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https://www.readbyqxmd.com/read/28088009/cardiac-output-and-systemic-vascular-resistance-clinical-assessment-compared-with-a-noninvasive-objective-measurement-in-children-with-shock
#1
Asma Razavi, Christopher J L Newth, Robinder G Khemani, Fernando Beltramo, Patrick A Ross
PURPOSE: To evaluate physician assessment of cardiac output and systemic vascular resistance in patients with shock compared with an ultrasonic cardiac output monitor (USCOM). To explore potential changes in therapy decisions if USCOM data were available using physician intervention answers. STUDY DESIGN: Double-blinded, prospective, observational study in a tertiary hospital pediatric intensive care unit. Forty children (<18years) admitted with shock, requiring ongoing volume resuscitation or inotropic support...
December 28, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28087566/application-of-whole-exome-sequencing-in-the-clinical-diagnosis-and-management-of-inherited-cardiovascular-diseases-in-adults
#2
Sara B Seidelmann, Emily Smith, Lakshman Subrahmanyan, Daniel Dykas, Maen D Abou Ziki, Bani Azari, Fady Hannah-Shmouni, Yuexin Jiang, Joseph G Akar, Mark Marieb, Daniel Jacoby, Allen E Bale, Richard P Lifton, Arya Mani
BACKGROUND: With the advent of high throughput sequencing, the identification of genetic causes of cardiovascular disease (CVD) has become an integral part of medical diagnosis and management and at the forefront of personalized medicine in this field. The use of whole exome sequencing for clinical diagnosis, risk stratification, and management of inherited CVD has not been previously evaluated. METHODS AND RESULTS: We analyzed the results of whole exome sequencing in first 200 adult patients with inherited CVD, who underwent genetic testing at the Yale Program for Cardiovascular Genetics...
February 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/28087409/thioredoxin-a-novel-biomarker-of-post-injury-sepsis
#3
Jesper Eriksson, Andreas Gidlöf, Mikael Eriksson, Emma Larsson, Olof Brattström, Anders Oldner
BACKGROUND: Thioredoxin (TRX), an endogenous anti-oxidant protein induced in inflammatory conditions, has been shown to increase in plasma and to be associated with outcome in septic patients. This biomarker has never been studied in a trauma setting. We hypothesized that TRX would be increased after trauma and associated with post-injury sepsis. METHODS: Single-centre prospective observational study conducted at the intensive care unit (ICU) at the Karolinska University Hospital, Stockholm, Sweden, a level-1 trauma centre...
January 10, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28087288/outcome-of-adult-patients-attended-by-rapid-response-teams-a-systematic-review-of-the-literature
#4
REVIEW
Joonas Tirkkonen, Tero Tamminen, Markus Skrifvars
BACKGROUND: An abundance of studies have investigated the impact of rapid response teams (RRTs) on in-hospital cardiac arrest rates. However, existing RRT data appear highly variable in terms of both study quality and reported uses of limitations of care, patient survival and patient long-term outcome. METHODS: A systematic electronic literature search (January, 1990-March, 2016) of the PubMed and Cochrane databases was performed. Bibliographies of articles included in the full-text review were searched for additional studies...
January 10, 2017: Resuscitation
https://www.readbyqxmd.com/read/28087235/hemodynamic-consequence-of-hand-ventilation-versus-machine-ventilation-during-transport-after-cardiac-surgery
#5
E Orestes O'Brien, Beverly J Newhouse, Brett Cronin, Kimberly Robbins, Albert P Nguyen, Swapnil Khoche, Ulrich Schmidt
OBJECTIVES: The hemodynamic consequences of ventilation of intubated patients during transport either by hand or using a transport ventilator have not been reported in patients after cardiac surgery. The authors hypothesized that bag-mask ventilation would alter end-tidal CO2 during transport and hemodynamic parameters in patients post-cardiac surgery. DESIGN: A prospective, randomized trial. SETTING: A university-affiliated tertiary care hospital...
