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heart failure diagnosis

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https://www.readbyqxmd.com/read/28441614/learning-from-an-analysis-of-closed-malpractice-litigation-involving-myocardial-infarction
#1
Kuan-Han Wu, Yung-Lin Yen, Chien-Hung Wu, Chi-Yuan Hwang, Shih-Yu Cheng
OBJECTIVE: To examine the epidemiologic data, identify the pattern of dispute, and determine clinical litigious errors by analyzing closed malpractice claims involving myocardial infarction (MI) in Taiwanese courts. METHODS: A retrospective descriptive study was performed to analyze the verdicts pertaining to MI from the population-based database of the Taiwan judicial system between 2002 and 2013. The results of adjudication, involved specialists, primary dispute leading to lawsuits, and litigious errors were recorded...
April 13, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28438737/association-of-tenofovir-use-with-risk-of-incident-heart-failure-in-hiv-infected-patients
#2
Ruijun Chen, Rebecca Scherzer, Priscilla Y Hsue, Vasantha Jotwani, Michelle M Estrella, Michael A Horberg, Carl Grunfeld, Michael G Shlipak
BACKGROUND: The antiretroviral medication, tenofovir disoproxil fumarate (TDF), is used by most human immunodeficiency virus-infected persons in the United States despite higher risks of chronic kidney disease. Although chronic kidney disease is a strong risk factor for heart failure (HF), the association of TDF with incident HF is unclear. METHODS AND RESULTS: We identified 21 435 human immunodeficiency virus-infected patients in the United States Veterans Health Administration actively using antiretrovirals between 2002 and 2011...
April 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28436997/truncating-mutations-on-myofibrillar-myopathies-causing-genes-as-prevalent-molecular-explanations-on-patients-with-dilated-cardiomyopathy
#3
Alexandre Janin, Karine N'Guyen, Gilbert Habib, Claire Dauphin, Valérie Chanavat, Patrice Bouvagnet, Romain Eschalier, Streichenberger Nathalie, Philippe Chevalier, Gilles Millat
Dilated Cardiomyopathy (DCM) is one of the leading causes of heart failure with high morbidity and mortality. More than 40 genes have been reported to cause DCM. To provide new insights into the pathophysiology of dilated cardiomyopathy, a NGS workflow based on a panel of 48 cardiomyopathies-causing genes was used to analyze a cohort of 222 DCM patients. Truncating variants were detected on 63 unrelated DCM cases (28.4%). Most of them were identified, as expected, on TTN (29 DCM probands), but truncating variants were also identified on myofibrillar myopathies causing genes in 17 DCM patients (7...
April 24, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28436256/clinical-and-economic-impact-of-hyperkalemia-in-patients-with-chronic-kidney-disease-and-heart-failure
#4
Michael Polson, Todd C Lord, Anne Kangethe, Lindsay Speicher, Carolyn Farnum, Melanie Brenner, Nina Oestreicher, Paula Alvarez
BACKGROUND: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34.6% of patients with CKD and 30.0% of patients with HF. OBJECTIVE: To evaluate the association of HK and use of RAASi therapies at optimal and suboptimal doses in patients with CKD and/or HF with health care resource utilization and overall cost of care in a diverse cohort of commercially insured patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28435488/clinician-performed-bedside-ultrasound-in-improving-diagnostic-accuracy-in-patients-presenting-to-the-ed-with-acute-dyspnea
#5
Dimitrios Papanagnou, Michael Secko, John Gullett, Michael Stone, Shahriar Zehtabchi
INTRODUCTION: Diagnosing acute dyspnea is a critical action performed by emergency physicians (EP). It has been shown that ultrasound (US) can be incorporated into the work-up of the dyspneic patient; but there is little data demonstrating its effect on decision-making. We sought to examine the impact of a bedside, clinician-performed cardiopulmonary US protocol on the clinical impression of EPs evaluating dyspneic patients, and to measure the change in physician confidence with the leading diagnosis before and after US...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433336/the-association-of-postoperative-glycemic-control-and-lower-extremity-procedure-outcomes
#6
