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https://www.readbyqxmd.com/read/29774392/cost-effectiveness-of-ventricular-assist-device-destination-therapy-for-advanced-heart-failure-in-duchenne-muscular-dystrophy
#1
Defne A Magnetta, JaHyun Kang, Peter D Wearden, Kenneth J Smith, Brian Feingold
Destination ventricular assist device therapy (DT-VAD) is well accepted in select adults with medically refractory heart failure (HF) who are not transplant candidates; however, its use in younger patients with progressive diseases is unclear. We sought to evaluate the cost-effectiveness of DT-VAD in Duchenne muscular dystrophy (DMD) patients with advanced HF. We created a Markov-state transition model (5-year horizon) to compare survival, costs, and quality of life (QOL) between medical management and DT-VAD in DMD with advanced HF...
May 17, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29768669/adding-smoking-to-the-fardal-model-of-cost-effectiveness-for-the-life-time-treatment-of-periodontal-diseases
#2
Øystein Fardal, Jostein Grytten, John Martin, Stig Ellingsen, Patrick Fardal, Peter Heasman, Gerard J Linden
BACKGROUND: Little is known about the financial costs that smoking adds to the life-time treatment of periodontal disease. METHODS: The total life-time cost of periodontal treatment was modelled using data from private periodontal practice. The costs of initial and supportive therapy, re-treatment and tooth replacements (with bridgework or implants) were identified using average dental charges from the American Dental Association survey. Smoking costs at $6 and $10 for 20 cigarettes were compared to the costs of life-time periodontal treatment for stable and unstable compliant patients...
May 16, 2018: Journal of Periodontology
https://www.readbyqxmd.com/read/29757390/battery-longevity-of-implantable-cardioverter-defibrillators-and-cardiac-resynchronization-therapy-defibrillators-technical-clinical-and-economic-aspects-an-expert-review-paper-from-ehra
#3
Giuseppe Boriani, Josè Merino, David J Wright, Fredrik Gadler, Beat Schaer, Maurizio Landolina
In recent years an extension of devices longevity has been obtained for implantable cardioverter-defibrillators (ICDs), including ICDs for cardiac resynchronization therapy (CRT-D) through improved battery chemistry and device technology and this implies important clinical benefits (reduced need for device replacements and associated complications, particularly infections), as well as economic benefits, in line with patient preferences and needs. From a clinical point of view, the availability of this improvement in technology allows to better tune the choice of the device to be implanted, taking into account that the reasons supporting the value of an extended device longevity as a clinical priority may differ according to the clinical setting (purely electrical diseases or left ventricular dysfunction/heart failure, respectively)...
May 10, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29752398/device-related-thrombus-after-left-atrial-appendage-closure-incidence-predictors-and-outcomes
#4
Srinivas R Dukkipati, Saibal Kar, David R Holmes, Shephal K Doshi, Vijendra Swarup, Douglas N Gibson, Brijeshwar Maini, Nicole T Gordon, Michael L Main, Vivek Y Reddy
Background -In patients with atrial fibrillation (AF), left atrial appendage closure (LAAC) with the Watchman device prevents thromboembolism from the LAA; however, thrombus may form on the left atrial face of the device, and then potentially embolize. Herein, we studied the incidence, predictors and clinical outcome of device-related thrombus (DRT) using a large series of clinical trial cohorts of patients undergoing Watchman implantation. Methods -We studied the device arms of 4 prospective FDA trials: PROTECT-AF (n=463); PREVAIL (n=269); CAP (n=566); CAP2 (n=578)...
May 11, 2018: Circulation
https://www.readbyqxmd.com/read/29750684/impact-of-30-day-readmission-after-left-ventricular-assist-device-implantation
#5
Saurabh Gupta, Rebecca J Cogswell, Samit S Roy, John R Spratt, Kenneth K Liao, Cindy M Martin, Ranjit John
Early readmission (within 30 days) after left ventricular assist device (LVAD) implantation might be a marker for increased mortality. We retrospectively reviewed the records of 277 adults who underwent continuous-flow LVAD implantation from 2005 through 2015 at our institution. The baseline characteristics of patients who were (versus were not) readmitted within 30 days after LVAD implantation were compared. To assess the impact of 30 day readmission on long-term survival, we used multivariate Cox regression...
