Addressing Disparities in Nurses’ Understanding of Congestive Heart Failure

Congestive heart failure (CHF) continues to affect millions of people a year and remains one of the leading causes of re-hospitalization in the US. Within the Central San Joaquin Valley (CSJV) the incidence of CHF remains significantly higher than the rest of California. In order to ensure appropriate patient care and outcomes registered nurses (RNs) must have a thorough and full understanding of the disease process and its associated symptomatology. This study aimed to find if the implementation of an interactive multimedia educational program focusing on all aspects of CHF could improve RNs education and understanding of CHF. It is crucial that RNs taking care of patients at the bedside are comfortable in both identifying and treating as well as performing patient education on CHF. The study aimed at finding if an interactive multimedia educational program focusing on the application of didactic material in an interactive case study could effectively improve RN understanding of CHF. If effective RNs caring for patients with CHF will be able to better provide patient care and education resulting in improved patient outcomes, self-care, and quality of life

The Limiting of the Impact of Proxy Culture Wars by Religious Sensitivity: The Fight of Neo-Pentecostal Churches against LGBTQ Rights Organizations over Uganda’s Future

It has been argued recently that Uganda’s sexual law should be interpreted as a part of gender power struggles, rather than in the original neo-colonial interpretation or as a result of structural changes and President Museveni’s pragmatic policy. Based on our intensive fieldwork during the dry season in 2017, we argue that an understanding of this development as a combination of the US proxy culture wars–US cultural wars being fought worldwide-interacting with local religious sensitivity is more plausible. The “sexual law” is a product of the clash between conservatives and progressivists over Uganda’s future. The Neo-Pentecostals—typically supported by conservative circles from the USA and Canada—stand against the influence of secular NGOs—mostly connected with the LGBTQ and progressivist circles from the USA and EU. However, the effect of international influence is limited due to religious sensitivity, shaped by local tradition. Uganda’s people are not passive victims of any kind. They take an active part in the global contest between cultural progressivists and conservatives

The Role of Magnetic Resonance Imaging and Cardiac Computed Tomography in the Assessment of Left Atrial Anatomy, Size, and Function

In the last decade, there has been increasing evidence that comprehensive evaluation of the left atrium is of utmost importance. Numerous studies have clearly demonstrated the prognostic value of left atrial volume for long-term outcome. Furthermore, advances in catheter ablation procedures used for the treatment of drug-refractory atrial fibrillation require the need for detailed knowledge of left atrial and pulmonary venous morphology as well of atrial wall characteristics. This review article discusses the role of cardiac magnetic resonance and computed tomography in assessment of left atrial size, its normal and abnormal morphology, and function. Special interest is paid to the utility of these rapidly involving noninvasive imaging methods before and after atrial fibrillation ablation

Corners Toolbox Allowing Processing Binary Images in a Compressed Form

Traditionally, the time needed to process a binary image depends on the size of the image. Here, the image is losslessly compressed using Schlesinger's corner representation. The compressed image is represented by residuals to a 22 pixels predictor. There is significantly less of such residuals (we call them corners) than black pixels, as residuals correspond to corners of object outlines only. The main benefit comes from the fact that set operations, translation and scaling can be performed on compressed images directly. The processing time depends on the number of corners (i.e. image complexity) and not on the number of pixels in the image. The described public domain package implements operations AND, OR, XOR, NOT, scale, shift, connected component labelling and skeletonization

Comparison of echocardiographic parameters in Fabry cardiomyopathy and light-chain cardiac amyloidosis

International audienceFabry cardiomyopathy (FC) and light-chain amyloid cardiomyopathy (AL) present with concentric left ventricular (LV) hypertrophy/remodeling and diastolic rather than systolic dysfunction. Direct comparisons are difficult due to rarity and confounded by variability of LV thickness

Comparison of routine contrast‑enhanced computed tomography with late gadolinium enhancement cardiac magnetic resonance imaging in the detection of myocardial pathology

