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https://www.readbyqxmd.com/read/29154379/proposed-in-training-electrocardiogram-interpretation-competencies-for-undergraduate-and-postgraduate-trainees
#1
Pavel Antiperovitch, Wojciech Zareba, Jonathan S Steinberg, Ljuba Bacharova, Larisa G Tereshchenko, Jeronimo Farre, Kjell Nikus, Takanori Ikeda, Adrian Baranchuk
Despite its importance in everyday clinical practice, the ability of physicians to interpret electrocardiograms (ECGs) is highly variable. ECG patterns are often misdiagnosed, and electrocardiographic emergencies are frequently missed, leading to adverse patient outcomes. Currently, many medical education programs lack an organized curriculum and competency assessment to ensure trainees master this essential skill. ECG patterns that were previously mentioned in literature were organized into groups from A to D based on their clinical importance and distributed among levels of training...
November 8, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29095982/dose-dependent-effects-of-intranasal-insulin-on-resting-state-brain-activity
#2
Stephanie Kullmann, Ralf Veit, Andreas Peter, Rolf Pohmann, Klaus Scheffler, Hans-Ulrich Häring, Andreas Fritsche, Hubert Preissl, Martin Heni
Context: Insulin action in the human brain influences eating behavior, cognition, and whole-body metabolism. Studies investigating brain insulin rely on intranasal application. Objective: To investigate effects of three doses of insulin and placebo as nasal sprays on the central and autonomous nervous system and analyze absorption of insulin into the bloodstream. Design, participants and methods: Nine healthy men received placebo, 40U, 80U and 160U insulin spray in randomized order...
October 31, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29093384/a-pilot-study-of-tranilast-for-cardiomyopathy-of-muscular-dystrophy
#3
Tsuyoshi Matsumura, Misa Matsui, Yuko Iwata, Masanori Asakura, Toshio Saito, Harutoshi Fujimura, Saburo Sakoda
Objective Heart failure is currently the most serious complication of muscular dystrophy. The transient receptor potential cation channel, subfamily V, member 2 (TRPV2) is a stretch-sensitive Ca channel. In damaged myocytes or cardiomyocytes, TRPV2 translocates to the cytoplasmic membrane and enhances Ca influx, triggering cell damage. Evidence suggests that the inhibition of TRPV2 may be a new therapeutic target in heart failure. We found that tranilast, which is widely used as an anti-allergic drug, inhibits TRPV2...
November 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29060773/detection-of-sympathoadrenal-discharge-by-parameterisation-of-skin-conductance-and-ecg-measurement
#4
Christian Tronstad, Ole Elvebakk, Havard Kalvoy, Marit R Bjorgaas, Orjan G Martinsen
Detection of sympathoadrenal discharge is valuable for stress monitoring, but measuring the circulating adrenaline level directly is inconvenient, making non-invasive physiological sensors an attractive alternative. Little is known however, about their performance in detecting different adrenaline levels. In this study, adrenaline measurements over time from 20 subjects × 2 trials were compared with skin conductance (SC) from different skin sites and ECG recordings from which the heart rate and QT interval were derived...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29055890/utility-of-prehospital-electrocardiogram-characteristics-as-prognostic-markers-in-out-of-hospital-pulseless-electrical-activity-arrests
#5
Michael L Ho, Mathieu Gatien, Christian Vaillancourt, Veronica Whitham, Ian G Stiell
BACKGROUND: It is unclear if there are predictors of survival, including ECG characteristics, that can guide resuscitative efforts in pulseless electrical activity (PEA) cardiac arrests. We studied the predictive potential of presenting prehospital ECGs on survival for patients with out-of-hospital cardiac arrest (OHCA) with PEA. METHODS: We studied prehospital ECGs of patients with OHCA prospectively enrolled between June 2007 and November 2009 at the Ottawa/OPALS (Ontario Prehospital Advanced Life Support Study) site of the Resuscitation Outcomes Consortium PRIMED study (Prehospital Resuscitation using an IMpedance valve and Early versus Delayed analysis)...
