Abstract Amersham Health has developed a product for the next technological advance in cardiacdiagnostic testing, MYOVIEW with Rapid Clearance, for myocardial perfusion imaging. This paper explains how the product works and examines how MYOVIEW will help the medical industry and cardiac patients.
From the Paper "Myocardial perfusion imaging is the answer to the challenges felt by many physicians when patients may have a suspected myocardial infarction. Oftentimes a physician may feel that a patient is not having an MI, however, as a precautionary measure, will have the patient admitted for observation. If it turns out that they were not having an MI, the patient has now spent unneeded time at the hospital, taking up valuable bed space and staff time, at often over crowded hospitals, that could have been better used by patients who truly needed it. In fact, Udelson states that ?missed MI is one of the most common causes of litigation against ED personnel, and this test may also facilitate an earlier diagnosis in such patients(Glow; Udelson, 2003).?"
Abstract This paper reviews the five major tests of cardiac function. The paper begins by discussing how the tests are performed. Next the paper discusses what each test assesses. The paper concludes by stating the risks to the patient of undergoing the tests.
From the Paper "The cardiac stress test is an exercise tolerance test given to see how well the heart functions under physical stress. The test is carried out in a clinic, hospital or the doctor's office. It consists of riding a bicycle or using a treadmill while ...."
Tags: echocardiography, cardiac angiogram, technetium scan, cardiac stress test
Abstract This paper describes the acquisition history and business approach of Quest Diagnostics, the nation's leading provider of diagnostic testing, information and services. This paper is written from the perspective of an independent consultant hired to resolve conflicts and analyze team dynamics in the company. Some areas considered include work-group productivity, an expanded discussion of social influence within the organization, and the role of the individual and diversity. Additionally, Steven Covey's "7 Habits of Highly Effective People" are integrated into this paper. The author concludes that everything comes back to the strength of the organization, and the organization must be maintained and promoted as an overall priority for any firm.
Organizational Behavior-Quest Diagnostics Overview of the Paper
Work-Group Productivity
Social Influence
Individual Differences and Personality
The Habits of Effective People
Perception, Attribution and Motivation
High Performance, Effective and Ineffective Teams
Quality Management and Teamwork
Conclusion
People
Process
Professionalism
From the Paper "When discussing the dynamic of Work-Group Productivity, there are multiple facets of the dynamic itself to consider. Of course, the success of any group is only as good as its weakest member, but from another point of view, the old adage that two heads, or perhaps twenty heads, is better than one. American businesses, Quest among them, have long ago reached the conclusion that the ability to make important decisions is greatly enhanced by having a group of decision makers involved as opposed to one individual (Robbins, 2005). By having a group involved in decision making, the stress of the decisions is spread among many, removing from the equation the possibility of one figure head melting down in the face of the stress of making decisions all on their own. Beyond this, of course, the group is able to provide a great deal of different perspectives, attitudes, and experiences to the table, making it possible for the decisions to not only be made in a time effective way, but also in such a way that allows for high quality decisions that remove much of the possibility of error and poor judgment."
Abstract Catheterization as a medical technique has been in practice for more than two millennia. While it first began as an experimentation with animals, it gradually became part of human treatments. The procedure of cardiac catheterization in humans was first put to clinical use more than five decades ago and has undergone many changes since then. What was once a purely experimental technique is now one of the most common invasive medical procedures in Europe and North America, with more than eighty-percent of those procedures performed to diagnose suspected heart disease. Animal cardiac catheterization was first accomplished in 1844 with a horse. The characterization of the human heart was first accomplished by a German medical student in 1929. By the 1940's, the practice had become improved and was starting to become common practice in a few hospitals in North America and Europe. By entering a catheter through an arm vein, surgeons were able to reach the atrium of the heart. Today, cardiac catheterization is accomplished with a great deal of skill and technology, but is much easier and less dangerous than when it first was being used. It is the purpose of this paper to examine the history of cardiac catheterization and its import to medicine today.
Abstract This paper explains that some surgeons have suggested that cardio pulmonary bypass surgery in and of itself activates an inflammatory response that results in a stress reaction. The author points out that the role of the anesthesiologist in cardiac surgery is, as much as possible, to reduce the stress response that results form cardiac surgery. The paper relates that the stress response can be mitigated by a variety of anesthetic techniques, including use of opioids and epidural anesthesia.
