WorldWideScience

Sample records for cardiology

  1. 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.

  2. Nuclear cardiology

    International Nuclear Information System (INIS)

    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

  3. Tele-cardiology.

    Science.gov (United States)

    Molefi, M; Fortuin, J; Wynchank, S

    2006-01-01

    After defining tele-medicine, we describe its situation in the public health service of South Africa and its application to cardiology. Methods of communication relevant to tele-cardiology are outlined, together with their bearing on primary healthcare. The range of tele-cardiological applications to electrocardiology, echocardiology, auscultation, imaging and pathology are indicated. Tele-cardiology's contributions to a range of cardiological problems and types of management are described briefly. Finally, a mention is made of the relevance of tele-medicine to education and the costs related to cardiology, with an indication of some future needs for tele-cardiology. PMID:16547558

  4. Nuclear cardiology

    International Nuclear Information System (INIS)

    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.)

  5. Nuclear cardiology in Cuba

    International Nuclear Information System (INIS)

    This paper is a brief summary of the Nuclear Cardiology history in Cuba, mentioning the current main mortality causes, the usefulness and results of nuclear tests among the imaging techniques nowadays used in Cardiology, including gated-SPECT, PET and hybrid imaging combining anatomical and functional information. This paper also reviews our present worldwide performance in Nuclear Cardiology, with emphasis on our development and future trends, and proposes some recommendations. (author)

  6. Pediatric nuclear cardiology

    International Nuclear Information System (INIS)

    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

  7. Reporting nuclear cardiology

    DEFF Research Database (Denmark)

    Trägårdh, Elin; Hesse, Birger; Knuuti, Juhani;

    2015-01-01

    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......, 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...

  8. Nuclear cardiology in Iran

    International Nuclear Information System (INIS)

    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-99m-M I B I

  9. American Society of Nuclear Cardiology

    Science.gov (United States)

    ... of Nuclear Cardiology Official publication of the American Society of Nuclear Cardiology Clinical Guidelines Procedures, Appropriate Use Criteria, Information Statements and Joint Society Statements Member Login Enter Forgot your password? Meetings & ...

  10. Cardiology without borders

    Institute of Scientific and Technical Information of China (English)

    Michael Wolk

    2004-01-01

    @@ Cardiovascular disease takes place in a border-free world. The challenge at the American College of Cardiology (ACC) and anywhere else in the world is to hold patient care above the artificial barriers raised by geopolitical issues. Fundamentally, the goal of ACC members or of any cardiology societies in the world is to provide excellent patient care. Cardiovascular disease is essentially the same throughout the world. Where there are minor variations among individuals, as clinicians we find priceless opportunity to learn. Expanding- rather contracting -our experience base helps us as individuals to realize our best potential as practitioners.

  11. Computers in cardiology

    International Nuclear Information System (INIS)

    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)

  12. 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......-coronary cardiac diseases. The advances in nuclear cardiology are discussed under the four headlines of: 1) myocardial perfusion, 2) cardiac performance including LV and right ventricular (RV) function, 3) myocardial metabolism, and 4) experimental nuclear cardiology Udgivelsesdato: 2008/6...

  13. Computer diagnosis in cardiology

    Directory of Open Access Journals (Sweden)

    Graham Wilfred Ewing

    2009-09-01

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

  14. 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.

  15. Nuclear medicine in cardiology

    International Nuclear Information System (INIS)

    Nuclear medicine in cardiology was reviewed. Electrocardiogram is obtained from the γ-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 201Tl 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. (Nakanishi, T.)

  16. Scientometric analysis of radiation cardiology

    International Nuclear Information System (INIS)

    The main bibliometric results in specific field of radiobiology - radiation cardiology - were discussed. This results indicate that cardiac morphogenesis and diseases in pollutant environment (radionuclides, smoking, hypo kinetic syndrome, etc.) is needed in additional investigations. (authors)

  17. 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)

  18. 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…

  19. Diagnostic standards in nuclear cardiology

    International Nuclear Information System (INIS)

    Establishing the accurate diagnosis and the adequate treatment of choice in ischemic heart disease (IHD) has become an emergency issue, with increasing the number of IHD patients in Japan. It is therefore important to determine myocardial viability and its related pathophysiology such as stunning and hibernation, which is a prerequisite for widely performed coronary revascularization. From these points of view, cardiovascular nuclear medicine, involving thallium-201 myocardial perfusion scintigraphy and cardiac radionuclide angiography, has become a well-established method for diagnosing IHD. However, no diagnostic standards are available in the routine practice. The Japanese Circulation Society has started a committee for preparing 'diagnostic standards in nuclear cardiology' in April 1989. Out of 8,947 facilities nationwide, 1,126 (12.5%) possess gamma cameras. Of these facilities, 799(70.9%) perform nuclear cardiologic examination. A questinnaire was sent to the 799 facilities, and 410 (51.3%) responded. Based on the 1989's questionnaire results, 'diagnostic standards in nuclear cardiology' was discussed through one year in 1990, and was completed in 1991. This is a report dealing with the present 'diagnostic standards in nuclear cardiology', focusing on thallium-201 myocardial perfusion imaging, cardiac radionuclide angiography, Tc-99m acute infarct imaging, and new radionuclides and PET. Items are included as follows: (1) equipment and techniques, (2) diagnostic standards, (3) stress test, (4) candidates for the examination, and (5) diagnostic cautions. (N.K.) 71 refs

  20. Recent Advances in Nuclear Cardiology.

    Science.gov (United States)

    Lee, Won Woo

    2016-09-01

    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. PMID:27540423

  1. Nobel Prizes: Contributions to Cardiology

    OpenAIRE

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

    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 cardiolo...

  2. Mobile Apps in Cardiology: Review

    OpenAIRE

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

    2013-01-01

    Background Cardiovascular diseases are the deadliest diseases worldwide, with 17.3 million deaths in 2008 alone. Among them, heart-related deaths are of the utmost relevance; a fact easily proven by the 7.25 million deaths caused by ischemic heart disease alone in that year. The latest advances in smartphones and mHealth have been used in the creation of thousands of medical apps related to cardiology, which can help to reduce these mortality rates. Objective The aim of this paper is to study...

  3. Patient doses in interventional cardiology

    International Nuclear Information System (INIS)

    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)

  4. [Radiation protection in interventional cardiology].

    Science.gov (United States)

    Durán, Ariel

    2015-01-01

    INTERVENTIONAL: cardiology progress makes each year a greater number of procedures and increasing complexity with a very good success rate. The problem is that this progress brings greater dose of radiation not only for the patient but to occupationally exposed workers as well. Simple methods for reducing or minimizing occupational radiation dose include: minimizing fluoroscopy time and the number of acquired images; using available patient dose reduction technologies; using good imaging-chain geometry; collimating; avoiding high-scatter areas; using protective shielding; using imaging equipment whose performance is controlled through a quality assurance programme; and wearing personal dosimeters so that you know your dose. Effective use of these methods requires both appropriate education and training in radiation protection for all interventional cardiology personnel, and the availability and use of appropriate protective tools and equipment. Regular review and investigation of personnel monitoring results, accompanied as appropriate by changes in how procedures are performed and equipment used, will ensure continual improvement in the practice of radiation protection in the interventional suite. PMID:26169040

  5. Nobel Prizes: Contributions to Cardiology

    International Nuclear Information System (INIS)

    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

  6. Nobel Prizes: Contributions to Cardiology

    Directory of Open Access Journals (Sweden)

    Evandro Tinoco Mesquita

    2015-01-01

    Full Text Available 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.

  7. Nobel Prizes: Contributions to Cardiology

    Directory of Open Access Journals (Sweden)

    Evandro Tinoco Mesquita

    2015-08-01

    Full Text Available 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.

  8. 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.

  9. Nobel prizes: contributions to cardiology.

    Science.gov (United States)

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

    2015-08-01

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

  10. Nobel Prizes: Contributions to Cardiology

    Science.gov (United States)

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

    2015-01-01

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

  11. [Over diagnostic imaging in cardiology].

    Science.gov (United States)

    Carpeggiani, Clara

    2014-03-01

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

  12. Nuclear cardiology for developing countries

    International Nuclear Information System (INIS)

    The role of nuclear medicine in developing countries must be oriented to the local needs for clinical practice, the health care of large populations and the demands for research with sometimes extremely limited resources. To help define the locally differing needs, it is stressed that nuclear medicine provides the unique opportunity to observe the body at the molecular level of organization and thus makes the body biochemically transparent. Depending on the particular diagnostic demands, complex imaging with gamma scintigraphy or emission tomography may be the only method to choose in some instances, but for others it may be an unnecessary luxury. Nuclear cardiology, with the purpose of non-invasively assessing cardiac function, myocardial perfusion and myocardial metabolism, is a particular challenge in both respects for developing countries. Given such requirements, single-probe devices with multipurpose application are less expensive than gamma cameras and promise advanced diagnostic uses. In one examination, left ventricular function, global cardio-pulmonary circulation and the general circulatory adaptation to exercise can be investigated by non-gated simultaneous blood pool measurements over four lung regions, the heart and the liver. In addition, such devices have the advantages of compactness, robustness and electronic stability. Despite enormous difficulties regarding funding, infrastructure, equipment and maintenance, developing countries should be encouraged to participate in the evolution of nuclear medicine by responding and adapting to defined needs and perhaps by maintaining at least one national centre of excellence with capacities for research and training. Funds are best secured by providing an indispensable service in co-operation with the various clinical disciplines. (author)

  13. Nuclear cardiology in Cuba present and perspectives

    International Nuclear Information System (INIS)

    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)

  14. Assessing and Reducing Exposures to Cardiology Staff

    International Nuclear Information System (INIS)

    Interventional radiology and interventional cardiology practices represent the highest radiological workload in hospitals and have the potential for high exposures to staff operating near patients. The IAEA has promoted the Information System on Occupational Exposure in Medicine, Industry and Research (ISEMIR) project where the working group on interventional cardiology assessed levels of exposure and methods applied for individual monitoring, and designed an international database of occupational exposures. Worldwide surveys of interventional cardiologists from 32 countries and 81 regulatory bodies from 55 countries provided information on dosimetry practice: only 57% of regulatory bodies define the number and/or position of dosimeters for staff monitoring and less than 40% could provide doses. The survey results proved poor compliance with staff monitoring recommendations in a large fraction of hospitals and the need for staff monitoring harmonization and monitoring technology advancements. Given the new occupational dose limit for the lens of the eye, the existence of high eye doses in interventional cardiology practice and the general lack of knowledge of actual eye doses in interventional cardiology (and other similar interventional practices), ISEMIR recommends improving training in occupational radiation protection and monitoring methods for assessing eye lens doses, and urging hospital management to utilize the international database under development for benchmarking occupational doses in interventional cardiology and, hence, improve optimization of protection. (author)

  15. Safe sedation in modern cardiological practice.

    Science.gov (United States)

    Furniss, Stephen S; Sneyd, J Robert

    2015-10-01

    Safe sedation is fundamental to many modern cardiological procedures, and following the publication of the report on safe sedation by the Academy of Medical Royal Colleges, this report discusses sedation specifically in cardiological practice. The major areas within cardiology that use sedation are cardioversion, catheter ablation particularly of atrial fibrillation, transoesophageal echocardiography, implantable device (cardiovascular implantable electronic device) procedures and other procedures such as transcatheter aortic valve replacement. There is increasing demand for cardiological sedation but there is wide geographical variation in its use and there are also growing data to support non-anaesthetists giving sedation. The use of benzodiazepines, particularly for short procedures, is common, but even here good record-keeping and audit together with an understanding of the continuum of sedation and having appropriately trained staff and the necessary facilities are vital. Nurse administration of propofol may be appropriate for some procedures in cardiology that require at least moderate sedation. Appropriate training is essential and the use of capnography and target controlled infusion pumps for propofol administration is recommended. PMID:26085525

  16. 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)

  17. Cardiac magnetic resonance in clinical cardiology

    Institute of Scientific and Technical Information of China (English)

    Andreas; Kumar; Rodrigo; Bagur

    2015-01-01

    Over the last decades, cardiac magnetic resonance(CMR) has transformed from a research tool to a widely used diagnostic method in clinical cardiology. This method can now make useful, unique contributions to the work-up of patients with ischemic and non-ischemic heart disease. Advantages of CMR, compared to other imaging methods, include very high resolution imaging with a spatial resolution up to 0.5 mm × 0.5 mm in plane, a large array of different imaging sequences to provide in vivo tissue characterization, and radiationfree imaging. The present manuscript highlights the relevance of CMR in the current clinical practice and new perspectives in cardiology.

  18. 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…

  19. 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)

  20. Onco-cardiology: Present and future.

    Science.gov (United States)

    Sueta, Daisuke; Hokimoto, Seiji

    2016-07-15

    "Onco-cardiology" is a term that indicates cardiotoxicity during treatment of malignant diseases. Many studies have demonstrated that chemotherapy agents induce cardiotoxicity in certain ratios. In clinical settings, active malignant diseases or a history thereof are often encountered in patients with cardiovascular disease (CVD); it is not uncommon for a patient to struggle with a prior treatment. We have previously demonstrated a close association between malignant diseases and coronary calcifications in coronary artery disease. The concurrence of arteriosclerotic diseases, including CVD, with malignant diseases should be carefully considered in clinical settings, particularly with regard to scheduled surgical procedures. Moreover, it is essential that all medical professionals associated with cancer care understand these associations. Our advocacy will provide new insight into onco-cardiology. PMID:27107544

  1. 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. PMID:26686266

  2. 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...

  3. Evaluating the benefits of nuclear cardiology

    International Nuclear Information System (INIS)

    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

  4. ICRP PUBLICATION 120: Radiological Protection in Cardiology

    International Nuclear Information System (INIS)

    Cardiac nuclear medicine, cardiac computed tomography (CT), interventional cardiology procedures, and electrophysiology procedures are increasing in number and account for an important share of patient radiation exposure in medicine. Complex percutaneous coronary interventions and cardiac electrophysiology procedures are associated with high radiation doses. These procedures can result in patient skin doses that are high enough to cause radiation injury and an increased risk of cancer. Treatment of congenital heart disease in children is of particular concern. Additionally, staff in cardiac catheterisation laboratories may receive high doses of radiation if radiological protection tools are not used properly. The Commission provided recommendations for radiological protection during fluoroscopically guided interventions in Publication 85, for radiological protection in CT in Publications 87 and 102, and for training in radiological protection in Publication 113 (ICRP, 2000b,c, 2007a, 2009). This report is focused specifically on cardiology, and brings together information relevant to cardiology from the Commission’s published documents. There is emphasis on those imaging procedures and interventions specific to cardiology. The material and recommendations in the current document have been updated to reflect the most recent recommendations of the Commission. This report provides guidance to assist the cardiologist with justification procedures and optimisation of protection in cardiac CT studies, cardiac nuclear medicine studies, and fluoroscopically guided cardiac interventions. It includes discussions of the biological effects of radiation, principles of radiological protection, protection of staff during fluoroscopically guided interventions, radiological protection training, and establishment of a quality assurance programme for cardiac imaging and intervention. As tissue injury, principally skin injury, is a risk for fluoroscopically guided interventions

  5. Patient cumulative radiation exposure in interventional cardiology

    International Nuclear Information System (INIS)

    Interventional cardiology procedures can involve potentially high doses of radiation to the patients. Stochastic effects of ionising radiation - radiation-induced cancers in the long term - may occur. We analysed clinical characteristics and dosimetric data in a population of patients undergoing interventional cardiology. In all, 1 591 patients who had undergone coronarography and/or angioplasty in the course of a year at the Saint-Gatien Clinic in Tours (France) were included. Information on patients' individual clinical characteristics and Dose-Area Product values were collected. Organ doses to the lung, oesophagus, bone marrow and breast were mathematically evaluated. The median age of patients was 70 years. Their median cumulative dose-area product value was 48.4 Gy.cm2 for the whole year and the median effective dose was 9.7 mSv. The median organ doses were 41 mGy for the lung, 31 mGy for the oesophagus, 10 mGy for the bone marrow and 4 mGy for the breast. Levels of doses close to the heart appear to be rather high in the case of repeated interventional cardiology procedures. Clinical characteristics should be taken into account when planning epidemiological studies on potential radiation-induced cancers. (authors)

  6. Acceptance testing and QA in interventional cardiology

    International Nuclear Information System (INIS)

    Interventional radiology has seen rapid growth in the field of cardiology over the past decade. This growth has been facilitated by advances in imaging technology and the development of increasingly sophisticated dedicated radiological equipment. Interventional cardiology (IC) procedures are complex and may involve prolonged irradiations, which may subject patients and operators to higher levels of risk than those, which normally prevail. Currently interventional cardiology contributes over 10% to annual collective dose in the UK in spite of contributing to a total annual frequency of 0.68%. The EU Medical Exposures Directive, 97/43/Euratom, identifies interventional radiology as an area of special concern. Acceptance testing and routine quality assurance (QA) programmes are particularly important in the field of interventional cardiology given the above. The requirements for acceptance testing and QA are underpinned in the EU Medical Exposures Directive and consequent national legislation. A QA survey of 16 interventional cardiology systems in Ireland was carried out by the Department of Medical Physics and Bioengineering, St. James's Hospital, Dublin. This is the continuation of a recently published survey and represents over half of the interventional cardiology systems in Ireland including new technology digital flat panel systems and dedicated mobile equipment in trailors. Acceptance testing and QA protocols were developed and reviewed in accordance with current international and national guidelines, standards and literature. Testing included assessing the performance of the X ray tube and generator, the automatic exposure control (AEC) device in fluoroscopy and digital acquisition modes and a subjective assessment of image quality using the Leeds test objects. Radiation shielding calculations and measurements were performed to determine the structural shielding required by new installations and electrical, mechanical and general radiation safety was also

  7. 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.

  8. Radiological protection in interventional cardiology in Chile

    International Nuclear Information System (INIS)

    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)

  9. Cardiological telemonitoring in rehabilitation and sports medicine.

    Science.gov (United States)

    Vainoras, Alfonsas; Marozas, Vaidotas; Korsakas, Stasys; Gargasas, Liudas; Siupsinskas, Laimonas; Miskinis, Vytenis

    2004-01-01

    The paper presents the development results of teleconsultative cardiology systems and their application in rehabilitation and sport medicine. The first teleconsultative cardiology (TELECARD) system was developed for outpatient departments in the city of Kaunas, using Internet links. It was based on the CompCardioSignal terminal. One branch of the TELECARD system with a mobile CompCardioSignal terminal was used for functional state evaluation of Lithuanian sportsmen during the 2000 Sydney Olympic Games. The examined results have shown that every sportsman responded differently to acclimatization and the TELECARD system provided support to physicians and coaches for making optimal decisions regarding the sportsmen's adaptation and other situations. The final telemetry system was used for rower monitoring. It was based on the new CompCardioSignal terminal with three EASI ECG leads and synchronously recorded motion signals for evaluation of human reaction to physical load. The developed telemonitoring systems were a useful tool for evaluation of human reaction to physical load in rehabilitation and sports activities. PMID:15718601

  10. The use of MR in cardiological diagnostics

    International Nuclear Information System (INIS)

    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

  11. The place of imagery in cardiology: some examples

    International Nuclear Information System (INIS)

    The authors present five cases to illustrate the diagnostic procedure that can be used in cardiology and the importance of imagery techniques. For each case the article shows the reason for the choice of technique and the limits to diagnosis

  12. Preliminary reference levels in interventional cardiology

    International Nuclear Information System (INIS)

    This article describes the European DIMOND approach to defining reference levels (RLs) for radiation doses delivered to patients during two types of invasive cardiology procedures, namely coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA). Representative centres of six European countries recorded patients' doses in terms of dose-area product (DAP), fluoroscopy time and number of radiographic exposures, using X-ray equipment that has been subject to constancy testing. In addition, a DAP trigger level for cardiac procedures which should alert the operator to possible skin injury, was set to 300 Gy x cm2. The estimation of maximum skin dose was recommended in the event that a DAP trigger level was likely to be exceeded. The proposed RLs for CA and PTCA were for DAP 45 Gy x cm2 and 75 Gy x cm2, for fluoroscopy time 7.5 min and 17 min and for number of frames 1250 and 1300, respectively. The proposed RLs should be considered as a first approach to help in the optimisation of these procedures. More studies are required to establish certain ''tolerances'' from the proposed levels taking into account the complexity of the procedure and the patient's size. (orig.)

  13. Radiography in cardiology [cardiac disorders, cardiac insufficiency

    International Nuclear Information System (INIS)

    The diagnostic procedure in cardiology nearly always requires an X-ray examination of the thorax. This examination is very informative when it is correctly performed and interpreted. The radiographs need to be read precisely and comprehensively: this includes the evaluation of the silhouette of the heart (size, form and position) as well as the examination of extra-cardiac thoracic structures allowing among other things to search for signs of cardiac insufficiency. The conclusion of the X-ray examination can be drawn after having brought together information concerning the case history, the clinical examination and the study of the radiographs. The radiologist finds himself in one of three situations: (1) the information provided by the X-ray pictures is characteristic of a disease and permits a diagnosis, (2) the X-ray pictures indicate a group of hypotheses; further complementary tests could be useful and (3) the X-ray pictures provide ambiguous even contradictory information; it is necessary to complete the radiological examination by other techniques such as an ultrasonographic study of the heart

  14. Filter's importance in nuclear cardiology imaging

    International Nuclear Information System (INIS)

    Full text: Nuclear Medicine is a medical speciality which employs tomography procedures for the diagnosis, treatment and prevention of diseases. One of the most commonly used apparatus is the Single Photon Emission Computed Tomography (SPECT). To perform exams, a very small amount of a radiopharmaceutical must be given to the patient. Then, a gamma camera is placed in convenient positions to perform the photon counting, which is used to reconstruct a full 3 dimensional distribution of the radionuclide inside the body or organ. This reconstruction provides a 3-dimensional image in spatial coordinates, of the body or organ under study, allowing the physician to give the diagnostic. Image reconstruction is usually worked in the frequency domain, due to a great simplification introduced by the Fourier decomposition of image spectra. After the reconstruction, an inverse Fourier transform must be applied to trace back the image into spatial coordinates. To optimize this reconstruction procedure, digital filters are used to remove undesirable components of frequency, which can 'shadow' relevant physical signatures of diseases. Unfortunately, the efficiency of the applied filter is strongly dependent on its own mathematical parameters. In this work we demonstrate how filters interfere on image quality in cardiology examinations with SPECT, concerning perfusion and myocardial viability and the importance of the medical physicist in the choice of the right filters avoiding some serious problems that could occur in the inadequate processing of an image damaging the medical diagnosis. (author)

  15. Cardiology education using hypermedia and digital imagery.

    Science.gov (United States)

    Klingler, J W; Andrews, L T; Leighton, R F

    1992-07-01

    A computer-based educational system for the study of cardiovascular imaging is described. This system, based on HyperCard * and a standard Macintosh II, integrates hypertext retrieval, computer graphics, sound, and medical images into a single interactive environment stored on a standard hard disk. This 'hypermedia' approach allows arbitrary complexity coupled with direct, immediate, easy traversal of the images and related text, which provides the opportunity for students to move at their own pace, choose their own direction through the material and repeat as often as desired. Storage on magnetic medium allows for easy updating with new studies and material in order to keep pace with advances in medical imaging technology. The system could be mastered onto CD-ROM for ease of distribution if so desired. The system includes a tutorial on the basics of digital image representation and example studies from cineangiography, nuclear medicine, echocardiography and magnetic resonance imaging of the heart. Quantitative techniques for evaluation of left ventricular function are explained using computer graphics overlays on the original medical images. Color encoded functional images are also included as an aid to visualization of ventricular performance data. The system has proven useful as a primer for digital imaging in cardiology prior to specific case study in a traditional mentor relationship. PMID:1458869

  16. Toward a personal health society in cardiology.

    Science.gov (United States)

    Fayn, Jocelyne; Rubel, Paul

    2010-03-01

    In this paper, we present a new generation of health services that has emerged due to the development of advanced information and communication technology (ICT) solutions, like the Enhanced Personal, Intelligent, and Mobile system for Early Detection and Interpretation of Cardiac Syndromes (EPI-MEDICS). It is a personal self-care system that allows any citizen to self-record high-quality ECGs on demand with a smart portable device, which is endowed with powerful ICT capabilities: self-adaptive embedded intelligence, mobile health record management support on SmartMedia card, embedded Web server, and wireless communication. The EPI-MEDICS solution design also provides ambient, intelligent, and pervasive computing services offering any citizen a ubiquitous, reliable, and efficient management of his/her own cardiac status. A multicentric evaluation performed in Europe with a series of device prototypes and the performance assessment of the original methods of signal synthesis that were designed to guarantee a high interoperability level of the recorded data within the clinical practice, as well as of the decision-support methodologies that were developed for an early detection of life-threatening myocardial ischemia and arrhythmia, at home or anywhere, demonstrate the pertinence of going toward a personal health society in cardiology, which still yields the highest mortality rate in industrialized countries. PMID:20007033

  17. Recent advances of MIBG imaging in cardiology

    International Nuclear Information System (INIS)

    The sympathetic nervous system plays an important role in the regulation of cardiovascular function both in healthy subjects and in patients with heart disease. Cardiac neurotransmission imaging allows in vivo noninvasive assessment of presynaptic storage, release and reuptake of neurotransmitters. Iodine-123 labeled metaiodobenzylguanidine (MIBG) is an analogue of the sympatholytic agent guanethidine and behaves in a manner that is similar to norepinephrine, a neurotransmitter of the sympathetic nervous system in the heart. Qualitative and quantitative assessment of MIBG uptake and washout kinetics has evaluated alterations of the cardiac sympathetic function in various heart diseases, such as cardiomyopathies, coronary artery disease, diabetic heart and arrhythmias. As reduced MIBG uptake has been related to the clinical indices of severity and prognosis, it can be used to evaluate the therapeutic effects on the cardiac sympathetic dysfunction. For example, angiotensin converting enzyme inhibitors and β-blockers which have been shown to improve functional capacity and prognosis in patients with heart failure, have been demonstrated to increase MIBG uptake and reduce its washout rate in these patients, indicating favorable effects on the sympathetic nervous system. Thus, MIBG imaging has become a promising noninvasive tool and a widely available modality for the assessment of prognosis and effects of medical therapy in various forms of cardiac pathology. The usefulness and recent advances of MIBG imaging in cardiology will be noted in this article. (author)

  18. Occupational dose measurement in interventional cardiology, dosimetry comparison study

    International Nuclear Information System (INIS)

    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)

  19. 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. PMID:26961569

  20. Eye lens dose in interventional cardiology.

    Science.gov (United States)

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

    2015-07-01

    The ICRP has recently recommended reducing the occupational exposure dose limit for the lens of the eye to 20 mSv y(-1), averaged over a period of 5 y, with no year exceeding 50 mSv, instead of the current 150 mSv y(-1). This reduction will have important implications for interventional cardiology and radiology (IC/IR) personnel. In this work, lens dose received by a staff working in IC is studied in order to determine whether eye lens dose monitoring or/and additional radiological protection measures are required. Eye lens dose exposure was monitored in 10 physicians and 6 nurses. The major IC procedures performed were coronary angiography and percutaneous transluminal coronary angioplasty. The personnel were provided with two thermoluminescent dosemeters (TLDs): one calibrated in terms of Hp(3) located close to the left ear of the operator and a whole-body dosemeter calibrated in terms of Hp(10) and Hp(0.07) positioned on the lead apron. The estimated annual eye lens dose for physicians ranged between 8 and 60 mSv, for a workload of 200 procedures y(-1). Lower doses were collected for nurses, with estimated annual Hp(3) between 2 and 4 mSv y(-1). It was observed that for nurses the Hp(0.07) measurement on the lead apron is a good estimate of eye lens dose. This is not the case for physicians, where the influence of both the position and use of protective devices such as the ceiling shield is very important and produces large differences among doses both at the eyes and on the thorax. For physicians, a good correlation between Hp(3) and dose area product is shown. PMID:25809107

  1. Contrast-induced nephropathy in interventional cardiology

    Directory of Open Access Journals (Sweden)

    Sudarsky D

    2011-07-01

    Full Text Available Doron Sudarsky, Eugenia NikolskyCardiology Department, Rambam Health Care Campus and Technion-Israel Institute of Technology, Haifa, IsraelAbstract: Development of contrast-induced nephropathy (CIN, ie, a rise in serum creatinine by either ≥0.5 mg/dL or by ≥25% from baseline within the first 2–3 days after contrast administration, is strongly associated with both increased inhospital and late morbidity and mortality after invasive cardiac procedures. The prevention of CIN is critical if long-term outcomes are to be optimized after percutaneous coronary intervention. The prevalence of CIN in patients receiving contrast varies markedly (from <1% to 50%, depending on the presence of well characterized risk factors, the most important of which are baseline chronic renal insufficiency and diabetes mellitus. Other risk factors include advanced age, anemia, left ventricular dysfunction, dehydration, hypotension, renal transplant, low serum albumin, concomitant use of nephrotoxins, and the volume of contrast agent. The pathophysiology of CIN is likely to be multifactorial, including direct cytotoxicity, apoptosis, disturbances in intrarenal hemodynamics, and immune mechanisms. Few strategies have been shown to be effective to prevent CIN beyond hydration, the goal of which is to establish brisk diuresis prior to contrast administration, and to avoid hypotension. New strategies of controlled hydration and diuresis are promising. Studies are mixed on whether prophylactic oral N-acetylcysteine reduces the incidence of CIN, although its use is generally recommended, given its low cost and favorable side effect profile. Agents which have been shown to be ineffective or harmful, or for which data supporting routine use do not exist, include fenoldopam, theophylline, dopamine, calcium channel blockers, prostaglandin E1, atrial natriuretic peptide, statins, and angiotensin-converting enzyme inhibitors.Keywords: contrast-induced nephropathy, contrast media

  2. Eye lens dose in interventional cardiology

    International Nuclear Information System (INIS)

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

  3. Comparison of nuclear cardiology in the United States and Europe

    International Nuclear Information System (INIS)

    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

  4. Methods and clinical applications in nuclear cardiology: a position statement

    International Nuclear Information System (INIS)

    Nuclear cardiological procedures have paved the way for non-invasive diagnostics of various partial functions of the heart. Many of these functions cannot be visualised for diagnosis by any other method (e.g. innervation). These techniques supplement morphological diagnosis with regard to treatment planning and monitoring. Furthermore, they possess considerable prognostic relevance, an increasingly important issue in clinical medicine today, not least in view of the cost-benefit ratio. Our current understanding shows that effective, targeted nuclear cardiology diagnosis - in particular for high-risk patients - can contribute toward cost savings while improving the quality of diagnostic and therapeutic measures. In the future, nuclear cardiology will have to withstand mounting competition from other imaging techniques (magnetic resonance imaging, electron beam tomography, multislice computed tomography). The continuing development of these methods increasingly enables measurement of functional aspects of the heart. Nuclear radiology methods will probably develop in the direction of molecular imaging. (orig.)

  5. Practical application of natriuretic peptides in paediatric cardiology

    DEFF Research Database (Denmark)

    Smith, Julie; Goetze, Jens P; Andersen, Claus B;

    2010-01-01

    conclude that in premature neonates with persistent arterial ducts; in teenagers with tetralogy of Fallot and pulmonary regurgitation; and in children with heart transplants and potential allograft rejection cardiac peptides can provide the clinician with additional information, but in children with atrial......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...

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

    Science.gov (United States)

    Wehrmacher, William H.; And Others

    1981-01-01

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

  7. 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…

  8. 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…

  9. DIHYDROPYRIDINE CALCIUM ANTAGONISTS. POSITION OF NIFEDIPINE IN MODERN CARDIOLOGY PRACTICE

    OpenAIRE

    A. A. Garganeeva

    2016-01-01

    Position of nifedipine in modern cardiology practice is highlighted. Nifedipine usage for arterial hypertension therapy , including combined one, stroke prevention, treatment of hypertensive crisis and ischemic heart disease is considered. Advantages of nifedipine innovative formulations are presented. Possible usage of nifedipine in pulmonary hypertension as well as pregnancy is discussed specially.

  10. QA in interventional cardiology: The lessons learned

    International Nuclear Information System (INIS)

    This presentation describes the methodology, shows the results and analyse the difficulties presented during implementation of the QA programmes in two Interventional Cardiology (IC) Centers of Uruguay in the context of an IAEA coordinated research project that explored the possibility of establishing guidance levels for interventional radiology procedures. First, cardiologists, technicians and nurses received specific information about the QA programme. X ray system tests methodologies were based on the DIMOND European Research Project. Characterizations were performed of the two X ray systems (Picker CV-PRO-1997- and Philips Integris 3000-1995). In clinical conditions (with couch and mattress), for all image intensifier diameters and all fluoroscopy and cine modes, Kerma rate and Kerma per frame (entrance patient dose) were measured with an ionization chamber (10x5-6 E, Radcal) at the entrance of four Plexiglas (PMMA) phantom thicknesses (16, 20, 24 and 28 cm). Simultaneously, spatial resolution and low contrast were evaluated at clinical distance to the monitor by a cardiologist and a physicist, using TOR [18FG] Leeds plate located in the center of the PMMA phantom and in the isocenter of the C-arm. In the same conditions, but for 10, 20 and 30 cm PMMA thicknesses, Kerma rate and Kerma per frame and image quality were studied with NEMA phantom (Standard XR21-2000). Constancy tests were performed with Leeds object test using 4 mm Cu attenuators and Leeds image plate. Kerma rates and Kerma per frame for the same conditions (geometry, cine or fluoroscopy modes, dose modes, image intensifier diameter, FOV and PMMA thickness) were different for each X ray system. As can be seen, values are high in the Philips unit. However, direct (subjective) observation of low and high contrast details of the Leeds test showed similar results. That would require objective evaluation (MTF, noise, contrast and SNR), but they consume more time. Differences in Kerma rate and Kerma per

  11. Nuclear cardiology in the UK: activity and practice 1997

    International Nuclear Information System (INIS)

    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

  12. Nuclear Cardiology. Guidance and Recommendations for Implementation in Developing Countries

    International Nuclear Information System (INIS)

    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

  13. Antiplatelet drugs in cardiological practice: Established strategies and new developments

    OpenAIRE

    Kroetz, Florian

    2008-01-01

    Florian Krötz, Hae-Young Sohn, Volker KlaussCardiology, Medical Policlinic, Ludwig-Maximilians-Universität, Ziemssenstr. 1, 80336 MünchenAbstract: A common pathophysiological course in vascular diseases is an overwhelming activation and aggregation of blood platelets, which results in atherothrombosis. By causing the last decisive step of cerebral, coronary, or peripheral arterial ischemia thrombotic complications of atherosclerotic disease represent a major player ...

  14. A qualitative model for computer-assisted instruction in cardiology.

    OpenAIRE

    Julen, N.; Siregar, P.; Sinteff, J. P.; Le Beux, P.

    1998-01-01

    CARDIOLAB is an interactive computational framework dedicated to teaching and computer-aided diagnosis in cardiology. The framework embodies models that simulate the heart's electrical activity. They constitute the core of a Computer-Assisted Instruction (CAI) program intended to teach, in a multimedia environment, the concepts underlying rhythmic disorders and cardiac diseases. The framework includes a qualitative model (QM) which is described in this paper. During simulation using QM, dynam...

  15. 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

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

    International Nuclear Information System (INIS)

    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)

  17. Nuclear cardiology in Senegal: a luxury or a need?

    International Nuclear Information System (INIS)

    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)

  18. Current status of nuclear cardiology in the Republic of Korea

    International Nuclear Information System (INIS)

    Since its introduction 20 years ago, nuclear cardiology in the Republic of Korea has grown impressively and is now widely used as a noninvasive procedure in the diagnosis and functional evaluation of various types of heart diseases. All of the classes of procedures, that is, first-pass radionuclide cardioangiography, gated blood pool scan, myocardial perfusion imaging, and myocardial infarct imaging, are being employed frequently and have been the subject of numerous studies. First-pass radionuclide ventriculography is being used in the detection and quantification of intracardiac shunts, the evaluation of chamber size, function, or cardiopulmonary dynamics in various disease states. With gated blood pool scans, several parameters of cardiac function are being measured in a variety of conditions including coronary heart disease. Quantifications of regurgitations are also being done. Both thallium-201 and technetium-99m pyrophosphate are being used in the diagnosis of coronary artery disease. Besides clinical imaging, active research in the field of nuclear cardiology has also been taking place in the Republic of Korea. Examples include investigations on new imaging agents such as 111In-antimyosin monoclonal antibody and hexakis technetium(I) cations, or instrumental developments such as the nuclear stethoscope. Despite such noteworthy accomplishments, however, there have also been some obstacles to further developments in the Republic of Korea, such as the unavailability of a cyclotron. Nevertheless, considering the rate of expansion these procedures are showing and the effort we are putting into further development, the future for nuclear cardiology in the Republic of Korea appears quite promising and may become an example for other developing countries. (author). 28 refs, 5 figs, 2 tabs

  19. Nuclear cardiology in the era of cardiac CT and MRI

    International Nuclear Information System (INIS)

    Full text: Current indications for classical nuclear cardiology are summarized (diagnosis, prognosis, myocardial viability, ventricular function). First, the use of nuclear cardiology is discussed within the clinical context (typical vs. atypical history of ischemia, findings on resting ECG etc.). An overview of different perfusion tracers is given both for SPECT (thallium, MIBI, microspheres) and PET (NH4, H2O, Rb). The advantages of gated imaging are mentioned, thus combining information regarding perfusion, ventricular function, regional wall motion and thickening. Then specificity and sensitivity data for detection of significant coronary artery disease are reviewed in both diabetic and non-diabetic patients: sensitivity values of 86% are reached for coronary artery stenosis of >50% in both populations. Sensitivity increases to around 90% for coronary artery stenosis of >70%. The issue of risk stratification and prognosis in both populations is raised: Negative predictive values as high as 0.97 for death and 0.94 for death or myocardial infarction are reached when patients have normal myocardial perfusion scans (follow-up 23+/-17 months). The current strengths and weaknesses of CT and MR imaging for detection of coronary artery disease are mentioned, including dobutamine stress MRI and perfusion imaging. With dobutamine stress MRI, sensitivity values between 83% and 91% are observed. When comparing dobutamine stress MRI with dobutamine echocardiography, image quality has a huge impact on sensitivity and specificity values with echo, but only minimal impact on MRI sensitivity/specificity values. In a second part of the talk, the advantages of positron emission tomography (PET) and its use in clinical cardiology (mainly detection of viability) are discussed. First, advantages of positron tomography are listed: short half life of the tracer, physiological labelling, absolute quantification, tomographic imaging. Different cardiac tracers are mentioned, such as

  20. 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.

  1. 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. PMID:26574617

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

    Science.gov (United States)

    Veitia, Marie C.; And Others

    1993-01-01

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

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

    DEFF Research Database (Denmark)

    Dümcke, Christine Elisabeth; Graff, J; Rasmussen, SPL; Madsen, Jan Lysgård; Møller, Søren

    2006-01-01

    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...

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

    OpenAIRE

    Schiattarella Pier; Farina Francesca; Raia Rosa; Esposito Roberta; Lomoriello Vincenzo; Versiero Marco; Santoro Alessandro; Galderisi Maurizio; Bonito Manuela; Olibet Marinella; de Simone Giovanni

    2010-01-01

    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...

  5. 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.

  6. 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.

  7. Investigation of radiation skin dose in interventional cardiology

    International Nuclear Information System (INIS)

    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 Gycm2 and 22.5 mSv for RFCA, and 32 Gycm2 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)

  8. Clinical and economic outcomes assessment in nuclear cardiology

    International Nuclear Information System (INIS)

    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

  9. Optimisation of patient and staff exposure in interventional cardiology

    International Nuclear Information System (INIS)

    The Council Directive of the European Community 97/43/Euratom (MED) deals with the health protection of individuals against dangers of ionising radiation in relation to medical exposure, and also focuses attention on some special practices (Art. 9), including interventional radiology, a technique involving high doses to the patient. The paper presents the European approach to optimisation of exposure in interventional cardiology. The DIMOND research consortium (DIMOND: Digital Imaging: Measures for Optimising Radiological Information Content and Dose) is working to develop quality criteria for cineangiographic images, to develop procedures for the classification of complexity of therapeutic and diagnostic procedures and to derive reference levels, related also to procedure complexity. DIMOND project also includes aspects of equipment characteristics and performance and content of training in radiation protection of personnel working in interventional radiology field. (author)

  10. Exploiting expert systems in cardiology: a comparative study.

    Science.gov (United States)

    Economou, George-Peter K; Sourla, Efrosini; Stamatopoulou, Konstantina-Maria; Syrimpeis, Vasileios; Sioutas, Spyros; Tsakalidis, Athanasios; Tzimas, Giannis

    2015-01-01

    An improved Adaptive Neuro-Fuzzy Inference System (ANFIS) in the field of critical cardiovascular diseases is presented. The system stems from an earlier application based only on a Sugeno-type Fuzzy Expert System (FES) with the addition of an Artificial Neural Network (ANN) computational structure. Thus, inherent characteristics of ANNs, along with the human-like knowledge representation of fuzzy systems are integrated. The ANFIS has been utilized into building five different sub-systems, distinctly covering Coronary Disease, Hypertension, Atrial Fibrillation, Heart Failure, and Diabetes, hence aiding doctors of medicine (MDs), guide trainees, and encourage medical experts in their diagnoses centering a wide range of Cardiology. The Fuzzy Rules have been trimmed down and the ANNs have been optimized in order to focus into each particular disease and produce results ready-to-be applied to real-world patients. PMID:25417018

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

    Science.gov (United States)

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

    2015-12-01

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

  12. Categories by Heart: Shortcut Reasoning in a Cardiology Clinic

    Directory of Open Access Journals (Sweden)

    Katarina Jacobsson

    2014-09-01

    Full Text Available This article examines the practice of doctors and nurses to invoke the categories of age, sex, class, ethnicity, and/or lifestyle factors when discussing individual patients and patient groups. In what situations are such references explicitly made, and what does this practice accomplish? The material consists of field notes from a cardiology clinic in Sweden, and a theory of descriptive practice guided the analysis. When professionals describe patients, discuss decisions, or explain why a patient is ill, age, sex, class, ethnicity, and/or lifestyle serve as contextualization cues, often including widespread results from epidemiological research about groups of patients at higher or lower risk for cardiac disease. These categories work as shortcut reasoning to nudge interpretations in a certain direction, legitimize decisions, and strengthen arguments. In general, studying the descriptions of patients/clients/students provides an entrance to professional methods of reasoning, including their implicit moral assumptions.

  13. 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. PMID:24960330

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

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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

  16. A telemedicine network for remote paediatric cardiology services in north-east Brazil

    OpenAIRE

    2015-01-01

    Abstract Problem Providing health care for children with congenital heart diseases remains a major challenge in low- and middle-income countries. Approach In October 2011, the Government of Paraíba, Brazil, established a paediatric cardiology network in partnership with the nongovernmental organization Círculo do Coração. A cardiology team supervised all network activities, using the Internet to keep in contact with remote health facilities. The network developed protocols for screening heart...

  17. Nuclear cardiology: Its role in cost effective care

    International Nuclear Information System (INIS)

    would not otherwise have been achieved if the early disease remained undetected. This publication presents a comprehensive overview of CVDs as a public health problem in developing countries, the relative role of nuclear cardiology methods within a scenario of unprecedented technology advances, and the evidence behind appropriateness recommendations. The potential expanding role of non-invasive functional imaging through the transition from diagnosis of obstructive CAD to defining the global burden of CVDs is also discussed, as well as the need for thorough training, education, and quality in nuclear cardiology practice. This report will be of interest for all medical practitioners involved in the management of CAD, including internists, cardiologists, and nuclear medicine physicians, as well as hospital administrators and health care stakeholders.

  18. Radiation doses to the staff of a nuclear cardiology department

    International Nuclear Information System (INIS)

    The last years, new radiopharmaceuticals are used in a Nuclear Medicine (NM) Department. Nowadays, Single Photon Emission Computed Tomography (SPECT) is a method of routine imaging, a fact that has required increased levels of radioactivity in certain patient examinations. The staff that is more likely to receive the greatest radiation dose in a NM Department is the technologist who deals with performance of patient examination and injection of radioactive material and the nurse who is caring for the patients visiting the Department some of which being totally helpless. The fact that each NM Dept possesses equipment with certain specifications, deals with various kind of patients, has specific design and radiation protection measures which can differ from other NM Depts and uses various examination protocols, makes essential the need to investigate the radiation doses received by each member of the staff, so as to continuously monitor doses and take protective measures if required, control less experienced staff and ensure that radiation dose levels are kept as low as possible at all times. The purpose of the current study was to evaluate radiation dose to the nuclear cardiology department staff by thermoluminescent dosemeters (TLDs) placed on the the skin at thyroid and abdominal region as well as evaluating protection measures taken currently in the Dept

  19. Clinical value of thallium 201 in a cardiology service

    International Nuclear Information System (INIS)

    At present the most widely used element in isotopic cardiology is undoubtedly 201Tl. In the few years since its appearance many publication testify to its growing use in the external detection of coronary thrombosis, the discovery of ischemia exertion, the non-traumatic observation of patients after an aortocoronary bridging operation, the diagnosis of coronary deficiency associated with another heart disease (aorta narrowing, mitral prolapsus, obstructive cardiomyopathy) and in combination with two other radioisotopic methods. The present work is intended as a modest contribution, still very recent, to the critical study of this new technique in all its present aspects. Part one presents the various characteristics responsible for the advantages and limits of 201Tl, then describes the techniques and apparatus used. The production, dosimetry, toxicity and biological behaviour of 201Tl are also discussed. A hundred and twenty-five examinations were performed in the Nuclear Medicine Service of the Limoges UHC between May 1977 and October 1978. The results are analysed in part two. This is followed by a discussion which attempts, in the light of our experience, to situate the place occupied by 201Tl in the range of complementary examinations useful in declared or assumed coronary cases. We then propose an examination procedure and precise indications we believe to be justified, accounting for economic problems before considering the future prospects of myocardium scintigraphy

  20. Antiplatelet drugs in cardiological practice: Established strategies and new developments

    Directory of Open Access Journals (Sweden)

    Florian Krötz

    2008-06-01

    Full Text Available Florian Krötz, Hae-Young Sohn, Volker KlaussCardiology, Medical Policlinic, Ludwig-Maximilians-Universität, Ziemssenstr. 1, 80336 MünchenAbstract: A common pathophysiological course in vascular diseases is an overwhelming activation and aggregation of blood platelets, which results in atherothrombosis. By causing the last decisive step of cerebral, coronary, or peripheral arterial ischemia thrombotic complications of atherosclerotic disease represent a major player in death cause statistics of most western countries. The development of novel therapies against platelet-dependent thrombosis and the concurrent improvement of existing therapeutic strategies thus is a paramount focus of pharmaceutical research. Currently, efficiency, dosing and indications of established antiplatelet substances are being re-evaluated, whilst new, so far unrecognized molecular targets for inhibition of platelet activity come up front. This not only allows for interesting new therapeutical options, but also widens our insight into the role platelets play in atherosclerosis in general. This article summarizes the relevant pathophysiology of platelet activation, presents current concepts in antiplatelet drug therapy, and highlights the role of platelets in vascular diseases apart from atherothrombosis.Keywords: atherothrombosis, antiplatelet drug therapy, pathophysiology, platelet activation

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

    Science.gov (United States)

    de Micheli, Alfredo

    2014-01-01

    The Mexican cardioangiology started in the nineteen century thanks to first endeavors of surgeons and physicians related to local academies and to School of Medicine, established in 1833 by Dr. Valentin Gómez Farías. Dr. Manuel Carpio, the future first head of department of physiology in this school, translated to Spanish language and published, in 1823, the article On pectoriloquo of the French physician Marat and later performed some experiments on the heart' motion. During the Secont Empire (1864-1867), the physician Samuel von Basch performed studies to define the arterial hypertension, called by him "latent atherosclerosis", i.e. the "essential hypertension". Once he had returned to his country, he invented in 1880, a sphygmomanometer of mercury column, that was the model for the instrument constructed by the Italian physician Scipione Riva-Rocci and presented in 1896. In our time, Dr. Demetrio Sodi Pallares systematized a metabolic therapy called "polarizing therapy", i.e. capable of repolarizing the heart's cells partly depolarized due to hypoxia or direct aggressions. These were the first steps in Mexico on the way to a promising medicine starting and the great adventure of Mexican cardiology. PMID:25260577

  2. Assessment of patients' skin dose during interventional cardiology procedures

    International Nuclear Information System (INIS)

    During the last 30 years the use of Interventional Cardiology (IC) procedures has increased significantly, mainly due to the benefits and advantages of the method that offers more accurate diagnosis and treatment along with less complications and hospitalization. However, IC procedures are based on the use of x-ray radiation, mostly localized at certain areas of patient's body and for extended periods of time. Consequently, patient may receive high radiation dose and deterministic effects, such as erythema, epilation or even dermal necrosis may be observed. Therefore, the need for reducing radiation dose is highly important. In order to achieve this, good knowledge of the dose levels delivered to the patient during IC procedures is essential since radiation effects are known to increase with dose. It is of great interest to know the point where the maximum skin dose (MSD) is noted since individual sensitivity may vary. MSDs greater than 1 Gy should be recorded. Patient dosimetry during IC procedures is a complex task since these type of procedures depend on various factors, such as complexity and severity of case, different specifications of x-ray equipment and patient's physical characteristics. Moreover, cardiologist's experience plays an important role. For these reasons, Food and Drug Administration (FDA), the International Commission on Radiological Protection (ICRP) as well as the World Health Organization (WHO), have published documents on radiation safety and ways to reduce skin injuries during IC procedures. Various methods have been proposed for measuring MSD such as the use of slow radiotherapy films, thermoluminescent detectors (TLD), scintillation detectors, Dose-Area Product (DAP) meter, as well as a combination of DAP and air kerma. A literature review on MSDs measured during IC procedures showed that doses ranged from 300 to 43000 mGy

  3. Protection Against X-ray Treatment in Intervention Cardiology

    International Nuclear Information System (INIS)

    The aim of this paper is to show basic propositions on protection against ionizing radiation in intervention cardiology. X-ray treatment should also be subjected to all radiological standards and principles of protection against radiation as well as all other radiological examinations. A cardiologist takes over the role of a radiologist after successfully completing additional education. The measures for reducing radiation include professional team, X-ray machines, a diagnostic room and, first of all, a patients body. A long-life diascopy is replaced by aimed photos. Concerning the X-ray machines, filtration, limiting of the bundle of rays and usage of reinforced foils are the important parts. Protection of thyroid gland, eye lenses, ovaries or spermaries and haematic organs must be ensured by safety measures. People who work with x-ray machines must have protective means in working order and personal dosimeters. Protective power of aprons, gloves and glasses must be at least 0.25 mm thick concerning lead. A medical check-up before working with radiation includes a general medical check-up with a working anamnesis and an ophtalmological, gynoecological, dermatological check-up and a psycho test as well as a haematologic analysis, an analysis of chromosome aberration and an urinanalysis. A legal and a physical person who has been appointed to work with the sources of ionizing radiation is obliged to appoint a person responsible for protection against ionizing radiation. The danger which accompanies exposure to radiation cannot be completely eliminated. However, the risk must be limited and reduced by means of administrative, organizational and technological measures. (author)

  4. The present role of nuclear cardiology in clinical practice

    Energy Technology Data Exchange (ETDEWEB)

    Clark, A.N.; Beller, G.A. [Virginia University, Charlottesville (United States). Cardiovascular Division Department of Medicine

    2005-03-01

    Many advances have been made in the field of nuclear cardiology in the past decade for enhancing the diagnostic and prognostic value of stress myocardial variability using SPECT technology. Gated SPECT for determining regional and global function have provided incremental diagnostic and prognostic information in the evaluation of patients with suspected or known coronary artery disease. Left ventricular ejection fraction and regional myocardial wall thickening can now be simultaneously evaluated with regional perfusion particularly with the use of the {sup 99m}Tc-labeled perfusion agents such as sestamibi and tetrofosmin. Many studies have shown that the extent and severity of stress-induced perfusion defects have incremental prognostic value over exercise electrocardiographic stress test variables alone. Patients with normal perfusions scans have <1% combined cardiac death and myocardial infarction rates per year and thus have an excellent prognosis. Diabetics are particularly benefited from stress perfusion imaging for detection of coronary artery disease and risk assessment. Diabetics have a worse prognostic than non diabetics for the same amount of hypoperfusion on stress SPECT studies. Quantitative rest perfusion imaging with {sup 201}Tl or with one of the {sup 99m}Tc-labeled imaging agents, or PET imaging with {sup 18}F-deoxyglucose can accurately distinguish viable from irreversibility injured myocardium providing useful information for identifying which patients with ischemic cardiomyopathy benefit most from coronary revascularization with a subsequent improvement in left ventricular function and enhanced survival. Finally, serial stress perfusion imaging can be employed to monitor the efficacy of medical therapy that improves endothelial function and myocardial blood flow reserve.

  5. Radiation dose and image quality for paediatric interventional cardiology

    International Nuclear Information System (INIS)

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

  6. Radiation dose and image quality for paediatric interventional cardiology

    Energy Technology Data Exchange (ETDEWEB)

    Vano, E [Radiology Department, Medicine School, Complutense University and San Carlos University Hospital, 28040 Madrid (Spain); Ubeda, C [Clinical Sciences Department, Faculty of the Science of Health, Tarapaca University, 18 de Septiembre 2222, Arica (Chile); Leyton, F [Institute of Public Health of Chile, Marathon 1000, Nunoa, Santiago (Chile); Miranda, P [Hemodynamic Department, Cardiovascular Service, Luis Calvo Mackenna Hospital, Avenida Antonio Varas 360, Providencia, Santiago (Chile)], E-mail: eliseov@med.ucm.es

    2008-08-07

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

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

    International Nuclear Information System (INIS)

    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)

  8. Dosimetric data and radiation risk analysis for new procedures in interventional cardiology

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate radiation doses to the patients and operators during interventional cardiology procedures, with a particular focus on the transcatheter aortic valve implantation (TAVI). Patient doses for 5549 diagnostic and therapeutic procedures and 76 TAVI were examined, as well as occupational doses to Cardiology Dept. operators. The average patient dose for TAVI was double that of PTCA and six times higher than a simple CA; statistically significant differences were shown in the average patient dose for both trans-femoral and trans-apical access; the measurements show a corresponding increase in the average occupational dose for the cardiologist. Interventional cardiology could increase the collective dose and occupationally exposed worker doses; this increase could be significant if the use of certain procedures is extended to younger people; particular attention in the choice of procedure, optimisation and staff education and organisation is therefore suggested. (authors)

  9. 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

    . The second year allows completion of the optional modules of advanced imaging, device therapy for implanters, cardiac transplantation, and mechanical circulatory support. The second year can also be devoted to continuation of specialist heart failure training and/or research for those not wishing to......It is well established that organized care of heart failure patients, including specialist management by cardiologists, improves patient outcomes. In response to this, other national training bodies (the UK and the USA) have developed heart failure subspecialty curricula within their Cardiology...... 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...

  10. The Brugada syndrome: a complex cardiological problem in the experience of the specialist in internal medicine

    Directory of Open Access Journals (Sweden)

    F. Frabetti

    2013-05-01

    Full Text Available BACKGROUND Brugada syndrome, a disease burdened by elevated risk of sudden unexpected cardiac death, often affects young aged subjects that have structurally healthy heart. The diagnostic itinerary is complex: anamnesis, ECG, pharmacological test and electrophysiological study. Its phenotypes are three. METHOD We have identified 13 cases (10 men and 3 women, 12 estimated at the Cardiological Outpatients’ Department and 1 at the First-aid Station. RESULTS 2 cases belonged to phenotype 1, 4 cases to phenotype 2 and 7 cases to phenotype 3. CONCLUSIONS Our work of specialists in internal medicine, toward this syndrome, is: an accurate anamnesis, a correct interpretation of ECG, fast sending of high risk cases to advanced level cardiological competences, a selection of cases to submit to pharmacological test, to address middle risk patients to cardiological competences, offering our cooperation in the follow-up.

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

    International Nuclear Information System (INIS)

    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.

