keyword
https://read.qxmd.com/read/38530689/efficacy-of-sacubitril-valsartan-on-survival-and-cardiac-remodeling-in-hypotensive-heart-failure-with-reduced-ejection-fraction-a-multicenter-study
#21
JOURNAL ARTICLE
Chien-Yi Hsu, Fa-Po Chung, Chieh-Ju Chao, Ying-Ju Chen, Cho-Kai Wu, Yen-Wen Wu, Jin-Long Huang, Pao-Hsien Chu, Charles Jia-Yin Hou, Hung-Yu Chang, Chung-Lieh Hung
OBJECTIVE: To investigate whether hypotensive patients diagnosed with heart failure and reduced ejection fraction (HFrEF) might benefit from angiotensin receptor-neprilysin inhibitors (ARNis) in real-world practice because patients with baseline systolic blood pressure (SBP) of less than 100 mm Hg have been excluded from landmark trials. PATIENTS AND METHODS: In this multicenter study conducted between January 1, 2013, and December 31, 2021, a total of 7562 symptomatic patients with HFrEF were enrolled and grouped by SBP (hypotension was defined as an SBP of less than 100 mm Hg) and ARNi use as follows: group 1, hypotensive/non-ARNi users (n=484); group 2, hypotensive/ARNi users (n=308); group 3, nonhypotensive/non-ARNi users (n=4560); and group 4, nonhypotensive/ARNi users (n=2210)...
March 26, 2024: Mayo Clinic Proceedings
https://read.qxmd.com/read/38530688/effect-of-sodium-glucose-cotransporter-2-inhibitors-in-adults-with-congenital-heart%C3%A2-disease
#22
JOURNAL ARTICLE
Ralph M L Neijenhuis, Simon T MacDonald, Filip Zemrak, Bart J A Mertens, Anna Dinsdale, Amanda Hunter, Niki L Walker, Lorna Swan, Sushma Reddy, Joris I Rotmans, J Wouter Jukema, Monique R M Jongbloed, Gruschen R Veldtman, Anastasia D Egorova
BACKGROUND: Heart failure (HF) is the principal cause of morbidity and mortality in adults with congenital heart disease (ACHD). Robust evidence-based treatment options are lacking. OBJECTIVES: This study aims to evaluate the safety, tolerability, and short-term HF-related effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in a real-world ACHD population. METHODS: All patients with ACHD treated with SGLT2i in 4 European ACHD centers were included in this retrospective study...
March 12, 2024: Journal of the American College of Cardiology
https://read.qxmd.com/read/38530649/iatrogenic-hyperchloremia-an-overview-in-hospitalized-patients-for-pharmacists
#23
JOURNAL ARTICLE
Amoreena Most, Sarah Nordbeck, Nicholas Farina
DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: The purpose of this therapeutic update is to provide pharmacists with a general overview of the pathophysiology of hyperchloremia and describe strategies to help prevent development of this electrolyte abnormality in hospitalized patients...
March 26, 2024: American Journal of Health-system Pharmacy: AJHP
https://read.qxmd.com/read/38529644/sherman-lecture-are-we-aiming-at-the-correct-targets-to-reduce-disparities-in-stroke-mortality-celebration-reflection-and-redirection
#24
REVIEW
George Howard
Although deaths from stroke have been reduced by 75% in the past 54 years, there has been virtually no reduction in the relative magnitude of Black-to-White disparity in stroke deaths, or the heavier burden of stroke deaths in the Stroke Belt region of the United States. Furthermore, although the rural-urban disparity has decreased in the past decade, this reduction is largely attributable to an increased stroke mortality in the urban areas, rather than reduced stroke mortality in rural areas. We need to focus our search for interventions to reduce disparities on those that benefit the disadvantaged populations, and support this review using relatively recently developed statistical approaches to estimate the magnitude of the potential reduction in the disparities...
