PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Cardiology”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1992

A survey of nuclear cardiological practice in Great Britain. The British Nuclear Cardiology Group.

There is little information on the practice of nuclear cardiology in Great Britain. On behalf of the British Nuclear Cardiology Group in October 1988 we sent a postal questionnaire to 143 hospitals with nuclear medicine facilities (at least 70% of such hospitals). Sixty nine replies were received (48%), of which 23 (33%) were from teaching hospitals and 46 (39%) non-teaching. In these hospitals 147,904 isotope investigations were performed annually (mean 2311 per centre) of which 17,298 (12%) (mean 254 per centre) were cardiac studies. Of these, 59% were equilibrium radionuclide ventriculograms, 14% first pass ventriculograms, and 27% thallium-201 scans. Rest studies were performed more commonly by radiographers or technicians (63%) than by doctors (20%), but doctors were more commonly involved in stress studies (48%). Radiologists reported the studies more often (28%) than they performed them (6%). Methods of acquisition and analysis were varied and, for instance, the lower limit of normal left ventricular ejection fraction ranged from 35% to 75% (mean 49%). For thallium imaging 42% of centres used dipyridamole in some patients and 24% used tomography. These data show that nuclear cardiology techniques are used much less frequently in Great Britain than in countries such as the United States and Germany, that the ratio of blood pool to myocardial perfusion imaging is much higher than elsewhere, and that methods are poorly standardised. They may provide the impetus to improve the service and serve as a baseline for future surveys.

Cardiology↗
PubMed1992

Seventh survey of staffing in cardiology in the United Kingdom 1991. British Cardiac Society, the Cardiology Committee of the Royal College of Physicians, and the Trafford Centre for Medical Research, University of Sussex.

The Seventh Survey of Staffing in Cardiology was conducted with an index date of 31 July 1991. At that time the total number of posts for cardiologists in England and Wales, defined as individuals trained in the specialty and spending at least 40% of their professional time working in it, was 340. Ten individuals worked part time only, making 335 whole time equivalent posts. This number increased from 1990 by 15 (4.7%). There were 67 cardiologists in Scotland and Northern Ireland, making a total for the United Kingdom of 407 posts (402 whole time equivalents). Sixteen Districts in England and Wales had no cardiologist at the time of the survey, and 31 other Districts had less than seven visiting sessions each week. The situation had not improved since the 1990 survey. The population of these 47 Districts is nearly nine million. Scotland had almost 800,000 additional people served by Health Boards without resident cardiologists. The number of senior registrars and lecturers is inadequate to provide a full period of training for most who advance to consultant status, and the situation will worsen from 1995 onwards. A major problem has been a top slice of 10 posts for a research allocation, few of which are occupied by individuals seeking a career in the specialty. These posts should be redesignated to increase training opportunities to counter the present shortfall and facilitate an expansion in consultant posts of at least 5% per annum over the next decade.

Cardiology↗
PubMed1992

Provision of services for the diagnosis and treatment of heart disease. Fourth report of a Joint Cardiology Committee of the Royal College of Physicians of London and the Royal College of Surgeons of England.

The principal conclusions of the fourth report of the Joint Cardiology Committee are: 1 Cardiovascular disease remains a major cause of death and morbidity in the population and of utilisation of medical services. 2 Reduction in the risk of cardiovascular disease is feasible, and better co-ordination is required of strategies most likely to be effective. 3 Pre-hospital care of cardiac emergencies, in particular the provision of facilities for defibrillation, should continue to be developed. 4 There remains a large shortfall in provision of cardiological services with almost one in five district hospitals in England and Wales having no physician with the appropriate training. Few of the larger districts have two cardiologists to meet the recommendation for populations of over 250,000. One hundred and fifty extra consultant posts (in both district and regional centres) together with adequate supporting staff and facilities are urgently needed to provide modest cover for existing requirements. 5 The provision of coronary bypass grafting has expanded since 1985, but few regions have fulfilled the unambitious objectives stated in the Third Joint Cardiology Report. 6 The development of coronary angioplasty has been slow and haphazard. All regional centres should have at least two cardiologists trained in coronary angioplasty and there should be a designated budget. Surgical cover is still required for most procedures and is best provided on site. 7 Advances in the management of arrhythmias, including the use of specialised pacemakers, implantable defibrillators, and percutaneous or surgical ablation of parts of the cardiac conducting system have resulted in great benefit to patients. Planned development of the emerging sub-specialty of arrhythmology is required. 8 Strategies must be developed to limit the increased exposure of cardiologists to ionising radiation which will result from the expansion and increasing complexity of interventional procedures. 9 Supra-regional funding for infant cardiac surgery and transplantation has been successful and should be continued. 10 Despite advances in non-invasive diagnosis of congenital heart disease the amount of cardiac catheterisation of children has risen due to the increase in number of interventional procedures. Vacant consultant posts in paediatric cardiology and the need for an increase in the number of such posts cannot be filled from existing senior registrar posts. All paediatric cardiac units should have a senior registrar and in the meantime it may be necessary to make proleptic appointments to consultant posts with arrangements for the appointees to complete their training. 11 Provision of care for the increasing number of adolescent and adult survivors of complex congenital heart disease is urgently required. The management of these patients is specialised, and the committee recommends that it should ultimately be undertaken by either adult or pediatric cardiologists with appropriate additional training working in supra-regionally funded centers alongside specially trained surgeons. 12 Cardiac rehabilitation should be available to all patients in the United Kingdom. 13 New recommendations for training in cardiology are for a total of at least five years in the specialty after general professional training, plus a year as senior registrar in general medicine. An additional year may be required for those wishing to work in interventional cardiology and adequate provision must be made for those with an academic interest. 14 It is essential that both basic and clinical research is carried out in cardiac centres but these activities are becoming increasingly limited by the lack of properly funded posts in the basic sciences and restriction in the number of honorary posts for clinical research workers. 15 A joint audit committee of the Royal College of Physicians and the British Cardiac Society has been established to coordinate audit in the specialty. All district and regional cardiac centres should cooperate with the work of the committee, in addition to their participation in local audit activities.

