Coronary Angiography

In the intervening 10 years tremendous advances in the field of cardiac computed tomography have occurred. We now can legitimately claim that computed tomography angiography (CTA) of the coronary arteries is available. In the evaluation of patients with suspected coronary artery disease (CAD), many guidelines today consider CTA an alternative to stress testing. The use of CTA in primary prevention patients is more controversial in considering diagnostic test interpretation in populations with a low prevalence to disease. However the nuclear technique most frequently used by cardiologists is myocardial perfusion imaging (MPI). The combination of a nuclear camera with CTA allows for the attainment of coronary anatomic, cardiac function and MPI from one piece of equipment. PET/SPECT cameras can now assess perfusion, function, and metabolism. Assessing cardiac viability is now fairly routine with these enhancements to cardiac imaging. This issue is full of important information that every cardiologist needs to now

Pulmonary embolism : diagnostic management and prognosis

This thesis describes the diagnostic management, short term prognosis and long term complications of pulmonary embolism. We have validated a newly derived clinical decision rule, the revised Geneva score, for predicting the pre-test probability of having acute pulmonary embolism. This rule can be used in clinical practice to managge patients with suspected pulmonary embolism. We further found that NT-pro-BNp levels are the best predictors of benign clinical course, when compared to troponin and D-dimer levels, and CT derived maesurements of the right ventricular volume and function. Finally, we demonstrate that although the incidence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism is very low, the long term clinical course after pulmonary embolism is complicated frequently by mortalitity, recurrent venous thombosis, newly diagnosed maligancies and arterial cardiovascular events.UBL - phd migration 201

UWOMJ Volume 83, No 1, Winter 2014

Schulich School of Medicine & Dentistry Rural and Remote Medicine Cover of issue reads Winter 2014 - Inside Table of Contents page reads Spring 2014https://ir.lib.uwo.ca/uwomj/1067/thumbnail.jp

Diseases of the Chest, Breast, Heart and Vessels 2019-2022

This open access book focuses on diagnostic and interventional imaging of the chest, breast, heart, and vessels. It consists of a remarkable collection of contributions authored by internationally respected experts, featuring the most recent diagnostic developments and technological advances with a highly didactical approach. The chapters are disease-oriented and cover all the relevant imaging modalities, including standard radiography, CT, nuclear medicine with PET, ultrasound and magnetic resonance imaging, as well as imaging-guided interventions. As such, it presents a comprehensive review of current knowledge on imaging of the heart and chest, as well as thoracic interventions and a selection of "hot topics". The book is intended for radiologists, however, it is also of interest to clinicians in oncology, cardiology, and pulmonology

Stratificazione del rischio coronarico in una popolazione di pazienti asintomatici: impatto della Cardio-TC

Scopo: valutare l’impatto della Coronaro-TC nella stratificazione del rischio coronarico in una popolazione di pazienti asintomatici con due o più fattori di rischio per malattia coronarica e comparare i risultati ottenuti con quelli calcolati con il sistema SCORE (Systematic Coronary Risk Evaluation). Materiali e Metodi: 123 pazienti (97 maschi e 26 femmine), con un punteggio SCORE a 10 anni inferiore al 5%, sono stati sottoposti ad un esame di Cardio-TC. È stato valutato inoltre il calcium score. I pazienti sono stati suddivisi in 3 gruppi: pazienti senza malattia coronarica, pazienti con stenosi non significative delle coronarie, e pazienti con stenosi significative delle coronarie. È stato sviluppato un modello di simulazione per la valutazione dei possibili differenti effetti terapeutici sulla base dei risultati della Cardio-TC e dello SCORE system. Sono stati comparati i risultati ed inoltre è stata valutata la percentuale di morte da tumore indotto da radiazioni. Abbiamo effettuato una valutazione globale del rischio coronarico con la Cardio-TC, incluso il rischio derivante l’uso di radiazioni, e comparato tale rischio con l’ipotesi di non effettuare alcuna terapia. Risultati: il rischio pretest di sviluppare malattia cardiovascolare nella popolazione asintomatica studiata è del 1,06%. Il valore medio del calcium score è 56,48 ± 176,61 (rischio moderato). 17 pazienti con stenosi significativa delle coronarie sono stati sottoposti a interventi di rivascolarizzazione. Il rischio medio di sviluppare eventi cardiovascolari utilizzando la Cardio-TC è del 0.42 ± 0.66. Utilizzando la Cardio TC per la stratificazione del rischio, abbiamo trovato un valore significativamente (p<0.05) inferiore. Conclusioni: La stratificazione del rischio coronarico risulta più accurata di quella ottenuta con lo SCORE system. Il rischio correlato all’uso di radiazioni risulta inferiore rispetto al rischio derivante dal non effettuare alcuna terapia

Stratificazione del rischio coronarico in una popolazione di pazienti asintomatici: impatto della Cardio-TC