  12. 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

  13. Laboratory reconstruction of personal doses in interventional radiology and cardiology

    International Nuclear Information System (INIS)

    People working in interventional cardiology represent one of the most occupationally exposed groups. As recommended by the ICRP, these workers should be equipped with two personal dosemeters, one of them worn on the neck outside the protective collar and the second one on the trunk under the protective apron. It is proved that this double dosimetry method provides more precise estimate of effective dose. In connection with the new lower limit of the eye lens dose, the demands on the eye lens dose estimate increase. The aim of our experiment was to examine the relation between eye lens dose and the quantities Hp(10),Hp(3) or Hp(0.07) measured with conventional personal dosemeters worn on neck and chest. Irradiation conditions imitating the common operation of interventional radiology were created in the laboratory. The patient's body was substituted for a slab PMMA phantom (30 cm x 30 cm x 15 cm). An anthropomorphic Random phantom representing a physician was clothed in a protective apron and a collar, with equivalent of 0.5 mm Pb for both. Three personal multicomponent whole-body thermoluminescent dosemeters (TLD), which allow to measure personal dose equivalents Hp(10),Hp(3) and Hp(0.07), were fixed the Random phantom, one on the collar on the neck and two on the chest over and under the apron. The use of the third dosemeter outside the apron, beyond the recommended double dosimetry, was motivated by the fact that the double dosimetry is not preferred in the Czech Republic yet. Moreover, a special TLD called EYE-D, measuring Hp(3), was employed to determine eye lens dose. It was placed on the Random phantom's temple in the proximity of the eye closer to the radiation source. The utilized PMMA slab phantom was irradiated with X-ray source with the quality RQR5 in four typical irradiation geometries, i.e. radiation beam entered the patient from the front, back, left and right side, which was simulated by the respective arrangement of both the phantoms

  14. Air kerma rates measurement in an interventional cardiology suite

    International Nuclear Information System (INIS)

    In Interventional Cardiology (IC), the assessment of the radiation that the physicians are exposed to is extremely important because the irradiation is not uniform and the received doses are substantially high. During the procedure, the radiation control is complex and there are several reasons for the high exposure levels. It is necessary to perform dosimetric assessments in different parts of the physicians' body and in different specific points of the examination room. By analyzing this information it is possible to determine the probable causes and to provide recommendations, aiming at optimizing the radiological protection. This work had the following objectives: to assess the exposition levels at representative points of critical anatomical regions of the physicians' body who perform IC examinations; to provide means to implement personal monitoring procedures; and to make them aware of the radiation risks. Measurements of air kerma rates were performed in 45 points around the examination table, along the room. Such measurements were made in the conditions frequently used in coronary angiography and coronary angioplasties procedures: adult patient phantom; RAO, LAO and AP incidences; fluoro and digital modes; 13cm and 17cm magnification modes; frequencies of 30f/s (fluoro) and 15 f/s (digital); typical field size used during examinations. Data were obtained at the lenses, chest, hands, gonads and knees levels. For AP incidence, the lowest contributions for scattered radiation and a more homogeneous distribution of radiation were observed. The highest air kerma rates were obtained during digital acquisition mode and for LAO incidence on interventional radiologists, anaesthesists and nurses. The most critical anatomical regions were the knees and gonads. Air kerma rates of about 7,8mGy/h were registered in some places. At physicians' hands position, rates of about 5mGy/h were reached. In several points and levels measured (workload ∼ 6 examinations/day), this

  15. 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

    2012-01-01

    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. PMID:22192673

  16. 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)

    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

  17. 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

  18. 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)

  19. The application of dual-isotope technique in nuclear cardiology and its scatter correction

    International Nuclear Information System (INIS)

    Acquisition of both stressed and rest myocardial perfusion simultaneously is possible when dual-isotope technique is used. And using this technique authors also can obtain data of myocardial perfusion and metabolism imaging with different clinical significance under the same physiological condition. The clinical application of dual-isotope in nuclear cardiology and its scatter correction was reviewed

  20. Clinical and scientific progress related to the interface between cardiology and psychology

    DEFF Research Database (Denmark)

    Erdman, R A M; Pedersen, Susanne S.

    2011-01-01

    In November 1975, as the first in the Netherlands, a full-time psychologist was employed at the Department of Cardiology of the Thoraxcenter of the Erasmus Medical Center. This innovative decision was consistent with a view to treat the patient as a whole rather than the heart as a single body pa...

  1. 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

    2011-01-01

    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 documen

  2. The establishment of local diagnostic reference levels for paediatric interventional cardiology

    International Nuclear Information System (INIS)

    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

  3. 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. PMID:23960607

  4. Investigation of the fluoroscopy units used in radiology and cardiology

    International Nuclear Information System (INIS)

    A nationwide survey was launched in 2002 in Switzerland in order to investigate the use of fluoroscopy and to establish national reference levels (RL) for dose intensive procedures particularly in interventional radiology. The two year investigation covered five radiology and nine cardiology departments in public hospitals and private clinics, and focused on twelve types of examinations: six diagnostic and six interventional. The performance of the fluoroscopy units used in these healthcare centres (image quality and dose) was assessed extensively. This characterization was useful since, unlike the American RAD-IR study where the fluoroscopy units where similar (Siemens, with Cu filtration), a large variability in the brands and the technical specifications of the fluoroscopy units used in the participating centres are registered in our case. The units are often programmed according to the anatomical region under investigation. Knowledge of the parameters used for the various categories of examinations is crucial for analysis of the results of the survey. First, the DAP meters of the fluoroscopy units were checked using an external reference DAP meter put on top of the measuring device of the fluoroscopy unit. The units were then characterized in terms of the image quality and the patient dose associated to the various modes used. Assessment of the image quality consisted of establishing the spatial resolution limit at the middle of a Leeds TOR(CDR) Test Object. The dose measurements were performed using an 11 cm3 ionization chamber connected to a Radcal 3036 dosemeter and a 20 cm thick PMMA phantom. The characteristics of the fluoroscopy units (dose rate, dose per frame, image quality index and spatial resolution) were established for three imaging modes (radiography, fluoroscopy and cine), various diameters (or magnifications) of the image intensifier and various imaging frequencies and for six categories of examinations: 1) barium based examinations, 2) bile

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

    International Nuclear Information System (INIS)

    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

  6. Activity and practice of nuclear cardiology in the Czech Republic, 2001

    International Nuclear Information System (INIS)

    Radionuclide myocardial perfusion imaging (MPI) has been on the rise in Europe and the USA. Details on nuclear cardiology in the Czech Republic are not available as yet, as it is impossible to obtain comprehensive data from official registers owing to different methods of reporting and data evaluation. A questionnaire concerning nuclear cardiology activity and practice in 2001 was sent to all nuclear medicine departments in the Czech Republic. All 48 departments completed the questionnaire. In 2001, 50 planar and 54 tomographic (SPET) scintillation cameras were used. The average age of the SPET cameras was 5 years (13% of SPET cameras were >8 years old). Out of the 48 centres, 39 (81%) provided a nuclear cardiology service; the total number of cardiological studies was 15,740 in 2001 (1.5 studies/1,000 population/year). The most frequently employed method was MPI (81.7%), the frequency of which had increased by 10% compared with 2000; 26 of the 39 (67%) departments reported that MPI activity was increasing. Nevertheless, the Czech Republic nuclear cardiology activity remained below the European average (2.2/1,000 population in 1994) and, particularly, below activity in the USA (15/1,000 in 1997). The activity was rather unevenly spread. Whereas two centres with >1,000 studies/year accounted for 20% of the total MPI studies, 16 of 39 (41%) departments exhibited low activity (99mTc-MIBI (60% of total MPI), followed by 201Tl (21%) and 99mTc-tetrofosmin (19%). ECG-gated SPET was employed by 20/39 (51%) centres, of which 11 (28%) performed it as a standard examination; 39% of the total MPI studies included this technique. Thirteen percent (5/39) of the departments used attenuation correction, and 69% (27/39) of the departments used a prone projection. Equilibrium radionuclide ventriculography, with 2,317 examinations (14.7%), ranked second among all nuclear cardiology methods, followed by first-pass angiocardiography (406 studies, 2.6%) and 18F-FDG (163 studies, 1

  7. A comparison of the quality of the information available on the internet on interventional radiology, vascular surgery, and cardiology

    OpenAIRE

    Alsafi, A.; Kaya, G.; Patel, H; M S Hamady

    2013-01-01

    Context and Aims: Internet use is rapidly expanding and increasingly plays a substantial role in patient education. We sought to evaluate and compare the quality of information available to patients online on three closely linked specialties: Interventional radiology (IR), cardiology, and vascular surgery. Materials and Methods: We searched the leading three search engines for the terms: "Interventional Radiology", "cardiology," and "vascular surgery," collating the top 50 hits from each sear...

  8. Testosterone and cardiovascular risk: myths and new truth about cardiological safety of androgen replacement therapy in men

    OpenAIRE

    S. Yu. Kalinchenko; I. A. Tyuzikov; L. O. Vorslov; Yu A Tishova

    2014-01-01

    In a critical review of the literature highlights issues cardiological safety of testosterone therapy in men with cardiovascular diseases, based on research evidence over the past 25 years, as well as a detailed analysis of a number of recent publications, was summoned by the ambiguous attitude of experts and researchers in connection with them demonstrated high frequency of adverse cardiological outcomes in men on the background of androgen replacement therapy. Most modern randomized studies...

  9. Inspection of cardiology departments in Norway: are they making it great in radiation protection?

    International Nuclear Information System (INIS)

    Staff involved in interventional cardiology receive the highest occupational doses in Norway, and skin burns of patients have been reported. To identify the level of radiation protection (RP) for patients and staff, and compliance with the RP regulation, the Norwegian Radiation Protection Authority carried out inspections. The inspections were conducted (2013-14) as quality system reviews, based on document reviews, interviews, on-site inspections and observations of interventional procedures. The inspections revealed that most of the hospitals had non-compliancies according to the RP regulation. Most deviations were associated with education in RP and follow-up of patients who had received high radiation doses. Lack of systematic optimisation of procedures and estimation of eye lens doses to evaluate the risk for cataracts were also common. Inspections turned out to increase the awareness of RP in cardiology and are identified as an effective tool for improving RP. (authors)

  10. Neuropsychological Testing in Interventional Cardiology Staff after Long-Term Exposure to Ionizing Radiation.

    Science.gov (United States)

    Marazziti, Donatella; Tomaiuolo, Francesco; Dell'Osso, Liliana; Demi, Virginia; Campana, Serena; Piccaluga, Emanuela; Guagliumi, Giulio; Conversano, Ciro; Baroni, Stefano; Andreassi, Maria Grazia; Picano, Eugenio

    2015-10-01

    This study aimed at comparing neuropsychological test scores in 83 cardiologists and nurses (exposed group, EG) working in the cardiac catheterization laboratory, and 83 control participants (non exposed group, nEG), to explore possible cognitive impairments. The neuropsychological assessment was carried out by means of a battery called "Esame Neuropsicologico Breve." EG participants showed significantly lower scores on the delayed recall, visual short-term memory, and semantic lexical access ability than the nEG ones. No dose response could be detected. EG participants showed lower memory and verbal fluency performances, as compared with nEG. These reduced skills suggest alterations of some left hemisphere structures that are more exposed to IR in interventional cardiology staff. On the basis of these findings, therefore, head protection would be a mandatory good practice to reduce effects of head exposure to ionizing radiation among invasive cardiology personnel (and among other exposed professionals). PMID:26400563

  11. Inspection of cardiology departments in Norway: are they making it great in radiation protection?

    Science.gov (United States)

    Silkoset, R D; Widmark, A; Friberg, E G

    2015-07-01

    Staff involved in interventional cardiology receive the highest occupational doses in Norway, and skin burns of patients have been reported. To identify the level of radiation protection (RP) for patients and staff, and compliance with the RP regulation, the Norwegian Radiation Protection Authority carried out inspections. The inspections were conducted (2013-14) as quality system reviews, based on document reviews, interviews, on-site inspections and observations of interventional procedures. The inspections revealed that most of the hospitals had non-compliances according to the RP regulation. Most deviations were associated with education in RP and follow-up of patients who had received high radiation doses. Lack of systematic optimisation of procedures and estimation of eye lens doses to evaluate the risk for cataracts were also common. Inspections turned out to increase the awareness of RP in cardiology and are identified as an effective tool for improving RP. PMID:25813484

  12. 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

    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...... 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...... 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...

  13. [The beginning of Mexican cardiology in the springtime of the Mexican National Academy of Medicine].

    Science.gov (United States)

    de Micheli, Alfredo

    2016-01-01

    The National Academy of Medicine was founded 141 years ago during the French intervention. Under the sponsorship of this brand-new medical association, Mexican cardioangiology took its first steps in the medical and surgical field as well. After the falling of the second empire, the medical and surgical advances of this discipline continued. The corresponding publications appeared in different volumes of the "Gaceta Médica de México"; at present journal of the Academy still published in our time. These steps permitted the development of the true cardiologic speciality during 40s of the twentieth century, due to the vision of Professor Ignacio Chávez, father of Mexican cardiology. Some examples of application are the epistemologic criteria in cardiologycal domains such as the conception of Riva-Rocci's sphygmomanometer in Italy in the nineteenth century and the so-called cardiac metabolic therapy in Mexico of our time, are included. PMID:26549154

  14. International project on individual monitoring and radiation exposure levels in interventional cardiology.

    Science.gov (United States)

    Padovani, R; Le Heron, J; Cruz-Suarez, R; Duran, A; Lefaure, C; Miller, D L; Sim, H K; Vano, E; Rehani, M; Czarwinski, R

    2011-03-01

    Within the Information System on Occupational Exposure in Medicine, Industry and Research (ISEMIR), a new International Atomic Energy Agency initiative, a Working Group on interventional cardiology, aims to assess staff radiation protection (RP) levels and to propose an international database of occupational exposures. A survey of regulatory bodies (RBs) has provided information at the country level on RP practice in interventional cardiology (IC). Concerning requirements for wearing personal dosemeters, only 57 % of the RB specifies the number and position of dosemeters for staff monitoring. Less than 40 % of the RBs could provide occupational doses. Reported annual median effective dose values (often <0.5 mSv) were lower than expected considering validated data from facility-specific studies, indicating that compliance with continuous individual monitoring is often not achieved in IC. A true assessment of annual personnel doses in IC will never be realised unless a knowledge of monitoring compliance is incorporated into the analysis. PMID:21051431

  15. 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

    INTRODUCTION: Myocardial perfusion imaging (MPI) is increasingly used for the diagnosis of ischaemic heart disease. The method is particularly applied as a gate keeper before coronary angiography (CAG) in patients with intermediate probability for ischaemic heart disease. This study aimed 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......%), whereas reversible ischaemia was seen in 88 patients (34%) and led to referral of 52 patients (59%) to CAG. 17 patients (19%) continued clinical control, and 19 cases (22%) were closed. Correlating results between MPI and all performed CAGs were found in 42 patients (61%), and divergent results were seen...

  16. Summary of the 4th Annual Scientific Session of Cardiology in South China

    Institute of Scientific and Technical Information of China (English)

    刘伊丽

    2002-01-01

    @@ The 4th Annual Scientific Session of South China was held from April 5 ~ 8, 2002 in Guangzhou. More than one thousand cardiologists came from Guangzhou,Guangxi, Hunan and Hainan Province participated in the meeting and 143 abstracts were presented. A distinguished faculty from the United States, Canada,Germany, Britain, Honkong, Beijing and Shanghai were invited to join this conference and gave a series of special lectures about the newest advances in cardiology.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Imaging skills for transthoracic echocardiography in cardiology fellows: The value of motion metrics

    OpenAIRE

    Mario Montealegre-Gallegos; Feroze Mahmood; Han Kim; Remco Bergman; Mitchell, John D.; Ruma Bose; Hawthorne, Katie M.; T David O′Halloran; Vanessa Wong; Hess, Philip E.; Robina Matyal

    2016-01-01

    Background: Proficiency in transthoracic echocardiography (TTE) requires an integration of cognitive knowledge and psychomotor skills. Whereas cognitive knowledge can be quantified, psychomotor skills are implied after repetitive task performance. We applied motion analyses to evaluate psychomotor skill acquisition during simulator-based TTE training. Methods and Results: During the first month of their fellowship training, 16 cardiology fellows underwent a multimodal TTE training program for...

  19. Prescription pattern of fixed dose drug combination in cardiology department in a tertiary care hospital

    OpenAIRE

    Pramod Kumar Manjhi; Lalit Mohan; Manish Kumar; Harihar Dikshit; Singh, B. P.; Anuj Kumar Pathak; Sanjeev Kumar

    2016-01-01

    Background: A cardiovascular disease (CVD) is one of the most common causes of mortality and morbidity globally. The drastic change in the lifestyle of population during 21st century has had a great impact on health especially cardiovascular diseases. Objective of this study was to assess the prescription pattern of fixed dose drug combinations (FDCs) in the department of cardiology in a tertiary care hospital. Methods: The prescriptions of 210 patients suffered by cardiovascular disorders...

  20. Cardiopulmonary exercise testing – Its application in cardiology and occupational medicine

    OpenAIRE

    Małgorzata Kurpesa; Katarzyna Jerka; Alicja Bortkiewicz

    2014-01-01

    Cardiopulmonary exercise testing is a method used to assess the exercise capacity. It is used in cardiology to define the diagnostic and prognostic information, the treatment and its effectiveness. This method is also useful in sport medicine and in occupational medicine. The cardiopulmonary exercise test involves measuring of gas exchange during exercise testing. The article presents the main parameters assessed during the test and the indications and contraindications for conducting the tes...

  1. Position paper on the importance of psychosocial factors in cardiology: Update 2013

    OpenAIRE

    Ladwig, Karl-Heinz; Lederbogen, Florian; Albus, Christian; Angermann, Christiane; Borggrefe, Martin; Fischer, Denise; Fritzsche, Kurt; Haass, Markus; Jordan, Jochen; Jünger, Jana; Kindermann, Ingrid; Köllner, Volker; Kuhn, Bernhard; Scherer, Martin; Seyfarth, Melchior

    2014-01-01

    [english] Background: The rapid progress of psychosomatic research in cardiology and also the increasing impact of psychosocial issues in the clinical daily routine have prompted the Clinical Commission of the German Heart Society (DGK) to agree to an update of the first state of the art paper on this issue which was originally released in 2008.Methods: The circle of experts was increased, general aspects were implemented and the state of the art was updated. Particular emphasis was dedicated...

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

    OpenAIRE

    A. A. Rassadina; S. A. Tarakanov; V I Kuznetsov

    2013-01-01

    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.

  3. Clinical use of nuclear cardiology in the assessment of heart failure

    International Nuclear Information System (INIS)

    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 123I-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 123I-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)

  4. Pulmonary Edema Assessed by Ultrasound: Impact in Cardiology and Intensive Care Practice.

    Science.gov (United States)

    Blanco, Pablo A; Cianciulli, Tomás F

    2016-05-01

    Pulmonary edema is a frequent condition found in adult patients hospitalized in cardiology wards and intensive care units. Ultrasonography is a diagnostic modality with a high sensitivity for the detection of extravascular lung water, visualized as B lines, and usually caused by cardiogenic or noncardiogenic pulmonary edema. This paper highlights a simple method for the assessment of patients with pulmonary edema, which allows for a differential diagnosis of its possible mechanism and contributes to therapeutic intervention guiding and monitoring. PMID:26841270

  5. Impact of cardiology referral: clinical outcomes and factors associated with physicians' adherence to recommendations

    Directory of Open Access Journals (Sweden)

    André C. Marques

    2014-12-01

    Full Text Available OBJECTIVES: Cardiology referral is common for patients admitted for non-cardiac diseases. Recommendations from cardiologists may involve complex and aggressive treatments that could be ignored or denied by other physicians. The purpose of this study was to compare the outcomes of patients who were given recommendations during cardiology referrals and to examine the clinical outcomes of patients who did not follow the recommendations. METHODS: We enrolled 589 consecutive patients who received in-hospital cardiology consultations. Data on recommendations, implementation of suggestions and outcomes were collected. RESULTS: Regarding adherence of the referring service to the recommendations, 77% of patients were classified in the adherence group and 23% were classified in the non-adherence group. Membership in the non-adherence group (p<0.001; odds ratio: 10.25; 95% CI: 4.45-23.62 and advanced age (p = 0.017; OR: 1.04; 95% CI: 1.01-1.07 were associated with unfavorable outcomes. Multivariate analysis identified four independent predictors of adherence to recommendations: follow-up notes in the medical chart (p<0.001; OR: 2.43; 95% CI: 1.48-4.01; verbal reinforcement (p = 0.001; OR: 1.86; 95% CI: 1.23-2.81; a small number of recommendation (p = 0.001; OR: 0.87; 95% CI: 0.80-0.94; and a younger patient age (p = 0.002; OR: 0.98; 95% CI: 0.96-0.99. CONCLUSIONS: Poor adherence to cardiology referral recommendations was associated with unfavorable clinical outcomes. Follow-up notes in the medical chart, verbal reinforcement, a limited number of recommendations and a patient age were associated with greater adherence to recommendations.

  6. A Computer System for Integration and Analysis of Cardiology Patient Information

    OpenAIRE

    Uretz, Eugene F.; Murphy, Tom; Millar, Roger; Jones, Jerry; Messer, Joseph V.

    1981-01-01

    A two phased approach to the statistical and mathematical analyses of cardiology data distributed over many large (Hewlett-Packard Image 1000) computer data bases is presented. During the first phase, patients satisfying specified criteria in each of the data bases are selected and specific data of these patients required for analyses during the second phase are retrieved and merged into a single random access file. During the second phase, statistical and mathematical analyses of the merged ...

  7. 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.

  8. 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. PMID:27476983

  9. Dose to patients and professionals in cardiology interventional: Progress of multicenter group Doccaci; Dosis a pacientes y a profesionales en cardiologia intervencionista: Avances del grupo multicentrico DOCCACI

    Energy Technology Data Exchange (ETDEWEB)

    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.

    2013-07-01

    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)

  10. The lebanese society of cardiology: plans and perspectives, navigating against contrary winds and progressing against all odds.

    Science.gov (United States)

    Kossaify, Antoine; Moussallem, Nicolas

    2014-01-01

    Scientific societies in medicine theoretically aim to improve a medical field as a science; however, this role is expanding nowadays to seeking also the improved practice of a certain medical field. In this regard, the current Lebanese Society of Cardiology (2013-2015) has laid many plans and considered many perspectives. These concern mainly, but not exclusively, the increase of public awareness regarding prevention, investment in research, implementation of guidelines, support of continuous medical education, organization of cardiology symposia and congresses, and achievement of national registries regarding main cardiac conditions, as well as the society's main objective of decreasing the burden of cardiovascular diseases in Lebanon. Nonetheless, the implementation of such plans and perspectives is facing contrary winds related to a multifaceted phenomenon: the dominance of private medicine with a subsequent lack of teamwork, the dominance of private media, the social and political unrest in Lebanon, significant discrepancies in the scientific background of cardiologists, and the absence of a standardized national cardiology licensing exam. Importantly, the implementation of such plans and perspectives requires individual commitment, along with the cooperation of the Order of Physicians, the Syndicate of Hospitals in Lebanon (representing private hospitals) and the Ministry of Health. Moreover, industry must be more committed to medical scientific societies; the support of cardiology events organized without the auspices of the Lebanese Society of Cardiology is not encouraged because of the presence of significant conflict of interest. PMID:25452697

  11. Protection against ionizing radiation by leaded glass googles during interventional cardiology

    International Nuclear Information System (INIS)

    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)

  12. The impact of carotid plaque presence and morphology on mortality outcome in cardiological patients

    Directory of Open Access Journals (Sweden)

    Pasanisi Emilio

    2006-03-01

    Full Text Available Abstract Background Carotid plaque severity and morphology can affect cardiovascular prognosis. We evaluate both the importance of echographically assessed carotid artery plaque geometry and morphology as predictors of death in hospitalised cardiological patients. Methods 541 hospitalised patients admitted in a cardiological division (age = 66 ± 11 years, 411 men, have been studied through ultrasound Duplex carotid scan and successively followed-up for a median of 34 months. Echo evaluation assessed plaque severity and morphology (presence of heterogeneity and profile. Results 361 patients showed carotid stenosis (67% with 70% stenosis, 4% with near occlusion and 2% with total occlusion. During the follow-up period, there were 83 all-cause deaths (15% of the total population. Using Cox's proportional hazard model, age (RR 1.06, 95% CI 1.03–1.09, p = 0.000, ejection fraction > 50% (RR = 0.62, 95% CI 0.4–0.96, p = 0.03, treatment with statins (RR = 0.52, 95% CI 0.29–0.95, p = 0.34 and the presence of a heterogeneous plaque (RR 1.6; 95% CI, 1.2 to 2.14, p = 0.002 were independent predictors of death. Kaplan – Meier survival estimates have shown the best outcome in patients without plaque, intermediate in patients with homogeneous plaques and the worst outcome in patients with heterogeneous plaques (90% vs 79% vs 73%, p = 0.0001. Conclusion In hospitalised cardiological patients, carotid plaque presence and morphology assessed by ultrasound are independent predictors of death.

  13. Biomarkers in Cardiology - Part 2: In Coronary Heart Disease, Valve Disease and Special Situations

    Directory of Open Access Journals (Sweden)

    2015-05-01

    Full Text Available Cardiovascular diseases are the main causes of mortality and morbidity in Brazil. Their primary and secondary preventions are a priority for the health system and require multiple approaches for increased effectiveness. Biomarkers are tools used to identify with greater accuracy high-risk individuals, establish a faster diagnosis, guide treatment, and determine prognosis. This review aims to highlight the importance of biomarkers in clinical cardiology practice and raise relevant points regarding their application and perspectives for the next few years. This document was divided into two parts. This second part addresses the application of biomarkers in coronary heart disease, valvular diseases, cardio-oncology, pulmonary embolism, and cardiorenal syndrome.

  14. [Pay for performance approach and its possible future influence on revenues in German interventional cardiology units].

    Science.gov (United States)

    Miljak, Tomislav; Rupp, Wolfgang

    2016-01-01

    Pay-for-performance in German health care system is still uncommon but--in view of scheduled legislative projects--could gain more influence in future. Beside others, risc adjusted in-hospital mortality and the door-to-ballon-time inpatients with ST-elevation myocardial infarction could become quality- and performance indicators in interventional cardiology units. As a result, process optimization based on these indicators could have an impact on both patient value (as already today) and revenues (from 2017 onwards). PMID:26800075

  15. Influence of dosemeter position for the assessment of eye lens dose during interventional cardiology

    OpenAIRE

    Principi, Sara; Ginjaume Egido, Mercè; Duch Guillen, María Amor; Sanchez, Roberto Mariano; Ferenandez, Jose Miguel; Vaño, Eliseo

    2015-01-01

    The equivalent dose limit for the eye lens for occupational exposure recommended by the ICRP has been reduced to 20 mSv y-1 averaged over defined periods of 5 y, with no single year exceeding 50 mSv. The compliance with this new requirement could not be easy in some workplace such as interventional radiology and cardiology. The aim of this study is to evaluate different possible approaches in order to have a good estimate of the eye lens dose during interventional procedures. Measurements wer...

  16. PET/CT cardiology: an area whose boundaries are still out of sight

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) and X-ray computed tomography (CT) performed with PET/CT cameras allow us to obtain concurrently information on the presence and degree of alterations of myocardial perfusion and metabolism and on coronary arteries calcification. Furthermore, by gated myocardial perfusion studies, PET may provide crucial information on regional coronary blood flow reserve and endothelial dysfunction. A number of recent papers provide some insight on the potential of PET/CT in cardiology and in the assessment of various cardiovascular diseases including various types of vasculitis and metabolic diseases

  17. Nuclear cardiological investigations in patients classified as physically disabled following myocardial infarction

    International Nuclear Information System (INIS)

    110 patients classified as physically disabled as a consequence of myocardial infarction were reinvestigated by means of nuclear cardiological methods. Resting 201Tl perfusion scintigraphy showed a normal distribution of radioactivity, while radionuclide ventriculography revealed a normal left ventricular ejection fraction and a normokinetic left ventricle in 20 patients. The investigation of a further 19 patients demonstrated only minimal pathological changes. The results in 34 patients revealed severe myocardial damage, and in a further 19 cases the development of left ventricular aneurysm. The results clearly show the value of 201Tl scintigraphy and radionuclide ventriculography in assessments of the degree of physical disability after myocardial infarction. (author) 15 refs.; 3 tabs

  18. Optimisation of interventional cardiology procedures; Optimisation des procedures en cardiologie interventionnelle

    Energy Technology Data Exchange (ETDEWEB)

    Bar, Olivier [SELARL, Cardiologie Interventionnelle Imagerie Cardiaque - CIIC, 8, place de la Cathedrale - 37042 Tours (France)

    2011-07-15

    Radiation-guided procedures in interventional cardiology include diagnostic and/or therapeutic procedures, primarily coronary catheterization and coronary angioplasty. Application of the principles of radiation protection and the use of optimised procedures are contributing to dose reduction while maintaining the radiological image quality necessary for performance of the procedures. The mandatory training in patient radiation protection and technical training in the use of radiology devices mean that implementing continuous optimisation of procedures is possible in practice. This optimisation approach is the basis of patient radiation protection; when associated with the wearing of protective equipment it also contributes to the radiation protection of the cardiologists. (author)

  19. THE ROLE OF P-GLYCOPROTEIN IN RATIONAL PHARMACOTHERAPY IN CARDIOLOGY

    Directory of Open Access Journals (Sweden)

    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.

  20. On the use of DICOM cine header information for optimisation: Results from the 2002 European DIMOND cardiology survey

    International Nuclear Information System (INIS)

    The paper explores the level of information contained within the DICOM header in images from various cardiology systems. Data were obtained in the European DIMOND survey on image quality (Italy (Ireland)) (Belgium)) (Greece)) and Spain). Images from five standard diagnostic cardiology procedures carried out in six European hospitals have been analysed. DICOM header information was extracted to a database in order to analyse how it could help in the optimisation of the procedures. The level of data contained in the headers differs widely between cardiology systems. None of the X-ray systems in the 2002 survey archives the dosimetric data in the DICOM header. The mean number of runs per procedure ranges between 7.5 and 15.4 and the mean number of frames per procedure between 575 and 1417. Differences in kV p, mA, pulse time, distances and C-arm angulations are substantial and suggest that there exists a wide range for optimisation. (authors)

  1. 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. PMID:26985078

  2. Influence of Ceiling Suspended Screen Positioning to the Scatter Radiation Levels in Interventional Cardiology

    International Nuclear Information System (INIS)

    The objective of this paper is to identify the effects of the ceiling suspended screen position to the scatter radiation levels in the interventional cardiology. The scatter radiation in terms of ambient dose equivalent H*(10) was measured for various positions of protective screen in the positions of the first operator, nurse and radiographer, at elevations 100-190 cm and in four different angulations of the x-ray tube. To assess the effectiveness of the protective screen, the scattered dose was also measured in the absence of any protection in all four angulations and elevations. To simulate real clinical situation the measurements were performed in the presence of 30 cm PMMA phantom using standard clinical protocol. The utility of protective screen varied for different positions and angulations. Scatter radiation levels varied in the range 70 - 3400 μSv/h for the first operator, 140 - 3200 μSv/h for the nurse and 50 - 560 μSv/h for radiographer. Ceiling suspended screens can provide a substantial level of protection (up to factor 18) in interventional cardiology, but they have to be properly managed and positioned to achieve sufficient level of protection. The guidance for optimal protection is provided in the paper.(author)

  3. Kerma rate evaluation in the air in a room interventional cardiology

    International Nuclear Information System (INIS)

    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 1m2, 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

  4. Influence of dosemeter position for the assessment of eye lens dose during interventional cardiology.

    Science.gov (United States)

    Principi, Sara; Ginjaume, Mercè; Duch, Maria Amor; Sánchez, Roberto M; Fernández, Jose M; Vano, Eliseo

    2015-04-01

    The equivalent dose limit for the eye lens for occupational exposure recommended by the ICRP has been reduced to 20 mSv y(-1) averaged over defined periods of 5 y, with no single year exceeding 50 mSv. The compliance with this new requirement could not be easy in some workplace such as interventional radiology and cardiology. The aim of this study is to evaluate different possible approaches in order to have a good estimate of the eye lens dose during interventional procedures. Measurements were performed with an X-ray system Philips Allura FD-10, using a PMMA phantom to simulate the patient scattered radiation and a Rando phantom to simulate the cardiologist. Thermoluminescence (TL) whole-body and TL eye lens dosemeters together with Philips DoseAware active dosemeters were located on different positions of the Rando phantom to estimate the eye lens dose in typical cardiology procedures. The results show that, for the studied conditions, any of the analysed dosemeter positions are suitable for eye lens dose assessment. However, the centre of the thyroid collar and the left ear position provide a better estimate. Furthermore, in practice, improper use of the ceiling-suspended screen can produce partial protection of some parts of the body, and thus large differences between the measured doses and the actual exposure of the eye could arise if the dosemeter is not situated close to the eye. PMID:25514919

  5. Paediatric interventional cardiology: flat detector versus image intensifier using a test object

    International Nuclear Information System (INIS)

    Entrance surface air kerma (ESAK) values and image quality parameters were measured and compared for two biplane angiography x-ray systems dedicated to paediatric interventional cardiology, one equipped with image intensifiers (II) and the other one with dynamic flat detectors (FDs). Polymethyl methacrylate phantoms of different thicknesses, ranging from 8 to 16 cm, and a Leeds TOR 18-FG test object were used. The parameters of the image quality evaluated were noise, signal-difference-to-noise ratio (SdNR), high contrast spatial resolution (HCSR) and three figures of merit combining entrance doses and signal-to-noise ratios or HCSR. The comparisons showed a better behaviour of the II-based system in the low contrast region over the whole interval of thicknesses. The FD-based system showed a better performance in HCSR. The FD system evaluated would need around two times more dose than the II system evaluated to reach a given value of SdNR; moreover, a better spatial resolution was measured (and perceived in conventional monitors) for the system equipped with flat detectors. According to the results of this paper, the use of dynamic FD systems does not lead to an automatic reduction in ESAK or to an automatic improvement in image quality by comparison with II systems. Any improvement also depends on the setting of the x-ray systems and it should still be possible to refine these settings for some of the dynamic FDs used in paediatric cardiology.

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

    International Nuclear Information System (INIS)

    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)

  7. Pulse waveform analysis as a bridge between pulse examination in Chinese medicine and cardiology.

    Science.gov (United States)

    de Sá Ferreira, Arthur; Lopes, Agnaldo José

    2013-04-01

    Pulse examination was probably the earliest attempt to distinguish between health and illnesses. Starting at the pre-Hippocratic era, Chinese medicine practitioners developed techniques for pulse examination and defined pulse images based on their perceptions of pulse waveforms at the radial artery. Pulse images were described using basic variables (frequency, rhythm, wideness, length, deepness, and qualities) developed under philosophical trends such as Taoism and Confucianism. Recent advances in biomedical instrumentation applied to cardiology opened possibilities to research on pulse examination based on ancient Chinese medical theories: the pulse wave analysis. Although strongly influenced by philosophy, some characteristics used to describe a pulse image are interpretable as parameters obtained by pulse waveform analysis such as pulse wave velocity and augmentation index. Those clinical parameters reflect concepts unique to Chinese medicine - such as yinyang - while are based on wave reflection and resonance theories of fluids mechanics. Major limitations for integration of Chinese and Western pulse examination are related to quantitative description of pulse images and pattern differentiation based on pulse examination. Recent evidence suggests that wave reflection and resonance phenomena may bridge Chinese medicine and cardiology to provide a more evidence-based medical practice. PMID:23546634

  8. Anticoagulation control in atrial fibrillation patients present to outpatient clinic of cardiology versus anticoagulant clinics

    Institute of Scientific and Technical Information of China (English)

    DU Xin; MA Chang-sheng; LIU Xiao-hui; DONG Jian-zeng; WANG Jun-nan; CHENG Xiao-jing

    2005-01-01

    @@ Nonvalvular atrial fibrillation (NVAF) is the most common sustained cardiac arrhythmia in clinical practice, which if untreated results in a doubling of cardiovascular morbidity and mortality. AF is an independent predictor of stroke, with an annual risk 5 to 6 times higher than patients in sinus rhythm.1 During recent years, several randomised clinical trials conducted by investigators around the world involving 13 843 participants with NVAF have demonstrated convincingly the value of warfarin therapies for stroke prevention in high risk patients.2-8 However, the dose response of warfarin is complex and its activity is easily altered by concurrent medications, food interactions, alcohol and illnesses. Adherence to medical advice and routine monitoring of the international normalized ratio (INR) is important, because low anticoagulant intensity predisposes the patients to thromboembolic complications and high intensity to haemorrhage. Studies suggested that anticoagulant clinics could improve the quality of anticoagulation control,9 and anticoagulant clinics are common in western countries. However, in China, most AF patients taking warfarin usually attend the outpatient clinic of cardiology, while the quality of anticoagulation control is never investigated. We therefore assessed anticoagulation control in the outpatient clinic of cardiology, and the quality of anticoagulation control since the establishment of anticoagulant clinics.

  9. Influence of dosemeter position for the assessment of eye lens dose during interventional cardiology

    International Nuclear Information System (INIS)

    The equivalent dose limit for the eye lens for occupational exposure recommended by the ICRP has been reduced to 20 mSv y-1 averaged over defined periods of 5 y, with no single year exceeding 50 mSv. The compliance with this new requirement could not be easy in some workplace such as interventional radiology and cardiology. The aim of this study is to evaluate different possible approaches in order to have a good estimate of the eye lens dose during interventional procedures. Measurements were performed with an X-ray system Philips Allura FD-10, using a PMMA phantom to simulate the patient scattered radiation and a Rando phantom to simulate the cardiologist. Thermoluminescence (TL) whole-body and TL eye lens dosemeters together with Philips DoseAware active dosemeters were located on different positions of the Rando phantom to estimate the eye lens dose in typical cardiology procedures. The results show that, for the studied conditions, any of the analysed dosemeter positions are suitable for eye lens dose assessment. However, the centre of the thyroid collar and the left ear position provide a better estimate. Furthermore, in practice, improper use of the ceiling-suspended screen can produce partial protection of some parts of the body, and thus large differences between the measured doses and the actual exposure of the eye could arise if the dosemeter is not situated close to the eye. (authors)

  10. Cardiology; Cardiologie

    Energy Technology Data Exchange (ETDEWEB)

    Manrique, A.; Agostini, D.; Py, M.; Guillo, P.; Weinmann, P.; Benabib, C.; Toussaint, J.F.; Eder, V.; Alibelli, M.J.; Franken, P. [Societe Fran ise de Medecine Nucleaire et Imagerie Moleculaire, 75 - Paris (France); Valli, N.; Garrigue, S.; Gatta, B.; Vialard, M.J.; Hossini, M.; Clementy, J.; Haissaguerre, M.; Ducassous, D.; Barat, J.L. [Hopital du Haut Leveque Univ. Victor Segalen, 33 - Bordeaux (France); Tran, N.; Groubatch, F.; Poussier, S.; Villemot, J.P.; Maskali, F.; Laurens, M.H.; Karcher, G.; Py, M. [Centre Hospitalier Universitaire, 54 - Nancy (France); Franken, P.R.; Vanhove, C. [AZ-VUB Bruxelles (Belgium)

    2005-11-15

    Medical examinations such SPECT or scintigraphy are used to establish a diagnosis, to provide the follow up in the case of cardiac diseases. three examples are detailed, monitoring of myocardium viability under SPECT, evaluation of patients reached by a Brugada syndrome with scintigraphy at Mibg {sup 123}I, analysis of transplant of mesenchyme cells with pinhole-SPECT among rats having a chronic myocardium infarction. (N.C.)

  11. Fetal cardiology

    International Nuclear Information System (INIS)

    Doppler echocardiography makes it possible to diagnose congenital heart disease in early pregnancy. It allows us to study the anatomical configuration of the fetal heart, and additionally, to evaluate the physiological conditions of the fetus. Evaluation of the direction, velocity, wave form pattern, and quantification of blood flow at the various sites in the fetal heart helps us to assess the characteristics of the fetal circulation and condition of the fetal heart. In order to use this technique in pathological situations, an initial study of the developing normal human fetal circulation was necessary. The authors studied 34 uncomplicated pregnancies by serial Doppler echocardiography. The studies were performed every 4 weeks from 16-weeks gestation to term. The pulsed Doppler sector scanner provided cardiac cross-sectional images, mitral and tricuspid blood velocities were obtained from apical four-chamber views. Angle corrected maximal and mean temporal velocities were calculated by digitizing the Doppler frequency shift recording on a graphic tablet computed with a minicomputer. The angle between the Doppler interrogation beam and the direction of blood flow was kept as small as possible in order to minimize the error

  12. In-Hospital Cardiology Consultation and Evidence-Based Care for Nursing Home Residents with Heart Failure

    Science.gov (United States)

    Aronow, Wilbert S.; Rich, Michael W.; Goodlin, Sarah J.; Birkner, Thomas; Zhang, Yan; Feller, Margaret A.; Aban, Inmaculada B.; Jones, Linda G.; Bearden, Donna M.; Allman, Richard M.; Ahmed, Ali

    2013-01-01

    Objectives To determine the association between cardiology consultation and evidence-based care for nursing home (NH) residents with heart failure (HF). Participants Hospitalized NH residents (n= 646) discharged from 106 Alabama hospitals with a primary discharge diagnosis of HF during 1998–2001. Design Observational. Measurements of Evidence-Based Care Pre-admission estimation of left ventricular ejection fraction (LVEF) for patients with known HF (n=494), in-hospital LVEF estimation for HF patients without known LVEF (n=452), and discharge prescriptions of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEIs-or-ARBs) to systolic HF (LVEF 100 mm Hg. Results Pre-admission LVEF was estimated in 38% and 12% of patients receiving and not receiving cardiology consultation, respectively (adjusted odds ratio {AOR}, 3.49; 95% CI, 2.16–5.66; p <0.001). In-hospital LVEF was estimated in 71% and 28% of patients receiving and not receiving cardiology consultation, respectively (AOR, 6.01; 95% CI, 3.69–9.79; p <0.001). ACEIs-or-ARBs were prescribed to 62% and 82% of patients receiving and not receiving cardiology consultation, respectively (AOR, 0.24; 95% CI, 0.07–0.81; p=0.022). Conclusion In-hospital cardiology consultation was associated with significantly higher odds of LVEF estimation among NH residents with HF. However, it did not translate into higher odds of discharge prescriptions for ACEIs-or-ARBs to NH resident with systolic HF who were eligible for the receipt of these drugs. PMID:21982687

  13. Diagnostic radiology and nuclear cardiology: their use in assessment of equine cardiovascular disease

    International Nuclear Information System (INIS)

    Survey thoracic radiography, although limited by physical considerations in the adult horse, can supply clinically useful information about changes in cardiac size and function. The radiographic features of cardiomegaly, altered pulmonary circulation, pulmonary edema, and pleural effusion as manifested in the horse are discussed. Nuclear cardiology can be performed in the standing horse. The initial transit of a radioactive tracer through the central circulation provides information about cardiac chamber size, efficiency of ventricular contraction, valvular competence, and presence of intracardiac or extracardiac shunts. Computer analysis of similar studies allows quantitation of several useful cardiac parameters including ventricular ejection fraction and shunt size (QP/QS). Gated blood pool nuclear studies are better suited to evaluate cardiac response to stress but are difficult to perform in the conscious horse with standard imaging equipment

  14. Assessment of the occupational exposure in real time during interventional cardiology procedures

    International Nuclear Information System (INIS)

    Interventional cardiology (IC) procedures can be complex, requiring the operators to work near the patient, during long exposure times. Owing to scattered radiation in the patient and the fluoroscopic equipment, the medical staff are exposed to a nonuniform radiation field and can receive high radiation doses. In this study, it is proposed to analyse staff doses obtained in real time, during IC procedures. A system for occupational dosimetry in real time was used. In order to identify some parameters that may affect the staff doses, Monte Carlo (MC) calculations, using MCNPX v.2.7.0 code and voxel phantoms, were performed. The data obtained from measurements, together with MC simulations, allowed the identification of actions and behaviours of the medical staff that could be considered a risk under routine working conditions. The implementation of this monitoring system for exposure of personnel may have a positive effect on optimisation of radiological protection in fluoroscopically guided cardiac procedures. (authors)

  15. Assessment of the occupational exposure in real time during interventional cardiology procedures.

    Science.gov (United States)

    Baptista, M; Figueira, C; Teles, P; Cardoso, G; Zankl, M; Vaz, P

    2015-07-01

    Interventional cardiology (IC) procedures can be complex, requiring the operators to work near the patient, during long exposure times. Owing to scattered radiation in the patient and the fluoroscopic equipment, the medical staff are exposed to a non-uniform radiation field and can receive high radiation doses. In this study, it is proposed to analyse staff doses obtained in real time, during IC procedures. A system for occupational dosimetry in real time was used. In order to identify some parameters that may affect the staff doses, Monte Carlo (MC) calculations, using MCNPX v.2.7.0 code and voxel phantoms, were performed. The data obtained from measurements, together with MC simulations, allowed the identification of actions and behaviours of the medical staff that could be considered a risk under routine working conditions. The implementation of this monitoring system for exposure of personnel may have a positive effect on optimisation of radiological protection in fluoroscopically guided cardiac procedures. PMID:25848113

  16. Performance of several active personal dosemeters in interventional radiology and cardiology

    International Nuclear Information System (INIS)

    Active personal dosemeters (APDs) are very useful instruments for optimizing radiation protection of workers and for increasing worker’s awareness of unexpected exposures. The challenge of monitoring personal equivalent doses with APDs in interventional fluoroscopy is that they must be sensitive to low energy photon beams and be able to record high dose rates. The aim of this work is to verify both the performance and the reliability of four active personal dosemeters (APDs) and one direct ion storage (DIS) dosemeter in typical X-ray radiation fields used during interventional radiology and cardiology (IR/IC) procedures. The values of the personal dose equivalent at a depth of 10 mm measured by the APDs are compared with the response of a whole body thermoluminescence dosemeter (TLD) as a reference dosemeter. The response is found to be satisfactory in the tested situations.

  17. Measurements of eye lens doses in interventional radiology and cardiology: Final results of the ORAMED project

    International Nuclear Information System (INIS)

    Within the ORAMED project (Optimization of Radiation Protection of Medical Staff) a coordinated measurement program for occupationally exposed medical staff was performed in different hospitals in Europe ( (www.oramed-fp7.eu)). The main objective was to obtain a set of standardized data on extremity and eye lens doses for staff involved in interventional radiology and cardiology and to optimize radiation protection. Special attention was given to the measurement of the doses to the eye lenses. In this paper an overview will be given of the measured eye lens doses and the main influence factors for these doses. The measured eye lens doses are extrapolated to annual doses. The extrapolations showed that monitoring of the eye lens should be performed on routine basis.

  18. First results of an eye lens dosimetry survey in an interventional cardiology department.

    Science.gov (United States)

    Ferrari, P; Mariotti, F; Campani, L; Castelluccio, D M; Pierotti, L; Pettinato, C; Golfieri, R; Marzocchi, A; De Palma, A

    2015-06-01

    The eye lens annual dose limit for exposed personnel to ionizing radiation has recently been revised by the ICRP--International Commission on Radiological Protection and the proposed new limit has been accepted by European legislation through the Council Directive 2013/59/EURATOM 2013. Among medical exposed personnel, the staff performing interventional cardiology are usually affected by relevant doses. For this reason a survey, employing dosemeters characterized in terms of H(p)(3), was performed in order to get the order of magnitude of the doses received by the eye lens, at least as a first guess.The survey showed that the annual dose limit can easily be reached if a proper radiation protection approach is not implemented. PMID:26052799

  19. Measurements of eye lens doses in interventional cardiology using OSL and electronic dosemeters†.

    Science.gov (United States)

    Sanchez, R M; Vano, E; Fernandez, J M; Ginjaume, M; Duch, M A

    2014-12-01

    The purpose of this paper is to test the appropriateness of OSL and electronic dosemeters to estimate eye lens doses at interventional cardiology environment. Using TLD as reference detectors, personal dose equivalent was measured in phantoms and during clinical procedures. For phantom measurements, OSL dose values resulted in an average difference of -15 % vs. TLD. Tests carried out with other electronic dosemeters revealed differences up to ±20 % versus TLD. With dosemeters positioned outside the goggles and when TLD doses were >20 μSv, the average difference OSL vs. TLD was -9 %. Eye lens doses of almost 700 μSv per procedure were measured in two cases out of a sample of 33 measurements in individual clinical procedures, thus showing the risk of high exposure to the lenses of the eye when protection rules are not followed. The differences found between OSL and TLD are acceptable for the purpose and range of doses measured in the survey. PMID:24464819

  20. Diagnostic radiology and nuclear cardiology. Their use in assessment of equine cardiovascular disease.

    Science.gov (United States)

    Koblik, P D; Hornof, W J

    1985-08-01

    Survey thoracic radiography, although limited by physical considerations in the adult horse, can supply clinically useful information about changes in cardiac size and function. The radiographic features of cardiomegaly, altered pulmonary circulation, pulmonary edema, and pleural effusion as manifested in the horse are discussed. Nuclear cardiology can be performed in the standing horse. The initial transit of a radioactive tracer through the central circulation provides information about cardiac chamber size, efficiency of ventricular contraction, valvular competence, and presence of intracardiac or extracardiac shunts. Computer analysis of similar studies allows quantitation of several useful cardiac parameters including ventricular ejection fraction and shunt size (QP/QS). Gated blood pool nuclear studies are better suited to evaluate cardiac response to stress but are difficult to perform in the conscious horse with standard imaging equipment. PMID:2934115

  1. Sustancias de contraste para estudios radiográficos en cardiología intervencionista

    OpenAIRE

    Luis Roberto Llerena Rojas; Lorenzo D. Llerena Rojas

    2002-01-01

    Las sustancias de contraste (SC) radiográficas utilizadas en Cardiología se clasifican en: 1. Iónicas de osmolalidad muy alta (OMA); 2. No iónicas de osmolalidad no muy alta (ONMA); 3. Iónicas de ONMA; 4. No iónicas Isosmolares. Todas las SC de OMA son iónicas, monómeras y triyodadas: un anillo de benceno con 3 átomos de yodo. Las iónicas de ONMA son dímeras y hexayodadas: dos anillos de benceno y 6 átomos de yodo. Las no iónicas de ONMA son monómeras y triyodadas y las isosmolares dímeras y ...