October 21, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29049921/estrus-resynchronization-in-ewes-with-unknown-pregnancy-status
#6
Vladinis O Miranda, Fernando C Oliveira, Jenniffer H Dias, Sergio F Vargas Júnior, Karina L Goularte, Manoel F Sá Filho, Ocilon G de Sá Filho, Hernan Baldassarre, Arnaldo D Vieira, Thomaz Lucia, Bernardo G Gasperin
Although fixed-time artificial insemination (FTAI) protocols are available for sheep, estrus resynchronization has not been previously reported. The objectives of this study were to evaluate the effect of estrus resynchronization with exogenous progestogen on endogenous progesterone levels and to compare pregnancy rates after two consecutive estrus synchronizations in ewes. In Experiment 1, ewes (n = 20) received an intravaginal device (IVD) containing 60 mg medroxyprogesterone acetate (MPA) for 10 days...
October 10, 2017: Theriogenology
https://www.readbyqxmd.com/read/29023795/real-time-ecg-simulation-for-hybrid-mock-circulatory-loops
#7
Leonie Korn, Daniel Rüschen, Niklas Zander, Steffen Leonhardt, Marian Walter
Classically, mock circulatory loops only simulate mechanical properties of the circulation. To connect the hydraulic world with electrophysiology, we present a real-time electrical activity model of the heart and show how to integrate this model into a real-time mock loop simulation. The model incorporates a predefined conduction pathway and a simplified volume conductor to solve the bidomain equations and the forward problem of electrocardiography, resulting in a physiological simulation of the electrocardiogram (ECG) at arbitrary electrode positions...
October 12, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29018174/prognostic-value-of-n-terminal-pro-b-type-natriuretic-peptide-levels-in-heart-failure-patients-with-and-without-atrial-fibrillation
#8
Søren Lund Kristensen, Pardeep S Jhund, Ulrik M Mogensen, Rasmus Rørth, William T Abraham, Akshay Desai, Kenneth Dickstein, Jean L Rouleau, Michael R Zile, Karl Swedberg, Milton Packer, Scott D Solomon, Lars Køber, John J V McMurray
BACKGROUND: Patients with heart failure (HF) and atrial fibrillation (AF) have higher circulating levels of NT-proBNP (N-terminal pro-B-type natriuretic peptide) than HF patients without AF. There is uncertainty about the prognostic importance of a given concentration of NT-proBNP in HF patients with and without AF. We investigated this question in a large cohort of patients with HF and reduced ejection fraction. METHODS AND RESULTS: We studied 14 737 patients with HF and reduced ejection fraction and a measurement of NT-proBNP at time of screening, enrolled in either the PARADIGM-HF trial (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) or the ATMOSPHERE trial (Aliskiren Trial to Minimize Outcomes in Patients With Heart Failure), of whom 3575 (24%) had AF on their baseline ECG...
October 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28976872/comparison-of-non-gated-vs-ecg-gated-ct-angiography-of-fontan-circulation-in-patients-with-implanted-stents-in-pulmonary-branches
#9
Marek Kardoš, Juraj Mikuláš, Ivan Vulev, Jozef Mašura
BACKGROUND: Motion artifacts may degrade CT examination of Fontan pathway and hinder accurate diagnosis of in-stent restenosis. PURPOSE: We retrospectively compared ECG-gated multi-detector computed tomography (CT) with non-ECG-gated CT in order to demonstrate whether or not one of the methods should be preferred. METHOD: The study included 13 patients with surgically reconstructed Fontan pathway. A total of 16 CT examinations were performed between February 2010 and November 2015...
2017: Acta Medica (Hradec Králové)
https://www.readbyqxmd.com/read/28973591/war-medicine-and-cultural-diplomacy-in-the-americas-frank-wilson-and-brazilian-cardiology
#10
Simone P Kropf, Joel D Howell
American cultural diplomacy played a key role in the institutionalization of Brazilian cardiology. In 1942, Frank Wilson, an internationally recognized pioneer in electrocardiography, made an extended wartime visit to Rio de Janeiro and São Paulo. The visit was sponsored by the United States Department of State as part of Roosevelt's Good Neighbor Policy and brought Wilson together with a group of physicians who would establish the specialty of cardiology in Brazil. This US cultural and diplomatic initiative strengthened an academic network that was already evolving and would eventually prove to be of benefit to both sides...
