751
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Alpert JS. Current realities and potential new pathways for cardiology training. Curr Cardiol Rep 2005; 7:77-8. [PMID: 15717951 DOI: 10.1007/s11886-005-0015-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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752
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Ghosh N, Yee R, Klein GJ, Quantz M, Novick RJ, Skanes AC, Krahn AD. Laser Lead Extraction: Is There a Learning Curve? PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2005; 28:180-4. [PMID: 15733175 DOI: 10.1111/j.1540-8159.2005.09368.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Laser extraction of device leads offers an attractive alternative to countertraction and electrosurgical dissection sheath, potentially increasing efficacy and reducing complications. Wider adoption of this technology depends on relative ease of use. We report the experience of a new center to define the "learning curve." We performed 76 laser lead extractions in 75 patients (age 63 +/- 17 years, 59 male) from July 2001 to January 2004. Two experienced device implanters who were novice extractors underwent a 2-day site visit to a high volume extraction center for training. Lead extractions were performed in the operating room with immediate surgical backup. The indication for extraction was infection in 39 (systemic in 15), erosion or pain in 11, and lead related or debulking in 25. Complete removal was achieved in 139 of 145 leads (14 ICD, 131 pacemaker). Partial removal (<4 cm retained) was achieved in five leads (4%), and one lead could not be extracted. Complete success was 95% in the first third of patients, 94% in the second third, and 100% in the latter third. Fluoroscopy time fell from 19 +/- 22 minute in the first third of patients to 11 +/- 8 minute in the second third to 8 +/- 4 minute in the latter third (ANOVA P = 0.02). No major complications occurred. Local bleeding required minor left subclavian vein repair in two individuals. Symptomatic venous thrombosis occurred in 3 of the first 11 cases 1-21 days after extraction, but did not occur in the next 64 consecutive patients who received a 1-month anticoagulation regimen (27% vs 0%, P < 0.001). One patient developed venous thrombosis 3 weeks following cessation of warfarin therapy. Practice guidelines reasonably recommend appropriate training prior to independent performance of lead extraction. The current study suggests that experienced device implanters with appropriate operative backup taking a limited, but intensive training program can be safe and effective at lead extraction in a short time, in part a reflection of the improved technology.
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753
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Obel P. The World in Review. Pacing Clin Electrophysiol 2005; 28:171-2. [PMID: 15679651 DOI: 10.1111/j.1540-8159.2005.09563.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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754
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Interventional cardiology. CLINICAL PRIVILEGE WHITE PAPER 2005:1-12. [PMID: 15688508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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755
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Elliott MJ. I wasn't trained for this! Cardiol Young 2005; 15 Suppl 1:165-8. [PMID: 15934711 DOI: 10.1017/s104795110500123x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
As once observed by Tom Spray, “When they invite you to give the history talk, you're finished!” Those words flashed through my mind when I was invited to deliver the version of the lecture celebrating George Daicoff, and forced me to think carefully about what I do, and what I believe about doing it. I have been doing cardiac surgery for 25 years, and paediatric cardiac surgery for 20 of those. Looking back, it would be tempting to think that I am here to follow in the illustrious footsteps of Kirklin, Debakey, Lillehei, Cooley, Ross, Yacoub or Daicoff. But I have to admit that would not be the truth. I was more influenced by Dr Kildare and M.A.S.H., driven by the drama of their lives and the beauty of their nurses. I have not been disappointed.