May 7, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29747917/elective-coronary-revascularization-procedures-in-patients-with-stable-coronary-artery-disease-incidence-determinants-and-outcome-from-the-coronor-study
#6
Martial Hamon, Gilles Lemesle, Thibaud Meurice, Olivier Tricot, Nicolas Lamblin, Christophe Bauters
OBJECTIVES: The authors sought to describe the incidence, determinants, and outcome of elective coronary revascularization (ECR) in patients with stable coronary artery disease (CAD). BACKGROUND: Observational data are lacking regarding the practice of ECR in patients with stable CAD receiving modern secondary prevention. METHODS: The authors analyzed coronary revascularization procedures performed during a 5-year follow-up in 4,094 stable CAD outpatients included in the prospective multicenter CORONOR (Suivi d'une cohorte de patients COROnariens stables en région NORd-Pas-de-Calais) registry...
May 14, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29742979/electrical-stimulation-of-the-lower-esophageal-sphincter-to-treat-gastroesophageal-reflux-after-poem
#7
Erwin Rieder, Matthias Paireder, Ivan Kristo, Katrin Schwameis, Sebastian F Schoppmann
As per-oral endoscopic myotomy (POEM) is not followed by any anti-reflux procedure, a common concern is the risk of postoperative gastro-esophageal reflux disease (GERD). Electrical stimulation of the lower esophageal sphincter (LES-EST) could be an option for post-POEM GERD. A 68-year old male obese patient underwent successful POEM but developed GERD not responsive to proton pump inhibitors. Consecutively, the patient had implanted an electrical LES stimulation device, consisting of bipolar LES-electrodes connected to a subcutaneous pulse generator...
May 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29738325/automated-low-flow-ascites-pump-in-a-real-world-setting-complications-and-outcomes
#8
Philipp Solbach, Christoph Höner Zu Siederdissen, Freya Wellhöner, Nicolas Richter, Benjamin Heidrich, Henrike Lenzen, Port Kerstin, Katja Hueper, Michael P Manns, Heiner Wedemeyer, Elmar Jaeckel
BACKGROUND AND AIMS: The aim of this study was to investigate the Alfapump, an automated low-flow pump system for the treatment of refractory ascites (RA) as an alternative for repeated large-volume paracentesis in patients with contraindication for placement of a transjugular intrahepatic portosystemic shunt (TIPS) or liver transplantation. MATERIALS AND METHODS: In 21 consecutive patients with RA and contraindication for a placement of a TIPS, the Alfapump was implanted at Hannover Medical School between December 2012 and May 2016...
May 7, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29728185/surgical-timing-for-bilateral-simultaneous-cochlear-implants-when-is-best
#9
Sebastiano Franchella, Roberto Bovo, Luigia Bandolin, Flavia Gheller, Silvia Montino, Daniele Borsetto, Sara Ghiselli, Alessandro Martini
INTRODUCTION: Hearing loss is considered the most common congenital disease and the prevalence of neonatal deafness can be estimated between 1 and 2 cases per 1000 live births. Infant deafness must be diagnosed as early as possible and an effective therapeutic intervention needs to be carried out in order to avoid the serious consequences of hearing deprivation during the evolutionary period: alterations in the development of central auditory pathways and lack of language acquisition...
June 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29710196/long-term-outcomes-of-pediatric-onset-hypertrophic-cardiomyopathy-and-age-specific-risk-factors-for-lethal-arrhythmic-events
#10
Niccolò Maurizi, Silvia Passantino, Gaia Spaziani, Francesca Girolami, Anna Arretini, Mattia Targetti, Iva Pollini, Alessia Tomberli, Silvia Pradella, Giovanni Battista Calabri, Veronica Vinattieri, Bruno Bertaccini, Ornella Leone, Luciano De Simone, Claudio Rapezzi, Niccolò Marchionni, Franco Cecchi, Silvia Favilli, Iacopo Olivotto
Importance: Predictors of lethal arrhythmic events (LAEs) after a pediatric diagnosis of hypertrophic cardiomyopathy (HCM) are unresolved. Existing algorithms for risk stratification are limited to patients older than 16 years because of a lack of data on younger individuals. Objective: To describe the long-term outcome of pediatric-onset HCM and identify age-specific arrhythmic risk factors. Design, Setting, and Participants: This study assessed patients with pediatric-onset hypertrophic cardiomyopathy diagnosed from 1974 to 2016 in 2 national referral centers for cardiomyopathies in Florence, Italy...