  2. The importance of pre-clinical animal testing in interventional cardiology.

    Science.gov (United States)

    Suzuki, Yoriyasu; Yeung, Alan C; Ikeno, Fumiaki

    2008-11-01

    The treatment of cardiovascular disease has changed dramatically over the past 2 decades, allowing patients to live longer and better quality lives. The introduction of new therapies has contributed much to this success. Nowhere has this been more evident than in interventional cardiology, where percutaneous cardiovascular intervention has evolved in the past 2 decades from a quirky experimental procedure to a therapeutic cornerstone for patients with symptomatic cardiovascular disease. The development of these technologies from the earliest stages requires preclinical experiments using animal models. Once introduced into the clinical arena, an understanding of therapeutic mechanisms of these devices can be ascertained through comparisons of animal model research findings with clinical pathological specimens. This review provides an overview of the emerging role, results of preclinical studies and development, and evaluation of animal models for percutaneous cardiovascular intervention technologies for patients with symptomatic cardiovascular disease. PMID:19142381

  3. Evaluation of occupational and medical doses on interventional cardiology procedures by Monte Carlo method

    International Nuclear Information System (INIS)

    Interventional cardiology consists on a set of medical procedures which are mainly focused on diagnosing and treating patients who suffer cardiovascular diseases. Even though the usage of X-ray is justified on this case, it is greatly advised to evaluate the dose which professionals and patients will be exposed due to the fact that the complexity and length of the procedures often require high doses. The objective of this work is to estimate the radiation dose on both a patient and a physician through conversion coefficient (CCs) of effective dose (E) and equivalent dose (H) during a coronary angiography examination.The dose CCs was estimated using the Visual Monte Carlo code (VMC) and a pair of simulators anthropomorphic voxel (Female Adult VoXel). The CCs were normalized in terms of kerma-area product (KAP). As expected, for all situations studied, the patient in anteroposterior projection (AP) obtained the highest conversion coefficient of equivalent dose and effective dose (author)

  4. Measurements of eye lens doses in interventional cardiology using OSL and electronic dosemeters

    International Nuclear Information System (INIS)

    The purpose of this paper is to test the appropriateness of OSL and electronic dosemeters to estimate eye lens doses at interventional cardiology environment. Using TLD as reference detectors, personal dose equivalent was measured in phantoms and during clinical procedures. For phantom measurements, OSL dose values resulted in an average difference of 215 % vs. TLD. Tests carried out with other electronic dosemeters revealed differences up to ±20 % versus TLD. With dosemeters positioned outside the goggles and when TLD doses were >20 μSv, the average difference OSL vs. TLD was 29 %. Eye lens doses of almost 700 μSv per procedure were measured in two cases out of a sample of 33 measurements in individual clinical procedures, thus showing the risk of high exposure to the lenses of the eye when protection rules are not followed. The differences found between OSL and TLD are acceptable for the purpose and range of doses measured in the survey (authors)

  5. Skin Dose to Patients from Interventional Radiology and Cardiology Procedures with Potentially Long Fluoroscopy Times

    International Nuclear Information System (INIS)

    The increasing frequency and complexity of interventional procedures means that there is an increasing potential for the patient to suffer radiation-induced skin injuries. Dose measurements were initiated in a number of radiology, neuroradiology and cardiology departments in the Northern Ireland region carry out interventional procedures with potentially long fluoroscopy times. The intention was to measure patient skin dose and thus estimate the likelihood of deterministic effects occurring from such examinations. For each patient, several thermoluminescence dosemeters were placed on the areas of skin the radiologist or cardiologist considered were most likely to receive the greatest irradiation. Results are presented which indicate that several types of procedure have the potential to produce deterministic effects to patients' skin. It was concluded that skin dose should be routinely measured for each patient undergoing an interventional radiology procedure which has potentially a long fluoroscopy time. (author)

  6. Tools for assessing quality of life in cardiology and cardiac surgery.

    Science.gov (United States)

    Gierlaszyńska, Karolina; Pudlo, Robert; Jaworska, Izabela; Byrczek-Godula, Kamila; Gąsior, Mariusz

    2016-03-01

    The holistic concept of health, popularization of knowledge, as well as social and economic factors have contributed to the growing interest in research concerning quality of life in cardiovascular diseases. The value of direct measurements of the patient's well-being and the extent of their functioning in everyday life (i.e., health-related quality of life; HRQoL) has gained appreciation. Questionnaires are the most popular method of measuring quality of life. On the basis of the literature, we can conclude that the Short-Form Health Survey (SF-36) questionnaire is one of the most widely used tools measuring the quality of life of patients undergoing cardiological treatment and cardiac surgery. PMID:27212988

  7. Cardiopulmonary exercise testing – Its application in cardiology and occupational medicine

    Directory of Open Access Journals (Sweden)

    Małgorzata Kurpesa

    2014-10-01

    Full Text Available Cardiopulmonary exercise testing is a method used to assess the exercise capacity. It is used in cardiology to define the diagnostic and prognostic information, the treatment and its effectiveness. This method is also useful in sport medicine and in occupational medicine. The cardiopulmonary exercise test involves measuring of gas exchange during exercise testing. The article presents the main parameters assessed during the test and the indications and contraindications for conducting the test. It also reveals the results of recently published clinical trials on the use of cardiopulmonary exercise test in patients with cardiovascular disease and in the working population. The study included variability of respiratory parameters during the cardiopulmonary exercise test and after its completion, as well as their impact on the prognostic value. In addition, the results of a study involving an optimal choice of interval training on the basis of oxygen consumption at peak exercise are summarized. Med Pr 2014;65(5:665–674

  8. Monitoring of doses to patients in interventional cardiology: first results from three Serbian hospitals

    International Nuclear Information System (INIS)

    The aim of this work is to assess level of radiation dose to patients in interventional cardiology procedures in three large Serbian hospitals and to investigate possibility for setting of trigger levels if dose quantities exceed certain levels. Three dedicated interventional cardiology laboratories were included in the survey. Information on annual workload was estimated based on number of coronary angiography (CA) procedures and percutaneous coronary interventions (PCI). Patients doses were assessed in terms of air kerma area product (PKA) and air kerma in international reference point (KIRP). Results were compared with internationally proposed Diagnostic Reference Levels (DRL) and similar surveys results. Average total annual number of procedures was 820, 1100 and 2500 in three hospitals, respectively, while total number of dose measurements was 337. All three centers reported PKA values higher than 100 Gy·cm2 and even values above 200 Gy·cm2, corresponding to 42% and 16% of all measurements. Measured KIRP value higher than 5 Gy was reported in one center, indicating that skin doses associated possibility of skin injuries were observed. PKA mean hospital values for CA ranged from 33 to 78 Gy·cm2 and for PCI from 73 to 113 Gy·cm2, while associated vales for KIRP were: 0.45-1.2 Gy and 1.1-1.8 Gy, respectively. Comparison of obtained results with international DRL indicated that significant number of procedures is not optimally performed as in some centers more than a half of patients receive doses above DRL. The presented results are valuable input for dose optimization strategies and increased awareness related to importance of dose management. With respect to high dose values, risk for stochastic effects and tissue reactions, dose management methods were proposed. (Author)

  9. Patient dose assessment in various Interventional radiology and cardiology procedures in Algeria (IAEA regional project results)

    International Nuclear Information System (INIS)

    Full text: Purpose: To evaluate patient doses in Interventional Radiology (IR) and Cardiology (IC) procedures in Algeria, within the framework of an International Atomic Energy Agency (IAEA) regional project on radiation protection of patients and medical exposure control (RAF 9033). Materials and Methods: Three public hospitals (CHU Bab el Oued, CHU Parnet and CHU Mustapha) and one specialised Cardiology Service (Clinique Maouche) were chosen for the study. For Maximum Skin Dose (MSD) evaluation, gafchromic films XR type R were used, placed on patient's back before the procedure. The Dose Area Product (DAP) and MSD were measured in 57 IR and IC procedures, either diagnostic or therapeutic. Results: The results revealed large variations in MSD (0.06-3.3 Gy) and DAP (5.5-332 mGycm2). Mean MSD was 0.227 Gy in cerebral angiography, 0.202 Gy in coronary angiography, 1.162 Gy in Percutaneus Transluminal Coronary Angioplasty (PTCA) and 0.128 in abdominal angiography. The correlation of DAP and MSD was significant (r = 0.7). The correlation was DAP and fluoroscopy time was also significant (r = 0.8). Conclusion: The highest MSD values were found in PTCA which is a therapeutic procedure. Two PTCAs out of the 57 procedures measured in total had MSD over the threshold of 2 Gy for deterministic effects (MSD1 = 3.0 Gy and MSD2 3.3 Gy). The large variations in MSD reveal the need to continuously monitor patient doses in IR and IC procedures with special emphasis in PTCA procedure. (author)

  10. Provision of Transition Education and Referral Patterns from Pediatric Cardiology to Adult Cardiac Care.

    Science.gov (United States)

    Harbison, Anna L; Grady, Stafford; Chi, Kevin; Fernandes, Susan M

    2016-02-01

    ACC/AHA guidelines recommend a structured preparation for and transfer to adult-oriented cardiac care for adult survivors of pediatric onset heart disease (POHD). Given this, we sought to describe the transition and transfer practices for a cohort of young adults with POHD and to determine factors associated with successful transfer to adult-oriented cardiac care. We performed a single-center, retrospective chart review on patients ≥18 years of age, with POHD likely to require lifelong cardiac care, who were seen in outpatient pediatric cardiology (PC) between 2008 and 2011. Successful transfer was defined as the subsequent attendance at adult cardiology (AC) within 2 years of PC visit. We identified 118 patients who met study criteria. Mean age 22.4 ± 2.0 years, 59 % male, 64 % white and 40 % Hispanic. Mean transition education topics noted was 3.3 ± 1.8 out of 20 and covered the underlying cardiac disease (89 %), follow-up and current medications (56 %) and exercise limitations (34 %). Recommendations for follow-up were AC (57 %) and PC (33 %). Of those told to transfer to AC, 79 % successfully transferred. Characteristics of successful transfer included: prior cardiac surgery (p = 0.008), cardiac medication use (p = 0.006) and frequency of follow-up ≤1 year (p = 0.037). One-quarter of all subjects did not follow-up within at least 2 years. Despite published guidelines, transition education appears lacking and the approach to transfer to adult cardiac care is not consistent. Given the increased risk of morbidity and mortality in this patient population, standardization of transition education and transfer processes appear warranted. PMID:26385471

  11. Use of nuclear cardiology examinations to predict slow recovery from takotsubo cardiomyopathy

    International Nuclear Information System (INIS)

    Takotsubo cardiomyopathy is generally believed to have a good prognosis. However, there are considerable differences among individuals in the severity of abnormal left ventricular wall motion and in the time required for normalization. We investigated the usefulness of nuclear cardiology examinations for the differentiation of severe cases of takotsubo cardiomyopathy, which are associated with long-term wall motion abnormality. The participants were 18 patients diagnosed with takotsubo cardiomyopathy. Assessment was performed using rest TL-201 or technetium-99m sestamibi myocardial perfusion single positron emission computed tomography (SPECT) (MPS); myocardial fatty acid metabolism was evaluated by using I-123 beta-methyl-iodophenyl-pentadecanoic acid (BMIPP). A polar map was constructed from SPECT short-axis views, and was divided concentrically into 3 regions: the apical, intermediate, and base areas. The ratio of the apex to the intermedia, using mean uptake percentages, was defined as the apical uptake ratio (AUR). Participants in whom local wall motion normalized in ≤28 days or >28 days, as determined by echocardiography, were grouped into the normal recovery group (13 patients) or the slow recovery group (5 patients), respectively. AUR in MPS was 0.96±0.04 in the normal recovery group and 0.80±0.05 in the slow recovery group (p=0.008). Similarly, AUR in BMIPP significantly differed: 0.81±0.03 in the normal recovery group and 0.67±0.03 in the slow recovery group (p=0.014). The use of nuclear cardiology examinations to evaluate local uptake ratio in the apex is useful for identifying severe takotsubo cardiomyopathy, in which abnormal local wall motion may persist. (author)

  12. A telemedicine network for remote paediatric cardiology services in north-east Brazil

    Science.gov (United States)

    Hazin, Sheila Maria Vieira; Regis, Cláudio Teixeira; Soares de Araújo, Juliana Sousa; Albuquerque, Fernanda Cruz de Lira; Moser, Lúcia Roberta Didier Nunes; Hatem, Thamine de Paula; Gomes de Freitas, Carolina Paim; Mourato, Felipe Alves; Tavares, Thiago Ribeiro; Gomes, Renata Grigório Silva; Severi, Rossana; Santos, Cícera Rocha; Ferreira da Silva, Jailson; Rezende, Juliana Landim; Vieira, Paulo Coelho; Filho, José Luiz de Lima

    2015-01-01

    Abstract Problem Providing health care for children with congenital heart diseases remains a major challenge in low- and middle-income countries. Approach In October 2011, the Government of Paraíba, Brazil, established a paediatric cardiology network in partnership with the nongovernmental organization Círculo do Coração. A cardiology team supervised all network activities, using the Internet to keep in contact with remote health facilities. The network developed protocols for screening heart defects. Echocardiograms were performed by physicians under direct online supervision of a cardiologist; alternatively, a video recording of the examination was subsequently reviewed by a cardiologist. Cardiovascular surgeons came to a paediatric hospital in the state capital once a week to perform heart surgeries. Local setting Until 2011, the State of Paraíba had no structured programme to care for children with heart disease. This often resulted in missed or late diagnosis, with adverse health consequences for the children. Relevant changes From 2012 to 2014, 73 751 babies were screened for heart defects and 857 abnormalities were identified. Detection of congenital heart diseases increased from 4.09 to 11.62 per 1000 live births (P Internet. Time to diagnosis, transfers and hospital stays were greatly reduced. A total of 330 operations were carried out with 6.7% (22/330) mortality. Lessons learnt Access to an echocardiography machine with remote supervision by a cardiologist improves the detection of congenital heart disease by neonatologists; virtual outpatient clinics facilitate clinical management; the use of Internet technology with simple screening techniques allows resources to be allocated more efficiently. PMID:26668441

  13. TERAPIA ELÉCTRICA EN CARDIOLOGÍA Electrical Therapy in cardiology

    Directory of Open Access Journals (Sweden)

    Guillermo Mora Pabón

    2005-01-01

    Full Text Available La terapia eléctrica en cardiología está encaminada a transferir electrones al miocardio, su mayor utilidad está dada en la cardioversión y desfibrilación. La terapia eléctrica cumple las leyes de la electricidad y el mayor factor a vencer es la impedancia o resistencia al flujo de electrones. Para mejorar la efectividad de la terapia eléctrica se han ideado diferentes formas en la onda de choque, en la duración y la polaridad. La terapia eléctrica ha logrado consolidarse como el tratamiento de elección del paro cardiorrespiratorio secundario a fibrilación ventricular y taquicardia ventricular sin pulso. Es igualmente el tratamiento de elección en taquiarritmias con compromiso hemodinámico. Pese a sus grandes ventajas tiene efectos secundarios que se deben conocer adecuadamente para dar un tratamiento oportuno.Electrical shock in cardiology are pursuid transfer of electrons to the myocardium. Its main indications are`s cardioversion and defibrillation. The electrical shock therapy follows laws of electricity laws and consequently, its main difficulty is the impedance or resistance of electrons flow. To make better the effectiveness of this therapy, a number of improvements have been made on the shock wave, its duration, and polarity. The electric shock therapy has become the preferred treatment when dealing with cardiorespiratory arrest secondary, ventricular fibrillation and pulseless ventricular tachycardia. Similarly, it is the preferred treatment for ventricular tachyarrhythmia associated with hemodynamic compromise. Despite its significant advantages, this treatment causes secondary effects, which should adequately be known in order to provide a timely treatment.

  14. 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. PMID:26377292

  15. Staff eye lens and extremity exposure in interventional cardiology: Results of the ORAMED project

    International Nuclear Information System (INIS)

    Within the ORAMED project a coordinated measurement program for occupationally exposed medical staff was performed in different hospitals in Europe. The main objectives of ORAMED were to obtain a set of standardized data on doses for staff in interventional cardiology and radiology and to optimize staff protection. Doses were measured with thermoluminescent dosemeters on the ring finger and wrist of both hands, on legs and at the level of the eyes of the main operator performing interventional procedures. In this paper an overview of the doses per procedure measured during 646 interventional cardiology procedures is given for cardiac angiographies and angioplasties (CA/PTCA), radiofrequency ablations (RFA) and pacemaker and defibrillator implantations (PM/ICD). 31% of the monitored procedures were associated with no collective protective equipment, whereas 44% involved a ceiling screen and a table curtain. Although associated with the smallest air kerma – area product (KAP), PM/ICD procedures led to the highest doses. As expected, KAP and doses values exhibited a very large variability. The left side of the operator, most frequently the closest to the X-ray scattering region, was more exposed than his right side. An analysis of the effect of parameters influencing the doses, namely collective protective equipment, X-ray tube configuration and catheter access route, was performed on the doses normalized to KAP. Ceiling screen and table curtain were observed to reduce normalized doses by atmost a factor 4, much smaller than theoretical attenuation factors typical for such protections, i.e. from 10 to 100. This observation was understood as their inappropriate use by the operators and their non-optimized design. Configurations with tube above the patient led to higher normalized doses to the operator than tube below, but the effect of using a biplane X-ray suite was more complex to analyze. For CA/PTCA procedures, the upper part of the operator’s body received

  16. Occupational doses in interventional cardiology: Experiences in obtaining worldwide data as part of the ISEMIR project

    International Nuclear Information System (INIS)

    The International Atomic Energy Agency (IAEA) initiated in early 2009 the Information System on Occupational Exposure in Medicine, Industry and Research, referred to as the ISEMIR project. The project is specifically aimed at improving occupational radiation protection in those areas of radiation use in medicine, industry and research where non-trivial occupational exposures occur. Interventional Cardiology (IC) was the first such area identified and a working group was formed in February 2009 - the Working Group on Interventional Cardiology (WGIC). One of the first actions of the WGIC was to devise questionnaires to gain insight into occupational radiation protection in IC around the world. This included a questionnaire addressed to national or state radiation protection (RP) regulatory bodies (RBs), asking, inter alia: the numbers of workers with personal dosimetry involved in IC procedures in 2008; values of occupational doses (effective dose) in the national authority's database (or database accessible by the national authority); and whether the RP RB defines the number and position of dosimeters for staff monitoring in IC. Responses were received from 81 RBs (56 national RBs and 25 state RBs) out of 191 attempted contacts. About half the RBs (41 out of 81) stated that they were not able to provide occupational dose data for IC, citing reasons that included: no central dose register in the country or state; no easy access to the central dose register by the RB; the RB only had records of doses if they exceed some particular threshold (e.g. investigation or action level); no specific classification for interventional cardiologists, or other persons in IC in the database. The other RBs (40 out of 81) were able to provide some occupational dose data, ranging from detailed dose values to data that were inconsistent and/or ambiguous. Some of the dose data supplied were not suitable for further analysis for reasons that included: reported dose data were

  17. Bridging the Gap, Facing the Challenge—the 26th Great Wall International Congress of Cardiology (GW-ICC)

    OpenAIRE

    Zhang, Yingmei; Ren, Jun

    2016-01-01

    The joint venue of the 26th Great Wall International Congress of Cardiology (GW-ICC) & Asia Pacific Heart Congress 2015 (APHC 2015) & International Congress Cardiovascular Prevention and Rehabilitation 2015 (ICCPR 2015) were held from October 29 to November 01, 2015 at the China National Convention Center (CNCC), Beijing, China. This year’s conference focused on cardiovascular disease prevention, health promotion, education and training, as well as disease management and rehabilitation.

  18. Bridging the Gap, Facing the Challenge-the 26(th) Great Wall International Congress of Cardiology (GW-ICC).

    Science.gov (United States)

    Zhang, Yingmei; Ren, Jun

    2016-02-01

    The joint venue of the 26(th) Great Wall International Congress of Cardiology (GW-ICC) & Asia Pacific Heart Congress 2015 (APHC 2015) & International Congress Cardiovascular Prevention and Rehabilitation 2015 (ICCPR 2015) were held from October 29 to November 01, 2015 at the China National Convention Center (CNCC), Beijing, China. This year's conference focused on cardiovascular disease prevention, health promotion, education and training, as well as disease management and rehabilitation. PMID:26885499

  19. Class attendance and cardiology examination performance: a study in problem-based medical curriculum

    Directory of Open Access Journals (Sweden)

    Bamuhair SS

    2016-02-01

    Full Text Available Samira S Bamuhair,1 Ali I Al Farhan,1,2 Alaa Althubaiti,1 Saeed ur Rahman,1,2 Hanan M Al-Kadri1,3 1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 2Department of Family Medicine and Primary Health Care, 3Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Riyadh, Saudi Arabia Background and aims: Information on the effect of students' class attendance on examination performance in a problem-based learning medical curriculum is limited. This study investigates the impact of different educational activities on students' academic performance in a problem-based learning curriculum. Methods: This is a retrospective cohort study conducted on the cardiology block at the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. All students who undertook the cardiology block during the academic year 2011–2012 were included. The students' attendance was measured using their overall attendance percentage. This percentage is a product of their attendance of many activities throughout the block. The students' performance was assessed by the final mark obtained, which is a product of many assessment elements. Statistical correlation between students' attendance and performance was established. Results: A total of 127 students were included. The average lecture attendance rate for the medical students in this study was found to be 86%. A significant positive correlation was noted between the overall attendance and the accumulated students' block mark (r=0.52; P<0.001. Students' attendance to different education activities was correlated to their final mark. Lecture attendance was the most significant predictor (P<0.001, that is, 1.0% increase in lecture attendance has predicted a 0.27 increase in students' final block mark. Conclusion: Class attendance has a positive effect on students' academic performance with stronger effect for lecture attendance compared to

  20. Position paper on the importance of psychosocial factors in cardiology: Update 2013

    Directory of Open Access Journals (Sweden)

    Ladwig, Karl-Heinz

    2014-05-01

    Full Text Available [english] Background: The rapid progress of psychosomatic research in cardiology and also the increasing impact of psychosocial issues in the clinical daily routine have prompted the Clinical Commission of the German Heart Society (DGK to agree to an update of the first state of the art paper on this issue which was originally released in 2008.Methods: The circle of experts was increased, general aspects were implemented and the state of the art was updated. Particular emphasis was dedicated to coronary heart diseases (CHD, heart rhythm diseases and heart failure because to date the evidence-based clinical knowledge is most advanced in these particular areas. Differences between men and women and over the life span were considered in the recommendations as were influences of cognitive capability and the interactive and synergistic impact of classical somatic risk factors on the affective comorbidity in heart disease patients.Results: A IA recommendation (recommendation grade I and evidence grade A was given for the need to consider psychosocial risk factors in the estimation of coronary risks as etiological and prognostic risk factors. Furthermore, for the recommendation to routinely integrate psychosocial patient management into the care of heart surgery patients because in these patients, comorbid affective disorders (e.g. depression, anxiety and post-traumatic stress disorder are highly prevalent and often have a malignant prognosis. A IB recommendation was given for the treatment of psychosocial risk factors aiming to prevent the onset of CHD, particularly if the psychosocial risk factor is harmful in itself (e.g. depression or constrains the treatment of the somatic risk factors. Patients with acute and chronic CHD should be offered anti-depressive medication if these patients suffer from medium to severe states of depression and in this case medication with selective reuptake inhibitors should be given. In the long-term course of treatment

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Challenging the holy grail of hospital accreditation: A cross sectional study of inpatient satisfaction in the field of cardiology

    Science.gov (United States)

    2010-01-01

    Background Subjective parameters such as quality of life or patient satisfaction gain importance as outcome parameters and benchmarks in health care. In many countries hospitals are now undergoing accreditation as mandatory or voluntary measures. It is believed but unproven that accreditations positively influence quality of care and patient satisfaction. The present study aims to assess in a defined specialty (cardiology) the relationship between patient satisfaction (as measured by the recommendation rate) and accreditation status. Methods Consecutive patients discharged from 25 cardiology units received a validated patient satisfaction questionnaire. Data from 3,037 patients (response rate > 55%) became available for analysis. Recommendation rate was used as primary endpoint. Different control variables such as staffing level were considered. Results The 15 accredited units did not differ significantly from the 10 non-accredited units regarding main hospital (i.e. staffing levels, no. of beds) and patient (age, gender) characteristics. The primary endpoint "recommendation rate of a given hospital" for accredited hospitals (65.6%, 95% Confidence Interval (CI) 63.4 - 67.8%) and hospitals without accreditation (65.8%, 95% CI 63.1 - 68.5%) was not significantly different. Conclusion Our results support the notion that - at least in the field of cardiology - successful accreditation is not linked with measurable better quality of care as perceived by the patient and reflected by the recommendation rate of a given institution. Hospital accreditation may represent a step towards quality management, but does not seem to improve overall patient satisfaction. PMID:20459873

  3. Challenging the holy grail of hospital accreditation: A cross sectional study of inpatient satisfaction in the field of cardiology

    Directory of Open Access Journals (Sweden)

    Erbel Raimund

    2010-05-01

    Full Text Available Abstract Background Subjective parameters such as quality of life or patient satisfaction gain importance as outcome parameters and benchmarks in health care. In many countries hospitals are now undergoing accreditation as mandatory or voluntary measures. It is believed but unproven that accreditations positively influence quality of care and patient satisfaction. The present study aims to assess in a defined specialty (cardiology the relationship between patient satisfaction (as measured by the recommendation rate and accreditation status. Methods Consecutive patients discharged from 25 cardiology units received a validated patient satisfaction questionnaire. Data from 3,037 patients (response rate > 55% became available for analysis. Recommendation rate was used as primary endpoint. Different control variables such as staffing level were considered. Results The 15 accredited units did not differ significantly from the 10 non-accredited units regarding main hospital (i.e. staffing levels, no. of beds and patient (age, gender characteristics. The primary endpoint "recommendation rate of a given hospital" for accredited hospitals (65.6%, 95% Confidence Interval (CI 63.4 - 67.8% and hospitals without accreditation (65.8%, 95% CI 63.1 - 68.5% was not significantly different. Conclusion Our results support the notion that - at least in the field of cardiology - successful accreditation is not linked with measurable better quality of care as perceived by the patient and reflected by the recommendation rate of a given institution. Hospital accreditation may represent a step towards quality management, but does not seem to improve overall patient satisfaction.

  4. Transition from image intensifier to flat panel detector in interventional cardiology: Impact of radiation dose

    Directory of Open Access Journals (Sweden)

    Roshan S Livingstone

    2015-01-01

    Full Text Available Flat panel detector (FPD technology in interventional cardiology is on the increase due to its varied advantages compared to the conventional image intensifier (II systems. It is not clear whether FPD imparts lower radiation doses compared to II systems though a few studies support this finding. This study intends to compare radiation doses from II and FPD systems for coronaryangiography (CAG and Percutaneous Transluminal Coronary Angioplasty (PTCA performed in a tertiary referral center. Radiation doses were measured using dose area product (DAP meter from patients who underwent CAG (n = 222 and PTCA (n = 75 performed using FPD angiography system. The DAP values from FPD were compared with earlier reported data using II systems from the same referral center where the study was conducted. The mean DAP values from FPD system for CAG and PTCA were 24.35 and 63.64 Gycm 2 and those from II system were 27.71 and 65.44 Gycm 2 . Transition from II to FPD system requires stringent dose optimization strategies right from the initial period of installation.

  5. Multiple procedures and cumulative individual radiation exposure in interventional cardiology: A long-term retrospective study

    International Nuclear Information System (INIS)

    Various studies address discrepancies between guideline recommendations for coronary angiographies and clinical practice. While the issue of the appropriateness of recurrent angiographies was studied focusing on the role of the cardiologist, little is known about individual patients' histories and the associated radiation exposures. We analyzed all patients with coronary artery disease (CAD) in an academic teaching practice who underwent at least one angiography with or without intervention between 2004 and 2009. All performed angiographies in these patients were analyzed and rated by three physicians for appropriateness levels according to cardiology guidelines. Typical exposure data from the medical literature were used to estimate individual radiation exposure. In the cohort of 147 patients, a total of 441 procedures were analyzed: between 1981 and 2009, three procedures were performed per patient (range 1-19) on average. Appropriateness ratings were 'high/intermediate' in 71 %, 'low/no' in 27.6 % and data were insufficient for ratings in 1.4 %. Procedures with 'low/no' ratings were associated with potentially avoidable exposures of up to 186 mSv for single patients. Using retrospective data, we exemplify the potential benefit of guideline adherence to decrease patients' radiation exposures. (orig.)

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

    International Nuclear Information System (INIS)

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

  7. Entrance surface air kerma in x-ray systems for paediatric interventional cardiology: a national survey

    International Nuclear Information System (INIS)

    The aims of this work were to report the results of a national survey on entrance surface air kerma (ESAK) values for different phantom thicknesses and operation modes in paediatric interventional cardiology (IC) systems and to compare them with previous values. The national survey also offers suggested investigation levels (ILs) for ESAK in paediatric cardiac procedures. ESAK was measured on phantoms of 4-16 cm thickness of polymethyl methacrylate slabs. For low fluoroscopy mode (FM), ESAK rates ranged from 0.11 to 33.1 mGy min-1 and for high FM from 0.34 to 61.0 mGy min-1. For cine mode, values of ESAK per frame were from 1.9 to 78.2 μGy fr-1. The ILs were suggested as the third quartile of the values measured. This research showed lower ESAK values than in previous research, particularly for ESAK values in cine modes. This work represents a first step towards launching a national programme in paediatric dosimetry for IC procedures. (authors)

  8. CardioSmart365: Artificial Intelligence in the Service of Cardiologic Patients

    Directory of Open Access Journals (Sweden)

    Efrosini Sourla

    2012-01-01

    Full Text Available Artificial intelligence has significantly contributed in the evolution of medical informatics and biomedicine, providing a variety of tools available to be exploited, from rule-based expert systems and fuzzy logic to neural networks and genetic algorithms. Moreover, familiarizing people with smartphones and the constantly growing use of medical-related mobile applications enables complete and systematic monitoring of a series of chronic diseases both by health professionals and patients. In this work, we propose an integrated system for monitoring and early notification for patients suffering from heart diseases. CardioSmart365 consists of web applications, smartphone native applications, decision support systems, and web services that allow interaction and communication among end users: cardiologists, patients, and general doctors. The key features of the proposed solution are (a recording and management of patients' measurements of vital signs performed at home on regular basis (blood pressure, blood glucose, oxygen saturation, weight, and height, (b management of patients' EMRs, (c cardiologic patient modules for the most common heart diseases, (d decision support systems based on fuzzy logic, (e integrated message management module for optimal communication between end users and instant notifications, and (f interconnection to Microsoft HealthVault platform. CardioSmart365 contributes to the effort for optimal patient monitoring at home and early response in cases of emergency.

  9. Management of stable angina: A commentary on the European Society of Cardiology guidelines.

    Science.gov (United States)

    Ambrosio, Giuseppe; Komajda, Michel; Mugelli, Alessandro; Lopez-Sendón, José; Tamargo, Juan; Camm, John

    2016-09-01

    In 2013 the European Society of Cardiology (ESC) released new guidelines on the management of stable coronary artery disease. These guidelines update and replace the previous ESC guidelines on the management of stable angina pectoris, issued in 2006. There are several new aspects in the 2013 ESC guidelines compared with the 2006 version. This opinion paper provides an in-depth interpretation of the ESC guidelines with regard to these issues, to help physicians in making evidence-based therapeutic choices in their routine clinical practice. The first new element is the definition of stable coronary artery disease itself, which has now broadened from a 'simple' symptom, angina pectoris, to a more complex disease that can even be asymptomatic. In the first-line setting, the major changes in the new guidelines are the upgrading of calcium channel blockers, the distinction between dihydropyridines and non-dihydropyridine calcium channel blockers, and the presence of important statements regarding the combination of calcium channel blockers with beta-blockers. In the second-line setting, the 2013 ESC guidelines recommend the addition of long-acting nitrates, ivabradine, nicorandil or ranolazine to first-line agents. Trimetazidine may also be considered. However, no clear distinction is made among different second-line drugs, despite different quality of evidence in favour of these agents. For example, the use of ranolazine is supported by strong and recent evidence, while data supporting the use of the traditional agents appear relatively scanty. PMID:27222385

  10. Staff lens doses in interventional urology. A comparison with interventional radiology, cardiology and vascular surgery values.

    Science.gov (United States)

    Vano, E; Fernandez, J M; Resel, L E; Moreno, J; Sanchez, R M

    2016-03-01

    The purpose of this work is to evaluate radiation doses to the lens of urologists during interventional procedures and to compare them with values measured during interventional radiology, cardiology and vascular surgery. The measurements were carried out in a surgical theatre using a mobile C-arm system and electronic occupational dosimeters (worn over the lead apron). Patient and staff dose measurements were collected in a sample of 34 urology interventions (nephrolithotomies). The same dosimetry system was used in other medical specialties for comparison purposes. Median and 3rd quartile values for urology procedures were: patient doses 30 and 40 Gy cm(2); personal dose equivalent Hp(10) over the apron (μSv/procedure): 393 and 848 (for urologists); 21 and 39 (for nurses). Median values of over apron dose per procedure for urologists resulted 18.7 times higher than those measured for radiologists and cardiologists working with proper protection (using ceiling suspended screens) in catheterisation laboratories, and 4.2 times higher than the values measured for vascular surgeons at the same hospital. Comparison with passive dosimeters worn near the eyes suggests that dosimeters worn over the apron could be a reasonable conservative estimate for ocular doses for interventional urology. Authors recommend that at least the main surgeon uses protective eyewear during interventional urology procedures. PMID:26583458

  11. Clustering of Enterococcus faecalis infections in a cardiology hospital neonatal intensive care unit

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    Tânia Mara Varejão Strabelli

    2006-04-01

    Full Text Available Early identification of an outbreak is one of the main advantages of routine epidemiological surveillance. Enterococcus spp. used to be regarded as microorganisms of low pathogenicity, because they are part of the normal microbial flora of the gastrointestinal and genitourinary tract. Recently, they have emerged as important pathogenic agents, sometimes causing infections with high mortality rates. We studied a clustering of primary bloodstream infections caused by Enterococcus faecalis in a cardiology hospital neonatal intensive care unit (NICU. Four cases of primary bloodstream infection by E. faecalis were detected from April 15 to May 13, 2004, during active infection surveillance. The isolates were sensitive to glycopeptides. Some aspects of the management of these patients, including the date of insertion and placement of a central venous catheter, prescription of a specific medication, contiguity of beds, personnel attending the patients, and occurrence of diarrhea were analyzed to look for factors that might affect the spread of the microorganisms. Measures taken to hamper the spread included contact precautions throughout the unit, cleansing and disinfection of equipment and surfaces, bathing children with 2% chlorhexidine-gluconate-containing soap, professional reeducation, and reinforcement of all measures to prevent infections. We suggest that there is a need to re-evaluate preventive infection measures and to review the strategies aimed at decreasing the nosocomial infection rate in the NICU.

  12. Radiological protection optimization derived from radiation induced lesions in interventional cardiology finding

    International Nuclear Information System (INIS)

    Interventional Cardiology is one of the specialties in which patients are submitted to the greatest radiation doses with x ray systems used for diagnostic purposes and then, it is also a specialty of high occupational radiation risk. In the last years, several cases of radiation induced lesions produced on patients derived of new complex interventional procedures have been described. As consequence, different rules for avoiding this kind of incidents have been recommended by International Organisations and regulatory Bodies. Nevertheless it has been devoted relatively few attention to the evaluation of the occupational risks that inevitably are also high in these facilities. In this work, some cases of radioinduced skin lesions produced on patients submitted to cardiac ablation procedures are described. Radiological protection considerations of interest for the regulatory Bodies are made, that permit to minimize the probability of these incidents, in what to the X-rays equipment is referred as well as to the operation procedures and level of radiation protection training of the medical specialists. (author)

  13. The usefulness of the nuclear cardiology in the cellular implant in patients with severe myocardial damage

    International Nuclear Information System (INIS)

    The recent therapeutic advances as the cellular implant as well as those different protocols of image acquisition in the field of the Nuclear Cardiology its have allowed that the patient with severe myocardial damage and without some possibility of revascularization is benefited with these advances. Doubtless the Tl-201 par excellence has an important paper for standardize the more appropriate therapeutic behavior for the heart attack patient; reason by this investigation protocol was developed. The objective of the study was to identify the heart attack regions without viable tissue with SPECT in patient with important myocardial damage without some possibility of traditional revascularization; for the 'Stem cell' cellular implantation therapy. The methodology it was carried out by a study of myocardial perfusion in 10 patients with important myocardial damage previous cellular implants, with PICANUC/ SPECT methodology and using a software (Emory Tool Box) for the image processing validated by the University of Emory Atlanta GA; and using as tracer the Tl - 201 to identify the heart attack regions without presence of viable tissue with an analysis model of 17 segments standardized for the left ventricle; qualifying this way the myocardial perfusion in: 0 (normal), 1 (light), 2 (moderate), 3 (severe), 4 (absent) and x (bad technique). The conclusions were that the SPECT study with PICANUC methodology with Tl-201 is safe and effective for the precise localization for the cellular implantation via direct intra myocardial. (Author)

  14. Influence of patient thickness and operation modes on occupational and patient radiation doses in interventional cardiology

    International Nuclear Information System (INIS)

    Patient and staff dose values in an interventional cardiology laboratory for different operational modes and several patient thicknesses (from 16 to 28 cm, simulated using polymethylmethacrylate) are presented. When increasing patient thicknesses and depending on fluoroscopy and cine modes, occupational doses can increase >30 times the baseline level. Scatter dose rates at the cardiologist's position with no radiation protective tools ranged from 1 to 14 mSv h-1 for fluoroscopy, and from 10 to 47 mSv h-1 during cine acquisition. Patient entrance surface air kerma rates increased by nearly 3 and staff dose rates by up to 2.6 when fluoroscopy was moved from the low to the high mode, for a typical 20 cm thickness. The respective increase factors were 6 and 4.2 when patient thickness rose from 16 to 28 cm, and by 10 and 8.3, when comparing cine acquisition with the low fluoroscopy mode. The knowledge of typical dose rates for each X-ray system in use in catheterisation laboratories is essential in order to optimise protection of patients and staff. (authors)

  15. Application of a visualization method of image data base in nuclear cardiology

    International Nuclear Information System (INIS)

    Medical imaging is undoubtedly one of the medical branches which benefited at most by the offsprings of computer science development. We present here a visualization software of image data base, making use of the last innovations in the field of multimedia application. The objective of such a software is to provide a reference tool for a given medical specialty offering at the same time, a high quality iconography, a rigorous content of the comments and the matching of graphical interfaces. Applied to nuclear cardiology and implanted on CD ROM, it contains a given number of clinical cases (around 150) which sweep quasi-exhaustively the subject. Each case centered around scintigraphic examination (myocardial tomographs, ventriculographs, SPECT, etc) makes available 'static' pictures (series of cross sections, planispheric images, ECG), animated cartoons (synchronized series, 3D visualization, etc) and also the clinical history of the patient and the records of complementary examinations (coronary-graphic, for instance). Being independent of the image data base which it visualizes, our software is easily applicable to other nuclear medicine specialties (neurology, renal exploration) and also to other modalities. It is multilingual already (French and English) and soon will be supplemented by a code dedicated to knowledge assessment intended to be an efficient tool in education and continuous formation. A Macintosh version will be soon obtainable and a demonstration diskette is free available on request

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

    International Nuclear Information System (INIS)

    The purpose of this article is to estimate lens doses using over apron active personal dosemeters in interventional catheterisation laboratories (cardiology IC, neuroradiology IN and radiology IR) and to investigate correlations between occupational lens doses and patient doses. Active electronic personal dosemeters placed over the lead apron were used on a sample of 204 IC procedures, 274 IN and 220 IR (all performed at the same university hospital). Patient dose values (kerma area product) were also recorded to evaluate correlations with occupational doses. Operators used the ceiling-suspended screen in most cases. The median and third quartile values of equivalent dose Hp(10) per procedure measured over the apron for IC, IN and IR resulted, respectively, in 21/67, 19/44 and 24/54 μSv. Patient dose values (median/third quartile) were 75/128, 83/176 and 61/159 Gy cm2, respectively. The median ratios for dosemeters worn over the apron by operators ( protected by the ceiling-suspended screen) and patient doses were 0.36; 0.21 and 0.46 μSv Gy-1 cm-2, respectively. With the conservative approach used (lens doses estimated from the over apron chest dosemeter) we came to the conclusion that more than 800 procedures y-1 and per operator were necessary to reach the new lens dose limit for the three interventional specialties. (authors)

  17. Multiple procedures and cumulative individual radiation exposure in interventional cardiology: A long-term retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Weltermann, Birgitta M.; Rock, Thomas; Berndt, Peter; Viehmann, Anja; Reinders, Sabrina; Gesenhues, Stefan [University of Duisburg-Essen, Institute for General Medicine, University Hospital, Essen (Germany); Brix, Gunnar; Schegerer, Alexander [Federal Office for Radiation Protection, Department of Radiation Protection and Health, Neuherberg (Germany)

    2015-09-15

    Various studies address discrepancies between guideline recommendations for coronary angiographies and clinical practice. While the issue of the appropriateness of recurrent angiographies was studied focusing on the role of the cardiologist, little is known about individual patients' histories and the associated radiation exposures. We analyzed all patients with coronary artery disease (CAD) in an academic teaching practice who underwent at least one angiography with or without intervention between 2004 and 2009. All performed angiographies in these patients were analyzed and rated by three physicians for appropriateness levels according to cardiology guidelines. Typical exposure data from the medical literature were used to estimate individual radiation exposure. In the cohort of 147 patients, a total of 441 procedures were analyzed: between 1981 and 2009, three procedures were performed per patient (range 1-19) on average. Appropriateness ratings were 'high/intermediate' in 71 %, 'low/no' in 27.6 % and data were insufficient for ratings in 1.4 %. Procedures with 'low/no' ratings were associated with potentially avoidable exposures of up to 186 mSv for single patients. Using retrospective data, we exemplify the potential benefit of guideline adherence to decrease patients' radiation exposures. (orig.)

  18. Recommendations to reduce extremity and eye lens doses in interventional radiology and cardiology

    International Nuclear Information System (INIS)

    The main aim of the Work Package 1 (WP1) of the ORAMED project, Collaborative Project (2008–2011), supported by the European Commission within its 7th Framework Programme, was to obtain a set of standardized data on extremity and eye lens doses for staff in interventional radiology and cardiology (IR/IC) workplaces and to recommend a series of guidelines on radiation protection in order to both guarantee and optimize staff protection. Within the project, coordinated measurements were performed in 34 hospitals in 6 European countries. Furthermore, simulations of the most representative workplaces in IR and IC were performed to determine the main parameters that influence the extremity and eye lens doses. The work presented in this paper shows the recommendations that were formulated by the results obtained from both measurements and simulations. The presented guidelines are directed to operators, assistant personnel, radiation protection officers and medical physics experts. They concern radiation protection issues, such as the use of room protective equipment, as well as the positioning of the extremity and eye lens dosemeters for routine monitoring.

  19. Forecasting of Corrosion Properties of Steel Wires for Production of Guide Wires for Cardiological Treatment

    Directory of Open Access Journals (Sweden)

    J. Przondziono

    2013-01-01

    Full Text Available The study presents evaluation of the influence of strain in drawing process and of surface modification on resistance to electrochemical corrosion of wires made of stainless steel for production of guide wires used in invasive cardiology. The results of static tensile test enabled us to determine the course of flow curve of wires made of X10CrNi 18-8 steel as well as mathematical form of flow stress function. Resistance to electrochemical corrosion was evaluated on the ground of registered anodic polarisation curves by means of potentiodynamic method. The tests were performed in solution simulating human blood on samples that were electrolytically polished and samples that were polished and then chemically passivated. Exemplary anodic polarisation curves were given. It was proved that with the applied strain, corrosion properties decrease. It was found that chemical passivation improves wire corrosion characteristics. Statistical analysis showed that there is a significant dependence between corrosion properties (polarisation resistance Rp and strain ε applied in drawing process. Functions that present the change Rp=f(ε were selected. The issue is of importance to guide wire manufacturers because application of the suggested methodology will enable us to forecast corrosion characteristics of wire with the required strength drawn with the applied strain.

  20. Eye dosimetry in interventional radiology and cardiology: current challenges and practical considerations.

    Science.gov (United States)

    Ciraj-Bjelac, O; Rehani, M M

    2014-12-01

    Interventional radiology and cardiology are areas with high potential for risk to eye lens. Accurate assessment of eye dose is one of the most important aspects of correlating doses with observed lens opacities among workers in interventional suites and ascertaining compliance with regulatory limits. The purpose of this paper is to review current approaches and opportunities in eye dosimetry and assess challenges in particular in accuracy and practicality. The possible approaches include practical dosimetry using passive dosemeters or active dosemeters with obvious advantage of active dosimetry. When neither of these is available, other approaches are based on either retrospective dose assessment using scatter radiation dose levels or correlations between patient dose indices and eye doses to the operators. In spite of all uncertainties and variations, estimation of eye dose from patient dose can be accepted as a compromise. Future challenges include development of practical methods for regular monitoring of individual eye doses and development of better techniques to estimate eye dose from measurements at some reference points. PMID:24262928

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

    Directory of Open Access Journals (Sweden)

    Sébastien Deferm

    2016-01-01

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

  2. 3D-Printing in Congenital Cardiology: From Flatland to Spaceland.

    Science.gov (United States)

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

    2016-01-01

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

  3. Combined cardiological and neurological abnormalities due to filamin A gene mutation

    Science.gov (United States)

    de Wit, Marie Claire Y.; de Coo, Irenaeus F. M.; Lequin, Maarten H.; Halley, Dicky J. J.; Roos-Hesselink, Jolien W.

    2010-01-01

    Background Cardiac defects can be the presenting symptom in patients with mutations in the X-linked gene FLNA. Dysfunction of this gene is associated with cardiac abnormalities, especially in the left ventricular outflow tract, but can also cause a congenital malformation of the cerebral cortex. We noticed that some patients diagnosed at the neurogenetics clinic had first presented to a cardiologist, suggesting that earlier recognition may be possible if the diagnosis is suspected. Methods and results From the Erasmus MC cerebral malformations database 24 patients were identified with cerebral bilateral periventricular nodular heterotopia (PNH) without other cerebral cortical malformations. In six of these patients, a pathogenic mutation in FLNA was present. In five a cardiac defect was also found in the outflow tract. Four had presented to a cardiologist before the cerebral abnormalities were diagnosed. Conclusions The cardiological phenotype typically consists of aortic or mitral regurgitation, coarctation of the aorta or other left-sided cardiac malformations. Most patients in this category will not have a FLNA mutation, but the presence of neurological complaints, hyperlaxity of the skin or joints and/or a family history with similar cardiac or neurological problems in a possibly X-linked pattern may alert the clinician to the possibility of a FLNA mutation. PMID:20730588

  4. Can nurses in cardiology areas prepare patients for implantable cardioverter defibrillator implant and life at home?

    Science.gov (United States)

    Tagney, Jenny

    2004-01-01

    This study explored nurses' confidence and competence in preparing patients for having an implantable cardioverter defibrillator implanted and for life at home after discharge. Whilst research has identified various physical and psychosocial effects to patients and their partners associated with device implant and subsequent lifestyle adjustments, no research has explored nurses' knowledge of the device or these effects. A survey was designed using a purposive sample of 152 nurses from cardiology areas in four large teaching hospitals and a 28-point postal questionnaire to explore knowledge of the device and its impact. Most subjects were not confident in their abilities to prepare patients for implant or life at home after implant. Knowledge of the device and its effects appeared poorly understood by all nurses, irrespective of additional qualifications, length of time since qualifying or area of work. Many participants were aware of the poor knowledge level of nurses and identified it as a weakness in current care practices. Lack of understanding may impair preparation of patients for implantation of or for living with an implantable cardioverter defibrillator, and feasible strategies to change this situation will require careful consideration and further investment. PMID:15152752

  5. The foundation and launch of the Melbourne Interventional Group: a collaborative interventional cardiology project.

    Science.gov (United States)

    Ajani, A E; Szto, G; Duffy, S J; Eccleston, D; Clark, D J; Lefkovits, J; Chew, D P; Warren, R; Black, A; New, G; Walton, A; Lew, R; Shaw, J; Horrigan, M; Sebastian, M; Yan, B P; Brennan, A; Meehan, A; Reid, C; Krum, H

    2006-02-01

    The Melbourne Interventional Group (MIG) is a voluntary collaborative venture of interventional cardiologists practicing at 12 major public and private hospitals in Victoria, designed to record data pertaining to percutaneous coronary interventions (PCI) and perform long-term follow-up. The potential advantages of collaboration involve large-scale analysis of current interventional strategies (e.g. drug-eluting stents, evaluation of new technologies and cost-effective analysis), provide a basis for multi-centred clinical trials and allow comparison of clinical outcomes with cardiac surgery. The established registry documents demographic, clinical and procedural characteristics of consecutive patients undergoing PCI and permits analysis of those characteristics at 30 days and 12 months. The registry is co-ordinated by the Centre of Clinical Research Excellence (CCRE), a research body within the Department of Epidemiology and Preventive Medicine (Monash University, Melbourne). The eventual goal of MIG is to provide a contemporary appraisal of Australian interventional cardiology practice, with opportunities to improve in-hospital and long-term outcomes of patients with coronary artery disease. PMID:16473790

  6. Length of Hospital Stay Prediction at the Admission Stage for Cardiology Patients Using Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Pei-Fang (Jennifer Tsai

    2016-01-01

    Full Text Available For hospitals’ admission management, the ability to predict length of stay (LOS as early as in the preadmission stage might be helpful to monitor the quality of inpatient care. This study is to develop artificial neural network (ANN models to predict LOS for inpatients with one of the three primary diagnoses: coronary atherosclerosis (CAS, heart failure (HF, and acute myocardial infarction (AMI in a cardiovascular unit in a Christian hospital in Taipei, Taiwan. A total of 2,377 cardiology patients discharged between October 1, 2010, and December 31, 2011, were analyzed. Using ANN or linear regression model was able to predict correctly for 88.07% to 89.95% CAS patients at the predischarge stage and for 88.31% to 91.53% at the preadmission stage. For AMI or HF patients, the accuracy ranged from 64.12% to 66.78% at the predischarge stage and 63.69% to 67.47% at the preadmission stage when a tolerance of 2 days was allowed.

  7. Overcoming a perfect storm: an academic cardiology section's story of survival.

    Science.gov (United States)

    Calvin, James E

    2007-03-01

    Increasingly, academic institutions are grappling with financial pressures that threaten the academic mission. The author presents an actual case history in which a section of cardiology in an academic health center was confronted with huge projected deficits that had to be eliminated within the fiscal year. The section used eight principles to shift from deficit to profitability (i.e., having revenue exceed costs). These principles included confronting the brutal facts, managing costs and revenue cycles, setting expectations for faculty, and quality improvement. The section accomplished deficit reduction through reducing faculty salaries (nearly $2 million) and nonfaculty salaries ($1.3 million) and reducing operational costs while maintaining revenues by increasing individual faculty productivity and reducing accounts receivable. In the face of these reductions, clinical revenues were maintained, but research revenue and productivity fell (but research is being fostered now that clinical services are profitable again). These principles can be used to stabilize the financial position of clinical practices in academic settings that are facing financial challenges. PMID:17327712

  8. [Personalized therapy in cardiology. Biomarkers, pharmacogenetics and therapy of monogenic diseases].

    Science.gov (United States)

    Eschenhagen, T; Blankenberg, S

    2013-02-01

    Improved therapy and prophylaxis of cardiovascular diseases have contributed to an increase in life expectancy like no other field of medicine. However, many cardiological diseases remain untreatable and standard therapies often work only in a minority of patients or cause more harm than benefit. Personalized approaches appear to be a promising solution. Monogenic heart diseases are paradigmatic for this approach and can in rare cases be treated mutation specifically. Overall, however, success remains limited. Next generation sequencing will facilitate the identification of mutations causing diseases. Cell culture models based on induced pluripotent stem cells open the perspective of individualized testing of disease severity and pharmacological or genetic therapy. In contrast to monogenic diseases genetic testing plays no practical role yet in the management of multifactorial cardiovascular diseases. Biomarkers can identify individuals with increased cardiovascular risk. Furthermore, biomarker-guided therapy represents an attractive option with troponin-guided therapy of acute coronary syndromes as a successful example. Individual responses to drugs vary and are partly determined by genes. Simple genetic analyses can improve response prediction and minimize side effects in cases such as warfarin and high doses of simvastatin. Taken together personalized approaches will gain importance in the cardiovascular field but this requires the development of better methods and research that quantifies the true value of the new knowledge. PMID:23371262

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

    Science.gov (United States)

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

    2016-03-01

    A practical method for skin dose estimation for interventional cardiology patients has been developed to inform pre-procedure planning and post-procedure patient management. Absorbed dose to the patient skin for certain interventional radiology procedures can exceed thresholds for deterministic skin injury, requiring documentation within the patient notes and appropriate patient follow-up. The primary objective was to reduce uncertainty associated with current methods, particularly surrounding field overlap. This was achieved by considering rectangular field geometry incident on a spherical patient model in a polar coordinate system. The angular size of each field was quantified at surface of the sphere, i.e. the skin surface. Computer-assisted design software enabled the modelling of a sufficient dataset that was subsequently validated with radiochromic film. Modelled overlap was found to agree with overlap measured using film to within 2.2° ± 2.0°, showing that the overall error associated with the model was < 1 %. Mathematical comparison against exposure data extracted from procedural Digital Imaging and Communication in Medicine files was used to generate a graphical skin dose map, demonstrating the dose distribution over a sphere centred at the interventional reference point. Dosimetric accuracy of the software was measured as between 3.5 and 17 % for different variables. PMID:25994848

  10. Use of active personal dosemeters in interventional radiology and cardiology: Tests in hospitals – ORAMED project

    International Nuclear Information System (INIS)

    Although active personal dosemeters (APDs) are not used quite often in hospital environments, the possibility to assess the dose and/or dose rate in real time is particularly interesting in interventional radiology and cardiology (IR/IC) since operators can receive relatively high doses while standing close to the primary radiation field. A study concerning the optimization of the use of APDs in IR/IC was performed in the framework of the ORAMED project, a Collaborative Project (2008–2011) supported by the European Commission within its 7th Framework Program. This paper reports on tests performed with APDs on phantoms using an X-ray facility in a hospital environment and APDs worn by interventionalists during routine practice in different European hospitals. The behaviour of the APDs is more satisfactory in hospitals than in laboratories with respect to the influence of the tube peak high voltage and pulse width, because the APDs are tested in scattered fields with dose equivalent rates generally lower than 1 Sv.h−1. .

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

    International Nuclear Information System (INIS)

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

  12. [The cardiology community and health reform. Some reflections to open a debate].

    Science.gov (United States)

    Schweiger, C

    2000-01-01

    A recently introduced health care reform in Italy will modify substantially the scenario in which all physicians and also the cardiac specialists working in and out of the hospitals will operate. Therefore it is important that the cardiological community, who manages a large proportion of human and financial resources of the Italian National Health Service, knows the reform and interacts with the national and local authorities for the best implementation of the basic principles on which the reform has been founded. These principles are the following: the Italian health service will guarantee all citizens the so-called "essential levels of care" identified in accordance with four distinctive features. They must: 1) safeguard real needs of care (i.e. cosmetic surgery is not considered), 2) be evidence based, 3) be appropriate for individual patients, 4) be cost-effective. In a context of scarce resources and rapidly increasing demand of care this basic strategy seems to be the only one suitable for a National Health Service, but the application of this principle in the real world of care seems a very difficult task, and the role of medical associations is obviously crucial for a good outcome. This report illustrates some articles of the law that deal with the medical profession: guidelines and appropriateness of the criteria; accreditation, clinical competence and quality control; continuing medical education. PMID:10832116

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

    Science.gov (United States)

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

    2015-07-01

    The purpose of this article is to estimate lens doses using over apron active personal dosemeters in interventional catheterisation laboratories (cardiology IC, neuroradiology IN and radiology IR) and to investigate correlations between occupational lens doses and patient doses. Active electronic personal dosemeters placed over the lead apron were used on a sample of 204 IC procedures, 274 IN and 220 IR (all performed at the same university hospital). Patient dose values (kerma area product) were also recorded to evaluate correlations with occupational doses. Operators used the ceiling-suspended screen in most cases. The median and third quartile values of equivalent dose Hp(10) per procedure measured over the apron for IC, IN and IR resulted, respectively, in 21/67, 19/44 and 24/54 µSv. Patient dose values (median/third quartile) were 75/128, 83/176 and 61/159 Gy cm(2), respectively. The median ratios for dosemeters worn over the apron by operators (protected by the ceiling-suspended screen) and patient doses were 0.36; 0.21 and 0.46 µSv Gy(-1) cm(-2), respectively. With the conservative approach used (lens doses estimated from the over apron chest dosemeter) we came to the conclusion that more than 800 procedures y(-1) and per operator were necessary to reach the new lens dose limit for the three interventional specialties. PMID:25848117

  14. The billing process at a teaching hospital specialized in cardiology and pulmonology

    Directory of Open Access Journals (Sweden)

    Gabriela Favaro Faria Guerrer

    2014-09-01

    Full Text Available The objective of this exploratory study was to describe and map out the billing process in a public tertiary-level university hospital specialized in cardiology and pulmonology. In the period between May and June of 2012, we identified and documented the steps in the process validated by the professionals involved in the hospital bill audit service. We found that during billing pre-analysis, auditors make corrections to justify the billing of procedures and to avoid unwarranted billing and loss of revenue. Mapping out the process allowed us to propose strategies to minimize the time for presenting bills to payment sources. By bringing visibility to this process, which is fundamental for the economic-financial balance of the studied hospital, we bring such knowledge to the public domain. Thus, it is accessible to other health organizations that wish to increment their revenue and reduce divergences between patient charts and the patient’s hospital bill. doi: 10.5216/ree.v16i3.23487.

  15. CHANGES OF INTERCELLULAR COOPERATION IN PERIPHERAL BLOOD IN TREATED PATIENTS WITH CARDIOLOGIC DISEASES

    Directory of Open Access Journals (Sweden)

    L. N. Korichkina

    2016-01-01

    Full Text Available Aim. To study changes of intercellular cooperation in peripheral blood induced by treatment in patients with arterial hypertension (HT, ischemic heart disease (IHD and chronic heart failure (CHF.Material and methods. 610 patients were involved into the study, including 250 patients with HT of stages I-III (50 untreated patients, 150 patients with IHD and 210 patients with CHF of stages I-III. All patients were treated except 50 hypertensive ones. 80 healthy patients (40 men, 40 women were included into control group. Blood smears of patients were evaluated (Romanovsky's stain. A number of leukocyte, autorosettes and autorosettes with erythrocyte lysis was calculated. The cellular association consisting of a neutrophil, monocyte or eosinocyte with 3 or more erythrocytes skintight to their surface defined as autorosettes. Erythrocytes number and hemoglobin level determined in peripheral blood.Results. Single autorosettes in peripheral blood were observed in patients of control group and in untreated patients with HT. Treated patients with HT, IHD and CHF had increased number of autorossets and autorosettes with erythrocytes lysis. This phenomenon resulted in reduction of erythrocytes number and hemoglobin level in peripheral blood.Conclusion. Treated patients with cardiologic diseases had changes in intercellular cooperation. It should be considered at intensive and long term therapy.

  16. Eye dosimetry in interventional radiology and cardiology: current challenges and practical considerations

    International Nuclear Information System (INIS)

    Interventional radiology and cardiology are areas with high potential for risk to eye lens. Accurate assessment of eye dose is one of the most important aspects of correlating doses with observed lens opacities among workers in interventional suites and ascertaining compliance with regulatory limits. The purpose of this paper is to review current approaches and opportunities in eye dosimetry and assess challenges in particular in accuracy and practicality. The possible approaches include practical dosimetry using passive dosemeters or active dosemeters with obvious advantage of active dosimetry. When neither of these is available, other approaches are based on either retrospective dose assessment using scatter radiation dose levels or correlations between patient dose indices and eye doses to the operators. In spite of all uncertainties and variations, estimation of eye dose from patient dose can be accepted as a compromise. Future challenges include development of practical methods for regular monitoring of individual eye doses and development of better techniques to estimate eye dose from measurements at some reference points. (authors)

  17. 3D-Printing in Congenital Cardiology: From Flatland to Spaceland

    Science.gov (United States)

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

    2016-01-01

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

  18. Contributions of nuclear cardiology to prognosis and risk stratification in coronary artery disease

    International Nuclear Information System (INIS)

    Myocardial perfusion imaging in patients with suspected or known coronary artery disease and stable symptoms enables not only accurate diagnosis of disease but also entails prognostic value. Myocardial perfusion SPECT contributes to assessment of future cardiac events independently of other clinical parameters. A normal stress myocardial perfusion scan is associated with a favorable prognosis in all pre-test risk subsets similar to that of the general population independent of history, symptoms, and exercise electrocardiography test variables. Cardiac risk and benefit from invasive therapeutic strategies increase in relation to the severity of the abnormality of perfusion and function assessed by gated myocardial perfusion SPECT. Thus, stress myocardial perfusion imaging may serve as a gatekeeper for referral to coronary angiography enabling effective risk stratification in patients with suspected or documented coronary artery disease. In severe coronary artery disease accompanied by left ventricular dysfunction preoperative prediction of reversibility of functional impairment and improvement in survival after revascularization can be achieved by viability testing using nuclear cardiology. Absence of viability is associated with no significant difference in functional and survival outcomes, irrespective of treatment strategy. Therefore, unnecessary revascularization can be avoided in cases with absent evidence of viability. (orig.)

