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Cardiac emergency medicine

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https://www.readbyqxmd.com/read/29450799/iron-oxide-labeling-does-not-affect-differentiation-potential-of-human-bone-marrow-mesenchymal-stem-cells-exhibited-by-their-differentiation-into-cardiac-and-neuronal-cells
#1
Sujata Mohanty, Krishan Gopal Jain, Sushmita Bose Nandy, Anupama Kakkar, Manoj Kumar, Amit Kumar Dinda, Harpal Singh, Alok Ray
Mesenchymal stem cells (MSCs) have shown promising outcomes in cardiac and neuronal diseases. Efficient and noninvasive tracking of MSCs is essential to harness their therapeutic potential. Iron oxide nanoparticles (IONPs) have emerged as effective means to label stem cells and visualize them using magnetic resonance imaging (MRI). It is known that IONPs do not affect viability and cell proliferation of stem cells. However, very few studies have demonstrated differentiation potential of iron oxide-labeled MSCs and their differentiation into specific lineages that can contribute to cellular therapies...
February 15, 2018: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/29442540/management-of-immune-related-adverse-events-in-patients-treated-with-immune-checkpoint-inhibitor-therapy-american-society-of-clinical-oncology-clinical-practice-guideline
#2
Julie R Brahmer, Christina Lacchetti, Bryan J Schneider, Michael B Atkins, Kelly J Brassil, Jeffrey M Caterino, Ian Chau, Marc S Ernstoff, Jennifer M Gardner, Pamela Ginex, Sigrun Hallmeyer, Jennifer Holter Chakrabarty, Natasha B Leighl, Jennifer S Mammen, David F McDermott, Aung Naing, Loretta J Nastoupil, Tanyanika Phillips, Laura D Porter, Igor Puzanov, Cristina A Reichner, Bianca D Santomasso, Carole Seigel, Alexander Spira, Maria E Suarez-Almazor, Yinghong Wang, Jeffrey S Weber, Jedd D Wolchok, John A Thompson
Purpose To increase awareness, outline strategies, and offer guidance on the recommended management of immune-related adverse events in patients treated with immune checkpoint inhibitor (ICPi) therapy. Methods A multidisciplinary, multi-organizational panel of experts in medical oncology, dermatology, gastroenterology, rheumatology, pulmonology, endocrinology, urology, neurology, hematology, emergency medicine, nursing, trialist, and advocacy was convened to develop the clinical practice guideline. Guideline development involved a systematic review of the literature and an informal consensus process...
February 14, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29441344/implementation-of-a-sustainable-training-system-for-emergency-in-vietnam
#3
REVIEW
Sunjoo Kang, Hyejin Seo, Binh Duy Ho, Phuong Thi Anh Nguyen
Purpose: This study analyzed the project outcomes to share lessons regarding the development of an emergency medicine education system in Vietnam. Methods: Retrospective evaluation was implemented using project outcome indicators. Results: A total of 13 training courses were administered, with the collaboration of international experts in Korea and Vietnam. A total of 23 kinds of emergency medicine education equipment were purchased, and a basic life support (BLS) and two advanced cardiac life support labs were remodeled to provide appropriate simulation training...
2018: Frontiers in Public Health
https://www.readbyqxmd.com/read/29407013/contemporary-emergency-department-management-of-patients-with-chest-pain-a-concise-review-and-guide-for-the-high-sensitivity-troponin-era
#4
REVIEW
James E Andruchow, Peter A Kavsak, Andrew D McRae
This article synthesizes current best evidence for the evaluation of patients with suspected acute coronary syndrome (ACS) using high-sensitivity troponin assays, enabling physicians to effectively incorporate them into practice. Unlike conventional assays, high-sensitivity assays can precisely measure blood cardiac troponin concentrations in the vast majority of healthy individuals, facilitating the creation of rapid diagnostic algorithms. Very low troponin concentrations on presentation accurately rule out acute myocardial infarction (AMI) and enable the discharge of approximately 20% of patients after a single test, whereas an additional 30%-40% of patients can be safely discharged after short-interval serial sampling in as little as 1 or 2 hours...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29395757/standardized-model-of-porcine-resuscitation-using-a-custom-made-resuscitation-board-results-in-optimal-hemodynamic-management
#5
Jakob Wollborn, Eva Ruetten, Bjoern Schlueter, Joerg Haberstroh, Ulrich Goebel, Martin A Schick
AIM: Standardized modeling of cardiac arrest and cardiopulmonary resuscitation (CPR) is crucial to evaluate new treatment options. Experimental porcine models are ideal, closely mimicking human-like physiology. However, anteroposterior chest diameter differs significantly, being larger in pigs and thus poses a challenge to achieve adequate perfusion pressures and consequently hemodynamics during CPR, which are commonly achieved during human resuscitation. The aim was to prove that standardized resuscitation is feasible and renders adequate hemodynamics and perfusion in pigs, using a specifically designed resuscitation board for a pneumatic chest compression device...
