological samples. By ion beam focusing to submicrometer beam spot size and single ion detection it is possible to target subcellular structures with defined numbers of ions. Focusing of high numbers of ions to single spots allows studying the influence of high local damage density on recruitment of damage response proteins. The online version of this article (doi:10.1186/s13014-015-0350-7) contains supplementary material, which is available to authorized users

Germany at CERN

CERN Document Server

2001-01-01

The Eighth Exhibition of German Industry, "Germany at CERN" started this week and offers German companies the opportunity to establish professional contacts with CERN. From left to right in the foreground: Maximilian Metzger (BMBF), Bettinna Schöneseffen (BMBF), Karl-Heinz Kissler (SPL division leader), Horst Wenninger, and Hans Hoffman. Behind and to the right of Karl-Heinz Kissler is His Excellency Mr Walter Lewalter, Ambassador and permanent representative of Germany to the UN office in Geneva.

Radioiodine therapy in patients with Graves' disease: Comparison of outcome between Freiburg and Munich

International Nuclear Information System (INIS)

Moser, E.; Dagres, E.; Blattmann, H.; Kreisig, T.; Mann, K.

1990-01-01

The aim on this paper was to compare the results of radioiodine therapy (RIT) in patients with Graves' disease treated at two different nuclear medicine departments, Freiburg (FR); Munich (M). A low dose concept applying 60-80 Gy provides only a moderate rate of success: FR (80 Gy): 80%; M (60 Gy): 54%. A dose of 150 Gy, however, succeeds in 81% of the FR-cases and in 86% of the M-cases. As a consequence, this 150 Gy approach has a higher incidence of post-treatment hypothyroidism: FR: 49%; M: 62%. As the rate of post-treatment hypothyroidism seems to be independent of the dose concept these early post-treatment numbers will increase by about 4% per year in all patients. Nevertheless, the high dose concept is recommended, because the aim of RIT is to remove hyperthyroidism reliably, as the surgeons have told us. A hypothyroidism after RIT of Graves' disease, however, is the lesser evil compared to remaining or recurrent hyperthyroidism since these patients can be treated with thyroid hormones without problems. (orig.) [de

[Presentation of the Psycho-Cardiological schedule and convergence levels analyses among the psycho-cardiological screening and the psychological assessment].

Science.gov (United States)

Pierobon, Antonia; Callegari, Simona; Giardini, Anna; Ferrari, Marina; Olmetti, Francesca; Corbellini, Daniela; Febo, Oreste; Majani, Giuseppina

2012-06-01

In Cardiovascular Rehabilitation the increasing inpatients complexity suggests the necessity to develop screening methods which allow to identify those patients that require a psychological intervention. A Psycho-Cardiological Schedule (PCS) was developed with the aim of detecting the critical situation indicators or the presence of psychological, social and cognitive problems. The PCS, compiled by a nurse or cardiologist in collaboration with a psychologist, allows to assess the need for a deeper psychological examination, clinical and/or with tests. Aim of the present study is to identify the convergence levels among the observational and anamnestic data of the PCS collected by a nurse and the clinical and/or test data of the psychological deeper assessment. Among the 87 patients recruited in January-February 2010, 28 (aged 53.5 +/- 12.6, M = 20, F = 8) fulfilled the criteria for a deeper psychological examination: age psychological/behavioural problems, neuropsychological disorders, low adherence to prescriptions, inadequate disease knowledge/representation. From data comparisons emerged convergence levels with 100% concordance as to smoke habits and problems in social-family support. High convergence levels also resulted as to emotional and/or behavioural problems (92.8%) and inadequate adherence to prescriptions (89.3%). Lower levels of concordance (82.1%) emerged when considering disease knowledge/representation, issues specifically linked to cognition and subjective illness experience, not directly detectable from behaviour. our data confirm the synergic efficacy of the two evaluations: the Psycho-Cardiological Schedule reliably identifies the problematic macro-categories, mainly if they are characterized by behavioural indicators, which facilitate the detection. The psychological approach appears more suitable for better specifing macro-categories characteristics and for detecting critical aspects not overt but not less important, providing therefore advice

Comparative study between ultrasonography and optical coherence tomography in interventional cardiology

Science.gov (United States)

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.

Comparison of working length control consistency between hand K-files and Mtwo NiTi rotary system.

Science.gov (United States)

Krajczár, Károly; Varga, Enikő; Marada, Gyula; Jeges, Sára; Tóth, Vilmos

2016-04-01

The purpose of this study was to investigate the consistency of working length control between hand instrumentation in comparison to engine driven Mtwo nickel-titanium rotary files. Forty extracted maxillary molars were selected and divided onto two parallel groups. The working lengths of the mesiobuccal root canals were estimated. The teeth were fixed in a phantom head. The root canal preparation was carried out group 1 (n=20) with hand K-files, (VDW, Munich, Germany) and group 2 (n=20) with Mtwo instruments (VDW, Munich, Germany). Vestibulo-oral and mesio-distal directional x-ray images were taken before the preparation with #10 K-file, inserted into the mesiobuccal root canal to the working length, and after preparation with #25, #30 and #40 files. Working lenght changes were detected with measurements between the radiological apex and the instrument tips. In the Mtwo group a difference in the working competency (protary files. Mtwo NiTi rotary file did therefore proved to be more accurate in comparison to the conventional hand instrumentation. Working length, Mtwo, nickel-titanium, hand preparation, engine driven preparation.

Assessing the costs and benefits of perioperative iron deficiency anemia management with ferric carboxymaltose in Germany

Directory of Open Access Journals (Sweden)

Froessler B

2018-04-01

Full Text Available Bernd Froessler,1,2 Alexandra M Rueger,3,4 Mark P Connolly5,6 1Department of Anesthesia, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia; 2Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA, Australia; 3Vifor Pharma, Munich, Germany; 4Charité Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Kardiologie Campus Virchow-Klinikum, Berlin, Germany; 5Unit of PharmacoEpidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands; 6Global Market Access Solutions Sàrl, St-Prex, Switzerland Background: Perioperative administration of ferric carboxymaltose (FCM was previously shown to reduce both the need for transfusions and the hospital length of stay in patients with preoperative iron deficiency anemia (IDA. In this study, we estimated the economic consequences of perioperative administration using FCM vs usual care in patients with IDA from the perspective of a German hospital using decision-analytic modeling.Materials and methods: The model was populated with clinical inputs (transfusion rates, blood units transfused, hospital length of stay from a previously reported randomized trial comparing FCM vs usual care for managing IDA patients undergoing elective abdominal surgery. We applied a hospital perspective to all costs, excluding surgery-related costs in both treatment arms. One-way sensitivity analyses were undertaken to evaluate key drivers of cost analysis.Results: The average costs per case treated using FCM compared to usual care were €2,461 and €3,246, respectively, for resource expenses paid by hospital per case. This would suggest potential savings achieved with preoperative intravenous iron treatment per patient of €786 per case. A sensitivity analysis varying the key input parameters indicated the cost analysis is most sensitive to changes in the length of stay and the cost of hospitalization per day.Conclusion: Perioperative administration

Assessment and Utility of Frailty Measures in Critical Illness, Cardiology, and Cardiac Surgery.

Science.gov (United States)

Rajabali, Naheed; Rolfson, Darryl; Bagshaw, Sean M

2016-09-01

Frailty is a clearly emerging theme in acute care medicine, with obvious prognostic and health resource implications. "Frailty" is a term used to describe a multidimensional syndrome of loss of homeostatic reserves that gives rise to a vulnerability to adverse outcomes after relatively minor stressor events. This is conceptually simple, yet there has been little consensus on the operational definition. The gold standard method to diagnose frailty remains a comprehensive geriatric assessment; however, a variety of validated physical performance measures, judgement-based tools, and multidimensional scales are being applied in critical care, cardiology, and cardiac surgery settings, including open cardiac surgery and transcatheter aortic value replacement. Frailty is common among patients admitted to the intensive care unit and correlates with an increased risk for adverse events, increased resource use, and less favourable patient-centred outcomes. Analogous findings have been described across selected acute cardiology and cardiac surgical settings, in particular those that commonly intersect with critical care services. The optimal methods for screening and diagnosing frailty across these settings remains an active area of investigation. Routine assessment for frailty conceivably has numerous purported benefits for patients, families, health care providers, and health administrators through better informed decision-making regarding treatments or goals of care, prognosis for survival, expectations for recovery, risk of complications, and expected resource use. In this review, we discuss the measurement of frailty and its utility in patients with critical illness and in cardiology and cardiac surgery settings. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Ambulatory cardiology network in Greece: Clinical and therapeutic implications in the outpatient setting. The TEVE-SSF study.

Science.gov (United States)

Panagiotopoulos, Konstantinos E; Panagiotopoulou, Eleni E; Katsaros, Konstantinos; Noikokirakis, Georgios; Mpouziou, Maria; Stamelou, Angeliki; Toumanidis, Savvas

2016-11-15

Community based registries are particularly valuable tools to Preventive Cardiology as they summarize epidemiological data of ischemic heart disease risk factors, medications and lifestyle characteristics. We enrolled 1191 patients, from an outpatient community based cardiology network, dedicated to cover medically, office based professionals. We recorded demographic and lifestyle characteristics, risk factors for ischemic heart disease, all clinical entities diagnosed and therapies which were prescribed for hypertension and lipid disorders specifically. Our population consisted of 659 males (55%) and 532 females (45%), (mean age 46±14). A sedentary lifestyle was almost universal (92%), followed by smoking (44%) and overweight body composition (38%). Unhealthy lifestyle increased significantly during the third decade of life, while multimorbidity ascended during the fifth. Cardiovascular morbidity was present in 611 patients (51%), while 289 patients (24%) were found negative for cardiovascular disease and positive for a different system diagnosis. Lipid disorders (32%) and hypertension (31%) were the most frequent cardiovascular entities. β-Blockers and statins were the most frequently prescribed medications for hypertension and lipid disorders respectively. Cardiovascular morbidity was frequent in this ambulatory middle aged population, whereas multimorbidity (mainly from gastrointestinal and endocrine system) was a significant coexisting problem, even for a cardiology oriented outpatient population. Unhealthy lifestyle is of major importance because it was present in the majority of our patients early in their life and because it was statistically related to hyperlipidemia and hypertension. Preventive Cardiology must introduce special interventions to deescalate the presence of unhealthy lifestyle in young populations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Dental tourism from Switzerland to Germany.

Science.gov (United States)

Gheorghe, Raluca; Zürcher, Andrea; Filippi, Andreas

In recent years the topic of dental tourism has increasingly come into focus of dentists and patients. In the present study an attempt was made to find out, why patients from a restricted region travel to Germany for dental care. In five German dental clinics located in the border area between Switzerland and Germany, 272 women and 236 men ranging in age from 5 to 94 years, who had undergone at least one dental treatment in Germany, were questioned concerning the reasons for their visits. The interviews took place within a period of 6 months and relied on a questionnaire to collect data regarding sociodemographic features and patient behavior. In comparison to residents of Germany, patients residing in Switzerland took on considerably longer travel distances for the dental visit, in some cases more than 50km (9.7%). For patients residing in Switzerland the technical equipment of the practice was more important (pSwitzerland (95.6%) confirmed that dental treatments in Germany were cheaper and that additional family members also came to Germany for dental care (65.0%).

Germany: Management of decommissioning waste in Germany

International Nuclear Information System (INIS)

Borrmann, F.; Brennecke, P.; Koch, W.; Kugel, K.; Steyer, S.

2007-01-01

Over the past two decades, Germany has gained a substantial amount of experience in the decommissioning of nuclear facilities of different types and sizes. Many research reactors and all prototype nuclear power plants, as well as a few larger nuclear power plants and fuel cycle facilities, are currently at varying stages of decommissioning. Several facilities have been fully dismantled and the sites have been cleared for reuse. The decommissioning projects comprise 18 power and prototype reactors, 33 research reactors and 11 fuel cycle facilities which are being or have been decommissioned. In the future, further nuclear power plants will be shut down and decommissioned in accordance with Germany?s energy policy to phase out the use of nuclear power for commercial electricity generation as given in the April 2002 amendment of the Atomic Energy Act. Radioactive waste, from operations as well as from decommissioning activities, is to be conditioned in such a way as to comply with the waste acceptance requirements of a repository. In Germany, all types of radioactive waste (i.e., short-lived and long-lived) are to be disposed of in deep geological formations. A distinction is being made for heat generating waste (i.e., high level waste) and waste with negligible heat generation (i.e., low level and intermediate level waste). Radioactive decommissioning waste is waste with negligible heat generation. Waste acceptance requirements of a repository are of particular importance for the conditioning of radioactive waste, including decommissioning waste. The waste acceptance requirements, as they resulted from the Konrad licensing procedure, are being applied by the waste generators for the conditioning of decommissioning waste. Compliance with these requirements must be demonstrated through the waste package quality control, even if the waste will be disposed of in the future. In 2002 the Konrad repository was licensed for the disposal of all types of waste with negligible

Baron von Zach's business relations with the Munich entrepreneur Joseph von Utzschneider (German Title: Geschäftsbeziehungen des Barons von Zach zu dem Münchner Unternehmer Joseph von Utzschneider)

Science.gov (United States)

Schneider, Ivo

The relationship between the astronomer von Zach on the one side and the entrepreneur Joseph von Utzschneider and his partner Georg von Reichenbach on the other dates presumably from the year 1807 when Zach spent two months in Munich. Already in the same year Zach had ordered an instrument for himself and began to solicit business for the institute of Reichenbach, Utzschneider, and Liebherr, which was founded in 1804. One of the clients canvassed by Zach was the director of the observatory in Naples Zuccari. Zuccari had ordered the whole equipment for the new observatory from this institute in 1813. The instruments for Naples, which were completed in 1814, were sent accompanied by Reichenbach by land and sea to their destination where Reichenbach supervised their setup. At that time Reichenbach had separated from Utzschneider who kept the optical institute in Benediktbeuern with his new partner Joseph von Fraunhofer whereas Reichenbach became owner of the mathematical-mechanical institute in Munich. For personal and economical reasons Utzschneider began soon after to produce not only optical glass but also optical devices similar to those offered by Reichenbach. As soon as two institutes in Munich competed against each other on the market for sophisticated geodetical and astronomical instruments Zach sided with Utzschneider. Zach's main professional argument for this decision was that both competitors got the optical glass for their instruments from Utzschneider's optical institute in Benediktbeuern. This meant that Utzschneider had first choice and so the optical part of his instruments could be considered as better than that of Reichenbach`s instruments. Zach's role as an agent in Italy and France for the sale of products coming from Utzschneider's manufactories is highlighted by three of Zach's letters to Utzschneider from 1817 and 1818, two of which are reproduced here for the first time.

Consumption Patterns of Nightlife Attendees in Munich: A Latent-Class Analysis.

Science.gov (United States)

Hannemann, Tessa-Virginia; Kraus, Ludwig; Piontek, Daniela

2017-09-19

The affinity for substance use among patrons of nightclubs has been well established. With novel psychoactive substances (NPS) quickly emerging on the European drug market, trends, and patterns of use are potentially changing. (1) The detection of subgroups of consumers in the electronic dance music scene of a major German metropolitan city, (2) describing the consumption patterns of these subgroups, (3) exploring the prevalence and type of NPS consumption in this population at nightlife events in Munich. A total of 1571 patrons answered questions regarding their own substance use and the emergence of NPS as well as their experience with these substances. A latent class analysis was employed to detect consumption patterns within the sample. A four class model was determined reflecting different consumption patterns: the conservative class (34.9%) whose substance was limited to cannabis; the traditional class (36.6%) which especially consumed traditional club drugs; the psychedelic class (17.5%) which, in addition to traditional club drugs also consumed psychedelic drugs; and an unselective class (10.9%) which displayed the greatest likelihood of consumption of all assessed drugs. "Smoking mixtures" and methylone were the new substances mentioned most often, the number of substances mentioned differed between latent classes. Specific strategies are needed to reduce harm in those displaying the riskiest substance use. Although NPS use is still a fringe phenomenon its prevalence is greater in this subpopulation than in the general population, especially among users in the high-risk unselective class.

Reflections

Indian Academy of Sciences (India)

physics, and to whom he always remained close - his sister Maja. .... moved to Munich at the beginning of 1882, when Albert was barely two years old. ... This was demonstrated during a further change in the sphere of activity of .... As is well known, in Germany one uses the polite form "Sie" for adults and for people who.

