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Quality management cardiology

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https://www.readbyqxmd.com/read/29338315/the-chronic-ischaemic-cardiovascular-disease-esc-pilot-registry-results-of-the-six-month-follow-up
#1
Michel Komajda, Mathieu Kerneis, Luigi Tavazzi, Serban Balanescu, Francesco Cosentino, Alberto Cremonesi, Roberto Ferrari, Serge Kownator, Hanna Szwed, Iveta Mintale, Zoran Olivari, Harald Rittger, Evgeny V Shlyakhto, Rimvydas Slapikas, Philippe Gabriel Steg, Marco Valgimigli, Eric Van Belle, Konstantinos Tsioufis, Wojciech Majda, Cécile Laroche, Aldo P Maggioni
Aim Chronic ischaemic cardiovascular disease (CICD) remains a leading cause of morbidity and mortality worldwide. The CICD Pilot Registry enrolled 2420 patients across 10 European Society of Cardiology countries prospectively to describe characteristics, management strategies and clinical outcomes in this setting. We report here the six-month outcomes. Methods and results From the overall population, 2203 patients were analysed at six months. Fifty-eight patients (2.6%) died after inclusion; 522 patients (23...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29327527/role-and-relevance-of-blood-pressure-variability-in-hypertension-related-co-morbidities
#2
Ashok Kumar, B C Kalmath, Georgi Abraham, Johann Christopher, Pln Kaparthi, Louie Fischer, Neeta Deshpande, N K Mishra, Praveen Raj, Rajesh Javerani, Ramesh Goyal, Reefa Dsouza, Shashank R Joshi
Despite maintaining mean blood pressure at optimal levels, cardiovascular complications still occur in hypertensive patients. Blood pressure variability (BPV) has been implicated as a prominent factor responsible for incurring this additional risk. In this review we attempted to generate a consensus on the importance of BPV in the hypertension management and to evaluate different therapeutic options available to reduce BPV. Panel comprising of 11 leading experts from India in different areas of clinical practice (including nephrology, diabetes and endocrinology, cardiology, and critical care medicine) was convened...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29309557/management-and-prognosis-of-atrial-fibrillation-in-diabetic-patients-an-eorp-af-general-pilot-registry-report
#3
Stefano Fumagalli, Salah A Said, Cecile Laroche, Debbie Gabbai, Serena Boni, Niccolò Marchionni, Giuseppe Boriani, Aldo P Maggioni, Agata Musialik-Lydka, Adam Sokal, Jens Petersen, Harry J G M Crijns, Gregory Y H Lip
Aims: Diabetes mellitus (DM) is one of the most important cardiovascular (CV) risk factors. The aim of this study was to evaluate clinical correlates of DM, including management and outcomes, in the EURObservational Research Programme (EORP) - Atrial Fibrillation (AF) General Pilot (EORP-AF) Registry of the European Society of Cardiology. Methods and Results: We studied consecutive patients (N = 3101) enrolled in 70 centers of 9 European countries between February 2012 and March 2013, and compared diabetics with non-diabetics during a one-year follow-up...
December 22, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29302468/the-euroaspire-surveys-lessons-learned-in-cardiovascular-disease-prevention
#4
Kornelia Kotseva
The Joint European Societies (JES) guidelines on cardiovascular disease (CVD) prevention published in 1994, 1998, 2003, 2007, 2012 and 2016 defined lifestyle and risk factors targets for patients with coronary or other atherosclerotic disease and people at high risk of developing CVD. Guideline implementation in Europe has been evaluated with four cross-sectional EUROASPIRE surveys starting in mid-1990s. The results showed poor lifestyle and risk factor management in patients with CHD and in high CVD risk people with high prevalences of smoking, obesity, central obesity and diabetes...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29241314/perioperative-antithrombotic-therapy-in-patients-undergoing-endoscopic-urologic-surgery-where-do-we-stand-with-current-literature
#5
Richard Naspro, Lori B Lerner, Roberta Rossini, Michele Manica, Henry H Woo, Ross J Calopedos, Cecilia M Cracco, Cesare M Scoffone, Thomas R Herrmann, Jean J de la Rosette, Jean-Nicolas Cornu, Luigi F DA Pozzo
INTRODUCTION: The number of patients on chronic anticoagulant or antiplatelet therapy requiring endoscopic urological surgery is increasing worldwide. Therefore, there is a strong demand to standardize the peri-operative treatment of this cohort of patients, both from a surgical and cardiological point of view, balancing the risks of bleeding versus thrombosis, and the important possible clinical and medical legal repercussions therein. EVIDENCE ACQUISITION: Although literature is scarce and the quality of evidence quite low, in line with other surgical specialties, guidelines and recommendations for the management of urological patients have begun to emerge...