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

    International Nuclear Information System (INIS)

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

  20. Emergency Surgery after Failed Percutaneous Transmitral Commissurotomy (PTMC) at Armed Forces Institute of Cardiology (AFIC)

    International Nuclear Information System (INIS)

    Objective: The aim of this study was to analyze the outcome of emergency after PTMC. Design: A cross-sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology (AFIC) Rawalpindi from January 2005 to June 2009. Patients and Methods: A cross-sectional study of 12 patients (2.3 percent) out of 523 who underwent PTMC and developed significant mitral regurgitation (MR) or cardiac tamponade (CT) was examined to analyze the outcome of emergency surgery. Transthoracic echocardiography (TTE) was used to select patients of MS with minimal calcification and transesophageal echocardiography (TEE) was used to rule out left atrial (LA) clot. Inuoe balloon was used in all cases for PTMC. Results: Out of twelve who presented for surgery after failed PTMC, 9(75 percent) had significant MR and 3(25 percent) had CT. Majority of patients were female (83.3 percent) with mean age of 30.9+-5.12 years. In patients with MR, anterior mitral leaflet (AML) tear was found in 8(66.7 percent) and posterior mitral leaflet tear in 1(8.3 percent). LA clot was found in 1(8.3 percent) patient who caused cerebral infarction. All patients underwent mitral valve replacement (MVR) with prosthetic valve on cardiopulmonary bypass (CPB). Two patients (16.7 percent) died; one because of cerebral infarction and one due to low cardiac output syndrome (LCOS). Conclusion: With increasing experience of PTMC the magnitude of failure cases is decreasing as was seen in our case in which failed percentage was just 2.3 percent. Moreover, percentage of success of emergency surgery was good i.e. 83.3 percent. In case of failure a well coordinated effort between cardiologist and surgical team can prevent mortality significantly. (author)

  1. Fetal cardiology: changing the definition of critical heart disease in the newborn.

    Science.gov (United States)

    Słodki, M; Respondek-Liberska, M; Pruetz, J D; Donofrio, M T

    2016-08-01

    Infants born with congenital heart disease (CHD) may require emergent treatment in the newborn period. These infants are likely to benefit the most from a prenatal diagnosis, which allows for optimal perinatal planning. Several cardiac centers have created guidelines for the management of these high-risk patients with CHD. This paper will review and compare several prenatal CHD classification systems with a particular focus on the most critical forms of CHD in the fetus and newborn. A contemporary definition of critical CHD is one which requires urgent intervention in the first 24 h of life to prevent death. Such cardiac interventions may be not only life saving for the infant but also decrease subsequent morbidity. Critical CHD cases may require delivery at specialized centers that can provide perinatal, obstetric, cardiology and cardiothoracic surgery care. Fetuses diagnosed in mid-gestation require detailed fetal diagnostics and serial monitoring during the prenatal period, in order to assess for ongoing changes and identify progression to a more severe cardiac status. Critical CHD may progress in utero and there is still much to be learned about how to best predict those who will require urgent neonatal interventions. Despite improved therapeutic capabilities, newborns with critical CHD continue to have significant morbidity and mortality due to compromise that begins in the delivery room. Fetal echocardiography is the best way to predict the need for specialized care at birth to improve outcome. Once the diagnosis is made of critical CHD, delivery at the proper time and in appropriate institution with specific care protocols should be initiated. More work needs to be done to better delineate the risk factors for progression of critical CHD and to determine which newborns will require specialized care. The most frequently described forms of critical CHD requiring immediate intervention include hypoplastic left heart syndrome with intact or severely restricted

  2. Development of a tele-stethoscope and its application in pediatric cardiology.

    Science.gov (United States)

    Hedayioglu, F L; Mattos, S S; Moser, L; de Lima, M E

    2007-01-01

    Over the years, many attempts have been made to develop special stethoscopes for the teaching of auscultation. The objective of this article is to report on the experience with the development and implementation of an electronic stethoscope and a virtual library of cardiac sounds. There were four stages to this project: (1) the building of the prototype to acquire, filter and amplify the cardiac sounds, (2) the development of a software program to record, reproduce and visualize them, (3) the testing of the prototype in a clinical scenario, and (4) the development of an internet site, to store and display the sounds collected. The first two stages are now complete. The prototype underwent an initial evaluation in a clinical scenario within the Unit and during virtual out-patient clinical sessions. One hundred auscultations were recorded during these tests. They were reviewed and discussed on-line by a panel of experience cardiologists during the sessions. Although the sounds were considered "satisfactory" for diagnostic purposes by the cardiology team, they identified some qualitative differences in the electronic recorded auscultations, such as a higher pitch of the recorded sounds. Prospective clinical studies are now being conducted to further evaluate the interference of the electronic device in the physicians' capability to diagnose different cardiac conditions. An internet site (www.caduceusvirtual.com.br/ auscultaped) was developed to host these cardiac auscultations. It is set as a library of cardiac sounds, catalogued by pathologies and already contains examples from auscultations of the majority of common congenital heart lesions, such as septal defects and valvar lesions. PMID:17249332

  3. Imaging skills for transthoracic echocardiography in cardiology fellows: The value of motion metrics

    Directory of Open Access Journals (Sweden)

    Mario Montealegre-Gallegos

    2016-01-01

    Full Text Available Background: Proficiency in transthoracic echocardiography (TTE requires an integration of cognitive knowledge and psychomotor skills. Whereas cognitive knowledge can be quantified, psychomotor skills are implied after repetitive task performance. We applied motion analyses to evaluate psychomotor skill acquisition during simulator-based TTE training. Methods and Results: During the first month of their fellowship training, 16 cardiology fellows underwent a multimodal TTE training program for 4 weeks (8 sessions. The program consisted of online and live didactics as well as simulator training. Kinematic metrics (path length, time, probe accelerations were obtained at the start and end of the course for 8 standard TTE views using a simulator. At the end of the course TTE image acquisition skills were tested on human models. After completion of the training program the trainees reported improved self-perceived comfort with TTE imaging. There was also an increase of 8.7% in post-test knowledge scores. There was a reduction in the number of probe accelerations [median decrease 49.5, 95% CI = 29-73, adjusted P < 0.01], total time [median decrease 10.6 s, 95% CI = 6.6-15.5, adjusted P < 0.01] and path length [median decrease 8.8 cm, 95% CI = 2.2-17.7, adjusted P < 0.01] from the start to the end of the course. During evaluation on human models, the trainees were able to obtain all the required TTE views without instructor assistance. Conclusion: Simulator-derived motion analyses can be used to objectively quantify acquisition of psychomotor skills during TTE training. Such an approach could be used to assess readiness for clinical practice of TTE.

  4. Radiation doses in flat detector digital systems in Interventional Cardiology procedures

    International Nuclear Information System (INIS)

    The purpose of the study was to investigate patient radiation doses in flat detector (FD) digital X-ray systems in Interventional Cardiology procedures in three of the busiest haemodynamic departments in Greece and compare the results with the corresponding reference levels (RLs). Material and method: 569 Coronary Angiography (CA) and 571 Percutaneous Transluminal Coronary Angioplasties (PTCA) were investigated since these two procedures are the most frequently performed in haemodynamic units. Patient data collected were: sex, age, weight, height, Dose Area Product (DAP), fluoroscopy time (T) and total number of frames (F). Results: Median values of DAP and F in CA were: 31.0 Gycm2 and 752 in Hospital A, 35.3 Gycm2 and 487 in Hospital B and 21.1 Gycm2 and 461 in Hospital C. Median values of DAP and F in PTCA were: 63.2 Gycm2 and 1274 in Hospital A, 90.3 Gycm2 and 974 in Hospital B and 35.6 Gycm2 and 582 in Hospital C. Concerning T, the timer in Hospital C malfunctioned, whereas in hospitals A and B examination time was 4.7 and 3.6 min for CA and 10.3 and 12.7 min for PTCA, respectively. The results reveal a noted variability between hospitals especially in PTCA. However, patient dose values are lower than RLs (45 and 85 Gycm2 in CA and PTCA respectively). Conclusions: Large variations between patient dose values and main technical parameters were revealed when using FD digital systems in Greece. Dose optimization can be greatly achieved through continuous staff education in radiation protection issues. Moreover, the standardization of IC procedures in digital flat panel systems will definitely decrease patient and staff doses. (author)

  5. How electricity was discovered and how it is related to cardiology.

    Science.gov (United States)

    de Micheli-Serra, Alfredo; Iturralde-Torres, Pedro; Izaguirre-Ávila, Raúl

    2012-01-01

    We relate the fundamental stages of the long road leading to the discovery of electricity and its uses in cardiology. The first observations on the electromagnetic phenomena were registered in ancient texts; many Greek and Roman writers referred to them, although they provided no explanations. The first extant treatise dates back to the XIII century and was written by Pierre de Maricourt during the siege of Lucera, Italy, by the army of Charles of Anjou, French king of Naples. There were no significant advances in the field of magnetism between the appearance of this treatise and the publication of the study De magnete magneticisque corporibus (1600) by the English physician William Gilbert. Scientists became increasingly interested in electromagnetic phenomena occurring in certain fish, i.e., the so-called electric ray that lived in the South American seas and the Torpedo fish that roamed the Mediterranean Sea. This interest increased in the 18th century, when condenser devices such as the Leyden jar were explored. It was subsequently demonstrated that the discharges produced by "electric fish" were of the same nature as those produced in this device. The famous "controversy" relating to animal electricity or electricity inherent to an animal's body also arose in the second half of the 18th century. The school of thought of the physicist Volta sustained the principle of a single electrical action generated by metallic contact. This led Volta to invent his electric pile, considered as the first wet cell battery. Toward the middle of the XIX century, the disciples of the physiologist Galvani were able to demonstrate the existence of animal electricity through experiments exploring the so-called current of injury. On the path of Volta's approach, many characteristics of electricity were detailed, which ultimately led to their usage in the industrial field. The route followed by Galvani-Nobili-Matteucci led to the successes of Waller, Einthoven, etcetera, enabling the

  6. Management of diabetes by a healthcare team in a cardiology unit: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Maria Antonieta P. de Moraes

    2013-11-01

    Full Text Available OBJECTIVE: To assess the effectiveness of healthcare team guidance in the implementation of a glycemic control protocol in the non-intensive care unit of a cardiology hospital. METHODS: This was a randomized clinical trial comparing 9 months of intensive guidance by a healthcare team on a protocol for diabetes care (Intervention Group, n = 95 with 9 months of standard care (Control Group, n = 87. Clinicaltrials.gov: NCT01154413. RESULTS: The mean age of the patients was 61.7±10 years, and the mean glycated hemoglobin level was 71±23 mmol/mol (8.7±2.1%. The mean capillary glycemia during hospitalization was similar between the groups (9.8±2.9 and 9.1±2.4 mmol/l for the Intervention Group and Control Group, respectively, p = 0.078. The number of hypoglycemic episodes (p = 0.77, hyperglycemic episodes (47 vs. 50 in the Intervention Group and Control Group, p = 0.35, respectively, and the length of stay in the hospital were similar between the groups (p = 0.64. The amount of regular insulin administered was 0 (0-10 IU in the Intervention Group and 28 (7-56 IU in the Control Group (p<0.001, and the amount of NPH insulin administered was similar between the groups (p = 0.16. CONCLUSIONS: While guidance on a glycemic control protocol given by a healthcare team resulted in a modification of the therapeutic strategy, no changes in glycemic control, frequency of episodes of hypoglycemia and hyperglycemia, or hospitalization duration were observed.

  7. Spatial and temporal overview of research in pediatric and congenital cardiology: trends and global challenges.

    Science.gov (United States)

    Bräutigam, Martina; Kempny, Aleksander; Radke, Robert; Baumgartner, Helmut; Diller, Gerhard-Paul

    2014-08-01

    Available information on the global distribution of research output in pediatric cardiology (PC) is sparse. This study took a bibliometric approach to characterize research output, assess the level of competition, describe the geographic distribution of the leading research centers in the field, and investigate determinants of research output. In addition, the study characterized the journals publishing PC research and identified temporal trends in research interest over time. Publications presenting original research in PC between 1995 and 2011 were identified. A total of 9,410 relevant articles were identified based on a PubMed search followed by subsequent electronic filtering and manual review. A dramatic increase in PC publications was seen during the study period (from 309 in 1995 to 1,075 in 2011). This was accompanied by an increase in impact factors and an overproportional rise in PC contributions relative to the general PubMed trend. Research in PC was shown to be highly competitive and becoming increasingly so (Herfindahl-Hirschman index of 1.64%). Research output correlated with gross domestic product, national levels of corruption, education, urbanization, geography, and presence of national centers of excellence. The data presented in this report allow benchmarking of different cities and countries and provide insights into the potential determinants of high-quality publications and the spectrum of publishing journals. The report also highlights the central role of subspecialty journals and shows that PC research output is related to national wealth, surrogates of appropriate use of resources, an adequate workforce, and education. Additionally, it emphasizes the potential beneficial effects of establishing centers of excellence in the field. PMID:24584212

  8. Appropriate use criteria in clinical routine practice: implications in a nuclear cardiology lab.

    Science.gov (United States)

    Gimelli, Alessia; Rovai, Ilaria; Liga, Riccardo; Pasanisi, Emilio Maria; Marzullo, Paolo

    2016-06-01

    The efforts for a broad application of the appropriate use criteria to reduce inappropriate nuclear stress testing have frequently been unsuccessful and the reported rates of inappropriateness have varied widely between studies. We sought to analyze the criteria of clinical appropriateness of a cohort of consecutive patients referred to our nuclear cardiology laboratory to perform stress myocardial perfusion imaging (MPI) and to assess the relationships between test appropriateness and the evaluation of ischaemia. A cohort of 251 consecutive patients, admitted to our Institute from January to March 2015, who underwent stress/rest MPI on a dedicated cardiac camera equipped with cadmium-zinc-telluride detectors, was selected. The level of clinical appropriateness of each MPI test was categorized in each patient according to the AUC criteria. According to the accepted criteria, the majority of the MPI stress-tests could be classified as clinically appropriate (218 of 251, 87 % of the tests), while only 16 (6 %) and 17 (7 %) resulted of uncertain appropriateness or clearly inappropriate, respectively. Of the 251 appropriate tests, 22 (10 %), 65 (30 %), and 131 (60 %) showed the presence of a mild (SDS < 4), moderate (4 ≥ SDS < 7), and severe (SDS ≥ 7) ischemic burden, respectively, while none of the inappropriate test showed moderate-to-severe ischaemia (P < 0.001 for comparisons). The rate of inappropriate MPI tests is considerably low in a high-volume laboratory. Appropriate and inappropriate studies identify patients at high and low probability of significant ischemia, respectively, providing insights on the effects of the level of appropriateness on stress-test results. PMID:26961179

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

    International Nuclear Information System (INIS)

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

  10. Single-photon emission computer tomography (SPECT) and positron emission tomography (PET) imaging in cardiology

    International Nuclear Information System (INIS)

    Nuclear imaging procedures are well-established diagnostic tools in clinical cardiology, providing noninvasive information about myocardial perfusion, cardiac function and metabolism. Scintigraphic parameters provide relevant information that aids in everyday clinical decision making for referring physicians. During the past two decades the clinical role of nuclear medicine procedures in cardiology has evolved significantly. At the beginning, the diagnostic role of nuclear medicine in detecting myocardial ischemia in patients with suspected coronary artery disease has been emphasized and myocardial perfusion imaging with exercise or pharmacological stress testing is a widely accepted technique for the detection and localization of coronary artery disease. The development of Tc-99m labeled perfusion tracers permits combined myocardial perfusion and left ventricular (LV) function studies at a single testing interval. Thus, the potential advantages of simultaneous assessment of myocardial perfusion ad LV function have been recently outlined. Gated imaging of the perfused myocardium is a well-established technique for this purpose, with a single injection of a Tc-99m labeled perfusion tracer. Recent data have demonstrated the impact and clinical role of these studies in the diagnosis of patients with suspected or known coronary artery disease. The addition of functional information to perfusion data has shown to improve the detection of multi-vessel disease. Subsequently, cardiac radionuclide imaging has made significant advances in the determination of prognosis in patients with ischemic heart disease, preoperative risk assessment for patients undergoing non-cardiac surgery and assessment of the efficacy of revascularization in patients undergoing coronary artery bypass surgery or interventional procedures. A key role of myocardial perfusion imaging has been its ability to provide prognostic information in patients after acute myocardial infarction, in patients with

  11. 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 BioFactors, 42(2):133-148, 2016. PMID:26876101

  12. [Distance methods of cardiologic monitoring in diagnostics of high loading effects on organism of sportsman and cosmonaut].

    Science.gov (United States)

    Kuznetsov, V I; Ryzhakov, N I; Tarakanov, S A; Nikitenko, A N; Rassadina, A A; Kozlenok, A V; Moroshkin, V S

    2012-01-01

    Increase of cardiovascular tension is a common thing for professional athletic training. Cardiovascular pathologies can be prevented by permanent physiological monitoring using, among others, the methods of cardiologic monitoring so far available in stationary diagnostic centers. On-line remote diagnostics during training is potent to enhance effectiveness and efficiency of sporting people's health management. In addition, RD will also enable extensive investigations of the bodily responses of individually determined training loads. The paper gives an overview of the current RM technologies. PMID:23457962

  13. Impact of Sterilisation and Strain Hardening in Drawing Process on Resistance to Electrochemical Corrosion of Wires Intended in Cardiology

    Directory of Open Access Journals (Sweden)

    Przondziono J.

    2016-03-01

    Full Text Available The study presents results of tests of impact of work hardening in cold drawing process, surface treatment and sterilisation on resistance to electrochemical corrosion of wires made of stainless steel X2CrNiMo 17-12-2 intended for cardiology. Potentiodynamic tests were performed on the ground of registered anodic polarisation curves in artificial plasma solution. Static uniaxial tension test made the ground for determination of strength characteristics of wires and the flow curve. Functions presenting the change of polarisation resistance according to strain applied in drawing process were selected.

  14. Pediatric cardiology. Clinical and practical experiences with heart diseases of children, juveniles and young adults; Kinderkardiologie. Klinik und Praxis der Herzerkrankungen bei Kindern, Jugendlichen und jungen Erwachsenen

    Energy Technology Data Exchange (ETDEWEB)

    Haas, Nikolaus A. [Herz- und Diabeteszentrum NRW, Bad Oeynhausen (Germany). Klinik fuer angeborene Herzfehler; Kleideiter, Ulrich [Klinik fuer Kinder- und Jugendmedizin, Coesfeld (Germany)

    2011-07-01

    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.

  15. Patient Dose Values during Interventional Cardiology Examinations in Yazd Hospitals, Iran

    Directory of Open Access Journals (Sweden)

    Verginia Tsapaki

    2010-05-01

    Full Text Available Background/Objective: The number of interventional cardiology (IC procedures has increased rapidly. Coronary angiography (CA and percutaneous transluminal coronary angioplasty (PTCA are now widely performed as a matter of routine and they are considered safe procedures for experienced cardiologists. However, it is also known that these procedures are associated with high radiation doses due to long fluoroscopy time (T, and large number of cineradiography frames (F. These levels of radiation may even lead to radiation skin injuries under certain conditions. "nPatients and Methods: A detailed study of radiation doses received by 168 patients who underwent CA, and 84 patients who underwent PTCA using 3 angiography x-ray systems in two hospitals of Yazd-Iran is presented. An air kerma-area product (KAP meter was used for patient dosimetry. KAP, fluoroscopy time and total number cine frames for CA and PTCA procedures were recorded for each patient. "nResults: Mean ± SD of KAP in CA and PTCA were 33 Gy.cm2 ± 18.8 Gy.cm2 and 80.3 Gy.cm2 ± 65.6 Gy.cm2, respectively. The comparison showed that CA KAP (33Gy.cm2, fluoroscopy time (2.7±2.4min, and cine frames number (571±149 except of on case, were lower than (P<0.001 the results of other studies and mean KAP due to PTCA procedures, except for three cases, were not significantly different from the other references' results. "nConclusion: The high-level expert cardiologists could not have a significant effect on the decrease of patient dose since they should also teach angiography examinations to medicine students. With increasing patient BMI the value of KAP increased, but the fluoroscopy time and cine frames number did not change significantly. In addition, the results showed that the use of flat panel detector was not sufficient for decreasing patient dose and the system's adjustment was more important.

  16. Dose assessment with radiochromic film in interventional cardiology in Latin America

    International Nuclear Information System (INIS)

    Interventional Cardiology (IC) is considered a practice with important benefits but also with the potential of high radiation doses (and radiation injuries) for patients and staff. Dosimetric data for this practice are still scarce in Latin America (LA). Radiation protection (RP) training for interventionalists and support of Medical Physicists are also scarce in the Region. The IAEA has promoted a large scale programme on RP of Patients in Medical Exposures (RLA/9/057) including as one of the objectives the avoidance of radio-injuries in interventional radiology. This paper presents the methodology of the project including the use of radiochromic films during IC procedures in a sample of LA centres. Skin dose distributions and peak skin dose have been measured with radiochromic films. These films have a dynamic range of 0.1 to 15 Gy. Films were positioned over the table and below the patient and the mattress. Manufacturer includes a calibration strip with each set of films. This standard strip allows to estimate the doses through comparing the optical densities of the strip and the film used during the clinical procedures. Results from 8 Centres in LA have been obtained for Coronary Angiography (CA), Percutaneous Transluminal Coronary Angioplasty (PTCA), and combined PTCA+CA. In 54.6% of the procedures, one or more factors that could enhance the risk of skin lesions were identified. For PTCA the measured peak skin doses are higher than during CA. When procedures are combined (CA+PTCA), in almost all the cases, the maximum doses are higher than 1 Gy (but the sample of the procedures was not selected at random). We conclude that procedures with CA+PTCA with large fluoroscopy time or large number of cine frames, carried out on patients with large body mass index, are the target group to investigate the risk of skin injuries. It is difficult to propose trigger levels for these parameters considering the lack of direct relation with the real peak skin dose, but 60

  17. Fluoroscopy time - an overestimated factor for patient radiation exposure in invasive cardiology

    International Nuclear Information System (INIS)

    Purpose: to analyze the effects of an optimized fluoroscopy time on patient radiation exposure in the course of coronary angiography (CA) and percutaneous coronary interventions (PTCA), in comparison to those with consistent collimation to the region of interest (ROI). Furthermore, to analyze efforts concerning reduction of radiographic frames as well as concerning adequate instead of best possible image quality. Material and methods: for 3,115 elective CAs and 1,713 PTCA performed by one interventionist since 1997, we documented the radiographic dose-area products (DAPR) and fluoroscopic dose-area products (DAPF), the number of radiographic frames and the fluoroscopy times during selected 2-month intervals. Under conditions of constant image intensifier entrance dose, levels of DAPR/frame and DAPF/s represent valid parameters for consistent collimation. Results: in 1997, the mean baseline values of DAP for elective CA and PTCA amounted to 37.1 and 31.6 Gy x cm2, respectively. A reduction of mean fluoroscopy times from 264 to 126 seconds for CA and from 630 to 449 seconds for PCI, both resulted in an overall DAP-reduction of merely 20%. Optimization of mean radiographic frames from 543 to 98 for CA and from 245 to 142 for PTCA enabled reductions of 53 and 13%, respectively. By restriction to adequate instead of best-possible image quality for coronary angiography in clinical routine, we achieved an optimized radiographic DAP/frame of 30.3 to 13.3 mGy x cm2, which enabled a 45% reduction of overall DAP. Most efficient however was a consistent collimation to the ROI, which resulted in a remarkable radiation reduction by 46% for CA and by 65% for PTCA. Conclusions: radiation-reducing educational efforts in the clinical routine of invasive cardiology should - against widely held opinion - focus less exclusively toward a reduction of fluoroscopy time but more efficiently toward consistent collimation to the region of interest, reduction of radiographic frames and

  18. "When are you seeing my patient?"--an analysis of the cardiology consultation service in a teaching hospital.

    LENUS (Irish Health Repository)

    Cronin, E

    2010-05-01

    The provision of an efficient consultation service is essential to the efficient functioning of any hospital. Surprisingly little is known about this activity. We present the first reported evaluation of a cardiology consultation service in an attempt to determine the characteristics, efficiency and workload implications of such a service. We performed an audit of the in-patient cardiology consultation service over a four week period. During this period, 125 consultations were seen, of which 85 (68%) were requested by medical specialties. Consultations were seen in a timely fashion, with 76 (61%) being seen on the same day that the request was received. The most common problem was chest pain, (49 patients; 38%) which was felt to be of cardiac origin in only a minority (20; 40%) of cases. Consultations had significant resource implications for our department, with 35 (28%) procedures being performed, 25 (20%) patients\\' care being taken over, and a further 27 (21.6%) new out-patient referrals generated. Our results indicate that the consultation service considered was efficiently delivered but contributed significantly to the department\\'s workload. The most frequent consultation request was for chest pain that was often non-cardiac in nature.

  19. Eye lens dosimetry in interventional cardiology: Results of staff dose measurements and link to patient dose levels

    International Nuclear Information System (INIS)

    Workers involved in interventional cardiology procedures receive high eye lens dose if protection is not used. Currently, there is no suitable method for routine use for the measurement of eye dose. Since most angiography machines are equipped with suitable patient dosemeters, deriving factors linking staff eye doses to the patient doses can be helpful. In this study the patient kerma-area product, cumulative dose at an interventional reference point and eye dose in terms of Hp(3) of the cardiologists, nurses and radiographers for interventional cardiology procedures have been measured. Correlations between the patient dose and the staff eye dose were obtained. The mean eye dose was 121 mSv for the first operator, 33 mSv for the second operator/nurse and 12 mSv for radiographer. Normalised eye lens doses per unit kerma-area product were 0.94 mSv Gy-1 cm-2 for the first operator, 0.33 mSv Gy-1 cm-2 for the second operator/nurse and 0.16 mSv Gy-1 cm-2 for radiographers. Statistical analysis indicated that there is a weak but significant (p < 0.01) correlation between the eye dose and the kerma-area product for all three staff categories. These values are based on a local practice and may provide useful reference for other studies for validation and for wider utilisation in assessing the eye dose using patient dose values. (authors)

  20. The Hirsch-index: a simple, new tool for the assessment of scientific output of individual scientists: The case of Dutch professors in clinical cardiology

    NARCIS (Netherlands)

    T. Opthof; A.A.M. Wilde

    2009-01-01

    In this brief paper we explore the Hirsch-index together with a couple of other bibliometric parameters for the assessment of the scientific output of 29 Dutch professors in clinical cardiology. It appears that even within such a homogeneous group there is large interindividual variability. Although

  1. Comparison of Mortality in Patients With Acute Myocardial Infarction Accidentally Admitted to Non-cardiology Departments Versus That in Patients Admitted to Coronary Care Units

    DEFF Research Database (Denmark)

    D'Souza, Maria; Saaby, Lotte; Poulsen, Tina S; Diederichsen, Axel C P; Hosbond, Susanne; Diederichsen, Søren Z; Larsen, Torben B; Schmidt, Henrik; Gerke, Oke; Hallas, Jesper; Gislason, Gunnar; Thygesen, Kristian; Mickley, Hans

    2014-01-01

    The aim of this study was to prospectively investigate the clinical characteristics including symptoms and long-term mortality in patients with acute myocardial infarction (AMI) accidentally admitted to non-cardiology departments (NCDs). For comparison, similar observations in patients admitted to...

  2. The Cardiology Information System: the need for data standards for integration of systems for patient care, registries and guidelines for clinical practice

    NARCIS (Netherlands)

    M.L. Simoons (Maarten); N.H.J.J. van der Putten; D. Wood; J-P. Bassand (Jean-Pierre); H. Boersma (Eric)

    2002-01-01

    textabstractThe building blocks come together, finally! Already three decades ago we were dreaming of the complete Cardiology Information System. However, at that time the computer programmers explained that it was too early. In the subsequent year information tech- nology (IT) specialists, replacin

  3. Cardiología intervencionista en arritmias cardíacas: experiencia inicial

    Directory of Open Access Journals (Sweden)

    Oswaldo Gutiérrez

    2000-04-01

    Full Text Available Introducción. La cateterización del corazón en electrofisiología se ha venido utilizando con fines diagnósticos y para establecer el recorrido anatómico de las taquicardias supraventriculares o ventriculares y así detectar zonas críticas suceptibles de ablación. El objetivo de este estudio es brindar una revisión de los casos realizados desde febrero de 1999 hasta la fecha, en el país. Materiales y Métodos. Se incluyeron pacientes que tuvieran las indicaciones usuales para realizar estudio electrofisiológico diagnóstico o procedimientos de ablación por catéter. Se colocaron múltiples catéteres intracardíacos para el registro y estimulación de las cámaras cardíacas así como para la aplicacion de radiofrecuencia. Resultados. Se realizaron 19 estudios (5 diagnósticos y 14 terapéuticos, edades entre 16 y 86 años, 6 hombres y 12 mujeres. Los estudios diagnósticos se realizaron en 3 pacientes con síncope, uno con taquicardia ventricular sostenida y uno con extrasistolia ventricular frecuente. Los procedimientos terapéuticos se realizaron en 3 pacientes con reentrada intranodal (éxito 100%, en 10 con vías accesorias o síndrome de Wolff-Parkinson-White (éxito de 90% y en una se realizó ablación del nódulo Aurículoventricular (100% por crisis de fibrilación auricular de alta respuesta ventricular. Ocurrió recidiva en un caso (seguimiento de 2 a 38 semanas y una complicación en otro (derrame pericárdico. Conclusiones. Estos procedimientos de Cardiología Intervencionista en Arritmias Cardíacas son seguros, aportan información diagnóstica relevante y/o tratamiento curativo con alta tasa de éxito y baja tasa de recurrencia en pacientes con diversos trastornos del ritmo cardíaco.Introduction. Electrophysiological cardiac catheterization have been used for diagnostic purposes and for detection of anatomic circuits of different taquiarrhythmias, suitable for ablation procedures. The objetive of this study is to

  4. Quality control and learning experience in clinical nuclear cardiology at a teaching hospital facility

    International Nuclear Information System (INIS)

    Full text: Introduction: Traditional Nuclear Medicine training includes seminars, guided practices and self learning modules (continuing education and internet-based). We have developed recently a combination of training, quality control and active clinical research, with postgraduate nuclear medicine residents and pre-graduate technology students. Goal: a) to assess the reproducibility of diverse techniques, among staff specialists and residents; and b) software application quality control. This, also in order to accomplish international parameters, mainly in nuclear cardiology training. Methodology and Results: Four main cardiovascular subjects were selected: A) Reproducibility in Lung V/Q Scans Interpretation: 401 studies from 382 patients with a possible pulmonary embolism were analyzed retrospectively; a blind lecture was performed by 6 independent observers with different experience level. Interpretation was based on individual experience and revised PIOPED criteria. Original reports included 27.2% high probability and 67.3% low probability. Interobserver agreement range was: 73-86% and correlation with original report: 74-82%. Excellent interobserver concordance and kappa was found, higher in experienced observers. B) Perfusion SPECT in Coronary Artery Disease (CAD): 60 cases with recent myocardial infarction with successful thrombolysis were blindly interpreted by 2 independent specialists and also by 5 in-training observers from different universities. Excellent interobserver agreement was obtained by specialists for normal/abnormal perfusion and wall motion (98.3% and 93.3%, respectively). Agreement between perfusion and wall motion was adequate, as well as assigned artery analysis. There was good correlation interpreting myocardial perfusion SPECT at both centers, with better adjustment in more experienced observers. Currently, we are developing another study comparing interobserver reproducibility for exercise electrocardiogram and perfusion images

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

    International Nuclear Information System (INIS)

    Purpose: To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Methods: Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Results: Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for <1 yr; 213 for 1 to <5 yr; 82 for 5 to <10 yr; and 102 for 10 to <16 yr. The third quartile values obtained for DAP by diagnostic and therapeutic procedures and age range were 1.17 and 1.11 Gy cm2 for <1 yr; 1.74 and 1.90 Gy cm2 for 1 to <5 yr; 2.83 and 3.22 Gy cm2 for 5 to <10 yr; and 7.34 and 8.68 Gy cm2 for 10 to <16 yr, respectively. The third quartile value obtained for the DAP/body weight ratio for the full sample of procedures was 0.17 (Gy cm2/kg) for diagnostic and therapeutic procedures. Conclusions: The data presented in this paper are an initial attempt at establishing local DRLs in pediatric interventional cardiology, from a large sample of procedures for the standard age bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there may be large differences in

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

    Energy Technology Data Exchange (ETDEWEB)

    Ubeda, Carlos, E-mail: cubeda@uta.cl [Medical Technology Department, Radiological Sciences Center, Health Sciences Faculty, Tarapaca University, Arica 1000000 (Chile); Miranda, Patricia [Hemodynamic Department, Cardiovascular Service, Luis Calvo Mackenna Hospital, Santiago 7500539 (Chile); Vano, Eliseo [Radiology Department, Faculty of Medicine, Complutense University and IdIS, San Carlos Hospital, Madrid 28040 (Spain)

    2015-02-15

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

  7. Benefits of an automatic patient dose registry system for interventional radiology and cardiology at five hospitals of the Madrid area

    International Nuclear Information System (INIS)

    The purpose of this article is to present the results of connecting the interventional radiology and cardiology laboratories of five university hospitals to a unique server using an automatic patient dose registry system (Dose On Line for Interventional Radiology, DOLIR) developed in-house, and to evaluate its feasibility more than a year after its introduction. The system receives and stores demographic and dosimetric parameters included in the MPPS DICOM objects sent by the modalities to a database. A web service provides a graphical interface to analyse the information received. During 2013, the system processed 10 788 procedures (6874 cardiac, 2906 vascular and 1008 neuro interventional). The percentages of patients requiring clinical follow-up due to potential tissue reactions before and after the use of DOLIR are presented. The system allowed users to verify in real-time, if diagnostic (or interventional) reference levels are fulfilled. (authors)

  8. A set of patient and staff dose data for validation of Monte Carlo calculations in interventional cardiology

    International Nuclear Information System (INIS)

    The purpose of this paper is to report a set of experimental values of patient and staff doses in a cardiac catheterisation laboratory using the range of radiographic and geometric parameters from routine clinical practice. The data obtained will be available for validation of Monte Carlo calculations and for training purposes. They will also help optimise radiation protection for patients and staff. Experimental measurements were made with an anthropomorphic phantom, and a monoplane flat detector-based X-ray system was used for interventional cardiology procedures. Standard operational protocols used in clinical practice were applied. Around 1000 patient dose and 5000 staff dose values were measured for different operational conditions (angulations, distances, collimation and wedge filter, magnification, phantom thicknesses, using Copper absorber, etc.). Uncertainties were also estimated. Increase factors of 3-10 for patients and staff doses were measured for the different C-arm angulations. (authors)

  9. Extremity and eye lens doses in interventional radiology and cardiology procedures: First results of the ORAMED project

    International Nuclear Information System (INIS)

    The main objective of WP1 of the ORAMED (Optimization of Radiation protection for Medical staff) project is to obtain a set of standardised data on extremity and eye lens doses for staff in interventional radiology (IR) and cardiology (IC) and to optimise staff protection. A coordinated measurement program in different hospitals in Europe will help towards this direction. This study aims at analysing the first results of the measurement campaign performed in IR and IC procedures in 34 European hospitals. The highest doses were found for pacemakers, renal angioplasties and embolisations. Left finger and wrist seem to receive the highest extremity doses, while the highest eye lens doses are measured during embolisations. Finally, it was concluded that it is difficult to find a general correlation between kerma area product and extremity or eye lens doses. (authors)

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2008-01-01

    A small-scale internal audit has been used to evaluate the impact of the use of a dynamic flat panel detector in the clinical routine in the National Interventional Cardiology Centre in Luxembourg. The parameters tested during commissioning and constancy control of an X-ray system, the introduction of new clinical protocols, the patient and the personal staff dosimetry were considered. The technical parameters tested by the hospital physicist stay the same as for the image intensifier. No innovative protocols have been adopted due to the existence of the flat panel detector. A reduction in dose was noted after the installation of a flat detector, due mostly to the continuing education of the interventional cardiologists as well as the initial calibration of the radiological system. The understanding of the X-ray system and its possibilities is vital for the optimisation of clinical procedures in patient and staff exposure. PMID:18448437

  12. A comparison of the quality of the information available on the internet on interventional radiology, vascular surgery, and cardiology

    Directory of Open Access Journals (Sweden)

    A Alsafi

    2013-01-01

    Full Text Available Context and Aims: Internet use is rapidly expanding and increasingly plays a substantial role in patient education. We sought to evaluate and compare the quality of information available to patients online on three closely linked specialties: Interventional radiology (IR, cardiology, and vascular surgery. Materials and Methods: We searched the leading three search engines for the terms: "Interventional Radiology", "cardiology," and "vascular surgery," collating the top 50 hits from each search. After excluding duplicates and irrelevant sites, 43, 25, and 36 sites remained, respectively. Sites were analyzed using the LIDA instrument (an online tool for assessing health-related websites and Fleisch Reading Ease Scores (FRES were compared across the different search terms and correlated with the country of origin and certification by the Health on the Net (HON Foundation. Results: There was no significant difference ( P>0.05 in the total LIDA, accessibility, usability or reliability scores between the three specialties. HONCode certification was associated with higher LIDA (83.1±1.6 vs. 71.53±0.8 ( P<0.0001, reliability (75.7±3.6 vs. 49.0±1.6 ( P<0.0001 and FRES (37.4±4.0 vs. 29.7±1.4 ( P=0.0441. Conclusion: Websites are generally well designed and easy to use; the majority however, lacks currency and reliability. Despite similarity in quality of online information, there is a disparity in knowledge of IR; this may be due to low web-traffic figures of IR sites. Wikipedia′s user-generated content, ranks highly in major search engines, as such; this could serve as means of disseminating reliable health information to patients.

  13. Patient cumulative radiation exposure in interventional cardiology; Exposition cumulee aux rayonnements ionisants des patients en cardiologie interventionnelle: caracteristiques cliniques et dosimetriques

    Energy Technology Data Exchange (ETDEWEB)

    Bernier, M.O.; Jacob, S.; Laurier, D. [Institut de radioprotection et de surete nucleaire (IRSN), DRPH, SRBE, LEPID, Fontenay-aux-Roses (France); Maccia, C. [Centre d' assurance de qualite des applications technologiques dans le domaine de la sante - CAATS, Bourg-la-Reine (France); Bar, O.; Blanchard, D. [Clinique Saint-Gatien, Tours (France); Catelinois, O. [Institut de veille sanitaire, St Maurice (France)

    2012-01-15

    Interventional cardiology procedures can involve potentially high doses of radiation to the patients. Stochastic effects of ionising radiation - radiation-induced cancers in the long term - may occur. We analysed clinical characteristics and dosimetric data in a population of patients undergoing interventional cardiology. In all, 1 591 patients who had undergone coronarography and/or angioplasty in the course of a year at the Saint-Gatien Clinic in Tours (France) were included. Information on patients' individual clinical characteristics and Dose-Area Product values were collected. Organ doses to the lung, oesophagus, bone marrow and breast were mathematically evaluated. The median age of patients was 70 years. Their median cumulative dose-area product value was 48.4 Gy.cm{sup 2} for the whole year and the median effective dose was 9.7 mSv. The median organ doses were 41 mGy for the lung, 31 mGy for the oesophagus, 10 mGy for the bone marrow and 4 mGy for the breast. Levels of doses close to the heart appear to be rather high in the case of repeated interventional cardiology procedures. Clinical characteristics should be taken into account when planning epidemiological studies on potential radiation-induced cancers. (authors)

  14. A review of partial volume correction techniques for emission tomography and their applications in neurology, cardiology and oncology

    International Nuclear Information System (INIS)

    Accurate quantification in PET and SPECT requires correction for a number of physical factors, such as photon attenuation, Compton scattering and random coincidences (in PET). Another factor affecting quantification is the limited spatial resolution. While considerable effort has gone into development of routine correction techniques for the former factors, less attention has been paid to the latter. Spatial resolution-related effects, referred to as ‘partial volume effects’ (PVEs), depend not only on the characteristics of the imaging system but also on the object and activity distribution. Spatial and/or temporal variations in PVE can often be confounding factors. Partial volume correction (PVC) could in theory be achieved by some kind of inverse filtering technique, reversing the effect of the system PSF. However, these methods are limited, and usually lead to noise-amplification or image artefacts. Some form of regularization is therefore needed, and this can be achieved using information from co-registered anatomical images, such as CT or MRI. The purpose of this paper is to enhance understanding of PVEs and to review possible approaches for PVC. We also present a review of clinical applications of PVC within the fields of neurology, cardiology and oncology, including specific examples. (topical review)

  15. Insights from the early experience of the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

    Science.gov (United States)

    Rumsfeld, John S; Holmes, David R; Stough, Wendy Gattis; Edwards, Fred H; Jacques, Louis B; Mack, Michael J

    2015-03-01

    The current system for postmarket surveillance of medical devices in the United States is limited. To help change this paradigm for transcatheter valve therapies (TVTs), starting with transcatheter aortic valve replacement, the Society of Thoracic Surgeons and the American College of Cardiology partnered to form the TVT Registry program in close collaboration with the U.S. Food and Drug Administration and the Center for Medicare and Medicaid Services. The goal of the TVT Registry is to measure and improve quality of care and patient outcomes in clinical practice and to have a pivotal role in the scientific evidence and surveillance for medical devices. Challenges were faced in the early experience of the registry included developing multistakeholder partnerships, data collection requirements, and the use of the registry for pre- and post-market device evaluations. In addressing these challenges, the TVT Registry demonstrates that it is feasible for professional societies to assume a pivotal role in pre- and/or post-market studies, leveraging a clinical registry infrastructure. Sharing the TVT Registry experience may help other professional societies and stakeholders better anticipate and plan for these challenges. PMID:25703888

  16. 核心脏病学目前的作用和未来展望%Nuclear Cardiology: the Present Functions and Future Perspectives

    Institute of Scientific and Technical Information of China (English)

    梅小莉

    2013-01-01

    近十年来,负荷单光子发射计算机断层成像心肌灌注显像(SPECT MPI)已成为可疑或已知冠心病(CAD)患者诊断和处理最常用的负荷显像技术,并已得到众多相关临床指南的充分肯定,推荐将SPECT MPI作为冠状动脉造影(CAG)的“守门人”,减少不必要的造影.然而,我国的核心脏病学起步较晚,导致部分临床医师对核心脏病学的认识不足.在选择冠状动脉造影、CT冠状动脉造影(CTCA)等技术诊断和处理CAD时,常常存在“误区”,以致出现过度应用的趋势.本文将重点介绍核心脏病学目前的作用,简要介绍最近核心脏病学在心脏混合显像及分子显像方面的进展,以促进核心脏病学在我国的合理应用.%For the past decade, the diagnosis and treatment of coronary artery disease (CAD) has shifted from the traditional model by evaluating coronary artery stenosis with morphological imaging methods to a novel model by focusing on the detection of ischemia for risk stratification. The myocardial perfusion imaging (MPI) using stress single photon emission computed tomography (SPECT) has become the most commonly used stress imaging technique for the diagnosis and treatment of patients with suspected or known CAD. It has got strong supports, including those of the American College of Cardiology, American Heart Association, American Society of Nuclear Cardiology (ACC/AHA/ASNC) and other numerous clinical guidelines. They all stressed that the SPECT MPI is recommended to be used as the "gate keeper" to coronary angiography in order to prevent unnecessary intervention test and save the cost. However, in China the introduction and application of nuclear cardiology was late and highly unbalanced. This leads to the lack of understanding of nuclear cardiology in some clinicians, and there often is misunderstanding on correct selection of coronary angiography, cardiac CT, CT coronary angiography and others for diagnosis and treatment of CAD

  17. ANUARIO 2012: CARDIOLOGÍA INTERVENCIONISTA. LAS REVISTAS DE LAS SOCIEDADES NACIONALES PRESENTAN UNA SELECCIÓN DE LAS INVESTIGACIONES QUE HAN IMPULSADO AVANCES RECIENTES EN CARDIOLOGÍA CLÍNICA / Almanac 2012: Interventional Cardiology. The National Society Journals present selected research that has driven recent advances in Clinical Cardiology

    Directory of Open Access Journals (Sweden)

    Pascal Meier

    2013-04-01

    Full Text Available Resumen: El campo de la cardiología intervencionista sigue avanzando rápidamente. La eficacia de las intervenciones percutáneas con las nuevas generaciones de stents liberadores de fármacos ha avanzado mucho en la última década. Esta mejora en el rendimiento del stent ha ampliado el nivel de indicación hacia intervenciones más complejas tales como intervencionismo del tronco coronario izquierdo y de múltiples vasos. En el campo del tratamiento médico coadyuvante continúan los grandes avances, como lo es el tratamiento antiplaquetario (bivalirudina, prasugrel, ticagrelor que mejorará aún más los resultados del intervencionismo coronario percutáneo. Lo mismo ocurre para la imagenología intravascular como es el caso del ultrasonido intravascular y la tomografía de coherencia óptica. Sin embargo, la cardiología intervencionista se ha convertido en un campo bastante amplio, que incluye también la ablación septal con alcohol para la miocardiopatía hipertrófica obstructiva, etc. En la actualidad, las intervenciones estructurales constituyen el área de mayor crecimiento, sobre todo para la estenosis válvular aórtica (implantación de válvula aórtica transcatéter y la regurgitación mitral (clipping mitral. En esta revisión se tratan los avances recientes en todos estos diferentes campos de la cardiología intervencionista / Abstract: The field of interventional cardiology continues to progress quickly. The efficacy of percutaneous interventions with newer generation drug-eluting stents has advanced a lot over the last decade. This improvement in stent performance has broadened the level of indication towards more complex interventions such as left main and multi-vessel PCI. Major improvements continue in the field of medical co-therapy such as antiplatelet therapies (bivalirudin, prasugrel, ticagrelor and this will further improve outcomes of PCI. The same is true for intravascular imaging such as ultrasound IVUS and

  18. Extremity doses of medical staff involved in interventional radiology and cardiology: Correlations and annual doses (hands and legs)

    International Nuclear Information System (INIS)

    An intensive measurement campaign was launched in different hospitals in Europe within work package 1 of the ORAMED project (Optimization of RAdiation protection for MEDical staff). Its main objective was to obtain a set of standardized data on extremity and eye lens doses for staff in interventional radiology (IR) and cardiology (IC) and to optimize staff protection. The monitored procedures were divided in three main categories: cardiac, general angiography and endoscopic retrograde cholangio-pancreatography(ERCP) procedures. Using a common measurement protocol, information such as the protective equipment used (lead table curtain, transparent lead glass ceiling screen, patient shielding, whole body shielding or special cabin etc.) as well as Kerma Area Product (KAP) values and access of the catheter were recorded. This study was performed with a final database of more than 1300 procedures performed in 34 European hospitals. Its objectives were firstly to determine if the measured extremity doses could be correlated to the KAP values; secondly to check if the doses to the eyes could be linked to the doses to the hands (finger or wrist positions) and finally if the doses to the fingers could be estimated based on the doses to the wrists. General correlations were very difficult to find and their strength was mostly influenced by three main parameters: the X-ray tube configuration, the room collective radioprotective equipment and the access of the catheter. The KAP value can provide a simple mean to estimate the extremity doses of the operator given that it is assessed correctly for the operator when he is actually using the X-ray tube. Moreover, this study showed that the doses to the left finger are strongly correlated to the doses to the left wrist when no ceiling shield is used. It is also possible to estimate the doses to the eyes given the doses to the left finger or left wrist but the X-ray tube configuration and the access have to be considered. The annual

  19. Distribution of kerma rate in the air inside of hemodynamic room for typical projections of interventionist cardiology procedures

    International Nuclear Information System (INIS)

    The evaluation of dose to physicians involved in Interventional Cardiology (IC) is an extreme important matter due to the high and non-uniform distribution of dose values. The radiation control during each procedure is complex and the reasons for the high exposures have many different causes. Many international recommendations have already been written aiming the radiation protection optimization in IC. In Brazil, there is not any special orientation for the protection of those occupational persons, nor a specific legislation. The purpose of this work is to evaluate the air kerma rate at critical anatomic regions of the occupationally exposed staff that carry out IC procedures, in representative incidences in order to give subsidies for individual monitoring procedures implementation and to give more information about their radiation protection. The air kerma rate has been measured in the often used condition in the two more common IC procedures namely angiography and coronary angioplasty, using an adult patient simulator irradiated under RAO, LAO and AP projections for fluoro and digital acquisition modes. The measurements have been made in 45 points around the examination table at 5 different representatives heights of: eyes lens, thorax, hands, gonads and knees. AP projection shows the smaller scattered radiation contributions and a more homogeneous exposure distribution. The digital acquisition mode gives air kerma rates about 4 times higher than fluoro mode for LAO projection in the position occupied by the interventionist doctor, the anesthetist and the nursing staff. The most critical anatomic regions are: knees and gonads (without protection). On the physician hands position, values as high as 5 mGy/h have been measured, which can overpass, depending on the number of procedures done, the individual occupational annual limit. Therefore, in IC it is necessary to implement additional protection tools, elaborate safety guides (based on international experiences

  20. Best-of 2001: nuclear cardiology and cardiac MRI; Le best-of 2001: cardiologie nucleaire et IRM cardiaque

    Energy Technology Data Exchange (ETDEWEB)

    Manrique, A. [Centre Hospitalier Universitaire, 76 - Rouen (France); Marie, P.Y. [Centre Hospitalier Universitaire, 54 - Nancy (France)

    2001-12-01

    This year 2001 has been very rich in innovations and in works-in-progress in the field of cardiac imaging. In nuclear cardiology, this year has been mainly impressed by a large number of studies concerning 'gated SPECT' which allows the simultaneous analysis of the perfusion and of the contraction of the left ventricle. The clinical contribution of this technique is quite significant in any of the fields of use of the conventional tomo-scintigraphy such as the screening of the coronary disease, the evaluation of its prognosis or the evaluation of the viability. Innovation has also concerned the field of the radio-tracers, with studies concerning some very promising tracers of the apoptosis or of the cellular hypoxia. At last, various works have been carried out on the gamma-cameras, particularly to make them suitable for imaging of tracers used in positron emission tomography (PET). This should allow to spread to any of the nuclear medicine centers the use of FDG imaging which is the golden standard for myocardial viability assessment. About MRI, a lot of studies have been performed about sequences using gadolinium as a vascular contrast agent, to identify and to localize the infarction sequelae, even when limited to sub-endocardium. Probably the most dramatic technical innovations concerned the development of methods enhancing the recorded signal (SENSE) and the design of real-time imaging sequences, without apnea and without ECG gating. But, as every year, important advances have also been registered in angio-MR of the coronary vessels, as in the myocardial perfusion analysis using sequences without the requirement of contrast agent injection. (author)

  1. December 2014 HeartWeek issue of cardiology in the young: highlights of HeartWeek 2014: diseases of the cardiac valves from the foetus to the adult.

    Science.gov (United States)

    Jacobs, Jeffrey P

    2014-12-01

    This December Issue of Cardiology in the Young represents the 12th annual publication generated from the two meetings that compose "HeartWeek in Florida". "HeartWeek in Florida", the joint collaborative project sponsored by the Cardiac Center at the Children's Hospital of Philadelphia, Pennsylvania, together with Johns Hopkins All Children's Heart Institute of Saint Petersburg, Florida, averages over 1000 attendees every year and is now recognised as one of the major planks of continuing medical and nursing education for those working in the fields of diagnosis and treatment of cardiac disease in the foetus, neonate, infant, child, and adult. "HeartWeek in Florida" combines the International Symposium on Congenital Heart Disease, organised by All Children's Hospital and Johns Hopkins Medicine and entering its 15th year, with the Annual Postgraduate Course in Pediatric Cardiovascular Disease, organised by The Children's Hospital of Philadelphia and entering its 18th year. This December, 2014 Issue of Cardiology in the Young features highlights of Johns Hopkins All Children's Heart Institute's 14th Annual International Symposium on Congenital Heart Disease, which was held at the Renaissance Vinoy Resort & Golf Club, Saint Petersburg, Florida, from 15-18 February, 2014. This Symposium was co-sponsored by The American Association for Thoracic Surgery (AATS) and had as its special focus " Diseases of the Cardiac Valves from the Fetus to the Adult ". We acknowledge the tremendous contributions made to paediatric and congenital cardiac care by Duke Cameron and Joel Brenner, and therefore we dedicate this December, 2014 HeartWeek Issue of Cardiology in the Young to them. Duke Cameron is Professor of Surgery at Johns Hopkins University and Cardiac Surgeon-in-Charge at The Johns Hopkins Hospital. Joel Brenner is Professor of Pediatrics at Johns Hopkins University and Director of the Taussig Heart Center at Bloomberg Children's Center, The Johns Hopkins Hospital. Together

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

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Donald L.; Hilohi, C. Michael; Spelic, David C. [Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland 20993 (United States)

    2012-10-15

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

  3. Prevalencia de Obesidad en pacientes hipertensos en el Servicio de Cardiología del Hospital México de Costa Rica

    OpenAIRE

    Eric Bogantes Pereria; Jorge Chavarría Víquez; Doris Arguedas Bolaños

    2009-01-01

    Resumen Introducción. El sobrepeso está asociado con un incremento en el riesgo de sufrir hipertensión arterial. Dada la alta prevalencia de obesidad en nuestra población, en este estudio se investigó y analizó la prevalencia de la obesidad en un grupo de pacientes hipertensos de la consulta externa del servicio de Cardiología del Hospital México, Costa Rica Materiales y métodos. Es un estudio retrospectivo, observacional donde se realizó el reclutamiento de un grupo de pacientes hipertensos ...

  4. A dataset to assess providers׳ knowledge and attitudes towards the 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline.

    Science.gov (United States)

    Pokharel, Yashashwi; Steinberg, Lynne; Chan, Winston; Akeroyd, Julia M; Jones, Peter H; Nambi, Vijay; Nasir, Khurram; Petersen, Laura; Ballantyne, Christie M; Virani, Salim S

    2016-06-01

    We previously examined provider׳s understanding of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol management guideline (DOI: http://dx.doi.org/10.1016/j.jacl.2015.11.002)(Virani et al., 2013) [1], and also assessed whether a case-based educational intervention could improve providers׳ knowledge gaps and attitudes towards the guideline (DOI: 10.1016/j.atherosclerosis.2015.12.044) (Pokharel, et al., 2016) [2]. Here we describe the dataset that we used to examine our objectives. PMID:27054163

  5. Kerma rate evaluation in the air in a room interventional cardiology; Avaliacao da taxa de Kerma no ar em uma sala de cardiologia intervencionista

    Energy Technology Data Exchange (ETDEWEB)

    Real, Jessica V.; Luz, Renata M. da, E-mail: jessica.real@pucrs.br, E-mail: renata.luz@pucrs.br [Hospital Sao Lucas (HSL/PUCRS), Porto Alegre, RS (Brazil); Fröhlich, Bruna D.; Silva, Ana Maria Marques da, E-mail: bruna.frohlich@acad.pucrs.br, E-mail: ana.marques@pucrs.br [Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil)

    2014-07-01

    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{sup 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.

  6. Computers in Cardiology.

    Science.gov (United States)

    Feldman, Charles L.

    The utilization of computers in the interpretation of electrocardiograms (EKG's) and vectorcardiograms is the subject of this report. A basic introduction into the operations of the electrocardiograms and vectorcardiograms is provided via an illustrated text. A historical development of the EKG starts with the 1950's with the first attempts to use…

  7. Telemedicine and cardiology

    Directory of Open Access Journals (Sweden)

    Jelkić Nikola

    2003-01-01

    Full Text Available Introduction Telecommunications and information technology provide clinical care at distance by means of telemedicine. Hospitals and other health care facilities use medical telemetry devices for monitoring patients' vital signs. These portable devices are used for measuring patient vital signs such as ECG, blood pressure, heart rate, respiration, capnography (CO2 and other important parameters and then transmit these information to a remote location using a nearby receiver. Application of telemetry Eliminating the need for wired connection with the patient, monitors allow, otherwise bedridden patients to be mobile, which shortens the recovery time. Wireless technology is also useful in the emergency care units, because emergency physicians need not leave their patients while consulting a handheld wireless device. This equipment also enables a paramedic to communicate with emergency physicians for early assessment, well before patients' arrive in hospital. Telemedicine Certain types of medical telemetry devices may be used in home conditions. Telemetry can provide monitoring and home health care services at distance, using advanced telecommunications and information technology in patients with reasonably stable, but a severe, chronic, difficult condition and caring home environment. This information can enable health-care providers to effectively manage treatment without need for acute emergency treatment and hospitalization. Conclusion Hospitals worldwide are under constant pressure to decrease healthcare cost and to improve treatment outcome. Telemedicine and home health care may be one of the solutions for the problem.

  8. Radiopharmaceuticals for nuclear cardiology

    International Nuclear Information System (INIS)

    One of the diagnostic technique periodically used in Nuclear Medicine is the angiographic studi e, employee for detect cardiovascular diseases. The radiopharmaceutical more used in the angiographic ones is 99mTc. Between thetopics described in the present work it find: myocardial infarction, radiopharmaceuticals classification for cardiac studies, labelled proceedings, cardiovascular diseases

  9. Computer diagnosis in cardiology

    Directory of Open Access Journals (Sweden)

    Graham Wilfred Ewing

    2009-01-01

    The article discusses the limitations of the conventional biomarker technique, and the potential value of non-invasive cognitive techniques, such as Virtual Scanning, to the medical practitioner. Finally, it discusses how the ability of Virtual Scanning to diagnose disease from its presymptomatic origins may lead to improved diagnostic accuracy and significantly reduced costs.

  10. Preventive Cardiology and Rehabilitation

    OpenAIRE

    Russo, Nicola

    2014-01-01

    Background: Despite the favourable effects of new therapeutic approaches during the acute phase of cardiac diseases and consequent favourable short-term outcomes, post-acute management and long term prognosis still remain unsatisfactory. Cardiac rehabilitation (CR) is a multidisciplinary treatment with established beneficial effects for the vast majority of cardiac patients and universally considered an important aspect of secondary prevention. Although it has been shown to reduce both morbid...