November 9, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28087181/challenging-the-99th-percentile-a-lower-troponin-cutoff-leads-to-low-mortality-of-chest-pain-patients
#6
Nils Arne Sörensen, Johannes Tobias Neumann, Francisco Ojeda, Tjark Schwemer, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Rule-out of non-ST-elevation myocardial infarction is based on consecutive measurements of cardiac troponins using the 99th percentile of the respective assay as cutoff. The new ESC guidelines alternatively offer rapid 1h algorithms with lower cutoffs than the 99th percentile for rule-out of non-ST-elevation myocardial infarction. We aimed to compare a recently introduced 1h algorithm based on a high-sensitivity cardiac troponin I (hs-TnI) cutoff of 6ng/L at 0h and 1h to the current standard of care using the 99th percentile (27ng/L) as cutoff with reference to follow-up events in a large chest pain cohort...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28086784/health-related-quality-of-life-assessment-in-acute-coronary-syndrome-patients-the-effectiveness-of-early-phase-i-cardiac-rehabilitation
#7
Lawrence Anchah, Mohamed Azmi Hassali, Melissa Siaw Han Lim, Mohamed Izham Mohamed Ibrahim, Kui Hian Sim, Tiong Kiam Ong
BACKGROUND: Acute Coronary Syndrome (ACS) is one of the most burdensome cardiovascular diseases in terms of the cost of interventions. The Cardiac Rehabilitation Programme (CRP) is well-established in improving clinical outcomes but the assessment of actual clinical improvement is challenging, especially when considering pharmaceutical care (PC) values in phase I CRP during admission and upon discharge from hospital and phase II outpatient interventions. This study explores the impact of pharmacists' interventions in the early stages of CRP on humanistic outcomes and follow-up at a referral hospital in Malaysia...
January 13, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28081585/drug-eluting-stent-placement-versus-coronary-artery-bypass-surgery-for-unprotected-left-main-coronary-artery-disease-a-meta-analysis-of-randomized-controlled-trials
#8
Sunil Upadhaya, Ramkaji Baniya, Seetharamprasad Madala, Suresh Kumar Subedi, Jahangir Khan, Ravi Kanth Velagapudi, Ghassan Bachuwa
BACKGROUND: Coronary artery bypass grafting (CABG) is the standard of care for treating left main coronary lesions. However, recently published randomized controlled trials (RCT) have shown conflicting results. We sought to compare clinical outcomes of percutaneous coronary intervention (PCI) with drug-eluting stent placement to CABG using a meta-analysis of randomized controlled trials. METHODS: A systemic search of Pubmed, Scopus, Cochrane library, and Clinicaltrials...
January 12, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28079865/differences-in-mortality-characteristics-in-neonates-with-down-s-syndrome
#9
C L Cua, U Haque, S Santoro, L Nicholson, C H Backes
OBJECTIVE: Neonates with Down's syndrome (nDS) may have multiple medical issues that place them at increased risk for mortality during the newborn period. Goal of this study was to determine if there are differences in baseline characteristics, medical complications or procedures performed during hospitalization between nDS who survived versus those who died during initial hospitalization. STUDY DESIGN: Data from 2000 to 2014 were reviewed using the Pediatric Health Information Systems (PHIS) database on all DS patients admitted to the hospital <30 days postnatal life...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28079661/femoral-neuropathy-following-spontaneous-retroperitoneal-hemorrhage-after-cardiac-surgery-a-case-report
#10
Dinah J White, F T Lytle
A woman underwent ascending aortic aneurysm repair, aortic root and valve replacement, and coronary artery bypass grafting. Her postoperative course was complicated by stroke and status epilepticus. With supportive care and antiepileptics, her neurologic status improved. Intravenous heparin and aspirin were initiated. On postoperative day 13, she developed a large retroperitoneal hematoma with femoral neuropathy. Because her hematoma was not amenable to percutaneous drainage or surgical evacuation, and considering her comorbidities, a conservative approach was elected...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28079556/cardiac-arrest-obstetric-cpr-acls
#11
Benjamin Cobb, Steven Lipman
In contrast with other high-resource countries, maternal mortality has seen an increase in the United States. Caring for pregnant women in cardiac arrest may prove uniquely challenging given the rarity of the event coupled by the physiological changes of pregnancy. Optimization of resuscitative efforts warrants special attention as described in the 2015 American Heart Association's "Scientific Statement on Maternal Cardiac Arrest." Current recommendations address a variety of topics ranging from the basic components of chest compressions and airway management to some of the logistical complexities and operational challenges involved in maternal cardiac arrest...
