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Larissa K Laskowski, Jonathan A Henesch, Lewis S Nelson, Robert S Hoffman, Silas W Smith
CONTEXT: Nearly pure caffeine is sold as a "dietary supplement," with instructions to ingest 1/64th to 1/16th of one teaspoon (50-200 mg). We report a patient with refractory cardiac dysrhythmias treated with defibrillation, beta-adrenergic blockade, and hemodialysis to highlight concentrated caffeine's dangers. CASE DETAILS: A 20-year-old woman presented with severe agitation, tremor, and vomiting approximately 1-2 h after suicidal ingestion of concentrated caffeine (powder and tablets)...
2015: Clinical Toxicology
Ashmeet Bhatia, Tokunbo Ajayi
Malignant mesothelioma is an uncommon neoplasm of serosal surfaces, such as the pleura, the peritoneum, less frequently pericardium and tunica vaginalis. It usually spreads locally to the lungs and mediastinum. We describe a case of malignant mesothelioma with metastasis to the heart. The patient presented with syncope, chest pain and light-headedness. He was found to have wide complex ventricular tachycardia (Vtach). He was cardioverted and then noted to have multiple (more than 20) similar episodes during the hospital course...
April 25, 2014: BMJ Case Reports
Prabal Khanal, Akshay Vankipuram, Aaron Ashby, Mithra Vankipuram, Ashish Gupta, Denise Drumm-Gurnee, Karen Josey, Linda Tinker, Marshall Smith
BACKGROUND: Advanced Cardiac Life Support (ACLS) is a series of team-based, sequential and time constrained interventions, requiring effective communication and coordination of activities that are performed by the care provider team on a patient undergoing cardiac arrest or respiratory failure. The state-of-the-art ACLS training is conducted in a face-to-face environment under expert supervision and suffers from several drawbacks including conflicting care provider schedules and high cost of training equipment...
October 2014: Journal of Biomedical Informatics
Etienne Delacrétaz, Roman Brenner, Anselm Schaumann, Lars Eckardt, Stephan Willems, Heinz-Friedrich Pitschner, Josef Kautzner, Burghard Schumacher, Peter S Hansen, Karl-Heinz Kuck
BACKGROUND: In the Ventricular Tachycardia Ablation in Coronary Heart Disease (VTACH) study, an intention-to-treat approach was used and may have diminished the observed degree of treatment effect. We present a subanalysis of the VTACH study by treatment actually received. METHODS AND RESULTS: The VTACH study was a prospective, open, randomized controlled trial, undertaken in 16 European centers, comparing defibrillator implantation with and without ventricular tachycardia (VT) ablation in patients with stable VT, previous myocardial infarction, and reduced left-ventricular ejection fraction...
May 2013: Journal of Cardiovascular Electrophysiology
Jarrod Mosier, Ajit Itty, Arthur Sanders, Jane Mohler, Christopher Wendel, Jacob Poulsen, Jeff Shellenberger, Lani Clark, Bentley Bobrow
BACKGROUND: Recent studies have shown that a new emergency medical services (EMS) protocol for treating patients who suffer out-of-hospital cardiac arrest (OHCA), cardiocerebral resuscitation (CCR), significantly improves survival compared to standard advanced life support (ALS). However, due to their different physiology, it is unclear if all elders, or any subsets of elders who are OHCA victims, would benefit from the CCR protocol. OBJECTIVES: The objectives of this analysis were to compare survival by age group for patients receiving CCR and ALS, to evaluate their neurologic outcome, and to determine what other factors affect survival in the subset of patients who do receive CCR...
March 2010: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Karl-Heinz Kuck, Anselm Schaumann, Lars Eckardt, Stephan Willems, Rodolfo Ventura, Etienne Delacrétaz, Heinz-Friedrich Pitschner, Josef Kautzner, Burghard Schumacher, Peter S Hansen
BACKGROUND: In patients with ventricular tachycardia (VT) and a history of myocardial infarction, intervention with an implantable cardioverter defibrillator (ICD) can prevent sudden cardiac death and thereby reduce total mortality. However, ICD shocks are painful and do not provide complete protection against sudden cardiac death. We assessed the potential benefit of catheter ablation before implantation of a cardioverter defibrillator. METHODS: The Ventricular Tachycardia Ablation in Coronary Heart Disease (VTACH) study was a prospective, open, randomised controlled trial, undertaken in 16 centres in four European countries...
January 2, 2010: Lancet
Stephan Rosenkranz, Lars S Maier, Christoph Maack, Michael Böhm
This article summarizes the results of a number of new clinical trials, registries and metaanalyses in the field of cardiovascular medicine. Key presentations made at the 73(rd) annual meeting of the German Cardiac Society, held in Mannheim, Germany, in April 2007 are reported. The data were presented by leading experts in the field with relevant positions in the trials, registries or metaanalyses. These comprehensive summaries should provide the readers with the most recent data on diagnostic and therapeutic developments in cardiovascular medicine...
July 2007: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Antoine Beuchat, Steven Taub, Jean-Damien Saby, Vincent Dierick, Gianmarco Codeluppi, Antonio F Corno, Ludwig K von Segesser
OBJECTIVE: Head-up displays allow the surgeons to simultaneously view the patient and the patient's vital parameters (ECG, blood pressure, etc.) using vision-through over a wireless net, potentially enhancing the speed, accuracy and safety of surgical decisions. The aim was to assess surgical reaction time to AFIB, bigeminy, trigeminy, VTACH, and VFIB and concentration during a surgical intervention comparing standard and cyber tools monitoring. METHODS: Using a patient simulator for beating heart surgery able to emulate heart signals and motion (arrhythmias) a group of surgeons performed coronary bypass procedures...
February 2005: European Journal of Cardio-thoracic Surgery
A J Schneider, W B Murray, S C Mentzer, F Miranda, S Vaduva
OBJECTIVE: The medical practitioner is faced with an increasing list of protocols and algorithms related to patient care. These recommendations are often difficult to recall, particularly in stressful emergency situations. Using advanced cardiac life support (ACLS) protocols, we built a computer-based system to exhibit precompiled response plans for medical emergencies. To validate the usefulness of this prompting device, we tested application of two of the nine ACLS algorithms, pulseless ventricular fibrillation/ventricular tachycardia (Vfib/Vtach) and bradycardia, in a simulated operating room (OR) environment...
November 1995: Journal of Clinical Monitoring
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