Pulmonary artery stiffness is independently associated with right ventricular mass and function: a cardiac MR imaging study

Purpose: To determine the relationship between pulmonary artery (PA) stiffness and both right ventricular (RV) mass and function with cardiac magnetic resonance (MR) imaging.Materials and Methods: The study was approved by the local research ethics committee, and all participants gave written informed consent. Cardiac MR imaging was performed at 1.5 T in 156 healthy volunteers (63% women; age range, 19-61 years; mean age, 36.1 years). High-temporal-resolution phase-contrast imaging was performed in the main and right PAs. Pulmonary pulse wave velocity (PWV) was determined by the interval between arterial systolic upslopes. RV function was assessed with feature tracking to derive peak systolic strain and strain rate, as well as peak early-diastolic strain rate. RV volumes, ejection fraction (RVEF), and mass were measured from the cine images. The association of pulmonary PWV with RV function and mass was quantified with univariate linear regression. Interstudy repeatability was assessed with intraclass correlation.Results: The repeatability coefficient for pulmonary PWV was 0.96. Increases in pulmonary PWV and RVEF were associated with increases in age (r = 0.32, P < .001 and r = 0.18, P = .025, respectively). After adjusting for age (P = .090), body surface area (P = .073), and sex (P = .005), pulmonary PWV demonstrated an independent positive association with RVEF (r = 0.34, P = .026). Significant associations were also seen with RV mass (r = 0.41, P = .004), RV radial strain (r = 0.38, P =. 022), and strain rate (r = 0.35, P = .002), and independent negative associations were seen with radial (r = 0.27, P = .003), longitudinal (r = 0.40, P = .007), and circumferential (r = 0.31, P = .005) peak early-diastolic strain rate with the same covariates.Conclusion: Pulmonary PWV is reliably assessed with cardiac MR imaging. In subjects with no known cardiovascular disease, increasing PA stiffness is associated with increasing age and is also moderately associated with both RV mass and function after controlling for age, body surface area, and sex. (C) RSNA, 201

Internship in Geriatrics Report

Dissertação de Mestrado em Geriatria apresentada à Faculdade de MedicinaIn the following report is presented my internship in Geriatrics, integrated in the Master in Geriatrics of the Faculty of Medicine of the University of Coimbra. The internship was held in the Orthogeriatrics Unit from the Internal Medicine Department of the Hospital de São Francisco Xavier - Centro Hospitalar Lisboa Ocidental E.P.E, between May and October of 2019.As a General Practitioner, I choose the Master in Geriatrics to develop competences in an area which I consider of top priority. The considerable expansion of the senior population imposes a redefinition of the health care provided. The recent and increasing scientific breakthroughs can now allow a medical care more personalized and with better outcomes for the patient, exposing, nonetheless, the existing gaps of this care in the Portuguese reality. Therefore, I consider this an imperative and promising medical area, in which, there is still plenty to explore, study and improve.During this Master, I aimed to acquire a strong scientific and clinical knowledge which can help me become a better doctor for this population, as well as to become an active part in the evolution of the medical care provided to the elderly that must happen in Portugal over the next years.I elected the Master in Geriatrics of the Faculty of Medicine of the University of Coimbra for its pioneer cycle of studies with recognized quality and experience in the teaching of Geriatrics, both present in its multiple previous editions.I choose the Orthogeriatrics Unit of the Centro Hospitalar Lisboa Ocidental to conduct this internship for its nationally recognized experienced medical team, as for its close objectives to the programmatic contents of the Master. O relatório que apresento pretende caraterizar o meu estágio em Geriatria, realizado no âmbito da disciplina de Estágio do Mestrado em Geriatria da Faculdade de Medicina da Universidade de Coimbra.Realizei este estágio na Unidade de Ortogeriatria, do Serviço de Medicina Interna do Hospital de São Francisco Xavier - Centro Hospitalar Lisboa Ocidental E.P.E, num período distribuído entre maio e outubro de 2019. Como médico de Medicina Geral e Familiar, optei por realizar o Mestrado em Geriatria para desenvolver competências numa área que considero de primordial importância. A franca expansão da população idosa impõe uma redefinição célere dos cuidados que lhe são prestados. Os crescentes avanços científicos em Geriatria permitem agora um acompanhamento médico mais dirigido e com mais ganhos em saúde, expondo, no entanto, as francas lacunas destes mesmos cuidados na realidade portuguesa. Considero assim que se trata de uma área importante e promissora, na qual há ainda muito por explorar, por conhecer e por melhorar. Procurei adquirir nesta área uma base de conhecimentos científicos e clínicos sólidos que me permitam ser melhor médico para esta população, bem como ser parte ativa na evolução dos cuidados prestados ao idoso que necessariamente acontecerá em Portugal nos próximos anos.Elegi o Mestrado em Geriatria da Faculdade de Medicina da Universidade de Coimbra por ser tratar de um ciclo de estudos pioneiro e de reconhecida qualidade e experiência em formação geriátrica, ambas evidenciadas nas suas múltiplas edições.Escolhi a Unidade de Ortogeriatria do Centro Hospitalar Lisboa Ocidental para realizar este estágio pelo reconhecido profissionalismo da sua equipa, assim como pela relação próxima com os conteúdos programáticos do mestrado

The experiences of early career geriatricians throughout Europe during the COVID-19 pandemic

The COVID-19 pandemic has severely affected older adults and brought about unprecedented challenges to geriatricians. We aimed to evaluate the experiences of early career geriatricians (residents or consultants with up to 10 years of experience) throughout Europe using an online survey. We obtained 721 responses. Most of the respondents were females (77.8%) and residents in geriatric medicine (54.6%). The majority (91.4%) were directly involved in the care of patients with COVID-19. The respondents reported moderate levels of anxiety and feelings of being overloaded with work. The anxiety levels were higher in women than in men. Most of the respondents experienced a feeling of a strong restriction on their private lives and a change in their work routine. The residents also reported a moderate disruption in their training and research activities. In conclusion, early career geriatricians experienced a major impact of COVID-19 on their professional and private lives