October 1, 2017: Journal of the History of Medicine and Allied Sciences
https://www.readbyqxmd.com/read/28928045/the-electrocardiographic-triangular-qrs-st-t-waveform-pattern-in-patients-with-st-segment-elevation-myocardial-infarction-incidence-pathophysiology-and-clinical-implications
#11
Alberto Cipriani, Gianpiero D'Amico, Giulia Brunello, Martina Perazzolo Marra, Federico Migliore, Luisa Cacciavillani, Giuseppe Tarantini, Barbara Bauce, Sabino Iliceto, Domenico Corrado, Alessandro Zorzi
BACKGROUND: A specific ECG pattern of presentation of ST-segment elevation acute myocardial infarction (STEMI), characterized by "triangular QRS-ST-T waveform" (TW), has been associated with poor in-hospital prognosis but longitudinal data on its incidence and clinical impact are lacking. We prospectively evaluated the incidence and prognostic meaning of the TW pattern in a cohort of consecutive STEMI patients. METHODS: All STEMI patients who presented within 12h of symptoms onset and showed no complete bundle branch block or paced ventricular rhythm were included...
August 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28852969/recovery-from-very-long-aortic-cross-clamping-in-redo-complex-aortic-surgery
#12
Shoichi Suehiro, Koji Shimizu, Megumi Ito, Hayato Nakata, Kazuhiro Akeho, Teiji Oda
A 68-year-old man had undergone ascending aortic replacement for acute type A aortic dissection. Three months later, he had a new aortic dissection with an ulcer-like projection located in the aortic arch with suspected graft infection. An emergent redo total aortic arch and root replacement was performed because of the coexistence of a fragile aortic root wall. The extensive redo procedure necessitated a very long aortic cross-clamping time (516 min). After 25 min of assisted circulation, he was easily weaned from the cardiopulmonary bypass...
August 29, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28844727/does-dispatcher-assisted-cpr-generate-the-same-outcomes-as-spontaneously-delivered-bystander-cpr-in-japan
#13
Hiroyuki Takahashi, Ryo Sagisaka, Yoshiki Natsume, Shota Tanaka, Hiroshi Takyu, Hideharu Tanaka
AIM: We investigated whether DA-CPR would have the same effect as spontaneously-delivered bystander CPR. METHODS: A total of 37,899 witnessed cardiogenic out of hospital cardiac arrest (OHCA) selected from a nationwide Utstein-Japanese database between 2008 and 2012. Patients were divided into four groups as follows: CPR initiated with dispatcher assistance (DA-CPR; n=10,424), no CPR provided with dispatcher assistance (DA-No CPR; n=4658), spontaneously-delivered bystander CPR provided without DA (BCPR; n=6630), and both BCPR and dispatcher assistance was not provided (No BCPR-No DA; n=16,187)...
August 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28757765/pulseless-electrical-activity-in-acute-massive-pulmonary-embolism-during-thrombolytic-therapy
#14
Han-Hua Yu, Jing-Ren Jeng
We report a case of acute pulmonary embolism with hemodynamic instability diagnosed by a computed tomography pulmonary angiogram. The patient developed pulseless electrical activity during systemic thrombolytic therapy with recombinant tissue plasminogen activator. Successful return of spontaneous circulation was achieved after immediate cardiopulmonary resuscitation with chest compressions for 6 min. His electrocardiogram (ECG) on arrival in the emergency department displayed sinus tachycardia, an S wave in lead I, a Q wave in lead III, incomplete right bundle branch block (RBBB), T-wave inversion (TWI) in leads V1-V3, ST elevation in leads aVR and V1, and ST depression in leads I, II, III, aVF, and V4-V6...
January 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28684376/the-association-between-arterial-stiffness-initial-stroke-severity-and-3-week-outcomes-in-patients-with-ischemic-stroke
#15
Emma Ormerod, Khalid Ali, James Cameron, Muzaffar Malik, Richard Lee, Spas Getov, Chakravarthi Rajkumar
OBJECTIVES: Vascular compliance is emerging as a useful cardiovascular risk factor. The aim of this study was to investigate the association between arterial stiffness and stroke severity at presentation and 3 weeks. METHODS: Forty two patients with acute ischemic stroke (55% male, mean age 71 years) were recruited over 15-months. Stroke subtypes were classified into lacunar circulation infarct (LACI), partial anterior circulation infarct (PACI), and posterior circulation infarct (POCI)...