Endocrinological and Cardiological Late Effects Among Survivors of Childhood Acute Lymphoblastic Leukemia

Directory of Open Access Journals (Sweden)

Hale Ören

2013-09-01

Full Text Available Objective: Survival rates for childhood acute lymphoblastic leukemia (ALL have significantly improved and late effects of therapy have been important in the follow-up of survivors. The objective of this study is to identify the endocrinological and cardiological late effects of ALL patients treated in our pediatric hematology unit. Materials and Methods: Patients treated for ALL with BFM protocols after at least 5 years of diagnosis and not relapsed were included in the study. Endocrinological late effects (growth failure, obesity, insulin resistance, dyslipidemia, thyroid gland disorders, osteopenia/osteoporosis, and pubertal disorders and cardiological late effects were evaluated. The study group was evaluated with anthropometric measurements, body mass index, and laboratory testing of fasting glucose, insulin, serum lipids, thyroid functions, and bone mineral densities. Echocardiography and pulsed wave Doppler imaging were performed for analysis of cardiac functions. Results: Of the 38 ALL survivors, at least 1 adverse event occurred in 23 (60%, with 8 of them (21% having multiple problems. Six (16% of the survivors were obese and 8 (21% of them were overweight. Subjects who were overweight or obese at the time of diagnosis were more likely to be overweight or obese at last follow-up. Obesity was more frequently determined in patients who were younger than 6 years of age at the time of diagnosis. Insulin resistance was observed in 8 (21% subjects. Insulin resistance was more frequently seen in subjects who had family history of type 2 diabetes mellitus. Hyperlipidemia was detected in 8 (21% patients. Hypothyroidism or premature thelarche were detected in 2 children. Two survivors had osteopenia. Cardiovascular abnormalities occurred in one of the subjects with hypertension and cardiac diastolic dysfunction. Conclusion: We point out the necessity of follow-up of these patients for endocrinological and cardiological late effects, since at least

Recent advances in nuclear cardiology Hot-spot and cold-spot myocardial scintigraphy

International Nuclear Information System (INIS)

Willerson, J.T.; Lewis, S.E.; Buja, L.M.; Bonte, F.J.; Parkey, R.W.

1981-01-01

Nuclear cardiology is a comparatively new field of cardiovascular medicine in which technologic advances have provided relatively noninvasive means of evaluating cardiovascular abnormalities. The purpose of this two-part review is to emphasize some important recent advances and to place in perspective the advantages and disadvantages of those new techniques that are particularly useful clinically

Generation of a high-brightness pulsed positron beam for the Munich scanning positron microscope

Energy Technology Data Exchange (ETDEWEB)

Piochacz, Christian

2009-11-20

Within the present work the prerequisites for the operation of the Munich scanning positron microscope (SPM) at the high intense neutron induced positron source Munich (NEPOMUC) were established. This was accomplished in two steps: Firstly, a re-moderation device was installed at the positron beam facility NEPOMUC, which enhances the brightness of the positron beam for all connected experiments. The second step was the design, set up and initial operation of the SPM interface for the high efficient conversion of the continuous beam into a bunched beam. The in-pile positron source NEPOMUC creates a positron beam with a diameter of typically 7 mm, a kinetic energy of 1 keV and an energy spread of 50 eV. The NEPOMUC re-moderator generates from this beam a low energy positron beam (20 - 200 eV) with a diameter of less than 2 mm and an energy spread well below 2.5 eV. This was achieved with an excellent total efficiency of 6.55{+-}0.25 %. The re-moderator was not only the rst step to implement the SPM at NEPOMUc, it enables also the operation of the pulsed low energy positron beam system (PLEPS). Within the present work, at this spectrometer rst positron lifetime measurements were performed, which revealed the defect types of an ion irradiated uranium molybdenum alloy. Moreover, the instruments which were already connected to the positron beam facility bene ts considerably of the high brightness enhancement. In the new SPM interface an additional re-moderation stage enhances the brightness of the beam even more and will enable positron lifetime measurements at the SPM with a lateral resolution below 1 {mu}m. The efficiency of the re-moderation process in this second stage was 24.5{+-}4.5 %. In order to convert high efficiently the continuous positron beam into a pulsed beam with a repetition rate of 50 MHz and a pulse duration of less than 50 ps, a sub-harmonic pre-bucher was combined with two sine wave bunchers. Furthermore, the additional re-moderation stage of the

Generation of a high-brightness pulsed positron beam for the Munich scanning positron microscope

International Nuclear Information System (INIS)

Piochacz, Christian

2009-01-01

Within the present work the prerequisites for the operation of the Munich scanning positron microscope (SPM) at the high intense neutron induced positron source Munich (NEPOMUC) were established. This was accomplished in two steps: Firstly, a re-moderation device was installed at the positron beam facility NEPOMUC, which enhances the brightness of the positron beam for all connected experiments. The second step was the design, set up and initial operation of the SPM interface for the high efficient conversion of the continuous beam into a bunched beam. The in-pile positron source NEPOMUC creates a positron beam with a diameter of typically 7 mm, a kinetic energy of 1 keV and an energy spread of 50 eV. The NEPOMUC re-moderator generates from this beam a low energy positron beam (20 - 200 eV) with a diameter of less than 2 mm and an energy spread well below 2.5 eV. This was achieved with an excellent total efficiency of 6.55±0.25 %. The re-moderator was not only the rst step to implement the SPM at NEPOMUc, it enables also the operation of the pulsed low energy positron beam system (PLEPS). Within the present work, at this spectrometer rst positron lifetime measurements were performed, which revealed the defect types of an ion irradiated uranium molybdenum alloy. Moreover, the instruments which were already connected to the positron beam facility bene ts considerably of the high brightness enhancement. In the new SPM interface an additional re-moderation stage enhances the brightness of the beam even more and will enable positron lifetime measurements at the SPM with a lateral resolution below 1 μm. The efficiency of the re-moderation process in this second stage was 24.5±4.5 %. In order to convert high efficiently the continuous positron beam into a pulsed beam with a repetition rate of 50 MHz and a pulse duration of less than 50 ps, a sub-harmonic pre-bucher was combined with two sine wave bunchers. Furthermore, the additional re-moderation stage of the SPM

[Fostering of health economics in Germany].

Science.gov (United States)

Ulrich, V

2012-05-01

Health economics is now well established in Germany with the aim to apply economic tools to answer problems in health and health care. After a short review of the international development of health economics and the development in Germany in particular, the article looks at selected recent topics of health economic analysis in Germany (economic evaluation, industrial economics, health and education).

The dawn of a new era in onco-cardiology: The Kumamoto Classification.

Science.gov (United States)

Sueta, Daisuke; Tabata, Noriaki; Akasaka, Tomonori; Yamashita, Takayoshi; Ikemoto, Tomokazu; Hokimoto, Seiji

2016-10-01

The term "onco-cardiology" has been used in reference to cardiotoxicity in the treatment of malignant disease. In actual clinical situations, however, cardiovascular disease (CVD) associated with malignant disease and the concurrence of atherosclerotic disease with malignant disease are commonly observed, complicating the course of treatment. Patients with malignant disease associated with coronary artery disease often die from the cardiovascular disease, so it is essential to classify these disease states. Additionally, the prevalence of these classifications makes it easy to manage patients with malignant disease and coronary artery disease. We divided the broad field of onco-cardiology into 4 classifications based on clinical scenarios (CSs): CS1 represents the so-called paraneoplastic syndrome. CS2 represents cardiotoxicity during treatment of malignant diseases. CS3 represents the concurrence of atherosclerotic disease with malignant disease, and CS4 represents cardiovascular disease with benign tumors. This classification facilitates the management of patients with malignant disease and coronary artery disease by promoting not only the primary but also the secondary prevention of CVD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Lincoln Image in Germany

Directory of Open Access Journals (Sweden)

Jörg Nagler

2016-05-01

Full Text Available This essay investigates the enduring fascination with the sixteenth President of the United States in Germany. In general, his legacy and its evaluation changed in relation to the determinate historical contexts, beginning with the monarchial system, extending through the Weimar Republic, the Third Reich, and now the Federal Republic of Germany. Certain social and political individuals/groups in Germany used the image and iconography of Lincoln as a projection screen to support their own political objectives. Although there were always multiple layers of Lincoln representations in Germany, the dominant images were: the national unifier, the libertarian universalist, the emancipator, the defender of moral values, the modernizer, the democrat who used the power of the democratic state, the egalitarian self-made man from humble origins, and the defender of social justice and workingmen’s rights.

European Society of Cardiology Heart Failure Association Standards for delivering heart failure care

NARCIS (Netherlands)

McDonagh, Theresa A.; Blue, Lynda; Clark, Andrew L.; Dahlstroem, Ulf; Ekman, Inger; Lainscak, Mitja; McDonald, Kenneth; Ryder, Mary; Stroemberg, Anna; Jaarsma, Tiny

The management of heart failure (HF) is complex. As a consequence, most cardiology society guidelines now state that HF care should be delivered in a multiprofessional manner. The evidence base for this approach now means that the establishment of HF management programmes is a priority. This

International design competition. Formula student Germany; Internationaler Konstruktionswettbewerb. Formula Student Germany

Energy Technology Data Exchange (ETDEWEB)

Liebl, Johannes; Siebenpfeiffer, Wolfgang (eds.)

2011-11-15

Within the International Design Competition 2011 at the Hockenheimring (Federal Republic of Germany) the following contributions were presented: (1) Formula Student Germany - Experience the Future (Tim Hannig); (2) Live at the Hockenheimring 2011; (3) Cutaway Model of the FSC Winning Car - The GFR11c by the Global Formula Racing Team of the DHBW Ravensburg; (4) Formula Student Racecar with Selective Cylinder Deactivation (Alexander Titz); (5) Construction of a crankshaft for the RS11 (Stefan Buhl); (6) The Wheel Design of the ARG 11 (Megan Rotondo); (7) Cutaway Model of the FSE Winning Car - The DUT11 by the DUT Racing Team of the Delft University of Technology; (8) Formula Student Electric - E-Scrutineering (Ann-Christin Bartoelke); (9) Development of an E-motor for Formular Student Electric (Urs Leuthold); (10) The Battery Management System of the FHWT04e (Andreas Hagemeyer); (11) Overall Results 2011 at a Glance; (12) Show your Colours; (13) Formula Student Germany visiting China (Alia Pierce).

Metabolomics, a promising approach to translational research in cardiology

Directory of Open Access Journals (Sweden)

Martino Deidda

2015-12-01

In this article, we will provide a description of metabolomics in comparison with other, better known “omics” disciplines such as genomics and proteomics. In addition, we will review the current rationale for the implementation of metabolomics in cardiology, its basic methodology and the available data from human studies in this discipline. The topics covered will delineate the importance of being able to use the metabolomic information to understand the mechanisms of diseases from the perspective of systems biology, and as a non-invasive approach to the diagnosis, grading and treatment of cardiovascular diseases.

Improved cardiovascular diagnostic accuracy by pocket size imaging device in non-cardiologic outpatients: the NaUSiCa (Naples Ultrasound Stethoscope in Cardiology study

Directory of Open Access Journals (Sweden)

Schiattarella Pier

2010-11-01

Full Text Available Abstract Miniaturization has evolved in the creation of a pocket-size imaging device which can be utilized as an ultrasound stethoscope. This study assessed the additional diagnostic power of pocket size device by both experts operators and trainees in comparison with physical examination and its appropriateness of use in comparison with standard echo machine in a non-cardiologic population. Three hundred four consecutive non cardiologic outpatients underwent a sequential assessment including physical examination, pocket size imaging device and standard Doppler-echo exam. Pocket size device was used by both expert operators and trainees (who received specific training before the beginning of the study. All the operators were requested to give only visual, qualitative insights on specific issues. All standard Doppler-echo exams were performed by expert operators. One hundred two pocket size device exams were performed by experts and two hundred two by trainees. The time duration of the pocket size device exam was 304 ± 117 sec. Diagnosis of cardiac abnormalities was made in 38.2% of cases by physical examination and in 69.7% of cases by physical examination + pocket size device (additional diagnostic power = 31.5%, p In conclusion, pocket size device showed a relevant additional diagnostic value in comparison with physical examination. Sensitivity and specificity were good in experts and suboptimal in trainees. Specificity was particularly influenced by the level of experience. Training programs are needed for pocket size device users.

SFC/SFBMN guidelines update for nuclear cardiology procedures: stress testing in adults and children

International Nuclear Information System (INIS)

Manrique, A.; Marie, P.Y.; Maunoury, Ch.; Acar, Ph.; Agostini, D.

2002-01-01

The guidelines update for nuclear cardiology procedures are studied in this article. We find the minimum technique conditions for the stress testing practice, the recommendations for the different ischemia activation tests, the choice of the stress test. (N.C.)

Challenges of intra-institutional transfer of care from paediatric to adult congenital cardiology: the need for retention as well as transition.

Science.gov (United States)

Bohun, Claudine M; Woods, Patricia; Winter, Christiane; Mitchell, Julie; McLarry, Joel; Weiss, Joseph; Broberg, Craig S

2016-02-01

Transferring patients with CHD from paediatric to adult care has been challenging, especially across institutions. Within a single institution, some issues such as provider interaction, information exchange, or administrative directives should not play a significant role, and should favour successful transfer. We studied patients who were eligible for transfer to the adult congenital heart disease service within our institution in order to identify factors associated with successful transfer to adult care providers versus failure to transfer. Patients above18 years of age with CHD who were seen by paediatric cardiologists before January, 2008 were identified through a patient-care database. Records were reviewed to determine follow-up between 2008 and 2011 and to determine whether the patient was seen in the adult congenital cardiology clinic, paediatric cardiology clinic, or had no follow-up, and statistical comparisons were made between groups. After reviewing 916 records, 229 patients were considered eligible for transition to adult congenital cardiology. Of these, 77 (34%) were transferred successfully to adult congenital cardiology, 47 (21%) continued to be seen by paediatric cardiologists, and 105 (46%) were lost to follow-up. Those who transferred successfully differed with regard to complexity of diagnosis, insurance, and whether a formal referral was made by a paediatric care provider. Only a small fraction of the patients who were lost to follow-up could be contacted. Within a single institution, with shared information systems, administrations, and care providers, successful transfer from paediatric to adult congenital cardiology was still poor. Efforts for successful retention are just as vital as those for transfer.

Cardiology update

Directory of Open Access Journals (Sweden)

Sunil K Verma

2015-01-01

Full Text Available In the year 2014, there were certain remarkable trials that have changed the practice of cardiology and beyond that these tried to explained some long awaited unanswered questions. Like SIMPLICITY HTN-3 trial clearly explained the uselessness of renal denervation therapy in systemic hypertension. PARADIGM-HF trial provided positive data that may be useful to enrich the basket of medical treatment with a new drug LCZ 696 after a long time. Another important meta-analysis in heart failure questioned the status of beta blockers as standard therapy to improve prognosis in patients with concomitant heart failure and atrial fibrillation . In myocardial infraction , CvLPRIT trial supported the concept of complete revascularization at the time of primary PCI and TASTE trials failed to show expected benefit of thrombus aspiration in acute MI. FFR got more strength from FAME 2 trial. Another important question that was addressed in SECURITY trial was optimal duration of DAPT after second generation DES implantation. One year follow-up results of ABSORB II suggested that bioresorbable scaffolds are currently facing problem of stent thrombosis that might be taken care in near future with improvement in strut technology. Successful use of "Heart in a box" machine provided a major thrust for cardiac transplantation. SEARCH-AF evaluated the efficacy of a novel mobile health technology in the real world to screen for atrial fibrillation (now called as life style disease. A Meta-analysis provided a more comprehensive picture of the new oral anticoagulants as a therapeutic option in atrial fibrillation. Positive results for trans catheter pm-VSD closure in paediatric population were also demonstrated by a randomized controlled trial. Role of corticosteroids in tubercular pericarditis also got the answer in a trial published in 2014.

What is the purpose of launching World Journal of Cardiology?

OpenAIRE

Ma, Lian-Sheng

2009-01-01

The first issue of World Journal of Cardiology (WJC), whose preparatory work was initiated on December 13, 2009, will be published on December 31, 2009. The WJC Editorial Board has now been established and consists of 298 distinguished experts from 40 countries. Our purpose of launching WJC is to publish peer-reviewed, high-quality articles via an open-access online publishing model, thereby acting as a platform for communication between peers and the wider public, and maximizing the benefits...

Cardiology update 2016

Directory of Open Access Journals (Sweden)

Sunil Kumar Verma

2016-01-01

Full Text Available In the latter half of 2016, the important trials were ATMOSPHERE, INOVATE-HF, and IMPEDANCE-HF. The inclusion of angiotensin receptor–neprilysin inhibitor (valsartan/sacubitril and sinoatrial node modulator (ivabradine in the guidelines was a significant change. HOPE-3 was a major trial in 2016 expanding the dimension of statin use. ixCELL-DCM trial evaluated stem cells in dilated cardiomyopathy. Mobile-health and medication event monitoring system technology showed increasing use of technology in both prevention and treatment in cardiology. RIDDLE-non-ST-segment elevation myocardial infarction (NSTEMI studied the immediate versus delayed intervention in NSTEMI. In STEMI, DANAMI 3-DEFER trial evaluated the concept of immediate stent implantation or deferred stent implantation 48 h after the index procedure with standard primary percutaneous coronary intervention. EARLY-BAMI tested intravenous metoprolol in acute STEMI with the use of magnetic resonance imaging. The utility of “Chest Pain Choice” tool demonstrated shared decision-making between physician and patients in the context of chest pain. Risk factors profile and demographic and angiographic features of aorto-ostial atherosclerotic coronary artery disease are evaluated extensively. Transcatheter aortic valve replacement results in comparison to surgery and its association with volume, and in-hospital outcomes are also analyzed. The VANISH trial addressed a very critical issue in post-MI ICMP. Factors associated with erosion related to Amplatzer septal occluder in atrial septal defect closure are described in detail.

Reversing course: Germany`s response to the challenge of transboundary air pollution

Energy Technology Data Exchange (ETDEWEB)

Sprinz, D.F.; Wahl, A.