  11. The genome and cardiology

    DEFF Research Database (Denmark)

    Bundgaard, Henning; Diness, Birgitte Rode; Tfelt-Hansen, Jacob;

    2014-01-01

    Several cardiac diseases are autosomal dominantly inherited. This includes cardiomyopathies, primary arrhythmias (channelopathies), dyslipidaemias, premature ischaemic heart diseases and diseases of the thoracic aorta. Sudden cardiac death in the young is also often due to one of the inherited ca...

  12. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association task force on practice guidelines

    Science.gov (United States)

    The goals of the American College of Cardiology (ACC) and the American Heart Association (AHA) are to prevent cardiovascular (CV) diseases, improve the management of people who have these diseases through professional education and research, and develop guidelines, standards and policies that promot...

  13. Ninth Argentine congress on biology and nuclear medicine; fourth Southernmost sessions of ALASBIMN (Latin-American Association of Biology and Nuclear Medicine); first Spanish-Argentine congress on nuclear medicine; first Argentine sessions on nuclear cardiology

    International Nuclear Information System (INIS)

    This work deals with all the papers presented at the 9. Argentine congress on biology and nuclear medicine; IV Southernmost sessions of ALASBIMN; I Spanish-Argentine congress on nuclear medicine and I Sessions Argentine sessions on nuclear cardiology held in Buenos Aires, Argentina, from October 14 - 18, 1991

  14. Gastrostomia endoscópica em pacientes com cardiopatia complicada Percutaneous endoscopic gastrostomy in cardiologic complicated patients

    Directory of Open Access Journals (Sweden)

    Celso CUKIER

    2000-10-01

    Full Text Available Pacientes cardiopatas complicados com isquemia cerebral e insuficiência cardíaca necessitam terapia nutricional enteral prolongada por se apresentarem em situação de risco nutricional. Complicações advindas do uso prolongado da sonda nasoenteral poderiam ser evitadas com a execução da gastrostomia endoscópica. Esta é alternativa técnica para acesso ao tubo digestivo em nutrição enteral. O objetivo deste estudo foi avaliar o tempo de indicação para gastrostomia endoscópica em pacientes com nutrição enteral com uso de sonda nasoenteral e as principais complicações do procedimento. Doze pacientes foram submetidos a gastrostomia endoscópica, sendo oito do sexo masculino. A idade média foi de 62,42 + 22,10 anos. A indicação principal foi síndrome isquêmica cerebral após parada cardiorespiratória por patologia clínica (sete pacientes ou cirurgia cardiovascular complicada (cinco. O tempo médio para indicação da gastrostomia endoscópica foi de 35,58 + 26,79 dias após introdução da nutrição enteral. Não houve intercorrências com o procedimento e, no período pós-operatório tardio, ocorreu infecção do orifício de inserção da gastrostomia endoscópica em um caso, resolvida com cuidados locais. Em conclusão, a gastrostomia endoscópica é técnica segura, com baixa incidência de complicações. Pode ser realizada em ambulatório, no leito do paciente, ou em centro de terapia intensiva e sua indicação deveria ser mais precoce.Complicated cardiologic patients with brain ischemia and heart failure need long term enteral nutrition. Long term nasoenteral tuibe feeding may cause complications that could be avoided with percutaneous endoscopic gastrostomy. The aim of this study was to evaluate the indications for percutaneous endoscopic gastrostomy and its main complications. Twelve patients were submitted to percutaneous endoscopic gastrostomy (eight male with main age of 62,42 ± 22,10 years old. Brain ischemia

  15. 2014 Korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: A joint report of the Korean Society of Cardiology and the Korean Society of Radiology

    International Nuclear Information System (INIS)

    The use of cardiac magnetic resonance (CMR) imaging is increasing for the assessment of certain cardiovascular diseases, due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there has been no guideline for the use of CMR in Korean people. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates, and patients to improve the overall performances in medical system. By addressing CMR usage and creating these guidelines, we hope to contribute to the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.

  16. European Society of Cardiology 2009 guidelines for preoperative cardiac risk assessment and perioperative cardiac management in noncardiac surgery. Key messages for clinical practice

    Directory of Open Access Journals (Sweden)

    Sanne E. Hoeks

    2010-07-01

    Full Text Available Patients undergoing noncardiac surgery are at risk of adverse perioperative and long-term outcome. When considering a patient for noncardiac surgery, a careful preoperative clinical risk evaluation and subsequent risk-reduction strategies are essential to reduce postoperative complications. To assist physicians with decision making, clinical guidelines are developed. The aim of clinical guidelines is to improve patient care by providing recommendations about appropriate healthcare in specific circumstances. Development of clinical guidelines is an important component in improving the quality of care. By translating the best available scientific evidence into specific recommendations, guidelines can serve as a useful tool to achieve effective and efficient patient care. In 2009, the first European Society of Cardiology guidelines on perioperative care were developed. This decisionmaking process integrates clinical markers, early coronary evaluation, functional capacity, and the type of surgery involved.

  17. 2014 Korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: A joint report of the Korean Society of Cardiology and the Korean Society of Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yeon Yee E. [Dept. of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seoul (Korea, Republic of); Hong, Yoo Jin; Choi, Eui Young [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); and others

    2015-04-15

    The use of cardiac magnetic resonance (CMR) imaging is increasing for the assessment of certain cardiovascular diseases, due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there has been no guideline for the use of CMR in Korean people. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates, and patients to improve the overall performances in medical system. By addressing CMR usage and creating these guidelines, we hope to contribute to the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.

  18. 2014 Korean Guidelines for Appropriate Utilization of Cardiovascular Magnetic Resonance Imaging: A Joint Report of the Korean Society of Cardiology and the Korean Society of Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yeonyee E. [Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Hong, Yoo Jin [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Kim, Hyung-Kwan [Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Kim, Jeong A [Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 411-706 (Korea, Republic of); Na, Jin Oh [Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703 (Korea, Republic of); Yang, Dong Hyun [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736 (Korea, Republic of); Kim, Young Jin [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Choi, Eui-Young [Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720 (Korea, Republic of)

    2014-07-01

    Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.

  19. TRADUCCIÓN DE ACRÓNIMOS Y SIGLAS EN TEXTOS MÉDICOS DE CARDIOLOGÍA / Translation of acronyms and initialisms in medical texts on cardiology

    OpenAIRE

    Ana V. Fernández Peraza; Lorena Treto Suárez; Beatriz Betancourt Ynfiesta

    2013-01-01

    Resumen Introducción y objetivos: Con frecuencia en los textos médicos se utilizan acrónimos y siglas. Su traducción no solamente constituye un problema lingüístico, sino también cultural. El objetivo fue analizar los problemas asociados a la traducción del inglés al español de acrónimos y siglas usados en textos médicos de Cardiología. Método: Se trata de un estudio sincrónico, descriptivo, interpretativo y cualitativo que se basa en el análisis léxico de acrónimos y siglas tanto en la lengu...

  20. Present and future of clinical cardiovascular PET imaging in Europe - a position statement by the European Council of Nuclear Cardiology (ECNC)

    International Nuclear Information System (INIS)

    This position statement was prepared by the European Council of Nuclear Cardiology and summarises the current and future potential of PET as a clinical cardiovascular diagnostic imaging tool. The first section describes how methodological developments have positively influenced the transition of PET from a research tool towards a clinical diagnostic test. In the second section, evidence in support of its superior diagnostic accuracy, its value to guide decision making and to predict outcome and its cost effectiveness is summarised. The third section finally outlines new PET-based approaches and concepts, which will likely influence clinical cardiovascular medicine in the future. The notion that integration of cardiac PET into healthcare systems and disease management algorithms will advance quality of care is increasingly supported by the literature highlighted in this statement. (orig.)

  1. Proposals for the type tests criteria and calibration conditions of passive eye lens dosemeters to be used in interventional cardiology and radiology workplaces

    International Nuclear Information System (INIS)

    The paper is aimed at making a proposal for the type test and calibration of eye lens passive dosemeters especially used in the interventional cardiology/radiology (IC/IR). Starting from the only existing standard dealing with eye lens dosimetry using TLDs (), parameters such as, detection threshold, energy and angle dependence of response criteria have been reviewed and it has been tried to harmonise them as much as possible with the IEC 62387 requirements, taking into account the particular use at IC/IR workplaces. Conversion coefficients from air kerma to dose equivalent at 3 mm depth for RQR and ISO radiation qualities, employed for type test and calibration purposes, have been calculated in a new phantom introduced within the ORAMED (Optimization of RAdiation protection for MEDical staff) project. This phantom is more representative of the head so that the estimation of Hlens by Hp(3) is more accurate.

  2. 2014 Korean Guidelines for Appropriate Utilization of Cardiovascular Magnetic Resonance Imaging: A Joint Report of the Korean Society of Cardiology and the Korean Society of Radiology

    International Nuclear Information System (INIS)

    Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology

  3. Gasto por procedimiento en la especialidad de cardiología intervencionista en pacientes con enfermedad coronaria del Seguro Social, Seccional Valle del Cauca. Noviembre 2003-diciembre 2004

    Directory of Open Access Journals (Sweden)

    Hernán Rodríguez

    2006-12-01

    Full Text Available Introducción: La enfermedad coronaria afecta a una gran proporción de afiliados al Seguro Social (ISS Valle del Cauca. Aquí se describe el gasto en la especialidad de cardiología intervencionista que asumió esta empresa promotora de salud (EPS por cuenta de la enfermedad entre noviembre 2003-diciembre 2004. El gasto sobrepasa lo presupuestado por el ISS y este desequilibrio se produce bajo el régimen contributivo del actual sistema de seguridad social colombiano, que actúa en contra del ISS pues un alto número de sus afiliados son mayores de 45 años. La población compensada del ISS Valle del Cauca es de 423,440 personas de las cuales 43% superan los 45 años de edad, segmento donde se observa mayor riesgo de enfermedad coronaria.Metodología: El estudio es descriptivo. Se analizó la distribución de la población compensada por edad y sexo y el pago hecho por el ISS Valle del Cauca a las instituciones prestadoras de salud (IPS en la especialidad de cardiología intervensionista en el período señalado. La información se obtuvo de la facturación presentada por las IPS al Seguro Social y se cruzó con los registros individuales de procedimientos en salud (RIPS para identificar los pacientes afectados por enfermedad coronaria y clasificarlos teniendo en cuenta los Códigos Internacionales de Enfermad (CIE 10 así como el Manual de Actividades, Procedimientos e Intervenciones del Plan Obligatorio de Salud (MAPIPOS. Se practicaron 1,349 procedimientos a 1,103 pacientes del ISS con diagnóstico de enfermedad coronaria.Análisis y resultados: La población compensada del ISS Valle del Cauca representa 9.3% de la población vallecaucana (4’532,378 habitantes en el Departamento/423,400 compensados. De éstos 43% son mayores de 45 años, en riesgo de padecer enfermedad coronaria y requerir intervención médica. El ISS pagó a las IPS que prestan servicios de cardiología intervencionista la suma de $5’320,786.046 (más de cinco mil

  4. Dose performance evaluation of a charge coupled device and a flat-panel digital fluoroscopy system recently installed in an Interventional Cardiology laboratory

    International Nuclear Information System (INIS)

    The purpose of the study was to evaluate the dose performance of a flat-panel (FP) and an image intensifier (II) charge coupled device (CCD) digital fluoroscopy X-ray systems newly installed in an Interventional Cardiology (IC) department. Filter entrance dose rate, detector dose rate (during fluoroscopy) and filter entrance dose per image were measured at 70 cm from the focus using 2 mm copper sheets to mimic normal size patient. Image quality was also evaluated. The patient dose survey included 277 patients, which had either a Coronary Angiography (CA) or a Percutaneous Transluminal Coronary Angioplasty (PTCA). Dose area product (DAP), fluoroscopy time (T) and total number of frames (F) values were also collected. The results showed that both systems performed within international recommendations with the exception of higher cine radiation doses, stressing the fact that neither specific protocols of measurement nor reference values for digital equipment were provided by the official bodies. (authors)

  5. Process management of oral medication administration in department of cardiology%心内科实施服药到口流程管理初探

    Institute of Scientific and Technical Information of China (English)

    丁小伟; 王珠琳

    2012-01-01

    Objective To investigate the effects of process management of oral medication administration in department of cardiology. Methods We developed regulations of oral medication administration for patients hospitalized in department of cardiology, assessed administration of oral medicines to patients and nurses' drug dispensing behaviors, carried out process management of oral medication administration, and strengthened supervision and monitoring etc. Results The compliance rate of patients taking oral medicines and patient satisfaction were significantly improved after implement of the process management (P<0. 01 for both). Conclusion Reasonable process management can ensure patients' adherence to oral administration of medicines, and improve safety and therapeutic effect of drugs.%目的 探讨流程管理在确保心内科患者服药到口工作中的实施效果.方法 采用制定心内科患者服药到口常规制度、评估服药与发药状况、实施服药到口流程管理及加强监督力度等方法.结果 实施流程管理前后不同周期患者服药到口率,实施流程管理前后患者满意度比较,差异有统计学意义(均P<0.01).结论 合理的流程管理能确保患者服药到口,保证心内科患者用药安全和治疗效果.

  6. Expert consensus (SBC/SBHCI) on the use of drug-eluting stents: recommendations of the Brazilian society of interventional cardiology/ Brazilian society of cardiology for the Brazilian public single healthcare system.

    Science.gov (United States)

    Lima, Valter C; Mattos, Luiz Alberto P; Caramori, Paulo R A; Perin, Marco A; Mangione, José A; Machado, Bruno M; Coelho, Wilson M C; Bueno, Ronaldo R L

    2006-10-01

    The authors review percutaneous coronary intervention (PCI) evolution and its growing application in myocardial revascularization for patients with coronary heart disease in Brazil and worldwide. PCI was introduced in 1977 using only the catheter balloon. Limitations of this method (acute occlusion and coronary restenosis) led to the adoption of coronary stents and more recently the advent of drug-eluting stents2, which were developed to drastically reduce restenosis rates. These developments allowed the exponential growth of percutaneous coronary intervention (PCI) procedures in Brazil which have replaced many bypass surgery procedures and have become the gold standard for the majority of symptomatic patients suffering from coronary artery disease. The preference for this procedure gained new dimensions in 2000 when the Brazilian Public Healthcare System (SUS) began reimbursing for stent procedures. This measure exemplified the importance of the Public Healthcare System's participation in incorporating medical advances and offering a high standard of cardiovascular treatment to a large portion of the Brazilian population. It is emphasized that prevention of in-stent restenosis is complex due to its unpredictable and ubiquitous occurrence. Control of this condition improves quality of life and reduces the recurrence of angina pectoris, the need to perform new revascularization procedures and hospital readmissions. The overall success of the drug-eluting stents has proven to be reliable and consistent in overcoming restenosis and has some beneficial impact for all clinical and angiographic conditions. This paper discusses the adoption and criteria for the use of drug-eluting stents in other countries as well as the recommendations established by the Brazilian Society of Interventional Cardiology for their reimbursement by SUS. The incorporation of new healthcare technology involves two distinct stages. During the first stage, the product is registered with the

  7. SFC/SFBMN guidelines update for nuclear cardiology procedures: stress testing in adults and children; Mise a jour des recommandations concernant la pratique des epreuves de provocation d'ischemie en cardiologie nucleaire chez l'adulte et chez l'enfant

    Energy Technology Data Exchange (ETDEWEB)

    Manrique, A. [Centre Hospitalier Universitaire, 76 - Rouen (France); Marie, P.Y. [Centre Hospitalier Universitaire Nancy-Brabois, Medecine Nucleaire, 54 - Vandoeuvre-les-Nancy (France); Maunoury, Ch.; Acar, Ph. [Centre Hospitalier Universitaire Necker Enfants Malades Biophysique et Medecine Nucleaire, 75 - Paris (France); Agostini, D. [Centre Hospitalier Universitaire, Service de Medecine Nucleaire, 14 - Caen (France)

    2002-12-01

    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.)

  8. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA).

    OpenAIRE

    Kristensen, Steen Dalby; Knuuti, Juhani; Saraste, Antti; Anker, Stefan; Botker, Hans Erik; Hert, Stefan De; Ford, Ian; Juanatey, Jose Ramon Gonzalez; Gorenek, Bulent; Heyndrickx, Guy Robert; Hoeft, Andreas; Huber, Kurt; Iung, Bernard; Kjeldsen, Keld Per; Longrois, Dan

    2014-01-01

    The American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) are pleased to announce the publication of two new versions of Clinical Practice Guidelines (CPGs) on Perioperative Cardiovascular Evaluation from our respective organizations.1–3 These revisions were begun independently, dictated both by emerging, new information regarding the topic and the controversy regarding the legitimacy of data from previously published pivo...

  9. Angioplastia coronaria en centros con residencia de cardiología en la Argentina. Estudio CONAREC XIV - Área de Investigación de la SAC

    Directory of Open Access Journals (Sweden)

    Bruno Linetzky

    2007-01-01

    Full Text Available IntroducciónLos nuevos tratamientos médicos y los avances técnicos, junto con la mayor experiencia adquirida en cardiología intervencionista, hicieron necesaria la realización de este nuevo registro, el protocolo CONAREC XIV, sobre empleo de angioplastia coronaria (ATC, un procedimiento que es seguro y eficaz para el tratamiento de la enfermedad coronaria.ObjetivoEvaluar las características de los pacientes, las indicaciones y los resultados de la ATC en nuestro país.Material y métodosSe realizó un registro prospectivo y consecutivo durante 6 meses de pacientes tratados con ATC en centros con residencia de cardiología. Se determinaron antecedentes, cuadro clínico de ingreso, tratamiento, resultados y complicaciones intrahospitalarias.ResultadosSe registraron 1.500 pacientes. La edad promedio fue de 62,8 ± 10,8 años y el 78,3% eran hombres. Antecedentes: 72% hipertensión arterial, 56,6% dislipidemia, 19,2% diabetes y 22,4% tabaquismo. Los cuadros clínicos de presentación fueron: 20% asintomáticos, 16,2% angina crónica estable, 45% síndrome coronario agudo sin supradesnivel del ST (SCA-SST, 19% síndrome coronario agudo con supradesnivel del ST (IAM-ST. En el 74,7% de los casos se realizó ATC de un vaso. Se utilizaron stents en el 94,5% de los casos y en el 18,7%, stents liberadores de drogas. El uso de pruebas funcionales previas a la ATC en cuadros estables fue del 53,9%, mientras que en el SCA-SST fue del 31,6%. La mediana de tiempo de evolución hasta la ATC en el SCA-SST fue de 1 día con un rango intercuartil 25-75% (RIC de 0 a 3. En el IAM-ST, el tiempo puerta-balón fue de 60 minutos (RIC 40-105 y la mortalidad fue del 8%.ConclusionesLa ATC se utiliza principalmente para el tratamiento de síndromes coronarios agudos. Se evidenció una tasa alta de uso de stents y de stents liberadores de drogas. El empleo de pruebas funcionales fue bajo. La tasa de complicaciones fue similar a la de los registros internacionales.

  10. Los anglicismos en el lenguaje de la cardiología en España y en la Argentina: la variación diatópica

    Directory of Open Access Journals (Sweden)

    María Isabel Fijo León

    2006-06-01

    Full Text Available La investigación que presentamos en este artículo pretende comprobar el grado de variación diatópica que se produce en un área médica concreta, la cardiología, y analizar cómo se manifiesta dicha variación en relación con el uso de anglicismos en el discurso especializado. Para ello, se ha llevado a cabo un estudio empírico contrastivo basado en un corpus de textos médicos de España y de la Argentina. ----------------------------------------------- Anglicisms in cardiological vocabulary in Spain and Argentina: diatopical variation. The study presented in this article aims to explore the degree to which diatopical variation occurs in a specific area of medicine, cardiology in particular, as well as to analyze how such variation is displayed in connection with the use of anglicisms in specialized discourse. With this objective we have performed a comparative, empirical study based on a corpus of medical textbooks from Spain and Argentina.

  11. ANALYSIS OF COST STRUCTURE FOR PHARMACOTHERAPY OF PATIENTS WITH STABLE ANGINA (THE CASE OF CARDIOLOGY DEPARTMENT OF TVER REGIONAL CLINICAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    M. A. Demidova

    2015-12-01

    Full Text Available Aim. To analyze the cost structure for pharmacotherapy of patients with stable angina (SA, in particular, to compare the cost of pharmacotherapy with drugs, both included and not included into the official Standard of care (SC. Material and methods. Medical records of patients with SA (n=100 admitted to the cardiology department of Tver Regional Clinical Hospital in January-July 2010 were studied retrospectivelly. Costs of treatment with drugs specified in SC for patients with SA as well as drugs not included in SC were considered. Costs of pharmacotherapy and cost structure were determined. Pharmacoeconomical methods, especially ABC analysis, were partially used.  Results. Totally 65502.39 ruble was spent for pharmacotherapy of 100 patients with SA. Cost structure was the following: 32679.34 ruble was spent for drugs recommended by SC, 23698.18 ruble — for drugs not included in SC, and 9124.87 ruble — for drugs to treat concomitant diseases which are not taken into account by SC for patients with SA. Conclusion. SA pharmacotherapy counts 50% of the total cost for drugs recommended by SC, 36% — for drugs not included in SC but belonged to pharmacological class presented in SC, and 14% — drugs from pharmacological class not included in SC. In the process of new SC elaboration for SA patients it is necessary to take into account treatment costs of concomitant diseases especially diabetes mellitus which can account up to 9.5% of total treatment cost of SA patients.

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

    International Nuclear Information System (INIS)

    This study evaluates per-procedure, collective and per capita effective dose to the population by interventional cardiology (IC) procedures performed during 2002-11 at the main hospital of Aosta Valley Region that can be considered as representative of the health-care level I countries, as defined by the UNSCEAR, based on its socio-demographic characteristics. IC procedures investigated were often multiple procedures in patients older than 60 y. The median extreme dose-area product values of 300 and 22 908 cGy cm2 were found for standard pacemaker implantation and coronary angioplasty, respectively, while the relative mean per-procedure effective dose ranged from 0.7 to 47 mSv. A 3-fold increase in frequency has been observed together with a correlated increase in the delivered per capita dose (0.05-0.27 mSv y-1) and the collective dose (5.8-35 man Sv y-1). Doses increased particularly from 2008 onwards mainly because of the introduction of coronary angioplasty procedures in the authors' institution. IC practice contributed remarkably in terms of effective dose to the population, delivering ∼10 % of the total dose by medical ionising radiation examination categories. (authors)

  13. Caracterización de la trombosis protésica en el servicio de cardiología de Las Tunas. 2006-2011

    Directory of Open Access Journals (Sweden)

    Maikel Santos Medina

    2015-11-01

    Full Text Available Se realizó un estudio descriptivo y transversal en el Servicio de Cardiología del Hospital “Dr. Ernesto Guevara de la Serna” de la provincia de Las Tunas, con el objetivo de caracterizar la trombosis de prótesis valvular en el período entre 2006 y 2011. El universo estuvo conformado por los 34 pacientes ingresados en el servicio por sospecha de trombosis protésica y la muestra por los 29 casos con diagnóstico definitivo de trombosis valvular protésica. Se utilizó la estadística descriptiva a través del análisis porcentual. La edad promedio de los casos fue de 47 años. Predominaron los pacientes del sexo femenino, con prótesis en posición mitral, con anticoagulación inadecuada y con ritmo sinusal en el electrocardiograma al ingreso. El edema agudo del pulmón fue la forma de presentación de disfunción ventricular izquierda que predominó. La mayoría de los pacientes fueron tratados con estreptoquinasa, lográndose resolución de la trombosis en la mayoría de los casos, con un número escaso de complicaciones tras el tratamiento trombolítico.

  14. TRADUCCIÓN DE ACRÓNIMOS Y SIGLAS EN TEXTOS MÉDICOS DE CARDIOLOGÍA / Translation of acronyms and initialisms in medical texts on cardiology

    Directory of Open Access Journals (Sweden)

    Ana V. Fernández Peraza

    2013-01-01

    Full Text Available Resumen Introducción y objetivos: Con frecuencia en los textos médicos se utilizan acrónimos y siglas. Su traducción no solamente constituye un problema lingüístico, sino también cultural. El objetivo fue analizar los problemas asociados a la traducción del inglés al español de acrónimos y siglas usados en textos médicos de Cardiología. Método: Se trata de un estudio sincrónico, descriptivo, interpretativo y cualitativo que se basa en el análisis léxico de acrónimos y siglas tanto en la lengua de partida (inglés como en la de llegada (español, dentro del marco de los estudios descriptivos de la traducción. Se utilizó una muestra textual empírica compuesta por 8 artículos médicos sobre Cardiología y los textos traducidos correspondientes. Resultados: En el corpus se identificaron 83 acrónimos y siglas, del total, solo 15 fueron identificados como acrónimos. Al analizar el total de casos identificados de siglas y acrónimos, se pudo determinar que, en la mayoría de los casos, se dieron soluciones satisfactorias a los problemas de traducción impuestos por el uso de siglas y acrónimos en los textos en la lengua de llegada y estas soluciones responden a las propuestas que se hacen en la literatura. Sin embargo, se encontraron dificultades evidentes con el uso de acrónimos y siglas sin su forma desarrollada o una explicación, especialmente los que se refieren a nombres de instituciones u organizaciones regionales, nacionales o locales. Conclusiones: Los acrónimos y siglas no constituyen meramente formas lingüísticas, sino que se refieren a fenómenos objetivos de la cultura científica y constituyen referentes culturales. Por lo que su uso y su traducción implican consideraciones lingüísticas y extralingüísticas que demandan del traductor el uso de medios auxiliares y fuentes de referencia, incluida la consulta a especialistas, para producir un texto caracterizado por su precisión y calidad, y que garantice el

  15. A large-scale multicentre study in Belgium of dose area product values and effective doses in interventional cardiology using contemporary X-ray equipment.

    Science.gov (United States)

    Bogaert, E; Bacher, K; Thierens, H

    2008-01-01

    In this paper, a large-scale multicentre patient dose study performed in eight Belgian interventional cardiology departments is presented. Effective dose (E) was calculated based on a detailed dose-area product (DAP)-registration during each procedure and by using conversion coefficients generated by the Monte Carlo-based computer program PCXMC. Conversion coefficients were found to be 0.177 mSv Gycm(-2) for systems that do not use any additional copper filtration in cineradiography and 0.207 mSv Gycm(-2) for systems that use additional copper filtration in cineradiography. Mean E values of 9.6 and 15.3 mSv for diagnostic and therapeutic procedures, respectively, were obtained. DAP distributions were investigated in order to derive dose reference levels: 71 and 106 Gycm2 for diagnostic and therapeutic procedures, respectively, are proposed. Significant differences were observed in DAP distributions taking into account whether additional copper filtration was used in the cineradiography mode. Apart from the skin, the organs most at risk are lungs and heart. The probability of fatal cancer for the studied population amounted to 1.1x10(-4) and 2.1x10(-4) for diagnostic and therapeutic procedures, respectively, for the age distribution of the patients considered in this multicentre study. PMID:17681964

  16. Acurácia do relacionamento probabilístico na avaliação da alta complexidade em cardiologia Precisión de la relación probabilística en la evaluación de la alta complejidad en cardiología Accuracy of probabilistic record linkage in the assessment of high-complexity cardiology procedures

    Directory of Open Access Journals (Sweden)

    Arn Migowski

    2011-04-01

    Full Text Available OBJETIVO: Avaliar a viabilidade de estratégia de relacionamento probabilístico de bases de dados na identificação de óbitos de pacientes submetidos a procedimentos de alta complexidade em cardiologia. MÉTODOS: O custo de processamento foi estimado com base em 1.672 registros de pacientes submetidos à cirurgia de revascularização do miocárdio, relacionados com todos os registros de óbito no Brasil em 2005. A acurácia do relacionamento baseou-se em linkage probabilístico entre 99 registros de autorização de internação hospitalar de pacientes submetidos a cirurgias cardíacas em instituto de referência em cardiologia, com status vital conhecido, e todos os registros de óbito do estado do Rio de Janeiro em 2005. O linkage foi realizado em quatro etapas: padronização das bases, blocagem, pareamento e classificação dos pares. Utilizou-se a blocagem em cinco passos, com chaves de blocagem com combinação de variáveis como soundex do primeiro e último nome, sexo e ano de nascimento. As variáveis utilizadas no pareamento foram "nome completo", com a utilização da distância de Levenshtein, e "data de nascimento". RESULTADOS: O segundo e o quinto passos de blocagem tiveram os maiores números de pares formados e os maiores tempos de processamento para o pareamento. O quarto passo demandou menor custo de processamento. No estudo de acurácia, após os cinco passos de blocagem, a sensibilidade do linkage foi de 90,6% e a especificidade foi de 100%. CONCLUSÕES: A estratégia de relacionamento probabilístico utilizada apresenta boa acurácia e poderá ser utilizada em estudos sobre a efetividade dos procedimentos de alta complexidade e alto custo em cardiologia.OBJETIVO: Evaluar la viabilidad de estrategia de relación probabilística en la identificación de pacientes sometidos a procedimientos de alta complejidad en cardiología. MÉTODOS: El costo de procesamiento fue calculado con base en 1.672 registros de pacientes

  17. Taquiarritmias supraventriculares no feto. Experiência de uma unidade de referência em cardiologia fetal Fetal supraventricular tachyarrhythmias. Experience of a fetal cardiology reference center

    Directory of Open Access Journals (Sweden)

    Paulo Zielinsky

    1998-05-01

    Full Text Available OBJETIVO: Avaliar a forma de apresentação, diagnóstico e tratamento das taquiarritmias supraventriculares fetais, através do relato de uma série de casos acompanhados em um centro terciário de cardiologia fetal. MÉTODOS: São descritos 25 casos de taquiarritmia supraventricular diagnosticados intra-útero, no período de janeiro/89 a outubro/97, em uma população compreendendo 3117 gestantes. RESULTADOS: Foram diagnosticados 17 casos de taquiarritmia supraventricular e 8 casos de flutter atrial fetal. As idades gestacionais variaram de 26 a 40 semanas. Doze fetos apresentavam hidropisia no momento do diagnóstico (6 com taquicardia supraventricular (TSV e 6 com flutter atrial. Quatro fetos com TSV apresentavam cardiopatias estruturais (dois casos de anomalia de Ebstein e dois com comunicação interventricular. Todos os fetos foram internados na Unidade de Cardiologia Fetal para monitorização e tratamento. Entre os 17 fetos com TSV, 12 apresentaram reversão da arritmia após administração de digoxina, mas esta medida não foi eficaz em nenhum paciente com flutter. Dois pacientes com TSV e seis com flutter necessitaram interrupção da gestação para cardioversão elétrica pós-natal. A mortalidade foi de 3/17 no grupo da TSV (incluindo dois pacientes com anomalia de Ebstein e de 0/8 no grupo com flutter. CONCLUSÃO: As taquiarritmias supraventriculares fetais são eventos raros na população geral. Entretanto, podem provocar insuficiência cardíaca e óbito intra-uterino. Como a resposta ao tratamento é satisfatória, tornam-se de extrema importância o diagnóstico precoce e o tratamento adequado.PURPOSE: To describe the presentation, diagnosis and treatment of fetal supraventricular tachyarrhythmias in a series of fetuses followed in a tertiary Fetal Cardiology Center. METHODS: Twenty-five fetuses with diagnosis of supraventricular tachyarrhytmia were reported from January 1989 to October 1997, among 3117 pregnant women

  18. Validation of the 2014 European Society of Cardiology Sudden Cardiac Death Risk Prediction Model in Hypertrophic Cardiomyopathy in a Reference Center in South America.

    Science.gov (United States)

    Fernández, Adrián; Quiroga, Alejandro; Ochoa, Juan Pablo; Mysuta, Mauricio; Casabé, José Horacio; Biagetti, Marcelo; Guevara, Eduardo; Favaloro, Liliana E; Fava, Agostina M; Galizio, Néstor

    2016-07-01

    Sudden cardiac death (SCD) is a common cause of death in hypertrophic cardiomyopathy (HC). Our aim was to conduct an external and independent validation in South America of the 2014 European Society of Cardiology (ESC) SCD risk prediction model to identify patients requiring an implantable cardioverter defibrillator. This study included 502 consecutive patients with HC followed from March, 1993 to December, 2014. A combined end point of SCD or appropriate implantable cardioverter defibrillator therapy was assessed. For the quantitative estimation of individual 5-year SCD risk, we used the formula: 1 - 0.998(exp(Prognostic index)). Our database also included the abnormal blood pressure response to exercise as a risk marker. We analyzed the 3 categories of 5-year risk proposed by the ESC: low risk (LR) <4%; intermediate risk (IR) ≥4% to <6%, and high risk (HR) ≥6%. The LR group included 387 patients (77%); the IR group 39 (8%); and the HR group 76 (15%). Fourteen patients (3%) had SCD/appropriate implantable cardioverter defibrillator therapy (LR: 0%; IR: 2 of 39 [5%]; and HR: 12 of 76 [16%]). In a receiver-operating characteristic curve, the new model proved to be an excellent predictor because the area under the curve for the estimated risk is 0.925 (statistical C: 0.925; 95% CI 0.8884 to 0.9539, p <0.0001). In conclusion, the SCD risk prediction model in HC proposed by the 2014 ESC guidelines was validated in our population and represents an improvement compared with previous approaches. A larger multicenter, independent and external validation of the model with long-term follow-up would be advisable. PMID:27189816

  19. Guideline-Directed Medication Use in Patients With Heart Failure With Reduced Ejection Fraction in India: American College of Cardiology's PINNACLE India Quality Improvement Program.

    Science.gov (United States)

    Pokharel, Yashashwi; Wei, Jessica; Hira, Ravi S; Kalra, Ankur; Shore, Supriya; Kerkar, Prafulla G; Kumar, Ganesh; Risch, Samantha; Vicera, Veronique; Oetgen, William J; Deswal, Anita; Turakhia, Mintu P; Glusenkamp, Nathan; Virani, Salim S

    2016-03-01

    Little is known about the use of guideline-directed medical therapy (GDMT) in outpatients with heart failure with reduced left ventricular ejection fraction (HFrEF; ≤40%) in India. Our objective was to understand the use of GDMT in outpatients with HFrEF in India. The Practice Innovation And Clinical Excellence (PINNACLE) India Quality Improvement Program (PIQIP) is a registry for cardiovascular quality improvement in India supported by the American College of Cardiology Foundation. Between January 2008 and September 2014, we evaluated documentation of use of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) and β-blockers, or both, among outpatients with HFrEF seeking care in 10 centers enrolled in the PIQIP registry. Among 75 639 patients in the PIQIP registry, 34 995 had EF reported, and 15 870 had an EF ≤40%. The mean age was 56 years; 23% were female. Hypertension, diabetes, coronary artery disease, and myocardial infarction were present in 37%, 23%, 27%, and 17%, respectively. Use of ACEIs/ARBs, β-blockers, and both were documented in 33.5%, 34.9%, and 29.6% of patients, respectively. The documentation of GDMT was higher in men, in patients age ≥65 years, and in those with presence of hypertension, diabetes, or coronary artery disease. Documentation of GDMT gradually increased over the study period. Among patients enrolled in the PIQIP registry, about two-thirds of patients with EF ≤40% did not have documented receipt of GDMT. This study is an initial step toward improving adherence to GDMT in India and highlights the feasibility of examining quality of care in HFrEF in a resource-limited setting. PMID:26880649

  20. Adherence to the European Society of Cardiology (ESC guidelines for chronic heart failure - A national survey of the cardiologists in Pakistan

    Directory of Open Access Journals (Sweden)

    Shoukat Sana

    2011-11-01

    Full Text Available Abstract Background The aims of this study were to evaluate the awareness of and attitudes towards the 2005 European Society of Cardiology (ESC guidelines for Heart Failure (HF of the cardiologists in Pakistan and assess barriers to adherence to guidelines. Methods A cross-sectional survey was conducted in person from March to July 2009 to all cardiologists practicing in 4 major cities in Pakistan (Karachi, Lahore, Quetta and Peshawar. A validated, semi-structured questionnaire assessing ESC 2005 Guidelines for HF was used to obtain information from cardiologists. It included questions about awareness and relevance of HF guidelines (See Additional File 1. Respondents' management choices were compared with those of an expert panel based on the guidelines for three fictitious patient cases. Cardiologists were also asked about major barriers to adherence to guidelines. Additional file 1 Questionnaire. Description: Questionnaire that was administered to participants. Click here for file Results A total of 372 cardiologists were approached; 305 consented to participate (overall response rate, 82.0%. The survey showed a very high awareness of CHF guidelines; 97.4% aware of any guideline. About 13.8% considered ESC guidelines as relevant or very relevant for guiding treatment decisions while 92.8% chose AHA guidelines in relevance. 87.2% of respondents perceived that they adhered to the HF guidelines. For the patient cases, the proportions of respondents who made recommendations that completely matched those of the guidelines were 7% (Scenario 1, 0% (Scenario 2 and 20% (Scenario 3. Respondents considered patient compliance (59% and cost/health economics (50% as major barriers to guideline implementation. Conclusion We found important self reported departures from recommended HF management guidelines among cardiologists of Pakistan.

  1. Children diagnosed with congenital cardiac malformations at the national university departments of pediatric cardiology: positive predictive values of data in the Danish National Patient Registry

    Directory of Open Access Journals (Sweden)

    Peter Agergaard

    2011-02-01

    Full Text Available Peter Agergaard1, Anders Hebert2, Jesper Bjerre3, Karina Meden Sørensen4, Charlotte Olesen3, John Rosendal Østergaard31Department of Pediatrics, Viborg Hospital, Viborg, Denmark; 2Department of Pediatrics, Copenhagen University Hospital, Rigshospitalet, Denmark; 3Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark; 4Department of Clinical Biochemistry and Immunology, Statens Serum Institut, Copenhagen, DenmarkIntroduction: The present study was conducted to establish the positive predictive value of congenital cardiac malformation diagnoses registered in the Danish National Patient Registry (NPR, thereby exploring whether the NPR can serve as a valid tool for epidemiologic studies of congenital cardiac malformations.Materials and methods: The study population comprised every individual born from 2000 to 2008 who was registered in the NPR with a congenital cardiac malformation diagnosis and treated at one of the two national departments of pediatric cardiology. Positive predictive values were established comparing NPR information with the clinical record of each individual.Results: A total of 2952 patients with a total of 3536 diagnoses were eligible for validation. Review of their clinical records unveiled no patient without cardiac malformation. In 98% (98%–99% of the cases, the NPR diagnosis could be found as the discharge diagnosis in the patient's clinical record, and in 90% (89%–91% of the cases the NPR diagnosis was considered a true reflection of the patient's actual malformation.Conclusions: Our study verifies that the present study population retrieved from the NPR is a valid tool for epidemiological research within the topic of congenital cardiac malformations, given that the research question is not dependent on a fully established sensitivity of the NPR. Precautions should be made regarding cardiac malformations characterized by low prevalence or poor predictive values, and the reported validity should not be

  2. Los segmentos cardíacos primitivos, su implicación en la cardiogénesis normal aplicada a la cardiología pediátrica

    OpenAIRE

    Salazar García, Marcela; Sánchez Gómez,Concepción; Contreras Ramos,Alejandra; Carrillo Ávalos,Blanca A; Revilla Monsalve,Ma Cristina; Palomino Garibay,Miguel Ángel

    2006-01-01

    El gran desarrollo de la imagenología diagnóstica en la cardiología pediátrica ha exigido un conocimiento preciso de la anatomía alterada de los corazones con cardiopatía congénita. De esta manera, la información sobre la embriología cardíaca, en los aspectos morfológicos y moleculares constituye un fundamento para comprender la anatomía de los corazones mal formados. Con base en estos hechos, en este trabajo se revisa la cardiogénesis normal, integrando los nuevos hallazgos logrados experime...

  3. 首诊心内科糖尿病患者胰岛素使用现状调查%Current status of insulin usage among ifrstly diagnosed diabetic patients in Department of Cardiology

    Institute of Scientific and Technical Information of China (English)

    文丽娜; 张晶晶

    2016-01-01

    Objective: To investigate the current status of insulin usage and its related problems among firstly diagnosed diabetic patients in Department of Cardiology and to provide professional and educational guidance to the patients. Methods: We randomly selected 192 diabetic patients at the clinic from August 2014 to August 2015.The sample included 84 patients who were firstly diagnosed diabetes in Department of Cardiology and 108 patients who were ifrstly diagnosed diabetes in Department of Endocrinology. We investigated and compared the current status of insulin usage in the two Departments. Results: The percentage of injection dose as prescription are as follows: Department of Endocrinology group VS Department of Cardiology group, 76.9% VS 64.3% (P=0.049); the percentage of correct injection site: Department of Endocrinology group VS Department of Cardiology group, 94.4% VS 84.5% (P=0.023); the percentage of injection after sterilization area is dried: Department of Endocrinology group VS Department of Cardiology group, 71.3% VS 53.6% (P=0.012); the percentage of exhausting before injection: Department of Endocrinology group VS Department of Cardiology group 73.1% VS 47.6% (P<0.001); the percentage of the needle stayed more than10 seconds after injection: Department of Endocrinology group VS Department of Cardiology group, 96.3% VS 84.5% (P=0.004); the percentage of taking off the needle from the pen after each injection: Department of Endocrinology group VS Department of Cardiology group, 37.0% VS 22.6% (P=0.032). Conclusion: Patients who were ifrst diagnosed of diabetes in Department of Cardiology received insufifcient guidance of correct methods in insulin injection, so they need professional guidance about using insulin from medical professionals.%目的:调查心内科首诊糖尿病患者胰岛素使用现状及问题,为其使用提供更专业的教育指导。方法:2014年8月至2015年8月,便利选取我院门诊糖尿病患者192例为研

  4. 美国心脏病学会2005年科学年会热点荟萃%Highlights of American College of Cardiology 2005 Annual Scientific Session

    Institute of Scientific and Technical Information of China (English)

    陈鲁原; 周颖

    2005-01-01

    美国心脏病学会(American College ofCardiology,ACC)第54届年会于2005年3月7-11日在美国佛罗里达州的奥兰多召开,来自世界各地的3万多名代表与会.现将本次大会中有关血管性疾病、高血压和预防(Vascular Disease,Hypertensionand Prevention,VHP)的临床研究系列的若干热点内容介绍如下.

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

    DEFF Research Database (Denmark)

    Flotats, Albert; Gutberlet, Matthias; Knuuti, Juhani;

    2011-01-01

    . However, hybrid cardiac imaging has also generated controversy with regard to which patients should undergo such integrated examination for clinical effectiveness and minimization of costs and radiation dose, and if software-based fusion of images obtained separately would be a useful alternative....... The European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC) in this paper want to present a position statement of the institutions on the current roles of SPECT/CT and PET/CT hybrid cardiac imaging in patients...

  6. Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

    Science.gov (United States)

    Rich, Michael W; Chyun, Deborah A; Skolnick, Adam H; Alexander, Karen P; Forman, Daniel E; Kitzman, Dalane W; Maurer, Mathew S; McClurken, James B; Resnick, Barbara M; Shen, Win K; Tirschwell, David L

    2016-05-24

    The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients aged ≥75 years have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older patients with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in a nursing home or assisted living facility. As a result, current guidelines are unable to provide evidence-based recommendations for diagnosis and treatment of older patients typical of those encountered in routine clinical practice. The objectives of this scientific statement are to summarize current guideline recommendations as they apply to older adults, identify critical gaps in knowledge that preclude informed evidence-based decision making, and recommend future research to close existing knowledge gaps. To achieve these objectives, we conducted a detailed review of current American College of Cardiology/American Heart Association and American Stroke Association guidelines to identify content and recommendations that explicitly targeted older patients. We found that there is a pervasive lack of evidence to guide clinical decision making in older patients with cardiovascular disease, as well as a paucity of data on the impact of diagnostic and therapeutic interventions on key outcomes that are particularly important to older patients, such as quality of life, physical function, and maintenance of independence. Accordingly, there is a critical need for a multitude of large population-based studies and clinical trials that include a broad spectrum of older patients representative of those seen in clinical practice and that incorporate relevant outcomes important to older patients in the study design. The

  7. Registro electrónico de pacientes “DELFOS” en Cardiología y Cirugía Cardiovascular pediátrica

    Directory of Open Access Journals (Sweden)

    Luis E. Marcano Sanz

    2015-03-01

    Full Text Available Introducción: El interés por los registros electrónicos de pacientes ha crecido significativamente en los últimos años. En Cuba no existe un sistema de registro electrónico de pacientes en cardiología y cirugía cardiovascular pediátrica.Objetivo: Diseñar y aplicar una herramienta informática que permita gestionar toda la información de los pacientes atendidos en la Red Cardiopediátrica Nacional, para apoyar la toma de decisiones gerenciales, clínicas, docentes e investigativas.Método: Se utilizó el software FileMaker pro 11, se programó de forma cooperativa con los usuarios un sistema de módulos independientes conectados en tiempo real que abarca desde la admisión hasta el seguimiento y la rehabilitación. La entrada de datos es validada, los cálculos se ejecutan automáticamente y se muestran en gráficos. Se implementó un servidor para compartir el sistema en todos los departamentos del hospital y en la web, con sus correspondientes permisos de acceso y autentificación.Resultados: Se logra un nivel alto de empleo, disminuyó el tiempo de obtener informes y otras salidas con mayor confiabilidad, organización y satisfacción de los usuarios finales en relación con las historias clínicas impresas. La información puede ser exportada en PDF o EXCEL. Se facilitan los accesos a enlaces de internet. La versión final quedó registrada en el Centro Nacional de Derecho de Autor con el número 2411 de 2012.Conclusiones: El “DELFOS” es una herramienta informática multiusuario de fácil utilización, que posibilita de modo seguro, rápido, estable y eficiente, el registro, procesamiento y recuperación en tiempo real de los datos de los pacientes y su empleo en la práctica clínica.

  8. 心内科住院患者医院感染的临床特点分析%Clinical characteristics and countermeasures of nosocomial infections in patients of cardiology department

    Institute of Scientific and Technical Information of China (English)

    胡华龙; 张卫

    2013-01-01

    OBJECTIVE To analyze the clinical features and countermeasure of the nosocomial infections in the hospitalized patients of cardiology department so as to provide basis for the clinical preuention of nosocomial infections. METHODS A total of 1509 patients in cardiology department were chosen, the incidence of nosocomial infection, pathogen distribution and risk factors for nosocomial infection were observed and analyzed. RESULTS There were 98 nosocomial infection cases with the infection rate of 6. 49% , among which there were 77 (78. 57%) cases with pulmonary infections. Totally 70 ( 71. 43%) strains of gram-negative bacteria were isolated, among which the Klebsiella pneumoniae and Staphylococcus aureus strains accounted for 23. 47% and 20. 41% , respectively. Univariate analysis showed that more than 60 years of age, hospitalization duration more than 30 days, albumin level higher than 30g / L, diabetes mellitus. LVEF more than 40. 00% and cardiac function higher than Ⅲ class (NYHA) were risk factors of nosocomial infections in the department of cardiology. Multiple logistic analysis showed that length of hospital stay more than 30 days, diabetes, LVEF more than 40. 00%, and the cardiac functional class higher than Ⅲ class (NYHA) were the risk factors of nosocomial infections in the department of cardiology. CONCLUSION There are multiple risk factors that can lead to the nosocomial infections in the department of cardiology, it is necessary to take effective prevention measures so as to prevent the nosocomial infections.%目的 分析心内科住院患者发生医院感染的临床特点,为临床制定控制医院感染措施提供依据.方法 收集心内科住院治疗的患者1509例,观察其医院感染的发生率、病原菌的分布,分析发生医院感染的高危因素.结果 98例患者发生医院感染,感染率6.49%,其中肺部感染77例,占78.57%,检出革兰阴性菌最高70株占71.43%,肺炎克雷伯菌及

  9. Dose Reduction in Nuclear Cardiology

    International Nuclear Information System (INIS)

    The media has drawn strong attention to the field of imaging and especially to that of nuclear cardiac imaging with respect to radiation doses arising therefrom. The paper provides some background on how to reduce doses in the field while keeping quality high. (author)

  10. Occupational hazards of interventional cardiology

    International Nuclear Information System (INIS)

    Complex catheter-based interventions and rising case volumes confer occupational risks to interventional cardiologists. Despite advances in technology, modern interventional procedures are performed in a manner remarkably similar to the techniques pioneered decades ago. Percutaneous interventions are associated with operator orthopedic injuries, exposures to blood borne pathogens, and the effects of chronic radiation exposure from fluoroscopy. This review highlights the occupational hazards of interventional procedures and provides a glimpse at the technologies and techniques that may reduce risks to operators in the catheterization laboratory

  11. [Emergent strategies in interventional cardiology

    NARCIS (Netherlands)

    G.A. Rodriguez-Granillo (Gaston); P.W.J.C. Serruys (Patrick); J. Aoki (Jiro)

    2005-01-01

    textabstractDespite the advances in the treatment of patients with coronary artery disease, sudden cardiac death is still unacceptably prevalent. Patients with ischemic heart disease usually require a combination of therapies (drugs and coronary intervention) and may continue to experience symptoms.

  12. Cardiology Patient Page: Electronic Cigarettes

    Science.gov (United States)

    ... cigarettes and without exposing others to secondhand smoke. Marketing for e-cigarettes often describes them as emitting ... Us: Follow Circulation on Twitter Visit Circulation on Facebook Follow Circulation on Google Plus Follow Circulation on ...

  13. Complex bioimpedance signals in cardiology

    Czech Academy of Sciences Publication Activity Database

    Viščor, Ivo; Halámek, Josef; Vondra, Vlastimil

    Milano: Fondazione Don Carlo Gnocchi, 2008, P1B: 14-16. [Conference of the European Study Group on Cardiovascular Oscillations /5./ - ESGCO 2008. Parma (IT), 07.04.2008-09.04.2008] R&D Projects: GA ČR GP102/07/P425; GA AV ČR IAA200650801 Institutional research plan: CEZ:AV0Z20650511 Keywords : bioimpedance * complex impedance * impedance phase * cardiac output * pulmonary artery Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering

  14. Mesenchymal Stem Cells in Cardiology.

    Science.gov (United States)

    White, Ian A; Sanina, Cristina; Balkan, Wayne; Hare, Joshua M

    2016-01-01

    Cardiovascular disease (CVD) accounts for more deaths globally than any other single disease. There are on average 1.5 million episodes of myocardial infarction (heart attack) each year in the United States alone with roughly one-third resulting in death. There is therefore a major need for developing new and effective strategies to promote cardiac repair. Intramyocardial transplantation of mesenchymal stem cells (MSCs) has emerged as a leading contender in the pursuit of clinical intervention and therapy. MSCs are potent mediators of cardiac repair and are therefore an attractive tool in the development of preclinical and clinical trials. MSCs are capable of secreting a large array of soluble factors, which have had demonstrated effects on pathogenic cardiac remolding, fibrosis, immune activation, and cardiac stem cell proliferation within the damaged heart. MSCs are also capable of differentiation into cardiomyocytes, endothelial cells, and vascular smooth muscle cells, although the relative contribution of trilineage differentiation and paracrine effectors on cardiac repair remains the subject of active investigation. PMID:27236666

  15. Nuclear cardiology and heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Giubbini, Raffaele; Bertagna, Francesco [University of Brescia, Department of Nuclear Medicine, Brescia (Italy); Milan, Elisa [Ospedale Di Castelfranco Veneto, Nuclear Medicine Unit, Castelfranco Veneto (Italy); Mut, Fernando; Dondi, Maurizio [International Atomic Energy Agency, Nuclear Medicine Section, Division of Human Health, Vienna (Austria); Metra, Marco [University of Brescia, Department of Cardiology, Brescia (Italy); Rodella, Carlo [Health Physics Department, Spedali Civili di Brescia, Brescia (Italy)

    2009-12-15

    The prevalence of heart failure in the adult population is increasing. It varies between 1% and 2%, although it mainly affects elderly people (6-10% of people over the age of 65 years will develop heart failure). The syndrome of heart failure arises as a consequence of an abnormality in cardiac structure, function, rhythm, or conduction. Coronary artery disease is the leading cause of heart failure and it accounts for this disorder in 60-70% of all patients affected. Nuclear techniques provide unique information on left ventricular function and perfusion by gated-single photon emission tomography (SPECT). Myocardial viability can be assessed by both SPECT and PET imaging. Finally, autonomic dysfunction has been shown to increase the risk of death in patients with heart disease and this may be applicable to all patients with cardiac disease regardless of aetiology. MIBG scanning has a very promising prognostic value in patients with heart failure. (orig.)

  16. Nuclear cardiology and heart failure

    International Nuclear Information System (INIS)

    The prevalence of heart failure in the adult population is increasing. It varies between 1% and 2%, although it mainly affects elderly people (6-10% of people over the age of 65 years will develop heart failure). The syndrome of heart failure arises as a consequence of an abnormality in cardiac structure, function, rhythm, or conduction. Coronary artery disease is the leading cause of heart failure and it accounts for this disorder in 60-70% of all patients affected. Nuclear techniques provide unique information on left ventricular function and perfusion by gated-single photon emission tomography (SPECT). Myocardial viability can be assessed by both SPECT and PET imaging. Finally, autonomic dysfunction has been shown to increase the risk of death in patients with heart disease and this may be applicable to all patients with cardiac disease regardless of aetiology. MIBG scanning has a very promising prognostic value in patients with heart failure. (orig.)

  17. Nuclear cardiology and coronary surgery

    DEFF Research Database (Denmark)

    Eckardt, R.; Andersen, L.I.; Hesse, B.

    2008-01-01

    Rising age, repeated percutaneous coronary revascularizations, and co-morbidity such as overweight, diabetes, and hypertension, characterize a change over the last 20-30 years in coronary patients referred to coronary artery bypass grafting (CABG). This patient group represents a great part of to...

  18. Occupational hazards of interventional cardiology

    Energy Technology Data Exchange (ETDEWEB)

    Smilowitz, Nathaniel R.; Balter, Stephen; Weisz, Giora, E-mail: gw2128@columbia.edu

    2013-07-15

    Complex catheter-based interventions and rising case volumes confer occupational risks to interventional cardiologists. Despite advances in technology, modern interventional procedures are performed in a manner remarkably similar to the techniques pioneered decades ago. Percutaneous interventions are associated with operator orthopedic injuries, exposures to blood borne pathogens, and the effects of chronic radiation exposure from fluoroscopy. This review highlights the occupational hazards of interventional procedures and provides a glimpse at the technologies and techniques that may reduce risks to operators in the catheterization laboratory.

  19. REHABILITATION IN CARDIOLOGY AND CARDIOSURGERY

    OpenAIRE

    N. V. Galtseva

    2015-01-01

    At the present time effectiveness of rehabilitation programs after heart surgery, myocardial infarction, and in some cases for coronary artery disease (CAD) is undeniable. According to the researches, physical exercises, which underlie cardio rehabilitation of patients with CAD, reduce cardiac mortality. In the review accumulated scientific data about modern approaches to cardio rehabilitation is discussed: goals, indications, contraindications, its organization, advantages. Controlled traini...

  20. REHABILITATION IN CARDIOLOGY AND CARDIOSURGERY

    Directory of Open Access Journals (Sweden)

    N. V. Galtseva

    2015-01-01

    Full Text Available At the present time effectiveness of rehabilitation programs after heart surgery, myocardial infarction, and in some cases for coronary artery disease (CAD is undeniable. According to the researches, physical exercises, which underlie cardio rehabilitation of patients with CAD, reduce cardiac mortality. In the review accumulated scientific data about modern approaches to cardio rehabilitation is discussed: goals, indications, contraindications, its organization, advantages. Controlled training in patients with CAD, making a complex program of cardio rehabilitation, kinds of control during cardio training are described in details. In this review the second phase of physical rehabilitation after cardiac surgery – a stationary phase, protocols of which are subjective and often contested, is considered. More frequently physical rehabilitation after coronary artery bypass surgery is doing breathing exercises, as there is data that physical exercises, in which tangential force vector in or around the sternum appears, should be avoided for at least 3 months after surgery. On the other hand, avoiding of heaving during the first weeks after surgery leads to more pronounced atrophy of the chest muscles. But there is data, according to which, early beginning of an adapted program of cardio rehabilitation (1–2 weeks after surgery is safely, it accelerates recovery and does not increase problems with the sternum. In this review the following idea is suggested: in order to follow the stages of rehabilitation after cardiac surgery it is necessary to start it on the stationary stage, and control of load rehabilitation programs must be carried out using hemodynamic changes during exercises, energy, SF-36 questionnaire. 

