1,331 research outputs found

    The multi-modality cardiac imaging approach to the Athlete's heart: an expert consensus of the European Association of Cardiovascular Imaging

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    The term 'athlete's heart' refers to a clinical picture characterized by a slow heart rate and enlargement of the heart. A multi-modality imaging approach to the athlete's heart aims to differentiate physiological changes due to intensive training in the athlete's heart from serious cardiac diseases with similar morphological features. Imaging assessment of the athlete's heart should begin with a thorough echocardiographic examination. Left ventricular (LV) wall thickness by echocardiography can contribute to the distinction between athlete's LV hypertrophy and hypertrophic cardiomyopathy (HCM). LV end-diastolic diameter becomes larger (>55 mm) than the normal limits only in end-stage HCM patients when the LV ejection fraction is <50%. Patients with HCM also show early impairment of LV diastolic function, whereas athletes have normal diastolic function. When echocardiography cannot provide a clear differential diagnosis, cardiac magnetic resonance (CMR) imaging should be performed. With CMR, accurate morphological and functional assessment can be made. Tissue characterization by late gadolinium enhancement may show a distinctive, non-ischaemic pattern in HCM and a variety of other myocardial conditions such as idiopathic dilated cardiomyopathy or myocarditis. The work-up of athletes with suspected coronary artery disease should start with an exercise ECG. In athletes with inconclusive exercise ECG results, exercise stress echocardiography should be considered. Nuclear cardiology techniques, coronary cardiac tomography (CCT) and/or CMR may be performed in selected cases. Owing to radiation exposure and the young age of most athletes, the use of CCT and nuclear cardiology techniques should be restricted to athletes with unclear stress echocardiography or CMR

    In My Nicaraguan High School: Giving Excluded Women and Men a Second Chance

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    When I went to Nicaragua for the first time during the Contra war, I had no idea that I would soon wind up helping a Nica friend start two literacy programs and then a Free High School for Adults. It opened in 2002, and now, only 15 years later, we have 1001 graduates, 54% women, 45% rural (mainly from subsistence farm families)--all of them excluded from the regular high schools for one reason or another: being pregnant, being a woman, turning eighteen,  working five days a week, or living too far from town without the ability to pay  bus fare. My real education came with theirs and is still going on, with no end in sight. What I wanted to know was how the teachers--all college graduates who were teaching in the high prestige regular high schools--figured out how to teach these people, many of whom had been out of school for decades and were unused to learning or scholastic discipline; many accustomed to being heads of households; some pregnant or carrying a baby to School for lack of child care or need to nurse; some drunk or exhausted early on Saturday mornings when classes began. The teachers told me their own stories, of overcoming prejudice and learning how to create a welcoming atmosphere. And the graduates told me THEIR stories, of what it took to succeed in those conditions, and how education--especially learning how to speak better-- transformed them, and they, in turn, transformed the entire culture and economy of the region

    Boomers

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