1998-03-01

Perhaps like no other country, Germany has radically changed its policies towards regulating air pollution in the European context. Acting originally as a dragger in the 1970s to regulate transboundary air pollutants due to pessimism about the relationship between causes and effects, Germany responded very decisively to its own damage assessment in the early 1980s. In particular the adverse effects to forests (`Waldsterben` or forest decline) led to the formulation of strict air pollution regulations in the domestic context, efforts to spread the regulatory system within the European Union, and activities within the United Nations Economic Commission for Europe to foster stronger, continent-wide emission reductions. Using three conceptual models (rational actor, domestic politics, and social learning), we show that Germany deviated strongly from the ideal policy cycle consisting of (i) domestic policy formulation, (ii) international negotiations, as well as (iii) implementation and compliance with the provisions of international environmental agreements. Both national policy-making as well as partial implementation have been well on the way towards compliance even before Germany entered international negotiations on substantive protocols. Therefore, one may conclude from this country study that push countries may use the results of their national policy processes to influence the policy of other countries. (orig.)

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

NARCIS (Netherlands)

Heidbuchel, H.; Papadakis, M.; Panhuyzen-Goedkoop, N.M.; Carre, F.; Dugmore, D.; Mellwig, K.P.; Rasmusen, H.K.; Solberg, E.E.; Borjesson, M.; Corrado, D.; Pelliccia, A.; Sharma, S.

2013-01-01

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

[Cardiologic application of a clinical database with graphic extension and its utilization in inter-hospital teleconsultation].

Science.gov (United States)

Cervesato, E; Nicolosi, G L; Zanuttini, D

1995-10-01

A local area network of personal computers has been operative in our Cardiology Department for seven years, to collect and retrieve on-line character-based data. At present, the network is based on 2 servers and 21 workstations. DBF and DOS files are used by a Clipper 5.2d compiled program to handle demographic data, clinical reports (32,000/year) and diagnostic codes of more than 52,000 patients. In the last two years, we started entring ECG tracings using: RS232 connection, floppy disk transfer, and modem connection with commercially available machines as well as by image scanner. We integrated our clinical database with three dedicated subsystems, written in Assembly and C languages, to manage drawings, digital ECGs and complete reports. Mass storage is provided by a 10 Gbyte magneto-optical disk autochanger physically connected to a dedicated server running an original software manager to optimize routine access to the optical disks. Interhospital network connections were established with two different institutions to allow clinical information sharing, long distance consultation and ECG transfer. The system has been found to be fast, user-friendly and suitable for daily operation of a large cardiological database. Standardized versions of the system are running in seven other cardiology institutions in Italy.

Sister chromatid exchange analysis and chromosoma aberration studies in interventional cardiology laboratory workers. One year follow up study

International Nuclear Information System (INIS)

Erol, M.K.; Oztas, S.; Bozkurt, E.; Karakelleoglu, S.

2002-01-01

Invasive cardiology laboratory workers are occupationally exposed to chronic ionizing radiation. It is known that ionizing radiation has a damaging effect on chromosomes. In present study, we investigated the frequency of sister chromatid exchange (SCE) and chromosomal aberrations in 11 invasive cardiology laboratory workers and 11 healthy controls. After a vacation period, we took blood samples for chromosome analysis in months 0, 4, 8 and 12 (last two month period was the nonradiation time). The SCE frequencies did not change significantly after exposure to ionizing radiation in any worker. Our study has revealed that non-specific structural chromosome aberrations such as gaps, isogaps, acentric chromosomes, chromatids and chromosome breakage could be in the 4th and 8th months after ionizing radiation exposure in the metaphase plaques. All abnormal chromosomal effects had disappeared by the end of the two month non-exposure period in each worker. In conclusion, the results suggest that SCE frequencies are not significantly affected in invasive cardiology laboratory workers who are exposed occupationally to ionizing radiation, although some degree of reversible chromosomal aberrations did appear. (author)

Man-made radioactivity of surface air and precipitation Munich-Neuherberg 1970-1975

International Nuclear Information System (INIS)

Hoetzl, H.; Rosner, G.; Winkler, R.

1976-07-01

The activity concentration of a number of artificial radionuclides and of Be 7 in surface air and the deposition of these nuclides to the ground by the precipitation is measured since 1970 resp. 1971 at Neuherberg near Munich. Air dust filters are compressed to give a pellet and precipitation is evaporated to a small volume before γ-spectrometry using a Ge(Li)-detector. After ashing of the samples Pusup(238, 239, 240) and Fe 55 are separated radiochemically and measured by alpha respectively X-ray spectrometry. The results, presented as monthly mean resp. sum values, are discussed and compared with results published by other authors (HASL, UKAEA, PTB, DWD a.o.). The contribution of artificial radioactivity to the radiation exposure from fallout nuclides during the years 1970 to 1975 was very low. Their concentration levels led to values of the annual intake, which are far beyond the admissible values according to the new Radiation Protection Ordinance of the FRG. With regard to the intake by inhalation Pu 239 is the most important of all observed nuclides, whereas in the case of ingestion Sr 90 is the critical nuclide. At this time the level of the activity concentration is mainly represented by the residual radioactivity from nuclear bomb tests. A continuous control is necessary because of the growth of nuclear power production and the increasing use of radionuclides. (orig.) [de

Prospective Analysis of Decision Making During Joint Cardiology Cardiothoracic Conference in Treatment of 107 Consecutive Children with Congenital Heart Disease.

Science.gov (United States)

Duignan, Sophie; Ryan, Aedin; O'Keeffe, Dara; Kenny, Damien; McMahon, Colin J

2018-05-12

The complexity and potential biases involved in decision making have long been recognised and examined in both the aviation and business industries. More recently, the medical community have started to explore this concept and its particular importance in our field. Paediatric cardiology is a rapidly expanding field and for many of the conditions we treat, there is limited evidence available to support our decision-making. Variability exists within decision-making in paediatric cardiology and this may influence outcomes. There are no validated tools available to support and examine consistent decision-making for various treatment strategies in children with congenital heart disease in a multidisciplinary cardiology and cardiothoracic institution. Our primary objective was to analyse the complexity of decision-making for children with cardiac conditions in the context of our joint cardiology and cardiothoracic conference (JCC). Two paediatric cardiologists acted as investigators by observing the weekly joint cardiology-cardiothoracic surgery conference and prospectively evaluating the degree of complexity of decision-making in the management of 107 sequential children with congenital heart disease discussed. Additionally, the group consensus on the same patients was prospectively assessed to compare this to the independent observers. Of 107 consecutive children discussed at our JCC conference 32 (27%) went on to receive surgical intervention, 20 (17%) underwent catheterisation and 65 (56%) received medical treatment. There were 53 (50%) cases rated as simple by one senior observer, while 54 (50%) were rated as complex to some degree. There was high inter-observer agreement with a Krippendorff's alpha of ≥ 0.8 between 2 observers and between 2 observers and the group consensus as a whole for grading of the complexity of decision-making. Different decisions were occasionally made on patients with the same data set. Discussions revisiting the same patient, in

[Nuclear cardiology with new radiopharmaceuticals].

Science.gov (United States)

Bunko, H

1994-08-01

In the field of nuclear cardiology, 99mTc labeled myocardial perfusion agents such as MIBI, Tetrofosmin and Teboroxime, 111In-antimyosin for imaging of myocardial necrosis, 123I-betamethyl-iodophenylpentadecanoic acid (BMIPP) for imaging of myocardial fatty acid metabolism and 123I-metaiodobenzylguanidine (MIBG) for imaging of myocardial adrenergic function are introduced recently in Japan. Improved image quality and simultaneous evaluation of myocardial perfusion, function and wall motion can be obtained with use of 99mTc labeled myocardial perfusion agents. 111In-antimyosin enables specific imaging of myocardial necrosis which leads to the use for wide variety of heart diseases. Discrepancy of the myocardial perfusion and metabolism in case of stunned myocardium or cardiomyopathy can be evaluated by 123I-BMIPP in conjunction with perfusion agent. Recently wide variety of diseases which may have cardiac adrenergic abnormality are targeted for 123I-MIBG imaging. These new radiopharmaceuticals are expected to be powerful tool for evaluation of the pathophysiology including severity and prognosis and evaluation of the etiology of the various heart diseases.

Performance of handheld electrocardiogram devices to detect atrial fibrillation in a cardiology and geriatric ward setting.

Science.gov (United States)

Desteghe, Lien; Raymaekers, Zina; Lutin, Mark; Vijgen, Johan; Dilling-Boer, Dagmara; Koopman, Pieter; Schurmans, Joris; Vanduynhoven, Philippe; Dendale, Paul; Heidbuchel, Hein

2017-01-01

To determine the usability, accuracy, and cost-effectiveness of two handheld single-lead electrocardiogram (ECG) devices for atrial fibrillation (AF) screening in a hospital population with an increased risk for AF. Hospitalized patients (n = 445) at cardiological or geriatric wards were screened for AF by two handheld ECG devices (MyDiagnostick and AliveCor). The performance of the automated algorithm of each device was evaluated against a full 12-lead or 6-lead ECG recording. All ECGs and monitor tracings were also independently reviewed in a blinded fashion by two electrophysiologists. Time investments by nurses and physicians were tracked and used to estimate cost-effectiveness of different screening strategies. Handheld recordings were not possible in 7 and 21.4% of cardiology and geriatric patients, respectively, because they were not able to hold the devices properly. Even after the exclusion of patients with an implanted device, sensitivity and specificity of the automated algorithms were suboptimal (Cardiology: 81.8 and 94.2%, respectively, for MyDiagnostick; 54.5 and 97.5%, respectively, for AliveCor; Geriatrics: 89.5 and 95.7%, respectively, for MyDiagnostick; 78.9 and 97.9%, respectively, for AliveCor). A scenario based on automated AliveCor evaluation in patients without AF history and without an implanted device proved to be the most cost-effective method, with a provider cost to identify one new AF patient of €193 and €82 at cardiology and geriatrics, respectively. The cost to detect one preventable stroke per year would be €7535 and €1916, respectively (based on average CHA 2 DS 2 -VASc of 3.9 ± 2.0 and 5.0 ± 1.5, respectively). Manual interpretation increases sensitivity, but decreases specificity, doubling the cost per detected patient, but remains cheaper than sole 12-lead ECG screening. Using AliveCor or MyDiagnostick handheld recorders requires a structured screening strategy to be effective and cost-effective in a hospital setting

Radioiodinated fatty acids for cardiological diagnosis

International Nuclear Information System (INIS)

Machulla, H.-J.; Knust, E.J.

1986-01-01

The development of fatty acids labelled with iodine-123 is reviewed. The variety of methods for producing 123 I and introducing radioiodine into the molecule is discussed and the important points of the biochemical background are recalled with the aim of finding a broad application for 123 I-labelled fatty acids. The results of the pharmacokinetic studies and biochemical analysis are presented as they prove that both 17- 123 I-heptadecanoic acid (IHA) and 15-(rho- 123 I-phenyl)pentadecanoic acid (IPPA) exhibit analogous behaviour to that of the naturally occurring fatty acids. Clinical applications demonstrated two fields of importance: (i) applications solely for imaging the heart and (ii) assessment of myocardial turnover rates of fatty acids for functional diagnosis. Moreover, very recent studies show that the provision of information about prognosis of myocardial diseases and the applied cardiological therapy appear to be possible. (author)

Uranium mining in Eastern Germany

International Nuclear Information System (INIS)

Sauer, H.D.

1990-01-01

A problem which simply does not exist in Western Germany is the uranium mining in the South of Eastern Germany (SDAG Wismuth). The cleaning up and control measure which are urgently needed will be a task for more than one generation. (orig./HP) [de

Nuclear energy in Germany

International Nuclear Information System (INIS)

1999-01-01

Since September 1998 the Federal Government formed by a Red/Green Coalition declared its goal: irreversible phase out of nuclear power plants. The first attempt to stop reprocessing as well as the first attempt to change nuclear law failed. The present situation is as follows: existing nuclear power plants operate in a most satisfying way producing 170 TWh/a. i.e. 35% of total production; transport license is not granted; no new NPP is planned, but Germany will participate in the French European Power Reactor (EPR) project. Concerning fast reactors, no industrial activities exist in Germany. There is no intention to build a facility, but Germany participates in the European CAPRA project. Existing research items are related to neutronics, safety analysis, irradiation experiment TRABANT, accelerator driven systems, thermohydraulics, safety

Comparison of interventional cardiology in two European countries: a nationwide Internet based registry study.

Science.gov (United States)

Gudnason, T; Gudnadottir, G S; Lagerqvist, B; Eyjolfsson, K; Nilsson, T; Thorgeirsson, G; Thorgeirsson, G; Andersen, K; James, S

2013-09-30

The practice of interventional cardiology differs between countries and regions. In this study we report the results of the first nation-wide long-term comparison of interventional cardiology in two countries using a common web-based registry. The Swedish Coronary Angiography and Angioplasty Registry (SCAAR) was used to prospectively and continuously collect background-, quality-, and outcome parameters for all coronary angiographies (CA) and percutaneous coronary interventions (PCI) performed in Iceland and Sweden during one year. The rate of CA per million inhabitants was higher in Iceland than in Sweden. A higher proportion of patients had CA for stable angina in Iceland than in Sweden, while the opposite was true for ST elevation myocardial infarction. Left main stem stenosis was more commonly found in Iceland than in Sweden. The PCI rate was similar in the two countries as was the general success rate of PCI, achievement of complete revascularisation and the overall stent use. Drug eluting stents were more commonly used in Iceland (23% vs. 19%). The use of fractional flow reserve (0.2% vs. 10%) and the radial approach (0.6% vs. 33%) was more frequent in Sweden than in Iceland. Serious complications and death were very rare in both countries. By prospectively comparing interventional cardiology in two countries, using a common web based registry online, we have discovered important differences in technique and indications. A discovery such as this can lead to a change in clinical practice and inspire prospective multinational randomised registry trials in unselected, real world populations. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Evaluating a Dutch cardiology primary care plus intervention on the Triple Aim outcomes: study design of a practice-based quantitative and qualitative research.

Science.gov (United States)

Quanjel, Tessa C C; Spreeuwenberg, Marieke D; Struijs, Jeroen N; Baan, Caroline A; Ruwaard, Dirk

2017-09-06

In an attempt to deal with the pressures on the health-care system and to guarantee sustainability, changes are needed. This study focuses on a cardiology primary care plus intervention. Primary care plus (PC+) is a new health-care delivery model focused on substitution of specialist care in the hospital setting with specialist care in the primary care setting. The intervention consists of a cardiology PC+ centre in which cardiologists, supported by other health-care professionals, provide consultations in a primary care setting. The PC+ centre aims to improve the health of the population and quality of care as experienced by patients, and reduce the number of referrals to hospital-based outpatient specialist care in order to reduce health-care costs. These aims reflect the Triple Aim principle. Hence, the objectives of the study are to evaluate the cardiology PC+ centre in terms of the Triple Aim outcomes and to evaluate the process of the introduction of PC+. The study is a practice-based, quantitative study with a longitudinal observational design, and an additional qualitative study to supplement, interpret and improve the quantitative study. The study population of the quantitative part will consist of adult patients (≥18 years) with non-acute and low-complexity cardiology-related health complaints, who will be referred to the cardiology PC+ centre (intervention group) or hospital-based outpatient cardiology care (control group). All eligible patients will be asked to complete questionnaires at three different time points consisting of questions about their demographics, health status and experience of care. Additionally, quantitative data will be collected about health-care utilization and related health-care costs at the PC+ centre and the hospital. The qualitative part, consisting of semi-structured interviews, focus groups, and observations, is designed to evaluate the process as well as to amplify, clarify and explain quantitative results. This study

[Methods of investigation in clinical cardiology. VIII. Socioeconomic evaluation of clinical cardiology practice].

Science.gov (United States)

Lázaro de Mercado, P

1997-06-01

Health services are systems whose mission is to improve the health status of both individuals and society in general. In recent decades, these systems have faced challenges such as their increasing complexity, limited resources, rapid innovation and diffusion of medical technologies, pressures on demand from society and professionals, and the lack of knowledge of the effects of these factors on costs and society's health. In addition, health care expenditures have grown twice as fast as wealth in industrialized countries during the last 25 years. These problems have prompted cost containment as a key issue in health policy and, at the same time, have promoted the development of socioeconomic evaluation as a scientific activity in the frame of health services research. Socioeconomic evaluation tries to determine if the sacrifice made by society, which devotes part of its limited resources to health care, maximizes the outcomes for population. This article describes basic concepts and methods of economic appraisal in health services which are illustrated with examples of clinical practice in cardiology. Common methods of evaluation are described; the relation between the clinical outcome of a procedure and its associated costs is emphasized in explaining the types of efficiency analysis (cost-efficacy, cost-effectiveness, cost-utility, and cost-benefit); and finally a guide for socioeconomic evaluation is provided.

The covariance of air quality conditions in six cities in Southern Germany - The role of meteorology.

