An Analysis of the Prevalence of Depression Post-Myocardial Infarction.

Coronary artery disease (CAD) is the leading cause of death in the United States. The World Bank and the World Health Organization predict that depression and coronary heart disease will be the largest causes of global health burden and disability by the year 2020. Studies have demonstrated that patients with CAD experience depression at a higher rate than the general population. Because of this connection, it is critical to recognize depression and manage depression effectively for people with CAD. Studies have also provided evidence that identifying and treating depression in patients early after a myocardial infarction improve clinical outcomes. In addition, a number of studies have discussed the negative effects that can occur from untreated depression in these patients. The cited negative effects include mortality, recurrent myocardial events, and a worse quality of life. This article discusses the results of a research that was completed at a cardiology office using a retroactive medical record review that focused on outpatients with cardiac diseases. The primary aim of the study was to collect data using the Patient Health Questionnaire-9 (PHQ-9), a public domain screening tool. This research was intended to provide evidence that would support using the PHQ-9 as a standard depression screening tool for patients post-myocardial infarction. By recognizing the symptoms of depression, the patient would then be treated accordingly.

Improving Clinical Outcomes for Patients With Class III Heart Failure.

Heart failure (HF) is a serious medical problem in the United States and is placing a financial strain on the health care system. It is the leading cause of mortality and as the overall incidence continues to increase, so does the economic impact on the health care system. Innovative treatment options, in the form of disease management programs and implantable cardiac devices, such as the CorVue capable implantable cardioverter defibrillator (ICD) pacemaker, offer the promise of an enhanced quality of life and reduced mortality. Even with these advances, HF continues to be a challenge. Studies reviewing HF management programs have shown promising results. However, more studies are needed to determine which combination of HF management interventions has the greatest financial impact and yields the best patient outcomes. The objective of the research study was to compare 30-day readmission rates of patients implanted with the CorVue capable ICD pacemaker with patients with congestive heart failure (CHF) with no implanted device. The aim of the research focused on the usefulness of intrathoracic impedance monitoring alerts in guiding empirical treatment of patients with CHF to prevent HF readmissions. Methodology included a retrospective medical chart review, comparing 30-day readmission events among patients with class III CHF who received home health intervention with similar patients implanted with the CorVue ICD.

Educating Providers in Return-to-Play Suggested Guidelines Postconcussion.

As the awareness of concussions increases, it is imperative to be able to evaluate, diagnose, and treat concussed individuals properly to prevent further complications or death. The primary purpose of this study was to compare a provider's current awareness and comfort level as it relates to the return-to-play guidelines for concussions. A secondary aim was to evaluate current protocols that are in use and determine whether they coincide with the suggested guidelines. An educational intervention was implemented to assess the knowledge and confidence of health care providers. The study design was a quantitative, convenient sample, pretest/posttest questionnaire. The questionnaire was administered to participants who were nurse practitioners prior to an educational PowerPoint presentation. At 8 weeks, the posttest was administered. Approximately 19% of individuals were not aware of a graded return-to-play protocols. The findings suggest that the educational intervention increased their confidence levels in making a diagnosis of a concussion, in assessing danger signs, and in understanding when to refer to a specialist. Additional supporting evidence from this study indicates that the educational intervention allowed the participants to achieve a greater comfort level in finding appropriate resources for them and their patients.

Osteomyelitis: an overview of imaging modalities.

Diagnosis, early intervention, and treatment of patients who have an infection are the basic foundations of patient care. Early, appropriate interventions are associated with decreased patient morbidity and mortality. Diagnostic procedures with clinical information and laboratory results are integral in the assessment of inflammatory diseases and the prevention of sepsis. Some of the imaging modalities currently used for the assessment of inflammation include computed tomography, plain radiography, positron emission tomography, technetium Tc 99m bone scintigraphy, magnetic resonance imaging, and leukocyte scintigraphy. In the case of patients who exhibit signs of osteomyelitis, it is necessary to understand that acute and chronic conditions are not based on the duration of the disease but on the histopathologic features of the disease. Although several imaging modalities are considered appropriate, there is not one singular procedure that is considered ideal. Rather, it is a combination of procedures and various other clinical factors. This article addresses some of the advantages and disadvantages of the modalities, with a focus on molecular imaging and the assessment of osteomyelitis.