January 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29388356/advances-in-carbon-nanotubes-hydrogel-hybrids-in-nanomedicine-for-therapeutics
#6
REVIEW
Arti Vashist, Ajeet Kaushik, Atul Vashist, Vidya Sagar, Anujit Ghosal, Y K Gupta, Sharif Ahmad, Madhavan Nair
In spite of significant advancement in hydrogel technology, low mechanical strength and lack of electrical conductivity have limited their next-level biomedical applications for skeletal muscles, cardiac and neural cells. Host-guest chemistry based hybrid nanocomposites systems have gained attention as they completely overcome these pitfalls and generate bioscaffolds with tunable electrical and mechanical characteristics. In recent years, carbon nanotube (CNT)-based hybrid hydrogels have emerged as innovative candidates with diverse applications in regenerative medicines, tissue engineering, drug delivery devices, implantable devices, biosensing, and biorobotics...
February 1, 2018: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/29376560/inotropic-agents-and-vasodilator-strategies-for-the-treatment-of-cardiogenic-shock-or-low-cardiac-output-syndrome
#7
REVIEW
Julia Schumann, Eva C Henrich, Hellen Strobl, Roland Prondzinsky, Sophie Weiche, Holger Thiele, Karl Werdan, Stefan Frantz, Susanne Unverzagt
BACKGROUND: Cardiogenic shock (CS) and low cardiac output syndrome (LCOS) as complications of acute myocardial infarction (AMI), heart failure (HF) or cardiac surgery are life-threatening conditions. While there is a broad body of evidence for the treatment of people with acute coronary syndrome under stable haemodynamic conditions, the treatment strategies for people who become haemodynamically unstable or develop CS remain less clear. We have therefore summarised here the evidence on the treatment of people with CS or LCOS with different inotropic agents and vasodilative drugs...
January 29, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29355793/position-of-the-french-working-group-on-perioperative-haemostasis-gihp-on-viscoelastic-tests-what-role-for-which-indication-in-bleeding-situations
#8
Stéphanie Roullet, Emmanuel de Maistre, Brigitte Ickx, Normand Blais, Sophie Susen, David Faraoni, Delphine Garrigue, Fanny Bonhomme, Anne Godier, Dominique Lasne
PURPOSE: Viscoelastic tests (VETs), thromboelastography (TEG®) and thromboelastometry (ROTEM®) are global tests of coagulation performed on whole blood. They evaluate the mechanical strength of a clot as it builds and develops after coagulation itself. The time required to obtain haemostasis results remains a major problem for clinicians dealing with bleeding, although some teams have developed a rapid laboratory response strategy. Indeed, the value of rapid point-of-care diagnostic devices such as VETs has increased over the years...
January 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29352416/point-of-care-ultrasound-in-pediatric-anesthesiology-and-critical-care-medicine
#9
REVIEW
Erik Su, Nicholas Dalesio, Aliaksei Pustavoitau
Ultrasound has increasingly become a clinical asset in the hands of the anesthesiologist and intensivist who cares for children. Though many applications for ultrasound parallel adult modalities, children as always are not simply small adults and benefit from the application of ultrasound to their management in various ways. Body composition and size are important factors that affect ultrasound performance in the child, as are the pathologies that may uniquely afflict children and aspects of procedures unique to this patient population...