January 10, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28079553/end-of-life-decisions-in-heart-failure-to-turn-off-the-intracardiac-device-or-not
#12
Bilal Ayach, Amrit Malik, Colette Seifer, Shelley Zieroth
PURPOSE OF REVIEW: Heart failure is a significant public health concern around the world. Implantable cardioverter defibrillators with or without cardiac resynchronization therapy (CRT-D) have proven survival benefit. As patients progress to end-stage disease, management shifts to palliative care, and cardiologists are often confronted with how to best manage these devices. RECENT FINDINGS: Studies suggest that up to one-third of patients with an implantable cardioverter defibrillator receive painful shocks in the last 24 h of life...
January 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28078858/use-of-lactated-ringer%C3%A2-s-solution-does-not-eliminate-the-risk-of-strong-ion-difference-related-metabolic-acidosis-following-on-pump-cardiac-surgery
#13
T Jovaisa, V Vicka, G Linkaitė, J Guseinovaitė, D Ringaitienė, I Norkienė
There is a growing interest in the effects of plasma sodium levels on postoperative outcomes. A trend of using balanced crystalloid solutions is based on the extensive data on chloride and the strong ion difference-related acidosis. However, effects of sodium are often overlooked in this context. The aim of the study was to establish the effects of the routine use of Lactated Ringer’s Solution (RL) on postoperative changes in sodium concentrations and whether these changes result in metabolic acidosis. We performed database analysis of 358 consecutive elective on-pump cardiac surgery cases in a tertiary referral university hospital...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28078682/population-pharmacokinetics-of-intravenous-clonidine-for-sedation-during-pediatric-extracorporeal-membrane-oxygenation-ecmo-and-continuous-veno-venous-hemofiltration-cvvh
#14
Niina Kleiber, Ron A A Mathôt, Maurice J Ahsman, Enno D Wildschut, Dick Tibboel, Saskia N de Wildt
AIMS: Clonidine is used for sedation in the pediatric intensive care unit. Extracorporeal membrane oxygenation (ECMO) provides temporary support if respiratory and cardiac function is threatened. ECMO influences the pharmacokinetics of drugs. Clonidine during pediatric ECMO cannot be effectively titrated as PK data are lacking. The aim of this study is to describe clonidine PK in a particular ECMO system and propose dosing guidelines for children on this particular ECMO circuit. METHODS: All children below the age of 18 who received clonidine during ECMO were eligible...
January 12, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28077517/two-phase-hospital-associated-outbreak-of-mycobacterium-abscessus-investigation-and-mitigation
#15
Arthur W Baker, Sarah S Lewis, Barbara D Alexander, Luke F Chen, Richard J Wallace, Barbara A Brown-Elliott, Pamela J Isaacs, Lisa C Pickett, Chetan B Patel, Peter K Smith, John M Reynolds, Jill Engel, Cameron R Wolfe, Carmelo A Milano, Jacob N Schroder, Robert D Davis, Matthew G Hartwig, Jason E Stout, Nancy Strittholt, Eileen K Maziarz, Jennifer Horan Saullo, Kevin C Hazen, Richard J Walczak, Ravikiran Vasireddy, Sruthi Vasireddy, Celeste M McKnight, Deverick J Anderson, Daniel J Sexton
BACKGROUND: Nontuberculous mycobacteria (NTM) commonly colonize municipal water and cause healthcare-associated outbreaks. We investigated a biphasic outbreak of Mycobacterium abscessus at a tertiary care hospital. METHODS: Case patients had recent hospital exposure and laboratory-confirmed colonization or infection with M. abscessus from January 2013 through December 2015. We conducted a multidisciplinary epidemiologic, field, and laboratory investigation. RESULTS: The incidence rate of M...