Bacground: Cardiac magnetic resonance imaging (MRI) represents the gold standard in noninvasive evaluation of myocardial tissue. However, some patients are unable to undergo cardiac MRI due to a variety of reasons. Aims: We sought to determine the diagnostic accuracy of routinely performed contrast‑enhanced computed tomography (CECT) compared with cardiac MRI in the evaluation of myocardial tissue. Methods: We retrospectively evaluated 96 consecutive patients (mean [SD] age, 51 [15] years; 41 women) who underwent both CECT and cardiac MRI within 30 days. All CECT scans that visualized the entire heart were analyzed, regardless of the indication for and protocol of the procedure. The presence of late gadolinium enhancement on cardiac MRI was compared with the finding of myocardial hypoattenuation on computed tomography scans. Results: With cardiac MRI as the gold standard, CECT revealed a per‑patient sensitivity of 66%, specificity of 89%, positive predictive value of 75%, negative predictive value of 84%, and accuracy of 81%. Per‑segment sensitivity was 54%; specificity, 98%; positive predictive value, 76%; negative predictive value, 94%; and accuracy, 92%. Conclusions: Our study suggests that routinely performed CECT has high specificity, but only moderate sensitivity, compared with cardiac MRI in the evaluation of myocardial tissue. This result supports the recommendation that all CECT scans that visualize the entire heart should be analyzed for myocardial tissue pathology

Non-Penetrance for Ocular Phenotype in Two Individuals Carrying Heterozygous Loss-of-Function ZEB1 Alleles

ZEB1 loss-of-function (LoF) alleles are known to cause a rare autosomal dominant disorder—posterior polymorphous corneal dystrophy type 3 (PPCD3). To date, 50 pathogenic LoF variants have been identified as disease-causing and familial studies have indicated that the PPCD3 phenotype is penetrant in approximately 95% of carriers. In this study, we interrogated in-house exomes (n = 3616) and genomes (n = 88) for the presence of putative heterozygous LoF variants in ZEB1. Next, we performed detailed phenotyping in a father and his son who carried a novel LoF c.1279C>T; p.(Glu427*) variant in ZEB1 (NM_030751.6) absent from the gnomAD v.2.1.1 dataset. Ocular examination of the two subjects did not show any abnormalities characteristic of PPCD3. GnomAD (n = 141,456 subjects) was also interrogated for LoF ZEB1 variants, notably 8 distinct heterozygous changes presumed to lead to ZEB1 haploinsufficiency, not reported to be associated with PPCD3, have been identified. The NM_030751.6 transcript has a pLI score ≥ 0.99, indicating extreme intolerance to haploinsufficiency. In conclusion, ZEB1 LoF variants are present in a general population at an extremely low frequency. As PPCD3 can be asymptomatic, the true penetrance of ZEB1 LoF variants remains currently unknown but is likely to be lower than estimated by the familial led approaches adopted to date

Role of magnetic resonance in the detection of cardiac involvement in patients with newly diagnosed extracardiac sarcoidosis: Single center experience

BACKGROUND: Sarcoidosis is a systemic inflammatory disease of unknown etiology, which can affect almost any organ. Cardiac involvement determines the prognosis of the affected individuals. Its prevalence in patients with extracardiac sarcoidosis with the absence of cardiac symptoms remains unclear. Cardiac magnetic resonance (CMR) provides an excellent diagnostic accuracy in the detection of the heart involvement by sarcoidosis. AIM: We sought to determine the prevalence of cardiac sarcoidosis in asymptomatic individuals with newly diagnoses extracardiac sarcoidosis using CMR. METHODS: We prospectively evaluated 55 consecutive patients mean (SD) aged 43 (11) years, including 23 women with newly diagnosed extracardiac sarcoidosis who underwent contrast-enhanced CMR and had no symptoms of heart disease. The presence of myocardial late gadolinium enhancement (LGE) of non-ischemic etiology on CMR examination was considered diagnostic for the presence of cardiac sarcoidosis. RESULTS: In 3 (6%) patients LGE pattern consistent with cardiac sarcoidosis was detected. In all these patients, preserved left ventricular systolic regional a well as global function was present and in none of them the elevation of blood biomarkers of myocardial injury or overload was found. CONCLUSIONS: Our study suggests that the prevalence of cardiac involvement in patients with newly diagnosed extracardiac sarcoidosis and no symptoms of heart disease is very low as assesed by CMR.  However, CMR may be considered as a part of routine evaluation of patients with extracardiac sarcoidosis due its higher diagnostic yield in comparison with echocardiography and ECG, respectively