Comparison of Bruce treadmill exercise test protocols: is ramped Bruce equal or superior to standard bruce in producing clinically valid studies for patients presenting for evaluation of cardiac ischemia or arrhythmia with body mass index equal to or greater than 30?

UNLABELLED: Clinically valid cardiac evaluation via treadmill stress testing requires patients to achieve specific target heart rates and to successfully complete the cardiac examination. METHODS: A comparison of the standard Bruce protocol and the ramped Bruce protocol was performed using data collected over a 1-y period from a targeted patient population with a body mass index (BMI) equal to or greater than 30 to determine which treadmill protocol provided more successful examination results. RESULTS: The functional capacity, metabolic equivalent units achieved, pressure rate product, and total time on the treadmill as measured for the obese patients were clinically valid and comparable to normal-weight and overweight patients (P < 0.001). Data gathered from each protocol demonstrated that the usage of the ramped Bruce protocol achieved more consistent results in comparison across all BMI groups in achieving 80%-85% of their age-predicted maximum heart rate. CONCLUSION: This study did not adequately establish that the ramped Bruce protocol was superior to the standard Bruce protocol for the examination of patients with a BMI equal to or greater than 30.

The history, implications, and development of the baccalaureate transition resource manual.

Life is full of transitions, changes, and adaptations. In this article, we will describe the developmental process and transition steps of a baccalaureate degree program in nuclear medicine technology (NMT). We will introduce a living document that was created by the leadership of the Society of Nuclear Medicine and Molecular Imaging Technologist Section (SNMMI-TS). This article suggests that the SNMMI-TS Baccalaureate Transition Resource Manual should be considered in programmatic degree criteria related to practitioner preparedness. We believe other institutions may benefit from this experience in the development of their own baccalaureate program. Our experiences may allow other institutions to have insights that will facilitate their own process for new program development. The resource manual delivers an innovative curriculum emphasizing interdisciplinary collaboration on degree content among science courses, general education courses, and additional NMT didactic completion courses. The Joint Review Committee on Educational Programs in Nuclear Medicine Technology did incorporate many of the recommendations from the Curriculum Guide for Educational Programs in Nuclear Medicine Technology, fourth edition, from the SNMMI-TS. The resource manual in conjunction with data on the transitioning of the first 3 pilot schools is the first step the SNMMI-TS has made in helping schools transition to the baccalaureate level. The manual is intended to be a living document and will be changed as additional programs make the transition and new models are created.

Gap analysis survey: an aid in transitioning to standardized curricula for nuclear medicine technology.

UNLABELLED: This article discusses the process by which the Society of Nuclear Medicine Technology Section (SNMTS) is assisting educators as they transition to comply with the fourth edition of the Curriculum Guide for Educational Programs in Nuclear Medicine Technology. METHODS: An electronic survey was sent to a list of nuclear medicine technology programs compiled by the educational division of the SNMTS. The collected data included committee member demographics, goals and objectives, conference call minutes, consultation discussions, transition examples, 4- and 2-y program curricula, and certificate program curricula. RESULTS: There were 56 responses to the survey. All respondents were program directors, with 3 respondents having more than one type of program, for a total of 59 programs. Of these, 19 (33.93%) were baccalaureate, 19 (28.57%) associate, and 21 (37.5%) certificate. Forty-eight respondents (85.71%) had accreditation through the Joint Review Commission on Educational Programs in Nuclear Medicine Technology, 6 (10.71%) had regional accreditation, and 2 (3.57%) were accredited through other entities. Thirteen categories of required general education courses were identified, and the existing program curricula of 9 (69.2%) courses were more than 50% compliant with the fourth edition Curriculum Guide. The fact that no measurable gap could be found within the didactic professional content across programs was due to the lack of a degree requirement and content standardization within the profession. The data indicated that the participating programs offer a minimum of 1-15 contact hours in emerging technology modalities. The required clinical hours ranged from 765 to 1,920 for degree or certificate completion. The average number of clinical hours required for all programs was 1,331.69. CONCLUSION: Standardization of the number and types of courses is needed both for current baccalaureate programs and for clinical education. This standardization will guide programs in transitioning from a certificate or associate level to the baccalaureate level. The greatest obstacle is in expanding curricula to meet the recommendations of the fourth edition Curriculum Guide. Such expansion to entry-level competency may be met by incorporating hybrid imaging courses, secondary-level courses, and equivalency courses on the basic sciences and emerging technologies.