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https://www.readbyqxmd.com/read/28820545/assessment-and-management-of-acute-severe-mitral-regurgitation-in-the-intensive-care-unit
#1
Marina Leitman, Vladimir Tyomkin, Ehud Raanani, Ram Sharony, Ludmila Tzatskin, Eli Peleg, Alex Blatt, Zvi Vered
BACKGROUND: Acute severe mitral regurgitation (MR) is a serious medical condition. Whilst clear guidelines exist regarding the management of chronic MR, acute severe MR is usually treated on an individual basis. Currently, few data exist regarding acute MR in the era of primary coronary interventions (PCI). The present study included patients admitted to the Department of Cardiology during recent years with acute severe MR of different etiologies, and an analysis of these data in the light of previous investigations...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28806965/decreased-circulating-dihomo-gamma-linolenic-acid-levels-are-associated-with-total-mortality-in-patients-with-acute-cardiovascular-disease-and-acute-decompensated-heart-failure
#2
Shohei Ouchi, Tetsuro Miyazaki, Kazunori Shimada, Yurina Sugita, Megumi Shimizu, Azusa Murata, Takao Kato, Tatsuro Aikawa, Shoko Suda, Tomoyuki Shiozawa, Masaru Hiki, Shuhei Takahashi, Takatoshi Kasai, Katsumi Miyauchi, Hiroyuki Daida
BACKGROUND: Polyunsaturated fatty acids (PUFAs) have important roles in the pathogenesis of cardiovascular diseases. However, the clinical significance of omega-6 PUFAs in acute cardiovascular disease remains unknown. METHODS: We enrolled 417 consecutive patients with acute cardiovascular disease admitted to the cardiac intensive care unit at Juntendo University Hospital between April 2012 and October 2013. We investigated the association between serum PUFA levels and long-term mortality...
August 14, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28806444/eliminating-creatine-kinase-myocardial-band-testing-in-suspected-acute-coronary-syndrome-a-value-based-quality-improvement
#3
Matthew D Alvin, Allan S Jaffe, Roy C Ziegelstein, Jeffrey C Trost
Cardiac biomarker testing is estimated to occur in nearly 30 million emergency department visits nationwide each year in the United States. The American College of Cardiology/European Society of Cardiology indicate that cardiac troponin is the biomarker of choice owing to its nearly absolute myocardial tissue specificity and high clinical sensitivity for myocardial injury. Multiple academic medical centers have implemented interventions to eliminate the routine ordering of creatine kinase-myocardial band tests, with published patient safety outcomes data; however, creatine kinase-myocardial band testing is still ordered in many hospitals and emergency departments...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28796275/immature-platelets-as-a-novel-biomarker-for-adverse-cardiovascular-events-in-patients-after-non-cardiac-surgery
#4
Aida Anetsberger, Manfred Blobner, Bernhard Haller, Sebastian Schmid, Katrin Umgelter, Theresa Hager, Clemens Langgartner, Eberhard F Kochs, Karl-Ludwig Laugwitz, Bettina Jungwirth, Isabell Bernlochner
This study evaluates whether immature platelets (IPF) determined in the post anesthesia care unit (PACU) can predict major adverse cardiovascular events (MACE) or other thromboembolic events after intermediate and high-risk surgery. IPF are increased in patients with acute coronary syndrome and recently gained interest as novel biomarker for risk stratification. In this prospective observational trial 732 patients undergoing intermediate or high-risk non-cardiac surgery were enrolled (NCT02097602). IPF was measured preoperatively and postoperatively in the PACU...