March 26, 2024: Journal of the American Heart Association
https://read.qxmd.com/read/38529448/functional-outcome-of-lower-limb-long-bone-trauma-management-in-pregnant-mothers-a-prospective-study-of-30-cases-from-a-tertiary-care-centre-in-north-india
#25
JOURNAL ARTICLE
Dharm Pal, Nitesh Kumar, Ashim Sharma, Kuldip Sandhu, Ajay Sharma, Dharminder Singh
INTRODUCTION: The occurrence of orthopedic injuries during pregnancy carries considerable morbidity and mortality for both the mother and fetus. Successful care of lower limb fractures during pregnancy requires a multidisciplinary approach. Both operative and non-operative treatments must be taken into account by the treating orthopedic physician. There is limited literature available on the management of these lower limb fractures in pregnancy, and peri-operative management of this obstetric and orthopedic trauma is largely unclear...
February 2024: Curēus
https://read.qxmd.com/read/38529422/advancements-in-mitraclip-intervention-for-mitral-regurgitation-a-comprehensive-review-and-comparative-analysis-of-clinical-trials
#26
REVIEW
Shitij Shrivastava, Shashwat Shrivastava, Sai Vishnu Vardhan Allu, Patrik Schmidt, Moiud Mohyeldin, Abeer Qasim
This comprehensive review explores the evolution and clinical impact of MitraClip intervention in the management of mitral regurgitation. Mitral regurgitation results from dysfunction in the mitral valve (MV) apparatus. The MitraClip Clip Delivery System was approved by the Food and Drug Administration (FDA) in 2013. The discussion delves into the procedural foundation of MitraClip intervention, primarily based on Alfieri's technique of edge-to-edge leaflet approximation. As highlighted by key clinical trials, including Endovascular Valve Edge-to-Edge Repair (EVEREST) II Trial, Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) Trial, and Percutaneous Repair with the MitraClip Device for Severe Functional/Secondary Mitral Regurgitation (MITRA-FR) trial, the efficacy and safety of MitraClip were evaluated in comparison to surgical interventions and guideline-directed medical therapy...
February 2024: Curēus
https://read.qxmd.com/read/38529120/development-and-validation-of-a-prediction-score-for-failure-to-casirivimab-imdevimab-in-hospitalized-patients-with-covid-19-pneumonia
#27
JOURNAL ARTICLE
Alessandro Cozzi-Lepri, Vanni Borghi, Salvatore Rotundo, Bianca Mariani, Anna Ferrari, Cosmo Del Borgo, Francesca Bai, Pietro Colletti, Piermauro Miraglia, Carlo Torti, Anna Maria Cattelan, Giovanni Cenderello, Marco Berruti, Carlo Tascini, Giustino Parruti, Simona Coladonato, Andrea Gori, Giulia Marchetti, Miriam Lichtner, Luigi Coppola, Chiara Sorace, Alessandra D'Abramo, Valentina Mazzotta, Giovanni Guaraldi, Erica Franceschini, Marianna Meschiari, Loredana Sarmati, Andrea Antinori, Emanuele Nicastri, Cristina Mussini
INTRODUCTION: Casirivimab and imdevimab (CAS/IMV) are two non-competing, high-affinity human IgG1 anti-SARS-CoV-2 monoclonal antibodies, that showed a survival benefit in seronegative hospitalized patients with COVID-19. This study aimed to estimate the day-28 risk of mechanical ventilation (MV) and death in individuals hospitalized for severe COVID-19 pneumonia and receiving CAS/IMV. Additionally, it aimed to identify variables measured at the time of hospital admission that could predict these outcomes and derive a prediction algorithm...