Science.gov (United States)

Dimitriou, Konstantinos; Kassomenos, Pavlos

2017-01-01

This paper analyzed air quality in six cities in Southern Germany (Ulm, Augsburg, Konstanz, Freiburg, Stuttgart and Munich), in conjunction with the prevailing synoptic conditions. Air quality was estimated through the calculation of a daily Air Stress Index (ASI) constituted by five independent components, each one expressing the contribution of one of the five main pollutants (PM 10 , O 3 , SO 2 , NO 2 and CO) to the total air stress. As it was deduced from ASI components, PM 10 from combustion sources and photochemically produced tropospheric O 3 are the most hazardous pollutants at the studied sites, throughout cold and warm periods respectively, yet PM 10 contribute substantially to the overall air stress during both seasons. The influence of anticyclonic high pressure systems, leading to atmospheric stagnation, was associated with increased ASI values, mainly due to the entrapment of PM 10 . Moderate air stress was generally estimated in all cities however a cleaner atmosphere was detected principally in Freiburg when North Europe was dominated by low pressure systems. Daily events of notably escalated ASI values were further analyzed with backward air mass trajectories. Throughout cold period, ASI episodes were commonly related to eastern airflows carrying exogenous PM 10 originated from eastern continental Europe. During warm period, ASI episodes were connected to the arrival of regionally circulated air parcels reflecting lack of dispersion and accumulation of pollutants in accordance with the synoptic analysis. Copyright © 2016 Elsevier B.V. All rights reserved.

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

International Nuclear Information System (INIS)

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

2003-01-01

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

Kerma rate evaluation in the air in a room interventional cardiology

International Nuclear Information System (INIS)

Real, Jessica V.; Luz, Renata M. da; Fröhlich, Bruna D.; Silva, Ana Maria Marques da

2014-01-01

In recent years, the number of interventional cardiology procedures is increasing. However, due to the long time of fluoroscopy in these procedures, care teams can receive high doses of radiation. The radiation scattered by the patient is not uniform, and their assessment is of utmost importance. This study aimed to estimate and map the kerma rate in the air at the time of the gonads, in an interventional cardiology room, seeking to optimize the dose absorbed by individuals occupationally exposed to ionizing radiation. For data collection, the room was divided into quadrants of 1m 2 , totaling 40 collection points. The simulator was positioned so that its entry surface was located in the interventional reference point. Were chosen the conditions that simulate angiography and angioplasty procedures performed in the service. The data were obtained for height of 1 meter, gonad region. The results obtained for kerma rates in air, in quadrants, show that higher measured values was in the vicinity of the X-ray tube. Has been found that the medical staff are more exposed, because of its location during the procedure, around the table. The law of the inverse square distance of the farthest points of the X-ray tube were verified

Magnetic resonance. Gamma Rays in cardiology laboratories

International Nuclear Information System (INIS)

Lombardi, M.

2001-01-01

In recent years Cardiologists have shown an increasing interest on the use of Magnetic Resonance Imaging (MRI) for assessing cardiovascular diseases. The first generation of MRI equipment dedicated to cardiology is now available. The MRI Laboratory of Clinical Physiology Institute in Pisa has joined a multi-centric international project for the development of prototype of this dedicated machine and is currently involved in several subprojects such as the study of myocardial perfusion and the assessment of congenital heart diseases. An interdisciplinary group (cardiologists, software and hardware engineers, biologists, etc.) is full time involved in the development of new analysis algorithms, etc. The new concept of installing a MRI machine within clinical cardiovascular department has started to induce fruitful cooperations either in the research field or in the clinical setting [it

Application of Contrast Echocardiography in Invasive Cardiology

Directory of Open Access Journals (Sweden)

Mustafa Bulut

2010-12-01

Full Text Available Contrast echocardiography by rendering better imaging of the borders of cardiac chambers is a useful tool for evaluating cardiac function, mass, myocardial vascularization, microvascular structure (small vessel vasculature and viability. Contrast was first started to be used for patients with suboptimal image quality. It can be used in detecting defects in myocardial blood supply in patients with chest pain and determining the success of interventionalprocedures. It can also be of help in demonstrating myocardial viability after reperfusion treatment in patients who had myocardial infarction. It is expected to be used more widely in invasive cardiology for decision making, guiding and determining the success of the procedures. Advances in imaging techniques , development of contrast materials for evaluation of left system, contrast echocardiography may become a routine clinical practice.

West-East migration in Germany since 1990

OpenAIRE

Beck, Grit

2011-01-01

Not only did 2.5 million people migrate from East Germany to West Germany between 1991 and 2006, 1.5 million people also moved from West to East Germany. This counter-current movement took placed largely unnoticed by the public and researchers alike. This paper uses both quantitative and qualitative data to first of all examine how the population structure in the New Länder has changed as a result of interregional migration between Länder in East and West Germany. It goes on to study the moti...

Atrial Fibrillation - A Common Ground for Neurology and Cardiology.

Science.gov (United States)

Abukhalil, Fawzi; Bodhit, Aakash; Cai, Peter Y; Ansari, Saeed; Thenkabail, Spandana; Ganji, Sarah; Saravanapavan, Pradeepan; Chandra Shekhar, Chandana; Waters, Michael F; Beaver, Thomas M; Shushrutha Hedna, Vishnumurthy

2013-01-01

Atrial fibrillation (AF) has a huge impact on clinical stroke because it is the primary cause of cardio-embolism, which constitutes ~20% of all strokes. As a result, there is a great need to explore safer and more effective primary and secondary prophylactic agents. In this article, we discuss the overlapping issues pertaining to AF from both a neurology and cardiology standpoint. We focus on the dynamic interplay of neurovascular and cardiovascular diseases in relation to AF, traditional and novel risk factors for AF leading to stroke, impact of AF on cognitive decline, and current upstream medical and surgical options for embolism prophylaxis.

Materials Research Society Symposium Proceedings on Diamond, SiC and Nitride Wide Bandgap Semiconductors Held at San Francisco, California on 4-8 April 1994. Volume 339.

Science.gov (United States)

1994-04-08

Investigaciones Cientificas y TUcnicas, Argentina. REFERENCES 1. Wide-band-gap Semiconductors, ed. C. G. Van de Walle, Proc. Seventh Trieste ICTP-IUPAP...Department E 16, Technical University of Munich, D-85747 Garching, Germany ** Departamento e Centro de Fisica (INIC), University of Aveiro, 3800...Departamento de Fisica , Universidade de Aveiro, 3800 Aveiro, Portugal ** National Institute for Research in Inorganic Materials, Namiki 1-1

The Motor and Cognitive Development of Overweight Preschool Children

Science.gov (United States)

Krombholz, Heinz

2012-01-01

The aim of this study was to investigate the development of overweight compared with healthy-weight children attending kindergartens in Munich, Germany. Mean age of the children at the beginning of the study was 53.2 months (SD = 7.5); the duration of the study was 20 months. At the beginning of the study children were classified as overweight (n…

Neuropathological research at the "Deutsche Forschungsanstalt fuer Psychiatrie" (German Institute for Psychiatric Research) in Munich (Kaiser-Wilhelm-Institute). Scientific utilization of children's organs from the "Kinderfachabteilungen" (Children's Special Departments) at Bavarian State Hospitals.

Science.gov (United States)

Steger, Florian

2006-09-01

During National Socialism, the politically motivated interest in psychiatric genetic research lead to the founding of research departments specialized in pathological-anatomical brain research, the two Kaiser Wilhelm-Institutes (KWI) in Berlin and Munich. The latter was indirectly provided with brain material by Bavarian State Hospitals, to three of which "Kinderfachabteilungen" (Special Pediatric Units) were affiliated. As children became victims of the systematically conducted child "euthanasia" in these Special Pediatric Units, this paper will address the question whether and to which extent the organs from victims of child "euthanasia" were used for (neuro-) pathological research at the KWI in Munich. By means of case studies and medical histories (with focus on the situation in Kaufbeuren-Irsee), I will argue that pediatric departments on a regular base delivered slide preparations, that the child "euthanasia" conduced in these departments systematically contributed to neuropathological research and that slide preparations from victims of child "euthanasia" were used in scientific publications after 1945.

Eine studentische Wiki-Bibliothek für unterrichtsbegleitende Materialien: Konzeption, Implementierung und Evaluation für das Medizinische Curriculum München (MeCuM [A student-driven wiki-library for educational materials: Concept, implementation, and evaluation for the Medical Curriculum Munich (MeCuM

Directory of Open Access Journals (Sweden)

Berger, Michael

2007-11-01

Full Text Available [english] Problem: The new study regulation for medical licensing in Germany has caused significant reform of the medical curricula. At Munich University (LMU, the Medical Curriculum Munich (MeCuM was introduced in 2004. More individual responsibility of the students regarding their academic goals as well as a problem-oriented thought process are essential features of the new curriculum. Through our project, an open web based platform for the design of curriculum-specific teaching and study material has become accessible to students and faculty of the MeCuM. Methods: Students created an online library in harmony with the curricular structure of the MeCuM. The technical implementation was carried out with the MediaWiki-Open-Source software. Contents can be edited from all students or faculty of the MeCuM in an anonymous or personalized manner. An online questionnaire was carried out to evaluate the project. Results: Our online library as a wiki is the first solution of this kind in medical education in Germany. The concept was implemented without technical difficulties and is linked to the official websites of LMU Munich. The website’s contents were visited 417,808 times from December 2005 through June 2007. Online-based evaluation showed that the project is positively recognized, and students are motivated to contribute actively. Discussion: The project closely reflects the academic curriculum of the MeCuM and creates additional opportunities for interaction between students and teachers. The design as an open source project allows easy handling as well as frequent control and ability to update the contents, but integrity and accuracy of the data content require further effort. Additional evaluation will be essential for improvements. The integration of faculty as reviewers and tutors is planned. Sustainability of the project is dependent upon continued student leadership. The concept of the project has been transferred to another medical

NORMAN HOLTER AND HIS METHOD OF REMOTE CARDIOLOGIC MONITORING. CASE HISTORY

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A. A. Rassadina

2013-01-01

Full Text Available This publication is devoted to the personality and creative designs of uncommon American scientist, the engineer and the inventor – Norman Jefferis «Jeff» Holter. Norman Jefferis Holter introduced the terminology of «nuclear medicine» for the name of the new at that time area which associated with employment of the achievements of the nuclear physics in the medical goals. Also he is the author of ambulatory cardiological monitoring.

The Paediatric Cardiology Hall of Fame – Donald Nixon Ross.

Science.gov (United States)

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.

Pharmacological stress agents in nuclear cardiology

International Nuclear Information System (INIS)

Buscombe, J.R.

2004-01-01

Treadmill test combined with myocardial perfusion scintigraphy (MPS) is a commonly used technique in the assessment of coronary artery disease. However there are a group of patients who may not be able to undergo treadmill tests. Patients with underlying conditions like neuromuscular disease, musculoskeletal disorder, heart failure and end-stage renal disease (ESRD) on renal dialysis would find it difficult to perform exercise on a treadmill or bicycle ergometer. These conditions prevent them from performing adequate exercise. Such patients would benefit from pharmacological stress procedures combined with MPS. Nuclear medicine departments use various pharmacological agents while performing stress tests on cardiac patients. The most commonly used pharmacological agents for cardiac stress are coronary vasodilators and catecholamines. In addition to these agents, adjuvant use of nitrates and atropine is also a common practice in nuclear cardiology. This review addresses various physiological and pharmacological properties of the commonly used pharmacological stress agents in MPS and critically analyses their advantages and disadvantages, as well as their safety and efficacy. (author)

How changes to the Medicare Benefits Schedule could improve the practice of cardiology and save taxpayer money.

Science.gov (United States)

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.

Farming for Health: Aspects from Germany

OpenAIRE

Neuberger, Konrad; Stephan, Ingrid; Hermanowski, Robert; Flake, Albrecht; Post, Franz-Joseph; van Elsen, Thomas

2006-01-01

Until now, the term ‘Farming for Health’ is unknown in Germany but it would cover a wide spectrum of different kinds of social agriculture already existing in Germany, such as farms that integrate disabled people or drug therapy into their farming system, or farms that integrate children, pupils or older people. Relevant work in Germany is done in ‘Sheltered Workshops’, where supporting and healing powers of farming and gardening are used for disabled people with a diversity of work possibili...

Social balcony construction. Modernisation of a nine-storey residential building; Sozialer Balkonbau. Modernisierung eines neungeschossigen Wohnblocks

Energy Technology Data Exchange (ETDEWEB)

Siegele, Klaus

2013-01-15

The architectural office Ebe +Ausfelder (Munich, Federal Republic of Germany) developed a concept of modernization for a residential building block in need of refurbishment within the multicultural Konrad district of Ingolstadt (Federal Republic of Germany). Beside the energetic refurbishment based on the KfW efficiency house 70 standard, this concept also considers the architectural upgrading of the building and its close environment. The south facade with the large balconies and moveable metal shutters are particularly striking. The jury of the price of design of the Wuestenrot foundation provided a certification for the exemplary renewal of the building structures from the 1960ies.

Innovative building automation concept for Pumavision Headquarters. Where Pimas are feeling well; Innovatives Gebaeudeautomationskonzept fuer Pumavision Headquarters. Wo Pumas sich wohl fuehlen sollen

Energy Technology Data Exchange (ETDEWEB)

Habermann, Ralf [IPM Gebaeudeleittechnik GmbH, Feucht bei Nuernberg (Germany); Kerz, Thomas [Siemens-Div. Building Technologies Deutschland, Frankfurt am Main (Germany). Business Unit CPS; Vogel, Helmut [Siemens-Div. Building Technologies Deutschland, Muenchen (Germany). Business Unit CPS Region Bayern

2011-03-15

The sport's and lifestyle company PUMA (Herzogenaurach, Federal Republic of Germany) claims the establishment of the first climate neutral corporate headquarter of its industry. Therefore, the electricity for the new 35,000 m{sup 2} large corporate headquarters exclusively results from renewable energy sources. The conversion of this goal is supported by the interdisciplinary building automation system Desigo from Siemens AG (Munich, Federal Republic of Germany). The basic heating and basic cooling of the main building are performed by a concrete core tempering. A part of the heating and cooling is produced by means of two heat pumps.

Evaluation of doses to staff involved in interventional cardiology in two Khartoum hospitals

International Nuclear Information System (INIS)

Bashir, M. K. A.

2009-11-01

In interventional cardiac procedures, staff operates near the patient in a non-uniformly scattered radiation field. Consequently, workers may receive, over a period of time, relatively high radiation doses. The measurement of individual doses to personnel becomes critical due to the use of protective devices and, as a consequence of the large number of methods proposed to assess the effective dose, In this study, staff doses were measured in two cardiac centers: Ahmed Gasim Hospital and Cardiac Center, Khartoum. The objective was to measure personal dose equivalent and accordingly estimate the effective dose which is received by staff in interventional cardiology. Measurements were performed using electronic personal dosimeters (EPDs) worn over lead apron during the examination and were read immediately following each examination. A total number of 40 radiation worker were monitored for a period of two weeks. The highest doses received by the cardiologist followed by nurses and then X-ray technicians. Staff received mean effective doses that ranged from 24 to 110 μSv estimated for four weeks. Recommendations on how to reduce staff doses in interventional cardiology are presented. (Author)

Therapeutic approach to patients complaining of high blood pressure in a cardiological emergency room

Directory of Open Access Journals (Sweden)

Miguel Gus

1999-03-01

Full Text Available OBJECTIVE: To evaluate the management of patients complaining of high blood pressure (BP in a cardiological emergency room. METHODS: Patients referred to the cardiological emergency room with the main complaint of high blood pressure were consecutively selected. The prescriptions and the choice of antihypertensive drugs were assessed. The classification of these patients as hypertensive emergencies or pseudoemergencies, according to the physician who provided initial care, was recorded. RESULTS: From a total of 858 patients presenting to the emergency room, 80 (9.3% complained of high BP, and 61 (76.3% received antihypertensive drugs. Sublingual nifedipine was the most commonly used drug (59%. One patient received intravenous medication, one patient was hospitalized and 6 patients (7.5% were classified as hypertensive emergencies or pseudoemergencies. CONCLUSION: High BP could seldom be classified as a hypertensive emergency or pseudoemergency, even though it was a frequent complaint (9.3% of visits. Currently, the therapeutic approach is not recommended, even in specialized clinics.

[Critical analysis of scales of quality of life in cardiology; applications to cardiac insufficiency].

Science.gov (United States)

Cohen-Solal, A; Caviezel, B; Laperche, T; Gourgon, R

1994-12-01

Scales of quality of life have only recently been imposed in cardiology. Essentially an Anglosaxon invention, they have been used for evaluating most treatment of cardiac failure. The main qualities of a good quality of life questionnaire are its sensitivity, its reproducibility and its validity. The contents of the questionnaire, particularly the relationship between items concerning symptoms and those concerning the psychological aspects of the disease, have a great influence on the quality of results. The "Living with Heart Failure Questionnaire" of the University of Minnesota is the most validated questionnaire at present. As with most other methods of therapeutic assessment in cardiology, the most recently obtained results from large multicenter trials, seem to show a much smaller benefit of drugs reputed to be effective in this condition, with respect to the quality of life of patients. This justifies: the continuation of validation of these questionnaires, a reflection on the efficacy of classical management of these patients.

Germany - an immigration country

OpenAIRE

Siebert, Horst

2003-01-01

Germany has about the same proportion of foreigners in its population as the United States, it is an immigration country. In a way, Germany has let immigration happen, but it did not really have an explicit immigration policy in the past. Now it has to make up its mind on its immigration policy in the future. The paper looks at the experience with immigration in the past, at the integration of foreigners and at the issues of immigration policy.

Self-reported "communication technology" usage in patients attending a cardiology outpatient clinic in a remote regional hospital.