August 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28794121/changes-in-primary-noncardiac-diagnoses-over-time-among-elderly-cardiac-intensive-care-unit-patients-in-the-united-states
#5
Shashank S Sinha, Michael W Sjoding, Devraj Sukul, Hallie C Prescott, Theodore J Iwashyna, Hitinder S Gurm, Colin R Cooke, Brahmajee K Nallamothu
BACKGROUND: Early reports suggest the number of cardiac intensive care unit (CICU) patients with primary noncardiac diagnoses is rising in the United States, but no national data currently exist. We examined changes in primary noncardiac diagnoses among elderly patients admitted to a CICU during the past decade. METHODS AND RESULTS: Using 2003 to 2013 Medicare data, we grouped elderly patients admitted to CICUs into 2 categories based on principal diagnosis at discharge: (1) primary noncardiac diagnoses and (2) primary cardiac diagnoses...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28772221/perioperative-prediction-of-agitated-hyperactive-delirium-after-cardiac-surgery-in-adults-the-development-of-a-practical-scorecard
#6
Hani N Mufti, Gregory M Hirsch
BACKGROUND: Delirium is a temporary mental disorder that occurs frequently among hospitalized patients. In this study we sought to develop a user-friendly scorecard based on perioperative features to identify patients at risk of developing agitated delirium after cardiac surgery. METHODS: Retrospective analysis was performed on adult patients undergoing cardiac surgery in a single center. A parsimonious predictive model was created, with subsequent internal validation...
July 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28763874/-correlation-between-serum-uric-acid-level-and-acute-renal-injury-after-coronary-artery-bypass-grafting
#7
D Q Xu, J Du, Z Zheng, Y Tang, L Zou, Y H Zhang, H T Zhang
Objective: To evaluate whether early postoperative serum uric acid level can predict postoperative acute renal injury (AKI) among patients undergoing coronary artery bypass grafting (CABG). Methods: The study retrospectively enrolled 1 306 patients undergoing CABG in Fuwai Hospital between September 2012 and December 2013. The patients were divided into 5 groups by the concentrations of serum uric acid measured on the morning of the first postoperative day, and uric acid categories were as follow: less than 195 μmol/L (Q1 group, 262 cases), 195-236 μmol/L (Q2 group, 263 cases), 237-280 μmol/L (Q3 group, 260 cases), 281-336 μmol/L (Q4 group, 261 cases), more than 336 μmol/L (Q5 group, 260 cases)...
July 11, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28761452/comparison-of-manual-versus-automated-blood-pressure-measurement-in-intensive-care-unit-coronary-care-unit-and-emergency-room
#8
Ahmad Mirdamadi, Mostafa Etebari
BACKGROUND: Accuracy of blood pressure (BP) measurement in clinical settings is one of the most concerns despite of promotion in techniques for the measurement of BP. Our aim was to compare automated versus manual BP measurement in intensive care unit (ICU), coronary care unit (CCU), and emergency room patients. METHODS: Totally, 117 patients in ICU, CCU, and emergency department were registered in the study. Demographic information was recorded. The cardioset heart monitoring device was used for measuring BP and mercury sphygmomanometer with appropriate cuffs was used for manual method...
January 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/28752905/the-quality-of-life-of-patients-developed-delirium-after-coronary-artery-bypass-grafting-is-determined-by-cognitive-function-after-discharge-a-cross-sectional-study
#9
Yuling Chen, Shu Ding, Xiangjun Tao, Xinwei Feng, Sai Lu, Yuzhi Shen, Ying Wu, Xiangguang An
AIMS: Postoperative delirium (POD) and declined cognitive function were common in patients (especially elderly patients) who underwent coronary artery bypass grafting (CABG), which may affect quality of life (QoL). The aim of this study was to determine the relationships among age, POD, declined cognitive function, and QoL in patients who underwent CABG. METHODS: Consecutive patients who underwent first time elective CABG and assessed for POD using Confusion Assessment Method for intensive care unit for 5 postoperative days from November 2013 to March 2015 were recruited...
July 28, 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/28748625/multiple-risk-factor-counseling-to-promote-heart-healthy-lifestyles-in-the-chest-pain-observation-unit-pilot-randomized-controlled-trial
#10
David A Katz, Mark Graber, Patricia Lounsbury, Mark W Vander Weg, Emily K Phillips, Christina Clair, Phillip A Horwitz, Xueya Cai, Alan J Christensen
OBJECTIVE: Admission to the chest pain observation unit (CPOU) may be an advantageous time for patients to consider heart-healthy lifestyle changes while undergoing diagnostic evaluation to rule out myocardial ischemia. The aim of this pragmatic trial was to assess the effectiveness of a multiple risk factor intervention in changing CPOU patients' health beliefs and readiness to change health behaviors. A secondary aim was to obtain preliminary estimates of the intervention's effect on diet, physical activity, and smoking...