2024: Frontiers in Medicine
https://read.qxmd.com/read/38528952/a-small-molecule-mst1-2-inhibitor-accelerates-murine-liver-regeneration-with-improved-survival-in-models-of-steatohepatitis
#28
JOURNAL ARTICLE
Ryan Watkins, Ana Gamo, Seung Hyuk Choi, Manoj Kumar, EeeLN Buckarma, Chantal McCabe, Jennifer Tomlinson, David Pereya, Blaz Lupse, Shirin Geravandi, Nathan W Werneburg, Chen Wang, Patrick Starlinger, Siying Zhu, Sijia Li, Shan Yu, Murali Surakattula, Tyler Baguley, Amin Ardestani, Kathrin Maedler, Jason Roland, Van Nguyen-Tran, Sean Joseph, Mike Petrassi, Nikki Rogers, Gregory Gores, Arnab Chatterjee, Matthew Tremblay, Weijun Shen, Rory Smoot
Dysfunctional liver regeneration following surgical resection remains a major cause of postoperative mortality and has no therapeutic options. Without targeted therapies, the current treatment paradigm relies on supportive therapy until homeostasis can be achieved. Pharmacologic acceleration of regeneration represents an alternative therapeutic avenue. Therefore, we aimed to generate a small molecule inhibitor that could accelerate liver regeneration with an emphasis on diseased models, which represent a significant portion of patients who require surgical resection and are often not studied...
March 2024: PNAS Nexus
https://read.qxmd.com/read/38528758/clinical-midterm-results-of-surgical-aortic-valve-replacement-with-sutureless-valves
#29
JOURNAL ARTICLE
Soonchang Hong, Jung-Woo Son, Yungjin Yoon
BACKGROUND: Sutureless aortic valves may enable shorter procedure times, which benefits patients with elevated surgical risk. We describe the outcomes of patients with aortic stenosis who underwent aortic valve replacement (AVR) using the sutureless Perceval aortic bioprosthesis. METHODS: Data from a retrospective cohort were obtained from a clinical database. The study enrolled patients with symptomatic severe aortic stenosis who underwent surgical AVR with a sutureless bioprosthesis between August 2015 and December 2020...
March 26, 2024: Journal of chest surgery
https://read.qxmd.com/read/38528618/domperidone-inhibits-cell-proliferation-via-targeting-mek-and-cdk4-in-esophageal-squamous-cell-carcinoma
#30
JOURNAL ARTICLE
Qiang Yuan, Yunshu Shi, Yuhan Zhang, Yaqian Shi, Zubair Hussain, Jimin Zhao, Yanan Jiang, Yan Qiao, Yaping Guo, Jing Lu, Ziming Dong, Zigang Dong, Junyong Wang, Kangdong Liu
BACKGROUND: Esophageal squamous cell carcinoma (ESCC) is one of the leading causes of digestive system tumor related death in the world. Unfortunately, effective chemopreventive agent is lack for patients with ESCC in clinical practice, which leads to the extremely high mortality rate. METHODS: A library of prescribed drugs was screened for finding critical anti-tumor properties in ESCC cells. The phosphoproteomics, kinase array, pulldown assay and drug affinity responsive target stabilization assay (DARTS) were applied to explore mechanisms and searched for synergistic targets...
March 25, 2024: Cancer Cell International
https://read.qxmd.com/read/38528520/cost-utility-analysis-of-tavi-compared-with-surgery-in-patients-with-severe-aortic-stenosis-at-low-risk-of-surgical-mortality-in-the-netherlands
#31
JOURNAL ARTICLE
Rob Eerdekens, Suzanne Kats, Janneke Pc Grutters, Michelle Green, Judith Shore, Pascal Candolfi, Wija Oortwijn, Pim Van Der Harst, Pim Tonino
BACKGROUND: There is growing evidence to support the benefits of transcatheter aortic valve implantation (TAVI) over surgical aortic valve replacement (SAVR) in patients with symptomatic severe aortic stenosis (sSAS) who are at high- or intermediate-risk of surgical mortality. The PARTNER 3 trial showed clinical benefits with SAPIEN 3 TAVI compared with SAVR in patients at low risk of surgical mortality. Whether TAVI is also cost-effective compared with SAVR for low-risk patients in the Dutch healthcare system remains uncertain...
