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Cardiac emergency medicine

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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
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/29201367/services-aimed-at-achieving-desirable-clinical-outcomes-in-patients-with-chronic-kidney-disease-and-diabetes-mellitus-a-narrative-review
#4
REVIEW
Fergus William Gardiner, Ezekiel Uba Nwose, Phillip Taderera Bwititi, Judith Crockett, Lexin Wang
There is a large number of patients with chronic kidney disease (CKD), diabetes mellitus (DM), and hypertension (HT) but whether the targets on blood pressure (BP) control in patients with DM and/or CKD are met is not clear. This narrative review therefore investigated evidence on services aimed at achieving desirable clinical results in patients with CKD and DM, and HT in Australia. Literature pertaining to pathology diagnosis and management of these patients as well as the complexities in management were considered...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/29175310/no-more-code-black-intervention-to-improve-inpatient-flow-at-a-large-public-hospital
#5
Charles E Coffey, Valda Carter, Eric Wei, Douglas Hutcheon, John P Gruen, Annie Anonas-Ternate, Rebecca Sandoval, Annie Marquez, Laura Sarff, Brad Spellberg
Code Black is a documentary movie, and now television series, whose name derives from a term used to describe critical hospital overcrowding resulting in dangerously inadequate patient flow. The Los Angeles County + University of Southern California (LAC+USC) Medical Center is a large, urban, public hospital with a long history of spending substantial amounts of time in Code Black-indeed the movie was created by a former Emergency Medicine resident at LAC+USC Medical Center. To change years of inadequate inpatient flow, we implemented time-limited cardiac monitoring criteria and empowered existing staff to enforce admission and downgrade criteria for our telemetry, step-down care unit, and intensive care units...
November 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29173418/future-directions-management-of-sudden-cardiac-death
#6
REVIEW
Robert W Neumar
There will always be a need to optimize early recognition and treatment of sudden cardiac arrest. For out-of-hospital cardiac arrest, this requires a complex system of care involving bystanders, 911 dispatchers, and emergency medical service and hospital-based providers. Optimizing this system is fundamental to improving outcomes. In addition, personnel and resources are needed to develop and sustain a research pipeline that will bring new scientific discoveries and technologies to the field. The 2015 Institute of Medicine report, "Strategies to Improve Cardiac Arrest Survival: A Time to Act," provides a roadmap...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29170302/5%C3%A2-a-study-analysing-the-diagnostic-performance-of-ecg-interpretation-for-30-day-major-cardiac-events-in-the-emergency-department
#7
Niall Morris, Rick Body
STUDY OBJECTIVE: This study evaluates the diagnostic accuracy of an Emergency Medicine (EM) clinician at identifying ischaemia on an ECG using 30-day major adverse cardiac events (MACE) as the primary outcome. METHODS: This is a secondary analysis of a prospective, multi-centre, observational cohort at 14 centres: the Bedside Evaluation of Sensitive Troponin study. All fourteen Emergency Departments were based in the United Kingdom. Emergency physicians' assessments of the ECG were collected using a standardised form...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29169287/point-of-care-testing-poct-and-evidence-based-laboratory-medicine-eblm-does-it-leverage-any-advantage-in-clinical-decision-making
#8
Christopher Florkowski, Andrew Don-Wauchope, Nuria Gimenez, Karina Rodriguez-Capote, Julien Wils, Annalise Zemlin
Point-of-care testing (POCT) is the analysis of patient specimens outside the clinical laboratory, near or at the site of patient care, usually performed by clinical staff without laboratory training, although it also encompasses patient self-monitoring. It is able to provide a rapid result near the patient and which can be acted upon immediately. The key driver is the concept that clinical decision making may be delayed when samples are sent to the clinical laboratory. Balanced against this are considerations of increased costs for purchase and maintenance of equipment, staff training, connectivity to the laboratory information system (LIS), quality control (QC) and external quality assurance (EQA) procedures, all required for accreditation under ISO 22870...
