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Acute cardiac care

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https://www.readbyqxmd.com/read/28331988/point-of-care-testing-of-cardiac-autonomic-function-for-risk-assessment-in-patients-with-suspected-acute-coronary-syndromes
#1
C Eick, M Duckheim, P Groga-Bada, N Klumpp, S Mannes, C S Zuern, M Gawaz, K D Rizas, Axel Bauer
BACKGROUND: Impaired cardiac autonomic function has been linked to adverse outcomes in patients with acute coronary syndromes (ACS) but is not included in clinical risk models. This is the first study to investigate whether point-of-care testing of cardiac autonomic function by means of short-term deceleration capacity (DC) of heart rate improves risk assessment in patients with suspected ACS. METHODS: 1821 patients with suspected ACS were prospectively enrolled if they were older than 17 years and in sinus rhythm...
March 22, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28331489/reversible-atrial-fibrillation-following-crotalinae-envenomation
#2
Dan Quan, Kenneth Zurcher
BACKGROUND: Cardiotoxicity is a documented complication of Crotalinae envenomation. Reported cardiac complications following snake envenomation have included acute myocardial infarction, electrocardiogram abnormalities and arrhythmias. Few reports exist describing arrhythmia induced by viper envenomation and to our knowledge none describe arrhythmia induced by Crotalinae envenomation. This report concerns the first known case of atrial fibrillation precipitated by rattlesnake bite. CASE PRESENTATION: A 73-year-old Caucasian man with a past medical history of hypertension, hyperlipidemia, type 1 diabetes mellitus, and a baseline first-degree atrioventricular block presented to the emergency department following a rattlesnake bite to his left lower leg...
2017: Journal of Venomous Animals and Toxins Including Tropical Diseases
https://www.readbyqxmd.com/read/28331015/association-between-clinically-recorded-alcohol-consumption-and-initial-presentation-of-12-cardiovascular-diseases-population-based-cohort-study-using-linked-health-records
#3
Steven Bell, Marina Daskalopoulou, Eleni Rapsomaniki, Julie George, Annie Britton, Martin Bobak, Juan P Casas, Caroline E Dale, Spiros Denaxas, Anoop D Shah, Harry Hemingway
Objectives To investigate the association between alcohol consumption and cardiovascular disease at higher resolution by examining the initial lifetime presentation of 12 cardiac, cerebrovascular, abdominal, or peripheral vascular diseases among five categories of consumption.Design Population based cohort study of linked electronic health records covering primary care, hospital admissions, and mortality in 1997-2010 (median follow-up six years).Setting CALIBER (ClinicAl research using LInked Bespoke studies and Electronic health Records)...
March 22, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28329287/outcome-after-procedures-for-retained-blood-syndrome-in-coronary-surgery
#4
Tuomas Tauriainen, Eeva-Maija Kinnunen, Joni Koski-Vähälä, Matti-Aleksi Mosorin, Juhani Airaksinen, Fausto Biancari
OBJECTIVES: Incomplete drainage of blood from around the heart and lungs can lead to retained blood syndrome (RBS) after cardiac surgery. The aim of this study was to assess the incidence of and the outcome after procedures for RBS in patients undergoing isolated coronary artery bypass grafting (CABG). METHODS: A total of 2764 consecutive patients who underwent isolated CABG from 2006 to 2013 were investigated retrospectively. Patients undergoing any procedure for RBS were compared with patients who did not undergo any procedure for RBS...
February 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28320797/design-and-reliability-of-a-specific-instrument-to-evaluate-patient-safety-for-patients-with-acute-myocardial-infarction-treated-in-a-predefined-care-track-a-retrospective-patient-record-review-study-in-a-single-tertiary-hospital-in-the-netherlands
#5
Daniëlle C Eindhoven, C Jan Willem Borleffs, Marlieke F Dietz, Martin J Schalij, Corline Brouwers, Martine C de Bruijne
OBJECTIVE: Numerous studies have shown that a substantial number of patients suffer from adverse events (AEs) as a result of hospital care. However, specific data on AEs in acute cardiac care are scarce. The current manuscript describes the development and validation of a specific instrument to evaluate patient safety of a predefined care track for patients with acute myocardial infarction (AMI). DESIGN: Retrospective patient record review study. SETTING AND PARTICIPANTS: A total of 879 hospital admissions treated in a tertiary care centre for an AMI (age 64±12 years, 71% male)...