April 18, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29709359/minimally-invasive-mitral-valve-surgery-is-associated-with-excellent-resource-utilization-cost-and-outcomes
#11
Robert B Hawkins, J Hunter Mehaffey, Samuel M Kessel, Jolian J Dahl, Irving L Kron, John A Kern, Leora T Yarboro, Gorav Ailawadi
OBJECTIVES: Minimally invasive mitral valve surgery (mini-MVR) has numerous associated benefits. However, many studies fail to include greater-risk patients. We hypothesized that a minimally invasive approach in a representative cohort provides excellent outcomes with reduced resource utilization. METHODS: Mitral valve surgical records from 2011 to 2016 were paired with institutional financial records. Patients were stratified by approach and propensity-score matched to balance preoperative difference...
April 3, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29698302/is-there-a-cardiotoxicity-associated-with-metallic-head-hip-prostheses-a-cohort-study-in-the-french-national-health-insurance-databases
#12
Marion Lassalle, Sandrine Colas, Annie Rudnichi, Mahmoud Zureik, Rosemary Dray-Spira
BACKGROUND: There are four distinguishable types of THA devices in wide use, as defined by the femoral and acetabular bearing surfaces: metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), metal-on-metal (MoM), and ceramic-on-ceramic (CoC). Metallic head THAs (MoP and MoM) can potentially induce cardiac toxicity because cobalt species, generated at the head-neck trunnion, and in the case of MoM devices, at the articular surface as well, can be absorbed systemically. However, studies have provided inconsistent results...
April 23, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29675773/ct-guided-translumbar-placement-of-permanent-catheters-in-the-inferior-vena-cava-description-of-the-technique-with-technical-success-and-complications-data
#13
Gerd Grözinger, Ulrich Grosse, Roland Syha, Rüdiger Hoffmann, Sasan Partovi, Konstantin Nikolaou, Stéphane Stahl, Alfred Königsrainer, Karolin Thiel, Christian Thiel
PURPOSE: To evaluate indications, technical success rate and complications of CT-guided translumbar catheter placement in the inferior vena cava for long-term central venous access (Port and Hickman catheters) as a bail-out approach in patients with no alternative options for permanent central venous access. MATERIALS AND METHODS: This retrospective study included 12 patients with a total of 17 interventions. All patients suffered from bilaterally chronically occluded venous vessels of their upper extremities, without patent internal jugular and/or subclavian veins...
April 19, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29662507/new-predictors-of-in-stent-restenosis-in-patients-with-diabetes-mellitus-undergoing-percutaneous-coronary-intervention-with-drug-eluting-stent
#14
Jian-Long Wang, Zheng Qin, Zhi-Jian Wang, Dong-Mei Shi, Yu-Yang Liu, Ying-Xin Zhao, Li-Xia Yang, Wan-Jun Cheng, Yu-Jie Zhou
Background: Percutaneous coronary intervention (PCI) had become the major therapeutic procedure for coronary artery disease (CAD), but the high rate of in-stent restenosis (ISR) still remained an unsolved clinical problem in clinical practice. Increasing evidences suggested that diabetes mellitus (DM) was a major risk factor for ISR, but the risk predictors of ISR in CAD patients with DM had not been well characterized. The aim of this study was to investigate the clinical and angiographic characteristic predictors significantly associated with the occurrence of ISR in diabetic patients following coronary stenting with drug-eluting stent (DES)...
February 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29625970/clinical-course-and-quality-of-life-in-high-risk-patients-with-hypertrophic-cardiomyopathy-and-implantable-cardioverter-defibrillators
#15
Barry J Maron, Susan A Casey, Iacopo Olivotto, Mark V Sherrid, Christopher Semsarian, Camillo Autore, Aisha Ahmed, Giuseppe Boriani, Pietro Francia, Stephen L Winters, Michael Giudici, Anna Koulova, Ross Garberich, Ethan J Rowin, Samuel F Sears, Martin S Maron, Paolo Spirito
BACKGROUND: High-risk patients with hypertrophic cardiomyopathy (HCM) are identified by contemporary risk stratification and effectively treated with implantable cardioverter-defibrillators (ICDs). However, long-term HCM clinical course after ICD therapy for ventricular tachyarrhythmias is incompletely understood. METHODS AND RESULTS: Cohort of 486 high-risk HCM patients with ICDs was assembled from 8 international centers. Clinical course and device interventions were addressed, and survey questionnaires assessed patient anxiety level and psychological well-being related to ICD therapy...
