Loftsaleh0750

The liver has a complex vascularization and is subjected to a high metabolic demand, making it vulnerable to hemodynamic changes. As a result, several pathologies can develop, one of which is congestive hepatopathy. This disease occurs secondary to various cardiovascular conditions that generate a persistent passive venous congestion in the liver, which in the long term can culminate in fibrosis and cirrhosis, which in turn increases the risk of developing hepatocellular carcinoma. In order to avoid this outcome, early diagnosis is crucial; however, both the clinical presentation and laboratory tests are unspecific, and they are only altered in advanced stages of the disease. One form of early detection is through imaging findings, there being various useful modalities such as Doppler ultrasonography (US), computed tomography, and magnetic resonance imaging. The purpose of this article is to detail the imaging findings of congestive hepatopathy in the different available modalities, with special emphasis on Doppler US, highlighting the role of the radiologist in the suspicion of this disease. We summarize the pathophysiologic mechanisms of congestive hepatopathy, clinical findings, and provide description of its main differential diagnoses.

Emergency departments (EDs) are often first to feel the intra-hospital effects of disasters. Compromised care standards during disasters eventuate from increased demands on health resources; the facilities, supplies, equipment and manpower imperative for a functioning healthcare facility. Emergency departments must understand the effect of disasters on their health resources. This paper examines the impact on resources within the ED as a result of a disaster and provides a review against the United Nations Office for Disaster Risk Reduction's Sendai Framework for Disaster Risk Reduction 2015-2030 priorities.

An integrative literature review design was utilised. Articles were extracted from databases and search engines. The Preferred Reporting Items of Systematic reviews and Meta-Analysis Guidelines for systematic literature reviews were used.

Seven papers met inclusion criteria. Tacrolimus mouse Disaster consumable stocking was used to mitigate disaster risk and improve resilience. Logistical challenges were exacerbated by poor building design. Ineffective human resource management, communications failure, insufficient ED space, diminished equipment and supplies and unreliable emergency power sources were described.

Disaster planning and preparedness strategies can address health resource deficits, increasing ED resilience. Further retrospective case studies are required to greater understand the effects of disasters on ED health resources.

Disaster planning and preparedness strategies can address health resource deficits, increasing ED resilience. Further retrospective case studies are required to greater understand the effects of disasters on ED health resources.Cardiovascular computed tomography (CCT) is a well-validated non-invasive imaging tool with an ever-expanding array of applications beyond the assessment of coronary artery disease. These include the evaluation of structural heart diseases, congenital heart diseases, peri-procedural electrophysiology applications, and the functional evaluation of ischemia. This breadth requires a robust and diverse training curriculum to ensure graduates of CCT training programs meet minimum competency standards for independent CCT interpretation. This statement from the Society of Cardiovascular Computed Tomography aims to supplement existing societal training guidelines by providing a curriculum and competency framework to inform the development of a comprehensive, integrated training experience for cardiology and radiology trainees in CCT.

CT coronary angiography (CTA) with Fractional Flow Reserve as determined by CT (FFR

) is a safe alternative to invasive coronary angiography. A negative FFR

has been shown to have low cardiac event rates compared to those with a positive FFR

. However, the clinical utility of FFR

according to age is not known.

Patients' in the ADVANCE (Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care) registry, were stratified into those ≥65 or <65 years of age. The impact of FFR

on clinical decision-making, as assessed by patient age, was determined by evaluating patient management using CTA results alone, followed by site investigators submitting a report on the treatment plan based upon the newly provided FFR

data. Outcomes at 1-year post CTA were assessed, including major adverse cardiovascular events (myocardial infarction, all-cause mortality or unplanned hospitalization for ACS leading to revascularisation) and total revascularisation. Positive FFR

was deemed to be≤0.8.

FFR

was cACE event with increasing age (OR 1.04, 95% CI 1.006-1.08, p=0.02). Amongst patients with a FFR

> 0.80, there was no effect of age on the odds of revascularisation.

The findings of this study point to a low risk of MACE events or need for revascularisation in those aged≥or <65 with a FFR

>0.80, despite the higher incidence of anatomic obstructive CAD in those ≥65 years. The findings show the clinical usefulness and outcomes of FFR

are largely constant regardless of age.

0.80, despite the higher incidence of anatomic obstructive CAD in those ≥65 years. The findings show the clinical usefulness and outcomes of FFRCT are largely constant regardless of age.

The association of age with coronary plaque dynamics is not well characterized by coronary computed tomography angiography (CCTA).

From a multinational registry of patients who underwent serial CCTA, 1153 subjects (61±5 years old, 61.1% male) were analyzed. Annualized volume changes of total, fibrous, fibrofatty, necrotic core, and dense calcification plaque components of the whole heart were compared by age quartile groups. Clinical events, a composite of all-cause death, acute coronary syndrome, and any revascularization after 30 days of the initial CCTA, were also analyzed. Random forest analysis was used to define the relative importance of age on plaque progression.

With a 3.3-years' median interval between the two CCTA, the median annual volume changes of total plaque in each age quartile group was 7.8, 10.5, 10.8, and 12.1mm

/year and for dense calcification, 2.5, 4.6, 5.4, and 7.1mm

/year, both of which demonstrated a tendency to increase by age (p-for-trend=0.001 and<0.001, respectively). However, this tendency was not observed in any other plaque components.