March 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28320259/levosimendan-for-hemodynamic-support-after-cardiac-surgery
#6
Giovanni Landoni, Vladimir V Lomivorotov, Gabriele Alvaro, Rosetta Lobreglio, Antonio Pisano, Fabio Guarracino, Maria G Calabrò, Evgeny V Grigoryev, Valery V Likhvantsev, Marcello F Salgado-Filho, Alessandro Bianchi, Vadim V Pasyuga, Massimo Baiocchi, Federico Pappalardo, Fabrizio Monaco, Vladimir A Boboshko, Marat N Abubakirov, Bruno Amantea, Rosalba Lembo, Luca Brazzi, Luigi Verniero, Pietro Bertini, Anna M Scandroglio, Tiziana Bove, Alessandro Belletti, Maria G Michienzi, Dmitriy L Shukevich, Tatiana S Zabelina, Rinaldo Bellomo, Alberto Zangrillo
Background Acute left ventricular dysfunction is a major complication of cardiac surgery and is associated with increased mortality. Meta-analyses of small trials suggest that levosimendan may result in a higher rate of survival among patients undergoing cardiac surgery. Methods We conducted a multicenter, randomized, double-blind, placebo-controlled trial involving patients in whom perioperative hemodynamic support was indicated after cardiac surgery, according to prespecified criteria. Patients were randomly assigned to receive levosimendan (in a continuous infusion at a dose of 0...
March 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28318620/factors-associated-with-mortality-risk-in-critical-care-patients-treated-with-veno-arterial-extracorporeal-membrane-oxygenation
#7
Sun Hee Lee, Dong-Soo Shin, Jong Ran Kim, Hyunjung Kim
OBJECTIVES: To identify factors associated with mortality in patients treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and to validate the discrimination of the risk assessment tools to predict mortality. BACKGROUND: VA-ECMO is a rescue therapy for patients with life-threatening cardiac failure, but mortality remains high. METHODS: In this retrospective study, we reviewed the medical records of adult patients who underwent VA-ECMO in an intensive care unit of a university hospital, between 2009 and 2013...
March 16, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28316318/synchronous-open-heart-surgery-and-laparoscopic-cholecystectomy-an-observational-case-study-with-28-patients
#8
Mustafa Bilge Erdogan, Mehmet Kaplan, Hakki Kazaz, Bulent Salman
Acute cholecystitis (AC) may be a severe problem and may increase the mortality rate and hospital stay in patients who undergo open heart surgery (OHS), due to its aggressive course; therefore, AC should be treated as soon as possible. We aimed to present data on our synchronous cardiac and laparoscopic cholecystectomy (LC) operations performed for AC complicating patients with cardiac disease and who were waiting to undergo OHS. Between January 2008 and September 2014, we performed 2773 OHSs in Medical Park Gaziantep Hospital...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28306694/real-world-use-of-ticagrelor-and-prasugrel-in-patients-with-nstemi-undergoing-percutaneous-coronary-intervention
#9
Vincenzo Sucato, Egle Corrado, Carmelo Castellana, Michele Carella, Simona Raso, Giuseppe Coppola, Giuseppe Andolina, Giuseppina Novo, Salvatore Evola, Salvatore Novo
OBJECTIVE: This retrospective observational study sought to describe the safety and efficacy profile of prasugrel and ticagrelor in patients with non-ST-segment elevation myocardial infarction (NSTEMI), who were admitted to the coronary intensive care unit (CICU) and underwent primary percutaneous coronary intervention (PCI). BACKGROUND AND METHODS: Dual antiplatelet therapy is mandatory for all the patients with acute coronary syndrome, who underwent PCI. Our study includes 111 patients with NSTEMI, who underwent PCI, in a maximum time of 72 h after their ischemic event...