January 19, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29332196/bioelectronic-modulation-of-carotid-sinus-nerve-activity-in-the-rat-a-potential-therapeutic-approach-for-type-2-diabetes
#10
Joana F Sacramento, Daniel J Chew, Bernardete F Melo, Matteo Donegá, Wesley Dopson, Maria P Guarino, Alison Robinson, Jesus Prieto-Lloret, Sonal Patel, Bradley J Holinski, Nishan Ramnarain, Victor Pikov, Kristoffer Famm, Silvia V Conde
AIMS/HYPOTHESIS: A new class of treatments termed bioelectronic medicines are now emerging that aim to target individual nerve fibres or specific brain circuits in pathological conditions to repair lost function and reinstate a healthy balance. Carotid sinus nerve (CSN) denervation has been shown to improve glucose homeostasis in insulin-resistant and glucose-intolerant rats; however, these positive effects from surgery appear to diminish over time and are heavily caveated by the severe adverse effects associated with permanent loss of chemosensory function...
January 14, 2018: Diabetologia
https://www.readbyqxmd.com/read/29315095/observational-study-in-healthy-volunteers-to-define-interobserver-reliability-of-ultrasound-haemodynamic-monitoring-techniques-performed-by-trainee-doctors
#11
Benjamin M Bussmann, Shrey Sharma, David Mcgregor, William Hulme, Tim Harris
OBJECTIVES: Bedside ultrasound is increasingly being used to guide fluid management in shocked patients. Little data exist on the inter-rater reliability of techniques used, especially when performed by nonexpert trainee doctors. The primary aim of this study is to measure the inter-rater reliability of five ultrasound techniques commonly used to guide fluid management: inferior vena cava collapsibility index (IVCCI), transthoracic echocardiography (TTE)-derived stroke volumes, ultrasound cardiac output monitor (USCOM) derived stroke volume and carotid artery blood flow and corrected flow time measurements...
January 8, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29303551/engineering-bioinspired-antioxidant-materials-promoting-cardiomyocyte-functionality-and-maturation-for-tissue-engineering-application
#12
Parvaiz Ahmad Shiekh, Anamika Singh, Ashok Kumar
Oxidative stress plays an important role in various pathological conditions such as wound healing, inflammation, myocardial infarction and biocompatibility of the materials. Antioxidant polymers to attenuate oxidative stress is an emerging field of biomaterial research with a huge impact in the field of tissue engineering and regenerative medicine. We describe here the fabrication and evaluation of an elastomeric antioxidant polyurethane (PUAO) for tissue engineering applications. Uniaxial and cyclic tensile testing, thermal analysis, degradation, cytotoxicity and antioxidant analysis was carried out...
January 5, 2018: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/29277921/clinical-factors-associated-with-physician-choice-of-femoral-versus-radial-access-a-real-world-experience-from-a-single-academic-center
#13
Jimmy Yee, Vishesh Kumar, Shenjing Li, Terezia Petraskova, Alex Pham, Julia Stys, Paul A Thompson, Marian Petrasko, Adam Stys, Tomasz Stys
OBJECTIVES: To analyze clinical factors associated with operator's preference in selection of femoral versus radial access for angiography and percutaneous intervention (PCI) procedures. BACKGROUND: There has been an increase in radial access in cardiac catheterization and PCI in the last few decades. METHODS: Data from 11 226 consecutive cardiac catheterization procedures were collected from Sanford University Medical Center (University of South Dakota, Sanford School of Medicine) from 2011 to 2015...
December 25, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29273259/contemporary-application-of-point-of-care-echocardiography-in-the-emergency-department
#14
REVIEW
Jordan Chenkin, Clare L Atzema
Point-of-care echocardiography is revolutionizing the management of patients presenting with undifferentiated shock and cardiac arrest in the emergency department (ED). Its primary purpose is to aid the clinician in rapidly ruling in and ruling out life-threatening diagnoses at the bedside. In addition, it has become an important component of the clinical examination for stable patients seen in the ED with nonspecific signs and symptoms such as shortness of breath or syncope. Although first described to facilitate the diagnosis of pericardial effusions and cardiac standstill, ED echocardiography has since evolved and is now widely used by emergency physicians to help diagnose other important cardiovascular pathologic conditions that may be contributing to undifferentiated shock, such as left ventricular failure and right ventricular dilatation resulting from pulmonary embolism...