  1. El método clínico y la creciente presencia tecnológica en la cardiología ¿relación excluyente? / The clinical method and the growing technological presence in cardiology: Are they mutually exclusive?

    Directory of Open Access Journals (Sweden)

    Suilbert Rodríguez Blanco

    2016-01-01

    Full Text Available Hipócrates fue quien dio vida al método clínico, al insistir en el valor supremo de la observación del enfermo y la acumulación de experiencias por parte del médico para poder realizar un diagnóstico correcto de las enfermedades. La obtención de la información clínica y su interpretación son dos momentos del proceso de atención médica que están estrechamente relacionados, de los que se derivan algunos componentes como la relación médico-paciente, el interrogatorio, el examen físico y la historia clínica. Unido a esto está el modernismo tecnológico en las ciencias médicas, el cuál es inevitable dado el avance de este, lo que no debe implicar el abandono del método clínico, pues se estarían violando los principios éticos y médicos, que desde la época de Hipócrates han estado vigentes. Se propone una reflexión alrededor de los componentes del método clínico, la presencia tecnológica en la cardiología moderna y la relación entre estos, a partir de la incuestionable vigencia e importancia de este método y el deber de los profesionales de la salud en su aplicación.

  2. Research developments of 'Cardiology' scientific and clinical centre (1995-2003) including those directed at reducing to minimum catastrophe effects on Chernobyl atom power station

    International Nuclear Information System (INIS)

    Diseases of blood circulation system in Republic of Belarus as well as in the entire world are considered to be an acute problem. This is due to high incidence of this pathology and the leading place these diseases occupy among the cause for labour losses (according to data obtained in the year 2002 - 54% among all fatal outcomes; 41,4%- cause for primary invalidity among the entire population and 27,5% - among able-bodied age population) For the years passed since the catastrophe, work has been performed to assess the possibilities for its consequences' effect on the above-mentioned negative indices. So far there has not been feasibility to present unambiguous treatment of results obtained. Growth in mortality level due to diseases of blood circulation system is observed virtually in all the regions of the republic, however, according to 2000 year data, mortality indices in Mogilev (448, 3) and Gomel (430,2) regions are somewhat higher than average republican one (414,1) The examination of residents in regions under pressure of catastrophe on Chernobyl and liquidators has revealed higher incidence of CHD in old age groups and higher frequency and level for CHD risk factor. The approaches which are common in the entire world for the fight against cardiovascular pathology including the suffered from Chernobyl catastrophe are as follows: target oriented preventive work, detection of diseases during early stages of pathological process, timely and adequate treatment and performance of rehabilitative activities. At the same time, positive results can be obtained only in comprehensive solution of the problems indicated which are applicable to departments of cardiological service and health care in general, different ministries and agencies being involved. As a result of its performance, detectability of arterial hypertensive patients has improved and labour losses due to them have reduced. Standardized index of mortality general in the republic among AH pts has

  3. Monitoring gene therapy by nuclear cardiology procedures. A porcine model of coronary artery disease treated by means of vascular endothelial growth factor (pVEGF)

    International Nuclear Information System (INIS)

    Gene therapy with different kinds of biomolecules has become in a recent challenge for several medical fields. Angiogenesis and arteriogenesis, focused in Cardiology, has been a relevant issue of research in the last seven years. Different working groups of researches have done efforts to find a new alternative for patients with severe or critical coronary artery disease without possibilities of medical treatment or revascularization procedures. Vascular endothelial growth factor (VEGF) is a hemodimeric glycoprotein of 34-42 kDa with angiogenic activity. pVEGF is a DNA molecule named plasmid that contains the encoded protein of the human VEGF. In recent years, some authors have reported improvement in peripheral vascular disease and coronary artery disease in animal models and in humans treated with different angiogenic factors, mainly VEGF and fibroblastic growth factor. The working group of the Biotechnology and Genetic Engineering Center in Havana has developed a pVEGF with angiogenic activity in vitro provided for this research. Fourteen Yorkshire (25-35 Kg) healthy pigs have been selected for this research. We have performed three studies with 99m Tc Sestamibi Gated SPECT at rest in different moments with the pigs under sedation. First in basal situation. The second one after 21 days of the aneroid constrictor placement in the left coronary tree of the 14 pigs operated by minimum access in order to induce myocardial ischemia, and the third one forty days after intramyocardial minimum access four sites injection of pVEGF(0.5 mg per ml) six animals or saline solution (placebo group) the other six, in a blind randomized fashion. The studies were performed with a DS7 single head gamma camera (SMV, France) coupled to a Power-Vision processor and the Emory-Tool-Box software for cardiac perfusion and function imaging interpretation. Gated SPECT was performed according recommendations and guidelines of the SNM and ASNC.The animals were injected with 25-30 mc of 99m

  4. A study of the dose distribution in the region of the eye lens and extremities for staff working in interventional cardiology

    International Nuclear Information System (INIS)

    The dose distributions at the region of eye lens and extremities of staff working in interventional cardiology were analyzed. The doses to physicians and nurses from three hospitals in Poland were measured with TL dosimeters (MCP-N) located on various places near eyebrows, on both fingers, wrists, knees and on the ankle. The procedures under investigation were coronary angiography (CA) and percutaneous coronary intervention (PCI), peacemaker and defibrillator implantations (PM/ICDs), cardiac resynchronization therapy with or without defibrillator implantations (CRT-D or CRT) and radiofrequency ablations (RFA). The study aimed at analyzing the distribution of radiation in selected anatomic regions, determining the typical locations of highest doses and estimating the dose ranges for selected types of procedures. The maximum registered doses per procedure to eye lens and ankle were 1.21 mSv and 1.46 mSv for CA PCI procedures, 0.02 mSv and 0.05 mSv for RFA and 0.13 mSv and 0.51 mSv for PM/ICDs, respectively. The maximum doses to fingers, wrists and knees were, accordingly, 2.11 mSv, 1.07 mSv and 0.77 mSv for CA PCI procedures, 0.38 mSv, 0.20 mSv and 0.04 mSv for RFA ones, 0.50 mSv, 0.25 mSv and 0.01 mSv for PM/ICDs procedures and 2.25 mSv, 1.12 mSv and 0.58 mSv for CRT and CRT-D ones. The factors which might influence the dose like utilized radiation, availability of additional protective equipment and position of the staff with respect to X-ray source were also analyzed. The annual doses for eye lens and extremities were estimated on the basis of individual annual workloads of the physicians participating in the study. The highest annual doses were revealed for physicians performing CA PCI procedures. Annual eye lens doses range up to 247 mSv indicating that the occupational limit for eye lens 150 mSv has been surpassed. In case of extremities the maximal estimated annual doses were 355 mSv, 136 mSv, 55 mSv and 328 mSv, for fingers, wrists, knees and for ankle

  5. Provision of services for the diagnosis and treatment of heart disease in England and Wales. Third report of a Joint Cardiology Committee. Royal College of Physicians of London and the Royal College of Surgeons of England.

    Science.gov (United States)

    1985-05-01

    The principal conclusions of the report are as follows. Cardiology continues to change rapidly. In the five years since the issue of the Second Report of the Joint Cardiology Committee in 1980 the specialty has been affected principally by the increase in coronary artery surgery and the increasing importance of non-invasive techniques of diagnosis, particularly echocardiography. The burden of heart disease in Britain shows some decline recently, but this falls short of that which has occurred in other countries. The vital role of the initial assessment of patients to ensure the efficient use of limited resources falls upon physicians and paediatricians in district general hospitals. Each district general hospital should have at least one physician, practising general medicine but having a special expertise and training in cardiology. He should undertake echocardiography, stress testing, ambulatory monitoring, emergency pacing, rehabilitation, and cardiac intensive care, with the necessary facilities and staff. He will also play an important part in the follow up of patients assessed and treated at cardiac centres. Paediatricians should continue to evaluate children with heart disease and their training should include periods at cardiac centres. Cardiac centres currently undertaking invasive investigations and cardiac surgery need to expand to cope with demand. A target figure of 750-1000 coronary artery bypass operations annually is suggested. This implies three or four surgeons and six cardiologists per centre. Other staffing should be based on these figures. Smaller centres are not necessarily non-viable but should be encouraged to expand or merge. Funding should be clarified so that regional contributions to regional services are identified and not lost in district budgets. Expensive capital equipment should be regionally funded whether sited in cardiac centres of district general hospitals. (7) Supraregional centres for the cardiac problems of infants under the

  6. 心内科老年住院患者失眠原因调查及护理探讨%Discussion on the nursing and reasons of insomnia among old inpatients in cardiology department

    Institute of Scientific and Technical Information of China (English)

    郭莹

    2012-01-01

    OBJECTIVE To investigate the reasons of insomnia among old inpau'ents in cardiology department, and discuss the effect nursing measures of improve sleep. METHODS By self-assessment questionnaire, we collected data on sleep status and related nursing measures for insomnia, and evaluated the effect of nursing measures. RESULTS Among the reason of insomnia among old inpatients in cardiology department, 22.5% of them were environment changes, 33% of them were uncomfortable from disease, 17.5% of them were mental factors and 2% of them were other reasons. Through nursing, all kinds of insomnia showed significantly decrease. There was significant difference between them (P< 0.05). CONCLUSION Comprehensive nursing measures could decrease the incidence of insomnia among old inpatients in cardiology department.%目的 调查了解心内科老年住院病人的睡眠状况及原因,探讨有效改善失眠状况的护理措施.方法 采用睡眠状况自评量表及科室自行设计的调查表收集病人睡眠状况相关资料并根据失眠的原因采取有针对性的护理措施,护理干预后再次进行睡眠状况评估.结果 心内科老年病人失眠的发生原因中,22.5%由于环境改变(噪音、光线等),33%由于疾病本身的因素引起,心理因素也占了17.5%,其他原因仅占2%.经过护理干预,各类型失眠的发生率均显著降低,差异有统计学意义(P<0.05).结论 采取综合护理措施可以有效减低心内科老年住院病人失眠的发生率.

  7. Control de la glucemia en el postoperatorio de cirugía cardíaca: Informe del Consejo de Emergencias de la Sociedad Argentina de Cardiología

    Directory of Open Access Journals (Sweden)

    Mariano N. Benzadón

    2012-02-01

    Full Text Available La hiperglucemia en el postoperatorio de cirugía cardÍaca es un hallazgo frecuente asociado a peor evolución, que afecta tanto a diabéticos como no diabéticos. A pesar de las múltiples publicaciones disponibles, aún no existe un abordaje universalmente aceptado a este problema. En una iniciativa originada en el Consejo de Emergencias de la Sociedad Argentina de Cardiología, se convocó a expertos de nuestro medio con el propósito de debatir cómo debe ser el manejo de la glucemia en el paciente crítico cardiovascular. Este documento refleja lo discutido en este evento académico con la intención de resumir los principales aspectos del control de la glucemia en el postoperatorio de cirugía cardíaca.

  8. A recommended practical approach to the management of anthracycline-based chemotherapy cardiotoxicity: an opinion paper of the working group on drug cardiotoxicity and cardioprotection, Italian Society of Cardiology.

    Science.gov (United States)

    Spallarossa, Paolo; Maurea, Nicola; Cadeddu, Christian; Madonna, Rosalinda; Mele, Donato; Monte, Ines; Novo, Giuseppina; Pagliaro, Pasquale; Pepe, Alessia; Tocchetti, Carlo G; Zito, Concetta; Mercuro, Giuseppe

    2016-05-01

    Anthracyclines are the mainstay of treatment of a variety of haematological malignancies and solid tumours. Unfortunately, the clinical use of these drugs is limited by cumulative, dose-related cardiotoxicity which may ultimately lead to a severe and irreversible form of cardiomyopathy. Thus, there is an increasing need for close cooperation among cardiologists, oncologists and haemato-oncologists. As anthracyclines save lives, the logical goal of this cooperation, besides preventing or mitigating cardiotoxicity, is to promote an acceptable balance between the potential cardiac side effects and the vital benefit of anticancer treatment. This manuscript, which is specifically addressed to the cardiologist who has not accumulated much experience in the field of cancer therapy, focuses on several topics, that is old and new mechanisms of cardiac toxicity, late cardiac toxicity, the importance of overall risk assessment, the key role of a cardiology consult before starting cancer therapy, and the pros and cons of primary and secondary prevention programmes. PMID:27183529

  9. 专病专护护理模式在心内科病房中的探索与实践%The exploration and practice of special nursing care model in cardiology ward

    Institute of Scientific and Technical Information of China (English)

    庄海峰

    2014-01-01

    Objective To investigate the implementation and effects of special nursing care model in cardiology ward .Methods Draw up a systematic plan for special nursing care .Improve the level of special nursing care by refined duties , explicit target and diversified missionary and training objectives .Focus on training nurse specialist , carry out the special nursing cars model and the final assessment .Results Theoretical level of nurse specialist and overall satisfaction of departments improved through the training and examination , compared with the situation before the model applied the differences were statistically significant (P<0.05).Conclusions The special nursing care model could improve the care level in cardiology department .%目的:探讨专病专护护理模式在心内科病房的实施和效果评价。方法制定系统的专病专护模式实施计划;通过从细化职责、明确培养目标,运用多元化的宣教、培训方式提高专病护理的水平,重点在于培养专病护士,推行专病专护护理模式并进行考核效果评价。结果通过培训考核再评价,专病护士专科理论水平较前提高,科室整体满意度上升,差异有统计学意义(P<0.05)。结论专病专护护理模式有助于提高心内科专科护理水平。

  10. Evaluation and characterization of digital X-ray equipment for paediatric cardiology in the Hospital Gregorio Maranon; Evaluacion y caracterizacion de la dinamica de trabajo y de la dosis recibida por el paciente en la sala de hemodinamica infantil del Hospital General Universitario Gregorio Maranon

    Energy Technology Data Exchange (ETDEWEB)

    Calama Santiago, J. A.; Gonzalez Ruiz, C.; Infante Utrilla, M. A.; Zanfano Hidalgo, R.; Penedo cobos, J. M.; Sierra Diaz, F.; Olivares Munoz, M. P.

    2006-07-01

    The purchase of a digital X-Ray equipment specific for paediatric cardiology in 2003 has allowed a careful examination of the technical characteristics of these patients. This data review includes the analysis of a dose index with several variable factors such as weight, size and age of patients, purpose, type and characteristics of the study and its development over time as a results of the experience gained by the staff involved. (Author)

  11. ANÁLISIS DEL ÍNDICE DE IMPACTO EN LA ESPECIALIDAD DE CARDIOLOGÍA SEGÚN EL JOURNAL CITATION REPORTS EN EL PERÍODO 2006-2008 / Analysis of the impact factor in cardiology according to the Journal Citation Reports during the period 2006-2008

    Directory of Open Access Journals (Sweden)

    Yenni González Lugo

    2010-03-01

    Full Text Available Heart diseases are at the top of the health statistics concerning the main causes of death in the world. This fact reveals the need of focussing the health scientific policy toward the diagnosis and treatment of these diseases. Currently, the best results in this field are not widely published; however, the challenge for Cuban publications, in general, is to reach a better visibility. In order to meet this challenge, a bibliometric study of the Cardiology journals which are available in the Web of Science was carried out, having the Impact Factor (IF as the main variable. The issues of the JCR Science Edition during the period from 2006 to 2008 were analysed. The results showed that there is not a sufficient amount of journals on this field, in spite of the fact that there is a group which has increased its number, year after year, with a relatively high impact factor. Although the vast majority of these journals are published in English, some others, of high renown, are published in Spanish or are multilingual. The Journal of the American College of Cardiology was the journal with the highest impact factor in 2008; therefore, it is the one with the highest visibility in this specialty. Finally, it was determined that most of the Cardiology journals are from North America, mainly from the US, while only 6 of them are from Europe.

  12. Department of Cardiology Nursing of Potential Risk Factors and Preventive Measures%心内科护理中潜在的风险因素及防范措施

    Institute of Scientific and Technical Information of China (English)

    宋静

    2014-01-01

    Objective To strengthen risk management, improve the nursing safety. Methods For analysis of potential risk factors of nursing in Department of Cardiology, targeted to take precautions. Results Nursing care, nursing accidents, fal s in hospital, nursing complications, nursing complaints and other unexpected, sudden nursing adverse events to reduce and eliminate. Conclusion The evaluation and measures are in place, can be ef ective in the prevention of nursing risk, ensure the safety of the patients, improve nursing quality.%目的加强风险管理,提高护理安全。方法分析心内科护理中潜在的风险因素,有针对性的采取防范措施。结果护理差错、护理事故、在院跌倒、护理并发症、护理投诉和其它意外的、突发的护理不良事件减少和消除。结论评估到位、措施到位,可以有效的预防护理风险,确保患者安全,提高护理质量。

  13. RESISTENCIA MICROBIANA EN EL CARDIOCENTRO ERNESTO CHE GUEVARA. ESTUDIO DE 5 AÑOS / Microbial resistance at the “Ernesto Che Guevara” Cardiology Hospital. A five year study

    Directory of Open Access Journals (Sweden)

    Nérida Rodríguez Oliva

    2009-06-01

    Full Text Available Introduction and Objectives: The appearance of nosocomial bacterial resistance represents a problem of growing concern because it largely affects the evolution of patients and the health resources devoted to it. The objective of this work was to determine the most common germs and their microbial resistance. Methods: A descriptive retrospective study was carried out analyzing the result of the isolation of germs from all type of secretions and from the blood cultures of a group ofpatients hospitalized at the Ernesto Che Guevara Cardiology Hospital in a five year period. Results: A total of 397 strains were isolated, 77 Staphylococcus aureus and 320 Enterobacteriaceae. The former presented 100% resistance to penicillin. The Staphylococcus sensitive to methicillin presented 4.9 % resistance to cotrimoxazole and gentamicin. The strains resistant to methicillin or oxacillin had a high resistance to gentamicin (87.5 % and ciprofloxacin (81.2 %, a medium resistance to cefazolin and oxacilline (20.5 %, and just 12.5 percent resistance to cotrimoxazole. Conclusions: the Staphylococcus aureus and the Enterobacteriaceae were the most common germs. The preoperative prophylaxis in these patients must not be done with cefazolin as a routine because the staphylococci resistant to methicillin or oxacillin have influence on other antimicrobials.

  14. The usefulness of the nuclear cardiology in the cellular implant in patients with severe myocardial damage; La utilidad de la cardiologia nuclear en el implante celular en pacientes con dano miocardico severo

    Energy Technology Data Exchange (ETDEWEB)

    Omelas A, M.; Arguero S, R.; Garrido G, M.H.; Rodriguez C, A.; Careaga, G.; Castano G, R.; Nambo, M.J.; Pascual P, J.; Ortega R, A.; Gaxiola A, A.; Magana S, J.A.; Estrada A, H.; Equipo de Tecnicos en Medicina Nuclear [Centro Medico Nacional Siglo XXI IMSS Hospital de Cardiologia-Servicio de Medicina Nuclear Mexico DF (Mexico)

    2005-07-01

    The recent therapeutic advances as the cellular implant as well as those different protocols of image acquisition in the field of the Nuclear Cardiology its have allowed that the patient with severe myocardial damage and without some possibility of revascularization is benefited with these advances. Doubtless the Tl-201 par excellence has an important paper for standardize the more appropriate therapeutic behavior for the heart attack patient; reason by this investigation protocol was developed. The objective of the study was to identify the heart attack regions without viable tissue with SPECT in patient with important myocardial damage without some possibility of traditional revascularization; for the 'Stem cell' cellular implantation therapy. The methodology it was carried out by a study of myocardial perfusion in 10 patients with important myocardial damage previous cellular implants, with PICANUC/ SPECT methodology and using a software (Emory Tool Box) for the image processing validated by the University of Emory Atlanta GA; and using as tracer the Tl - 201 to identify the heart attack regions without presence of viable tissue with an analysis model of 17 segments standardized for the left ventricle; qualifying this way the myocardial perfusion in: 0 (normal), 1 (light), 2 (moderate), 3 (severe), 4 (absent) and x (bad technique). The conclusions were that the SPECT study with PICANUC methodology with Tl-201 is safe and effective for the precise localization for the cellular implantation via direct intra myocardial. (Author)

  15. Bleeding risk assessment and management in atrial fibrillation patients. Executive Summary of a Position Document from the European Heart Rhythm Association [EHRA], endorsed by the European Society of Cardiology [ESC] Working Group on Thrombosis.

    Science.gov (United States)

    Lip, Gregory Y H; Andreotti, Felicita; Fauchier, Laurent; Huber, Kurt; Hylek, Elaine; Knight, Eve; Lane, Deirdre; Levi, Marcel; Marín, Francisco; Palareti, Gualtiero; Kirchhof, Paulus

    2011-12-01

    In this executive summary of a Consensus Document from the European Heart Rhythm Association, endorsed by the European Society of Cardiology Working Group on Thrombosis, we comprehensively review the published evidence and propose a consensus on bleeding risk assessments in atrial fibrillation (AF) patients. The main aim of the document was to summarise 'best practice' in dealing with bleeding risk in AF patients when approaching antithrombotic therapy, by addressing the epidemiology and size of the problem, and review established bleeding risk factors. We also summarise definitions of bleeding in the published literature. Patient values and preferences balancing the risk of bleeding against thromboembolism as well as the prognostic implications of bleeding are reviewed. We also provide an overview of published bleeding risk stratification and bleeding risk schema. Brief discussion of special situations (e.g. periablation, peri-devices such as implantable cardioverter defibrillators [ICD] or pacemakers, presentation with acute coronary syndromes and/or requiring percutanous coronary interventions/stents and bridging therapy) is made, as well as a discussion of the prevention of bleeds and managing bleeding complications. Finally, this document puts forwards consensus statements that may help to define evidence gaps and assist in everyday clinical practice. PMID:22048796

  16. 心内科临床药师参与药物治疗和干预医嘱的实践与分析%Practice of clinical pharmacists in drug therapy and intervention in the department of cardiology

    Institute of Scientific and Technical Information of China (English)

    唐巧云; 黄丽

    2015-01-01

    目的:探讨心内科临床药师参与药物治疗和干预医嘱的途径和方法。方法对临床药师参与心内科药物治疗的4例典型案例进行分析。结果临床药师在参与药物品种选择、剂量调整,提醒医师关注药物的药代动力学、相互作用、不良反应等方面取得一定成效。结论临床药师利用与医护人员互补的药学专业知识,为医师及患者提供药学服务,可促进临床合理用药。%Objective To discuss ways and methods of clinical pharmacists in clinical drug therapy and medication intervention. Methods Clinical pharmacistsˊ experience in the treatment of four typical cases in cardiology department was analyzed. Results Clinical pharmacists achived results in certain areas,such as participating in drug selection and adjusting the dose,reminding doctors to pay attention to pharmacokinetics,interaction and drug adverse reaction. Conclusion Clinical pharmacists should master necessary basic theory of medicine and pharmacy so as to provide pharmaceutical care for doctors and patients,which can promote rational drug use in the clinic.

  17. Advances in heart rate variability signal analysis: joint position statement by the e-Cardiology ESC Working Group and the European Heart Rhythm Association co-endorsed by the Asia Pacific Heart Rhythm Society.

    Science.gov (United States)

    Sassi, Roberto; Cerutti, Sergio; Lombardi, Federico; Malik, Marek; Huikuri, Heikki V; Peng, Chung-Kang; Schmidt, Georg; Yamamoto, Yoshiharu

    2015-09-01

    Following the publication of the Task Force document on heart rate variability (HRV) in 1996, a number of articles have been published to describe new HRV methodologies and their application in different physiological and clinical studies. This document presents a critical review of the new methods. A particular attention has been paid to methodologies that have not been reported in the 1996 standardization document but have been more recently tested in sufficiently sized populations. The following methods were considered: Long-range correlation and fractal analysis; Short-term complexity; Entropy and regularity; and Nonlinear dynamical systems and chaotic behaviour. For each of these methods, technical aspects, clinical achievements, and suggestions for clinical application were reviewed. While the novel approaches have contributed in the technical understanding of the signal character of HRV, their success in developing new clinical tools, such as those for the identification of high-risk patients, has been rather limited. Available results obtained in selected populations of patients by specialized laboratories are nevertheless of interest but new prospective studies are needed. The investigation of new parameters, descriptive of the complex regulation mechanisms of heart rate, has to be encouraged because not all information in the HRV signal is captured by traditional methods. The new technologies thus could provide after proper validation, additional physiological, and clinical meaning. Multidisciplinary dialogue and specialized courses in the combination of clinical cardiology and complex signal processing methods seem warranted for further advances in studies of cardiac oscillations and in the understanding normal and abnormal cardiac control processes. PMID:26177817

  18. Distribution of kerma rate in the air inside of hemodynamic room for typical projections of interventionist cardiology procedures; Distribuicao da taxa de kerma no ar em uma sala de hemodinamica para projecoes tipicas de procedimentos de cardiologia intervencionista

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, Mirtha Elizabet Gamarra

    2008-07-01

    The evaluation of dose to physicians involved in Interventional Cardiology (IC) is an extreme important matter due to the high and non-uniform distribution of dose values. The radiation control during each procedure is complex and the reasons for the high exposures have many different causes. Many international recommendations have already been written aiming the radiation protection optimization in IC. In Brazil, there is not any special orientation for the protection of those occupational persons, nor a specific legislation. The purpose of this work is to evaluate the air kerma rate at critical anatomic regions of the occupationally exposed staff that carry out IC procedures, in representative incidences in order to give subsidies for individual monitoring procedures implementation and to give more information about their radiation protection. The air kerma rate has been measured in the often used condition in the two more common IC procedures namely angiography and coronary angioplasty, using an adult patient simulator irradiated under RAO, LAO and AP projections for fluoro and digital acquisition modes. The measurements have been made in 45 points around the examination table at 5 different representatives heights of: eyes lens, thorax, hands, gonads and knees. AP projection shows the smaller scattered radiation contributions and a more homogeneous exposure distribution. The digital acquisition mode gives air kerma rates about 4 times higher than fluoro mode for LAO projection in the position occupied by the interventionist doctor, the anesthetist and the nursing staff. The most critical anatomic regions are: knees and gonads (without protection). On the physician hands position, values as high as 5 mGy/h have been measured, which can overpass, depending on the number of procedures done, the individual occupational annual limit. Therefore, in IC it is necessary to implement additional protection tools, elaborate safety guides (based on international experiences

  19. Condições ergonômicas do trabalho da equipe de enfermagem em unidade de internação de cardiologia Condiciones ergonómicas del trabajo de la equipe de enfermería en unidad de internación de cardiología Ergonomic conditions of the work of the team of nursing in an unit of cardiology

    Directory of Open Access Journals (Sweden)

    Maria Helena Palucci Marziale

    1998-01-01

    Full Text Available Com o objetivo de analisar as condições ergonômicas da situação de trabalho do pessoal de enfermagem em uma unidade de internação hospitalar, utilizamos como pressuposto metodológico a globalidade da situação experienciada através da análise de seus elementos quais sejam: o homem (trabalhador de enfermagem, a atividade de trabalho (tarefas prescritas, atividades reais e postos de trabalho e o ambiente (temperatura, ruido e iluminação. Buscando a demanda para a investigação identificamos a unidade de Cardiologia como local para realização da pesquisa. Os resultados apontaram que as condições de trabalho na unidade estudada são insatisfatórias e que o trabalhador enfrenta problemas relacionados a inadequação de: salário, postos de trabalho, relacionamento, organização de trabalho, formação e atividades executadas. Diante da situação experenciada sugerimos algumas recomendações.Con el objetivo de analizar las condiciones ergonómicas de la situación de trabajo del personal de enfermería en una unidad de internación hospitalar, utilizamos como presupuesto metodológico la globalidad de la situación experenciada a trasis de la análises de sus elementos, los cudes serion: el hombre (trabajador de enfermería, la actividad de trabajo (tareas prescriptas, actividades redas y puestos de trabajo y el ambiente (temperatura, ruído e iluminación. Buscando la demanda para la investigación identificamos la unidad de Cardiología como lugar para la realización de la pesquisa. Los resultados senalaron que el trabajador enfrenta problemas relacionados a la inadequación de sueldos, de los puestos de trabajo, en el relacionamento, en la organización de trabajo, en el nivel de formación y en las actividades ejecutadas. Frente a la situación se presentarán las recomendaciones.Aiming at finding out the ergonomics conditions of the nursing personnel in a hospital admission unit, the authors utilized as a methodological

  20. Myocardial perfusion scintigraphy: the evidence. A consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society, endorsed by the Royal College of Physicians of London and the Royal College of Radiologists

    International Nuclear Information System (INIS)

    This review summarises the evidence for the role of myocardial perfusion scintigraphy (MPS) in patients with known or suspected coronary artery disease. It is the product of a consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society and is endorsed by the Royal College of Physicians of London and the Royal College of Radiologists. It was used to inform the UK National Institute of Clinical Excellence in their appraisal of MPS in patients with chest pain and myocardial infarction. MPS is a well-established, non-invasive imaging technique with a large body of evidence to support its effectiveness in the diagnosis and management of angina and myocardial infarction. It is more accurate than the exercise ECG in detecting myocardial ischaemia and it is the single most powerful technique for predicting future coronary events. The high diagnostic accuracy of MPS allows reliable risk stratification and guides the selection of patients for further interventions, such as revascularisation. This in turn allows more appropriate utilisation of resources, with the potential for both improved clinical outcomes and greater cost-effectiveness. Evidence from modelling and observational studies supports the enhanced cost-effectiveness associated with MPS use. In patients presenting with stable or acute chest pain, strategies of investigation involving MPS are more cost-effective than those not using the technique. MPS also has particular advantages over alternative techniques in the management of a number of patient subgroups, including women, the elderly and those with diabetes, and its use will have a favourable impact on cost-effectiveness in these groups. MPS is already an integral part of many clinical guidelines for the investigation and management of angina and myocardial infarction. However, the technique is underutilised in the UK, as judged by the inappropriately long waiting times and by

  1. Importância dos estudos pré-clínicos em animais de experimentação para a cardiologia intervencionista The importance of pre-clinical animal testing in interventional cardiology

    Directory of Open Access Journals (Sweden)

    Yoriyasu Suzuki

    2008-11-01

    Full Text Available O tratamento da doença cardiovascular mudou radicalmente nas últimas duas décadas, proporcionando aos pacientes uma sobrevida maior e melhor qualidade de vida. Grande parte desse sucesso deve-se à introdução de novas terapias. Em nenhuma outra área essa mudança foi mais evidente do que na cardiologia intervencionista, pois nos últimos vinte anos as intervenções cardiovasculares percutâneas saíram do terreno experimental para formar a base terapêutica dos portadores de doença cardiovascular sintomática. O desenvolvimento dessas tecnologias, desde os primeiros estágios, requer a realização de estudos pré-clínicos com modelos animais. É possível compreender os mecanismos terapêuticos desses dispositivos, uma vez introduzidos na esfera clínica, comparando-se os achados das pesquisas realizadas com modelos animais com amostras de exames anatomopatológicos. Esta análise apresenta uma visão geral do papel emergente dos estudos pré-clínicos, bem como dos resultados, do desenvolvimento e da avaliação de modelos amimais, nas tecnologias de intervenção cardiovascular percutânea para tratamento de pacientes com doença cardiovascular sintomática.The treatment of cardiovascular disease has changed dramatically over the past 2 decades, allowing patients to live longer and better quality lives. The introduction of new therapies has contributed much to this success. Nowhere has this been more evident than in interventional cardiology, where percutaneous cardiovascular intervention has evolved in the past 2 decades from a quirky experimental procedure to a therapeutic cornerstone for patients with symptomatic cardiovascular disease. The development of these technologies from the earliest stages requires preclinical experiments using animal models. Once introduced into the clinical arena, an understanding of therapeutic mechanisms of these devices can be ascertained through comparisons of animal model research findings with

  2. Anatomical eponyms in Cardiology from to the 60s to the XXI century Epônimos anatômicos em Cardiologia dos anos 60 ao século XXI

    Directory of Open Access Journals (Sweden)

    Alexandre Lins Werneck

    2011-03-01

    Full Text Available BACKGROUND: Eponym from the Greek [epi, "upon"] + [onuma, name], is a person, whether real or fictitious, after whom an item is named or thought to be named. Eponymous terms are used every day in Medicine, in our clinical years, and they have been part of the tradition of Medicine, culture, and history. Despite all the inconvenience, all those who are no against eponym has only one statement: "medical eponyms will continue to be used because there is a sense of history to their use. They are use in contemporary life, eponyms are here to stay". METHODS: The following study aims at to show the presence of current anatomical eponyms on the best well-known Textbooks and Atlas of Human Anatomy, ranging from the oldest to the newest one, comprising a period from 1960 until 2011, regarding the cardiovascular system, particularly the heart. The three International Anatomical Terminologies have been critical as the basis of our study. Exclusion criteria were syndromes, diseases, signs, anomalies, surgical procedures, indexes, tests, grading, and the methods, which are used as eponyms in Cardiology, once they are not considered Anatomical Terms. It has been our intent to show that different eponyms characterize the same anatomical structure. RESULTS: A list with the 25 most common eponyms listed by the three International Anatomical Terminologies is listed in Table1. CONCLUSION: Should eponyms be abandoned? Of course not, once they remain a useful reflection of medical history. We could prove to our journey from 1960 to 2011, that the best well-known Atlas and Textbooks available do not use so many anatomical eponyms in Cardiology. They are only 25 (without including arteries, veins, and nerves of the cardiovascular system and all the authors use no more than 9 or 12 of them. We just want to alert the Health and Allied Health Sciences Professional and students that we 'strongly recommend' not to use an eponym when it is made at the expense of an

  3. Insuficiência cardíaca descompensada na unidade de emergência de hospital especializado em cardiologia Decompensated heart failure in the emergency department of a cardiology hospital

    Directory of Open Access Journals (Sweden)

    Sandrigo Mangini

    2008-06-01

    égias terapêuticas mais avançadas.BACKGROUND: National studies on decompensated heart failure (DHF are key to the understanding of this condition in our midst. OBJECTIVE: To determine the characteristics of DHF patients in an emergency department. METHODS: A total of 212 patients diagnosed with decompensated heart failure who had been admitted to an emergency department (EU of a cardiology hospital were prospectively evaluated. Clinical variables, form of presentation and causes of decompensation were studied. In 100 patients, ancillary tests, prescription of vasoactive drugs, length of hospital stay and mortality were also analyzed. RESULTS: There was a predominance of the male gender (56% and the most frequent etiology was ischemia (29,7% despite high frequency of valvular (15% and chagasic (14,7% etiologies. The most common form of presentation and cause of decompensation were congestion (80.7% and poor compliance/inadequate medication (43.4%, respectively. In the subanalysis of the 100 patients, systolic dysfunction was the most common cause of decompensation (55%; use of vasoactive drugs occurred in 20%, and mortality was 10%. The comparative analysis between the patients who were discharged and those who died during hospitalization confirmed some criteria of poor prognosis: reduced systolic blood pressure, low cardiac output associated with congestion, need for vasoactive drugs, reduced left ventricular ejection fraction, increased left ventricular diastolic diameter (LVDD and hyponatremia. CONCLUSION: This study presents information about the profile of decompensated heart failure patients attended on the emergency unit of a brazilian southeast cardiology hospital. Clinical, hemodynamical and ancillary data may provide information for risk assessment in the initial evaluation helping the decision on hospitalization and advanced strategic therapies.

  4. Radioisotopes and radiopharmaceuticals in nuclear cardiology

    International Nuclear Information System (INIS)

    Nuclear medicine studies of the heart represent one of the fastest growing areas of research and clinical interest. Some years ago, nuclear medicine cardiac studies were limited to the evaluations of myocardial infraction. Developments in radiopharmaceuticals chemistry and instrumentation have made possible advances in cardiovascular nuclear medicine. Techniques and Radiopharmaceuticals no exist for the imaging of viable myocardium and the determination of myocardial tissue metabolism, as well as radionuclide angiography to obtain quantitative information of cardiac output, mean transit times, cardiac volumes, and ejection fractions. This paper will firstly describe that anatomy and physiology of the heart as to relate to the radiopharmaceuticals which will be discussed, and will secondly explore various radiopharmaceuticals which have been used for various purposes in cardiac imaging, than will explore radioisotopes which have been proposed for myocardial treatment

  5. 4-D OCT in Developmental Cardiology

    Science.gov (United States)

    Jenkins, Michael W.; Rollins, Andrew M.

    Although strong evidence exists to suggest that altered cardiac function can lead to CHDs, few studies have investigated the influential role of cardiac function and biophysical forces on the development of the cardiovascular system due to a lack of proper in vivo imaging tools. 4-D imaging is needed to decipher the complex spatial and temporal patterns of biomechanical forces acting upon the heart. Numerous solutions over the past several years have demonstrated 4-D OCT imaging of the developing cardiovascular system. This chapter will focus on these solutions and explain their context in the evolution of 4-D OCT imaging. The first sections describe the relevant techniques (prospective gating, direct 4-D imaging, retrospective gating), while later sections focus on 4-D Doppler imaging and measurements of force implementing 4-D OCT Doppler. Finally, the techniques are summarized, and some possible future directions are discussed.

  6. Improving Performance in a Nuclear Cardiology Department

    Science.gov (United States)

    LaFleur, Doug; Smalley, Karolyn; Austin, John

    2005-01-01

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

  7. Patient doses in interventional cardiology procedures

    International Nuclear Information System (INIS)

    In most countries of European Union legislation requires the determination of the total skin dose to patient resulting from interventional procedures to assess the risk of deterministic effect. To this end, various dose indicators like dose area product (DAP), cumulative dose (CD) and entrance dose at the patient plane (EFD) are used in clinical practice. The study aims at relating those dose indicators with doses ascribe to the most irradiated areas of the patient skin usually expressed in terms of local maximal skin dose (MSD). For the study the local MSD and related to their areas are investigated and compared for coronary angiography CA and intervention (PCI). Two methods implying radiographic films Kodak EDR2 and matrixes of thermoluminescent dosimeters (TLDs) are applied for direct measurements of dose distribution for selected procedures. Both methods are compared. Additionally, for patient dosimetry the following data: MSD, CD, EFD, fluoroscopy time (FT), number of acquired images, total DAP, fluoro-DAP and record-DAP were collected for randomly selected procedure. The statistical quantities like: median, 3rd quartile, mean and standard deviation for all dosimetric parameters are determined. Preliminary study showed that the values of data collected for coronary procedures are in the ranges 0,7 - 27,3 min for fluoroscopy time, 50 - 350 Gy cm2 for total DAP, 300 - 2000 mGy for CD, 140 - 2000 mGy for EFD and 100 - 1500 mGy for local maximal skin dose. For interventions the ranges are, accordingly 3,0 - 43,6 min , 25 - 450 Gy cm2, 270 - 6600 mGy, 80 - 2600 mGy and 80 - 1500 mGy. As a result of the study the correlations between dose indicators and local MSD are analyzed. The concentration of dose on irradiated films are going to be investigated in some detail as well. (author)

  8. Pediatric patient doses in interventional cardiology procedures

    International Nuclear Information System (INIS)

    The radiation doses from interventional procedures is relevant when treating children because of their greater radiosensitivity compared with adults. The purposes of this paper were to estimate the dose received by 18 pediatric patients who underwent cardiac interventional procedures and to correlate the maximum entrance surface air kerma (Ke,max), estimated with radiochromic films, with the cumulative air kerma values displayed at the end of procedures. This study was performed in children up to 6 years. The study was performed in two hospitals, one located in Recife and the other one in São Paulo. The x-ray imaging systems used were Phillips Allura 12 model with image intensifier system and a Phillips Allura FD10 flat panel system. To estimate the Ke,max on the patient’s skin radiochromic films(Gafchromic XR-RV2) were used. These values were estimated from the maximum optical density measured on film using a calibration curve. The results showed cumulative air kerma values ranging from 78.3- 500.0mGy, with a mean value of 242,3 mGy. The resulting Ke,max values ranged from 20.0-461.8 mGy, with a mean value of 208,8 mGy. The Ke,max values were correlated with the displayed cumulative air kerma values. The correlation factor R² was 0.78, meaning that the value displayed in the equipment’s console can be useful for monitoring the skin absorbed dose throughout the procedure. The routine fluoroscopy time records is not able by itself alert the physician about the risk of dose exceeding the threshold of adverse reactions, which can vary from an early erythema to serious harmful skin damage. (author)

  9. Transitioning from population to individualized preventive cardiology

    Directory of Open Access Journals (Sweden)

    Morris PB

    2013-04-01

    Full Text Available Pamela B Morris,1 Richard F Wright2 1Seinsheimer Cardiovascular Health Program and Women’s Heart Care, Medical University of South Carolina, Charleston, SC, USA; 2Heart Failure Center, Pacific Heart Institute, Santa Monica, CA, USA Abstract: There is an ongoing discussion about whether treatment strategies developed from population based studies lead to inappropriate care of individual patients. This article proposes that despite management of lipid-lowering therapy to established low-density lipoprotein cholesterol (LDL-C goals, significant residual risk for cardiovascular events remains in patients with established cardiovascular disease, diabetes, and metabolic syndrome (ie, central obesity, raised triglyceride levels and/or reduced high-density lipoprotein cholesterol levels. In these patients, LDL-C is often an inaccurate predictor of risk because the cholesterol content within the low-density lipoprotein particle (LDL-P can be highly variable and thus LDL-C often inaccurately expresses an individual's likelihood of an atherosclerotic event. The LDL-P number has been found to be a better discriminator of cardiovascular risk than LDL-C in individual patients in several large epidemiologic studies that use sub-group analyses, including the Framingham Offspring Study and the Multi-Ethnic Study of Atherosclerosis. In contrast, epidemiology studies that utilize population statistics focusing on the role of lipids for initial risk assessment in entire populations do not separately evaluate these higher risk patients. The measurement of LDL-P in patients with cardiometabolic risk allows treatment of individuals through the optimization of lipid-lowering therapy to personalized goals, which would be expected to reduce that individual's risk of subsequent atherosclerotic events. Keywords: cardiovascular disease, individualized medicine, low-density lipoprotein particles, low-density lipoprotein cholesterol

  10. Nuclear cardiologic study of Takotsubo cardiomyopathy

    International Nuclear Information System (INIS)

    Transient left ventricular apical ballooning syndrome, also known as Takotsubo cardiomyopathy (T.T.C.) was described for the first time in Japan in the earliest nineties. It represents 1 to 2 % of acute cardiac events and mimics closely acute myocardial infarction. The aim of this study was to investigate 99 mTc- tetrofosmine or 201Thallium myocardial Single Photon Emission Computed Tomography (SPECT), 123I-meta-iodo-benzyl-guanidine (123I-mibg) myocardial SPECT and myocardial Positron Emission Tomography using 18F-fluorodeoxyglucose (18F-FDG) in patients with T.T.C., assessing respectively left ventricular perfusion, innervation and metabolism. We studied four patients (three females) with T.T.C.. We performed two weeks after acute phase (subacute phase) myocardial perfusion SPECT and 123I-mibg myocardial SPECT for each patient. Two of them underwent myocardial PET with FDG. Then, we assessed left ventricular innervation and metabolism three months (chronic phase I) and more than six months (chronic phase II) after the acute phase. We compared the discrepancies between radionuclides uptake in the left ventricular apical region during a follow-up period of more than six months. In subacute phase, perfusion SPECT was normal for each patient. Conversely, 123I-mibg SPECT and FDG-PET showed concordant apical uptake defect. This perfusion-metabolism pattern called 'inverse flow-metabolism mismatch' is the metabolic state of stunned myocardium. After three months, we found improvement of apical tracer uptake in both FDG-PET and 123I-mibg SPECT. These findings suggest that T.T.C. is characterized by myocardial apical stunning which is related to a disturbance of cardiac sympathetic innervation. 123I-mibg SPECT might be useful to diagnose earlier this pathology and to rule out acute myocardial infarction. (authors)

  11. Challenges in cardiology research in pregnancy.

    Science.gov (United States)

    Naqvi, Tasneem Z

    2014-11-01

    Research in pregnancy is challenging as it involves a special 'vulnerable' group due to the involvement of the mother and the fetus. These challenges, which are inherent in studying pregnancy in physiologic and pathologic states, have contributed to the scant research in pregnancy. Until recently, most studies in pregnancy were nonrandomized and retrospective in nature, representing prevailing clinical standards of practice and clinicians' biases. Prospective studies were generally limited to single centers, comprising of small sample sizes and were observational in nature, rather than randomized studies involving therapy. Ethical and legal factors, research mandates, patient factors, the protracted nature of pregnancy, institutional commitment to research, interdisciplinary clinical and research collaboration, funding support, administrative issues and the level of involvement of national cardiac and obstetric and gynecological societies have been barriers to research in pregnancy in developed countries. Even prospective observational studies are difficult to perform due the difficulties involved with obtaining consent, study recruitment and follow-up. Misconceptions regarding research have led to a lack of participation by women. The longitudinal nature of prospective studies in pregnancy, the problems associated with enrolling women before pregnancy and in the first trimester and the failure to understand the commitment required by the patient, as well as many social factors, have led to increased drop-out rates during pregnancy, as well as difficulty with follow-up in the post-partum state. These factors, along with the failure to supplement funding support due to longer study periods than anticipated, have led to studies of small sample sizes. Understanding patient factors that lead to a lack of participation in research or dropping out following initial consent could help make research participation more conducive for pregnant women. The involvement of national societies in the planning and funding of multicenter studies, interdepartmental and interinstitutional collaboration, institutional and extramural funding support and patient incentives are crucial for shortening study duration and ensuring adequacy of sample sizes for successful research in pregnancy. National health service structures, such as those found in Europe and Canada, makes multicenter collaboration for prospective studies more feasible than for countries such as the USA, in which the fees-for-service system is used. Utilization of telemedicine and handheld ultrasound systems and participation in prospective multicenter registries could not only improve the clinical care of pregnant women in underdeveloped countries, but also provide a platform for research during pregnancy. Multicenter and even global registries supported by European cardiac societies have been formed recently that are beginning to bring forth much-needed data regarding pathological states, such as peripartum cardiomyopathy and pregnancy in congenital heart disease. Such studies are largely confined to non-US countries and have started seeing participation from underdeveloped countries. Studies on pregnancy in connective tissue disorders, older women, post-chemoradiation therapy or organ transplantation and in the HIV state remain limited. PMID:25495817

  12. The year in cardiology 2015: prevention

    OpenAIRE

    Chapman, M. John; Blankenberg, Stefan; Landmesser, Ulf

    2016-01-01

    International audience Improved prevention of cardiovascular disease (CVD) is of critical importance, as coronary heart disease (CHD) still represents the most common cause of death worldwide, engendering inestimable socioeconomic cost. The year 2015 has witnessed dramatic progress in CVD prevention on several fronts. Notably, this includes (i) event reduction in high-risk patients in general practice following introduction of a comprehensive strategy to attenuate modifiable risk factors, ...

  13. Cardio online Reader - Conjunctions in Cardiology

    Czech Academy of Sciences Publication Activity Database

    Zvolský, Miroslav; Papíková, Vendula; Veselý, Arnošt

    2011-01-01

    Roč. 7, č. 1 (2011), s. 69-74. ISSN 1801-5603 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic databases * Web 2.0 * medical subject headlines * decision support Subject RIV: IN - Informatics, Computer Science http://www.ejbi.eu/images/2011-1/Zvolsky_en.pdf

  14. Molecular cardiology: the beat goes on

    International Nuclear Information System (INIS)

    Recombination DNA techniques have given cardiac physiologists their first access to the genes, proteins, and chemical signals that regulate the human heart. Scientists have been investigating the molecular biology of the angiotensinogen converting enzyme, renin, and of atrial natriuretic factor (ANF), an important cardiac-peptide hormone with a wide range of physiologic activities. Renin initiates a regulatory cascade that eventually produces angiotensin II, a potent hypertensive agent. By studying renin's genetic organization, and protein chemistry, scientists hope to be able to design a rational therapeutic to specifically inhibit this aspartyl protease. To determine if renin is endogenously produced or if it makes its way to these cells through the circulation. A combination of fluorescent-labeled antibodies and radio-labeled nucleic acid probes derived from renin cDNA were used

  15. Nuclear Cardiology in Acute Coronary Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Paeng, Jin Chul; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2009-06-15

    Nuclear myocardial perfusion imaging is very effective in the evaluation of patients with suspicious acute coronary syndrome (ACS), for adequate diagnosis and treatment. There have been many clinical evidences to support the efficacy and cost-effectiveness. In addition, many authoritative guidelines support the utility of myocardial perfusion imaging in ACS with an appropriate diagnostic protocol. However, with the development of other cardiac imaging modalities, the choice of modality for the diagnosis of suspicious ACS now depends on the availability of each modality in each institute. Newly developed imaging technologies, especially including molecular imaging, are expected to have great potential not only for diagnosis but also for primary, secondary, and tertiary prevention of ACS.

  16. Nuclear Cardiology in Acute Coronary Syndrome

    International Nuclear Information System (INIS)

    Nuclear myocardial perfusion imaging is very effective in the evaluation of patients with suspicious acute coronary syndrome (ACS), for adequate diagnosis and treatment. There have been many clinical evidences to support the efficacy and cost-effectiveness. In addition, many authoritative guidelines support the utility of myocardial perfusion imaging in ACS with an appropriate diagnostic protocol. However, with the development of other cardiac imaging modalities, the choice of modality for the diagnosis of suspicious ACS now depends on the availability of each modality in each institute. Newly developed imaging technologies, especially including molecular imaging, are expected to have great potential not only for diagnosis but also for primary, secondary, and tertiary prevention of ACS

  17. Nuclear cardiology in acute coronary syndromes

    International Nuclear Information System (INIS)

    Acute coronary syndromes are a frequent manifestation of a coronary artery disease, usually being associated with chest pain and presenting as a medical emergency. Since a considerable number of patients with chest pain, however, have a non cardiac etiology of trier pain, properly triaging these patients represents a diagnostic challenge for physicians in the emergency department. As the available diagnostic procedures have limited accuracy, many different diagnostic strategies have been evaluated. Among these, radionuclide myocardial perfusion imaging (MPI) at rest or in combination with stress procedures has been investigated in many trails. MPI has been proven to be useful, especially in a patient population with a low to intermediate probability of an ischemic event. Perfusion scintigraphy has a high sensitivity in the detection of myocardial infarction and reveals an excellent negative predictive value, allowing a safe discharge strategy of patients with a negative scan result. Moreover, it enables risk stratification and provides incremental and independent prognostic information regarding short to long term future cardiac adverse events. Several cost effectiveness studies have shown that perfusion imaging leads to lower overall direct costs, mainly by a reduction of unnecessary hospital admissions and diagnostic angiograms, without worsening of the clinical outcome of these patients. As a possible study endpoint, myocardial perfusion imaging in the acute setting enables the quantification of salvaged myocardium and therefore the evaluation of treatment efficacy. Besides perfusion agents, several infarcts avid radiopharmaceuticals have been developed, which in part show promising results. However, larger randomized trials evaluating these tracers in clinical settings are needed to warrant routine clinical application

  18. A CAMAC system for cardiologic monitoring

    International Nuclear Information System (INIS)

    Standard CAMAC rules and features are summarized and a configuration is described for E.C.G. monitoring in intensive care units. This configuration contains intelligent modules (including microprocessors) for the biomedical signals pre-processing and for the CAMAC control. One of these modules analyses in real time the arrythmias from two different E.C.G. channels. With micro-programmed algorithms each arrhythmia is counted and stored in numerical files which are transmitted via the CAMAC data-way to an autonomous crate controller JCAM-10 linked to an interactive graphic and alphanumeric display unit. (author)

  19. Computer diagnosis in cardiology: Oxidative stress hypothesis

    OpenAIRE

    Ezekiel Uba Nwose; Graham Wilfred Ewing

    2009-01-01

    Background : Virtual scanning is one of the emerging technologies in complementary medicine practice. The diagnostic principle is hinged on perception and ultra weak light emission, while the treatment options associated with it includes diet, flash light, exercise and relaxation. However, a mechanism that links the diagnostic and treatment principles has yet to be elucidated. Aims: The objective here is to further explanation of oxidative stress concept as the biochemical basis of the techno...

  20. Telemonitorizaciones en cardiología

    Directory of Open Access Journals (Sweden)

    Juan C. Chachques

    2008-01-01

    Full Text Available La telemonitorización (home monitoring establece un puente entre el clínico y el paciente por medio de nuevas tecnologías de comunicación. Las aplicaciones actuales de las telemonitorizaciones cardiológicas son: seguimiento continuo de pacientes en insuficiencia cardíaca (medición de frecuencia cardíaca, oximetría, presiones intracardíacas e impedancia pulmonar para diagnosticar edema, monitorización del funcionamiento de marcapasos y desfibriladores, monitorización de tratamientos farmacológicos de la hipertensión pulmonar, seguimiento de pacientes con apnea del sueño, prevención de la muerte súbita infantil y monitorización de pacientes portadores de prótesis valvulares cardíacas. La monitorización telefónica o a través de Internet es simple y no requiere ningún equipo excepcional en los hogares. Nuestro grupo investiga la aplicación de las tecnologías de RADAR en la monitorización cardiológica. La home monitoring tiene el potencial para ser aplicada en grandes poblaciones de pacientes y ser integrada en los sistemas actuales de asistencia médica.El objetivo final es mejorar los resultados de los tratamientos actuales y disminuir los gastos de salud.

  1. The management of conjoined twins: Cardiology assessment.

    Science.gov (United States)

    Andrews, Rachel E; Yates, Robert W M; Sullivan, Ian D

    2015-10-01

    Structural cardiac defects occur in at least 1 twin in about 75% of conjoined twins with thoracic level fusion. Outcomes after surgical separation of thoracic level conjoined twins have been favorable when the hearts have been separate. However, even in this situation, the outlook is poor for an individual twin with an important cardiac defect. Arterial anastomosis between twin circulations is an important additional consideration, with poor outcomes for perfusion recipient twins. Surgical separation is contraindicated when ventricular level cardiac fusion exists. Cardiac assessment is a key component of prenatal counseling. PMID:26382259

  2. Non-invasive methods of investigative cardiology

    International Nuclear Information System (INIS)

    Non-invasive assessment of heart and chamber size employs various techniques which yield different information. Overall size as estimated by biplane chest roentgenogram in the upright or - better - supine position is a valuable quantitative method. Correlation with individual chamber size is, however, only fair. Information on wall thickness can currently be obtained only by ultrasound echocardiography. ECG and vectorcardiography as a means for determining ventricular hypertrophy have remained semi-quantitative techniques, but can probably be developed into more quantitative information by means of computer analysis. A method of predicting left ventricular muscle mass using the Frank orthogonal lead system is described. Regional disorders of contraction and contractility have been difficult to assess non-invasively. Kymographic techniques describe only motion of the lateral wall. Ultrasound techniques, even using a two-dimensional approach, rarely include the ventricular apical region. Systolic time intervals and radionuclide minimal transit times have remained of limited importance. The value of ECG-gated computertomography cannot be assessed as yet. The greatest promise can be expected from radionuclide techniques with gated blood pool scanning and myocardial scintigraphic techniques. (orig.)

  3. Cardiovascular rehabilitation. Results in the cardiology service.

    Directory of Open Access Journals (Sweden)

    Juan José Navarro López

    2004-04-01

    Full Text Available Fundaments: Physical exercise produces changes in almost all the organism systems, the cardiovascular function is the main affected, important changes happen in the central heart bomb and in the outlying vasomotor regulation of the sanguine distribution. It has been demonstrated that the exercise favors modifications in the risk factors that comprises the lipídic patron, the glicemia, the overweight and some described more recently as the fibrinogen and the factors of the clotting. Objective : To analyze and to compare the effects of complex exercises in the patients included in the cardiovascular rehabilitation. Methods : Types study before and after, the total patients (30 included in the program of cardiovascular rehabilitation during 4 months in the Cienfuegos University Hospital ¨Dr. Gustavo Aldereguía Lima¨. Results : Out of the total of patient, 25 are males (83.3%, the diagnoses were: myocardium sharp attack, arterial hypertension with angina, myocardial revascularization and stable angina. In a highly significant way p < 0,0001 double product varied as much at the end of the jogging and the ergometric parameters: the maxim body burden reached, tolerated and the total time of exercise. In a significant way p < 0,001 varied the double product of the ergometric test and the units of the basal metabolism. Conclusions: For the clinical changes, ergometrics and psychological evaluated in those patients we can consider them integrally rehabilitated with this group of exercises.