Cardiac Surgical Procedures↗
PubMed1992

[A survey of cardiological emergencies in Piedmont].

OBJECTIVES AND DESIGN: In order to assess the current behavioural status of patients receiving emergency cardiological treatment and the emergency services in the Piedmont Region, our Division carried out a survey of the Region's DEA and first aid centres based on the compilation of a questionnaire for each patient who passed through these structures over a 5-month period. The study included only patients hospitalised within 12 hours of symptoms' onset. The questionnaire aimed to assess the time the patient took to reach a decision, the eventual call for a home visit, the type of doctor called, the time spent by the doctor, the use of either a private vehicle or of an ambulance for transport to hospital, the time taken to get to the hospital, and the overall time taken to admit the patient to the emergency cardiological ward. The statistical analysis of data was carried out using both single and multiple variables. The selection of prognostic variables was carried out using a stepwise method. RESULTS: Data presented in this study refer to 1705 records, collected in 39 Piedmontese hospitals (75% of those with DEA or First Aid Center). Patients with acute myocardial infarction were 970 (57%). A doctor was requested at home in nearly half of the cases (49.3%). There was no correlation between the type of emergency and the request for a home visit, whereas the latter varied in relation to the different geographical areas and to the patients' age. A small majority of patients used personal transport to get to the hospital (55.5%) in comparison to those using an ambulance (44.5%) (p less than 0.001). Time taken to reach a decision was related to the type of pathology (acute pulmonary edema less than acute myocardial infarction less than arrhythmia) and to geographical area; mean decision time in the overall sample was 125 +/- 158 minutes. The mean duration of doctors' intervention at home was 74 +/- 82 minutes. The mean time taken to reach the hospital using private transport was 22 minutes, and the time taken using ambulance was the same, but this should be added to the time taken for the ambulance to reach the patient (a mean total time of 15 minutes). Overall mean hospitalisation time was 192 minutes. CONCLUSIONS: The critical factors causing delay in hospitalisation time are the poor levels of health education of the population in general, and the poor activation capacity of certain peripheral parts of the National Health Service. In particular, it is worth drawing attention to the delay due to the intervention of the family doctor in the current organisational model. Doctors called from first aid stations are able to provide a more rapid intervention, but are currently unable to meet the requirements of patients needing emergency cardiological treatments. These data confirm the rationale for intervention projects in cardiological emergencies, considering on one hand that a fleet of special vehicles be created, and on the other that doctors from first aid stations be specifically trained and increasingly involved.

Aged↗
PubMed1992

Pediatric cardiology research in 1990: a review of abstracts submitted to the Society for Pediatric Research, American Academy of Pediatrics, and American Heart Association Scientific Sessions.

We assessed pediatric cardiology research by reviewing pediatric cardiology abstracts submitted in 1990 to the Society of Pediatric Research, American Academy of Pediatrics, and American Heart Association national meetings. Included were accepted and rejected studies. Abstracts were reviewed for disease being studied, methodology used to answer the research question, study design, and acceptance/rejection. Abstracts were analyzed from 123 institutions, 81 American and 42 foreign. Out of 423 abstracts, 307 (72.6%) were clinical and the remainder were basic science investigations. Slightly more than half of the clinical submissions were related to congenital heart disease. Coronary artery disease and inflammatory diseases accounted for 12% of clinical submissions. Echocardiography, clinical outcome measures, and electrophysiology were the most common research methodologies. Almost 80% of basic science research was performed in normal tissues; animal physiology, fetal physiology, and cellular/biochemical studies were the most common methodologies. With regard to study design, half of the clinical studies were retrospective and only 6% were either prospective epidemiologic or prospective controlled intervention trials. For basic sciences, 38% of abstracts were descriptions of phenomena and 62% were hypothesis testing, with developmental hypotheses being most common. Acceptance rates favored higher quality study design. However, areas of greatest interest to cardiologists, congenital heart disease, cardiomyopathy, and electrophysiology, had poorer quality study design than did other areas. We have shown broad interest in pediatric cardiology research. However, clinical studies frequently were retrospective or had uncontrolled study designs. Basic science research was performed at a small number of institutions and emphasized either description of phenomena or developmental biology of normal tissues.

Abstracting and Indexing↗