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https://www.readbyqxmd.com/read/28728194/-relevance-of-living-wills-during-post-resuscitation-care
#1
Martin Christ, Katharina Isabel von Auenmüller, Martin Grett, Scharbanu Amirie, Michael Brand, Hans-Joachim Trappe
Background There is hardly any evidence about the influence of living wills on acute life-threatening disease like out-of-hospital cardiac-arrest (OHCA). We therefore initiated this study to quantify the percentage of victims of OHCA who's living wills are available during post-resuscitation care. Methods All victims of OHCA who were admitted to our hospital between January 1(st) 2008 and July 31(th) 2016 were identified by analysis of our central admission register. Data from individual patients were collected from the patient's health records and anonymously stored on a central database...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28727751/oral-health-and-cardiovascular-care-perceptions-of-people-with-cardiovascular-disease
#2
Paula Sanchez, Bronwyn Everett, Yenna Salamonson, Shilpi Ajwani, Sameer Bhole, Joshua Bishop, Karen Lintern, Samantha Nolan, Rohan Rajaratnam, Julie Redfern, Maria Sheehan, Fiona Skarligos, Lissa Spencer, Ravi Srinivas, Ajesh George
MAIN OBJECTIVE: The aim of this study was to explore the perception of patients with cardiovascular disease towards oral health and the potential for cardiac care clinicians to promote oral health. METHOD: A needs assessment was undertaken with twelve patients with cardiovascular disease attending cardiac rehabilitation between 2015 and 2016, in three metropolitan hospitals in Sydney, Australia. These patients participated in face-to-face semi-structured interviews...
2017: PloS One
https://www.readbyqxmd.com/read/28727607/new-onset-heart-failure-and-mortality-in-hospital-survivors-of-sepsis-related-left-ventricular-dysfunction
#3
Saraschandra Vallabhajosyula, Jacob C Jentzer, Jeffrey B Geske, Mukesh Kumar, Ankit Sakhuja, Akhil Singhal, Joseph T Poterucha, Kianoush Kashani, Joseph G Murphy, Ognjen Gajic, Rahul Kashyap
BACKGROUND: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72 hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28724126/comparative-outcomes-after-percutaneous-coronary-intervention-among-black-and-white-patients-treated-at-us-veterans-affairs-hospitals
#4
Taisei Kobayashi, Thomas J Glorioso, Ehrin J Armstrong, Thomas M Maddox, Mary E Plomondon, Gary K Grunwald, Steven M Bradley, Thomas T Tsai, Stephen W Waldo, Sunil V Rao, Subhash Banerjee, Brahmajee K Nallamothu, Deepak L Bhatt, A Garvey Rene, Robert L Wilensky, Peter W Groeneveld, Jay Giri
Importance: Current comparative outcomes among black and white patients treated with percutaneous coronary intervention (PCI) in the Veterans Affairs (VA) health system are not known. Objective: To compare outcomes between black and white patients undergoing PCI in the VA health system. Design, Setting, and Participants: This study compared black and white patients who underwent PCI between October 1, 2007, and September 30, 2013, at 63 VA hospitals using data recorded in the VA Clinical Assessment, Reporting, and Tracking System for Cardiac Catheterization Laboratories (CART-CL) program...
July 19, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28723830/early-versus-delayed-coronary-artery-bypass-graft-surgery-for-patients-with-non-st-elevation-myocardial-infarction
#5
Le Dung Ha, Gbolahan Ogunbayo, Ayman Elbadawi, Odunayo Olorunfemi, Adrian Messerli
BACKGROUND: Although coronary artery bypass graft surgery (CABG) has been proven to have mortality and morbidity benefits in patients with non-ST elevation myocardial infarction and multivessel disease, the appropriate timing of this procedure remains unclear. Therefore, we proposed a propensity score-matched analysis comparing the clinical outcomes between patients who underwent CABG within the first 48 h of admission (early CABG) and patients who underwent CABG after 48 h of admission (delayed CABG)...
July 18, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28718877/takotsubo-syndrome-in-hemodynamically-unstable-patients-admitted-to-the-intensive-care-unit-a-retrospective-study
#6
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...
July 18, 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
#7
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
https://www.readbyqxmd.com/read/28717918/-syncope-falls-and-vertigo
#8
REVIEW
C Weingart, H-J Schneider, C C Sieber
Dizziness/vertigo, falls and syncope are among the most common reasons for seeking medical care. As clinical entities they share common pathogenetic and clinical features and differences. The diagnostic work-up can often be initiated in a general practitioner's or internist's practice and, if necessary, completed in an interdisciplinary emergency unit. Simple diagnostic tools can be used in an outpatient setting to obtain valuable diagnostic information. First and foremost, it is important to differentiate between prognostically favorable clinical events and potentially serious disease...