  4. Monitoring Device Safety in Interventional Cardiology

    OpenAIRE

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

    2006-01-01

    Objective: A variety of postmarketing surveillance strategies to monitor the safety of medical devices have been supported by the U.S. Food and Drug Administration, but there are few systems to automate surveillance. Our objective was to develop a system to perform real-time monitoring of safety data using a variety of process control techniques.

  5. Cardiology needs good planning for the future.

    Science.gov (United States)

    Goodroe, J H; Hicks, K J

    1990-08-01

    In today's health care environment, hospitals have to develop strategies to maintain their market share, especially in cardiac services. The authors share generic strategies in cost leadership, product differentiation and technological leadership that can be adapted and implemented in cardiac centers. PMID:10106882

  6. The pediatric cardiology pharmacopeia: 2013 update.

    Science.gov (United States)

    Severin, Paul Nicholas; Awad, Sawsan; Shields, Beth; Hoffman, Joan; Bonney, William; Cortez, Edmundo; Ganesan, Rani; Patel, Aloka; Barnes, Steve; Barnes, Sean; Al-Anani, Shada; Gupta, Umang; Cheddar, Yolandee Bell; Gonzalez, Ismael E; Mallula, Kiran; Ghawi, Hani; Kazmouz, Suhaib; Gendi, Salwa; Abdulla, Ra-id

    2013-01-01

    The use of medications plays a pivotal role in the management of children with heart diseases. Most children with increased pulmonary blood flow require chronic use of anticongestive heart failure medications until more definitive interventional or surgical procedures are performed. The use of such medications, particularly inotropic agents and diuretics, is even more amplified during the postoperative period. Currently, children are undergoing surgical intervention at an ever younger age with excellent results aided by advanced anesthetic and postoperative care. The most significant of these advanced measures includes invasive and noninvasive monitoring as well as a wide array of pharmacologic agents. This review update provides a medication guide for medical practitioners involved in care of children with heart diseases. PMID:23192622

  7. Concepts in cardiology - a historical perspective

    OpenAIRE

    Savona-Ventura, Charles; Grech, Victor E.

    1999-01-01

    Our current knowledge of the anatomy and physiology of the circulatory system has been reached by deduction and reasoning over several centuries. In this article, the history of these theories is briefly outlined.

  8. Computer diagnosis in cardiology: Oxidative stress hypothesis

    Directory of Open Access Journals (Sweden)

    Ezekiel Uba Nwose

    2009-10-01

    Full Text Available Background: Virtual scanning is one of the emerging technologies in complementary medicine practice. The diagnostic principle is hinged on perception and ultra weak light emission, while the treatment options associated with it includes diet, flash light, exercise and relaxation. However, a mechanism that links the diagnostic and treatment principles has yet to be elucidated. Aims: The objective here is to further explanation of oxidative stress concept as the biochemical basis of the technology. Materials and Methods: Using available literature and basic science textbook, the function of the hypothalamus-pituitary-adrenalin axis as neuro-endocrine physiological system that is strongly linked to the rate of alterations in biochemical processes through to cardiovascular complications is articulated. Results: The hypothesis brings to fore the potential of using the alterations in biochemical processes associated with cognition as tool to validate the Virtual Scanning technology for possible incorporation into clinical practice. Or vice versa to use Virtual Scanning technology to determine the chemiluminescence-related biochemical changes resulting from pathologies that could benefit from relaxation, light therapy, exercise and antioxidant nutrition. Conclusions: This article advances the applicability of cognitive test procedure for indication of the disease(s affecting heart function. The implication for some laboratory indices that are already available in clinical practice is highlighted. Investigation of this hypothesis will help provide clear link between plausible mechanism and the theory proposed.

  9. Computer diagnosis in cardiology: Oxidative stress hypothesis

    Directory of Open Access Journals (Sweden)

    Ezekiel Uba Nwose

    2009-01-01

    Full Text Available Background : Virtual scanning is one of the emerging technologies in complementary medicine practice. The diagnostic principle is hinged on perception and ultra weak light emission, while the treatment options associated with it includes diet, flash light, exercise and relaxation. However, a mechanism that links the diagnostic and treatment principles has yet to be elucidated. Aims: The objective here is to further explanation of oxidative stress concept as the biochemical basis of the technology. Materials and Methods: Using available literature and basic science textbook, the function of the hypothalamus-pituitary-adrenalin axis as neuro-endocrine physiological system that is strongly linked to the rate of alterations in biochemical processes through to cardiovascular complications is articulated. Results: The hypothesis brings to fore the potential of using the alterations in biochemical processes associated with cognition as tool to validate the Virtual Scanning technology for possible incorporation into clinical practice. Or vice versa to use Virtual Scanning technology to determine the chemiluminescence-related biochemical changes resulting from pathologies that could benefit from relaxation, light therapy, exercise and antioxidant nutrition. Conclusions: This article advances the applicability of cognitive test procedure for indication of the disease(s affecting heart function. The implication for some laboratory indices that are already available in clinical practice is highlighted. Investigation of this hypothesis will help provide clear link between plausible mechanism and the theory proposed.

  10. I diretriz de ressuscitação cardiopulmonar e cuidados cardiovasculares de emergência da Sociedade Brasileira de Cardiologia: resumo executivo I guideline for cardiopulmonary resuscitation and emergency cardiovascular care - Brazilian Society of Cardiology: executive summary

    Directory of Open Access Journals (Sweden)

    Maria Margarita Gonzalez

    2013-02-01

    the early recognition and delivery of cardiopulmonary resuscitation maneuvers focused on high-quality thoracic compressions and rapid defibrillation by means of the implementation of public access-to-defibrillation programs. These aspects are of the utmost importance and may make the difference on the patient's outcomes, such as on hospital survival with no permanent neurological damage. Early initiation of the Advanced Cardiology Life Support also plays an essential role by keeping the quality of thoracic compressions; adequate airway management; specific treatment for the different arrest rhythms; defibrillation; and assessment and treatment of the possible causes during all the assistance. More recently, emphasis has been given to post-resuscitation care, with the purpose of reducing mortality by means of early recognition and treatment of the post-cardiac arrest syndrome. Therapeutic hypothermia has provided significant improvement of neurological damage and should be performed in comatose individuals post-cardiac arrest. For physicians working in the emergency department or intensive care unit, it is extremely important to improve the treatment given to these patients by means of specific training, thus giving them the chance of higher success and of better survival rates.

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

    Science.gov (United States)

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

    2014-02-01

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

  12. Alunos de um programa de pós-graduação em cardiologia: são os resultados de quase 30 anos adequados? Alumnos de un programa de postgrado en cardiología: ¿Son los resultados de casi 30 años adecuados? Graduates from a postgraduate program in cardiology: are the results of almost 30 years adequate?

    Directory of Open Access Journals (Sweden)

    Luana Brock

    2010-04-01

    muitas áreas que necessitam de melhoras, ele parece estar contribuindo para melhorar a qualidade profissional e das publicações brasileiras indexadas.FUNDAMENTO: El Postgrado Stricto Sensu en Brasil se implementó en el año 1965 para aumentar la calidad de la enseñanza en las Universidades y preparar a investigadores completos e independientes. La participación brasileña en las publicaciones ISI ha aumentado desde entonces de forma significativa, pero poca información está disponible sobre la calidad de los postgrados. OBJETIVO: Revisar 29 años de programa de postgrado en Cardiología en la Universidad Federal de São Paulo y analizar las características de los alumnos de Maestría y Doctorado con relación al origen, publicaciones y carrera subsiguiente. MÉTODOS: Desarrollamos un cuestionario para evaluar a 168 alumnos de postgrado que produjeron 196 tesis (116 de Maestría y 80 de Doctorado, en el período de 1975-2004 y contactamos el 95,9% de ellos. La informaciones sobre las publicaciones se obtuvieron mediante los banco de datos científicos usuales. RESULTADOS: El 30% de los alumnos de postgrado eran de las regiones Norte-Nordeste-Centro-Oeste y solamente el 50% de ellos retornó a su región de origen. La edad promedio cuando del ingreso en el Postgrado fue de 32,5 años y 34,9 años para alumnos de Maestría y Doctorado, respectivamente; la duración promedio de los programas de postgrado fue respectivamente de 39,0 y 43,2 meses y aproximadamente el 50% de los alumnos hizo el curso de postgrado sin cualquier beca de estudio. La publicación de las tesis durante estos 29 años presentó un promedio del 36,5% para Maestría y el 61,9% para Doctorado, sin embargo, cualesquiera publicaciones posteriores fueron del orden de un 70,2% y un 90,6%, respectivamente. El factor de impacto promedio de la tesis publicada fue de un 1,3 para Maestría y un 3,1 para Doctorado, con un 65,5% y un 87,5% de Qualis A, respectivamente. Actualmente, hay ex-alumnos de

  13. ANUARIO 2012: CARDIOPATÍAS CONGÉNITAS. LAS REVISTAS DE LAS SOCIEDADES NACIONALES PRESENTAN UNA SELECCIÓN DE LAS INVESTIGACIONES QUE HAN IMPULSADO AVANCES RECIENTES EN CARDIOLOGÍA CLÍNICA / Almanac 2012: Congenital Heart Disease. The National Society Journals present selected research that has driven recent advances in Clinical Cardiology

    Directory of Open Access Journals (Sweden)

    Nathalie Dedieu

    2013-01-01

    Full Text Available Resumen Este Anuario destaca trabajos recientes sobre cardiopatías congénitas que han sido publicados en las principales revistas de Cardiología. Se citan más de 100 artículos. Los subtítulos se utilizan para agrupar los trabajos relevantes y permitir que los lectores se concentren en sus temas de interés, pero no pretenden abarcar todos los aspectos de las cardiopatías congénitas./ Abstract This Almanac highlights recent papers on congenital heart disease in the major cardiac journals. Over 100 articles are cited. Subheadings are used to group relevant papers and allow readers to focus on their areas of interest, but are not meant to be comprehensive for all aspects of congenital cardiac disease.

  14. Síndrome metabólica em ambulatório cardiológico Síndrome metabólico en ambulatorio cardiológico Metabolic syndrome in outpatient cardiology clinics

    Directory of Open Access Journals (Sweden)

    José Bonifácio Barbosa

    2010-01-01

    de prevalencia de intervalos de confianza del 95% se estimaron por la regresión de Poisson. RESULTADOS: La prevalencia de SM fue mayor en ambos sexos por el concepto de la IDF (62,3% en hombres y 64,6% en mujeres, con relación al del National Cholesterol Education Program - Adult Treatment Prevention (NCEP ATPIII (48,9% en hombres y 59% en mujeres. Los componentes del SM más prevalentes fueron: hipertensión arterial sistémica - HAS (87,2% y 86%; hipertrigliceridemia (84,4% y 82,5%; circunferencia abdominal alterada (77,8% y 100%; HDL-c bajo (58,1% y 49,9%; y glucemia alterada (59,9% y 51,9%, por los conceptos NCEP ATPIII y IDF, respectivamente. Después del análisis ajustado, edad > 60 años e índice de masa corporal (IMC > 30 se asociaron a un mayor riesgo de SM (p BACKGROUND: In Brazil, the prevalence of the metabolic syndrome (MS is little known in several regions. OBJECTIVE: To analyze the prevalence of MS, its components and the agreement between two diagnostic definitions in a population aged > 13 years. METHODS: Cross-sectional study conducted from June to October 2007 in 719 patients of outpatient cardiology clinics in the city of São Luis, State of Maranhão, Brazil. Blood pressure (BP, weight, height, waist circumference and lipid profile were measured. Risk factors for MS were evaluated according to the International Diabetes Federation (IDF definition. Prevalence ratios and 95% confidence intervals were estimated using Poisson regression. RESULTS: The prevalence of MS was higher in both genders when using IDF definition (62.3% in men and 64.6% in women than when using that of the National Cholesterol Education Program - Adult Treatment Prevention (NCEP ATPIII (48.9% in men and 59% in women. The most prevalent MS components were: hypertension (87.2% and 86%; hypertriglyceridemia (84.4% and 82.5%; increased waist circumference (77.8% and 100%; low HDL-c (58.1% and 49.9%; and high blood glucose (59.9% and 51.9%, using NCEP ATPIII and IDF definitions

  15. The Cardiology Audit and Registration Data Standards (CARDS), European data standards for clinical cardiology practice

    NARCIS (Netherlands)

    M.R. Flynn (Rachel); C. Barrett (Conor); F.G. Cosio (Francisco); A.K. Gitt (Anselm); L.C. Wallentin (Lars); P. Kearney (Peter); M. Lonergan (Moira); E. Shelley (Emer); M.L. Simoons (Maarten)

    2005-01-01

    textabstractAIMS: Systematic registration of data from clinical practice is important for clinical care, local, national and international registries, and audit. Data to be collected for these different purposes should be harmonized. Therefore, during Ireland's Presidency of the European Union (EU)

  16. Effect of healthcare failure mode and effect analysis on prevention of nosocomial infections in department of cardiology%医疗失效模式与效应分析对心内科患者医院感染的预防效果评价

    Institute of Scientific and Technical Information of China (English)

    吴素华; 李芹; 吴艳芳; 刘敏; 孙景仙

    2015-01-01

    OBJECTIVE To explore the effect of healthcare failure mode and effect analysis on prevention of nosoco‐mial infections in patients of department of cardiology so as to reduce the infection rate .METHODS A total of 400 patients who were treated in the department of cardiology from Jan 2012 to Dec 2014 were enrolled in the study and randomly divided into the control group and the experimental group ,with 200 cases in each . The control group was treated with conventional nursing ,while the experimental group was treated with healthcare failure mode and effect analysis on the basis of the conventional nursing ;the incidence of infections was compared be‐tween the two groups of patients ,and the hand hygiene compliance of the nursing staff was observed .RESULTS The incidence of nosocomial infections was 9 .00% in the control group ,5 .50% in the experimental group ,and there was significant difference between the two groups (P< 0 .05) .The rate of hand washing of the nursing staff was 58 .20% in the control group ,significantly lower than 95 .20% in the experimental group ;the rate of correct hand washing of the control group was 62 .89% ,significantly lower than 96 .43% of the experimental group (P<0 .05) .CONCLUSION The application of the healthcare failure mode and effect analysis can remarkably reduce the incidence of infections in the hospitalized patients of department of cardiology and improve the hand hygiene com‐pliance of the nursing staff .%目的:研究医疗失效模式与效应分析对心内科患者医院感染的预防效果,为降低感染率提供参考依据。方法选择2012年1月-2014年12月心内科患者400例,随机分为对照组和试验组,每组各200例,对照组给予常规护理,试验组则在此基础上运用医疗失效模式与效应分析,比较两组患者感染率及护理人员手卫生依从性。结果患者医院感染率对照组为9.00%、试验组为5.50%,两组患者比较差

  17. Consenso de especialistas (SBC/SBHCI sobre o uso de stents farmacológicos: recomendações da sociedade brasileira de cardiologia/sociedade brasileira de hemodinâmica e cardiologia intervencionista ao sistema único de saúde Expert consensus (SBC/SBHCI on the use of drug-eluting stents: recommendations of the Brazilian society of interventional cardiology/ Brazilian society of cardiology for the Brazilian public single healthcare system

    Directory of Open Access Journals (Sweden)

    Valter C. Lima

    2006-10-01

    perform new revascularization procedures and hospital readmissions. The overall success of the drug-eluting stents has proven to be reliable and consistent in overcoming restenosis and has some beneficial impact for all clinical and angiographic conditions. This paper discusses the adoption and criteria for the use of drug-eluting stents in other countries as well as the recommendations established by the Brazilian Society of Interventional Cardiology for their reimbursement by SUS. The incorporation of new healthcare technology involves two distinct stages. During the first stage, the product is registered with the National Health Surveillance Agency (ANVISA. During this stage the interested company submits to the regulatory agency, results from clinical studies that demonstrate the efficacy and safety of the new device or pharmaceutical product. Frequently, in addition to clinical studies, approval records for clinical use from the regulatory agencies of other countries, mainly the United States of America and the European Community are also submitted. The successful completion of this stage means that the medication or device may be prescribed or used by the physicians in Brazil. The second stage in the incorporation of new healthcare technology involves the reimbursement or financing of the treatment that was approved in the previous stage based on its efficacy and safety. This stage can be more complex than the first one since the new technology, whether a substitution for established treatment methods or the introduction of a new treatment concept, are usually more expensive. The incorporation of new technology requires a cost-effectiveness analysis so that fund administrators can make decisions based on the universal scenario of limited resources to finance healthcare with treatments that are more and more burdensome. The difficulties of funding management are aggravated by medical and social ethical implications that arise when a treatment is approved based on its

  18. Common usage of cardiologic anatomical terminology: critical analysis and a trilingual discussion proposal Uso comum da terminologia anatômica cardiológica: análise crítica e proposta de discussão trilingue

    Directory of Open Access Journals (Sweden)

    Alexandre Lins Werneck

    2009-09-01

    Full Text Available BACKGROUND: 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. OBJECTIVE: To design and produce a multilingual terminological dictionary (Latim-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. METHODS: 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. RESULTS: 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. CONCLUSIONS: The

  19. Prognóstico da esclerose valvar aórtica na mortalidade cardíaca de pacientes atendidos no instituto de cardiologia do Rio Grande do Sul Prognosis of aortic valve sclerosis in cardiovascular mortality of patients seen at the cardiology institute of Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Eduardo Maffini da Rosa

    2007-02-01

    Full Text Available OBJETIVO: Avaliar o efeito prognóstico da esclerose valvular aórtica na mortalidade e morte de causa cardíaca de pacientes atendidos no Instituto de Cardiologia do Rio Grande do Sul nos anos de 1996 a 2000. MÉTODOS: Estudo de coorte histórico que utilizou informações contidas nos bancos de dados do laboratório de ecocardiografia do Hospital de Cardiologia e nos Registros de Óbitos da Secretária da Saúde do Rio Grande do Sul. O período de avaliação foi de 1996 a 2000. Os desfechos foram morte e morte de causa cardíaca. RESULTADOS: Foram analisados 8.585 casos, dos quais 2.154 (25% eram portadores de esclerose valvular aórtica. O tempo de seguimento médio foi de 41±6 meses, e a ocorrência de morte e morte cardíaca foram respectivamente, de 299 (3,5% e 95 (1,1%. O grupo de pacientes com esclerose valvular aórtica apresentou mais miocardiopatia segmentar, disfunção ventricular, aumento ventricular e hipertrofia ventricular, e não apresentou, entretanto, maior risco de morte ou morte de causa cardíaca quando feita análise de multivariança. CONCLUSÃO: A presença de esclerose valvular aórtica não aumentou o risco de morte e de morte de causa cardíaca na população estudada.OBJECTIVE: To evaluate the prognostic effect of aortic valve sclerosis on all-cause and cardiovascular mortality of patients seen at the Cardiology Institute of the Brazilian state of Rio Grande do Sul from 1996 to 2000. METHODS: A historical cohort study using information from both the database of the Echocardiography Laboratory of the Cardiology Hospital and the Death Registry of Rio Grande do Sul Health Department. The evaluation was carried out from 1996 to 2000. Study endpoints were all-cause and cardiovascular mortality. RESULTS: A total of 8585 patients were analyzed, 2154 (25% of whom had aortic valve sclerosis. Mean follow-up was 41±6 months, and all-cause and cardiovascular deaths were 299 (3.5% and 95 (1.1%, respectively. The group of

  20. ANUARIO 2012: LA TERAPIA CELULAR EN LA ENFERMEDAD CARDIOVASCULAR. LAS REVISTAS DE LAS SOCIEDADES NACIONALES PRESENTAN UNA SELECCIÓN DE LAS INVESTIGACIONES QUE HAN IMPULSADO AVANCES RECIENTES EN CARDIOLOGÍA CLÍNICA / Almanac 2012: Cell Therapy in Cardiovascular Disease. The National Society Journals present selected research that has driven recent advances in Clinical Cardiology

    Directory of Open Access Journals (Sweden)

    Anthony Mathur

    2013-01-01

    Full Text Available Resumen La rápida puesta en práctica de la investigación de transferencia que se ha visto en la aplicación de la medicina regenerativa a la cardiología ha dado lugar a interesantes avances en nuestra comprensión de algunos de los mecanismos fundamentales relacionados con la biología humana. La primera generación de células utilizadas en ensayos fase I-II (principalmente células mononucleares de la médula ósea, están entrando ahora en la fase III de los ensayos clínicos, con el objetivo de producir una estrategia terapéutica basada en células que puedan cambiar el pronóstico de la enfermedad cardíaca. La primera generación de terapia celular parece haber abordado las preocupaciones de seguridad, y mostró "actividad" en numerosos meta-análisis publicados. Con los conocimientos adquiridos hasta el momento, esta disciplina se está moviendo hacia la próxima generación de células -las células modificadas-, que se han desarrollado para mostrar un fenotipo que mejorará aún más el proceso de reparación/rescate del miocardio. Este anuario cubre las últimas investigaciones básicas que pueden tener aplicación en los seres humanos próximamente, así como los resultados de los últimos ensayos clínicos. / Abstract The rapid translation from bench to bedside that has been seen in the application of regenerative medicine to cardiology has led to exciting new advances in our understanding of some of the fundamental mecha-nisms related to human biology. The first generation of cells used in phase I-II trials (mainly bone marrow mononuclear cells are now entering phase III clinical trials with the goal of producing a cell based therapeutic that can change the outcome of cardiac disease. First generation cell therapy appears to have addressed safety concerns as well as showing ´activity´ in numerous published meta-analyses. With the know-ledge gained to date, the field is moving towards the next generation of cells-the

  1. 舒适护理改善心内科住院患者负性情绪和心理障碍的效果研究%The study of the effect of comfortable nursing to improve negativity mood and mental barrier of the cardiology hospitalized patients

    Institute of Scientific and Technical Information of China (English)

    夏冰

    2012-01-01

      目的:探讨心理舒适护理改善心内科住院患者负性情绪和心理障碍的效果,为临床康复护理提供依据.方法:按抛硬币分组法将60例心内科住院患者随机分为研究组和对照组各30例.两组均给予常规药物治疗,对照组按普通护理,研究组在此基础上则给予以健康教育、音乐疗法以及亲情照护为干预措施的心理舒适护理.分别于入院时和出院时,采用焦虑自评量表( SAS)、抑郁自评量表( SDS)和症状自评量表(SCL-90)评价两组的情绪和心理状况.结果:入院时,两组SAS、SDS和SCL-90评分无显著性差异(P>0.05);出院时,研究组 SAS、SDS和SCL-90评分明显低于对照组(P0.05),when they left hospital,the grade of SAS,SDS and SCL-90 in study groups was lower than that in control group(P<0.01).Conclusion:Psy-chological comfortable nursing could improve negativity mood and mental barrier of the cardiology hospitalized patients ,it was conducive to promote patient's treatment and rehabilitation.

  2. RESULTADOS DE LA VALVULOPLASTIA MITRAL PERCUTÁNEA. EXPERIENCIA EN EL INSTITUTO DE CARDIOLOGÍA Y CIRUGÍA CARDIOVASCULAR DE CUBA (1998-2004 / Results of percutaneous mitral valvuloplasty. Experiences at the Cardiology and Cardiovascular Surgery Institute in Cuba (1998-2004

    Directory of Open Access Journals (Sweden)

    Raymid García Fernández

    2010-03-01

    Full Text Available Antecedents and Objectives: The percutaneous mitral valvuloplasty is the procedure of choice in patients with mitral stenosis and an adequate valvular anatomy. The cases treated in Cuba were few until 1998, and the first ones were carried out by foreign medical professionals. This article aims at showing the results of the development of this technique in Cuba. Method: A total of 110 consecutive percutaneous mitral valvuloplasties were carried out in 107 patients (three of them were repeated due to restenosis at the Cuban Cardiology and Cardiovascular Surgery Institute, between June 17th 1998 and June 30th 2004 (106 using the Inoue method and 4 by Multi-track. The average evolution time was 24.6 months (72 maximum and 1,93 minimum. Results: Before the procedure, 94.54 percent of the patients were within the functional classification III and IV of the NYHA; after the procedure 96,36 percent were within functional classification I and II. Using the Wilkins score ≤ 8, average areas of 2,18 cm2 were obtained; and between 9 and 12, areas of 1,81 cm2. The initial success of the procedure was 96,36 percent, and without complications 92,72 percent. Mortality was 0,9 percent, survival 100 percent, and 91,74 percent of the patients were free from complications. As an adverse event in the follow-up it was determined a mitral reestenosis in 5 patients (4,54 %. The average stay in hospital was of 1,36 days. The savings concerning hospitalization was of $ 4136775.39. Conclusions: Percutaneous mitral valvuloplasty is a safe and effective method in patients with mitral stenosis; its results remain in the sort, medium or long run.

  3. The Different Nursing Models of Care Elderly Patients in Department of Cardiology for Improving the Quality Sleep Effect%探讨不同护理模式对于改善老年心内科患者的睡眠质量的效果

    Institute of Scientific and Technical Information of China (English)

    苗洁; 郭丽梅

    2014-01-01

    目的:探讨不同的护理模式在改善心内科老年患者睡眠质量的效果。方法:随机选取本院心内科的老年患者200例,按照随机抽样法将其分为两组,每组100例。对照组进行常规护理和睡眠健康教育;试验组在常规内科护理基础上根据其具体情况有针对性的采取适当的护理模式进行护理,这些护理模式可包括以下措施:心理护理、行为习惯指导、药物使用指导、合理的作息时间安排、良好的环境等。比较两组患者在接受护理的不同阶段内睡眠质量和匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分。结果:入院时,两组PSQI评分0.05). The rate of PSQI<7 of the experiment group were significantly higher than the control group(P<0.05)after 1 week and 2 weeks,and the difference between the two groups were statistically significant(P<0.05). Conclusion:The specific circumstances of nursing in department of cardiology for elderly patients with insomnia,can obviously improve the quality of sleep,is conducive to the support of patients with disease resistance,early rehabilitation.

  4. Rationale and design of the Multidisciplinary Approach to Novel Therapies in Cardiology Oncology Research Trial (MANTICORE 101 - Breast): a randomized, placebo-controlled trial to determine if conventional heart failure pharmacotherapy can prevent trastuzumab-mediated left ventricular remodeling among patients with HER2+ early breast cancer using cardiac MRI

    International Nuclear Information System (INIS)

    MANTICORE 101 - Breast (Multidisciplinary Approach to Novel Therapies in Cardiology Oncology Research) is a randomized trial to determine if conventional heart failure pharmacotherapy (angiotensin converting enzyme inhibitor or beta-blocker) can prevent trastuzumab-mediated left ventricular remodeling, measured with cardiac MRI, among patients with HER2+ early breast cancer. One hundred and fifty-nine patients with histologically confirmed HER2+ breast cancer will be enrolled in a parallel 3-arm, randomized, placebo controlled, double-blind design. After baseline assessments, participants will be randomized in a 1:1:1 ratio to an angiotensin-converting enzyme inhibitor (perindopril), beta-blocker (bisoprolol), or placebo. Participants will receive drug or placebo for 1 year beginning 7 days before trastuzumab therapy. Dosages for all groups will be systematically up-titrated, as tolerated, at 1 week intervals for a total of 3 weeks. The primary objective of this randomized clinical trial is to determine if conventional heart failure pharmacotherapy can prevent trastuzumab-mediated left ventricular remodeling among patients with HER2+ early breast cancer, as measured by 12 month change in left ventricular end-diastolic volume using cardiac MRI. Secondary objectives include 1) determine the evolution of left ventricular remodeling on cardiac MRI in patients with HER2+ early breast cancer, 2) understand the mechanism of trastuzumab mediated cardiac toxicity by assessing for the presence of myocardial injury and apoptosis on serum biomarkers and cardiac MRI, and 3) correlate cardiac biomarkers of myocyte injury and extra-cellular matrix remodeling with left ventricular remodeling on cardiac MRI in patients with HER2+ early breast cancer. Cardiac toxicity as a result of cancer therapies is now recognized as a significant health problem of increasing prevalence. To our knowledge, MANTICORE will be the first randomized trial testing proven heart failure pharmacotherapy in

  5. Rationale and design of the Multidisciplinary Approach to Novel Therapies in Cardiology Oncology Research Trial (MANTICORE 101 - Breast: a randomized, placebo-controlled trial to determine if conventional heart failure pharmacotherapy can prevent trastuzumab-mediated left ventricular remodeling among patients with HER2+ early breast cancer using cardiac MRI

    Directory of Open Access Journals (Sweden)

    Ezekowitz Justin

    2011-07-01

    Full Text Available Abstract Background MANTICORE 101 - Breast (Multidisciplinary Approach to Novel Therapies in Cardiology Oncology Research is a randomized trial to determine if conventional heart failure pharmacotherapy (angiotensin converting enzyme inhibitor or beta-blocker can prevent trastuzumab-mediated left ventricular remodeling, measured with cardiac MRI, among patients with HER2+ early breast cancer. Methods/Design One hundred and fifty-nine patients with histologically confirmed HER2+ breast cancer will be enrolled in a parallel 3-arm, randomized, placebo controlled, double-blind design. After baseline assessments, participants will be randomized in a 1:1:1 ratio to an angiotensin-converting enzyme inhibitor (perindopril, beta-blocker (bisoprolol, or placebo. Participants will receive drug or placebo for 1 year beginning 7 days before trastuzumab therapy. Dosages for all groups will be systematically up-titrated, as tolerated, at 1 week intervals for a total of 3 weeks. The primary objective of this randomized clinical trial is to determine if conventional heart failure pharmacotherapy can prevent trastuzumab-mediated left ventricular remodeling among patients with HER2+ early breast cancer, as measured by 12 month change in left ventricular end-diastolic volume using cardiac MRI. Secondary objectives include 1 determine the evolution of left ventricular remodeling on cardiac MRI in patients with HER2+ early breast cancer, 2 understand the mechanism of trastuzumab mediated cardiac toxicity by assessing for the presence of myocardial injury and apoptosis on serum biomarkers and cardiac MRI, and 3 correlate cardiac biomarkers of myocyte injury and extra-cellular matrix remodeling with left ventricular remodeling on cardiac MRI in patients with HER2+ early breast cancer. Discussion Cardiac toxicity as a result of cancer therapies is now recognized as a significant health problem of increasing prevalence. To our knowledge, MANTICORE will be the first

  6. Frecuencia y factores de riesgo asociados a desnutrición de niños con cardiopatía congénita Frequency and risk factors associated with malnutrition among children with congenital heart disease in a cardiology hospital

    Directory of Open Access Journals (Sweden)

    Miguel Angel Villasís-Keever

    2001-08-01

    Full Text Available Objetivo. Determinar la frecuencia y factores asociados a desnutrición en niños con cardiopatía congénita (CC. Material y métodos. Estudio transversal analítico, hecho entre agosto de 1997 y mayo de 1998, en el servicio de cardiopatías congénitas del hospital de Cardiología del Centro Médico Nacional Siglo XXI, del Instituto Mexicano del Seguro Social de la Ciudad de México, México, a 244 menores de 17 años, de ambos sexos, con diagnóstico de CC y sin otras malformaciones. El estado de nutrición se evaluó mediante los índices peso/edad (P/E, talla/edad (T/E y peso/talla (P/T, y se definió desnutrición con puntuaciones Z mayores a -2. Se consideraron factores de riesgo: edad, sexo, antecedentes perinatales, historia de alimentación, administración de suplementos nutricios, estado socioeconómico y funcionalidad y composición de la familia. Se formaron cuatro grupos de CC: acianógenas con flujo pulmonar aumentado (AFPA o con flujo pulmonar normal (AFPN; cianógenas con flujo pulmonar aumentado (CFPA o disminuido (CFPD. Análisis estadístico: ji cudrada, U-Mann Whitney, Kruskal-Wallis. Se aplicó regresión logística para el control de las variables de confusión y se calculó razón de momios (RM e intervalos de confianza al 95% (IC 95%. Resultados. El grupo de AFPA (62.7% fue el más frecuente, seguido por CFPD (15.6%, AFPN (11.5% y CFPA (10.2%; con P/E, 40.9% tuvieron desnutrición; con T/E, 24.6%; y con P/T, 31.1%. Los grupos más afectados fueron los lactantes y los ninos con CFPA. Los factores asociados a desnutrición fueron: presencia de cardiopatía cianógena (RM 2.54; IC 95% 0.98-6.58 y la falta de administración de algún complemento nutricio (RM 2.38; IC 95% 1.06-5.34. Entre mayor número de miembros en una familia (RM 1.42; IC 95% 0.99-2.05 mayor frecuencia de desnutrición; a mayor edad menor riesgo de desnutrición (RM 0.92; IC 95% 0.89-0.96. Conclusiones. La desnutrición en niños con CC es frecuente; es

  7. Friedreich's Ataxia: a review from a cardiology perspective.

    LENUS (Irish Health Repository)

    Bourke, T

    2011-12-01

    Neuromuscular disorders are not among the common causes of cardiomyopathy in the general population; however, cardiomyopathy is known to occur in several neuromuscular disorders including Friedreich\\'s Ataxia (FA). In patients with neuromuscular disorders, concomitant cardiac involvement contributes significantly to morbidity and mortality and often leads to premature death.

  8. Multi-electrode array technologies for neuroscience and cardiology

    Science.gov (United States)

    Spira, Micha E.; Hai, Aviad

    2013-02-01

    At present, the prime methodology for studying neuronal circuit-connectivity, physiology and pathology under in vitro or in vivo conditions is by using substrate-integrated microelectrode arrays. Although this methodology permits simultaneous, cell-non-invasive, long-term recordings of extracellular field potentials generated by action potentials, it is 'blind' to subthreshold synaptic potentials generated by single cells. On the other hand, intracellular recordings of the full electrophysiological repertoire (subthreshold synaptic potentials, membrane oscillations and action potentials) are, at present, obtained only by sharp or patch microelectrodes. These, however, are limited to single cells at a time and for short durations. Recently a number of laboratories began to merge the advantages of extracellular microelectrode arrays and intracellular microelectrodes. This Review describes the novel approaches, identifying their strengths and limitations from the point of view of the end users -- with the intention to help steer the bioengineering efforts towards the needs of brain-circuit research.

  9. Patient dose optimisation in cardiology during fluoroscopy examinations

    International Nuclear Information System (INIS)

    Data from 1200 cardiac examinations recorded during the past ten months have been analysed. The DAP's obtained for most of the examinations are comparable to the published data. Moreover, an excellent correlation has been found between the high DAP value and the experience of the operator. DAP measurements for 'high dose examinations' are becoming mandatory in several countries, and medical physicists should help the physicians to interpret these measurements in order to improve the safety of the ionising radiation use. In our Centre it appeared that for their first examinations physicians should be more closely guided by seniors. (author)

  10. Proposed application of lower body negative pressure to cardiology

    Science.gov (United States)

    Schmidt, E. V.; Debusk, R. F.; Popp, R. L.

    1975-01-01

    Potential medical applications are presented of lower body negative pressure to the evaluation and treatment of cardiac patients. The essential features of an LBNP unit and the basic cardiovascular physiology of lower body negative pressure (LBNP) testing are described. Some of the results of previous spaceflight experiences and bedrest studies are summarized. The deconditioning effects of weightlessness experienced by orbiting astronauts are compared with the effects of bedrest restrictions prescribed for convalescing cardiac patients. The potential of LBNP for evaluating both pharmacological and physical activity regimens was examined, particularly in relation to post-myocardial infarction and coronary artery bypass patients. Applications of LBNP to the cardiac catheterization laboratory and the out-patient follow-up of cardiac patients are proposed.

  11. Value of nuclear magnetic resonance imaging in cardiology

    International Nuclear Information System (INIS)

    The present study summarizes an experience with Magnetic Resonance Imaging (MRI) in the evaluation of twelve patients with a variety of cardiac abnormalities (myocardial infarction, mural thrombi, obstructive cardiomyopathy, pericarditis). The results are compared with clinical data, with measurements from other techniques such as two-dimensional echocardiography and with the images in normal subjects. An anticipated advantage of MRI is the ability to provide better tissue characterization, than has been attained with other imaging techniques, by relaxation time measurement

  12. Cardiospecific troponins in non-ischemic cardiological pathologies

    Directory of Open Access Journals (Sweden)

    Giuseppe Lippi

    2006-10-01

    Full Text Available Cardiospecific troponin T (TnT and I (TnI are low-molecularweight proteins that form part of the troponin complex and are integral components of the myofibrillar contractile apparatus of the heart. Loss of integrity of cardiac myocyte membranes causes release of cardiac troponins into the circulation, which can be detected by highly sensitive assays for cTnT and cTnI developed to the stat diagnosis of acute coronary syndrome. Regardless of preanalytical and analytical sources (incorrect collection or handling of the specimen, malfunctioning of the analyzer, heterophilic antibodies, a diagnostic troponin value is expression of myocardial damage, though it does not provide definitive clue on the nature of such an increment. In fact, increases in serum cardiac troponins also occur in the absence of cardiac ischemia and may sometimes led to an inappropriate or unjustified clinical decision making. Abnormal troponin values in plasma are frequently observed in various clinical contexts independent from the acute coronary disease, like myocarditis, pulmonary embolism, acute heart failure, septic shock, and as a result of cardiotoxic drugs as well as after therapeutic procedures like coronary angioplasty, electrophysiological ablations, or electrical cardioversion. Awareness of this issue is essential to either prevent unjustified alarmism or underestimation of clinical situations that may finally compromise the patient’s health.

  13. RUSSIAN CLINICAL TRAILS IN CARDIOLOGY. YESTERDAY, TODAY AND TOMORROW

    OpenAIRE

    S. A. Shalnova; S. Y. Martsevich

    2016-01-01

    The organization of randomized clinical trials (RCTs) in accordance to the principles of Good Clinical Practice (GCP) is presented. The situation with RCTs in Russia and worldwide is also considered. Issues that must be addressed to improve a quality of the RCTs are reviewed. Information about Russian clinical and epidemiological studies structured for this purpose. The CONSORT (Consolidated Standards of Reporting Trials) Statement was designed to improve the quality of reporting the results ...

  14. Copeptin for risk stratification in acute illness: beyond cardiological problems

    Directory of Open Access Journals (Sweden)

    Roberto Cemin

    2013-10-01

    Full Text Available Copeptin (Cop has been recently proposed as a reliable marker for the diagnosis of acute coronary syndrome, altough its concentration was found to increase in a variety of other severe clinical conditions. The aim of the present study was to assess the utility of Cop to identify high-risk patients in the emergency room (ER. Eighty-five patients admitted to ER of the San Maurizio Regional Hospital of Bolzano between February to March 2010 with epigastric or chest pain and/or discomfort were included in the study. Blood was drawn at admission and sampled for Cop in standard laboratory tests. Cop levels were significantly higher in patients who died at the hospital or shortly afterwards as compared with survivors (median 61 vs 40.6 pmol/L; P=0.014. Cop levels were also higher in patients with severe health problems (62.9 vs 28.3 pmol/L; P<0.0001. The area under the receiver-operating characteristic curve of Cop was 0.70 for in-hospital death [95% confidence interval (CI 0.53-0.86], 0.74 for acute and subacute death (95% CI 0.61-0.87 and 0.90 for prediction of severe acute illness (95% CI 0.84-0.97. Accordingly, a Cop level >33.1 pmol/L correctly identified in-hospital death with 71% sensitivity and 74% specificity. A Cop level >13.6 pmol/L was instead associated with 89% sensitivity and 80% specificity for identifying patients with acute and severe conditions. The results of our analysis would suggest that the use of Cop may be a valuable aid in the ER for identifying patients with life-threatening conditions.

  15. Electronic medical record in cardiology: a 10-year Italian experience

    Directory of Open Access Journals (Sweden)

    Clara Carpeggiani

    2015-08-01

    Full Text Available SummaryObjectives:the aim of this study was to report a ten years experience in the electronic medical record (EMR use. An estimated 80% of healthcare transactions are still paper-based.Methods:an EMR system was built at the end of 1998 in an Italian tertiary care center to achieve total integration among different human and instrumental sources, eliminating paper-based medical records. Physicians and nurses who used EMR system reported their opinions. In particular the hospital activity supported electronically, regarding 4,911 adult patients hospitalized in the 2004- 2008 period, was examined.Results:the final EMR product integrated multimedia document (text, images, signals. EMR presented for the most part advantages and was well adopted by the personnel. Appropriateness evaluation was also possible for some procedures. Some disadvantages were encountered, such as start-up costs, long time required to learn how to use the tool, little to no standardization between systems and the EMR technology.Conclusion:the EMR is a strategic goal for clinical system integration to allow a better health care quality. The advantages of the EMR overcome the disadvantages, yielding a positive return on investment to health care organization.

  16. Electronic medical record in cardiology: a 10-year Italian experience

    OpenAIRE

    Clara Carpeggiani; Alberto Macerata; Maria Aurora Morales

    2015-01-01

    SummaryObjectives:the aim of this study was to report a ten years experience in the electronic medical record (EMR) use. An estimated 80% of healthcare transactions are still paper-based.Methods:an EMR system was built at the end of 1998 in an Italian tertiary care center to achieve total integration among different human and instrumental sources, eliminating paper-based medical records. Physicians and nurses who used EMR system reported their opinions. In particular the hospital activity sup...

  17. Guidelines for radiation safety in interventional cardiology (JCS 2006)

    International Nuclear Information System (INIS)

    The guidelines are made for physicians in cardiovascular field who may be unfamiliar to radiation safety, to understand and know it easily. The introductory chapter describes the basic knowledge for management of radiation exposure and clinical feature of radiation-induced dermal damages like classification, clinical progress and case presentation. Following chapter is itemized, explained in a style of Q and A, and contains sections of; the fundamental knowledge's of radiation exposure management and of radiation skin damage, informed consent and measures for excessive exposure and skin damage crisis, factors influencing the exposure dose, contrivances to reduce the dose in patients, additional factors affecting the crisis of skin damage, contrivances to reduce the dose in medical personnel exposure, management of imaging instruments, methods to measure the exposure dose in patients, intervention in vessels other than the coronary artery, electro-physiological examinations and treatments, nuclear medical diagnoses, CT examinations, diagnosis and treatment of pregnant women, and present states in other countries. (T.I.)

  18. Comparison of two angiographic systems in paediatric interventional cardiology

    International Nuclear Information System (INIS)

    The aim of this work was to analyse the radiation dose for patients and staff between X-ray systems, a new biplane with flat-panel detectors (FDs) and a conventional system equipped with image intensifier (II). Entrance surface air kerma (ESAK) and scatter doses were measured on polymethyl methacrylate (PMMA) phantoms of different thicknesses (from 4 to 16 cm). The ESAK values for the different acquisition modes and PMMA thicknesses were higher for the II in comparison with FDs. For the II, the scatter dose rates ranged from 0.67 to 12.2 mSv h-1 at the eye position of the cardiologist during fluoroscopy and cine modes. At the lower extremities, these values were 1.11 and 24.24 mSv h-1 . In the case of the FDs, these values ranged from 0.24 to 0.67 mSv h-1 for eye lens and from 0.73 to 2.01 mSv h-1 for the position of cardiologist's ankle. The newly installed X-ray system showed an average reduction factor of up to 9.7 times for ESAK values. For the staff with an average reduction factor of 15.9 times at the eye position during fluoroscopy and cine modes, no protective tools are used. At the lower extremities, this value was 7.6 times. (authors)

  19. Analysis of occupational doses in interventional radiology and cardiology installations

    International Nuclear Information System (INIS)

    The relationship between patient dose (PD) and occupational dose (OD) is not easily predictable in interventional radiology installations due to a large number of factors which can modify the occupational risk (OR). In the present work an analysis is made of the four main aspects which influence OR, namely, x-ray beam used, radiation protection (RP) tools available (aprons, thyroid protectors, gloves, screens, etc) and their regular use, type and number of procedures performed (diagnostic or therapeutic, complexity level, etc), and RP training level of the specialists. High filtration x-ray beams can entail a decrease of 20% in OD. A regular use of ceiling mounted faceplates can involve dose savings up to 65%. Mean values of dose per procedure for interventional radiologists are something greater (about 15%) than those recorded for cardiologists, except for the dosimeters placed on left forearm and shoulder. The ratio between OD and PD range around 100 μSv/1,000 cGy.cm2. The influence of the staff RP training level on OD is difficult to assess. In the IC Service from the Madrid San Carlos University Hospital (SCUH), PD have been reduced in above 30% and OD in a factor of 3, after running some training programmes. (author)

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

    Science.gov (United States)

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

    1984-01-01

    This article describes the transformation of the gamma-camera images into digital form. The incidence of a gamma photon on the detector, produces two voltage pulses, which are proportional to the coordinates of the incidence points, and a digital pulse, indicative of the occurrence of the event. The coordinate pulses passes through a analog-digital converter, that is activated by the pulse. The result is the appearance of a digital number at the out-put of the converter, which is proportional to the voltage at its in-put. This number, is stored on the accumulation memory of the system, either on a list mode or on a matrix mode. Static images can be stored on a single matrix. Dynamic data can be stored on a series of matrixes, each representing a different period of acquisition. It is also possible to capture information on a series of matrixes syncronized with the electrocardiogram of the patient. In this instance, each matrix represents a distinct period of the cardiac cycle. Data stored on the memory, can be used to process and display images and quantitative histograms on a video screen. In order to do that, it is necessary to translate the digital data on the memory to voltage levels, and to transform these on light levels on the screen. This, is achieved through a digital analog converter. The reading of the digital memory must be syncronic with the electronic scanning of the video screen. PMID:6466002

  1. PHARMACOGENETIC TESTING OPPORTUNITIES IN CARDIOLOGY BASED ON EXOME SEQUENCING

    Directory of Open Access Journals (Sweden)

    N. V. Shcherbakova

    2015-09-01

    Full Text Available Aim. To study what cardiac drugs currently have any comments on biomarkers and what information can be obtained by pharmacogenetic testing using data exome sequencing in patients with cardiac diseases.Material and methods. Exome sequencing in random participant of the ATEROGEN IVANOVO study and bioinformatics analysis of the data were performed. Point mutations were annotated using ANNOVAR program, as well as comparison with a number of specialized databases was done on the basis of user protocols.Results. 11 cardiac drugs and 7 genes which variants can influence cardiac drug metabolism were analyzed. According to exome sequencing of the participant we did not reveal allelic variants that require dose regime correction and careful efficacy control.Conclusion. The exome sequencing application is the next step to a wide range of personalized therapy. Future opportunities for improvement of the risk-benefit ratio in each patient are the main purpose of the collection and analysis of pharmacogenetic data.

  2. Design and implementation of an intravascular brachytherapy installation in cardiology

    International Nuclear Information System (INIS)

    Intravascular Brachytherapy (IVB) is a very promising technique for reducing restenosis rates. However, neither the exact absolute dose needed nor the optimal spatial and temporal distribution of dose inside the vessel wall for a successful treatment, nor the physical dosimetry of the various radioactive sources and devices for dose delivery, are well known. In this paper, an overview will be given of the design strategy, the dosimetric and radiation protection-related problems that we have met during the implementation of this technique at San Carlos hospital, adopted or foreseen solutions, and future research fields that we intend to carry out in order to reduce uncertainties and to achieve a deeper knowledge of the parameters that have an influence on the treatment. (author)

  3. The Two Channels Complex Bioimpedance Signals in Cardiology

    Czech Academy of Sciences Publication Activity Database

    Halámek, Josef; Vondra, Vlastimil; Jurák, Pavel; Verner, Petr

    Brno: University of Technology, 2006, s. 137-139. ISBN 80-214-3152-0. ISSN 1211-412X. [BIOSIGNAL 2006 /18./. Brno (CZ), 28.06.2006-30.06.2006] R&D Projects: GA ČR GA102/06/0136 Institutional research plan: CEZ:AV0Z20650511 Keywords : bioimpedance * compex signal Subject RIV: FS - Medical Facilities ; Equipment

  4. Comparison of two angiographic systems in paediatric interventional cardiology.

    Science.gov (United States)

    Ubeda, C; Vano, E; Miranda, P; Aguirre, D; Riquelme, N; Guarda, E

    2015-07-01

    The aim of this work was to analyse the radiation dose for patients and staff between X-ray systems, a new biplane with flat-panel detectors (FDs) and a conventional system equipped with image intensifier (II). Entrance surface air kerma (ESAK) and scatter doses were measured on polymethyl methacrylate (PMMA) phantoms of different thicknesses (from 4 to 16 cm). The ESAK values for the different acquisition modes and PMMA thicknesses were higher for the II in comparison with FDs. For the II, the scatter dose rates ranged from 0.67 to 12.2 mSv h(-1) at the eye position of the cardiologist during fluoroscopy and cine modes. At the lower extremities, these values were 1.11 and 24.24 mSv h(-1). In the case of the FDs, these values ranged from 0.24 to 0.67 mSv h(-1) for eye lens and from 0.73 to 2.01 mSv h(-1) for the position of cardiologist's ankle. The newly installed X-ray system showed an average reduction factor of up to 9.7 times for ESAK values. For the staff with an average reduction factor of 15.9 times at the eye position during fluoroscopy and cine modes, no protective tools are used. At the lower extremities, this value was 7.6 times. PMID:25843951

  5. MICROCIRCULATORY ISCHEMIA AND STATINS: LESSONS OF INTERVENTION CARDIOLOGY

    Directory of Open Access Journals (Sweden)

    An. A. Alexandrov

    2015-12-01

    Full Text Available Review is devoted to the pathogenesis of microcirculatory ischemia. Microcirculatory dysfunction has been identified in different groups of patients including syndrome X, diabetes mellitus 2 type, coronary heart disease. In coronary patients after transluminal angioplasty microcirculatory dysfunction is the reason of phenomenon of “non-reflow”. In result the procedure of revascularization is less effective. Therapy by statins can be beneficial for patients with microcirculatory ischemia.

  6. Steps Towards Quantification of the Cardiological Stress Exam

    OpenAIRE

    Chabiniok, Radomir; Chabiniok, R.; Sammut, E.; Sammut, Eva; Hadjicharalambous, M; Hadjicharalambous, Myrianthi; Asner, L; Asner, Liya; Nordsletten, D.; Nordsletten, David; Razavi, Reza; RAZAVI, R.; Smith, Nicolas; Smith, N.

    2015-01-01

    In this work we aim to advance the translation of model-based myocardial contractility estimation to the clinical problem of quantitative assessment of the dobutamine stress exam. In particular, we address the question of limited spatial resolution of the observations obtained from cine MRI during the stress test, in which typically only a small number of cine MRI slices are acquired. Due to the relative risk during the dobutamine infusion, a safe acquisition protocol with a healthy volunteer...

  7. Bases da terapia celular em cardiologia Cell therapy in cardiology

    Directory of Open Access Journals (Sweden)

    Antonio Carlos C. Carvalho

    2009-05-01

    Full Text Available O implante de células para o tratamento de doenças cardiovasculares encontra-se sob investigação em vários centros no mundo. Várias linhagens celulares, de células-tronco bem caracterizadas a frações contendo diferentes tipos de células, têm sido investigadas em modelos animais. Apesar dos avanços obtidos na última década, na área de ciência básica, com relação a esta nova modalidade terapêutica, diversas questões permanecem sem resposta. Pouco ainda se sabe sobre os mecanismos através dos quais a terapia celular possa gerar resultados efetivos. Adicionalmente, a melhor via para o transplante, o número total e a concentração de células, e o melhor tipo celular permanecem questões importantes, ainda sem definição. É fato de que diversas células da medula óssea exercem seus efeitos através de mecanismos parácrinos e de que existe um complexo mecanismo de interação, contato e liberação de sinais entre essas células e as outras populações celulares nos órgãos lesados. Atualmente, a maioria dos estudos em humanos se concentra em células de origem adulta e autóloga, em oposição ao uso de células de origem embrionária. Esta revisão analisa os principais ensaios clínicos que utilizaram células derivadas de medula óssea em quatro cardiopatias: doença arterial coronariana aguda e crônica, e nas cardiomiopatias chagásica e dilatada. Os resultados desses estudos demonstram que o procedimento é seguro e exequível, e potencialmente eficaz. Inquestionavelmente, mais estudos pré-clínicos e clínicos são necessários para acessar o real potencial benefício desse novo modelo terapêutico.Cell transplantation for the treatment of cardiovascular diseases is being investigated in many centers throughout the world. Various cell lines, from well characterized stem cells to cell fractions containing different types of cells, have been investigated in animal models. Despite progress in the basic research of this new therapy obtained over the last decade, many questions remain unanswered. We still know very little about the mechanisms of action that may lead to positive results after cell therapy. Additionally, the best route for cell transplantation, the best number and concentration of cells and the best cell type for transplant remain important questions that are still undefined. It is a fact that many bone marrow cells exert their effects through paracrine mechanisms, and that a complex mechanism of interaction, contact and signal release exists between these cells and other cell populations in damaged organs. Currently the majority of human studies are focused on the use of adult and autologous cells in contrast to the use of embryonic cells. This review describes the main clinical trials that have been performed using bone marrow-derived cells in the setting of four distinct heart diseases: acute and chronic ischemic heart disease and chagasic and dilated cardiomyopathies. Results from these studies demonstrate the procedure to be safe and feasible, and potentially efficacious. Undoubtedly more pre-clinical and clinical studies are necessary to assess the real potential benefit of this new therapeutic model.

  8. Bases da terapia celular em cardiologia Cell therapy in cardiology

    OpenAIRE

    Antonio Carlos C. Carvalho; Regina Coeli S. Goldenberg; Fábio Antonio A. Tuche; Hans Fernando R. Dohmann

    2009-01-01

    O implante de células para o tratamento de doenças cardiovasculares encontra-se sob investigação em vários centros no mundo. Várias linhagens celulares, de células-tronco bem caracterizadas a frações contendo diferentes tipos de células, têm sido investigadas em modelos animais. Apesar dos avanços obtidos na última década, na área de ciência básica, com relação a esta nova modalidade terapêutica, diversas questões permanecem sem resposta. Pouco ainda se sabe sobre os mecanismos através dos qu...

  9. Development of radioiodinated fatty acids for applications in nuclear cardiology

    International Nuclear Information System (INIS)

    The use of radioiodinated fatty acids for the evaluation of myocardial perfusion and the assessment of regional fatty acid metabolism in relation to myocardial disease have seen rapid growth in the last few years. In this paper the development and use of these agents are reviewed. In addition to a discussion of the design of structurally modified fatty acids, the development of new radiolabeling methods for preparation of the iodine-123-labeled agents is presented. The development of these new agents is discussed, and their potential use in conjunction with single-photon tomography is an exciting new area. A summary of the clinical studies involving measurement of regional washout rate which have been performed with agents such as 17-([123I]iodo)heptadecanoic acid and 15-(p-[123I]iodo phenyl)pentadecanoic acid is also presented. The combined interest and expertise of chemists and clinicians have worked effectively together to make many recent contributions to this area of radiopharmaceutical development

  10. Practical application of natriuretic peptides in paediatric cardiology

    DEFF Research Database (Denmark)

    Smith, Julie; Goetze, Jens P; Andersen, Claus B;

    2010-01-01

    diagnostic tools. Natriuretic peptide measurements could be that extra tool. We discuss and suggest N-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide reference intervals for children without cardiovascular disease and cut-off points for the four specific paediatric heart conditions. We...

  11. Epidemiology and Decision Support Tools with Application in Cardiology

    Czech Academy of Sciences Publication Activity Database

    Zvárová, Jana; Peleška, Jan; Štefek, Martin; Švejda, David; Tomečková, Marie

    1997-01-01

    Roč. 17, 1/2 (1997), s. 271-281. ISSN 0208-5216. [ICB Seminar Statistics and Clinical Practice /34./. Waršava, 24.06.1996-28.06.1996] Grant ostatní: COPERNICUS(XE) 10053; IGA MZ ČR(CZ) IZ3792; IGA MZ ČR(CZ) IZ4038

  12. Bibliometric indexes, databases and impact factors in cardiology

    Directory of Open Access Journals (Sweden)

    Igor R C Bienert

    2015-04-01

    Full Text Available AbstractBibliometry is a quantitative statistical technique to measure levels of production and dissemination of knowledge, as well as a useful tool to track the development of an scientific area. The valuation of production required for recognition of researchers and magazines is accomplished through tools called bibliometricindexes, divided into quality indicators and scientific impact. Initially developed for monographs of statistical measures especially in libraries, today bibliometrics is mainly used to evaluate productivity of authors and citation repercussion. However, these tools have limitations and sometimes provoke controversies about indiscriminate application, leading to the development of newer indexes. It is important to know the most common search indexes and use it properly even acknowledging its limitations as it has a direct impact in their daily practice, reputation and funds achievement.