March 26, 2024: Cost Effectiveness and Resource Allocation: C/E
https://read.qxmd.com/read/38528312/a-canadian-simulation-model-for-major-depressive-disorder-study-protocol
#32
REVIEW
Shahzad Ghanbarian, Gavin W K Wong, Mary Bunka, Louisa Edwards, Sonya Cressman, Tania Conte, Sandra Peterson, Rohit Vijh, Morgan Price, Christian Schuetz, David Erickson, Linda Riches, Ginny Landry, Kim McGrail, Jehannine Austin, Stirling Bryan
BACKGROUND: Major depressive disorder (MDD) is a common, often recurrent condition and a significant driver of healthcare costs. People with MDD often receive pharmacological therapy as the first-line treatment, but the majority of people require more than one medication trial to find one that relieves symptoms without causing intolerable side effects. There is an acute need for more effective interventions to improve patients' remission and quality of life and reduce the condition's economic burden on the healthcare system...
March 26, 2024: PharmacoEconomics Open
https://read.qxmd.com/read/38527578/off-pump-coronary-artery-bypass-grafting-does-not-confer-superior-outcomes-among-frail-patients
#33
JOURNAL ARTICLE
Sara Sakowitz, Syed Shahyan Bakhtiyar, Joanna Curry, Saad Mallick, Amulya Vadlakonda, Konmal Ali, Yas Sanaiha, Peyman Benharash
BACKGROUND: Off-pump coronary revascularization (OPCAB) has been proposed to benefit patients at greater surgical risk as it avoids the use of extracorporeal circulation. While historically older patients were considered high risk candidates, recent studies implicate frailty as a more comprehensive measure of perioperative fitness. Yet, outcomes of OPCAB among frail patients have not been elucidated. Thus, using a national cohort of frail patients, we assessed the impact of OPCAB, relative to on-pump (ONCAB)...
March 23, 2024: American Journal of Cardiology
https://read.qxmd.com/read/38527156/hemodiafiltration-a-synergy-yet-to-be-convincing
#34
EDITORIAL
Brammah Rajarajeswaran Thangarajah
The desperate attempt to improve mortality, morbidity, quality of life and patient-reported outcomes in patients on hemodialysis has led to multiple attempts to improve the different modes, frequencies, and durations of dialysis sessions in the last few decades. Nothing has been more appealing than the combination of diffusion and convection in the form of hemodiafiltration. Despite the concrete evidence of better clearance of middle weight molecules and better hemodynamic stability, tangible evidence to support the universal adoption is still at a distance...
2024: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://read.qxmd.com/read/38527130/scrutinizing-the-role-of-venoarterial-extracorporeal-membrane-oxygenation-has-clinical-practice-outpaced-the-evidence
#35
REVIEW
Enzo Lüsebrink, Leonhard Binzenhöfer, Daniel Hering, Laura Villegas Sierra, Benedikt Schrage, Clemens Scherer, Walter S Speidl, Aitor Uribarri, Manel Sabate, Marko Noc, Elena Sandoval, Andrejs Erglis, Federico Pappalardo, Frederic De Roeck, Guido Tavazzi, Jordi Riera, Roberto Roncon-Albuquerque, Benjamin Meder, Peter Luedike, Tienush Rassaf, Jörg Hausleiter, Christian Hagl, Sebastian Zimmer, Dirk Westermann, Alain Combes, Uwe Zeymer, Steffen Massberg, Andreas Schäfer, Martin Orban, Holger Thiele
The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for temporary mechanical circulatory support in various clinical scenarios has been increasing consistently, despite the lack of sufficient evidence regarding its benefit and safety from adequately powered randomized controlled trials. Although the ARREST trial (Advanced Reperfusion Strategies for Patients with Out-of-Hospital Cardiac Arrest and Refractory Ventricular Fibrillation) and a secondary analysis of the PRAGUE OHCA trial (Prague Out-of-Hospital Cardiac Arrest) provided some evidence in favor of VA-ECMO in the setting of out-of-hospital cardiac arrest, the INCEPTION trial (Early Initiation of Extracorporeal Life Support in Refractory Out-of-Hospital Cardiac Arrest) has not found a relevant improvement of short-term mortality with extracorporeal cardiopulmonary resuscitation...