July 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28716521/update-on-quality-of-care-in-hispanics-and-other-racial-ethnic-groups-in-the-united-states-discharged-with-the-diagnosis-of-acute-myocardial-infarction-in-2013
#9
Tomás Romero, Kristina L Greenwood, Dale Glaser
BACKGROUND: Disparities in Acute Myocardial Infarction (AMI) care and outcomes have been frequently reported in racial-ethnic minorities in the U.S. Some studies have attributed disparities in Hispanics and other minorities to lower quality of services at hospitals where they seek care. Current information from hospitals with large Hispanic representations and updated quality resources is needed. METHODS: Retrospective observational study of 839 AMI patients discharged in 2013 from three Southern California Hospitals (A, B, C) with tertiary cardiac care level...
July 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28716062/the-effects-of-acute-and-elective-cardiac-surgery-on-the-anxiety-traits-of-patients-with-marfan-syndrome
#10
Kálmán Benke, Bence Ágg, Miklós Pólos, Alex Ali Sayour, Tamás Radovits, Elektra Bartha, Péter Nagy, Balázs Rákóczi, Ákos Koller, Viola Szokolai, Julianna Hedberg, Béla Merkely, Zsolt B Nagy, Zoltán Szabolcs
BACKGROUND: Marfan syndrome is a genetic disease, presenting with dysfunction of connective tissues leading to lesions in the cardiovascular and skeletal muscle system. Within these symptoms, the most typical is weakness of the connective tissue in the aorta, manifesting as aortic dilatation (aneurysm). This could, in turn, become annuloaortic ectasia, or life-threatening dissection. As a result, life-saving and preventative cardiac surgical interventions are frequent among Marfan syndrome patients...
July 17, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28714410/management-of-blood-pressure-and-heart-rate-in-patients-with-acute-stroke
#11
Carlo Maida, Antonino Tuttolomondo, Domenico Di Raimondo, Antonio Pinto
BACKGROUND: Stroke represent one of the most devastating of all neurological diseases, affecting about 15 million people per year and is an important cause of morbidity and mortality worldwide and currently the leading cause of adult disability in developed countries. Blood pressure and heart rate may undergo several modifications in patients with both ischemic and hemorrhagic stroke in fact raised blood pressure levels may lead to cerebral edema, hematoma expansion or hemorrhagic transformation and in contrast low blood pressure can lead to increased cerebral infarction or perihematomal ischemia...
July 14, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28712683/-stratification-of-thoracic-pain-with-modified-heart-score-and-its-relationship-to-short-term-cardiovascular-events
#12
Manuel Chacón-Diaz, Jorge Salinas, Rafael Doig
OBJECTIVE: Chest pain is a major reason for emergency room care worldwide. The relationship between the Modified Heart Score and the presence of major cardiac events at 30 days after emergency admission was evaluated. METHODS: Retrospective, observational study in a single center. In patients older than 18 years old, who were treated for chest pain, in whom the Modified HEART Score was applied at admission and related to the presence of major cardiac events (myocardial infarction, death, hospitalization due to cardiac causes and percutaneous coronary revascularization Or surgical) at 30 days of follow-up...
July 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28712187/utility-of-heart-type-fatty-acid-binding-protein-h-fabp-point-of-care-test-in-the-early-hours-of-stemi-compared-with-troponin-i-in-pakistani-population
#13
Walid Ahmad Abbasi, Muhammad Saleem, Shahid Rasheed, Azhar Mahmood Kiyani
BACKGROUND: Acute coronary syndrome remains a dominant cause of high morbidity and mortality despite advancements in treatment This study was conducted to examine the utility of point-of-care test of heart-type fatty-acid binding protein (h-FABP) and compare it with the point-of-care test of cardiac troponin I (cTnI) in the first 06 hours of STEMI. METHODS: This cross-sectional, comparative study which was conducted in Rawalpindi institute of cardiology, Rawalpindi, Pakistan, from January to June 2015...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28711123/care-of-the-patient-with-chest-pain-in-the-observation-unit
#14
REVIEW
Joseph B Borawski, Louis G Graff, Alexander T Limkakeng
Care of the patient presenting to an emergency department (ED) with chest pain remains a common yet challenging aspect of emergency medicine. Acute coronary syndrome presents in nonspecific fashion. The development and evolution of the ED-based observation unit has helped to safely assess and diagnose those most at risk for an adverse cardiac event. Furthermore, there are several provocative testing modalities to help assess for coronary artery disease. This article serves to describe and discuss the modern ED-based observation unit approach to patients with chest pain and/or angina equivalents presenting to an ED...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28707310/sleep-deprivation-in-interventional-cardiology-implications-for-patient-care-and-physician-health
#15
Yader Sandoval, Angie S Lobo, Virend K Somers, Kenneth Rosenfield, Steven M Bradley, Paul Sorajja, Peter Tajti, Emmanouil S Brilakis
The burden and impact of sleep deprivation on both patient care and on the health of interventional cardiologists is not well understood. Due to the nature of emergent procedures occurring in the cardiac catheterization laboratory, interventionalists are prone to suffer from acute and/or chronic sleep deprivation. Sleep deprivation has been associated with numerous adverse effects, such as impaired performance, cognitive deficits, reduced psychomotor vigilance, and workplace errors and injuries, among many others...