April 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29582745/regional-differences-in-aortic-valve-replacements-atlantic-canadian-experience
#16
Connor McGuire, Alexandra M Yip, Jeffrey B MacLeod, Vernon Paddock, Sohrab Lutchmedial, Najef Nadeem, Greg Hirsch, Corey Adams, Kevin Melvin, Sean Connors, Ansar Hassan, Jean-François Légaré
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is evolving rapidly and is increasingly being adopted in the treatment of aortic valve disease. The goal of this study was to examine regional differences in surgical aortic valve replacement (SAVR) and TAVI across Atlantic Canada. METHODS: We identified all patients who underwent SAVR or TAVI between Jan. 1, 2010, and Dec. 31, 2014, in New Brunswick, Nova Scotia and Newfoundland and Labrador. Data obtained included patient demographic characteristics and surgical procedure details...
April 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29573134/magnetoelastic-galfenol-as-a-stent-material-for-wirelessly-controlled-degradation-rates
#17
Andrew DeRouin, Roger Guillory, Weilue He, Megan Frost, Jeremy Goldman, Keat Ghee Ong
The gold standard of care for coronary artery disease, a leading cause of death for in the world, is balloon angioplasty in conjunction with stent deployment. However, implantation injuries and long-term presence of foreign material often promotes significant luminal tissue growth, leading to a narrowing of the artery and severely restricted blood flow. A promising method to mitigate this process is the use of biodegradable metallic stents, but thus far they have either degraded too slowly (iron) or disappeared prematurely (magnesium)...
March 23, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/29571643/acute-kidney-injury-after-total-arch-replacement-combined-with-frozen-elephant-trunk-implantation-incidence-risk-factors-and-outcome
#18
Hui Zhou, Guyan Wang, Lijing Yang, Sheng Shi, Jun Li, Meng Wang, Congya Zhang, Hongyan Li, Xiangyang Qian, Xiaogang Sun, Qian Chang, Cuntao Yu
OBJECTIVES: Acute kidney injury (AKI) is common after thoracic aortic surgery and is a significant predictor of morbidity and mortality. Total arch replacement (TAR) combined with frozen elephant trunk (FET) implantation has been reported to produce satisfactory clinical outcomes, whereas several features of the surgical procedure may induce postoperative AKI. The authors aimed to clarify the incidence of and risk factors for postoperative AKI and the association of AKI with short-term outcomes...
February 15, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29563819/a-case-of-brucella-melitensis-endocarditis-in-a-patient-with-cardiovascular-implantable-electronic-device
#19
Wasl Al-Adsani, Ali Ahmad, Mohammad Al-Mousa
Background: Brucellosis is a bacterial infection, caused by the nonmotile gram-negative aerobic coccobacilli. The clinical manifestation of brucellosis is variable, ranging from mild disease to severe disease. The gold standard test to confirm the diagnosis of brucellosis is assaying blood, bone marrow, or other body fluids or by tissue culture. Preferred first-line treatment in adults with uncomplicated, nonlocalized disease consists of doxycycline-aminoglycoside combination. The recommended duration of treatment is 6 weeks...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29529622/the-mark-coventry-award-patellofemoral-arthroplasty-results-in-better-range-of-movement-and-early-patient-reported-outcomes-than-tka
#20
Anders Odgaard, Frank Madsen, Per Wagner Kristensen, Andreas Kappel, Jesper Fabrin
BACKGROUND: Controversy exists over the surgical treatment for severe patellofemoral osteoarthritis. We therefore wished to compare the outcome of patellofemoral arthroplasty (PFA) with TKA in a blinded randomized controlled trial. QUESTIONS/PURPOSES: In the first 2 years after surgery: (1) Does the overall gain in quality of life differ between the implants based on the area under the curve of patient-reported outcomes (PROs) versus time? (2) Do patients obtain a better quality of life at specific points in time after PFA than after TKA? (3) Do patients get a better range of movement after PFA than after TKA? (4) Does PFA result in more complications than TKA? METHODS: Patients were eligible if they had debilitating symptoms and isolated patellofemoral disease...
January 2018: Clinical Orthopaedics and related Research
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