March 26, 2024: Circulation
https://read.qxmd.com/read/38526761/intraoperative-kidney-replacement-therapy-in-acute-liver-failure
#36
JOURNAL ARTICLE
Daniel Henderson, Anish Gupta, Shina Menon, Akash Deep
Paediatric acute liver failure (PALF) is often characterised by its rapidity of onset and potential for significant morbidity and even mortality. Patients often develop multiorgan dysfunction/failure, including severe acute kidney injury (AKI). Whilst the management of PALF focuses on complications of hepatic dysfunction, the associated kidney impairment can significantly affect patient outcomes. Severe AKI requiring continuous kidney replacement therapy (CKRT) is a common complication of both PALF and liver transplantation...
March 25, 2024: Pediatric Nephrology
https://read.qxmd.com/read/38526749/echocardiography-in-the-recognition-and-management-of-mechanical-complications-of-acute-myocardial-infarction
#37
REVIEW
Robert S Zhang, Richard Ro, Daniel Bamira, Alan Vainrib, Lily Zhang, Ambika C Nayar, Muhamed Saric, Samuel Bernard
PURPOSE OF REVIEW: Although rare, the development of mechanical complications following an acute myocardial infarction is associated with a high morbidity and mortality. Here, we review the clinical features, diagnostic strategy, and treatment options for each of the mechanical complications, with a focus on the role of echocardiography. RECENT FINDINGS: The growth of percutaneous structural interventions worldwide has given rise to new non-surgical options for management of mechanical complications...
March 25, 2024: Current Cardiology Reports
https://read.qxmd.com/read/38526681/reinforcement-learning-for-intensive-care-medicine-actionable-clinical-insights-from-novel-approaches-to-reward-shaping-and-off-policy-model-evaluation
#38
JOURNAL ARTICLE
Luca F Roggeveen, Ali El Hassouni, Harm-Jan de Grooth, Armand R J Girbes, Mark Hoogendoorn, Paul W G Elbers
BACKGROUND: Reinforcement learning (RL) holds great promise for intensive care medicine given the abundant availability of data and frequent sequential decision-making. But despite the emergence of promising algorithms, RL driven bedside clinical decision support is still far from reality. Major challenges include trust and safety. To help address these issues, we introduce cross off-policy evaluation and policy restriction and show how detailed policy analysis may increase clinical interpretability...
March 25, 2024: Intensive Care Medicine Experimental
https://read.qxmd.com/read/38526015/barriers-toward-xenotransplantation-in-arab-world
#39
REVIEW
Maya Ghazi, Aalaa Saleh, Malak Abdallah, Diala El Masri, Jad El Masri, Lemir Majed El Ayoubi, Jihad Hawi, Abdo Jurjus
Organ transplant is a crucial therapeutic strategy offering a life-saving and transformative medical intervention. It provides an opportunity to improve their quality of life and increase their lifespan. The shortage of organs remains a critical global challenge, leading to a prolonged waiting times for organ receivers, which contributes to an increase in morbidity and mortality rates. Hence, xenotransplantation offered a promising solution to the global shortage of organs through the use of animal organs, leading to an increase in donor availability, reducing waiting times, minimizing organ trafficking, improving genetic engineering advancements, and driving scientific innovation...
2024: Xenotransplantation
https://read.qxmd.com/read/38525596/estimating-vitamin-k-antagonist-anticoagulation-benefit-in-people-with-atrial-fibrillation-accounting-for-competing-risks-evidence-from-12-randomized-trials
#40
JOURNAL ARTICLE
Sachin J Shah, Carl van Walraven, Sun Young Jeon, John Boscardin, F D Richard Hobbs, Stuart J Connolly, Michael D Ezekowitz, Kenneth E Covinsky, Margaret C Fang, Daniel E Singer
BACKGROUND: Patients with atrial fibrillation have a high mortality rate that is only partially attributable to vascular outcomes. The competing risk of death may affect the expected anticoagulant benefit. We determined if competing risks materially affect the guideline-endorsed estimate of anticoagulant benefit. METHODS: We conducted a secondary analysis of 12 randomized controlled trials that randomized patients with atrial fibrillation to vitamin K antagonists (VKAs) or either placebo or antiplatelets...
March 25, 2024: Circulation. Cardiovascular Quality and Outcomes
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