July 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28741665/remote-ischemic-preconditioning-and-clinical-outcomes-in-on-pump-coronary-artery-bypass-grafting-a-meta-analysis-of-14-randomized-controlled-trials
#11
Bin Yi, Jianhui Wang, Dingwu Yi, Yanling Zhu, Yumei Jiang, Yi Li, Shaoyan Mo, Yi Liu, Jian Rong
The purpose of this article is to perform the first pooled analysis on remote ischemic preconditioning (RIPC) used for the improvement of clinical outcomes of patients only undergoing on-pump coronary artery bypass grafting (CABG) in randomized controlled trials (RCTs). A systematic search was performed using PubMed, the Cochrane Library, and the Web of Science to identify studies that described the effect of RIPC on postoperative mortality in patients only undergoing on-pump CABG. The outcomes included postoperative mortality, postoperative morbidity (including incidence of myocardial infarction, atrial fibrillation, stroke, acute kidney injury, and renal replacement therapy), mechanical ventilation (MV), intensive care unit length of stay (ICU LOS), and hospital length of stay (HLOS)...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28740712/hybrid-approach-of-percutaneous-coronary-intervention-followed-by-minimally-invasive-mitral-valve-surgery-a-5-year-single-center-experience
#12
Orlando Santana, Steve Xydas, Roy F Williams, Maurice Mawad, Todd B Heimowitz, Andrés M Pineda, Howard S Goldman, Christos G Mihos
BACKGROUND: The current study evaluated the safety and feasibility of staged ("hybrid") percutaneous coronary intervention (PCI) followed by isolated minimally invasive mitral valve (MV) surgery [PCI + minimally invasive mitral valve surgery (MIMVS)], for patients with concomitant coronary artery and MV disease. METHODS: A total of 93 patients who underwent PCI + MIMVS for coronary artery and MV disease between February 2009 and April 2014 were retrospectively analyzed...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740710/percutaneous-coronary-intervention-followed-by-minimally-invasive-valve-surgery-compared-with-median-sternotomy-coronary-artery-bypass-graft-and-valve-surgery-in-patients-with-prior-cardiac-surgery
#13
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Jason C Wigley, Nirat Beohar, Christos G Mihos
BACKGROUND: In patients with prior cardiac surgery requiring re-operative coronary and valve surgery, a hybrid approach of percutaneous coronary intervention followed by minimally invasive valve surgery (PCI + MIVS) may be an alternative to the standard median sternotomy coronary artery bypass and valve surgery (CABG + valve). METHODS: The outcomes of patients with prior cardiac surgery, presenting with coronary artery and valvular disease, who underwent PCI + MIVS (N=39) were retrospectively compared with those who underwent CABG + valve (N=28) via a repeat median sternotomy, between February 2009 and April 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28736557/the-effect-of-admission-renal-function-on-the-treatment-and-outcome-of-patients-with-acute-coronary-syndrome
#14
Zach Rozenbaum, Sydney Benchetrit, Saar Minha, Yoram Neuman, Meital Shlezinger, Ilan Goldenberg, Morris Mosseri, David Pereg
BACKGROUND: Chronic kidney disease is a frequent comorbidity among patients with acute coronary syndrome (ACS). We aimed to evaluate treatment characteristics in ACS patients according to their renal function and to assess the effect of differences in therapy on clinical outcomes. METHODS: Included were patients with ACS enrolled in the biennial Acute Coronary Syndrome Israeli Surveys (ACSIS) during 2000-2013. Excluded were patients with cardiogenic shock at presentation...