Scopo: valutare l’impatto della Coronaro-TC nella stratificazione del rischio coronarico in una popolazione di pazienti asintomatici con due o più fattori di rischio per malattia coronarica e comparare i risultati ottenuti con quelli calcolati con il sistema SCORE (Systematic Coronary Risk Evaluation). Materiali e Metodi: 123 pazienti (97 maschi e 26 femmine), con un punteggio SCORE a 10 anni inferiore al 5%, sono stati sottoposti ad un esame di Cardio-TC. È stato valutato inoltre il calcium score. I pazienti sono stati suddivisi in 3 gruppi: pazienti senza malattia coronarica, pazienti con stenosi non significative delle coronarie, e pazienti con stenosi significative delle coronarie. È stato sviluppato un modello di simulazione per la valutazione dei possibili differenti effetti terapeutici sulla base dei risultati della Cardio-TC e dello SCORE system. Sono stati comparati i risultati ed inoltre è stata valutata la percentuale di morte da tumore indotto da radiazioni. Abbiamo effettuato una valutazione globale del rischio coronarico con la Cardio-TC, incluso il rischio derivante l’uso di radiazioni, e comparato tale rischio con l’ipotesi di non effettuare alcuna terapia. Risultati: il rischio pretest di sviluppare malattia cardiovascolare nella popolazione asintomatica studiata è del 1,06%. Il valore medio del calcium score è 56,48 ± 176,61 (rischio moderato). 17 pazienti con stenosi significativa delle coronarie sono stati sottoposti a interventi di rivascolarizzazione. Il rischio medio di sviluppare eventi cardiovascolari utilizzando la Cardio-TC è del 0.42 ± 0.66. Utilizzando la Cardio TC per la stratificazione del rischio, abbiamo trovato un valore significativamente (p<0.05) inferiore. Conclusioni: La stratificazione del rischio coronarico risulta più accurata di quella ottenuta con lo SCORE system. Il rischio correlato all’uso di radiazioni risulta inferiore rispetto al rischio derivante dal non effettuare alcuna terapia

Diseases of the Chest, Breast, Heart and Vessels 2019-2022

This open access book focuses on diagnostic and interventional imaging of the chest, breast, heart, and vessels. It consists of a remarkable collection of contributions authored by internationally respected experts, featuring the most recent diagnostic developments and technological advances with a highly didactical approach. The chapters are disease-oriented and cover all the relevant imaging modalities, including standard radiography, CT, nuclear medicine with PET, ultrasound and magnetic resonance imaging, as well as imaging-guided interventions. As such, it presents a comprehensive review of current knowledge on imaging of the heart and chest, as well as thoracic interventions and a selection of "hot topics". The book is intended for radiologists, however, it is also of interest to clinicians in oncology, cardiology, and pulmonology

Liver Biopsy

Liver biopsy is recommended as the gold standard method to determine diagnosis, fibrosis staging, prognosis and therapeutic indications in patients with chronic liver disease. However, liver biopsy is an invasive procedure with a risk of complications which can be serious. This book provides the management of the complications in liver biopsy. Additionally, this book provides also the references for the new technology of liver biopsy including the non-invasive elastography, imaging methods and blood panels which could be the alternatives to liver biopsy. The non-invasive methods, especially the elastography, which is the new procedure in hot topics, which were frequently reported in these years. In this book, the professionals of elastography show the mechanism, availability and how to use this technology in a clinical field of elastography. The comprehension of elastography could be a great help for better dealing and for understanding of liver biopsy

A study of clinicopathological characteristics, symptoms and patients experiences related to outcomes in people with cancer and I-PE

Background: The clinical course of incidental pulmonary embolism in cancer population represents an area of controversy. It presents a growing challenge for clinicians because of a lack of prospective data.Aim: This research aims to investigate the impact of an incidentally diagnosed pulmonary embolism on cancer population’ outcomes and to explore their experience of living with cancer and i-PE. The second aim was to explore the role of the key thrombogenic biomarkers as a predictive biomarker of thrombosis.Methods: Mixed method research with critical integrative analysis. A systematic literature review and qualitative analysis to examine patients’ experience of living with cancer-associated thrombosis. A prospective observational case-controlled cohort study with embedded semi-structured interview study to investigate the quality of life and patients’ experience of living with cancer and incidental pulmonary embolism. A retrospective case control-study and scientific analysis of defined biological key factors associated with thrombosis.Results: The diagnosis of cancer-associated thrombosis including incidental pulmonary embolism negatively affect patients’ life, and patients experience this diagnosis in the context of living with cancer. Yet it is a diagnosis that often misattributed, misdiagnosed and associated with lack of information among patients and some of the clinical care professionals. The scientific analysis of the biological biomarkers illustrates the potential role of TF-mRNA as a predictive biomarker for cancer- associated incidental pulmonary embolism and the role of anti-factor ten anticoagulation in reducing the risk of thrombosis.Conclusion: Awareness of patients and care professionals regarding the high risk of thrombosis among cancer population represent an urgent need. Risk assessment tools to predict patients at increased risk of thrombosis would be of value and help target education and reduce the risk of diagnostic overshadowing

Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.

BackgroundInjuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city.Materials and methodsAdministrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury.ResultsA total of 6,234 injured people were seen at the Central Hospital of Yaoundé's emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital (p &lt; 0.001), whereas patients suffering intentional injuries and bites were less likely to be hospitalized (p &lt; 0.001). Males were significantly more likely to be admitted than females (p &lt; 0.001)DiscussionPatterns in terms of age, gender, and mechanism of injury are similar to reports from other countries from the same geographic region, but the magnitude of cases reported is high for a single institution in an African city the size of Yaoundé. As the burden of disease is predicted to increase dramatically in sub-Saharan Africa, immediate efforts in prevention and treatment in Cameroon are strongly warranted