Ultrasound education in Cusco, Peru and increasing ultrasound gel sterility in low-resource environments
To characterize the utilization of ultrasound in the urgent and emergency department setting at CRH before and after an educational ultrasound curriculum is implemented. Rates of utilization, body part examined, gender of patient, age of patient and chief complaint will be captured before and after the educational intervention.
The Relative Strength of Association of Ankle-Brachial vs. Toe-Brachial Index with Cardiovascular Mortality in Individuals With and Without Diabetes Mellitus.
Among diabetic individuals with clinically suspected PAD, both those with low and high ABI scores are at higher risk of CVD death. In contrast, a linear relationship was observed between TBI scores and CVD death irrespective of diabetes status. These findings suggest that stiffened ankle arteries may limit the predictive value of ABI scores in individuals with diabetes; a limitation that may be overcome by measurement of the TBI.
Associations of cardiovascular disease risk factors with density and volume
components of coronary artery calcium (CAC): the Multi-Ethnic Study of Atherosclerosis
Background: Coronary artery calcium (CAC) predicts incident cardiovascular disease (CVD) beyond traditional risk factors. While higher CAC volume is associated with higher CVD risk, higher CAC density is associated with lower CVD risk. Whether risk factors for CAC volume and CAC density are similar or distinct is unknown. We sought to evaluate the independent associations of CVD risk factors with CAC volume an CAC density. Methods: Baseline measurements from 6,814 participants free of clinical CVD were collected for the Multi-Ethnic Study of Atherosclerosis between 2000 and 2002. Participants with no CAC )n=3,416) and missing data were excluded, for a final analytic sample of 3.375 participants. Multivariable linear regression models were used to evaluate independent predictors of CAC density and CAC volume. Conclusions: Whereas most CVD risk factors were associated with higher CAC volume, the same risk factors were assocated with lower CAC density. For example, diabetes was associated with higher natural logarithm (ln) transformed CAC volume (standardized [beta]=0.44 ln-units, p<0.01) but lower CAC density ([beta]=-0.07 Hounsfield unit (Hu) category unit, p<0.01). Relative to Non-Hispanic White, Chinese, African-American, and Hispanic race/ethnicities were associated with lower ln CAC volume ([beta]=-0.62, -0.52, and -0.40 ln-units, respectively, p<0.01 for each), and higher CAC density ([beta]=0.41, 0.18, and 0.21 Hu category units, respectively, p<0.01 for each). CAC density and CAC volume were also differentially associated with race/ethnicity.