This document summarizes key points from a presentation on various congenital heart defects assessed by ECG-synchronized cardiac CT angiography. It discusses cases of unicuspid aortic valve, bicuspid aortic valve, infectious endocarditis with a subvalvular abscess and fistula, and quadricuspid aortic valve. For each case, it provides imaging findings and highlights important associated clinical features, complications, classifications where relevant, and management considerations for these congenital valve abnormalities.
A refresher course on imaging in peripheral arterial disease (PAD). The session also includes talk on clinical exam in PAD, MRA in PAD and interventional radiology treatment of PAD.
Acute type A dissection, is on of the highest mortality cases in cardiovascular surgery. It doubled it incident with concomitant complication such as malperfusion or pericardial tamponade. In this presentation, the patient have both coronary malperfusion and pericardial tamponade
A refresher course on imaging in peripheral arterial disease (PAD). The session also includes talk on clinical exam in PAD, MRA in PAD and interventional radiology treatment of PAD.
Acute type A dissection, is on of the highest mortality cases in cardiovascular surgery. It doubled it incident with concomitant complication such as malperfusion or pericardial tamponade. In this presentation, the patient have both coronary malperfusion and pericardial tamponade
atherosclerosis is one of most common cause of aortic ds,screening of abdominal aorta in vulnerable population is very useful for prevention and early detection of future omplication.
STICH (Surgical Treatment for Ischemic Heart Failure)theheart.org
- Population and treatment:
1212 patients with coronary artery disease amenable to coronary artery bypass graft (CABG) with LVEF <35%
Randomized to CABG or standard medical therapy alone
- Primary outcome:
All-cause death
STICH myocardial viability substudy:
- A substudy designed to determine whether substantial viable myocardium evident at baseline (visualized by SPECT imaging or dobutamine echo) affects all-cause mortality over five years or influences the relative effectiveness of the selected treatment strategy
See the article at http://www.theheart.org/article/1204899.do
CT and MRI of Aortic Valve Disease: Clinical Update Sam Watermeier
This article from Current Radiology Reports explores new improvements in CT and MR imaging techniques, which yield valuable information for patients with a variety of aortic valve and root pathology.
atherosclerosis is one of most common cause of aortic ds,screening of abdominal aorta in vulnerable population is very useful for prevention and early detection of future omplication.
STICH (Surgical Treatment for Ischemic Heart Failure)theheart.org
- Population and treatment:
1212 patients with coronary artery disease amenable to coronary artery bypass graft (CABG) with LVEF <35%
Randomized to CABG or standard medical therapy alone
- Primary outcome:
All-cause death
STICH myocardial viability substudy:
- A substudy designed to determine whether substantial viable myocardium evident at baseline (visualized by SPECT imaging or dobutamine echo) affects all-cause mortality over five years or influences the relative effectiveness of the selected treatment strategy
See the article at http://www.theheart.org/article/1204899.do
CT and MRI of Aortic Valve Disease: Clinical Update Sam Watermeier
This article from Current Radiology Reports explores new improvements in CT and MR imaging techniques, which yield valuable information for patients with a variety of aortic valve and root pathology.
Review course covering high resolution imaging of the arteries of the abdomen, pelvis, and legs. This new CT technique replaces the need for catheterization in most patients.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
1. Richard L. Hallett, MD
Chief, Cardiovascular Imaging
Northwest Radiology Network – Indianapolis, IN
Adjunct Assistant Professor of Radiology
Stanford University Hospital and Clinics
Stanford, CA
NASCI 2016 Baltimore, MD October 15, 2016
8. CASE 1 QUESTION:
WHICH OF THE FOLLOWING IS TRUE
REGARDING UNICUSPID AORTIC VALVE?
A. Most cases present in adulthood
B. UAV have better results from balloon
valvuloplasty than bicuspid aortic valve (BAV)
C. UAV shares some overlap with BAV patients,
including risk of aortopathy and coarctation
D. Have larger valve opening area than BAV
9. CASE 1 QUESTION: ANSWER
WHICH OF THE FOLLOWING IS TRUE
REGARDING UNICUSPID AORTIC VALVE?
A. Most cases present in adulthood
B. UAV have better results from balloon
valvuloplasty than bicuspid aortic valve (BAV)
C. UAV shares some overlap with BAV patients,
including risk of aortopathy and coarctation
D. Have larger valve opening area than BAV
Mookadam F, et al. J Heart Valve Dis 2010, 19(6)678-83
10. CONGENITAL “UNICUSPID”
AORTIC VALVE
• Unicuspid unicommisural (one lateral commisural
attachment, slit-like orifice)
• Unicuspid acomissural (no lateral attachments,
pinhole orifice, neonates)
• Mean age of diagnosis 14 months
• #1 presentation: CHF
• #1 lesion: isolated AS (37%)
Singh S, et al. Texas Heart J. 2015; 42: 273-276
Mookadam F, et al. J Heart Valve Dis 2010; 19(6)678-83
16. SAM QUESTION:
Bicuspid aortic valve (BAV) is best characterized as:
A. An isolated defect causing aortic valve
abnormalities
B. A systemic disorder with aortic tissue showing
decreased levels of matrix metalloproteinases
C. A systemic disorder that shares some
histopathologic findings with Marfan syndrome
D. A systemic disorder with sporadic heritance
17. SAM QUESTION: ANSWER
Bicuspid aortic valve (BAV) is best characterized as:
A. An isolated defect causing aortic valve
abnormalities
B. A systemic disorder with aortic tissue showing
decreased levels of matrix metalloproteinases
C. A systemic disorder that shares some
histopathologic findings with Marfan syndrome
D. A systemic disorder with sporadic heritance
Hanneman K, et al. Pre- and Postoperative Imaging of the Aortic Root.