Table of Contents
Introduction
Synopsis
Stages of Anesthesia for Cardiac Patients
Implications for Practice
From the Paper "The job of an anesthesiologist during a CBS procedure includes minimizing the autoimmune and stress response. Studies have shown that "greater fear or distress prior to surgery" is typically associated with slower and more complex and complicated post-operative recovery (Glaser, et. al, 1998). Stress response in fact delays healings. The body naturally perceives surgery as a "threatening" experience, and thus a variety of stress factors are involved in the surgical process (Glaser, et. al, 1998). Among these stress concerns include worries related to survival and recovery, as well as separation from family (Glaser, et. al, 1998); these factors are especially prevalent among cardiovascular patients, who face at bets long postoperative periods and "delicate" recovery prognosis."
Abstract This paper discusses how CPR administration methods since the 1950's have largely remained unchanged, although medical understanding of how the human body reacts to sudden cardiac reperfusion has greatly advanced. The writer describes a recent change in CPR procedure by the American Heart Association, and the use of advanced external defibrillators (AED's). The writer explains some of the medical advances in cardiac reperfusion methods, such as total liquid ventilation (TLV), and describes studies that were carried out to find the best reperfusion techniques. This paper contains a table.
From the Paper "First responders are always trained to provide the latest protocol for administering CPR. However, most people fall into three categories: never trained in CPR, fully trained and current, or fully trained but not current. A lot of people are turned off by the nature of administering CPR instead opting to do nothing rather than face a possible lawsuit if it is done improperly. Still others fear getting a disease from contact with mucus/saliva or blood born pathogens. With all of the infectious diseases carried throughout our society it is little wonder that a person would hesitate to perform resuscitation on a total stranger. As to the liability issue of performing CPR, most if not all states have a "Good Samaritan" law which precludes anyone receiving CPR from suing if they are injured as a result of the act. Chest compressions during CPR almost always result in broken ribs even when administered by first responders who do it for a living."
Abstract This paper examines the importance of cardiac surgery and the strides it has made in recent history. It specifically examines three articles "Changes in Mitral Regurgitation After Replacement of the Stenotic Aortic Valve" by E.C. Waisbren et al, "Impact of Cardiac Intraoperative Precursor Events on Adverse Outcomes" by D.R. Wong et al and "Surgical Management of Infective Endocarditis: Early Predictors of Short-Term Morbidity and Mortality" by D.S. Jassal et al.
From the Paper "Cardiac surgery is an essential treatment for many that is often thought of as a last resort to treat heart diseases and acute cardiac medical events. Non-surgical interventions are the preferred methods of treatment in most cases and yet cardiac surgery is an essential and necessary specialized branch of medicine that has made significant scientific strides toward efficacy and care. Cardiac surgery is in fact more highly specialized and more effective than many other surgical specialties as it has been given monumental emphasis, as heart disease is the most common cause of death among most adult populations. In the United States significant research emphasis has been placed on cardiac surgery and non-surgical cardiac treatment and for this reason there are many more alternatives for those suffering from acute cardiac event and chronic heart disease than ever before. In short there is no better time in human history to have heart disease and acute cardiac events and live to tell about it. The strong emphasis on cardiac health has created a system which supports thousands of highly qualified and well trained physicians and surgeons who are highly versed in the most up to date specialized treatments for all the varied cardiac events and conditions."
Abstract This paper discusses the use of radio-diagnostic imagery instead of the more standard form of autopsy in forensic medicine. The paper examines the pros and cons of using images provided by machinery such as MRIs instead of the information provided by the more invasive autopsy procedure. The paper discusses the accuracy of radio-diagnostic imagery compared with its less technologically advanced counterpart in determining causes of death. The author concludes that while radio-diagnostic imaging can be useful in forensic medicine, it can not yet replace traditional autopsy.
Table of Contents:
Objective
Introduction
Negative Findings in the use of Radio-diagnostic Imaging in Forensic Medicine
Positive Findings in the use of Radio-diagnostic Imaging in Forensic Medicine
Discussion
Conclusion
From the Paper "There has been an increase in the use of MRI in forensics in making a diagnosis when death involved either injury or disease. Stated to be one of the: "main criticisms of the use of MRI as an alternative to conventional autopsy is the lack of validation of this imaging technique." This is due to the mixed results that have been reported related to MRI post mortem examinations in the fields of neuropathology and paediatrics."