Science.gov (United States)

Gandiya, Tariro; Dua, Anahita; King, Gerry; Mazzocco, Thomas; Hussain, Amir; Leslie, Stephen J

2012-04-01

This study assessed the perceived usage of, and attitudes toward, communication technologies (mobile phone and texting, e-mail, and the World Wide Web) in patients attending a cardiology clinic with a view to guiding future health service redesign. This was performed in a remote regional hospital serving both urban and rural populations. A self-completion questionnaire was completed by a convenience sample of 221 patients attending a general cardiology clinic. The questions asked about patients' access to and use of technology at home. Data collected also included age, gender, travel time to the clinic, mode of travel, and whether the respondent was accompanied to the clinic. Appropriate statistical tests were used with significance taken at the 0.05 level. Age was the strongest predictor of use of communication technologies, with younger patients more likely to use e-mail, Web, mobile phone, and texting. However, frequency of use of e-mail was not related to age. It is encouraging that over 99% of patients used at least one communication technology. This study has highlighted that there may be several potential barriers to the widespread implementation of communication technologies in general cardiology patients. Cognizance should be taken of these findings when attempting service redesign.

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

Science.gov (United States)

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. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

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

Science.gov (United States)

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. Copyright © 2017 Elsevier Inc. All rights reserved.

Germany's socio-economic model and the Euro crisis

Directory of Open Access Journals (Sweden)

Michael Dauderstädt

2013-03-01

Full Text Available Germany's socio-economic model, the "social market economy", was established in West Germany after World War II and extended to the unified Germany in 1990. During a prolonged recession after the adoption of the Euro in 1998, major reforms (Agenda 2010 were introduced which many consider as the key of Germany's recent success. The reforms had mixed results: employment increased but has consisted to a large extent of precarious low-wage jobs. Growth depended on export surpluses based on an internal real devaluation (low unit labour costs which make Germany vulnerable to global recessions as in 2009. Overall inequality increased substantially.

Variation in CAD Secondary Prevention Prescription among Outpatient Cardiology Practices: Insights from the NCDR®

Science.gov (United States)

Maddox, Thomas M.; Chan, Paul S.; Spertus, John A.; Tang, Fengming; Jones, Phil; Ho, P. Michael; Bradley, Steven M.; Tsai, Thomas T.; Bhatt, Deepak L.; Peterson, Pamela N.

2014-01-01

Objectives This study assesses practice variation of secondary prevention medication prescription among coronary artery disease (CAD) patients treated in outpatient practices participating in the NCDR® PINNACLE Registry®. Background Among patients with CAD, secondary prevention with a combination of beta-blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers, and statins reduces cardiac mortality and myocardial infarction (MI). Accordingly, every CAD patient should receive the combination of these medications for which they are eligible. However, little is known about current prescription patterns of these medications and the variation in use among outpatient cardiology clinics. Methods Using data from NCDR® PINNACLE Registry®, a national outpatient cardiology practice registry, we assessed medication prescription patterns among eligible CAD patients between July 2008 and December 2010. Overall rates of prescription and variation by practice were calculated, adjusting for patient characteristics. Results Among 156,145 CAD patients in 58 practices, 103,830 (66.5%) were prescribed the optimal combination of medications for which they were eligible. The median rate of optimal combined prescription by practice was 73.5% and varied from 28.8% to 100%. After adjustment for patient factors, the practice median rate ratio for prescription was 1.25 (95% CI 1.2,1.32), indicating a 25% likelihood that 2 random practices would differ in treating identical CAD patients. Conclusions Among a national registry of CAD patients treated in outpatient cardiology practices, over one-third of patients failed to receive their optimal combination of secondary prevention medications. Significant variation was observed across practices, even after adjusting for patient characteristics, suggesting that quality improvement efforts may be needed to support more uniform practice. PMID:24184238

Nudging Germany

DEFF Research Database (Denmark)

Purnhagen, Kai; Reisch, Lucia A.

Since 2015 behavioural scientists investigate at the German chancellery how one could regulate better. This piece illustrates the background of this new strategy and possible concequences for regulation and Rechtswissenschaft in Germany. We first discuss the concept of behaviourally informed regu...

Germany. A pioneer on earthen feet?

International Nuclear Information System (INIS)

Michaelowa, A.

2003-01-01

Germany is one of the two OECD countries having achieved substantial greenhouse gas reductions in the last decade. While a part was large reductions in industry after the economic crash in East Germany, a relevant share is due to the huge public infrastructure investments in East Germany. The real success of German climate policy in the past decade is the strong reduction of methane and nitrous oxide which has been almost unnoticed. German climate policy is a good example of how lobbying of interest groups leads to a complex maze of hundreds of measures whose effects are difficult to evaluate. Paradoxically, policies have focused on expensive measures and Germany clearly is a pioneer in the most expensive forms of renewable energy. Concerning cost-effective measures and market instruments, Germany is a laggard. Only slowly, policymakers start to notice this distortion and first, shaky steps towards a more cost-efficient policy are made. Several challenges such as nuclear phase-out and trends in household energy consumption will put pressure on government to embrace the Kyoto Mechanisms and to refocus domestic instruments well before the first commitment period

Daptomycin: a novel lipopeptide antibiotic against Gram-positive pathogens

Directory of Open Access Journals (Sweden)

Andres Beiras-Fernandez

2010-08-01

Full Text Available Andres Beiras-Fernandez1,*, Ferdinand Vogt1,*, Ralf Sodian1, Florian Weis21Department of Cardiac Surgery, University Hospital Großhadern, Ludwig-Maximilian-University, Munich, Germany; 2Department of Anesthesiology, University Hospital Großhadern, Ludwig-Maximilian-University, Munich, Germany *Andres Beiras-Fernandez and Ferdinand Vogt contributed equally to this paperAbstract: The aim of this review is to summarize the historical background of drug resistance of Gram-positive pathogens as well as to describe in detail the novel lipopeptide antibiotic daptomycin. Pharmacological and pharmacokinetic aspects are reviewed and the current clinical use of daptomycin is presented. Daptomycin seems to be a reliable drug in the treatment of complicated skin and skin structure infections, infective right-sided endocarditis, and bacteremia caused by Gram-positive agents. Its unique mechanism of action and its low resistance profile, together with its rapid bactericidal action make it a favorable alternative to vancomycin in multi-drug resistant cocci. The role of daptomycin in the treatment of prosthetic material infections, osteomyelitis, and urogenital infections needs to be evaluated in randomized clinical trials.Keywords: daptomycin, multi-drug resistance, methicillin-resistant Staphylococcus aureus (MRSA, pneumonia, urinary tract infection, left-sided endocarditis

Cardiology Centre Patients’ Awareness of the Negative Effects of Trans Fatty Acids on Cardiovascular Diseases

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Plociņa Lāsma

2017-12-01

Full Text Available It is very important to promote public awareness of the negative effects on health — trans fatty acid effects on cardiovascular disease. The study included 70 patients of the Latvian Centre of Cardiology, Pauls Stradiņš Clinical University Hospital (PSCUH. The PSCUH research institute gave permission to conduct the study. The patients answered questions about their awareness of trans fatty acids. The questionnaire used was obtained from the study “Use of Trans Fat Information on Food Labels and Its Determinants in a Multiethnic College Student Population” and modified for survey of the cardiology unit patients. The majority (74% of the respondents had heard and read something about trans fatty acids, but 62% women and 54% men were poorly informed about trans fatty acids and their negative effect on cardiovascular diseases. Unclear issues for patients were discussed after the questionnaire.

Cardiovascular Magnetic Resonance in Cardiology Practice: A Concise Guide to Image Acquisition and Clinical Interpretation.

Science.gov (United States)

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. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

NEWS FROM THE ANNUAL CONGRESS OF EUROPEAN SOCIETY OF CARDIOLOGY (BARCELONA 2014: REALIZED AND UNREALIZED EXPECTATIONS

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S. Y. Martsevich

2014-01-01

Full Text Available News from Congress of the European Society of Cardiology (Barcelona, 2014 is highlighted. Results of recent controlled clinical trials, new clinical recommendations and registers data that were presented at the Congress are discussed.

NEWS FROM THE ANNUAL CONGRESS OF EUROPEAN SOCIETY OF CARDIOLOGY (BARCELONA 2014: REALIZED AND UNREALIZED EXPECTATIONS

Directory of Open Access Journals (Sweden)

S. Y. Martsevich

2015-09-01

Full Text Available News from Congress of the European Society of Cardiology (Barcelona, 2014 is highlighted. Results of recent controlled clinical trials, new clinical recommendations and registers data that were presented at the Congress are discussed.

Munich Music Questionnaire: adaptation into Brazilian Portuguese and application in cochlear implant users.

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Frederigue-Lopes, Natália Barreto; Bevilacqua, Maria Cecilia; Costa, Orozimbo Alves

2015-01-01

To translate the Munich Music Questionnaire (MUMU) to Brazilian Portuguese, to adapt it culturally, and to describe the results obtained among adult users of cochlear implant (CI). We translated the questionnaire to Brazilian Portuguese, reviewed the grammatical and idiomatic equivalences (back-translation), and adapted it from a linguistic and cultural perspective. The resulting version of this process was applied among adult CI users through direct interviews. The Brazilian Portuguese version of MUMU was applied to 19 adult CI users with postlingual hearing loss, who had been users of the device for at least one year. The answers to the questionnaire were analyzed by distribution of frequency and percentage of occurrence in each question. The results showed a decrease in the frequency of CI users that listen to music, comparing the period before hearing loss and after the CI. Regarding the role that music played in the life of each participant, the responses did not score change, so the music remained being an important factor in the life of the evaluated subjects, even after the CI. The subjective evaluation tool MUMU was translated and culturally adapted to the population studied. In Brazilian Portuguese, it was called Questionário de Música de Munique. The study showed its applicability in the daily monitoring of CI users, thus providing a profile of the activities related to music in everyday life.

Carcinoma basocelular simulando tumor intranasal: tratamento com cirurgia micrográfica pelo método de Munique Basal cell carcinoma mimicking intranasal tumor: treatment by Munich method of micrographic surgery

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Luis Fernando Figueiredo Kopke

2007-12-01

Full Text Available Relata-se caso incomum de carcinoma basocelular que simulava tumor intranasal de crescimento expansivo, na cavidade da narina esquerda. Operado com cirurgia micrográfica pelo método de Munique, foi possível demonstrar que o tumor se originava da pele aparentemente normal e suprajacente do nariz. Por ser tridimensional, esse método de cirurgia micrográfica permite estudo mais preciso da peça cirúrgica. Discutem-se também aspectos peculiares da cirurgia micrográfica pelo método de Munique, o que contribui para a ampliação do conceito das cirurgias microscopicamente controladas.A rare case of basal cell carcinoma mimicking an expansive intranasal tumor in the left nostril is reported. Through the Munich micrographic surgery method, it was possible to demonstrate that the tumor originated from the apparently normal nose skin. Since this micrographic surgery is a tri-dimensional method, it enables a more accurate study of the specimen. Some peculiar aspects of the micrographic surgery using the Munich method are discussed, thus contributing to further understanding about the concept of microscopically controlled surgeries.

Integrated solid waste management in Germany

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-07-01

This report covers Germany`s experience with integrated solid waste management programs. The municipal solid waste practices of four cities include practices and procedures that waste facility managers with local or state governments may consider for managing their own day-to-day operations.

Cardiology in Brazilian scientific journals: an overview Cardiologia em revistas científicas brasileiras: um panorama

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Kavita Kirankumar Patel

2012-06-01

Full Text Available Cardiology has been and is a very significant fraction of the Brazilian contribution to science. In older days, the most significant part of this work was directed to foreign periodicals, but the quasi-simultaneous emergence of SciELO and PUBMED has ordained a redirection of much of this work to Brazilian periodicals. We here survey some of this more recent contribution for the benefit of readers of Revista Brasileira de Cirurgia Cardiovascular. This is offered as an update. Articles on the general themes of Cardiology and Pneumology published by four ISI Indexed Brazilian journals not specializing in cardiology are re-visited, after a search through 10 journals.A Cardiologia foi, e continua sendo, responsável por uma fracção muito significativa da contribuição brasileira para a ciência. No passado, os trabalhos mais importantes eram direcionados para periódicos estrangeiros, mas o surgimento quase simultâneo do SciELO e PUBMED facilitou um redirecionamento de grande parte desses trabalhos a periódicos brasileiros. Neste artigo, examinamos algumas das contribuições mais recentes em benefício aos leitores da Revista Brasileira de Cirurgia Cardiovascular. Esta discussão é oferecida como uma atualização. Artigos sobre os temas gerais da cardiologia e pneumologia publicados por quatro revistas brasileiras indexadas no ISI - não especializadas em cardiologia - são revistos.

Effects of short-term piano training on measures of finger tapping, somatosensory perception and motor-related brain activity in patients with cerebral palsy

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Alves-Pinto A

2017-10-01

Full Text Available Ana Alves-Pinto,1 Stefan Ehrlich,2 Gordon Cheng,2 Varvara Turova,1 Tobias Blumenstein,1 Renée Lampe1 1Research Unit of the Buhl-Strohmaier Foundation for Paediatric Neuroorthopaedics and Cerebral Palsy, Department of Orthopaedics, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; 2Chair for Cognitive Systems, Department of Electrical and Computer Engineering, Technical University of Munich, Munich, Germany Abstract: Playing a musical instrument demands the integration of sensory and perceptual information with motor processes in order to produce a harmonic musical piece. The diversity of brain mechanisms involved and the joyful character of playing an instrument make musical instrument training a potential vehicle for neurorehabilitation of motor skills in patients with cerebral palsy (CP. This clinical condition is characterized by motor impairments that can affect, among others, manual function, and limit severely the execution of basic daily activities. In this study, adolescents and adult patients with CP, as well as a group of typically developing children learned to play piano for 4 consecutive weeks, having completed a total of 8 hours of training. For ten of the participants, learning was supported by a special technical system aimed at helping people with sensorimotor deficits to better discriminate fingers and orient themselves along the piano keyboard. Potential effects of piano training were assessed with tests of finger tapping at the piano and tests of perception of vibratory stimulation of fingers, and by measuring neuronal correlates of motor learning in the absence of and after piano training. Results were highly variable especially among participants with CP. Nevertheless, a significant effect of training on the ability to perceive the localization of vibrations over fingers was found. No effects of training on the performance of simple finger tapping sequences at the piano or on motor

Germany after Federal elections

International Nuclear Information System (INIS)

Niedzballa, G.

2010-01-01

The political, economical and social situation in Germany after the election and attitude to nuclear energy are summarised. The Coalition agreement include: 1.Extension of the remaining lifetimes of the nuclear power plants (Nuclear Power considered as “Bridging technology”; Safety first; Skimming of additional profits) 2. No nuclear new builds in Germany 3. Approval and promotion (loan guarantees) of nuclear exports 4. Reversal of the moratorium regarding the exploration of Gorleben salt dome (Completion of the exploration; International Peer Review Group) 5.Further research regarding competence preservation and safety

Prolonged closed cardiac massage using LUCAS device in out-of-hospital cardiac arrest with prolonged transport time

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Edouard Matevossian

2009-04-01

Full Text Available Edouard Matevossian1, Dietrich Doll4, Jakob Säckl1, Inga Sinicina5, Jürgen Schneider2, Gerhard Simon3, Norbert Hüser11Department of Surgery, 2Department of Anesthesiology and Intensive-Care Medicine; 3Department of Radiology, Technische Universität of Munich, Germany; 4Department of Visceral, Vascular and Thoracic Surgery, Philips University of Marburg, Marburg, Germany; 5Institute of Clinical Forensic Medicine, Ludwig-Maximilian University of Munich, Munich, GermanyAbstract: Saving more human lives through more effective reanimation measures is the goal of the new international guidelines on cardiopulmonary resuscitation as the decisive aspect for survival after cardiovascular arrest is that basic resuscitation should start immediately. According to the updated guidelines, the greatest efficacy in cardiac massage is only achieved when the right compression point, an adequate compression depth, vertical pressure, the correct frequency, and equally long phases of compression and decompression are achieved. The very highest priority is placed on restoring continuous circulation. Against this background, standardized continuous chest compression with active decompression has contributed to a favorable outcome in this case. The hydraulically operated and variably adjustable automatic Lund University Cardiac Arrest System (LUCAS device (Jolife, Lund, Sweden undoubtedly meets these requirements. This case report describes a 44-year-old patient who – approximately 15 min after the onset of clinical death due to apparent ventricular fibrillation – received cardiopulmonary resuscitation, initially by laypersons and then by the emergency medical team (manual chest compressions followed by situation-adjusted LUCAS compressions. Sinus rhythm was restored after more than 90 min of continuous resuscitation, with seven defibrillations. Interventional diagnostic workup did not reveal a causal morphological correlate for the condition on coronary

Sports Cardiology: Core Curriculum for Providing Cardiovascular Care to Competitive Athletes and Highly Active People.

Science.gov (United States)

Baggish, Aaron L; Battle, Robert W; Beckerman, James G; Bove, Alfred A; Lampert, Rachel J; Levine, Benjamin D; Link, Mark S; Martinez, Matthew W; Molossi, Silvana M; Salerno, Jack; Wasfy, Meagan M; Weiner, Rory B; Emery, Michael S

2017-10-10

The last few decades have seen substantial growth in the populations of competitive athletes and highly active people (CAHAP). Although vigorous physical exercise is an effective way to reduce the risk of cardiovascular (CV) disease, CAHAP remain susceptible to inherited and acquired CV disease, and may be most at risk for adverse CV outcomes during intense physical activity. Traditionally, multidisciplinary teams comprising athletic trainers, physical therapists, primary care sports medicine physicians, and orthopedic surgeons have provided clinical care for CAHAP. However, there is increasing recognition that a care team including qualified CV specialists optimizes care delivery for CAHAP. In recognition of the increasing demand for CV specialists competent in the care of CAHAP, the American College of Cardiology has recently established a Sports and Exercise Council. An important primary objective of this council is to define the essential skills necessary to practice effective sports cardiology. Copyright © 2017. Published by Elsevier Inc.