September 1, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29269162/echocardiography-in-cardiac-arrest-an-emergency-medicine-review
#15
REVIEW
Brit Long, Stephen Alerhand, Kurian Maliel, Alex Koyfman
INTRODUCTION: Cardiac arrest management primarily focuses on optimal chest compressions and early defibrillation for shockable cardiac rhythms. Non-shockable rhythms such as pulseless electrical activity (PEA) and asystole present challenges in management. Point-of-care ultrasound (POCUS) in cardiac arrest is promising. OBJECTIVES: This review provides a focused assessment of POCUS in cardiac arrest, with an overview of transthoracic (TTE) and transesophageal echocardiogram (TEE), uses in arrest, and literature support...
December 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29266739/predicting-re-presentation-following-discharge-from-the-emergency-department-with-non-specific-chest-pain
#16
Tessa M Potezny, Christopher M Horwood, Paul Hakendorf, Cynthia Papendick, Campbell H Thompson
OBJECTIVE: To determine the 30 day major adverse cardiac events (MACE) and re-presentation rates of non-specific chest pain (NSCP) patients following four different disposition pathways and to contrast re-presentation rates of patients with NSCP with those for all other patients presenting to the ED. METHODS: Cases were derived from the ED database for two large teaching hospitals where patients aged 18 or over were triaged between 2009 and 2016, and their diagnosis on leaving the ED was NSCP...
December 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29261337/current-and-emerging-imaging-techniques-in-the-diagnosis-and-assessment-of-pulmonary-hypertension
#17
Christopher S Johns, Jim M Wild, Smitha Rajaram, Andy J Swift, David G Kiely
Pulmonary hypertension (PH) is a challenging condition to diagnose and treat. Over the last two decades, there have been significant advances in therapeutic approaches and imaging technologies. Current guidelines emphasize the importance of cardiac catheterization; however, the increasing availability of non-invasive imaging has the potential to improve diagnostic rates, whilst providing additional information on patient phenotypes. Areas covered: This review discusses the role of imaging in the diagnosis, prognostic assessment and follow-up of patients with PH...
February 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29226111/comparison-of-electronic-learning-versus-lecture-based-learning-in-improving-emergency-medicine-residents-knowledge-about-mild-induced-hypothermia-after-cardiac-arrest
#18
Maryam Soleimanpour, Farzad Rahmani, Mehrad Naghizadeh Golzari, Alireza Ala, Hamid Reza Morteza Bagi, Robab Mehdizadeh Esfanjani, Hassan Soleimanpour
Background: The process of medical education depends on several issues such as training materials, students, professors, educational fields, and the applied technologies. The current study aimed at comparing the impacts of e-learning and lecture-based learning of mild induced hypothermia (MIH) after cardiac arrest on the increase of knowledge among emergency medicine residents. Methods: In a pre- and post-intervention study, MIH after cardiac arrest was taught to 44 emergency medicine residents...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29211225/off-pump-versus-on-pump-coronary-artery-bypass-grafting-in-frail-patients-study-protocol-for-the-fragile-multicenter-randomized-controlled-trial
#19
Omar Asdrúbal Vilca Mejía, Michel Pompeu Barros Oliveira Sá, Maurilio Onofre Deininger, Luís Roberto Palma Dallan, Rodrigo Coelho Segalote, Marco Antonio Praça de Oliveira, Fernando Antibas Atik, Magaly Arrais Dos Santos, Pedro Gabriel Melo de Barros E Silva, Rodrigo Mussi Milani, Alexandre Ciappina Hueb, Rosangela Monteiro, Ricardo Carvalho Lima, Luiz Augusto Ferreira Lisboa, Luís Alberto Oliveira Dallan, John Puskas, Fabio Biscegli Jatene
INTRODUCTION: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29209617/mirroring-the-multiple-potentials-of-micrornas-in-acute-myocardial-infarction
#20
REVIEW
Solenne Paiva, Onnik Agbulut
At present, cardiovascular diseases are depicted to be the leading cause of death worldwide according to the World Health Organization. In the future, projections predict that ischemic heart disease will persist in the top main causes of illness. Within this alarming context, some tiny master regulators of gene expression programs, namely, microRNAs (miRNAs) carry three promising potentials. In fact, miRNAs can prove to be useful not only in terms of biomarkers allowing heart injury detection but also in terms of therapeutics to overcome limitations of past strategies and treat the lesions...
2017: Frontiers in Cardiovascular Medicine
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