Todd R Vogel, Jamie B Smith, Robin L Kruse
OBJECTIVE: The effect of postoperative hyperglycemia in patients undergoing open and endovascular procedures on the lower extremities has not been fully characterized with regard to associated admission diagnoses, hospital complications, mortality, and 30-day readmission. This study evaluated the relationship of postoperative hyperglycemia on outcomes after lower extremity vascular procedures for peripheral artery disease. METHODS: Patients with peripheral artery disease admitted for elective lower extremity procedures between September 2008 and March 2014 were selected from the Cerner Health Facts (Cerner Corporation, Kansas City, Mo) database using International Classification of Diseases, Ninth Edition, Clinical Modification diagnosis and procedure codes...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28433323/is-there-a-clinically-meaningful-difference-in-patient-reported-dyspnea-in-acute-heart-failure-an-analysis-from-urgent-dyspnea
#7
Peter S Pang, Kathleen A Lane, Miguel Tavares, Alan B Storrow, Changyu Shen, W Frank Peacock, Richard Nowak, Alexandre Mebazaa, Said Laribi, Judd E Hollander, Mihai Gheorghiade, Sean P Collins
BACKGROUND: Dyspnea is the most common presenting symptom in patients with acute heart failure (AHF), but is difficult to quantify as a research measure. The URGENT Dyspnea study compared 3 scales: (1) 10 cm VAS, (2) 5-point Likert, and (3) a 7-point Likert (both VAS and 5-point Likert were recorded in the upright and supine positions). However, the minimal clinically important difference (MCID) to patients has not been well established. METHODS: We performed a secondary analysis from URGENT Dyspnea, an observational, multi-center study of AHF patients enrolled within 1 h of first physician assessment in the ED...
April 19, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28432156/epidemiology-of-valvular-heart-disease-in-a-swedish-nationwide-hospital-based-register-study
#8
Pontus Andell, Xinjun Li, Andreas Martinsson, Charlotte Andersson, Martin Stagmo, Bengt Zöller, Kristina Sundquist, J Gustav Smith
OBJECTIVE: Transitions in the spectrum of valvular heart diseases (VHDs) in developed countries over the 20th century have been reported from clinical case series, but large, contemporary population-based studies are lacking. METHODS: We used nationwide registers to identify all patients with a first diagnosis of VHD at Swedish hospitals between 2003 and 2010. Age-stratified and sex-stratified incidence of each VHD and adjusted comorbidity profiles were assessed...
April 21, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28431934/etiological-analysis-and-epidemiological-comparison-among-adult-cap-and-nhcap-patients-in-okinawa-japan
#9
Gretchen Parrott, Daijiro Nebeya, Takeshi Kinjo, Kazuya Miyagi, Shusaku Haranaga, Futoshi Higa, Masao Tateyama, Jiro Fujita
BACKGROUND: Etiological epidemiology and diagnosis are important issues for CAP and NHCAP. Despite the availability of effective therapies, significant morbidity and mortality ensues. METHODS: We retrospectively analyzed the etiology of 200 pneumonia patients at the University of the Ryukyus Hospital. Patients were categorized into CAP (n = 97) or NHCAP (n = 103), according to the Japanese Respiratory Society guidelines. Diagnoses were made using clinical tests including, Gram stain, bacterial culture, serum and urinary tests...
April 18, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28428353/development-of-a-bnp1-32-immunoassay-that-does-not-cross-react-with-probnp
#10
Lynley K Lewis, Sara D Raudsepp, Tim G Yandle, Timothy C Prickett, A Mark Richards
BACKGROUND: Plasma B-type natriuretic peptide (BNP) concentration reflects cardiac dysfunction and assists in determining the diagnosis and prognosis of heart failure (HF). Current BNP assays overestimate circulating bioactive BNP1-32 concentrations as they also detect less active BNP metabolites and proBNP. A specific BNP1-32 assay with negligible cross-reactivity to proBNP and/or BNP metabolites may be advantageous. METHODS: We developed a Luminex-based specific BNP1-32 immunoassay and compared results obtained from 3 other BNP assays (a Luminex-based total-BNP assay, our BNP RIA, and the commercially available Abbott Architect BNP assay) in plasma from 42 patients with HF and 22 healthy controls...