Global Political Aspects of Putin’s Speech at the 43-th Munich Security Conference. One Decade Past

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Николай Петрович Пархитько

2018-12-01

Full Text Available In February 10th 2007 President of Russia V. Putin held a speech at the 43th Munich Security Conference. The speech included both the matters of security and global policy. Researchers in Russia together as well as their western colleagues (political scientists, journalists, historians and other analysts obviously came to the same opinion - that was the speech of the Russian president that attracted all the attention to this annual conference not being so traditionally popular as, for example, the “G-8” or the APEC summits. And though the estimations of the ideas advocated by Putin in his speech predictably differ depending on political creed and engagement of the analysts (sometimes that was also the matter of their erudition, the importance of the event was undisputable. Today one decade past the event we have the opportunity not just to analyze the crucial principles which Putin tried to clarify to his foreign partners, but also to verify them through the prism of approbation, as the scientists say. But before we start to study the speech itself, we should reveal the global political circumstances, in which the Conference took place. What was Russia as a global power in the beginning of the XXI century and was it a true global power in 2007? Was the political weight of the Russian president enough for bringing the influence into the world? Finally, what was the perceptions of Russia in the western community 15 years after the greatest transformation of the global political role of the country in Europe and in the world? After finding the answers on these questions we will reveal the main theses of the Russian presidents’ speech and will try to give them possibly candid estimation. In the work the authors used a wide methodological list. The historical-analytical method made it possible to reveal the evolution of the problems outlined in the speech of V.V. Putin for the specified time period (10 years. The comparative method allowed us

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

Science.gov (United States)

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.

Human gene therapy and imaging: cardiology

International Nuclear Information System (INIS)

Wu, Joseph C.; Yla-Herttuala, Seppo

2005-01-01

This review discusses the basics of cardiovascular gene therapy, the results of recent human clinical trials, and the rapid progress in imaging techniques in cardiology. Improved understanding of the molecular and genetic basis of coronary heart disease has made gene therapy a potential new alternative for the treatment of cardiovascular diseases. Experimental studies have established the proof-of-principle that gene transfer to the cardiovascular system can achieve therapeutic effects. First human clinical trials provided initial evidence of feasibility and safety of cardiovascular gene therapy. However, phase II/III clinical trials have so far been rather disappointing and one of the major problems in cardiovascular gene therapy has been the inability to verify gene expression in the target tissue. New imaging techniques could significantly contribute to the development of better gene therapeutic approaches. Although the exact choice of imaging modality will depend on the biological question asked, further improvement in image resolution and detection sensitivity will be needed for all modalities as we move from imaging of organs and tissues to imaging of cells and genes. (orig.)

[Tularemia in Germany].

Science.gov (United States)

Kohlmann, R; Geis, G; Gatermann, S G

2014-07-01

The bacterium Francisella tularensis is known for more than 100 years by now as the etiological agent of the disease tularemia, a zoonotic infection with a worldwide distribution in the Northern Hemisphere. The prevalence of tularemia shows a wide geographic variation, being comparably infrequent in Germany. Tularemia can present itself with multiple clinical manifestations including ulceroglandular, glandular, oropharyngeal, oculoglandular, respiratory and typhoidal forms. Due to the low prevalence and the unspecific symptomatology, a rapid diagnosis and early start of an effective therapy are rarely obtained. Thus, in this article we summarize important aspects concerning etiology, ecology and routes of transmission, recent epidemiologic situation, clinical picture, diagnostics and treatment of tularemia, focusing on the situation in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

Recent facts about photovoltaics in Germany

International Nuclear Information System (INIS)

Wirth, Harry

2015-01-01

Germany is leaving the age of fossil fuel behind. In building a sustainable energy future, photovoltaics is going to have an important role. The following summary consists of the most recent facts, figures and findings and shall assist in forming an overall assessment of the photovoltaic expansion in Germany.

THE ROLE OF P-GLYCOPROTEIN IN RATIONAL PHARMACOTHERAPY IN CARDIOLOGY

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A. V. Shulkin

2015-09-01

Full Text Available On the basis of the analysis of published data the role of P-glycoprotein, carrier protein, in rational pharmacotherapy in cardiology was shown on the example of its substrates – digoxin, antiplatelet agents and anticoagulants. Determination of C3435T polymorphism of multidrug resistance gene (MDR1, encoding P-glycoprotein, in pharmacotherapy with digoxin, antiplatelet drugs (clopidogrel tikagrelol, prasugrel and anticoagulants (dabigatran etexilate, rivaroxaban, edoxaban is not feasible in routine practice. Drug in- teractions have clinical implications for the efficacy and safety of pharmacotherapy in coadministration of these drugs with P-glycoprotein substrates, inducers and inhibitors.

Multimodal imaging: Simultaneous EEG in a 3T Hybrid MR–PET system

Energy Technology Data Exchange (ETDEWEB)

Neuner, I., E-mail: i.neuner@fz-juelich.de [Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Jülich GmbH (Germany); Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University (Germany); JARA BRAIN—Translational Medicine (Germany); Warbrick, T.; Tellmann, L.; Rota Kops, E.; Arrubla, J.; Boers, F.; Herzog, H. [Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Jülich GmbH (Germany); Shah, N.J. [Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Jülich GmbH (Germany); Department of Neurology, RWTH Aachen University (Germany); JARA BRAIN—Translational Medicine (Germany)

2013-02-21

The new generation of integrated MR–PET systems allows the simultaneous acquisition of MR and PET data. While MR delivers structural data with an excellent spatial resolution, the advantage of PET is its information on a molecular level. However, both modalities have a low temporal resolution. Thus, for pharmacological studies or patients who suffer from treatment resistant epilepsy the combination of yet another modality such as EEG could be desirable. We tested the feasibility of evoked visual potentials in a 3T Hybrid MR–PET system (Siemens Germany) in comparison to a standalone 3T Trio System (Siemens Germany). A T2⁎-weighted EPI sequence was used: TR: 2.2 s, TE: 30 ms, FOV: 200 mm, slice thickness 3, 36 slices in a healthy volunteer (male, 27 years old) using an MR-compatible 32-channel EEG system (Brainproducts, Munich, Germany). We applied 200 trials of visual stimulation from a white and black checkerboard. Visual evoked potentials were analyzed using Brain Vision Analyzer (Brainproducts, Munich, Germany). Gradient correction and cardioballistic artefact correction were performed as implemented in Vision Analyzer. Visual event related potentials were successfully recorded at the 3T Hybrid MR–PET system. Both curves differ slightly in shape and latency due to the following factors: the distance from the screen varies slightly and the size of the field of view of the subjects is smaller in the 3T MR–PET system in comparison to the 3T stand alone system. Extending the 3T MR–PET Hybrid system to 3T Hybrid MR–PET–EEG is feasible and adds another tool to clinical neuroimaging and research.

Measurements of transuranium nuclides in the environment at the Institute for Radiation Protection of the Gessellschaft fuer Strehlen-und Umweltforschung mbH, Munich

International Nuclear Information System (INIS)

Rosner, G.; Hoetzl, H.; Winkler, R.

1978-01-01

Work on environmental transuranium nuclides at the Institute for Radiation Protection of the Gesellschaft fur Strahlen-und Umweltforschung mbH, Munich, is briefly described and standard needs are discussed. Fallout plutonium measurements in air dust and precipitation samples started in 1970/1971. The procedure is outlined and results are presented as annual mean and sum values, respectively. Since 1973, transuranium nuclides in primary coolant, stack effluent air and waste-water samples from nuclear power stations are measured. Nuclides detected are 239 240 Pu, 238 Pu and/or 241 Am, 242 Cm and 244 Cm. Examples of alpha particle spectra are given. Needs for standards in environmental transuranium analysis are discussed. (author)

A high intensity Stern-Gerlach polarized hydrogen source for the Munich MP-Tandem laboratory using ECR ionization and charge exchange in cesium vapor

International Nuclear Information System (INIS)

Hertenberger, R.; Eisermann, Y.; Metz, A.; Schiemenz, P.; Graw, G.

2001-01-01

The 14 year old Lamb-Shift hydrogen source of the Munich Tandem laboratory is presently replaced by a newly developed Stern-Gerlach type atomic beam source (ABS) with electron-cyclotron-resonance (ECR) ionization and subsequent double charge exchange in a supersonic cesium vapor jet target. The atomic beam source provides an intensity of 6.4*10 16 atoms/sec of polarized hydrogen and of about 5*10 16 atoms/sec of polarized deuterium. Beam intensities larger than 100 μA were observed for positive H-vector + and D-vector + ion beams after ECR ionization and intensities larger than 10 μA for negative D-vector - ion beams in three magnetic substates

On New Spain and Mexican medicinal botany in cardiology.

Science.gov (United States)

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.

[Neuro-cardiology or cardio-neurology - a new specialization of the future?].

Science.gov (United States)

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.

Safe production and application of hydrogen at Munich airport

Energy Technology Data Exchange (ETDEWEB)

Szamer, R.

2005-07-01

At Munich International Airport the world's first public filling station for liquid and gaseous hydrogen with on-site hydrogen gas production has been installed. In order to prove the safety, liability and economic feasibility of hydrogen this pilot project examined the complete sequence of hydrogen production and application: on-site production with pressurized electrolyser and steam reformer, storage and filling of gaseous and liquid hydrogen, application of hydrogen for propelling several vehicles, e.g. airport busses in day to day operation, cars, fork lifter. TUV SUD Group, one of the largest service provider for technical safety and quality, was involved in the safety evaluation of the hydrogen project from the very beginning with the following services: safety consultancy throughout all project phases, e.g. for licensing procedures, plant design and operation safety analysis of the overall plant and of subsystems (electrolyser, filling stations, storage tanks, control systems etc.) safety assessment and acceptance testing of CH2 busses, CH2 fork lifter and LH2 passenger cars inspections and tests The challenges of this complex project relating to safety will be presented in the lecture, e.g. identification of potential hazards, safety requirements for the design and operation of the hydrogen plant as wells as for the various applications. Project description The hydrogen plant (cf. Figure 1) comprises two supply paths, one for compressed gaseous hydrogen (CH2) and one for cryogenic liquid hydrogen. Gaseous hydrogen is produced via high-pressure electrolysis at an operating pressure of 3 MPa (30 bar) and/or steam reforming process. The hydrogen will be led into a compressor, compressed to 35 MPa (350 bar) and stored in high pressure cylinders with a total geometrical storage volume of 10 m. The cylinders supply the high-pressure filling stations which refuels the 3 hydrogen buses and the fork lifter. Liquid hydrogen (LH2) is delivered in tank trucks and

Transport of radioactive waste in Germany - a survey

International Nuclear Information System (INIS)

Alter, U.

1995-01-01

The transport of radioactive waste is centralised and coordinated by the German Railway Company (Deutsche Bahn AG, DB) in Germany. The conditioning of radioactive waste is now centralised and carried out by the Gesellschaft fuer Nucklear Service (GNS). The Germany Railway Company, DB, is totally and exclusively responsible for the transport, the GNS is totally and exclusively responsible for the conditioning of radioactive waste. The German Railway Company transports all radioactive waste from nuclear power plants, conditioning facilities and the existing intermediate storage facilities in Germany. In 1992 nearly 177 shipments of radioactive waste were carried out, in 1991 the total amount was 179 shipments. A brief description of the transport procedures, the use of different waste packages for radioactive waste with negligible heat generation and the transport routes within Germany will be given. For this purpose the inspection authorities in Germany have used a new documentation system, a special computer program for waste flow tracking and quality assurance and compliance assurance, developed by the electrical power companies in Germany. (Author)

Cardiac troponins--Translational biomarkers in cardiology: Theory and practice of cardiac troponin high-sensitivity assays.

Science.gov (United States)

Adamcova, Michaela; Popelova-Lencova, Olga; Jirkovsky, Eduard; Simko, Fedor; Gersl, Vladimir; Sterba, Martin

2016-01-01

Tn is a unique translational biomarker in cardiology whose potential has not been diminished in the new era of high sensitive assays. cTns can be valuable markers in cardiac diseases as well as in infectious diseases and respiratory diseases. Furthermore, the role of cTns is growing in the routine evaluation of cardioxicity and in determining the efficacy/safety ratio of novel cardioprotective strategies in clinical settings. cTns can detect myocardial injury not only in a wide spectrum of laboratory animals in experimental studies in vivo, but also in isolated heart models or cardiomyocytes in vitro. The crucial issue regarding the cross-species usage of cardiac troponin investigation remains the choice of cardiac troponin testing. This review summarizes the recent proteomic data on aminoacid sequences of cTnT and cTnI in various species, as well as selected analytical characteristics of human cardiac troponin high-sensitivity assays. Due to the highly phylogenetically conserved structure of troponins, the same bioindicator can be investigated using the same method in both clinical and experimental cardiology, thus contributing to a better understanding of the pathogenesis of cardiac diseases as well as to increased effectiveness of troponin use in clinical practice. Measuring cardiac troponins using commercially available human high-sensitivity cardiac troponin tests with convenient antibodies selected on the basis of adequate proteomic knowledge can solve many issues which would otherwise be difficult to address in clinical settings for various ethical and practical reasons. Our survey could help elaborate the practical guidelines for optimizing the choice of cTns assay in cardiology. © 2016 International Union of Biochemistry and Molecular Biology.

Radiopharmaceuticals used in nuclear cardiology

International Nuclear Information System (INIS)

Costa, H.

1985-01-01

During the last years, since short physical mean life radionuclides have started to be used, radionuclide scanning has been experienced with remarkable culmination. There are detector devices, which jointly with computation equipments, allow to obtain multiple images per second as properly rapid gammagraphic series, in order to obtain whole hemodynamic data or to generate functional images no representing an anatomical structure but reporting about cardiac dynamics at regional level. In these techniques, employed in Nuclear Cardiology, the following radionuclides and radiopharmaceuticals are used: radiolabeled albumin 99m Tc red blood cells, 113m In-transferrin, very short physical mean life radionuclides, such as 195m Au, 178 Ta, 191 Ir. In addition, 113 Xe for coronary flow measurements; radiolabeled microspheres and macroparticles for angiogammagraphy; 129 Cs, 43 K, 81 Rb, 82 Rb and 201 Ti, the most largerly used, for myocardial gammagraphy. It is pointed out that fatty acids are the newest, basically if are radioiodate, and some 99m Tc labeled long chain hydrocarbons. It is expressed that 99m Tc-Sn-pyrophosphate has been used for myocardial infarction. Working on the development of new radiopharmaceuticals, basically fatty acids and 99m Tc chelating agents, for the improvement of these techniques is carried out. (author)

Eastern Germany Ahead in Employment of Women

OpenAIRE

Elke Holst; Anna Wieber

2014-01-01

Almost a quarter of a century after the fall of the Wall, there are still more women in employment in eastern Germany than in the west. Although the disparity is marginal now, the two regions started from dramatically different levels. In 1991, immediately after reunification, the employment rate for women in western Germany was 54.6 percent, but since then it has increased year on year, reaching 67.5 percent in 2012. In eastern Germany, female employment initially plummeted after the fall of...

Depression Disturbs Germany

Institute of Scientific and Technical Information of China (English)

2011-01-01

The suicide of Robert Enke,the goalkeeper of the Germany national football team who had battled depression for years,stunned the country and cast depression into the national spotlight as a disturbing disease.

European Society of Cardiology Council for Cardiology Practice worldwide survey of transcatheter aortic valve implantation beliefs and practices.

Science.gov (United States)

Asteggiano, Riccardo; Bramlage, Peter; Richter, Dimitrios J

2018-04-01

Background Transcatheter aortic valve implantation (TAVI) continues to gain popularity in the management of patients with severe aortic stenosis (SAS). Distribution of resources to maximise appropriate use remains a priority. Design & methods To determine the current perceptions and behaviours regarding SAS patient management, an 18-point multiple-choice questionnaire was distributed to European Society of Cardiology (ESC) Council for Cardiology Practice (CCP) e-journal and/or electronic newsletter subscribers. Respondents to all questions were considered. Sub-analyses based on respondent age, practice setting and geographical location were performed. Results Of 1245 full respondents, 41.5% were aged ≥ 51 years, 22.7% were aged 41-50 years and 35.8% were aged ≤ 40 years. The majority were located in Europe (77.5%), followed by Asia/Oceania (11.6%), America (7.6%) and Africa (3.4%). In-hospital and out-of-hospital cardiologists accounted for 57.4% of and 28.5% of the sample, respectively, with the remainder being general practitioners/other. The majority of respondents (70.1%) claimed to diagnose between one and five cases of SAS per month. Free access to TAVI was reported by 41.2%, being less common for those aged ≤ 40 years (32.7%; p < 0.001), those located in Asia/Oceania, America and Africa (20.1%, 18.1% and 2.4%, respectively; p < 0.01 in each case) and in-hospital compared to out-of-hospital cardiologists (35.7% vs. 54.5%, respectively; p < 0.001). The most common reason for not referring a patient for an aortic valve intervention was assessment that the patient was high risk/non-operable (55.5%), followed by short life expectancy (30.5%). The most common reason for referring a patient for TAVI over surgical replacement was surgical risk score (56.9%). The most commonly perceived main complication of TAVI was stroke (28.9%), while the most frequently selected main benefit was improvement in quality of life (37.2%). A high

Validation of the 2014 European Society of Cardiology guidelines risk prediction model for the primary prevention of sudden cardiac death in hypertrophic cardiomyopathy.