November 23, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/29168541/evaluation-of-bioresorbable-vascular-scaffolds-in-acute-coronary-syndrome-a-two-center-one-year-follow-up-analysis
#9
Sylwia Iwańczyk, Jarosław Hiczkiewicz, Aleksander Araszkiewicz, Magdalena Łanocha, Daria Adamczak, Wojciech Faron, Stefan Grajek, Maciej Lesiak
BACKGROUND: Bioresorbable vascular scaffolds (BVS) have emerged as a new treatment option in cardiovascular medicine. Nonetheless, there is still limited data on the use of these novel devices in patients with acute coronary syndromes (ACS). The purpose of this study was to evaluate the feasibility and efficacy of BVS implantation in patients with ACS. METHODS: The present report is a prospective, two-centre registry that involved 165 consecutive patients hospitalized with the diagnosis of ACS and treated with the Absorb BVS (Abbot Vascular, Santa Clara, USA)...
November 23, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/29162440/automated-external-defibrillators-in-the-hospital-a-case-of-medical-reversal
#10
John A Stewart
Automated external defibrillators (AEDs) emerged in the 1980s as an important innovation in pre-hospital emergency cardiac care (ECC). In the years since, the American Heart Association (AHA) and the International Liaison Committee for Resuscitation (ILCOR) have promoted AED technology for use in hospitals as well, resulting in the widespread purchase and use of AED-capable defibrillators. In-hospital use of AEDs now appears to have decreased survival from cardiac arrests. This article will look at the use of AEDs in hospitals as a case of "medical reversal...
November 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#11
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29128035/bedside-identification-of-massive-pulmonary-embolism-with-point-of-care-transesophageal-echocardiography
#12
Tomislav Jelic, Melanie Baimel, Jordan Chenkin
BACKGROUND: Pulmonary embolism can be difficult to diagnose, particularly in those who are hemodynamically unstable and cannot be imaged to confirm the diagnosis. Echocardiography can allow for rapid assessment of patients in shock, but requires adequate transthoracic windows to obtain clinically useful information. Emergency physician-performed transesophageal echocardiography (TEE) may be a useful tool when transthoracic echocardiography fails. CASE REPORT: An 86-year-old woman presented to the emergency department after a fall at home...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29117092/the-development-and-validation-of-a-concise-instrument-for-formative-assessment-of-team-leader-performance-during-simulated-pediatric-resuscitations
#13
Lindsay D Nadkarni, Cindy G Roskind, Marc A Auerbach, Aaron W Calhoun, Mark D Adler, David O Kessler
AIM: The aim of this study was to assess the validity of a formative feedback instrument for leaders of simulated resuscitations. METHODS: This is a prospective validation study with a fully crossed (person × scenario × rater) study design. The Concise Assessment of Leader Management (CALM) instrument was designed by pediatric emergency medicine and graduate medical education experts to be used off the shelf to evaluate and provide formative feedback to resuscitation leaders...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29116359/use-of-automated-external-defibrillators-for-in-hospital-cardiac-arrest-any-time-any-place
#14
A Wutzler, C Kloppe, A K Bilgard, A Mügge, C Hanefeld
BACKGROUND: Acute treatment of in-hospital cardiac arrest (IHCA) is challenging and overall survival rates are low. However, data on the use of public-access automated external defibrillators (AEDs) for IHCA remain controversial. The aim of our study was to evaluate characteristics of patients experiencing IHCA and feasibility of public-access AED use for resuscitation in a university hospital. METHODS: IHCA events outside the intensive care unit were analysed over a period of 21 months...
November 7, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29109195/sleep-apnea-and-cardiovascular-disease-lessons-from-recent-trials-and-need-for-team-science
#15
REVIEW
Luciano F Drager, R Doug McEvoy, Ferran Barbe, Geraldo Lorenzi-Filho, Susan Redline
Emerging research highlights the complex interrelationships between sleep-disordered breathing and cardiovascular disease, presenting clinical and research opportunities as well as challenges. Patients presenting to cardiology clinics have a high prevalence of obstructive and central sleep apnea associated with Cheyne-Stokes respiration. Multiple mechanisms have been identified by which sleep disturbances adversely affect cardiovascular structure and function. Epidemiological research indicates that obstructive sleep apnea is associated with increases in the incidence and progression of coronary heart disease, heart failure, stroke, and atrial fibrillation...
