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The probability of recurring strokes in patients with atrial fibrillation is high. Within 1.8 years, 6.6% of the patients suffered a new stroke. While effective secondary prevention options exist, low adherence challenges effective medical treatment. The aim of our study was to examine the risk understanding of acute stroke patients and to find the best way to communicate risk reduction.

Risk communication had three formats a text, a pictogram, and a cube diagram. All three were developed on the basis of the criteria of evidence-based patient information. Patients who were admitted to the stroke unit and diagnosed with acute stroke, assessed the information material. Data on secondary prevention using acetylsalicylic acid were taken as an example, with no reference to actual patient treatment. In a first step, we interviewed a focus group to check the feasibility of the questionnaire (qualitative study). In the second step, the information material was tested in a pilot randomized controlled trial.

Acute stroke patients (qualitative study, n=13) understood the information and were interested in numerical risk communication. The visualized representations were superior in terms of understandability of the numbers communicated (pilot randomized controlled trial, n=60, 50% correct answers for question 1, p value of 0.502, and 55% correct answers for question 2, p value of 0.338). Stroke-related neurologic deficits, measured with the National Institute of Health Stroke Scale (NIHSS) on admission, revealed a significant influence on the number of correct answers to stroke risk questions, whereas the type of stroke and education did not.

Acute stroke patients were able to understand risk communication. Visualization helped them capture information on stroke risk.

Acute stroke patients were able to understand risk communication. Visualization helped them capture information on stroke risk.

This study identified the information needs of people with diabetes aged 65 and older through surveys and focus groups to inform the development of a patient-centered educational decision aid for diabetes care, SEE-Diabetes (Support-Engage-Empower-Diabetes).

We conducted survey (N=37) and three focus groups (N=9). The survey collected demographics, diabetes duration, insulin usage, and clinic notes accessibility through a patient portal. In focus groups, participants evaluated the Assessment and Plan section of three selected deidentified clinic notes to assess readability and helpfulness for diabetes care.

The mean age of participants was 66 (24-82, SD=12), and 22 were female (60%). The mean diabetes duration was 20.9 years (1-63, SD=15). Most participants (80%) read their clinical notes via patient portal. In the focus groups, the readability of clinic notes was noted as a primary concern because of medical abbreviations and poor formatting. Participants found the helpfulness of clinic notes was negatively impacted by vague or insufficient self-care information.

We found the high use of patient portal for reading clinic notes, which offers a use case opportunity for the proposed SEE-Diabetes educational aid. Feedback about the readability and helpfulness of clinic notes will be considered during the design process.

We found the high use of patient portal for reading clinic notes, which offers a use case opportunity for the proposed SEE-Diabetes educational aid. Feedback about the readability and helpfulness of clinic notes will be considered during the design process.

The purpose of this study was to investigate the value of 4D flow MRI for mitral filling measurements, using transthoracic echocardiography (TTE) and 2D flow MRI as references, as well as identify relationships with age and left ventricle (LV) remodeling in healthy volunteers.

Fifty healthy volunteers (22 men, 28 women; mean age, 51.3±16.9 [SD] years; age range 20-80 years) prospectively underwent TTE and MRI on the same day. 4D flow volume acquisition was done at 3T with reconstructed spatial/temporal resolutions 1×1.48×2.38mm

/34ms. Early (E) and late (A) flow rate and maximal velocity peaks were measured from 4D flow data with three strategies static planes at 1) the mitral valve leaflets tip (4D

) and 2) annulus (4D

); and 3) while tracking the annulus through time (4D

).

4D

– and 4D

-derived E/A ratios were in good agreement with 2D flow and TTE estimates with a superiority over maximal velocities (4D

r=0.71 and r=0.66; 4D

r=0.74 and r=0.71, respectively) of flow rates (4D

r=0.89 and 0.72; 4D

r=0.91 and 0.76, respectively). Measurements of 4D

and 4D

were highly reproducible (ICC=0.89 and 0.95, respectively) and significantly correlated with age and LV remodeling (4D

r=-0.76 and ρ=-0.49; 4D

r=-0.79 and ρ=-0.51, respectively).

E/A ratio can be accurately measured using 4D flow MRI either at a fixed mitral leaflet tip location or through annulus plane time-resolved tracking.