March 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28306631/thermoregulate-autoregulate-and-ventilate-brain-directed-critical-care-for-pediatric-cardiac-arrest
#10
Jonathan E Kurz, Craig M Smith, Mark S Wainwright
PURPOSE OF REVIEW: Cardiac arrest in childhood is associated with a high risk for mortality and poor long-term functional outcome. This review discusses the current evidence for neuroprotective therapies and goals for postarrest care in the context of the pathophysiology of hypoxic-ischemic injury, modalities for neurologic prognostication in these children and potential future monitoring paradigms for maximizing cerebral perfusion in the postarrest period. RECENT FINDINGS: The recent publication of the in-hospital and out-of-hospital Therapeutic Hypothermia After Cardiac Arrest trials demonstrated a lack of statistically significant benefit for the use of postarrest therapeutic hypothermia...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28303021/age-and-surgical-complexity-impact-on-renoprotection-by-remote-ischemic-preconditioning-during-adult-cardiac-surgery-a-meta-analysis
#11
Chenghui Zhou, Heerajnarain Bulluck, Nengxin Fang, Lihuan Li, Derek J Hausenloy
We aimed to conduct an up-to-date meta-analysis to comprehensively assess the renoprotective effect of remote ischemic preconditioning (RIPC) in patients undergoing adult cardiac surgery. 21 randomized controlled trials (RCTs) with a total of 6302 patients were selected and identified. Compared with controls, RIPC significantly reduced the incidence of acute kidney injury (AKI) [odds ratio (OR) = 0.79; P = 0.02; I(2) = 38%], and in particular, AKI stage I (OR = 0.65; P = 0.01; I(2) = 55%)...
March 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28296663/acute-decompensation-in-pediatric-cardiac-patients-outcomes-after-rapid-response-events
#12
Aarti C Bavare, Kimia S Rafie, Patricia X Bastero, Joseph L Hagan, Paul A Checchia
OBJECTIVE: We studied rapid response events after acute clinical instability outside ICU settings in pediatric cardiac patients. Our objective was to describe the characteristics and outcomes after rapid response events in this high-risk cohort and elucidate the cardiac conditions and risk factors associated with worse outcomes. DESIGN: A retrospective single-center study was carried out over a 3-year period from July 2011 to June 2014. SETTING: Referral high-volume pediatric cardiac center located within a tertiary academic pediatric hospital...
March 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28296531/risk-factors-associated-with-acute-kidney-injury-in-a-cohort-of-20-575-arthroplasty-patients
#13
Pyry Jämsä, Esa Jämsen, Leo-Pekka Lyytikäinen, Jarkko Kalliovalkama, Antti Eskelinen, Niku Oksala
Background and purpose - Patients developing postoperative acute kidney injury (AKI) are at risk of higher morbidity and mortality. In arthroplasty patients, many pre- and perioperative factors are associated with AKI but some of the risk factors are unclear. We report the incidence of postoperative AKI, the conditions associated with it, and survival rates in AKI patients. Patients and methods - We obtained data from 20,575 consecutive hip or knee arthroplasties. Postoperative AKI, occurring within 7 days after the operation, was defined using the risk, injury, failure, loss, and end-stage (RIFLE) criteria...
March 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28291783/oesophageal-heat-exchangers-with-a-diameter-of-11mm-or-14-7mm-are-equally-effective-and-safe-for-targeted-temperature-management
#14
Daniel C Schroeder, Maria Guschlbauer, Alexandra C Maul, Daniel A Cremer, Ingrid Becker, David de la Puente Bethencourt, Peter Paal, Stephan A Padosch, Wolfgang A Wetsch, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
BACKGROUND: Targeted temperature management (TTM) is widely used in critical care settings for conditions including hepatic encephalopathy, hypoxic ischemic encephalopathy, meningitis, myocardial infarction, paediatric cardiac arrest, spinal cord injury, traumatic brain injury, ischemic stroke and sepsis. Furthermore, TTM is a key treatment for patients after out-of-hospital cardiac-arrest (OHCA). However, the optimal cooling method, which is quick, safe and cost-effective still remains controversial...
2017: PloS One
https://www.readbyqxmd.com/read/28290631/acute-coronary-syndrome-current-treatment
#15
Timothy L Switaj, Scott R Christensen, Dean M Brewer
Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis can be made based on patient history, symptoms, electrocardiography findings, and cardiac biomarkers, which delineate between ST elevation myocardial infarction and non-ST elevation acute coronary syndrome. Rapid reperfusion with primary percutaneous coronary intervention is the goal with either clinical presentation...