November 7, 2017: Circulation
https://www.readbyqxmd.com/read/29085546/characteristics-of-emergency-medicine-residency-programs-in-colombia
#16
Andrés Patiño, Victor Alcalde, Camilo Gutierrez, Mauricio Garcia Romero, Atilio Moreno Carrillo, Luis E Vargas, Carlos E Vallejo, Virginia Zarama, José L Mora Rodriguez, Yury Bustos, Juliana Granada, Leonar G Aguiar, Salvador Menéndez, Jorge I Cohen, Miguel A Saavedra, Juan M Rodriguez, Tatiana Roldan, Christian Arbelaez
INTRODUCTION: Emergency medicine (EM) is in different stages of development around the world. Colombia has made significant strides in EM development in the last two decades and recognized it as a medical specialty in 2005. The country now has seven EM residency programs: three in the capital city of Bogotá, two in Medellin, one in Manizales, and one in Cali. The seven residency programs are in different stages of maturity, with the oldest founded 20 years ago and two founded in the last two years...
October 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29072885/cardiopulmonary-ultrasound-for-critically-ill-adults-improves-diagnostic-accuracy-in-a-resource-limited-setting-the-africa-trial
#17
Torben K Becker, Chelsea A Tafoya, Maxwell Osei-Ampofo, Matthew J Tafoya, Ross A Kessler, Nikhil Theyyunni, Hussein A Yakubu, Daniel Opuni, Daniel J Clauw, James A Cranford, Chris K Oppong, Rockefeller A Oteng
OBJECTIVE: To assess the effects of a cardiopulmonary ultrasound (CPUS) examination on diagnostic accuracy for critically ill patients in a resource-limited setting. METHODS: Approximately half of the emergency medicine resident physicians at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, were trained in a CPUS protocol. Adult patients triaged to the resuscitation area of the emergency department (ED) were enrolled if they exhibited signs or symptoms of shock or respiratory distress...
October 26, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29071403/specific-cell-re-programming-approaches-and-perspectives
#18
Frauke Hausburg, Julia Jeannine Jung, Robert David
Many disorders are manifested by dysfunction of key cell types or their disturbed integration in complex organs. Thereby, adult organ systems often bear restricted self-renewal potential and are incapable of achieving functional regeneration. This underlies the need for novel strategies in the field of cell (re-)programming-based regenerative medicine as well as for drug development in vitro. The regenerative field has been hampered by restricted availability of adult stem cells and the potentially hazardous features of pluripotent embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs)...
October 26, 2017: Advances in Biochemical Engineering/biotechnology
https://www.readbyqxmd.com/read/29066419/effect-of-stem-cell-niche-elasticity-ecm-protein-on-the-self-beating-cardiomyocyte-differentiation-of-inducedpluripotent-stem-ips-cells-at-different-stages
#19
Mitsuhi Hirata, Tetsuji Yamaoka
Stem cell-based myocardial regeneration therapies have emerged as alternative strategies to heart transplantation for serious heart diseases, but autologous beating mature cardiomyocytes are not available. Here we investigated the effect of culture substrates on the cardiomyocyte differentiation of induced pluripotent stem cells (iPSs) in vitro by separately evaluating the following continuous three steps: (1) cardiac marker gene expression, (2) contractile gene expression and self-beating, and (3) beating duration...
October 21, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/29063738/cardiovascular-outcomes-of-pregnancy-in-marfan-s-syndrome-patients-a-literature-review
#20
REVIEW
So Yeon Kim, Diana S Wolfe, Cynthia C Taub
AIMS: Pregnancy in patients with Marfan's syndrome (MFS) carries an increased risk of cardiovascular complications, resulting in increased maternal and fetal mortality and morbidity. Literature on MFS pregnant patients is relatively sparse, and there has yet to be a concrete consensus on the management of this unique patient population. The purpose of our paper is to provide a literature review of case reports and studies on MFS during pregnancy (published between 2005 and 2015) and to explore cardiovascular outcomes of patients with MFS...
October 23, 2017: Congenital Heart Disease
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