Radiographics. 2016;36:19–37.
18. BICUSPID AORTIC VALVE
• 1-2% of the population
• Decreased Fibrillin-1 levels (M)
• Increased matrix metalloproteinases (M)
• NOTCH1 and ACTA2 genes
• Some inherited - autosomal dominant
19. BICUSPID AORTIC VALVE
• Aortic Dilatation / Aneurysms
• Aortic Dissection
• Aortic Coarctation
• Family members of BAV patients can show
aortic dilatation even though they have
trileaflet valves
20. BAV: CLASSIFICATION
• Sievers and Schmidtke – 2007
• Classification based on 304 surgical BAV
specimens
• Raphe: conjoint or fused portions of two
adjacent leaflets that become a malformed
commissure
27. CASE 3 QUESTION
Regarding HACEK infectious endocarditis (IE), which
is true?
A. HACEK are gram positive bacteria that are part
of normal skin flora
B. HACEK organisms cause a majority of infectious
endocarditis (IE) cases
C. HACEK IE patients tend to be younger than
other IE patients
D. Outcomes are poorer than other IE patients
28. CASE 3 QUESTION - ANSWER
Regarding HACEK infectious endocarditis (IE), which
is true?
A. HACEK are gram positive bacteria that are part
of normal skin flora
B. HACEK organisms cause a majority of infectious
endocarditis (IE) cases
C. HACEK IE patients tend to be younger than
other IE patients
D. Outcomes are poorer than other IE patients
Chambers ST et al. HACEK Infective Endocarditis: Characteristics and Outcomes from a Large,
Multi-National Cohort
Abbate A, editor. PLoS ONE. 2013;8:e63181.
36. QUESTION
The most common complication of Quadricuspid
Aortic Valve (QAV) is:
A. Valvular aortic stenosis
B. Aortic regurgitation
C. Atrial fibrillation
D. Left ventricular hypertrophy
Douglas, H., Moore, M., & Purvis, J. (2012). Comprehensive assessment of a quadricuspid
aortic valve and coronary arteries by multidetector cardiac CT. Heart, 98(24), 1838-1838.
37. QUESTION: ANSWER
The most common complication of Quadricuspid
Aortic Valve (QAV) is:
A. Valvular aortic stenosis
B. Aortic regurgitation
C. Atrial fibrillation
D. Left ventricular hypertrophy
Douglas, H., Moore, M., & Purvis, J. Heart, 2012: 98(24), 1838-1838.
38. QUADRICUSPID AORTIC VALVE
(QAV)
• Rare, 1/6000 aortic valve surgery patients1
• M = F, avg. age at Dx ~ 50
• Classification by size of cusps2
• Most common: 3 same size + 1 smaller cusp
(type B)
• Echo: “X”-shaped SAX view
• CT/MR: confirmatory; perform planimetry and/or
flow measurement3
1. Douglas, H., Moore, M., & Purvis, J. (2012) Heart 2012; 98(24), 1838-1838.
2. Hurwitz L, et al. Am J Cardiol 1973; 31(5) 623-626.
3. Khan SK, Tamin SS, Araoz PA. J Comput Assist Tomogr. 35 (5): 637-41.
39. CLASSIFICATION OF QAV1
A 4 equal sized cusps
B 3 equal + 1 smaller (most common)
C 2 equal + 2 equal smaller
D 1 large + 2 intermediate + 1 smaller
E 3 equal + 1 larger
F 2 equal large + 2 smaller unequal sizes
G 4 unequal sized cusps
1. Hurwitz L, et al. Am J Cardiol 1973; 31(5) 623-626.
40. QUADRICUSPID AORTIC VALVE
(QAV)
• Usually isolated, but can be associated with:
• Single or Anomalous Coronary Arteries
• Displacement of coronary ostia (from addl
cusp)
• HCM / Subaortic Stenosis
• PDA, VSD
• Endocarditis
1. Jagganath AD, et al. Echocardiography 2011; 28(9), 1035-1040.
2. Zhu J, et al. J Cardiothor Surg 2013; 8(1) 87.
3. Tutarel O. J. Heart Valve Dis. 2004;13 (4): 534-7.
41. QUADRICUSPID AORTIC VALVE
(QAV)
• Complications:
• Aortic Insufficiency (#1)
• Up to 75% at time of Dx
• LVH
• Conduction problems (BBB)
• TX: Reconstruction and/or Surgical valve
replacement
1. Jagganath AD, et al. Echocardiography 2011; 28(9), 1035-1040.
2. Zhu J, et al. J Cardiothor Surg 2013; 8(1) 87.
3. Tutarel O. J. Heart Valve Dis. 2004;13 (4): 534-7.
42. CONCLUSION
• Whether 1, 2, 3, or
4 cusps, aortic
valve pathology
can be well
assessed by ECG
synchronized CTA
43. THANKS FOR YOUR ATTENTION!!
HANDOUT:
http://stanford.edu/~hallett
Choose folder: NASCI 2016
xraydoc97@yahoo.com
hallett@stanford.edu