December 14, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/29210056/utility-of-a-precision-medicine-test-in-elderly-adults-with-symptoms-suggestive-of-coronary-artery-disease
#6
Joseph A Ladapo, Matthew J Budoff, David Sharp, Jane Z Kuo, Lin Huang, Bruce Maniet, Lee Herman, Mark Monane
BACKGROUND: Diagnosing obstructive coronary artery disease (CAD) is challenging in elderly adults, and current diagnostic approaches for CAD expose these individuals to risks from contrast dye and invasive procedures. DESIGN: A Registry to Evaluate Patterns of Care Associated with the Use of Corus CAD in Real World Clinical Care Settings (PRESET; NCT01677156), pragmatic clinical trial. SETTING: Community, 21 primary care practices. PARTICIPANTS: Of 566 stable, nonacute outpatients presenting with symptoms suggestive of obstructive CAD, the 176 who were aged 65 and older (median age 70, 61% female) were the current study participants...
December 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29191503/management-of-adults-with-congenital-heart-disease-and-pulmonary-arterial-hypertension-in-the-uk-survey-of-current-practice-unmet-needs-and-expert-commentary
#7
Robert Tulloh, Kostas Dimopoulos, Robin Condliffe, Paul Clift
BACKGROUND: Pulmonary arterial hypertension (PAH) is a well-recognised complication of adult congenital heart disease (CHD). However, management is not currently standardised between centres and specific guidelines are lacking. In order to identify and understand the unmet needs related to PAH associated with CHD (PAH-CHD), a survey of physicians was performed. METHODS: An electronic survey was sent to two physician groups: (1) cardiologists registered in a UK cardiology directory; (2) specialist pulmonary hypertension (PH) physicians known to manage patients with adult PAH-CHD...
November 13, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29188357/-management-of-valvular-heart-disease-esc-eacts-guidelines-2017
#8
REVIEW
M Haude
After 5 years the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery have released an update on the guidelines for the management of valvular heart diseases. In recent years published results of randomized trials in patients with aortic valve stenosis have resulted in updated recommendations for catheter-based prosthesis implantation (TAVI), which is now extended to patients presenting without a low risk for conventional surgical valve replacement. In mitral or tricuspid valvular disease, the recommendations for catheter-based therapies are less strong because of a lack of supportive scientific data...
December 2017: Herz
https://www.readbyqxmd.com/read/29167886/payment-reform-to-enhance-collaboration-of-primary-care-and-cardiology-a-review
#9
Steven A Farmer, Paul N Casale, Linda D Gillam, John S Rumsfeld, Shari Erickson, Neil M Kirschner, Kevin de Regnier, Bruce R Williams, R Shawn Martin, Mark B McClellan
Importance: The US health care system faces an unsustainable trajectory of high costs and inconsistent outcomes. The fee-for-service payment model has contributed to inefficiency, and new payment methods are a promising approach to improving value. Health reforms are needed to increase patient access, reduce costs, and improve health care quality, and the landmark Medicare Access and CHIP Reauthorization Act presents a roadmap for reform. The product of a collaboration between primary care and cardiology clinicians, this review describes a conceptual approach to delivery and payment reforms that aim to better support primary care-cardiology comanagement of chronic cardiovascular disease (CVD)...
