ABSTRACT
The core content for a medical specialty outlines the scope of the discipline as well as the categories of knowledge considered essential to practice in the field. It provides a template for the development of curricula for medical school, graduate, and postgraduate education, as well as for creating certification standards. Venous and Lymphatic Medicine (VLM) is a specialty that has benefitted from contributions from specialists from several medical disciplines. Optimally, the societies, boards, and residency review committees representing these disciplines would uniformly recognize the scope of VLM to develop education and assessment standards to allow training and identification of qualified practitioners. In order to inform the standard setting bodies and other stakeholders of the current scope of VLM, a task force of VLM experts from cardiology, dermatology, emergency medicine, general surgery, interventional radiology, vascular medicine, and vascular surgery was formed to revise a 2014 consensus document defining the core content of the specialty of VLM.
ABSTRACT
BACKGROUND: Pulmonary arterial pressure measurement is an integral part of the pre-heart transplant evaluation. In the clinical arena, the correlation and agreement between pulmonary artery systolic pressure (PASP) measured by Doppler echocardiography versus catheterization in pre-heart transplant patients has not been studied. METHODS: Data on all patients evaluated for heart transplantation at our program between 2003 and 2005 (n = 176) were retrospectively reviewed. Patients with both transthoracic echocardiography (with interpretable images) and right heart catheterization performed were included (n = 108; mean time difference, 2.2 days; median, 2 days). The tricuspid valve regurgitant jet was identified by color flow Doppler and jet maximum velocity was measured by continuous wave Doppler. The PASP was estimated by using the modified Bernoulli equation and adding right atrial pressure. We correlated echocardiographically estimated PASP with that measured by right heart catheterization. RESULTS: Mean estimated PASP by echocardiography was 46.6 +/- 13.7 mmHg versus 44.8 +/- 17.9 mmHg by right heart catheterization (P = NS). However, the correlation between echocardiographic and measured PASP was poor (r = 0.49, P < .001). The correlation was poor in both ischemic and nonischemic cardiomyopathy. CONCLUSION: Among patients referred for heart transplant evaluation, there is poor agreement and correlation between echocardiographically estimated PASP and values obtained by right heart catheterization. Furthermore, echocardiographically obtained estimates of PASP should not be exclusively relied upon to exclude heart transplant recipient candidates.
Subject(s)
Cardiac Catheterization/methods , Heart Diseases/surgery , Heart Transplantation , Pulmonary Artery/physiopathology , Systole/physiology , Adolescent , Adult , Aged , Blood Pressure , Coronary Artery Bypass/statistics & numerical data , Echocardiography , Echocardiography, Transesophageal , Female , Heart Diseases/classification , Humans , Male , Middle Aged , Pulmonary Artery/diagnostic imaging , Retrospective Studies , Tricuspid Valve Insufficiency/diagnostic imaging , Vena Cava, Inferior/pathology , Vena Cava, Inferior/physiopathology , Waiting ListsABSTRACT
Scombrotoxic or histamine fish poisoning is a common condition normally associated with consuming spoiled tuna, mackerel, bonito, or skipjack. Typical symptoms like flushing, urticaria, and palpitations mimic those of allergy so histamine fish poisoning can easily be misdiagnosed. Diagnosis is often clinical and the mainstay of treatment is antihistamines.