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Vriesendorp, Pieter A; Schinkel, Arend F L; Liebregts, Max; Theuns, Dominic A M J; van Cleemput, Johan; Ten Cate, Folkert J; Willems, Rik; Michels, Michelle

2015-08-01

The recently released 2014 European Society of Cardiology guidelines of hypertrophic cardiomyopathy (HCM) use a new clinical risk prediction model for sudden cardiac death (SCD), based on the HCM Risk-SCD study. Our study is the first external and independent validation of this new risk prediction model. The study population consisted of a consecutive cohort of 706 patients with HCM without prior SCD event, from 2 tertiary referral centers. The primary end point was a composite of SCD and appropriate implantable cardioverter-defibrillator therapy, identical to the HCM Risk-SCD end point. The 5-year SCD risk was calculated using the HCM Risk-SCD formula. Receiver operating characteristic curves and C-statistics were calculated for the 2014 European Society of Cardiology guidelines, and risk stratification methods of the 2003 American College of Cardiology/European Society of Cardiology guidelines and 2011 American College of Cardiology Foundation/American Heart Association guidelines. During follow-up of 7.7±5.3 years, SCD occurred in 42 (5.9%) of 706 patients (ages 49±16 years; 34% women). The C-statistic of the new model was 0.69 (95% CI, 0.57-0.82; P=0.008), which performed significantly better than the conventional risk factor models based on the 2003 guidelines (C-statistic of 0.55: 95% CI, 0.47-0.63; P=0.3), and 2011 guidelines (C-statistic of 0.60: 95% CI, 0.50-0.70; P=0.07). The HCM Risk-SCD model improves the risk stratification of patients with HCM for primary prevention of SCD, and calculating an individual risk estimate contributes to the clinical decision-making process. Improved risk stratification is important for the decision making before implantable cardioverter-defibrillator implantation for the primary prevention of SCD. © 2015 American Heart Association, Inc.

Application of Appropriate Use Criteria for Initial Transthoracic Echocardiography in an Academic Outpatient Pediatric Cardiology Program.

Science.gov (United States)

Safa, Raya; Aggarwal, Sanjeev; Misra, Amrit; Kobayashi, Daisuke

2017-08-01

Transthoracic echocardiography (TTE) is a non-invasive diagnostic modality for children with suspected heart disease. The American College of Cardiology published Appropriate Use Criteria (AUC) for an initial outpatient pediatric TTE in 2014 to promote effective care and improve resource utilization. The objective was to determine the appropriateness of TTE per the published AUC in a single academic pediatric cardiology clinic as a baseline performance quality measure. The echocardiography database was used to identify initial outpatient TTE in children during January-March 2014. TTE indications (appropriate [A], may be appropriate [M], or rarely appropriate [R]) and findings (normal, incidental, or abnormal) were recorded. The effect of AUC and age groups on yield of abnormal TTE findings was analyzed. Of the 2166 screened studies, our study cohort consisted of 247 TTEs. Indications rated A, M, and R were found in 129, 27, and 90, respectively, and 1 was unclassifiable. Majority of TTE (n = 183) were normal, although incidental findings were noted in 32 and abnormal findings in 32 cases. Abnormal findings were noted in 26/129 of A, 2/27 of M, and 4/90 of R. Indications rated A were significantly associated with yield of abnormal TTE findings, adjusted by age group. Infants and adolescents were more likely to have abnormal TTE findings compared to young children. Recently published AUC were validated for initial TTE in the outpatient pediatric cardiology clinic. Appropriateness rated by AUC was highly associated with yield of abnormal TTE findings and worked best in infants and adolescent.

New devices and technology in interventional cardiology.

Science.gov (United States)

Tobis, Jonathan Marvin; Abudayyeh, Islam

2015-01-01

There have been substantial improvements made in the tools and techniques used since the advent of percutaneous coronary intervention. What was primarily developed as a treatment of coronary artery disease is now used to address a variety of structural heart disease problems. The outcomes have been remarkably successful with relatively low complication rates that rival the results of open-heart surgery. This article will review some of the new devices available for management of structural cardiac conditions including congenital defects and acquired valvular abnormalities. Transcatheter treatment offers advantages over surgical intervention in recovery time, improved patient satisfaction, lower procedural risk, and avoidance of cardio-pulmonary bypass especially in high-risk patients. We will discuss different medical conditions and introduce the devices used to treat these conditions. Each device or technique has benefits and risks, and familiarity with the devices along with patient selection will best optimize the outcome. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

The Impact of Communication Skills Training on Cardiology Fellows' and Attending Physicians' Perceived Comfort with Difficult Conversations.

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Berlacher, Kathryn; Arnold, Robert M; Reitschuler-Cross, Eva; Teuteberg, Jeffrey; Teuteberg, Winifred

2017-07-01

Cardiologists need to decide which treatments are appropriate for seriously ill patients and whether they align with patient goals. Reconciling medical options with patients' wishes requires skilled communication. Although there is evidence that communication is teachable, few cardiologists receive formal training. To demonstrate that providing communication skills training to cardiologists is feasible and improves their perceived preparedness (PP) for leading difficult conversations. CardioTalk is a workshop to improve communication through short didactic sessions followed by interactions with standardized patients. Competencies include giving bad news, defining goals of care, responding to emotion, supporting religious beliefs, and withdrawing therapies. Settings/Subjects: First year cardiology fellows, heart failure fellows, and cardiac intensive care unit attendings. Surveys evaluated the curriculum's efficacy and learners' PP before and after the workshop. Eight cardiology attendings and 20 cardiology fellows participated. Eighty-nine percent reported having any prior education in communication. Fellows reported more prior education than attendings (100% vs. 62.5%, p = 0.017). Level of PP improved in all competencies for all learners. Ninety-six percent of respondents would recommend the training to peers. All attendings felt that it should be required for cardiologists in the cardiac intensive care unit and reported improved preparedness to teach communication to learners. All learners improved in levels of PP in communication competencies. CardioTalk is the first described training program that prepares cardiologists for the challenges they face when having conversations with seriously ill patients.

Gauge Invariance and the Goldstone Theorem

Science.gov (United States)

Guralnik, Gerald S.

This paper was originally created for and printed in the "Proceedings of seminar on unified theories of elementary particles" held in Feldafing, Germany from July 5 to 16, 1965 under the auspices of the Max-Planck-Institute for Physics and Astrophysics in Munich. It details and expands upon the 1964 Guralnik, Hagen, and Kibble paper demonstrating that the Goldstone theorem does not require physical zero mass particles in gauge theories.

Deployable Laboratory Applications of Nano- and Bio-Technology (Applications de nanotechnologie et biotechnologie destinees a un laboratoire deployable)

Science.gov (United States)

2014-10-01

specialists in hygiene, microbiology , epidemiology or veterinary epidemiology; 3 laboratory technicians and 4 engineers. Designation of special...Transportable Microbiology Laboratory 3-1 3.1 Challenges and Issues 3-1 3.2 Objectives 3-1 3.3 Responses 3-1 3.3.1 Constitution 3-1 3.3.2 Deployment 3-3 3.4...Bundeswehr Institute of Microbiology Neuherbergstrasse 11 80937 Munich GERMANY Email: Romanwoelfel@bundeswehr.org viii STO-TR-HFM-177

ボランティアコーディネーションについての一考察─ドイツ・ミュンヘンのストリートライフ・フェスティバルを題材に─

OpenAIRE

櫻井, 由美子; Yumiko, SAKURAI

2015-01-01

Volunteer coordination,which has been insufficiently researched,is necessary to foster volunteer activities.This study examines volunteer coordination in the Streetlife Festival in Munich,Germany.The festival is organized by an environmental NPO with an ecological approach;a great variety of people attend the exhibitions and go to the street stands.Volunteer groups and coordinating organizations inform festival attendees about their work,promote themselves and recruit new members.This study e...

Toward Clarity on Understanding Tropical Cyclone Intensification

Science.gov (United States)

2015-08-01

Munich, Germany MICHAEL T. MONTGOMERY Department of Meteorology, Naval Postgraduate School , Monterey, California (Manuscript received 13 January 2015...PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate School ,Department of...Fig. 1b of Chen and Zhang (2013), which shows time series of minimum surface pressure from a simulation of Hurri- cane Wilma (2005), obtained by

Portuguese Society of Cardiothoracic and Vascular Surgery/Portuguese Society of Cardiology recommendations for waiting times for cardiac surgery.

Science.gov (United States)

Neves, José; Pereira, Hélder; Sousa Uva, Miguel; Gavina, Cristina; Leite Moreira, Adelino; Loureiro, Maria José

2015-11-01

Appointed jointly by the Portuguese Society of Cardiothoracic and Vascular Surgery (SPCCTV) and the Portuguese Society of Cardiology (SPC), the Working Group on Waiting Times for Cardiac Surgery was established with the aim of developing practical recommendations for clinically acceptable waiting times for the three critical phases of the care of adults with heart disease who require surgery or other cardiological intervention: cardiology appointments; the diagnostic process; and invasive treatment. Cardiac surgery has specific characteristics that are not comparable to other surgical specialties. It is important to reduce maximum waiting times and to increase the efficacy of systems for patient monitoring and tracking. The information in this document is mainly based on available clinical information. The methodology used to establish the criteria was based on studies on the natural history of heart disease, clinical studies comparing medical treatment with intervention, retrospective and prospective analyses of patients on waiting lists, and the opinions of experts and working groups. Following the first step, represented by publication of this document, the SPCCTV and SPC, as the bodies best suited to oversee this process, are committed to working together to define operational strategies that will reconcile the clinical evidence with the actual situation and with available resources. Copyright © 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

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

Science.gov (United States)

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

2017-04-01

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.

Methodological adequacy of articles published in two open-access Brazilian cardiology periodicals.

Science.gov (United States)

Macedo, Cristiane Rufino; Silva, Davi Leite da; Puga, Maria Eduarda

2010-01-01

The use of rigorous scientific methods has contributed towards developing scientific articles of excellent methodological quality. This has made it possible to promote their citation and increase the impact factor. Brazilian periodicals have had to adapt to certain quality standards demanded by these indexing organizations, such as the content and the number of original articles published in each issue. This study aimed to evaluate the methodological adequacy of two Brazilian periodicals within the field of cardiology that are indexed in several databases and freely accessible through the Scientific Electronic Library Online (SciELO), and which are now indexed by the Web of Science (Institute for Scientific Information, ISI). Descriptive study at Brazilian Cochrane Center. All the published articles were evaluated according to merit assessment (content) and form assessment (performance). Ninety-six percent of the articles analyzed presented study designs that were adequate for answering the objectives. These two Brazilian periodicals within the field of cardiology published methodologically adequate articles, since they followed the quality standards. Thus, these periodicals can be considered both for consultation and as vehicles for publishing future articles. For further analyses, it is essential to apply other indicators of scientific activity such as bibliometrics, which evaluates quantitative aspects of the production, dissemination and use of information, and scientometrics, which is also concerned with the development of science policies, within which it is often superimposed on bibliometrics.

The visual arts influence in Nazi Germany

Directory of Open Access Journals (Sweden)

Bie Yanan

2016-01-01

Full Text Available This article will discuss the influence of visual art in Nazi Germany from two parts of visual arts, which are political photography and poster propaganda, analyzing the unique social and historical stage of Nazi Germany. And it emphasizes the ideology of the Nazis, which in Nazi Germany inflamed the political sentiment of the masses and took the visual art as their important instrument of political propaganda, while Nazi party used visual art on anti-society and war which is worth warning and criticizing for later generation.

Market value-oriented gas pricing in Germany

International Nuclear Information System (INIS)

Eimermacher, T.

1996-01-01

In Germany, natural gas faces stiff competition from other types of energy. In many applications, natural gas is capable of replacing other fuels. In addition there is a growing gas-to-gas competition in some European countries, either through pipeline construction by a competitor as in Germany or by mandatory third-party access as in UK. Competition leads to market value-oriented energy pricing, which is particularly evident in Germany. For the consumer, this competitive situation ensures that natural gas can be obtained (and remains available in the long term) at competitive prices

The foundation of NCVD PCI Registry: the Malaysia's first multi-centre interventional cardiology project.

Science.gov (United States)

Liew, H B; Rosli, M A; Wan Azman, W A; Robaayah, Z; Sim, K H

2008-09-01

The National Cardiovascular Database for Percutaneous Coronary Intervention (NCVD PCI) Registry is the first multicentre interventional cardiology project, involving the main cardiac centres in the country. The ultimate goal of NCVD PCI is to provide a contemporary appraisal of PCI in Malaysia. This article introduces the foundation, the aims, methodology, database collection and preliminary results of the first six-month database.

Agro-environmental policies in Germany

International Nuclear Information System (INIS)

Frohberg, K.; Weingarten

1997-01-01

Agricultural activities always have impacts on the environment. Whereas soil erosion is a minor problem in Germany water pollution due to modern and intensive agriculture is of major concern. At first the paper discusses to what extent agriculture contributes to environmental pollution in Germany, in particular to the pollution of surface waters (as well as hydroelectric power constructions on the Danube) and groundwater by nutrients and pesticides. Agro-environmental policy in Germany is dominated by command-and-control-measures. Hence, in the second section, recent developments of the most important legal and institutional settings concerning water conservation policies are surveyed with special emphasis on the Federal Water Act and the Implementation of the Nitrate Directive into German legislation by the Fertilizer Ordinance. Thirdly, impacts of alternative water conservation policies are investigated using a regionalized agricultural sector model. Information obtained by this model analysis cover the development of N-balances, potential nitrate concentrations in the recharged groundwater, costs potentially effected by this and resulting agricultural incomes on the country level of the former Federal Republic Germany. The last section focuses on programs promoting environmentally sound farming practices, which gained increasing importance in the Common Agricultural Policy of the European Union in the last years. It is argued that this development will also continue in the future. (author)

EMI in Germany

DEFF Research Database (Denmark)

Weiss, Felix; Schindler, Steffen

2017-01-01

This article discusses effectively maintained inequality considering two different examples from the Germany education system: secondary school attainment and enrolment in highly ranked universities among freshmen. In our analyses of secondary school attainment, we investigate whether considering...

Fast geomagnetic Field Intensity Variations between 1400 and 400 BCE: New Archaeointensity Data from Germany

Science.gov (United States)

Hervé, G.; Schnepp, E.; Metzler-Nebelsick, C.; Lhuillier, F.; Gilder, S.; Genevey, A.; Fassbinder, J.; Gallet, Y.

2017-12-01

Thirty-five mean archaeointensity data were obtained on ceramic sherds dated between 1400 and 400 BCE from sites located near Munich, Germany. The 453 sherds were collected from 52 graves, pits and wells dated by archaeological correlation, radiocarbon and/or dendrochronology. Rock magnetic analyses indicate that the remanent magnetization was mainly carried by magnetite. Data from Thellier-Thellier experiments were corrected for anisotropy and cooling rate effects. Triaxe and multispecimen (MSP-DSC) protocols were also measured on a subset of specimens. Around 60% of the samples provide reliable results when using stringent criteria selection. The 35 average archaeointensity values based on 154 pots are consistent with previous data and triple the Western Europe database between 1400 and 400 BCE. A secular variation curve for central-western Europe, built using a Bayesian approach, shows a double oscillation in geomagnetic field strength with intensity maxima of 70 μT around 1000-900 BCE and another up to 90 μT around 600-500 BCE. The maximum rate of variation was 0.25 μT/yr circa 700 BCE. The secular variation trend in Western Europe is similar to that observed in the Middle East and the Caucasus except that we find no evidence for hyper-rapid field variations (i.e. geomagnetic spikes). Virtual Axial Dipole Moments from Western Europe, the Middle East and central Asia differ by more than 20 ZA·m2 prior to 600 BCE, which signifies a departure from an axial dipole field especially between 1000 and 600 BCE. Our observations suggest that the regional Levantine Iron Age anomaly has been accompanied by an increase of the axial dipole moment together with a tilt of the dipole.

Recent advances in the Laboratory of Molecular and Cellular Cardiology.

Science.gov (United States)

Breitbart, R E; London, B; Nguyen, H T; Satler, C A

1995-12-01

This article highlights some of the research in cardiac molecular biology in progress in the Department of Cardiology at Children's Hospital. It provides a sampling of investigative approaches to key questions in cardiovascular development and function and, as such, is intended as an overview rather than a comprehensive treatment of these problems. The featured projects, encompassing four different "model" systems, include (1) genetic analysis of the mef2 gene required for fruit fly cardial cell differentiation, (2) cardiac-specific homeobox factors in zebrafish cardiovascular development, (3) mouse transgenic and gene knockout models of cardiac potassium ion channel function, and (4) mapping and identification of human gene mutations causing long QT syndrome.

