Notes

Minor [18F]PSMA-1007 Appendiceal Uptake Resembling Nodal Disease.
0017), and younger age (β=-0.18; p=0.049) were independently associated with the IVC maximum diameter. Only the mean RAP was independently associated with the IVCCI (β=-0.45; p<0.0001). The regression equation (R
=0.43, p<0.0001) was as follows estimated mean RAP=3.7+0.62×maximum IVC diameter / BSA - 0.07×IVCCI.

Distension of the IVC mainly occurs with elevated RAP. However, the presence of significant tricuspid regurgitation, a larger body surface area, and younger age are associated with the IVC maximum diameter, independently of RAP. Neuronal Signaling antagonist Interestingly, IVCCI is influenced only by RAP.
Distension of the IVC mainly occurs with elevated RAP. However, the presence of significant tricuspid regurgitation, a larger body surface area, and younger age are associated with the IVC maximum diameter, independently of RAP. Interestingly, IVCCI is influenced only by RAP.The development of artificial intelligence (AI) began in the mid-20th century but has been rapidly accelerating in the past decade. link2 Reflecting the development of digital health over the past few years, this trend is also seen in medicine. The field of cardiovascular medicine uses a wide variety and a large amount of biosignals, so there are many situations where AI can contribute. The development of AI is in progress for all aspects of the healthcare system, including the prevention, screening, and treatment of diseases and the prediction of the prognosis. AI is expected to be used to provide specialist-level medical care, even in a situation where medical resources are scarce. However, like other medical devices, the concept and mechanism of AI must be fully understood when used; otherwise, it may be used inappropriately, resulting in detriment to the patient. Therefore, it is important to understand what we need to know as a cardiologist handling AI. This review introduces the basics and principles of AI, then shows how far the current development of AI has come, and finally gives a brief introduction of how to start the AI development for those who want to develop their own AI.Hypertension (HT) treatment should focus on the prevention of new-onset heart failure (HF) or its exacerbation due to the increasing trend of HF incidence in Japan. According to the SPRINT trial, strict control of blood pressure (BP) of approximately 120 mmHg suppresses the progression of HF stages A and B to a more severe stage. However, in stages C and D, the target value for BP reduction differs depending on whether HF is HF reduced ejection fraction (EF) (HFrEF) or HF preserved EF (HFpEF). Additionally, the relationship between BP control and the prognosis of HF mostly showed the J-curve phenomenon in both HFrEF and HFpEF; however, patients with HFpEF need a lower target BP value than those with HFrEF. One reason is that vascular failure is associated with the pathophysiology of HF. Therefore, it is important to utilize an antihypertensive treatment strategy that considers vascular insufficiency. In addition, the presence or absence of compelling indications is important for the selection of antihypertensive (with cardioprotective effects for HF) medications. The uptitration of cardioprotective medications such as angiotensin-converting enzyme inhibitors/angiotensin II type 1a receptor blockers and beta-blockers is recommended in patients with HFrEF; however, it is often not practically possible to increase the dosage. In these cases, the use of medications in combination with other medication classes is also useful. Moreover, it is also useful to properly use medications of the same class considering their onset of action and half-life in the blood. It is still unclear how cardioprotective medications are used in patients with HFrEF, especially on certain age groups. The optimal initiation and continuation of cardioprotective medications should be carefully determined.The clinical significance of the coronary artery calcium score (CACS) has been discussed since Agatston et al. first reported its utility in 1990. CACS is less invasive and less expensive than contrast-enhanced coronary computed tomography (CT) angiography. However, to date, discussion continues on who is eligible for CACS assessment and how test results should be handled. Although the CACS cutoff value of 400 has been used in many previous studies for the detection of significant coronary artery disease (CAD) or cardiac event risk, other studies have reported that the frequency of significant ischemia, likelihood of CAD, and cardiac event rate are increasing, from mild to moderate CACS. The prognostic significance of patients with moderate CACS (1-400) is still uncertain, whereas in 2016, the Society of Cardiovascular CT and Society of Thoracic Radiology guidelines determined CACS ≥300 as moderate to severely increased risk. link3 Another important value is CACS = 0. It is known that CACS = 0 decreases the likelihood of CAD after assessment of the pretest probability. In addition, management using statin therapy is a clinical situation that may benefit from CACS = 0. A previous study reported no significant difference in the prognosis between patients with and without statin therapy with CACS = 0. Some studies have reported the significance of the combination of CACS and noninvasive cardiac imaging, whereas CACS assessment is recommended for use in combination with risk assessment of pretest probability using clinical information including age, sex, and chest symptoms. While the utility of CACS in the management of CAD and primary prevention has been reconfirmed, the benefit of moderate values of CACS to predict prognosis with subsequent treatment and noninvasive cardiac imaging is still controversial.Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of several malignancies, improving patient survival and quality of life. Endocrinopathies have emerged as a clinically significant group of immune-related adverse events (IRAEs). Although the mechanism of ICI toxicities has not been clarified, inhibition of immune checkpoints reduces immune tolerance to autoantigens, resulting in the development of autoimmunity disorders. We report current evidence regarding endocrine IRAEs that may have diagnostic and therapeutic implications. Management should be focused on a multidisciplinary approach to reach a prompt diagnosis and an appropriate and safe treatment.
Cardiovascular nurses' skills and experiences of cardiac critical care, management of cardiovascular emergencies, and mechanical circulatory support have been considered vital in providing nursing care for COVID-19 patients in intensive care units during the COVID-19 pandemic. To our knowledge, there are no studies have focused on the contribution and experiences of cardiovascular nurses in the critical care of COVID-19 patients.