November 22, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29167745/the-use-of-smartphones-to-influence-lifestyle-changes-in-overweight-and-obese-youth-with-congenital-heart-disease-a-single-arm-study-pilot-and-feasibility-study-protocol-smart-heart-trial
#10
Meghan Rombeek, Stefanie De Jesus, Luis Altamirano-Diaz, Eva Welisch, Harry Prapavessis, Jamie A Seabrook, Kambiz Norozi
Background: Both obesity and congenital heart disease (CHD) are risk factors for the long-term cardiovascular health of children and adolescents. The addition of smart mobile technology to conventional lifestyle counseling for weight management offers great potential to appeal to technologically literate youth and can address a large geographical area with minimal burden to participants. This pilot study seeks to examine the influence of a 1-year lifestyle intervention on nutrition and physical activity-related health outcomes in overweight or obese children and adolescents with CHD...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29140557/withdrawn-pharmacological-cardioversion-for-atrial-fibrillation-and-flutter
#11
REVIEW
John Cordina, Gillian E Mead
BACKGROUND: Atrial fibrillation is the commonest cardiac dysrhythmia. It is associated with significant morbidity and mortality. There are two approaches to the management of atrial fibrillation: controlling the ventricular rate or converting to sinus rhythm in the expectation that this would abolish its adverse effects. OBJECTIVES: To assess the effects of pharmacological cardioversion of atrial fibrillation in adults on the annual risk of stroke, peripheral embolism, and mortality...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29124952/current-management-and-treatment-of-patients-with-stable-coronary-artery-diseases-presenting-to-cardiologists-in-different-clinical-contexts-a-prospective-observational-nationwide-study
#12
Leonardo De Luca, Pier Luigi Temporelli, Donata Lucci, Lucio Gonzini, Carmine Riccio, Furio Colivicchi, Giovanna Geraci, Dario Formigli, Patrizia Maras, Colomba Falcone, Andrea Di Lenarda, Michele Massimo Gulizia
Background Stable coronary artery disease (CAD) is a leading cause of mortality worldwide. Few studies document the complete sequence of investigation of the overall stable CAD population during outpatient visits or hospitalisation. Aim To obtain accurate and up-to-date information on current management of patients with stable CAD. Methods START (STable coronary Artery diseases RegisTry) was a prospective, observational, nationwide study aimed at evaluating the presentation, management, treatment and quality of life of stable CAD patients presenting to cardiologists during outpatient visits or discharged from cardiology wards...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29119462/syncope-in-pediatric-practice
#13
REVIEW
Pratibha Singhi, Arushi Gahlot Saini
Syncope is defined as a sudden, self-limited loss of consciousness and postural tone followed by spontaneous and complete recovery without any neurological sequelae. It is one of the most common paroxysmal disorders in children and adolescents. The three major causes of syncope in children are neural, cardiovascular and other non-cardiovascular causes. The common unifying mechanism is transient global hypoperfusion of the brain. The diagnosis is primarily clinical and objective laboratory investigations add little to the diagnosis in children especially in neurocardiogenic subtype...
November 9, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29119450/surgical-treatment-for-adult-congenital-heart-disease-consideration-for-indications-and-procedures
#14
REVIEW
Kozo Matsuo, Masashi Kabasawa, Soichi Asano, Shigeru Tateno, Yasutaka Kawasoe, Yoshitomo Okajima, Naoki Hayashida, Hirokazu Murayama
The number of the adult patients with congenital heart diseases (ACHD) continues to grow owing to improvement of surgical results and medical management. Corrective surgery for complex CHD does not always mean complete cure. It is not rare that the patients will visit the cardiology institutes because of secondary lesions due to residua or sequela in adults. Some patients with CHD remain unrepairable with different degree of heart failure and pulmonary arterial hypertension. Association of arrhythmias is common in ACHD patients and sometimes critical...
November 8, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29119223/-acute-myocardial-infarction-in-patients-with-st-segment-elevation-myocardial-infarction-esc-guidelines-2017
#15
REVIEW
H Thiele, S Desch, S de Waha
This article gives an update on the management of acute ST-segment elevation myocardial infarction (STEMI) according to the recently released European Society of Cardiology guidelines 2017 and the modifications are compared to the previous STEMI guidelines from 2012. Primary percutaneous coronary intervention (PCI) remains the preferred reperfusion strategy. New guideline recommendations relate to the access site with a clear preference for the radial artery, use of drug-eluting stents over bare metal stents, complete revascularization during the index hospitalization, and avoidance of routine thrombus aspiration...