Tags: MRI, forensic, medicine, Post, Mortem, Magnetic, Resonance, Imaging
Abstract This paper explains that the new technology heart pumps, such as Left Ventricular Assist Devices (LVAD), assist the heart permanently instead of temporarily as the traditional pumps were used. The paper describes the use of animal parts for transplants especially the pig heart, which closely resembles the human heart, and the problems of organ rejection. The author believes that successful cardiac technological developments will lead to further developments for other parts of the body.
From the Paper "Traditional pumps were meant to be temporary solutions to most heart problems. These small pumps were implanted into the chest cavity of patients with the sole function of assisting the heart's own pumps. They helped to keep the rhythm of the heart's beat, regulating the pumping of blood throughout the body, and helping the heart in times of need. Traditional heart pumps were expected to help the heart recover to the points at which they could be removed and the heart would operate properly on its own. Their other function was to help keep the patient alive until they eventually moved up the waiting list for donor hearts and got a heart transplant. "
This paper reviews the qualitative research method used by K.K. Baird and L.L. Pierce as reported in their article 'Adherence to Cardiac Therapy for Men with Coronary Artery Disease' in "Rehabilitation Nursing".
Abstract This paper explains that the purpose of the reviewed study was to find out why these men with coronary artery disease were not taking care of themselves so that new and better ways can be found for these people. The author reports that the qualitative method consisted of one hour interviews with five informants that were involved in a cardiac therapy program. The paper states that the qualitative method is far more appropriate for this type of study than the quantitative method would have been and the researchers used bracketing to shield the data that they collected and analyzed from their own preconceived ideas, which could have greatly affected the results of the study; however, one possible limitations is that the study sample was not large enough.
From the Paper "The way that the subjects for this study were obtained was very appropriate, since they were all older men between 60 and 70 years old that were involved in a cardiac therapy program as a result of CAD. They had all been diagnosed within the past two years, and they were willing participants. The sample size was also adequate. Although the study could have certainly been conducted with more individuals, the fact that there were only five patients interviewed allowed the researchers to have a lot of time with each person. This helped the patients feel that they could actually talk about what they needed and wanted, as well as what they had difficulty with."
Abstract This paper examines three diverse individuals to assess risk and develop appropriate plans. Three case studies are presented, all with different variables, such as age, gender, blood pressure, cholesterol, etc. A separate plan for reducing risk is also presented for each. Although many variables have a direct bearing on cardiac risk assessment, this paper limit risk factors to blood pressure, total cholesterol, reported HDL and whether or not the individual is diabetic or a smoker.
An analysis of the quantitative research article "Sleep is Related to Physical Function and Emotional Well-Being after Cardiac Surgery" by Nancy S. Redeker, Jeanne S. Ruggiero and Christine Hedges.
Abstract This paper explains that the research question, reported in the "Nursing Research" article "Sleep is Related to Physical Function and Emotional Well-Being after Cardiac Surgery" by Redeker e.al., is "What is the relation of daytime napping to physical function and emotional well-being?" The author points out that this reported study has a multi-center, nonrandomized, prospective design. The paper also reports that the weaknesses of the study are that preoperative data on sleeping patterns were not available, dropout caused issues of internal validity and the sample was not representative. The author concludes that a randomized, case-control design would afford more validity.
Table of Contents:
Study
Problem
Study Purpose
Research Question
Hypotheses
Study Variables
Review of Related Literature
Study Design
Sample and Setting
Identification and Control of Extraneous Variables
Study Instruments/Tools
From the Paper "The hypotheses examined by the study were based on two theoretical models that regulate sleep patterns, namely: a) the chronobionic or circardian rhythm model of sleep regulation, and b) homeostatic model of sleep regulation. The circadian rhythm regulates the need for sleep according to the time of day while physiological homeostasis regulates the need for sleep in response to the body's tiredness due to physical exertion or extended wake periods."
Abstract This paper examines diagnostic x-ray imaging quality assurance (QA) and quality control (QC). It defines QA and QC for diagnostic x-ray imaging and then discusses how this occurs within all areas of a radiology department. Lastly, the paper discusses the growth of quality assurance in pediatric radiology. The paper contains tables and images.