February 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28285949/considerations-in-cardio-oncology-multiple-mobile-left-sided-cardiac-thrombi-in-chemotherapy-induced-cardiomyopathy
#16
Toshinori Minamishima, Kenichi Matsushita, Hiromu Morikubo, Aoi Isaka, Noriko Matsushita, Hidehito Endo, Hiroshi Kubota, Konomi Sakata, Toru Satoh, Hideaki Yoshino
With advances in cancer chemotherapy, the importance of the new clinical discipline of cardio-oncology, which is concerned with the cardiac effects of chemotherapy, is increasing. Herein we describe the case of a 48-year-old woman with a history of breast cancer who presented with symptoms of heart failure due to chemotherapy-induced cardiomyopathy. Treatment for the patient's breast cancer had included surgery and chemotherapy with anthracyclines and trastuzumab. Echocardiography revealed multiple mobile thrombi in the left ventricle and atrium...
March 10, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28282683/-indications-and-clinical-implications-of-the-use-of-the-cardiac-markers-bnp-and-nt-probnp
#17
Andreas Luchner, Stephan von Haehling, Christian Holubarsch, Till Keller, Fabian Knebel, Christian Zugck, Ulrich Laufs
B-type natriuretic peptides are markers of myocardial wall stress. BNP or NT-proBNP are used for the differential diagnosis of acute dyspnoe where normal serum concentrations make a cardiac cause unlikely. New data show their importance for risk prediction in different stages of heart failure and in primary prevention. Natriuretic peptide guided therapy improves titration of heart failure medications. Compared to BNP, NT-proBNP is better suited during therapy with the new angiotensin-rezeptor-neprilysin-inhibitor Sacubitril/Valsartan...
March 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28281270/liposome-enhanced-lateral-flow-assays-for-clinical-analyses
#18
Katie A Edwards, Ricki Korff, Antje J Baeumner
Clinical and environmental analyses frequently necessitate rapid, simple, and inexpensive point-of-care or field tests. These semiquantitative tests may be later followed up by confirmatory laboratory-based assays, but provide an initial scenario assessment important for resource mobilization and threat confinement. Lateral-flow assays (LFAs) and dip-stick assays, which are typically antibody-based and yield a visually detectable signal, provide an assay format suiting these applications extremely well. Signal generation is commonly obtained through the use of colloidal gold or latex beads, which yield a colored band either directly proportional or inversely proportional to the concentration of the analyte of interest...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28280785/cost-effectiveness-analysis-of-quadripolar%C3%A2-versus-bipolar-left-ventricular-leads-for-cardiac-resynchronization-defibrillator-therapy%C3%A2-in%C3%A2-a-large-multicenter-uk%C3%A2-registry
#19
Jonathan M Behar, Hui Men Selina Chin, Steve Fearn, Julian O M Ormerod, James Gamble, Paul W X Foley, Julian Bostock, Simon Claridge, Tom Jackson, Manav Sohal, Antonios P Antoniadis, Reza Razavi, Tim R Betts, Neil Herring, Christopher Aldo Rinaldi
OBJECTIVES: The objective of this study was to evaluate the cost-effectiveness of quadripolar versus bipolar cardiac resynchronization defibrillator therapy systems. BACKGROUND: Quadripolar left ventricular (LV) leads for cardiac resynchronization therapy reduce phrenic nerve stimulation (PNS) and are associated with reduced mortality compared with bipolar leads. METHODS: A total of 606 patients received implants at 3 UK centers (319 Q, 287 B), between 2009 and 2014; mean follow-up was 879 days...
February 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28279622/comorbidity-and-coexisting-symptoms-and-infections-presented-in-general-practice-by-copd-patients-does-livestock-density-in-the-residential-environment-play-a-role
#20
Christos Baliatsas, Floor Borlée, Christel E van Dijk, Baukje van der Star, Jan-Paul Zock, Lidwien A M Smit, Peter Spreeuwenberg, Dick Heederik, C Joris Yzermans
OBJECTIVES: Patients with chronic obstructive pulmonary disease (COPD) constitute a potentially susceptible group towards environmental exposures such as livestock farm emissions, given their compromised respiratory health status. The primary aim of this study was to examine the association between livestock exposure and comorbidities and coexisting symptoms and infections in COPD patients. METHODS: Data were collected from 1828 COPD patients (without co-occurring asthma) registered in 23 general practices and living in a rural area with a high livestock density...
March 1, 2017: International Journal of Hygiene and Environmental Health
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