IncobotulinumtoxinA use in aesthetic indications in daily practice: a European multicenter, noninterventional, retrospective study

Directory of Open Access Journals (Sweden)

Pavicic T

2015-03-01

Full Text Available Tatjana Pavicic,1 Welf Prager,2 Markus Klöppel,3 Simon Ravichandran,4 Olivier Galatoire5 1Private Practice, Munich, Germany; 2Dr. Prager & Partner, Derma-Hamburg, Hamburg, Germany; 3Private Practice Clinic of Esthetic Surgery, MediCenter Munich-Solln, Munich, Germany; 4Clinetix Rejuvenation, Glasgow, Scotland, UK; 5Department of Ophthalmology, Adolphe Rothschild Ophthalmological Foundation, Paris, France Purpose: To characterize utilization patterns and treatment satisfaction with incobotulinumtoxinA for aesthetic indications and assess adherence to the Summary of Product Characteristics. Patients and methods: Data were collected retrospectively from physicians in Germany, France, and the UK regarding patients (n=638 treated with incobotulinumtoxinA for aesthetic indications. Data on indication, treatment interval, dose injected, physician and patient satisfaction, and adverse drug reactions were recorded according to routine daily practice. Results: Most patients (76.0% received incobotulinumtoxinA for glabellar frown lines (GFL and were given doses of ≤20 U. The majority of treatment intervals were 5 months or longer. Overall, 64.1% of patients were treated for off-label indications, sometimes in combination with treatment for GFL. The most frequently treated off-label indications were horizontal forehead lines (38.6% and/or crow's feet (CF; 31.7%; for CF, >95% of injected doses were ≤24 U. In Germany, a smaller proportion of patients were given incobotulinumtoxinA treatment for CF (27.6%, compared with France (40.4% and the UK (33.2%, although country-specific differences were less prominent when treatment cycle data for CF were examined. Treatment satisfaction among physicians and patients (overall, and for GFL specifically was very high, with excellent tolerability and only one mild adverse drug reaction reported. Conclusion: In daily practice, incobotulinumtoxinA is mainly used for GFL; however, its use for CF and horizontal forehead

Classification and Quality Standards of Heart Failure Units: Scientific Consensus of the Spanish Society of Cardiology.

Science.gov (United States)

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. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Cross analysis of knowledge and learning methods followed by French residents in cardiology.

Science.gov (United States)

Menet, Aymeric; Assez, Nathalie; Lacroix, Dominique

2015-01-01

No scientific assessment of the theoretical teaching of cardiology in France is available. To analyse the impact of the available teaching modalities on the theoretical knowledge of French residents in cardiology. Electronic questionnaires were returned by 283 residents. In the first part, an inventory of the teaching/learning methods was taken, using 21 questions (Yes/No format). The second part was a knowledge test, comprising 15 multiple-choice questions, exploring the core curriculum. Of the 21 variables tested, four emerged as independent predictors of the score obtained in the knowledge test: access to self-assessment (P=0.0093); access to teaching methods other than lectures (P=0.036); systematic discussion about clinical decisions (P=0.013); and the opportunity to prepare and give lectures (P=0.039). The fifth variable was seniority in residency (P=0.0003). Each item of the knowledge test was analysed independently: the score was higher when teaching the item was driven by reading guidelines and was lower if the item had not been covered by the programme (Pcardiology by involving students in the training, by using teaching methods other than lectures and by facilitating access to self-assessment. The use of digital tools may be a particularly effective approach. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Germany at CERN

CERN Multimedia

2005-01-01

From left to right: Maximilian Metzger, CERN's Secretary-General, Hermann Schunck, Director at the German Federal Ministry of Education and Research, and Robert Aymar, CERN's Director-General, talking to Wolfgang Holler from Butting, one of the companies at the "Germany at CERN" exhibition. Far right : Susanne-Corinna Langer-Greipl from BMBF, delegate to the CERN Finance Committee. For three days, CERN's Main Building was transformed into a showcase for German industry. Twenty-nine companies from sectors related to particle physics (electrical engineering, vacuum and low temperature technology, radiation protection, etc.) were here for the ninth "Germany at CERN" exhibition, organised by the German Federal Ministry of Education and Research (BMBF), which gave them the opportunity to meet scientists and administrators from the Laboratory. On 1 March the exhibition was visited by a German delegation headed by Dr Hermann Schunck, Director at BMBF.

Risk profiles of treatment noncompletion for inpatients and outpatients undergoing alcohol disorder rehabilitation treatment

Directory of Open Access Journals (Sweden)

Preuss UW

2012-05-01

Full Text Available Ulrich W Preuss,1 Jörg Zimmermann,2,3 Gabriele Schultz,2 Anna Watzke,2 Peggy Schmidt,4 Bärbel Löhnert,5 Michael Soyka2,61Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle-Wittenberg, Halle, Germany; 2Ev Krankenhaus Bethanien GmbH, Fachklinik Gristower Wiek, Johanna-Odebrecht-Stiftung, Germany; 3Karl-Jaspers-Klinik, Fachkrankenhaus für Psychiatrie und Psychotherapie, Psychiatrieverbund Oldenburger Land, Germany; 4Department of Psychiatry, Ludwig-Maximilians-Universität Munich, Germany; 5Klientenzentrierte Problemberatung, Dachau/Munich, Germany; 6Privatklinik Meiringen, Meiringen, Switzerland Background: Rehabilitation treatment noncompletion is considered a risk factor for long term relapse in alcohol-dependent individuals. The aim of this analysis of in- and outpatients in alcohol dependence rehabilitation in Germany is to identify social, mental, and somatic risk profiles for treatment noncompletion.Methods: A total of 92 individuals from an outpatient program and 303 individuals from two inpatient rehabilitation treatment units in three different locations in Germany were recruited and assessed with a structured interview and several measures of psychopathology (personality disorders, anxiety, depression, and impulsivity at treatment admission, with termination at 12 months follow-up. Participants were subdivided into treatment completers and noncompleters for any reason.Results: A total of 10.2% of inpatients and 16.1% of outpatients did not complete treatment. Compared with treatment completers, noncompleters had a significantly lower rate of continuous abstinence at 1-year follow-up, more recent alcohol consumption before admission, and a higher rate of borderline personality disorders. Among inpatients, an elevated rate of lifetime mental disorders, depression, and suicide attempts was found among treatment noncompleters; among outpatients, treatment noncompleters were more often than completers to be

CSNI/NEA RASPLAV Seminar 2000, 14-15 November 2000, Munich, Germany - Executive Summary

International Nuclear Information System (INIS)

Asmolov, V.; Behbahani, A.; Hache, G.; Nakamura, H.; Raj Sehgal, B.; Strizhov, V.; Trambauer, K.; Tuomisto, H.; Vitanza, C.

2000-11-01

The objective of the RASPLAV Project was to provide data on the behaviour of molten core materials on the RPV lower head under severe accident conditions, and to assess the possible physicochemical interactions between molten corium and the vessel wall. Data were also obtained to confirm heat transfer modelling for a large convective corium pool within the lower head. The project consisted of the following components: - To provide data from large-scale integral experiments on the behaviour and interactions of prototypic core-melt materials within the lower head; - To perform small-scale corium experiments to measure the thermo-physical properties (density, electrical and thermal conductivity, viscosity, etc.) required for performing and interpreting the integral (large-scale) tests; - To determine the uncertainties introduced by using non-prototypic conditions and materials by means of the small-scale corium experiments; - To carry out the molten-salt experiments with the following objectives: - To study heat transfer processes in the melt; - To justify the choice of procedures for large-scale experiments, such as the heating method; To develop an understanding of relevant phenomena, such as crust formation, and non-eutectic materials behaviour; - To develop computer tools and models for analysis of results from the large-scale integral tests and the supporting small-scale experiments. During the first phase of the RASPLAV Project (1994-97) the large-scale experiments demonstrated clearly that behaviour of corium melts differed from that of simulant materials. Under certain conditions, the corium would separate into two layers that were enriched in zirconium or in uranium. The second phase of the RASPLAV Project started in July 1997 and concentrated on exploring the physical and chemical phenomena occurring in a convective molten pool. The effect of different corium compositions, the potential for and the effects of material stratification and the influence of various boundary conditions were investigated. The work involved a combination of integral and separate effect tests including molten-salt tests to investigate non-eutectic mixtures and the effects of stratification, extension of the material property database to allow interpretation and modelling of the experimental data. The CSNI decided to hold a seminar where the major outcome of the RASPLAV Project could be presented and discussed also in the context of other experienced activities on Severe Accidents. The objectives of the seminar are: - to review the experimental results of the RASPLAV Project; - to exchange information on complementary research; - to discuss the progress made on understanding severe accident progression; - to discuss the applicability to nuclear power plants and use of the results. The Seminar was intended to provide an in-depth review of the RASPLAV Project in terms of the technical capabilities, results and analyses produced during the project execution. The application of the results and their significance for power plant applications were addressed. Relevant results of the complementary research carried out at various laboratories were also presented. The seminar consisted of five sessions. The abstracts of the presentations are given in the appendix, as well as the list of participants and the conference program

A new device to test cutting efficiency of mechanical endodontic instruments

Science.gov (United States)

Rubini, Alessio Giansiracusa; Plotino, Gianluca; Al-Sudani, Dina; Grande, Nicola M.; Putorti, Ermanno; Sonnino, GianPaolo; Cotti, Elisabetta; Testarelli, Luca; Gambarini, Gianluca

2014-01-01

Background The purpose of the present study was to introduce a new device specifically designed to evaluate the cutting efficiency of mechanically driven endodontic instruments. Material/Methods Twenty new Reciproc R25 (VDW, Munich, Germany) files were used to be investigated in the new device developed to test the cutting ability of endodontic instruments. The device consists of a main frame to which a mobile plastic support for the hand-piece is connected and a stainless-steel block containing a Plexiglas block against which the cutting efficiency of the instruments was tested. The length of the block cut in 1 minute was measured in a computerized program with a precision of 0.1mm. The instruments were activated by using a torque-controlled motor (Silver Reciproc; VDW, Munich, Germany) in a reciprocating movement by the “Reciproc ALL” program (Group 1) and in counter-clockwise rotation at 300 rpm (Group 2). Mean and standard deviations of each group were calculated and data were statistically analyzed with a one-way ANOVA test (P0.05). Conclusions The cutting testing device evaluated in the present study was reliable and easy to use and may be effectively used to test cutting efficiency of both rotary and reciprocating mechanical endodontic instruments. PMID:24603777

Is Germany a model for managers?

Science.gov (United States)

Wever, K S; Allen, C S

1992-01-01

Most American managers have a hard time making sense of Germany. The country has a fraction of the resources and less than one-third the population of the United States. Labor costs are substantially higher, paid vacations are at least three times as long, and strong unions are deeply involved at all levels of business, from the local plant to the corporate boardroom. Yet German companies manage to produce internationally competitive products in key manufacturing sectors, making Germany the greatest competitive threat to the United States after Japan. The seemingly paradoxical nature of the German economy typically evokes one of two diametrically opposed responses. The first is to celebrate the German economy as a "model" worth emulating--indeed, as the answer to declining U.S. competitiveness. The alternative, more skeptical response is to question Germany's staying power in a new, more competitive global economy. According to Kirsten Wever and Christopher Allen, the problem with both points of view is that they miss the forest for the trees. Observers are so preoccupied with praising--or blaming--individual components of the German economy that they fail to see the dynamic logic that ties these components together into a coherent system. In their review of recent research on the German business system, Wever and Allen argue that managers can learn an important lesson from Germany. In the global economy, competition isn't just between companies but between entire socioeconomic systems. Germany's ability to design a cohesive economic and social system that adapts continuously to changing requirements goes a long way toward explaining that country's competitive success.

GERMANY & TURKEY – A PARTNERSHIP PERSPECTIVE

Directory of Open Access Journals (Sweden)

Bestenigar KARA

2015-04-01

Full Text Available The article shortly deals with economic and commercial relations between Turkey, that keeps close regulary economic, political and cultural relationship and Germany, which is one of six founding fathers of the European Union. The subject of article has been searched within the following framework: Measurement of commercial relations between export and import between, investment relations between Germany and Turkey, mutual distribution sector.

Mental health of Turkish women in Germany

DEFF Research Database (Denmark)

Bromand, Z; Temur-Erman, S; Yesil, R

2012-01-01

The purpose of the present study was to examine the protective and risk factors of mental distress among Turkish women living in Germany.......The purpose of the present study was to examine the protective and risk factors of mental distress among Turkish women living in Germany....

Poverty, health, and nutrition in Germany.

Science.gov (United States)

Helmert, U; Mielck, A; Shea, S

1997-01-01

To investigate the relation between poverty and several variables describing health and nutrition behavior in East Germany and West Germany. Data are from the third National Health Survey in West Germany and the first Health Survey for the new federal states of Germany (1991/92). Both health surveys included a self-administered questionnaire ascertaining sociodemographic variables, smoking history, nutritional behavior (using a food-frequency list), physical activity, and a medical examination comprising measurements of height, weight, blood pressure, and blood sampling for serum cholesterol determination. Participants included 4958 subjects in the West Survey and 2186 subjects in the East Survey aged 25-69 years, with a respective net response rate of 69.0% and 70.2%. Poverty was defined as a household equivalence income of 62.5% or less of the median income of the general population. The lowest income group (poverty or near poverty) comprised 11.6% of East German versus 15.9% of West German males and 14.8% of East German versus 19.3% of West German females. For most but not all health and nutrition parameters, less favorable results were obtained for subjects with an equivalence income below or near poverty. The most striking poverty-related differences regarding cardiovascular disease risk factors were found for lack of regular exercise for both genders and obesity in females. No poverty-related differences were found for the prevalence of hypercholesterolemia, despite a much higher prevalence of obesity in persons with an income below the poverty line. Current nutritional behavior and changes in nutritional behavior during the last three years was strongly related to income status, with a more unhealthy status for low-income population groups in both East and West Germany. In Germany, poverty has strong effects on individual health status and nutritional behavior. Because of rising unemployment rates and reductions in social security payments for low

Library Consortia in Germany

Directory of Open Access Journals (Sweden)

Werner Reinhardt

2001-07-01

Full Text Available Looking at the present situation in Germany consortia show a considerable variety of organizational forms. Only in the case of the Friedrich-Althoff-Consortium in Berlin-Brandenburg a corporate body with deed of partnership does exist. In other German states consortia have been formed which are represented by an individual library (e.g. Baden-Württemberg or by a central institution such as the Bayerische Staatsbibliothek in Bavaria or the Hochschulbibliothekszentrum NRW in North Rhine-Westphalia. Rarely contracts for nationwide consortia have been signed; resulting from an initiative of a professional society, the „Gesellschaft Deutscher Chemiker“, an agreement was reached allowing for the use of the Beilstein-Crossfire-database in participating universities all over Germany.

Provisions for containment venting in Germany

International Nuclear Information System (INIS)

Wilhelm, J.G.

1997-01-01

In this short paper an overlook is given of the systems developed in Germany for filtered containment venting and their implementation in nuclear power plants. More information on the development can be found in the Proceedings of the DOE/NRC Aircleaning Conferences. In Germany, 28.8 % of the electric energy is produced by 19 nuclear power reactors. No new power reactor is expected to be built at least within the next ten years, but France and Germany cooperate in the development of a future European Power Reactor (ERP). This reactor type will be fitted with a core catcher and passive cooling in order to avoid serious consequences of a hypothetical core meltdown accident so that provisions for containment venting are not required. 3 refs., 6 figs., 1 tab

Provisions for containment venting in Germany

Energy Technology Data Exchange (ETDEWEB)

Wilhelm, J.G.

1997-08-01

In this short paper an overlook is given of the systems developed in Germany for filtered containment venting and their implementation in nuclear power plants. More information on the development can be found in the Proceedings of the DOE/NRC Aircleaning Conferences. In Germany, 28.8 % of the electric energy is produced by 19 nuclear power reactors. No new power reactor is expected to be built at least within the next ten years, but France and Germany cooperate in the development of a future European Power Reactor (ERP). This reactor type will be fitted with a core catcher and passive cooling in order to avoid serious consequences of a hypothetical core meltdown accident so that provisions for containment venting are not required. 3 refs., 6 figs., 1 tab.

Radioactive waste interim storage in Germany

International Nuclear Information System (INIS)

2015-12-01

The short summary on the radioactive waste interim storage in Germany covers the following issues: importance of interim storage in the frame of radioactive waste management, responsibilities and regulations, waste forms, storage containers, transport of vitrified high-level radioactive wastes from the reprocessing plants, central interim storage facilities (Gorleben, Ahaus, Nord/Lubmin), local interim storage facilities at nuclear power plant sites, federal state collecting facilities, safety, radiation exposure in Germany.

Electricity prices differences between France and Germany

International Nuclear Information System (INIS)

Hensing, I.; Nolden, A.; Riechmann, Ch.; Schulz, W.

1998-01-01

High electricity prices in Germany especially as compared to France have played an important role in the electricity liberalization debate in Germany. The price differences can largely be explained by cost differences in electricity generation, the electricity grids, personnel cost and local taxes. Further analysis suggests that efficiency improvements upon market liberalization will only partly remove these price and cost differentials. Parts of the cost differentials are attributable to politically-motivated regulations and the (future) regulation of network functions. This implies that Germany can only expect to arrive at internationally comparable electricity prices if it advances with a reform of political and monopoly regulations alongside liberalizing electricity generation and trade. (author)