April 20, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28427562/cardiokines-as-modulators-of-stress-induced-cardiac-disorders
#11
Anna Planavila, Joaquim Fernández-Solà, Francesc Villarroya
Almost 30 years ago, the protein, atrial natriuretic peptide, was identified as a heart-secreted hormone that provides a peripheral signal from the myocardium that communicates to the rest of the organism to modify blood pressure and volume under conditions of heart failure. Since then, additional peripheral factors secreted by the heart, termed cardiokines, have been identified and shown to coordinate this interorgan cross talk. In addition to this interorgan communication, cardiokines also act in an autocrine/paracrine manner to play a role in intercellular communication within the myocardium...
2017: Advances in Protein Chemistry and Structural Biology
https://www.readbyqxmd.com/read/28427050/expression-of-high-mobility-group-protein-b1-in-cardiac-tissue-of-elderly-patients-with-coronary-artery-disease-with-or-without-inflammatory-rheumatic-disease
#12
Mei Bruton, Ivana Hollan, Julie Xiao, Eva Lindroos, Knut Mikkelsen, Stein E Rynning, Kjell Saatvedt, Sven M Almdahl, Helena E Harris, Ingrid E Lundberg, Cecilia Wick
BACKGROUND: It is known from clinical practice and observational studies that elderly patients with a diagnosis of inflammatory rheumatic diseases (IRD) bear a significantly increased risk for cardiovascular diseases such as coronary artery disease (CAD) and heart failure. The molecular mechanism, however, is still not known. Recently, high mobility group protein B1 (HMGB1), a ubiquitous, highly conserved single polypeptide expressed in all mammal eukaryotic cells, has been identified to mediate myocardial dysfunction in vitro once released from the nuclei of cardiomyocytes...
April 21, 2017: Gerontology
https://www.readbyqxmd.com/read/28425041/familial-amyloid-cardiomyopathy-masquerading-as-chronic-guillain-barre-syndrome-things-are-not-always-what-they-seem
#13
Die Hu, Ling Liu, Shuguang Yuan, Yuhong Yi, Daoquan Peng
Familial amyloid cardiomyopathy is a challenging condition that mimics many other diseases, particularly in patients with pronounced neurological presentations and unexplained or equivocal cardiac abnormalities. In this case, a 57-year-old man was admitted for outpatient cardiological evaluation of progressive right heart failure and limb paraesthesias. The patient presented with hypertension, chronic Guillain-Barre syndrome, and sick sinus syndrome. Transthoracic echocardiograms showed a thickened ventricular wall and enlarged atrium...
April 19, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28420670/confirmed-early-myocardial-rupture-in-a-patient-with-pulseless-electrical-activity-pea-following-late-presentation-of-st-elevation-myocardial-infarction
#14
Baskar Sekar, Joe Martins, Sanjiv Petkar
A 69 year old male, an ex-smoker, was admitted with ongoing chest pain of 11 hours duration. Past medical history included treated hypertension and gastro-oesophageal reflux disease. He delayed seeking medical attention as he assumed the pain to be due to indigestion and kept taking antacids without much symptomatic relief. Clinical examination on arrival was unremarkable. Admission 12 lead electrocardiogram (ECG) was diagnostic of a recent anterolateral myocardial infarction (MI) (Figure 1a). Bedside trans-thoracic echocardiogram (TTE) confirmed an established anterolateral MI (Video 1, Figure 1b)...