  13. LISINOPRIL USAGE IN CARDIOLOGIC PRACTICE: DATA OF EVIDENCE BASED MEDICINE

    Directory of Open Access Journals (Sweden)

    N. P. Kutishenko

    2015-12-01

    Full Text Available Data of multicenter clinical trials on assessment of angiotensin converting enzyme inhibitor, lisinopril efficacy in therapy of patients with arterial hypertension, heart failure, myocardial infarction complicated with left ventricle dysfunction and diabetes (GISSI-3, ATLAS, ALLHAT, EUCLID are presented in the review. The results of these trials establish more active usage of lisinopril in clinical practice.

  14. Cell-based therapies and imaging in cardiology

    Energy Technology Data Exchange (ETDEWEB)

    Bengel, Frank M. [Technische Universitaet Muenchen, Nuklearmedizinische Klinik und Poliklinik, Munich (Germany); Schachinger, Volker; Dimmeler, Stefanie [University of Frankfurt, Department of Molecular Cardiology, Frankfurt (Germany)

    2005-12-01

    Cell therapy for cardiac repair has emerged as one of the most exciting and promising developments in cardiovascular medicine. Evidence from experimental and clinical studies is increasing that this innovative treatment will influence clinical practice in the future. But open questions and controversies with regard to the basic mechanisms of this therapy continue to exist and emphasise the need for specific techniques to visualise the mechanisms and success of therapy in vivo. Several non-invasive imaging approaches which aim at tracking of transplanted cells in the heart have been introduced. Among these are direct labelling of cells with radionuclides or paramagnetic agents, and the use of reporter genes for imaging of cell transplantation and differentiation. Initial studies have suggested that these molecular imaging techniques have great potential. Integration of cell imaging into studies of cardiac cell therapy holds promise to facilitate further growth of the field towards a broadly clinically useful application. (orig.)

  15. Glucagon-like peptide 1--a cardiologic dimension

    DEFF Research Database (Denmark)

    Treiman, Marek; Elvekjaer, Mikkel; Engstrøm, Thomas;

    2010-01-01

    Recent experimental data suggest glucagon-like peptide 1 (GLP-1) and its analogs to have direct effects on the cardiovascular system, in addition to their classic glucoregulatory actions. These direct effects may be cardioprotective, contractility augmenting, and vasorelaxant. A few preliminary c...

  16. Flat detector computed tomography in diagnostic and interventional pediatric cardiology

    International Nuclear Information System (INIS)

    Purpose: In this study the use of flat detector computed tomography (FD-CT) in the catheterization of patients with congenital heart disease was evaluated. Application reports were created for various issues based on the achieved image quality in diverse anatomical regions. Materials and Methods: FD-CT was applied in 176 cases during catheterization between January 2010 and April 2012. A five-point Likert scale ('essential' to 'misleading') was used to evaluate image quality. All cases were analyzed retrospectively and application reports for the visualization of the aorta, pulmonary arteries, pulmonary veins, semilunar valves, cavopulmonary connections and atrial baffles were generated. Contrast dye consumption and radiation dose were evaluated. Results: During the observation period FD-CT was applied in all 176 cases. The mean patient age was 7.0 years (0.01 - 42.53 years). The clinical value of FD-CT was rated superior to conventional angiography in 96.6 % of the cases and was never rated as 'misleading'. FD-CT was rated 'essential' in 3.4 % of all cases, 'very useful' in 77.3 % of all cases, 'useful' in 15.9 % of all cases and 'not useful' in 3.4 % of all cases. The mean dose-area product was 99 μGym2 (19.3 - 1276.6 μGym2), and the used contrast dye was 1.76 ml/kg (0.9 - 5 ml/kg). Application reports for the visualization of different anatomical regions are demonstrated. Conclusion: FD-CT is a new and auxiliary procedure in diagnostic and interventional catheterization of patients with congenital heart disease. Particularly extracardiac structures can be displayed in three-dimensional high resolution and be used for diagnosis, surgical planning and 3 D navigation. (orig.)

  17. Novel iodinated tracers, MIBG and BMIPP, for nuclear cardiology

    OpenAIRE

    Tamaki, Nagara; Yoshinaga, Keiichiro

    2010-01-01

    With the rapid growth of molecular biology, in vivo imaging of such molecular process (i.e., molecular imaging) has been well developed. The molecular imaging has been focused on justifying advanced treatments and for assessing the treatment effects. Most of molecular imaging has been developed using PET camera and suitable PET radiopharmaceuticals. However, this technique cannot be widely available and we need alternative approach. 123I-labeled compounds have been also suitable for molecular...

  18. Application of receptive music therapy in internal medicine and cardiology

    Directory of Open Access Journals (Sweden)

    Cyntia Marconato

    2001-08-01

    Full Text Available OBJECTIVE: To investigate the effects of receptive music therapy in clinical practice. METHODS: Receptive music therapy was individually applied via musical auditions, including five stages: musical stimulation, sensation, situation, reflection, and behavioral alteration. Following anamnesis and obtainment of consent, patients answered a first questionnaire on health risk evaluation (Q1, and after participating in 16 weekly music therapy sessions, answered a second one (Q2. RESULTS: Two men and 8 women, aged above 18 years, referred to us due to symptoms of stress, emotional suffering, and the need to change lifestyles (health risk behavior were studied between August 1998 and December 1999. Comparison between answers to Q1 and Q2, showed a trend (P=0.059 for reduction of ingestion of cholesterol-rich foods and for increased prospects in life with a tendency towards improvement, and also of increased intake of fiber-rich food (55.6%, increased levels of personal satisfaction (44.5%, and decreased levels of stress (66.7%. CONCLUSION: The study demonstrated decreased stress levels and increased personal satisfaction, higher consumption of fiber-rich food, lower cholesterol intake, and a better perspective on life, suggesting that receptive music therapy may be applied in clinical practice as an auxiliary therapeutic intervention for the treatment of behavioral health risks.

  19. Congenital cardiology: recent advances emphasise the need for collaboration

    OpenAIRE

    Mulder, B.J.M.

    2006-01-01

    The population of adult patients with congenital heart disease is steadily growing, due to the developments in cardiac surgery and thereby decreased mortality. However, morbidity in these patients is substantial. Patients with repaired lesions often need reoperations later in life. Most congenital heart defects, operated or not, have the potential to lead to clinical heart failure. Arrhythmias affect up to 50% of patients with congenital heart disease. The prevalence of pulmonary hypertension...

  20. Research on cachexia, sarcopenia and skeletal muscle in cardiology

    OpenAIRE

    Coats, Andrew J S

    2012-01-01

    Background The awareness of cardiac cachexia, i.e. involuntary weight loss in patients with underlying cardiovascular disease, has increased over the last two decades. Methods and results This mini-review looks at recent research in the cardiovascular literature that is relevant to the areas of interest of the Journal of Cachexia, Sarcopenia and Muscle. It identifies significant research in the last 3 years on the obesity paradox, the causes and effects of skeletal muscle wasting, animal mode...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Tsapaki, Virginia [Medical Physics Department, Konstantopoulio Agia Olga Hospital, Athens (Greece); Kottou, Sophia [Medical Physics Department, Athens University, Medical School, Athens (Greece); Vano, Eliseo [Medical Physics Service and Radiology Department, San Carlos University Hospital and Complutense University, Madrid (Spain); Komppa, Tuomo [Stuk, Radiation and Nuclear Safety Authority, Helsinki (Finland); Padovani, Renato [Servizio di Fisica Medica, Ospedale S Maria della Misericordia, Udine (Italy); Dowling, Annita [Medical Physics and Bioengineering Department, St James' s Hospital and Haughton Institute, Dublin (Ireland); Molfetas, Michael [Medical Physics Department, ' Evangelismos' Hospital, Athens (Greece); Neofotistou, Vassiliki [Medical Physics Department, Regional Athens General Hospital ' G Gennimatas' , Athens (Greece)

    2004-03-21

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

  3. Graphics and statistics for cardiology: comparing categorical and continuous variables.

    Science.gov (United States)

    Rice, Kenneth; Lumley, Thomas

    2016-03-01

    Graphs are a standard tool for succinctly describing data, and play a crucial role supporting statistical analyses of that data. However, all too often, graphical display of data in submitted manuscripts is either inappropriate for the task at hand or poorly executed, requiring revision prior to publication. To assist authors, in this paper, we present several forms of graph, for data typically seen in Heart, including dot charts, violin plots, histograms and boxplots for quantitative data, and mosaic plots and bar charts for categorical data. Justification for using these specific plots is drawn from the literature on visual perception; we also provide software instruction and examples, using various popular packages. PMID:26819235

  4. Clinical Trials and Statistics in Cardiology Atherosclerotic Cardiovascular Diseases

    Czech Academy of Sciences Publication Activity Database

    Tomečková, Marie

    Prague : EuroMISE, 2004 - (Zvárová, J.; Hanzlíček, P.; Peleška, J.; Přečková, P.; Svátek, V.; Valenta, Z.). s. 28 ISBN 80-903431-0-4. [International Joint Meeting EuroMISE 2004. 12.04.2004-16.04.2004, Prague] R&D Projects: GA MŠk LN00B107 Keywords : atherosclerosis * clinical trials Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  5. Application of receptive music therapy in internal medicine and cardiology

    OpenAIRE

    Cyntia Marconato; Eva Cantalejo Munhoz; Marcia Maria Menim; Maria Thereza Albach

    2001-01-01

    OBJECTIVE: To investigate the effects of receptive music therapy in clinical practice. METHODS: Receptive music therapy was individually applied via musical auditions, including five stages: musical stimulation, sensation, situation, reflection, and behavioral alteration. Following anamnesis and obtainment of consent, patients answered a first questionnaire on health risk evaluation (Q1), and after participating in 16 weekly music therapy sessions, answered a second one (Q2). RESULTS: Two men...

  6. Cardiovascular rehabilitation. Results in the cardiology service. Rehabilitación cardiovascular. Resultados en el servicio de cardiología.

    Directory of Open Access Journals (Sweden)

    Claudio González Rodríguez.

    Full Text Available Fundaments: Physical exercise produces changes in almost all the organism systems, the cardiovascular function is the main affected, important changes happen in the central heart bomb and in the outlying vasomotor regulation of the sanguine distribution. It has been demonstrated that the exercise favors modifications in the risk factors that comprises the lipídic patron, the glicemia, the overweight and some described more recently as the fibrinogen and the factors of the clotting. Objective : To analyze and to compare the effects of complex exercises in the patients included in the cardiovascular rehabilitation. Methods : Types study before and after, the total patients (30 included in the program of cardiovascular rehabilitation during 4 months in the Cienfuegos University Hospital ¨Dr. Gustavo Aldereguía Lima¨. Results : Out of the total of patient, 25 are males (83.3%, the diagnoses were: myocardium sharp attack, arterial hypertension with angina, myocardial revascularization and stable angina. In a highly significant way p < 0,0001 double product varied as much at the end of the jogging and the ergometric parameters: the maxim body burden reached, tolerated and the total time of exercise. In a significant way p < 0,001 varied the double product of the ergometric test and the units of the basal metabolism. Conclusions: For the clinical changes, ergometrics and psychological evaluated in those patients we can consider them integrally rehabilitated with this group of exercises.
    Fundamento: El ejercicio físico produce cambios en casi todos los sistemas del organismo, la función cardiovascular es la principal afectada, ocurren cambios importantes en la bomba cardiaca central y en la regulación vasomotora periférica de la distribución sanguínea. Se ha demostrado que el ejercicio favorece modificaciones en los factores de riesgo que comprenden el patrón lipídico, la glicemia, el sobrepeso y algunos descritos más recientemente como el fibrinógeno y los factores de la coagulación. Objetivo: Analizar y comparar los efectos de un complejo de ejercicios en los pacientes incluidos en la rehabilitación cardiovascular. Métodos: Estudio de tipo antes y después del total (30 pacientes incluidos en el programa de rehabilitación cardiovascular durante 4 meses en el Hospital Universitario ¨Dr. Gustavo Aldereguía Lima¨ de Cienfuegos. Resultados: Del total de pacientes 25 son masculinos (83.3 %, los diagnósticos fueron: infarto agudo del miocardio, hipertensión arterial con angina, revascularización miocárdica y angina estable. De forma altamente significativa p < 0,0001 varió el doble producto al final del trote y los parámetros ergométricos: carga máxima alcanzada y tolerada y el tiempo total de ejercicio. De forma significativa p < 0,001 varió el doble producto de la prueba ergométrica y las unidades del metabolismo basal. Conclusiones: Por los cambios clínicos, ergométricos y psicológicos evaluados a estos pacientes los podemos considerar rehabilitados integralmente con este complejo de ejercicios.

  7. Software Reuse in Cardiology Related Medical Database Using K-Means Clustering Technique

    OpenAIRE

    M. Bhanu Sridhar; Srinivas, Y.; M. H. M. Krishna Prasad

    2012-01-01

    Software technology based on reuse is identified as a process of designing software for the reuse purpose. The software reuse is a process in which the existing software is used to build new software. A metric is a quantitative indicator of an attribute of an item or thing. Reusability is the likelihood for a segment of source code that can be used again to add new functionalities with slight or no modification. A lot of research has been projected using reusability in reducing code, domain, ...

  8. Evaluation of the dose to the patient and medical staff in interventional cardiology employing computational models

    International Nuclear Information System (INIS)

    Interventional radiology, among guided X-rays procedures, is a methodology characterised by high level of doses, both for the patient and for the medical staff. The aim of the present study is to estimate the dose associated with coronary angiography procedures by means of numerical models (simplified and anthropomorphic) and MCNPX Monte Carlo code. Numerical estimates were supported by measurement performed with a dose area product meter that is commonly employed in such kind of studies. In the present work the main considerations and the preliminary results are presented. (authors)

  9. Class attendance and cardiology examination performance: a study in problem-based medical curriculum

    OpenAIRE

    Bamuhair SS; Al Farhan AI; Althubaiti A; ur Rahman S; Al-Kadri HM

    2016-01-01

    Samira S Bamuhair,1 Ali I Al Farhan,1,2 Alaa Althubaiti,1 Saeed ur Rahman,1,2 Hanan M Al-Kadri1,3 1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 2Department of Family Medicine and Primary Health Care, 3Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Riyadh, Saudi Arabia Background and aims: Information on the effect of students' class attendance on examination performance in a problem-based learning medical curriculum is limited. T...

  10. A cardiological web as an adjunct to medical teaching: prospective analysis.

    Science.gov (United States)

    Gómez-Arbonés, X; Ferreira, A; Piqué, M; Roca, J; Tomás, J; Frutos, J L; Vinyas, J; Prat, J; Ballester, M

    2004-03-01

    The aim of the study was to deliver and evaluate an educational web for medical students. A web of the complete cardiovascular course was prepared as an adjunct educational material for the classes. The use and utility of the web was assessed through a questionnaire (frequency of use, impact on in-class attendance and students' satisfaction). The number of visits, the time of the week and the hour when the web was used were registered. A total of 76 students returned the questionnaire. The web was available for 10 weeks and was visited 1062 times, especially at weekends. An increase in visits was noted prior to final examination. The web was accessed preferentially from the faculty or hospital computers. The quality of the web was assessed and rated a mean of 7.7 (score: 1-10); 93.4% students attended the class, but the web freed them from transcribing the contents; 88.2% of students evaluated the web as a useful or very useful adjunct to medical teaching. The Internet can be used to deliver learning in medical students and could be considered as added value to the pedagogic process and did not deter students from attending ordinary classes. PMID:15203530

  11. Maximum skin dose assessment in interventional cardiology: large area detectors and calculation methods

    International Nuclear Information System (INIS)

    Advances in imaging technology have facilitated the development of increasingly complex radiological procedures for interventional radiology. Such interventional procedures can involve significant patient exposure, although often represent alternatives to more hazardous surgery or are the sole method for treatment. Interventional radiology is already an established part of mainstream medicine and is likely to expand further with the continuing development and adoption of new procedures. Between all medical exposures, interventional radiology is first of the list of the more expansive radiological practice in terms of effective dose per examination with a mean value of 20 mSv. Currently interventional radiology contribute 4% to the annual collective dose, in spite of contributing to total annual frequency only 0.3% but considering the perspectives of this method can be expected a large expansion of this value. In IR procedures the potential for deterministic effects on the skin is a risk to be taken into account together with stochastic long term risk. Indeed, the International Commission on Radiological Protection (ICRP) in its publication No 85, affirms that the patient dose of priority concern is the absorbed dose in the area of skin that receives the maximum dose during an interventional procedure. For the mentioned reasons, in IR it is important to give to practitioners information on the dose received by the skin of the patient during the procedure. In this paper maximum local skin dose (MSD) is called the absorbed dose in the area of skin receiving the maximum dose during an interventional procedure

  12. Study on the development of a patient dosimetry gown for interventional cardiology procedures

    International Nuclear Information System (INIS)

    In recent years, dose justification and optimization have been attempted in percutaneous coronary intervention (PCI); however, deterministic effects have been reported. To prevent radiation skin injuries in PCI, it is necessary to measure the patient entrance skin dose (ESD), but an accurate dose measurement method has not yet been established. In this study, we developed a dosimetry gown that can measure the ESD during PCI using multiple radiophotoluminescence dosimeters (RPLDs). The RPLDs were placed into 84 pockets that were sewn into a dosimetry gown. Patients wear the original dosimetry gown during the procedures, after which we obtain accurate ESD measurements. We believe that this method using RPLDs and a newly-designed dosimetry gown provides accurate ESD measurements during PCI. We expect this system to become a standard method for measuring ESD during PCI. (author)

  13. Derivation and application of dose reduction factors for protective eyewear worn in interventional radiology and cardiology

    International Nuclear Information System (INIS)

    Doses to the eyes of interventional radiologists and cardiologists could exceed the annual limit of 20 mSv proposed by the International Commission on Radiological Protection. Lead glasses of various designs are available to provide protection, but standard eye dosemeters will not take account of the protection they provide. The aim of this study has been to derive dose reduction factors (DRFs) equal to the ratio of the dose with no eyewear, divided by that when lead glasses are worn. Thirty sets of protective eyewear have been tested in x-ray fields using anthropomorphic phantoms to simulate the patient and clinician in two centres. The experiments performed have determined DRFs from simulations of interventional procedures by measuring doses to the eyes of the phantom representing the clinician, using TLDs in Glasgow, Scotland and with an electronic dosemeter in Gothenburg, Sweden. During interventional procedures scattered x-rays arising from the patient will be incident on the head of the clinician from below and to the side. DRFs for x-rays incident on the front of lead glasses vary from 5.2 to 7.6, while values for orientations similar to those used in the majority of clinical practice are between 1.4 and 5.2. Specialised designs with lead glass side shields or of a wraparound style with angled lenses performed better than lead glasses based on the design of standard spectacles. Results suggest that application of a DRF of 2 would provide a conservative factor that could be applied to personal dosemeter measurements to account for the dose reduction provided by any type of lead glasses provided certain criteria relating to design and consistency of use are applied. (paper)

  14. Predictors of Hospitalization in Patients with Syncope Assisted in Specialized Cardiology Hospital

    International Nuclear Information System (INIS)

    Risk stratification of a syncopal episode is necessary to better differentiate patients needing hospitalization of those who can be safely sent home from the emergency department. Currently there are no strict guidelines from our Brazilian medical societies to guide the cardiologist that evaluate patients in an emergency setting. To analyze the criteria adopted for defining the need for hospitalization and compare them with the predictors of high risk for adverse outcome defined by the OESIL score that is already validated in the medical literature for assessing syncope. A cross-sectional study of patients diagnosed with syncope during emergency department evaluation at our institution in the year 2011. Of the 46,476 emergency visits made in that year, 216 were due to syncope. Of the 216 patients analyzed, 39% were hospitalized. The variables associated with the need of hospital admission were - having health care insurance, previous known cardiovascular disease, no history of prior stroke, previous syncope and abnormal electrocardiograms during the presentation. Patients classified in OESIL scores of 0-1 had a greater chance of emergency discharge; 2-3 scores showed greater association with the need of hospitalization. A score ≥ 2 OESIL provided an odds ratio 7.8 times higher for hospitalization compared to score 0 (p <0.001, 95% CI:4,03-15,11). In approximately 39% no etiological cause for syncope was found and in 18% cardiac cause was identified. Factors such as cardiovascular disease, prior history of syncope, health insurance, no previous stroke and abnormal electrocardiograms, were the criteria used by doctors to indicate hospital admission. There was a good correlation between the clinical judgment and the OESIL criteria for high risk described in literature

  15. Patient dose measurements in an interventional cardiology procedure in Pakistan, as part of an IAEA project

    International Nuclear Information System (INIS)

    Full text: Purpose: To evaluate patient dose in percutaneous transluminal coronary angioplasty (PTCA) in Pakistan, as part of a project of the International Atomic Energy Agency (IAEA) on Radiation Protection of patients and Medical Exposure Control (RAS/9/047). Methods and Materials: Data were collected from 22 catheterization laboratories in 15 hospitals in large cities of Pakistan. Gafchromic films were placed on patients back before the procedure. Dose Area Product (DAP) was also recorded. Furthermore, information about patients that repeated PTCA was collected. Results: A total of 80 films were evaluated. Sixty five (65) patients had Peak Skin Dose (PSD) lower than 1 Gy. Ten (10) patients had PSD of 1-2 Gy which is just below the threshold of erythema. Five (5) patients had PSD higher than the 2 Gy threshold with 1 of these patients having PSD in the region of 4-6 Gy. Eight patients of the sample had 2 or more PTCAs with PSD value in each case above the threshold for deterministic effects. In none of the patients DAP exceed 400Gycm2. Conclusion: The high PSD measured with the gafchromic films showed the importance of radiation protection measures that are needed to optimize dose without affecting the clinical purpose. The fact that DAP was not enough to reveal high skin dose points out to need for PSD estimation and strengthening radiation protection and the requirement to train effectively staff involved in dose optimization. (The authors acknowledge the technical expertise provided by Dr Madan Rehani from IAEA). (author)

  16. When Using the Mean is Meaningless: Examples from Probability Theory and Cardiology.

    Science.gov (United States)

    Liebovitch, Larry S.; Todorov, Angelo T.; Wood, Mark A.; Ellenbogen, Kenneth A.

    This chapter describes how the mean of fractal processes does not exist and is not a meaningful measure of some data. It discusses how important it is to stay open to the possibility that sometimes analytic techniques fail to satisfy some assumptions on which the mean is based. (KHR)

  17. Radiation protection in pediatric interventional cardiology. Current status and challenges in Chile

    International Nuclear Information System (INIS)

    Further actions to improve radiation safety in this medical practice are discussed. All the X-ray systems used in paediatric IC procedures in Chile have been characterized in terms of dose and image quality. In addition, dose rates of scattered radiation to the position of the eyes and ankles of cardiologists have been measured. In May 2010, in Santiago, Chile, a workshop organized by the International Atomic Energy Agency (IAEA) was the starting point for a pilot program on patient dosimetry and medical personnel for Latin America and the Caribbean, with participants from 11 countries. A pilot training course on Radiological Protection was given as part of the program. The first dose values reported for paediatric patients under the pilot program conducted by the IAEA in Latin America and the Caribbean included 70 procedures in Chile later extending to a total of 544 procedures. We think that a fundamental first step to improve IC radiation safety in Chile, would be to revise and update legislation on the use of ionizing radiation, including the implementation of quality assurance programs and training in radiation protection according to those involved in IC procedures

  18. Automated volume of interest delineation and rendering of cone beam CT images in interventional cardiology

    Science.gov (United States)

    Lorenz, Cristian; Schäfer, Dirk; Eshuis, Peter; Carroll, John; Grass, Michael

    2012-02-01

    Interventional C-arm systems allow the efficient acquisition of 3D cone beam CT images. They can be used for intervention planning, navigation, and outcome assessment. We present a fast and completely automated volume of interest (VOI) delineation for cardiac interventions, covering the whole visceral cavity including mediastinum and lungs but leaving out rib-cage and spine. The problem is addressed in a model based approach. The procedure has been evaluated on 22 patient cases and achieves an average surface error below 2mm. The method is able to cope with varying image intensities, varying truncations due to the limited reconstruction volume, and partially with heavy metal and motion artifacts.

  19. Patient doses in paediatric interventional cardiology: impact of 3D rotational angiography

    International Nuclear Information System (INIS)

    The aim of this study was to calculate the contribution of 3D rotational angiography to radiation doses received by paediatric patients in a cardiac catheterisation laboratory. The percentage increase in the median value of air kerma-area product due to cone beam CT was 33 and 16% for diagnostic and therapeutic procedures, respectively. Results are presented separately for five age groups and ten weight groups. Several methods for reducing radiation from 3D rotational angiography are suggested and patient doses are compared with previously published values. (paper)

  20. Coronary computed tomography angiography and its increasing application in day to day cardiology practice.

    Science.gov (United States)

    Markham, R; Murdoch, D; Walters, D L; Hamilton-Craig, C

    2016-01-01

    Coronary artery disease (CAD) is the leading single cause of death in Australia affecting around 1.4 million people. Coronary computed tomography angiography has an established role in the assessment of patients with low to intermediate pretest probability for CAD who have chest pain and is typically used with the aim to rule out significant coronary artery stenosis. Use was initially limited because of concerns over radiation exposure, a Medicare rebate restricted to specialist referrals and an absence of data supporting its use as an alternative to functional testing in patients with chest pain. Recent advances in scanner technology and image sequencing, along with data from randomised control trials, have addressed these issues and indicate that coronary computed tomography angiography will play a greater role in the assessment of CAD in the coming years. PMID:26813899

  1. CardioGRID: a framework for the analysis of cardiological signals in GRID computing

    International Nuclear Information System (INIS)

    The present paper describes the development of the CardioGRID framework into the GRID infrastructure. The core GRID services; Workload Management System (WMS), Data Management System and Grid Authentication have been implemented. Additionally, a web-based tool -the CardioGRID portal- has been developed to facilitate the user interaction with the GRID. As a result, the user is able to process the electrocardiogram (ECG) signals obtained form a portable data acquisition device and to process it on the GRID. Once the CardioGRID portal is prompted and the user identity is verified through a digital X.509 certificate, the operator may either upload new raw ECG data to the GRID Storage Elements or use already stored data. Then, subsequent analytics from these data are performed as GRID jobs and relevant medical quantities are derived through middle-ware job retrieval mechanism. In summary in this paper was described the development of a medical GRID based system, and its integration to an existing platform for Digital Repositories Infrastructure.

  2. CardioGRID: a framework for the analysis of cardiological signals in GRID computing

    Science.gov (United States)

    Francisco Garcia Eijo, Juan; Risk, Marcelo; Prieto Castrillo, Francisco; Suarez Ortega, Cesar; Boton Fernandez, Maria; Pardo Diaz, Alfonso; Rubio del Solar, Manuel; Ramos Pollan, Raul

    2011-09-01

    The present paper describes the development of the CardioGRID framework into the GRID infrastructure. The core GRID services; Workload Management System (WMS), Data Management System and Grid Authentication have been implemented. Additionally, a web-based tool -the CardioGRID portal- has been developed to facilitate the user interaction with the GRID. As a result, the user is able to process the electrocardiogram (ECG) signals obtained form a portable data acquisition device and to process it on the GRID. Once the CardioGRID portal is prompted and the user identity is verified through a digital X.509 certificate, the operator may either upload new raw ECG data to the GRID Storage Elements or use already stored data. Then, subsequent analytics from these data are performed as GRID jobs and relevant medical quantities are derived through middle-ware job retrieval mechanism. In summary in this paper was described the development of a medical GRID based system, and its integration to an existing platform for Digital Repositories Infrastructure.

  3. Sudden unexplained death: Heritability and diagnostic yield of cardiological and genetic examination in surviving relatives

    NARCIS (Netherlands)

    Tan, Hanno L.; Hofman, Nynke; Van Langen, Irene M.; Van Der Wal, Allard C.; Wilde, Arthur A. M.

    2005-01-01

    Background-Sudden death mostly follows from cardiac disorders that elicit lethal ventricular arrhythmias. In young individuals, it often remains unexplained because history and/or postmortem analysis are absent or provide no clue. Because such sudden unexplained deaths (SUDs) may have heritable caus

  4. Bioelectrical Signal Processing in Cardiology: inverse solution mapping on epicardial and endocardial potentials

    OpenAIRE

    Ratés i Borràs, Àngels

    2015-01-01

    Inverse electrocardiography is aimed at reconstructing the heart electrical activity and its corresponding spread throughout the heart from non-invasive body surface measurements obtained through the Electrocardiogram (ECG) technique. This field has showed increasing promise during the last decades due to its main application: predict possible cardiac diseases such that medical interventions are avoided and costs which were meant to these clinical operations are also reduced. Still, properly ...

  5. Nuclear cardiology between echocardiography and coronary angiography in the management of CAD

    International Nuclear Information System (INIS)

    In managing coronary artery disease there are clearly posed questions: In diagnosis to assess presence, extent and severity of CAD, in therapy to assess prognosis and benefit of PTCA and ACVB. Coronary angiography remains the gold standard for assessing coronary stenosis, function imaging - stress echocardiography - and myocardial perfusion imaging (MIP) are assessing ischemia, i.e. extent and severity of CAD meaning prognosis and benefit of invasive therapy. The costs of echo /MPI/ catherization are 1 : 2: 6. When the essential conditions in non invasive investigations are observed - exact indication, maximal quality, evaluation of efficacy D, M and O - equal acceptance of all methods by cardiologists is attainable and there will be a great potential of cost saving in invasive diagnostics and therapy. The part of MPI is assessed in evaluating myocardium viability and benefit of invasive therapy, in the diagnosis of ischemia and evaluation of outcome MPI eventually will be replaced by stress echocardiography in future. (orig.)

  6. SPET in cardiology. Diagnosis, prognosis and management of patients with coronary artery disease

    International Nuclear Information System (INIS)

    Stress myocardial perfusion imaging has been considered as a most valuable means for diagnosis and treatment strategy in patients with suspected and known coronary artery disease. 99mTC perfusion imaging agents provide excellent myocardial perfusion images. In addition, greater photon flux from the tracer permits simultaneous assessment of regional perfusion and function with use ECG-gated acquisition. Gated SPET imaging technique has a potential for higher diagnostic accuracy for diagnosis of coronary artery disease and assessment of the disease severity. In addition, radionuclide imaging plays an important role to differentiate reversible ischemic myocardium which may improve LV function after revascularization from irreversible scar in patients with history of myocardial infraction. While FDG-PET is considered as a most reliable means for myocardial assessment, SPET imaging has been widely used for the viability assessment, with gaining higher accuracy for predicting reversible ischemia. Recently a variety of new radiopharmaceutical agents have been introduced to probe myocardial function 'in vivo' (123I)BMIPP, a branched fatty acid analog, has been used for metabolic imaging using SPET. Less uptake of BMIPP than perfusion is often observed in the ischemic myocardium. Such a perfusion metabolic mismatch which seems to be similarly observed in FDG-PET is identified in the stunned or hibernating myocardium with regional dysfunctions. Severe ischemia is identified as reduced BMIPP uptake at rest, suggesting its role as an ischemic memory imaging. These new techniques will provide insights into new pathological states in the ischemic heart disease and enable to select optimal treatment of these patients

  7. Role of myocardial perfusion single photon emission computed tomography in pediatric cardiology practice

    Directory of Open Access Journals (Sweden)

    Sundaram P

    2009-01-01

    Full Text Available Diagnostic and prognostic power of myocardial perfusion imaging in patients with coronary artery disease has been demonstrated with planar imaging which was further improvised with addition of gated SPECT and newer Technetium labeled myocardial perfusion tracers like SestaMIBI, Tetrofosmin. Myocardial perfusion abnormalities at rest and after stress are considered to be the best predictors of cardiac event-free survival in adults with ischemic heart disease. This article highlights various myocardial perfusion imaging (MPIradiopharmaceuticals, exercise procedures, pharmacological stress protocols, indications for MPI and myocardial perfusion patterns in children with some of the common congenital and acquired heart diseases.

  8. Occupational cataracts and lens opacities in interventional cardiology. The O'CLOC study

    Energy Technology Data Exchange (ETDEWEB)

    Jacob, Sophie; Bertrand, Alexandre; Bernier, Marie-Odile [Institut de Radioprotection et de Surete Nucleaire (IRSN), Fontenay-aux-Roses (France). Lab. of Epidemiology

    2010-07-01

    Interventional cardiologists are repeatedly and acutely exposed to scattered ionizing radiation (X-rays) during their diagnostic or therapeutic procedures. These exposures may cause damages to the eye lenses and induce early cataracts known as radiation-induced cataracts. The O'CLOC study is an ongoing epidemiological study designed to test the hypothesis of an increased risk of cataract among interventional cardiologists as compared with unexposed cardiologists. This paper summarizes a detailed article on the O'CLOC study protocol that has been published elsewhere. (orig.)

  9. Occupational cataracts and lens opacities in interventional cardiology. The O'CLOC study

    International Nuclear Information System (INIS)

    Interventional cardiologists are repeatedly and acutely exposed to scattered ionizing radiation (X-rays) during their diagnostic or therapeutic procedures. These exposures may cause damages to the eye lenses and induce early cataracts known as radiation-induced cataracts. The O'CLOC study is an ongoing epidemiological study designed to test the hypothesis of an increased risk of cataract among interventional cardiologists as compared with unexposed cardiologists. This paper summarizes a detailed article on the O'CLOC study protocol that has been published elsewhere. (orig.)

  10. 3D-Printing in Congenital Cardiology: From Flatland to Spaceland

    OpenAIRE

    Sébastien Deferm; Bart Meyns; Dirk Vlasselaers; Werner Budts

    2016-01-01

    Medical imaging has changed to a great extent over the past few decades. It has been revolutionized by three-dimensional (3D) imaging techniques. Despite much of modern medicine relying on 3D imaging, which can be obtained accurately, we keep on being limited by visualization of the 3D content on two-dimensional flat screens. 3D-printing of graspable models could become a feasible technique to overcome this gap. Therefore, we printed pre- and postoperative 3D-models of a complex congenital he...

  11. Skill-Building Simulations in Cardiology: The HeartLab and EkgLab Experience

    OpenAIRE

    Bergeron, Bryan P.; Greenes, Robert A

    1987-01-01

    HeartLab and EkgLab are two simulation-based programs designed to teach medical students the essentials of the auscultatory cardiac exam and of electrocardiogram interpretation, respectively. The issues considered throughout the development of these projects, namely implementation language selection, program architecture, simulation design, patient models, and the approach to validation, are applicable to the design of any simulation-based system.

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

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, F.F. Jr.; Ambrose, K.R. [Oak Ridge National Lab., TN (United States); Kropp, J.; Biersack, H.J. [Bonn Univ. (Germany). Inst. fuer Klinische und Experimentelle Nuklearmedizin; Goodman, M.M. [University of Tennessee Medical Center, Knoxville, TN (United States). Dept. of Radiology; Franken, P. [Free Univ. Hospital, Brussels (Belgium). Nuclear Medicine Dept.; Reske, S.N. [Ulm Univ. (Germany). Sektion Nuklearmedizin; Som, P. [Brookhaven National Lab., Upton, NY (United States); Sloof, G.W.; Visser, F.C. [Free Univ. Hospital, Amsterdam (Netherlands). Cardiology Dept.

    1993-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, F.F. Jr.; Ambrose, K.R. (Oak Ridge National Lab., TN (United States)); Kropp, J.; Biersack, H.J. (Bonn Univ. (Germany). Inst. fuer Klinische und Experimentelle Nuklearmedizin); Goodman, M.M. (University of Tennessee Medical Center, Knoxville, TN (United States). Dept. of Radiology); Franken, P. (Free Univ. Hospital, Brussels (Belgium). Nuclear Medicine Dept.); Reske, S.N. (Ulm Univ. (Germany

    1993-01-01

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

  14. Gestión de recursos materiales en una unidad de cardiología intervencionista

    OpenAIRE

    Fernández Peña, Elena

    2012-01-01

    El principal objetivo de este trabajo es demostrar a la enfermería en general y a las direcciones de enfermería la actividad cotidiana realizada por el personal que se dedica a la gestión, y hacer que se reconozca dicho cometido como un eslabón más en la cadena de misiones encomendadas a la enfermería, ya que supone un porcentaje muy alto del trabajo diario de la gestión enfermera. El presente trabajo está dividido en tres capítulos: En el primero tratamos de explicar los diferentes métodos q...

  15. PRIMARY PREVENTION OF DIABETES MELLITUS: CORRECTION OF EARLY DISORDERS OF GLUCOSE METABOLISM IN CARDIOLOGY PRACTICE

    Directory of Open Access Journals (Sweden)

    M. N. Mamedov

    2015-12-01

    Full Text Available Early glucose metabolism disorders (GMD are of interest in development of effective approaches to prevention of type 2 diabetes mellitus (DM. Data of international clinical trials shows that early GMD are an independent risk factor for cardiovascular disease. The possibilities of GMD prevention and early treatment are discussed. Antihyperglycemic medications classification, their mode of action and efficacy are presented from evidence-based medicine point of view. This data confirms that successful DM primary prevention at early stage of GMD reduces the risk of cardiovascular complications.

  16. PRIMARY PREVENTION OF DIABETES MELLITUS: CORRECTION OF EARLY DISORDERS OF GLUCOSE METABOLISM IN CARDIOLOGY PRACTICE

    Directory of Open Access Journals (Sweden)

    M. N. Mamedov

    2012-01-01

    Full Text Available Early glucose metabolism disorders (GMD are of interest in development of effective approaches to prevention of type 2 diabetes mellitus (DM. Data of international clinical trials shows that early GMD are an independent risk factor for cardiovascular disease. The possibilities of GMD prevention and early treatment are discussed. Antihyperglycemic medications classification, their mode of action and efficacy are presented from evidence-based medicine point of view. This data confirms that successful DM primary prevention at early stage of GMD reduces the risk of cardiovascular complications.

  17. Predictors of Hospitalization in Patients with Syncope Assisted in Specialized Cardiology Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Leonardo Marques; Dutra, João Pedro Passos [Instituto de Cardiologia, Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS (Brazil); Mantovani, Augusto [UFCSPA - Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Lima, Gustavo Glotz de [Instituto de Cardiologia, Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS (Brazil); UFCSPA - Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Leiria, Tiago Luiz Luz, E-mail: drleiria@cardiol.br [Instituto de Cardiologia, Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS (Brazil)

    2013-12-15

    Risk stratification of a syncopal episode is necessary to better differentiate patients needing hospitalization of those who can be safely sent home from the emergency department. Currently there are no strict guidelines from our Brazilian medical societies to guide the cardiologist that evaluate patients in an emergency setting. To analyze the criteria adopted for defining the need for hospitalization and compare them with the predictors of high risk for adverse outcome defined by the OESIL score that is already validated in the medical literature for assessing syncope. A cross-sectional study of patients diagnosed with syncope during emergency department evaluation at our institution in the year 2011. Of the 46,476 emergency visits made in that year, 216 were due to syncope. Of the 216 patients analyzed, 39% were hospitalized. The variables associated with the need of hospital admission were - having health care insurance, previous known cardiovascular disease, no history of prior stroke, previous syncope and abnormal electrocardiograms during the presentation. Patients classified in OESIL scores of 0-1 had a greater chance of emergency discharge; 2-3 scores showed greater association with the need of hospitalization. A score ≥ 2 OESIL provided an odds ratio 7.8 times higher for hospitalization compared to score 0 (p <0.001, 95% CI:4,03-15,11). In approximately 39% no etiological cause for syncope was found and in 18% cardiac cause was identified. Factors such as cardiovascular disease, prior history of syncope, health insurance, no previous stroke and abnormal electrocardiograms, were the criteria used by doctors to indicate hospital admission. There was a good correlation between the clinical judgment and the OESIL criteria for high risk described in literature.

  18. Durable mechanical circulatory support in advanced heart failure: a critical care cardiology perspective.

    Science.gov (United States)

    Lala, Anuradha; Mehra, Mandeep R

    2013-11-01

    Though cardiac transplantation for advanced heart disease patients remains definitive therapy for patients with advanced heart failure, it is challenged by inadequate donor supply, causing durable mechanical circulatory support (MCS) to slowly become a new primary standard. Selecting appropriate patients for MCS involves meeting a number of prespecifications as is required in evaluation for cardiac transplant candidacy. As technology evolves to bring forth more durable smaller devices, selection criteria for appropriate MCS recipients will likely expand to encompass a broader, less sick population. The "Holy Grail" for MCS will be a focus on clinical recovery and explantation of devices rather than the currently more narrowly defined indications of bridge to transplantation or lifetime device therapy. PMID:24188222

  19. Stress Computed Tomography Myocardial Perfusion Imaging: A New Topic in Cardiology.

    Science.gov (United States)

    Seitun, Sara; Castiglione Morelli, Margherita; Budaj, Irilda; Boccalini, Sara; Galletto Pregliasco, Athena; Valbusa, Alberto; Cademartiri, Filippo; Ferro, Carlo

    2016-02-01

    Since its introduction about 15 years ago, coronary computed tomography angiography has become today the most accurate clinical instrument for noninvasive assessment of coronary atherosclerosis. Important technical developments have led to a continuous stream of new clinical applications together with a significant reduction in radiation dose exposure. Latest generation computed tomography scanners (≥ 64 slices) allow the possibility of performing static or dynamic perfusion imaging during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson), combining both functional and anatomical information in the same examination. In this article, the emerging role and state-of-the-art of myocardial computed tomography perfusion imaging are reviewed and are illustrated by clinical cases from our experience with a second-generation dual-source 128-slice scanner (Somatom Definition Flash, Siemens; Erlangen, Germany). Technical aspects, data analysis, diagnostic accuracy, radiation dose and future prospects are reviewed. PMID:26774540

  20. Role of myocardial perfusion single photon emission computed tomography in pediatric cardiology practice

    International Nuclear Information System (INIS)

    Diagnostic and prognostic power of myocardial perfusion imaging in patients with coronary artery disease has been demonstrated with planar imaging which was further improvised with addition of gated SPECT and newer Technetium labeled myocardial perfusion tracers like SestaMIBI, Tetrofosmin. Myocardial perfusion abnormalities at rest and after stress are considered to be the best predictors of cardiac event–free survival in adults with ischemic heart disease. This article highlights various myocardial perfusion imaging (MPI) radiopharmaceuticals, exercise procedures, pharmacological stress protocols, indications for MPI and myocardial perfusion patterns in children with some of the common congenital and acquired heart diseases

  1. VIDEOCONFERENCING WEB APPLICATION FOR CARDIOLOGY DOMAIN USING FLEX/J2EE TECHNOLOGIES

    Directory of Open Access Journals (Sweden)

    Imen Debbabi

    2014-12-01

    Full Text Available The recent advances in computer technology and data networking have made videoconferencing system a popular medium for users to interact with one another from remote locations. This system offers communication between more than two users, who are able to interact through their webcams, microphone and other components. The use of this system has been increased recently due to many reasons, for one thing, progress in Internet access in different networks like companies, universities and houses, with the increase of available bandwidth whereas the decrease of delay in sending and receiving packets . On the other hand, the coming of Rich Internet Applications (RIA means that a large part of web application started to be implemented on the web browsers. This paper discusses the conception of multiparty videoconferencing systems using technologies of Web 2.0. For our conceptual Videoconferencing Platform, we have developed many feature : live audio video, text chat, video recording, user and room management and quality control. Videoconferencing modules have been carried out using open source technologies Flex and J2EE.

  2. Estimative of dose area product in interventional cardiology procedures: a literature review

    International Nuclear Information System (INIS)

    The aim of this work is to present a literature review of the values of dose area product (DAP) in coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA), achieved by papers pubMaria E. D.lished in the last ten years. The results shows that the average values of DAP decreased by 22.6% and 5.78% for CA and PTCA procedures, respectively, in comparison with the studies published in the last 5 and 10 years. It was found that these values are in accordance to the recommendations published by IAEA and NCRP Although there was a reduction along the years for the average values of DAP, the data highlight the need for further studies on reference levels, as large variability are observed. (author)

  3. How well are European Society of Cardiology (ESC) guidelines adhered to in patients with syncope?

    LENUS (Irish Health Repository)

    O'Dwyer, C

    2010-01-01

    The ESC guidelines on syncope were published in 2001 and updated in 2004. Adherence to the recommendations enables early stratification of low and high risk patients and prevents unnecessary investigations and admissions. Vasovagal syncope (VVS) is the commonest cause of syncope in all age groups and a low risk condition. The study objective was to determine whether the ESC guidelines were adhered to prior to referral to a syncope unit; 100 consecutive patients with unexplained syncope (52 +\\/- 23 (15-91) years); 53 female. Sixty-six patients had VVS. Forty nine (75%) of patients with VVS had undergone unnecessary investigations prior to diagnosis and 31 (47%) were admitted to hospital for investigation. Research from other countries confirms that adherence to the ESC guidelines expediates accurate diagnosis, improves resource utilization and reduces health care cost. Greater awareness amongst Irish practitioners of guidelines may improve syncope management and reduce costs.

  4. Dual antiplatelet therapy with prasugrel or ticagrelor versus clopidogrel in interventional cardiology

    DEFF Research Database (Denmark)

    Clemmensen, Peter; Dridi, Nadia Paarup; Holmvang, Lene

    2013-01-01

    For several years, clopidogrel plus aspirin has been the dual antiplatelet therapy (DAPT) of choice for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) with stent implantation. More recently, prasugrel and ticagrelor have demonstrated greater effica...

  5. SNOMED CT and its use in the Minimal Data Model for Cardiology

    Czech Academy of Sciences Publication Activity Database

    Přečková, Petra

    Strasbourg: ULP, 2008. [Meeting of the Doctoral Schools of the Charles University (Prague) and Louis Pasteur University (Strasbourg) /5./. 12.11.2008-14.11.2008, Strasbourg] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : classification systems * interoperability * electronic health record Subject RIV: IN - Informatics, Computer Science

  6. Cardio Online Reader – An Easy Way to Obtain Valid Scientific Articles in Cardiology

    Czech Academy of Sciences Publication Activity Database

    Zvolský, Miroslav

    Praha: Ústav informatiky AV ČR, v. v. i. & MATFYZPRESS, 2011 - (Kuželová, D.; Hakl, F.), s. 149-153 ISBN 978-80-7378-170-5. [Doktorandské dny 2011 Ústavu informatiky AV ČR, v. v. i.. Jizerka (CZ), 05.10.2011-07.10.2011] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic databases * Web 2.0 * medical subject headings * decision support Subject RIV: IN - Informatics, Computer Science

  7. Selecting Relevant Information for Medical Decision Support with Application in Cardiology

    Czech Academy of Sciences Publication Activity Database

    Kalina, Jan; Seidl, L.; Grünfeldová, H.; Slovák, Dalibor; Zvárová, Jana

    2013-01-01

    Roč. 9, č. 1 (2013), s. 2-6. ISSN 1801-5603 R&D Projects: GA MŠk(CZ) 1M06014 Institutional support: RVO:67985807 Keywords : decision support system * web-service * information extraction * high dimension * gene expressions Subject RIV: IN - Informatics, Computer Science http://www.ejbi.org/img/ejbi/2013/1/Kalina_en.pdf

  8. Pilot program on patient dosimetry in pediatric interventional cardiology in Chile

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to present the results of a pilot program on patient dosimetry carried out in Chile during the last 5 yr, using a biplane x-ray angiography system settled for pediatrics. This research was conducted in Latin America under the auspices of the International Atomic Energy Agency (IAEA) supporting programs on radiological protection (RP) of patients. Methods: Patient age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time, and two dosimetric quantities [air kerma-area product (Pka) and cumulative dose (CD) at the patient entrance reference point] were recorded for each procedure. Results: The study includes 544 patients grouped into four age groups. The distributions by age group were 150 for ka and CD for the four age groups were 0.94, 1.46, 2.13, and 5.03 Gy cm2 and 23.9, 26.8, 33.5, and 51.6 mGy, respectively. No significant statistical differences were found between diagnostic and therapeutic procedures. A moderate correlation (r = 0.64) was seen between Pka and patient weight. Conclusions: The dose values reported in this paper were lower than those published in the previous work for the same age groups as a result of the optimization actions carried out by cardiologists and medical physicists with the support of the IAEA. Methodology and results will be used as a starting point for a wider survey in Chile and Latin America with the goal to obtain regional diagnostic reference levels as recently recommended by the International Commission on Radiological Protection for interventional procedures.

  9. Manual Skill Acquisition During Transesophageal Echocardiography Simulator Training of Cardiology Fellows : A Kinematic Assessment

    NARCIS (Netherlands)

    Matyal, Robina; Montealegre-Gallegos, Mario; Mitchell, John D.; Kim, Han; Bergman, Remco; Hawthorne, Katie M.; O'Halloran, David; Wong, Vanessa; Hess, Phillip E.; Mahmood, Feroze

    2015-01-01

    Objective: To investigate whether a transesophageal echocardiography (TEE) simulator with motion analysis can be used to impart proficiency in TEE in an integrated curriculum-based model. Design: A prospective cohort study. Setting: A tertiary-care university hospital. Participants: TEE-naive cardio

  10. Disseminating Results of data Mining in Cardiology Data through Semantic Web

    Czech Academy of Sciences Publication Activity Database

    Rauch, Jan; Zvárová, Jana; Kliegr, T.; Šimůnek, M.; Tomečková, Marie

    Prague, 2009. s. 149-149. [ISCB 2009. Annual Conference /30./. 23.08.2009-27.08.2009, Prague] R&D Projects: GA MŠk(CZ) 1M06014; GA ČR GA201/08/0802 Institutional research plan: CEZ:AV0Z10300504 Keywords : the SEWEBAR -Cardio project * semantic web * analytiytical reports Subject RIV: IN - Informatics, Computer Science

  11. Advanced technology in interventional cardiology: A roadmap for the future of precision coronary interventions.

    Science.gov (United States)

    Dugas, Chad M; Schussler, Jeffrey M

    2016-07-01

    Several specific new technologies [high-resolution CT coronary imaging with fractional flow reserve (CTCA-FFR), virtual reality (VR), vascular robotic systems (VRS), and three-dimensional printing] are poised to improve the treatment of patients with cardiovascular disease and at the same time the safety of the physicians who care for them. This article focuses on the potential clinical impact each of these modalities will have, as well as speculating on synergies that use of them together may achieve. PMID:27020905

  12. Acute ischemic heart disease and interventional cardiology: a time for pause

    Directory of Open Access Journals (Sweden)

    Brophy James M

    2006-10-01

    Full Text Available Abstract Background A major change has occurred in the last few years in the therapeutic approach to patients presenting with all forms of acute coronary syndromes. Whether or not these patients present initially to tertiary cardiac care centers, they are now routinely referred for early coronary angiography and increasingly undergo percutaneous revascularization. This practice is driven primarily by the angiographic image and technical feasibility. Concomitantly, there has been a decline in expectant or ischemia-guided medical management based on specific clinical presentation, response to initial treatment, and results of noninvasive stratification. This 'tertiarization' of acute coronary care has been fuelled by the increasing sophistication of the cardiac armamentarium, the peer-reviewed publication of clinical studies purporting to show the superiority of invasive cardiac interventions, and predominantly supporting (non-peer-reviewed editorials, newsletters, and opinion pieces. Discussion This review presents another perspective, based on a critical reexamination of the evidence. The topics addressed are: reperfusion treatment of ST-elevation myocardial infarction; the indications for invasive intervention following thrombolysis; the role of invasive management in non-ST-elevation myocardial infarction and unstable angina; and cost-effectiveness and real world considerations. A few cases encountered in recent practice in community and tertiary hospitals are presented for illustrative purposes The numerous and far-reaching scientific, economic, and philosophical implications that are a consequence of this marked change in clinical practice as well as healthcare, decisional and conflict of interest issues are explored. Summary The weight of evidence does not support the contemporary unfocused broad use of invasive interventional procedures across the spectrum of acute coronary clinical presentations. Excessive and unselective recourse to these procedures has deleterious implications for the organization of cardiac health care and undesirable economic, scientific and intellectual consequences. It is suggested that there is need for a new equilibrium based on more refined clinical risk stratification in the treatment of patients who present with acute coronary syndromes.

  13. UK Cardiology Training in Core Echocardiography Symposium Report: the good the bad and the ugly

    OpenAIRE

    Kydd, Anna; Sohaib, Afzal; Sarwar, Rizwan; Holdsworth, David; Rana, Bushra

    2014-01-01

    Training in core echocardiography skills within the UK has been the focus of considerable discussion following recent national surveys. This article reports the proceedings of a joint meeting held by the British Society of Echocardiography and British Junior Cardiologists' Association. It considers the current issues impacting on high-quality training and presents potential solutions for the future.

  14. Opportunities and challenges of clinical trials in cardiology using composite primary endpoints

    Institute of Scientific and Technical Information of China (English)

    Geraldine; Rauch; Bernhard; Rauch; Svenja; Schüler; Meinhard; Kieser

    2015-01-01

    In clinical trials, the primary efficacy endpoint often corresponds to a so-called "composite endpoint". Composite endpoints combine several events of interest within a single outcome variable. Thereby it is intended to enlarge the expected effect size and thereby increase the power of the study. However, composite endpoints also come along with serious challenges and problems. On the one hand, composite endpoints may lead to difficulties during the planning phase of a trial with respect to the sample size calculation, asthe expected clinical effect of an intervention on the composite endpoint depends on the effects on its single components and their correlations. This may lead to wrong assumptions on the sample size needed. Too optimistic assumptions on the expected effect may lead to an underpowered of the trial, whereas a too conservatively estimated effect results in an unnecessarily high sample size. On the other hand, the interpretation of composite endpoints may be difficult, as the observed effect of the composite does not necessarily reflect the effects of the single components. Therefore the demonstration of the clinical efficacy of a new intervention by exclusively evaluating the composite endpoint may be misleading. The present paper summarizes results and recommendations of the latest research addressing the above mentioned problems in the planning, analysis and interpretation of clinical trials with composite endpoints, thereby providing a practical guidance for users.

  15. The radiology informed consent form: recommendations from the European Society of Cardiology position paper.

    Science.gov (United States)

    Carpeggiani, Clara; Picano, Eugenio

    2016-06-01

    Every radiological and nuclear medicine examination confers a definite long-term risk of cancer, but most patients undergoing such examinations receive no or inaccurate information about radiation dose and corresponding risk related to the dose received. Informed consent is a procedure to support (not substitute) the physician/patient dialogue and relationship, facilitating a free, informed and aware expression of the patient's will in the principle of patient autonomy. Physicians are responsible for providing patients with all the information on risks, benefits and alternatives useful to the patient to make the decision. In current radiological practice the information on the radiation dose and long-term cancer risks is difficult to find and not easy to understand. The form using plain language should spell-out the type of examination, the effective dose (mSv), the effective dose expressed in number of chest radiographs and the risk of cancer. The current practice clashes against the guidelines and the law. PMID:27269736

  16. Electronic Medical Records Optimize Clinical Data Management in the Outpatient Cardiological Clinic

    OpenAIRE

    Dalmiani, Stefano; Morales, Maria Aurora; Carpeggiani, Clara; Macerata, Alberto; Marcheschi, Paolo

    2003-01-01

    A system based on a relational database with administrative and clinical information and integrated with an Information System, where the system covers the role of a Functional Island, is routinely used in our Institution. To analyze how Electronic Medical Records (EMR) may help physicians in organizing and reducing time waste in a busy outpatient clinic, a sample of 1000 reports were evaluated for system performance. The time needed for building new clinical histories or modifying the alread...

  17. Strain Imaging: The Emergence of Speckle Tracking Echocardiography into Clinical Pediatric Cardiology.

    Science.gov (United States)

    Colquitt, John L; Pignatelli, Ricardo H

    2016-01-01

    Speckle tracking echocardiography measures myocardial strain and allows for the quantification of regional and global left and right ventricular function. A growing body of literature is supporting its transition from research into clinical practice. This article aims to provide a practical review of strain imaging as it applies to congenital and pediatric heart disease, with the goals of increasing literacy and advocating for greater clinical integration. PMID:26879728

  18. American Academy of Dermatology Cardiovascular Research Technologies 2013 American College of Cardiology

    OpenAIRE

    Alexander, Walter

    2013-01-01

    Dermatology topics include agents for psoriasis, urticaria, and infantile hemangiomas. The pros and cons of antiplatelet drugs prasugrel (Effient) and ticagrelor (Brilinta) are discussed, and an investigational agent, cangrelor, shows promise in reducing ischemic events when compared with clopidogrel (Plavix).

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

    Science.gov (United States)

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

    2009-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Erlandsson, Kjell; Kacperski, Krzysztof; Van Gramberg, Dean; Hutton, Brian F [Institute of Nuclear Medicine, University College London and UCLH NHS Foundation Trust, London NW1 2BU (United Kingdom)], E-mail: kjell.erlandsson@uclh.nhs.uk

    2009-05-07

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