E/A ratio can be accurately measured using 4D flow MRI either at a fixed mitral leaflet tip location or through annulus plane time-resolved tracking.Biochemical recurrence after primary treatment in prostate cancer is not uncommon. A rising serum prostate-specific antigen level represents a first sign of disease relapse. At this time of low disease burden, imaging and particularly magnetic resonance imaging and positron emission tomography/computed tomography (PET/CT) are essential to determine the localization of the recurrence, which may be local, in lymph nodes, and/or metastatic. Imaging results allow best determine modalities of salvage treatment, which can be local by using radiotherapy or other focal treatments or systemic using hormonotherapy. Current evidence suggests that multiparametric magnetic resonance imaging, PET/CT with prostate specific membrane antigen and lympho-magnetic resonance imaging are effective and complementary to detect local recurrences and distant metastases.Medical imaging is integral to the diagnosis and management of the co-morbidities associated with obesity. While individuals with obesity are increasingly imaged within Medical Radiation Science practice, identifying and understanding the challenges of imaging patients with obesity is an essential requirement for all Medical Radiation Practitioners (MRPs). This Continuing Professional Development article introduces key concepts related to imaging this patient group, explores technical considerations and system limitations within planar radiography, computed tomography (CT), nuclear medicine (NM), magnetic resonance imaging (MRI) and ultrasound (US) and explores patient centred care considerations when imaging patients with obesity.We report a case of a distal radial access (dRA) pseudoaneurysm complicating a chronic total occlusion (CTO) percutaneous coronary intervention (PCI). After hospital discharge, the patient developed progressive pain and swelling at the access site and ultrasound revealed a distal radial artery pseudoaneurysm. This completely resolved conservatively with manual compression. This case highlights a potential vascular complication of the recently introduced dRA with its conservative management.

In contrast with other respiratory viruses, children infected with SARS-CoV-2 are largely spared from severe COVID-19.

To critically assess age-related differences in three host proteins involved in SARS-CoV-2 cellular entry angiotensin-converting enzyme 2 (ACE2), transmembrane serine protease 2 (TMPRSS2) and furin.

We systematically searched Medline, Embase, and PubMed databases for relevant publications. Studies were eligible if they evaluated ACE2, TMPRSS2 or furin expression, methylation, or protein level in children.

Sixteen papers were included. Age-dependent differences in membrane-bound and soluble ACE2 were shown in several studies, with ACE2 expression increasing with age. OTUB2-IN-1 order TMPRSS2 and furin are key proteases involved in SARS-CoV-2 spike protein cleavage. TMPRSS2 expression is increased by circulating androgens and is thus low in pre-pubertal children. Furin has not currently been well researched.

High levels of study heterogeneity.

Low expression of key host proteins may partially explain the reduced incidence of severe COVID-19 among children, although further research is needed.

Low expression of key host proteins may partially explain the reduced incidence of severe COVID-19 among children, although further research is needed.

Organ transplantation is hampered by shortage of suitable organs. In countries with a legal framework, organ donation following euthanasia is an option labeled “donation after cardio-circulatory death category V” (DCD-V). We describe our experience with lung transplantation (LTx) after euthanasia and evaluate post-transplant outcome using a matched comparison to DCD-III (withdrawal from life-sustaining therapy) and donation after brain death (DBD).

All bilateral LTx between 2007 and 2020 were retrospectively analyzed. Matching was performed for recipient age and gender, indication for LTx, mean pulmonary artery pressure, extracorporeal life support, and donor age, which resulted in 12 DCD-III and 13 DBD matching. Primary graft dysfunction (PGD), chronic lung allograft dysfunction (CLAD), and patient survival were analyzed.

A total of 769 LTx were performed of which 22 from DCD-V donors (2.9%). Thirteen women and 9 men expressed their wish to become organ donor after euthanasia. Euthanasia request was granted for irremediable neuromuscular (N=9) or psychiatric (N=8) disorder or unbearable and unrecoverable pain (N=5). PGD (grade 3, within 72 hours post-transplant) was 23.8% in the DCD-V cohort, which is comparable to DCD-III (27.9%; p=1.00) and DBD (32.3%; p=.59). CLAD-free 3- and 5-year survival were 86.4% and 62.8%, respectively, and comparable to DCD-III (74.4% and 60.0%; p=.62) and DBD (72.6% and 55.5%; p=.32). Five-year patient survival was 90.9%, not significantly different from both DCD-III (86.0%; p=1.00) and DBD (78.1%; p=.36).

We observed that LTx with DCD-V allografts is feasible and safe, yielding no evidence for differences in short- and long-term outcome compared to matched cohorts of DCD-III and DBD.

We observed that LTx with DCD-V allografts is feasible and safe, yielding no evidence for differences in short- and long-term outcome compared to matched cohorts of DCD-III and DBD.Polypharmacy is characterized by the simultaneous use of multiple medications, including prescription drugs, over-the-counter drugs, and nutritional supplements. Polypharmacy is known to increase the risk of adverse drugs reactions, drug-drug interactions, and medication errors, and to negatively impact quality of life. The prevalence of polypharmacy varies by population, but has been reported to exceed 90% among older adults with cancer. Polypharmacy may be exacerbated among older adults with cancer receiving radiation therapy due to the resulting acute or chronic side effects that need to be managed with additional medications. The medications prescribed to manage radiation-related side effects increase the risk of adverse drug events, as do changes in nutritional status related to the secondary side effects of radiation treatment. Side effects from treatment may result in the need for breaks in cancer therapy or treatment delays, which ultimately can lead to worse oncologic outcomes. Few studies have examined polypharmacy in the context of older adults undergoing radiation therapy.