April 18, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28420576/prevalence-of-hypertension-and-prehypertension-in-adolescence-in-ahvaz-iran
#15
Armaghan Moravej Aleali, Seyed Mahmoud Latifi, Homeira Rashidi, Seyed Peyman Payami, Azar Sabet
BACKGROUND: High blood pressure is a risk factor for some disease like stroke, coronary heart disease, and renal failure. High blood pressure in children is an increasing health problem. OBJECTIVES: The aim of this study was to determine prevalence of hypertension and pre-hypertension age between 10 to 17 years old. PATIENTS AND METHODS: This descriptive analytic study was conducted using multiphase sampling method in Ahvaz (Southwest of Iran)...
April 7, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28419735/hospital-use-in-aboriginal-and-non-aboriginal-patients-with-chronic-disease
#16
David Whyatt, Matthew Yap, Raji Tenneti, Glenn Pearson, Alistair Vickery
OBJECTIVE: The objective of this study was to compare rates of hospital utilisation in Aboriginal and non-Aboriginal peoples before and after hospital admission for chronic obstructive pulmonary disease, heart failure and/or type 2 diabetes mellitus. METHODS: This was a longitudinal cohort study from 2002 to 2014, which was conducted in all hospitals in Western Australia. The participants of this study were Aboriginal and non-Aboriginal patients with a principal diagnosis of heart failure, type 2 diabetes or chronic obstructive pulmonary disease, on admission to hospital, where such an event had not occurred in the previous 3 years...
April 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28417478/point-of-care-lung-sonography-an-audit-of-1150-examinations
#17
Giuseppe Francesco Sferrazza Papa, Michele Mondoni, Giovanni Volpicelli, Paolo Carlucci, Fabiano Di Marco, Elena Maria Parazzini, Francesca Reali, Giulia Michela Pellegrino, Paola Fracasso, Simone Sferrazza Papa, Livio Colombo, Stefano Centanni
OBJECTIVES: Point-of-care lung sonography has theoretical usefulness in numerous diseases; however clinical indications and the impact of this technique have not been fully investigated. We aimed to describe the current use of point-of-care lung sonography. METHODS: A 2-year prospective observational study was performed by pulmonologists in an Italian university hospital. Techniques, indications, consequences of lung sonography, and barriers to the examination were analyzed...
April 18, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28417241/use-of-tumor-necrosis-factor-alpha-inhibitors-for-inflammatory-bowel-disease-patients-with-concurrent-heart-failure
#18
Yan Jiang, Oliver Lin, Sidhartha R Sinha
BACKGROUND: Prescribing information for tumor necrosis factor alpha (TNFα) inhibitors, a mainstay of treatment for moderate to severe inflammatory bowel disease (IBD), instructs cautious use in those with heart failure (HF). However, the limited data behind these warnings are inconclusive and should be weighed against mounting evidence demonstrating worse cardiac outcomes in active IBD. AIMS: To assess whether TNFα inhibitor use is reduced in patients with IBD and HF by analyzing physician practice and prescription patterns...
April 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28417024/new-classification-for-heart-failure-with-mildly-reduced-ejection-fraction-greater-clarity-or-more-confusion
#19
Sunil Nadar
The latest European Society of Cardiology (ESC) guidelines for the diagnosis and management of heart failure include a new patient group for those with heart failure with mildly reduced ejection fraction (HFmrEF). By defining this group of patients as a separate entity, the ESC hope to encourage more research focusing on patients with HFmrEF. Previously, patients with this condition were caught between two classifications-heart failure with reduced ejection fraction and heart failure with preserved ejection fraction...
February 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28414688/ecg-of-the-month-mental-disturbance-for-4-days
#20
D Luke Glancy, Theresa Mills, Fred Lopez
A family brought their 61-year-old mother to the emergency department because for 4 days she had been confused, incoherent, and somnolent. She also had dysphagia, dysarthria, diplopia, and had fallen out of bed. She had been in the hospital 3 weeks earlier for atrial fibrillation and an exacerbation of congestive heart failure. She also carried a diagnosis of chronic obstructive pulmonary disease and used an albuterol inhaler. She was obese (BMI of 45); and had adult-onset diabetes mellitus. She had a 43 pack-year history of cigarette smoking but had recently quit...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
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