There is currently no 'gold standard' model of clinical education. The perception that one model is superior to any other is based on anecdotes and historical precedents, rather than on meaningful, robust, comparative studies.
length (inferolateral + anteroseptal) showed a significant difference (p < 0.0001) between UE (46.71 ± 2.75 mm) and CE (57.74 ± 2.60). Conclusion: Despite exposure to destructive hydrodynamic forces, CE is feasible in an ovine VV ECMO model. CE results in significantly improved EDS and increased length of visualised endocardium.
Heart, Lung and CirculationCSANZ 2012 Abstracts 2012;21:S143-S316 3D-ST vs. 2D-ST GLS REST LD PD R 0.75 0.81 0.53 p value <0.0001 <0.0001 0.01Conclusions: GLS by 3D-ST provide a faster, more effective method to quantify LV function during DSE compared with 2D-ST. Reduced correlation at peak dose reflects increased signal noise. 3D-STE is a potential bedside clinical tool for quantifying GLS.http://dx.
Background:Coronary computed tomography has an increasing role in the diagnosis of coronary artery disease. There is growing awareness of dose delivered during any investigation using ionising radiation. We sought to investigate the change in radiation dose using prospective gating on a 256 detector scanner following the change from data reconstruction with filtered back projection (FBP) to reconstruction with an iterative technique (iDose). iDose reduces the noise in the images relative to reconstruction FBP. This allows scans to be performed at a lower peak voltage (kVp) without a decrease in image quality. CTCA was performed at 120 kVp for FBP reconstruction. This was reduced to 100 kVp with iDose.Methods: Sequential CTCA scans performed on each system were reviewed. Only those scans performed to evaluate for native coronary artery disease were included. Patient weight and the dose length product delivered during the CTCA component of the scan (excluding locators, trackers and non-contrast scans) were recorded. T tests were performed to assess statistical significance.Results: Eighty-two scans fulfilled inclusion criteria; 44 were performed at 120 kVp with FBP and 38 were performed at 100 kVp with iDose. Figures are reported as mean ± SD. The mean weight was similar between the groups at 87 ± 17 and 83 ± 21 kg respectively, (p = 0.36).The mean DLP for the CTCA component of the scan was significantly different at 238 ± 49 mG/cm and 115 ± 47 mG/cm respectively (p < 0.001).Conclusions: Changing scan technique with the introduction of iDose reduced radiation dose by 51%, allowing CTCA to be performed for 115 mgy/cm, equivalent to a dose of 1.61 mSv.
Background: There is overwhelming evidence of the effectiveness of secondary prevention medications. The aim of this analysis was to determine the use of secondary prevention medications in patients with acute coronary syndrome (ACS) in a representative sample of patients recruited to the CONCORDANCE study from 20 hospitals located in geographically diverse regions of Australia.
Methods: We investigated the proportion of patients that reported taking each of the five indicated classes of medications at discharge and six months after their index ACS event: (1) ACE/ARB, (2) beta blocker, (3) statin lipid lowering, (4) aspirin, and (5) ADP receptor blocker.Results: Of 754 patients in this analysis, the mean age was 61.9 ± 13.2 y and 26% were female. At six months follow-up 81% were taking ACE/ARB, (2) 78% beta blocker, (3) 91% statin lipid lowering, (4) 86% aspirin and (5) 66% ADP receptor blockers. The mean number of medications per patient was 3.83 (SD 1.27), 36% were taking all five indicated medications and 68% were taking four or more of five indicated medications. In comparison the mean number of medications per patient at discharge was 4.22 (SD 1.0), 53% were taking all five indicated medications and 77% were taking four or more of five indicated medications.Conclusion: Despite having very high risk of recurrent events, the use of indicated secondary prevention medications in ACS patients is sub-optimal at discharge and falls off further six months after their index event. Interventions are urgently required to improve these rates to prevent subsequent CV events. http://dx.
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