November 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28643129/magnetohydrodynamic-voltage-recorder-for-comparing-peripheral-blood-flow
#16
Kevin J Wu, T Stan Gregory, Michael C Lastinger, Jonathan R Murrow, Zion Tsz Ho Tse
Blood flow is a clinical metric for monitoring of cardiovascular diseases but current measurements methods are costly or uncomfortable for patients. It was shown that the interaction of the magnetic field (B 0) during MRI and blood flow in the body, through the magnetohydrodynamic (MHD) effect, produce voltages (V MHD) observable through intra-MRI electrocardiography (ECG), which are correlated with regional blood flow. This study shows the reproducibility of V MHD outside the MRI and its application in a portable flow monitoring device...
October 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28615177/direct-transport-to-a-percutaneous-cardiac-intervention-center-and-outcomes-in-patients-with-out-of-hospital-cardiac-arrest
#17
Kristian Kragholm, Carolina Malta Hansen, Matthew E Dupre, Ying Xian, Benjamin Strauss, Clark Tyson, Lisa Monk, Claire Corbett, Christopher B Fordyce, David A Pearson, Emil L Fosbøl, James G Jollis, Benjamin S Abella, Bryan McNally, Christopher B Granger
BACKGROUND: Practice guidelines recommend regional systems of care for out-of-hospital cardiac arrest. However, whether emergency medical services should bypass nonpercutaneous cardiac intervention (non-PCI) facilities and transport out-of-hospital cardiac arrest patients directly to PCI centers despite longer transport time remains unknown. METHODS AND RESULTS: Using the Cardiac Arrest Registry to Enhance Survival with geocoding of arrest location, we identified out-of-hospital cardiac arrest patients with prehospital return of spontaneous circulation and evaluated the association between direct transport to a PCI center and outcomes in North Carolina during 2012 to 2014...
June 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28608915/abc-om-pediatrisk-ekg-tolkning
#18
Caroline Fransson, Stefan Johansson, Cecilia Halvorsen
The ABC of paediatric ECG interpretation In paediatric patients, ECG is used as a tool for investigation of arrhythmias, chest pain, syncope, intoxications and congenital heart abnormalities. Paediatric ECGs differ significantly from adult ECGs, and change gradually during childhood, largely because of the changes that start with the transition of foetal circulation at birth. This evolution is most prominent during the first year of life, but it is not until the late adolescent years that the ECG corresponds to that of adults...
June 9, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28596923/unilateral-dilated-pupil-and-spontaneous-cardiac-arrest-with-successful-bystander-resuscitation
#19
James M Hancox, Julian Spiers, Nicholas Crombie, David N Naumann
A 75-year-old man collapsed on a golf course and received cardiopulmonary resuscitation from a bystander, including the use of a public automated external defibrillator (AED). The AED was discharged once, with return of spontaneous circulation. An air ambulance crew found the patient haemodynamically stable, with no acute abnormalities on a 12-lead ECG. He had reduced consciousness and a dilated left pupil. On contacting the patient's wife by telephone, she said that he had fallen and hit his head earlier that day...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28591174/the-acute-effects-of-lower-limb-intermittent-negative-pressure-on-foot-macro-and-microcirculation-in-patients-with-peripheral-arterial-disease
#20
Øyvind Heiberg Sundby, Lars Øivind Høiseth, Iacob Mathiesen, Harald Weedon-Fekjær, Jon O Sundhagen, Jonny Hisdal
BACKGROUND: Intermittent negative pressure (INP) applied to the lower leg and foot increases foot perfusion in healthy volunteers. The aim of the present study was to describe the effects of INP to the lower leg and foot on foot macro- and microcirculation in patients with lower extremity peripheral arterial disease (PAD). METHODS: In this experimental study, we analyzed foot circulation during INP in 20 patients [median (range): 75 (63-84yrs)] with PAD. One leg was placed inside an air-tight vacuum chamber connected to an INP-generator...
2017: PloS One
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