January 11, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28076990/outcomes-in-the-absence-of-the-ductus-venosus-diagnosed-in-the-first-trimester
#16
Hiroko Takita, Junichi Hasegawa, Tatsuya Arakaki, Shoko Hamada, Mayumi Tokunaka, Masamitsu Nakamura, Ryu Matsuoka, Akihiko Sekizawa
PURPOSE: To clarify the outcomes of the absence of the ductus venosus diagnosed in fetuses suspected to have a structural abnormality during a morphological assessment in the first trimester. METHODS: Infants in whom ultrasound fetal morphological assessments were attempted in the first trimester (11 to 13-6 weeks of gestation) and who were subsequently delivered between 2013 and 2015 at Showa University Hospital were enrolled. In cases in which the absence of the ductus venosus was diagnosed in the first trimester, the prognosis was assessed...
January 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#17
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVE: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
January 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28075423/effects-of-device-guided-slow-breathing-training-on-exercise-capacity-cardiac-function-and-respiratory-patterns-during-sleep-in-male-and-female-patients-with-chronic-heart-failure
#18
Kalina Kawecka-Jaszcz, Grzegorz Bilo, Tomasz Drożdż, Dorota Dębicka-Dąbrowska, Grzegorz Kiełbasa, Gabriella Malfatto, Katarzyna Styczkiewicz, Carolina Lombardi, Agnieszka Bednarek, Sabrina Salerno, Danuta Czarnecka, Gianfranco Parati
INTRODUCTION    Slow breathing training (SBT) has been proposed as new non-pharmacological treatment in chronic heart failure (CHF) patients.  OBJECTIVES    The aim of this study was to assess the effects of SBT on exercise capacity, haemodynamic parameters and sleep respiratory patterns in a relatively large sample of CHF patients. PATIENTS ABD METHODS    A cross-over open study was conducted. The patients completed, in random order, 10-12 week periods of SBT with the RESPeRATE device (InterCure Ltd...
January 10, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28075422/inflammation-cardiometabolic-markers-and-functional-changes-in-a-randomized-controlled-trial-of-a-12-month-exercise-program-for-prostate-cancer-men
#19
Katarzyna Hojan, Eliza Kwiatkowska-Borowczyk, Ewa Leporowska, Piotr Milecki
INTRODUCTION    Previous studies have shown that physical exercise in cancer patients during radiotherapy (RT) and androgen deprivation therapy (ADT) improves cardiac fitness and quality of life (QoL), and reduces fatigue but it is still not entirely known how it affects inflammation or metabolic factors and what its consequences are in prostate cancer (PCa) patients. OBJECTIVES    Effect of a 12-month physical exercise program on inflammatory and cardiometabolic factors, and on functional status in PCa patients undergoing RT and ADT...
January 10, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28075307/chronic-heart-failure-part-2-treatment-and-management
#20
Rebecca Brake, Ian David Jones
Chronic heart failure is a common and complex clinical syndrome that results from impaired cardiac relaxation or contraction. There have been considerable advances in the management of chronic heart failure; however, the mortality rate remains high. Patients with chronic heart failure may experience multiple debilitating symptoms, such as fatigue, pain, and peripheral oedema. However, breathlessness may be considered the most debilitating symptom. The management of chronic heart failure aims to improve the patient's quality of life by reducing symptoms and supporting the patient to manage their condition...
January 11, 2017: Nursing Standard
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