June 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28728882/variation-in-the-cost-of-5-common-operations-in-the-united-states
#15
Elliot Wakeam, George Molina, Neel Shah, Stuart R Lipsitz, David C Chang, Atul A Gawande, Alex B Haynes
BACKGROUND: Health care costs are an important policy focus in the United States. The magnitude and drivers of variation in the costs of common operative procedures are not well understood. We sought to characterize variation in costs across hospitals. METHODS: We used data from the Nationwide Inpatient Sample from 2001-2011 for 5 elective operations: colectomy, coronary artery bypass graft, total knee arthroplasty, cesarean section, and lung resection. Hospitals were benchmarked for each using hierarchical risk- and reliability-adjustment methods to generate an observed-to-expected cost ratio, which was adjusted for patient demographics, comorbidity, wage index, and procedure complexity...
September 2017: Surgery
https://www.readbyqxmd.com/read/28728745/early-readmissions-after-acute-myocardial-infarction
#16
Chun Shing Kwok, Chun Wai Wong, Hannah Shufflebotham, Luke Brindley, Tamseel Fatima, Adrian Shufflebotham, Diane Barker, Ashish Pawala, Grant Heatlie, Mamas A Mamas
This study aims to evaluate the rate, predictors, and causes of 30-day readmissions in a single tertiary hospital in the United Kingdom. We conducted a retrospective study of all patients admitted between 2012 and 2014 with a diagnosis of acute myocardial infarction, who were in the Myocardial Infarction National Audit Project register. Data on patient demographics, comorbidities, care received, and in-hospital mortality were collected. Rates of 30-day readmission and causes of readmission were evaluated. Univariate and multiple logistic regressions were used to identify predictors of all-cause, cardiac, and noncardiac readmission...
September 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28724192/handheld-echocardiography-during-hospitalization-for-acute-myocardial-infarction
#17
Michael W Cullen, Jeffrey B Geske, Nandan S Anavekar, J Wells Askew, Bradley R Lewis, Jae K Oh
BACKGROUND: Handheld echocardiography (HHE) is concordant with standard transthoracic echocardiography (TTE) in a variety of settings but has not been thoroughly compared to traditional TTE in patients with acute myocardial infarction (AMI). HYPOTHESIS: Completed by experienced operators, HHE provides accurate diagnostic capabilities compared with standard TTE in AMI patients. METHODS: This study prospectively enrolled patients admitted to the coronary care unit with AMI...
July 19, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#18
Sandrine Charpentier, Sebastien Beaune, Luc Marie Joly, Abdo Khoury, François-Xavier Duchateau, Raphael Briot, Bertrand Renaud, François-Xavier Ageron
OBJECTIVE: The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). PATIENTS AND METHODS: All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013...
July 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28718877/takotsubo-syndrome-in-hemodynamically-unstable-patients-admitted-to-the-intensive-care-unit-a-retrospective-study
#19
J Oras, J Lundgren, B Redfors, D Brandin, E Omerovic, H Seeman-Lodding, S-E Ricksten
INTRODUCTION: Takotsubo syndrome (TS) is an acute cardiac condition that is often triggered by critical illness but that has rarely been studied in the intensive care unit (ICU) setting. The aim of this study was to (i) estimate the incidence of TS in a hemodynamically unstable ICU-population; (ii) identify predictors of TS in this population; (iii) study the impact of TS on prognosis and course of hospitalization. METHODS: Medical records from all patients admitted to our general ICU from 2012 to 2015 were analyzed...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28718658/the-effect-of-nurse-to-patient-ratios-on-nurse-sensitive-patient-outcomes-in-acute-specialist-units-a-systematic-review-and-meta-analysis
#20
Andrea Driscoll, Maria J Grant, Diane Carroll, Sally Dalton, Christi Deaton, Ian Jones, Daniela Lehwaldt, Gabrielle McKee, Theresa Munyombwe, Felicity Astin
BACKGROUND: Nurses are pivotal in the provision of high quality care in acute hospitals. However, the optimal dosing of the number of nurses caring for patients remains elusive. In light of this, an updated review of the evidence on the effect of nurse staffing levels on patient outcomes is required. AIM: To undertake a systematic review and meta-analysis examining the association between nurse staffing levels and nurse-sensitive patient outcomes in acute specialist units...
July 1, 2017: European Journal of Cardiovascular Nursing
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