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756
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AACN new subspecialty certification exams. Crit Care Nurse 2005; Suppl:38-9. [PMID: 15747498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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757
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Connors JJ, Sacks D, Furlan AJ, Selman WR, Russell EJ, Stieg PE, Hadley MN, Wojak JC, Koroshetz WJ, Heros RC, Strother CM, Duckwiler GR, Durham JD, Tomsick TO, Rosenwasser RH, McDougall CG, Haughton VM, Derdeyn CP, Wechsler LR, Hudgins PA, Alberts MJ, Raabe RD, Gomez CR, Cawley CM, Krol KL, Futrell N, Hauser RA, Frank JI. Training, competency, and credentialing standards for diagnostic cervicocerebral angiography, carotid stenting, and cerebrovascular intervention: A Joint Statement from the American Academy of Neurology, the American Association of Neurological Surgeons, the American Society of Interventional and Therapeutic Neuroradiology, the American Society of Neuroradiology, the Congress of Neurological Surgeons, the AANS/CNS Cerebrovascular Section, and the Society of Interventional Radiology. Neurology 2005; 64:190-8. [PMID: 15668413 DOI: 10.1212/01.wnl.0000148958.34025.09] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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758
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759
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Clausell N, Fuchs FD, Manfroi WC, Ribeiro JP. [The post graduate program of the school of medicine of UFRGS on cardiology and cardiovascular sciences]. Arq Bras Cardiol 2005; 83:458-60. [PMID: 15654442 DOI: 10.1590/s0066-782x2004001800003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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760
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Coronary artery stenting. CLINICAL PRIVILEGE WHITE PAPER 2005:11-8. [PMID: 15868689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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761
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Westaby S. Houston and oxford: a celebration of international fellowship. Tex Heart Inst J 2005; 32:303-17. [PMID: 16392210 PMCID: PMC1336700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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762
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Adult transthoracic echocardiography. CLINICAL PRIVILEGE WHITE PAPER 2005:1-8. [PMID: 15633268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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763
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Reddi BAJ, Carpenter RHS. Venous excess: a new approach to cardiovascular control and its teaching. J Appl Physiol (1985) 2005; 98:356-64. [PMID: 15322065 DOI: 10.1152/japplphysiol.00535.2004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The circulatory control system is driven partly by factors relating to the arterial side and partly by factors relating to the venous side. Students are generally provided with a conceptually clear account of the arterial side, based on sound homeostatic mechanisms of negative feedback from a well-defined error signal, arterial pressure. However, on the venous side, teaching is often based on the notion of venous return, a concept that, as normally presented, is imprecise and intangible, a frequent cause of confusion that may lead to errors of clinical practice. Although one can trace these misconceptions back to some of Guyton's publications, Guyton himself was well aware of the complexities of venous resistance and capacitance but has not always been well served by subsequent misinterpretation. The fundamental problem with venous return that makes it inappropriate for controlling the circulation is that it lacks the essential requirement of being an error signal. We propose instead a new variable, venous excess, which represents the accumulation of any mismatch between the rate of blood entering the great veins and the rate of leaving, the cardiac output. As well as being directly observable without intervention (in a patient's jugular vein), it meets all of the requirements of an error signal: via the Starling mechanism it stimulates cardiac output, regulates venous compliance, and in the longer term is an important determinant of fluid intake and excretion, and these effects act to reduce the original perturbation. Based on this concept, we suggest a simple and secure basis for teaching the control of the circulation that avoids undue reliance on entities that are difficult to specify or measure and emphasizes the role of feedback and the similarities between the arterial and venous mechanisms.
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764
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Peripheral vessel stenting. CLINICAL PRIVILEGE WHITE PAPER 2005:19-28. [PMID: 15868690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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765
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Sacks D. Response to the ACC/ACP/SCAI/SVMB/SVS Clinical Competence Statement on Catheter-based Peripheral Vascular Interventions. J Vasc Interv Radiol 2005; 16:1-4. [PMID: 15640400 DOI: 10.1097/01.rvi.0000149507.62015.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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766
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Ayres NA, Miller-Hance W, Fyfe DA, Stevenson JG, Sahn DJ, Young LT, Minich LL, Kimball TR, Geva T, Smith FC, Rychik J. Indications and guidelines for performance of transesophageal echocardiography in the patient with pediatric acquired or congenital heart disease. J Am Soc Echocardiogr 2005; 18:91-8. [PMID: 15637497 DOI: 10.1016/j.echo.2004.11.004] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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767
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Fehske W, Buck T, Hagendorff A, von Bardeleben RS, Voelker W, Heinemann S. Qualitätsleitlinien Echokardiographie. ACTA ACUST UNITED AC 2005; 94:61-73; quiz 74. [PMID: 15668833 DOI: 10.1007/s00392-005-0169-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2004] [Accepted: 08/25/2004] [Indexed: 12/20/2022]
Abstract
Measures of quality assurance in echocardiography can be categorized according to standard principles into measures of reviewing structure, processing, and results. This document contains 1) the description of a three level system for education and qualifying in echocardiographic examinations (quality of structure) and 2) the draft of an external quality assurance process for reviewing the results of one echocardiographic investigator or of one laboratory of echocardiography (quality of results). The document also contains a draft description of a nationwide independent institution for certification, which is needed for both projects.A level 1 investigator should be able to perform and interpret a basic investigation. A basic investigation allows to exclude most of all cardiac diseases that can be diagnosed by echocardiography, and pathological findings should be filtered out. A level 2 investigator is able to perform an extended examination, and a comprehensive echocardiographic diagnosis can be established after her or his examination. Additional specific training and experience is necessary to be certified for TEE and stress echo examinations. A level 3 echocardiographer has done research work in echocardiography and should have performed certified teaching courses in echocardiography. The external quality assurance process should provide the possibility to certify the results and reports of a single investigator or of an echo laboratory, according to standard principles of reviewing the records. The process of certification is exclusively performed on a voluntary basis. The nationwide institution of certification should be part of the academy of education in cardiology of the German Society of Cardiology.