Table of Contents:
Diagnostic X-Ray Imaging Quality Assurance (QA)
Diagnostic X-Ray Imaging Quality Control (QC)
Radiographic Unit Monitoring
Sensitometery and Darkroom Monitoring
Use of Technique Charts
Analysis of Repeat Rates
Continuing Education
Repeat Analysis
Timer Quality Control in Radiographic Equipment
Collimator Quality Control
Vertical Beam Alignment Quality Control
Collimation
Focal-spot Size
Fluoroscopy Quality Control
Automatic Exposure Systems
Tomography Quality Control
Ensuring QC in Conventional Radiographic Systems
Radiation Safety/QA Program
Test Frequency
Different Types of Tests and Duration
Growth of Quality Assurance in Pediatric Radiology
Exhibits
From the Paper "The various parameters to be checked under radiography are (i) assessment of the focal spot size which is the surface area of the anode which is bombarded by the electron beam. In case of radiography machine, it ranges from 0.1 to 1.2 mm or more than that. In case of mammo-machines the values are 0.3 to 0.6. The assessment of focal spot size is applied to get a X-ray image having the least blur. Small focal spot are likely to concentrate heat and emits load on focal spot areas. In case the quantity of heat emitted at the time of an individual exposure is more than the track capacity, the anode surface is liable to melt. Besides, the assessment of the focal spot size is necessary to compare it with the original focal spot size with that of the machine. Also spot size of any machine is stated on the top of the X-Ray tube. (Mukhtar, n. d.)"
Abstract The paper shows that diagnostic imaging is a rapidly growing healthcare industry that involves the application of electromagnetic radiation to create images of internal structures of the human body with the goal of providing an accurate diagnosis of the patient's condition. It points out that a common theme in the literature review is the need for an increased receptiveness on the part of all healthcare practitioners, both senior clinicians as well as those in training, to improve interdisciplinary activities, as well as more effective communications and collaboration among the various imaging subspecialties. Regrettably, the same market forces that have driven the rapid growth of diagnostic imaging for the benefit of the healthcare consumer are the same forces that are fueling the growing tendency to use these techniques unnecessarily or for inappropriate purposes. The writer points out, however, that there are a lot of imaging machines out there that are going to require skilled and competent technicians to operate them.
Introduction
Review and Discussion
Background and Overview
Diagnostic Imaging Today
Identifying Effective Supervisory Techniques in Support of a Constructive Clinical Learning Experience
Current and Future Trends
Bibliography
From the Paper " According to Anreson and Carroll, "These external accrediting agencies for specialized services provide a means to legitimate the organization. Internal participants also make legitimacy evaluations that can affect their own levels of involvement and motivation" (p. 36). Just as the Holy Bible points out that "No man can serve two masters: for either he will hate the one, and love the other, or else he will hold to the one, and despise the other" (Matthew 6:24, KJV), Anreson and Carroll note that one or another of these internal or external assessments may represent the most important at any given time within certain areas of the organization and different sources of legitimacy may conflict with one another.
A fundamental consideration in this regard concerns the need for changing an organizational component that is not going to be easily changed. According to Amy C. Edmondson's essay, "Framing for Learning: Lessons in Successful Technology Implementation" (2003), "The decision to bring a new, innovative technology into a complex organization is only the first step in an implementation journey. Many new technologies disrupt existing organizational routines and relationships, requiring potential users to re-learn how to work together--a challenge that usually proves more difficult than anticipated" (p. 34). As a result, any type of new technology will cause the subsequent implementation process to take place along a variety of paths that are determined less by the unique qualities of the technology itself than by a complex interaction between the technology and the adopting organization. Edmonson suggests that "Those participating in an implementation effort may have considerable leeway in how to interpret the technology's benefits and challenges, and so the same technology can be seen differently and can elicit different responses, even in organizations that may appear quite similar (p. 35)."
Abstract This paper explores the chemical structure and clinical uses of technetium-based radio-pharmaceuticals which have since the 1970s, served as the mainstay for every hospital's nuclear medicine department. Today, fully 85% of all diagnostic scans in American hospitals use 99mTc in some chemical form. It includes a brief overview of several "technetium-essential" and "technetium-tagged" radio-pharmaceuticals, as well as a discussion of current areas of research and development for new technetium drugs.
From the Paper "Technetium-99m has several physical properties that make it ideal for use in nuclear medicine. Foremost among these is that Tc-99m generally emits only gamma rays. These gamma ray photons are of a high enough energy (140,000 eV) that they can easily pass through dense tissue and exit the body, but can be effectively stopped and detected by a special gamma camera. Other radionuclides generate alpha and/or beta particles, which are diagnostically useless since they lack the penetrating ability to exit the human body. Worse, the ionizing ability of these decay products can damage tissue."