To explore the experiences of cardiovascular nurses working in a COVID-19 intensive care unit during the pandemic.

The study was conducted as a qualitative study with phenomenological approach in June-December 2020. Study data were gathered from ten cardiovascular nurses through semi-structured interviews.

Six themes emerged from the interview data the duties and responsibilities in a COVID-19 intensive care unit; the differences of COVID-19 intensive care unit practices from cardiovascular practices; the transferrable skills of cardiovascular nurses in a COVID-19 intensive care unit; the difficulties encountered working in a COVID-19 intensive care unit; the difficulty of working with personal protective equipment; and the psychosocial effects of working in a COVID-19 intensive care unit.

Cardiovascular nurses made an important contribution to the management of nursing services with their experiences and skills in the COVID-19 pandemic.
Cardiovascular nurses made an important contribution to the management of nursing services with their experiences and skills in the COVID-19 pandemic.
Adverse events are a leading cause of death worldwide, although many are considered preventable. Incident reporting is a prerequisite for preventing adverse events; however, underreporting is common. The Green Cross method is an alternative incident reporting process that includes a daily team meeting to discuss incidents and work on improvements.

The aim of this quality improvement project was to improve the culture of incident reporting by implementing the Green Cross method and to evaluate the improvement by describing nurses' experience with the culture of incident reporting.

The project included a three-month implementation of the method in a postanesthesia care unit, which was evaluated by focus group interviews (n=22 nurses) and analysed by qualitative content analysis.

Four focus group interviews were conducted before implementation (n=19 nurses) and four after implementation (n=16 nurses). Before implementation, Theme 1, "Incident reporting with potential for improvement", was constructed, describing a culture wherein nurses expressed motivation to report incidents but barriers, such as finding the system complicated and experiencing emotional obstacles towards reporting, prevented them. After implementation, Theme 2, "Increased focus on transparency", was constructed, describing a culture wherein nurses perceived an increased rate of incident reporting but still encountered barriers, such as finding reporting uncomfortable and demanding, experiencing a threatened working environment, and still wanting visible improvement.

The nurses in the postanesthesia care unit experienced the Green Cross method as a useful patient safety initiative for improving the rate of incident reporting, but barriers to reporting still existed.
The nurses in the postanesthesia care unit experienced the Green Cross method as a useful patient safety initiative for improving the rate of incident reporting, but barriers to reporting still existed.
To evaluate the long-term effectiveness of an action research intervention aimed at improving hand hygiene in an intensive care unit of a public hospital in Italy.

An observational, prospective before-after study was carried out.Compliance with hand hygiene was estimated by measuring the utilization of hand hygiene products before the intervention and four years after the end of the project. Products used were the following detergent liquid soap, antiseptic liquid soap and alcohol-based hand gel. Endpoints were quantity consumed (in grams) for each product category. Quantitative consumptions per workshift were compared.

In 2017 the median consumption of antiseptic liquid soap and alcohol-based hand gel per workshift was significantly higher than in 2012 (111.5g vs 72.5g, p=0.014, and 18.0g vs 5.0g, p<0.001). Odds in favour of a higher value in 2017 were 1.991 (CI95% 1.191 to 3.731) for antiseptic solution, and 5.391 (CI95% 3.091 to 13.611) for antiseptic gel. Covariates were not associated with consumption of products, and this made it possible to compare the measurements in the two data collections.

Results of this study support the long-term effectiveness of the action research intervention to improve practices of hand hygiene in an intensive care setting.
Results of this study support the long-term effectiveness of the action research intervention to improve practices of hand hygiene in an intensive care setting.
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