November 8, 2017: Herz
https://www.readbyqxmd.com/read/29098756/reducing-the-risk-of-healthcare-associated-infections-through-lean-six-sigma-the-case-of-the-medicine-areas-at-the-federico-ii-university-hospital-in-naples-italy
#16
Giovanni Improta, Mario Cesarelli, Paolo Montuori, Liberatina Carmela Santillo, Maria Triassi
RATIONALE, AIMS, AND OBJECTIVES: Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. METHODS: Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016...
November 3, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29055505/2017-acc-expert-consensus-decision%C3%A2-pathway-on-the-management%C3%A2-of-mitral-regurgitation-a-report-of-the-american-college-of-cardiology-task-force-on-expert-consensus-decision-pathways
#17
REVIEW
Patrick T O'Gara, Paul A Grayburn, Vinay Badhwar, Luis C Afonso, John D Carroll, Sammy Elmariah, Aaron P Kithcart, Rick A Nishimura, Thomas J Ryan, Allan Schwartz, Lynne Warner Stevenson
Mitral regurgitation (MR) is a complex valve lesion that can pose significant management challenges for the cardiovascular clinician. This Expert Consensus Document emphasizes that recognition of MR should prompt an assessment of its etiology, mechanism, and severity, as well as indications for treatment. A structured approach to evaluation based on clinical findings, precise echocardiographic imaging, and when necessary, adjunctive testing, can help clarify decision making. Treatment goals include timely intervention by an experienced heart team to prevent left ventricular dysfunction, heart failure, reduced quality of life, and premature death...
November 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29030806/palliative-care-in-the-management-of-patients-with-advanced-heart-failure
#18
Susan E Lowey
Globally, there are 18-million individuals living with heart failure, a disease that is responsible for 12-15 million office visits and 6.5 million inpatient hospitalizations each year. As HF becomes advanced or end-stage, patients often live in a cycle of frequent transitions between care settings, and with unmet needs, including distress from inadequately managed symptoms. Prognostication in patients with heart failure can be challenging due to the unpredictable exacerbating-remitting illness trajectory that is associated with this progressive disease...
October 14, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29018938/heart-failure-with-preserved-ejection-fraction-current-management-and-future-strategies-expert-opinion-on-the-behalf-of-the-nucleus-of-the-heart-failure-working-group-of-the-german-society-of-cardiology-dkg
#19
REVIEW
Carsten Tschöpe, Christoph Birner, Michael Böhm, Oliver Bruder, Stefan Frantz, Andreas Luchner, Lars Maier, Stefan Störk, Behrouz Kherad, Ulrich Laufs
About 50% of all patients suffering from heart failure (HF) exhibit a reduced ejection fraction (EF ≤ 40%), termed HFrEF. The others may be classified into HF with midrange EF (HFmrEF 40-50%) or preserved ejection fraction (HFpEF, EF ≥ 50%). Presentation and pathophysiology of HFpEF is heterogeneous and its management remains a challenge since evidence of therapeutic benefits on outcome is scarce. Up to now, there are no therapies improving survival in patients with HFpEF. Thus, the treatment targets symptom relief, quality of life and reduction of cardiac decompensations by controlling fluid retention and managing risk factors and comorbidities...
January 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28993401/diagnosis-and-management-of-noncardiac-complications-in-adults-with-congenital-heart-disease-a-scientific-statement-from-the-american-heart-association
#20
REVIEW
George K Lui, Arwa Saidi, Ami B Bhatt, Luke J Burchill, Jason F Deen, Michael G Earing, Michael Gewitz, Jonathan Ginns, Joseph D Kay, Yuli Y Kim, Adrienne H Kovacs, Eric V Krieger, Fred M Wu, Shi-Joon Yoo
Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD...
November 14, 2017: Circulation
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