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768
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Carotid artery stenting. CLINICAL PRIVILEGE WHITE PAPER 2005:1-10. [PMID: 15868688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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769
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Alves de Lima A, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. MEDICAL TEACHER 2005; 27:46-52. [PMID: 16147770 DOI: 10.1080/01421590400013529] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The study was designed to illustrate how residents perceive the Mini Clinical Examination Exercise as an assessment tool and its influence on their approach to learning and studying. A phenomenographic approach was applied. All 16 residents from a cardiology training program in Buenos Aires were included. Results show that in all cases residents demonstrate an intrinsic interest in the subject matter. They show self-regulating strategies when required to select, relate and make critical appraisals of their own. They consistently demonstrate an aim to build a relationship between individual experience and their chosen topic. The residents feel comfortable because it melts with their routine. Residents find the Mini Clinical Examination Exercise to be a useful assessment tool with a favorable influence towards a constructive approach to study and learning.
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770
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Hirshfeld JW, Balter S, Brinker JA, Kern MJ, Klein LW, Lindsay BD, Tommaso CL, Tracy CM, Wagner LK, Creager MA, Elnicki M, Hirshfeld JW, Lorell BH, Rodgers GP, Tracy CM, Weitz HH. ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures. A report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training. J Am Coll Cardiol 2004; 44:2259-82. [PMID: 15582335 DOI: 10.1016/j.jacc.2004.10.014] [Citation(s) in RCA: 171] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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771
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By the numbers. Hospitals/healthcare systems. MODERN HEALTHCARE 2004; Suppl:12-6, 18. [PMID: 15638172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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772
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Moss AJ, Dubner SJ, Schapachnik E, Perez Riera AR. Virtual cardiac symposia: Worldwide, Internet-based, educational forums for cardiologists. Am J Cardiol 2004; 94:1588-9. [PMID: 15589027 DOI: 10.1016/j.amjcard.2004.08.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2004] [Revised: 08/27/2004] [Accepted: 08/27/2004] [Indexed: 11/23/2022]
Abstract
In this study, we detail our recent experience with 2 successful Internet-based virtual cardiac symposia that focused on the Brugada syndrome and the long QT syndrome. The responses from cardiologists around the world exceeded our expectations, and clearly, this approach answered an unmet need and has major educational potential. Although we initiated the Virtual Cardiac Symposia with the idea of assisting cardiologists caring for patients with relatively infrequent cardiac conditions, we believe that this Internet-based educational approach will have similar applicability and value for cardiologists caring for patients with common cardiac disorders.
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773
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Weeks B, Friedman AH. Training pediatric residents to evaluate congenital heart disease in the current era. Pediatr Clin North Am 2004; 51:1641-51, ix. [PMID: 15561178 DOI: 10.1016/j.pcl.2004.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Working with young pediatricians to create an exciting educational environment in which to learn cardiology remains a challenge for all of us. Numerous forces impact our efforts, making the process of training residents to evaluate and treat congenital heart disease in the current era a dynamic and, at times, difficult endeavor. This article considers the changes that have occurred in the medical school graduate who chooses pediatrics and subsequently pediatric cardiology as a career; explores the changes in the graduate medical training guidelines, requirements, and restrictions that have been put into place within the last several years; and discusses the seemingly constant advances in scientific understanding and technology that shape our field and move us forward as a discipline.
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774
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775
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Timuralp B. [Cardiology education at each level is still a serious problem]. ANADOLU KARDIYOLOJI DERGISI : AKD = THE ANATOLIAN JOURNAL OF CARDIOLOGY 2004; 4:285. [PMID: 15590353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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