July 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28706585/atrial-tachyarrhythmia-in-adult-congenital-heart-disease
#16
REVIEW
Arsha Karbassi, Krishnakumar Nair, Louise Harris, Rachel M Wald, S Lucy Roche
The adult congenital heart disease (ACHD) population continues to grow and most cardiologists, emergency room physicians and family doctors will intermittently come into contact with these patients. Oftentimes this may be in the setting of a presentation with atrial tachyarrhythmia; one of the commonest late complications of ACHD and problem with potentially serious implications. Providing appropriate initial care and ongoing management of atrial tachyarrhythmia in ACHD patients requires a degree of specialist knowledge and an awareness of certain key issues...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28704244/implementation-of-a-standardized-transfusion-protocol-for-cardiac-patients-treated-with-venoarterial-extracorporeal-membrane-oxygenation-is-associated-with-decreased-blood-component-utilization-and-may-improve-clinical-outcome
#17
Christine M Cahill, Neil Blumberg, Amy E Schmidt, Peter A Knight, Amber L Melvin, Howard T Massey, Joseph M Delehanty, Seth B Zebrak, Majed A Refaai
BACKGROUND: Extracorporeal membrane oxygenation supplies oxygenated blood to the body supporting the heart and lungs. Survival rates of 20% to 50% are reported among patients receiving ECMO for cardiac arrest, severe cardiogenic shock, or failure to wean from cardiopulmonary bypass following cardiac surgery. Bleeding is one of the most common complications in ECMO patients due to coagulopathy, systemic anticoagulation, and the presence of large bore cannulas at systemic pressure. Absence of a standardized transfusion protocol in this population leads to inconsistent transfusion practices...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28703290/the-association-between-peri-operative-acute-risk-change-arc-and-long-term-survival-after-cardiac-surgery
#18
T G Coulson, M Bailey, C M Reid, L Tran, D V Mullany, J A Smith, D Pilcher
Acute risk change has been described as the difference in calculated mortality risk between the pre-operative and postoperative periods of cardiac surgery. We aimed to assess whether this was associated with long-term survival after cardiac surgery. We retrospectively analysed 22,570 cardiac surgical patients, with minimum and maximum follow-up of 1.0 and 6.7 years. Acute risk change was calculated as the arithmetic difference between pre- and postoperative mortality risk. 'Rising risk' represented an increase in risk from pre- to postoperative phase...
July 13, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28702263/factors-associated-with-the-incidence-and-severity-of-new-onset-atrial-fibrillation-in-adult-critically-ill-patients
#19
Péricles A D Duarte, Gustavo Elias Leichtweis, Luiza Andriolo, Yasmim A Delevatti, Amaury C Jorge, Andreia C Fumagalli, Luiz Claudio Santos, Cecilia K Miura, Sergio K Saito
BACKGROUND: Acute Atrial Fibrillation (AF) is common in critically ill patients, with significant morbidity and mortality; however, its incidence and severity in Intensive Care Units (ICUs) from low-income countries are poorly studied. Additionally, impact of vasoactive drugs on its incidence and severity is still not understood. This study aimed to assess epidemiology and risk factors for acute new-onset AF in critically ill adult patients and the role of vasoactive drugs. METHOD: Cohort performed in seven general ICUs (including cardiac surgery) in three cities in Paraná State (southern Brazil) for 45 days...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28701838/a-retrospective-study-of-physiological-observation-reporting-practices-and-the-recognition-response-and-outcomes-following-cardiopulmonary-arrest-in-a-low-to-middle-income-country
#20
Ambepitiyawaduge Pubudu De Silva, Jayasingha Arachchilage Sujeewa, Nirodha De Silva, Rathnayake Mudiyanselage Danapala Rathnayake, Lakmal Vithanage, Ponsuge Chathurani Sigera, Sithum Munasinghe, Abi Beane, Tim Stephens, Priyantha Lakmini Athapattu, Kosala Saroj Amarasiri Jayasinghe, Arjen M Dondorp, Rashan Haniffa
BACKGROUND AND AIMS: In Sri Lanka, as in most low-to-middle-income countries (LMICs), early warning systems (EWSs) are not in use. Understanding observation-reporting practices and response to deterioration is a necessary step in evaluating the feasibility of EWS implementation in a LMIC setting. This study describes the practices of observation reporting and the recognition and response to presumed cardiopulmonary arrest in a LMIC. PATIENTS AND METHODS: This retrospective study was carried out at District General Hospital Monaragala, Sri Lanka...
June 2017: Indian Journal of Critical Care Medicine
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