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https://www.readbyqxmd.com/read/28647950/turner-syndrome-care-of-the-patient-birth-to-late-adolescence
#1
Denise Gruccio Paolucci, Vaneeta Bamba
Turner syndrome (TS) is a genetic condition occurring in females resulting from the loss of part or all of one of the X chromosomes. The two hallmark features of Turner syndrome include short stature and primary ovarian insufficiency. In addition, Turner syndrome can involve multiple healthcare issues including cardiac and renal anomalies, autoimmune disorders, hearing loss, ophthalmologic issues, bone anomalies, dermatologic issues and psychosocial and educational concerns. The presenting signs of Turner syndrome can vary markedly, leading to delayed or even missed diagnosis...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647057/prevalence-of-obstructive-sleep-apnoea-in-acute-coronary-syndrome-routine-screening-in-intensive-coronary-care-units
#2
S Morra, F Bughin, K Solecki, M Aboubadra, B Lattuca, F Gouzi, J-C Macia, T-T Cung, S Cade, F Cransac, J-M Davy, Y Dauvilliers, D Corrado, F Roubille
INTRODUCTION: Increased evidence has shown that, despite the maximum care afforded to patients admitted with acute coronary syndromes (ACS), a residual risk of mortality remains, in which obstructive sleep apnoea (OSA) appears to be a largely undiagnosed factor, particularly in the intensive cardiac care unit (ICCU). The purpose of this study is to determine whether the systematic screening for sleep-disordered breathing (SDB) is feasible and may be recommended. The aims of our study are to determine: (1) The estimated prevalence of OSA in patients admitted to the ICCU for ACS determined by a validated, user-friendly portable screening device; (2) The feasibility of the screening in this context; (3) To assess any negative impact of OSA on the severity of ACS...
June 21, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28647051/longitudinal-nosocomial-outbreak-of-pseudomonas-fluorescens-bloodstream-infection-of-2-years-duration-in-a-coronary-care-unit
#3
Yuichiro Oba, Takahiro Nakajima, Chiyo Ogida, Miyuki Kawanami, Mamoru Fujiwara, Ikuko Matsumura
BACKGROUND: Outbreaks of bloodstream infections (BSI) of nonfermenting bacteria are a critical issue and often associated with hospital environments. We experienced a long-lasting outbreak of Pseudomonas fluorescens BSI limited to a coronary care unit (CCU). METHODS: We conducted a retrospective epidemiologic investigation and a case-control study for Pseudomonas fluorescens BSI from April 2011-July 2014. Environmental sample culture was conducted to detect the specific environmental source of transmission...
June 21, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28646467/symptom-management-challenges-in-heart-failure-pharmacotherapy-considerations
#4
REVIEW
Diana Stewart, Mary Lynn McPherson
Heart failure is a chronic, progressive illness that is increasing in prevalence in the USA. Patients with advanced heart failure experience a high symptom burden that is comparable to patients with advanced cancer. Palliative care, however, is underutilized in patients with heart failure, and symptoms may go untreated as the disease progresses. A combination of pharmacologic and non-pharmacologic interventions should be used to address symptoms and maintain quality of life. While there have been significant advances in evidence-based heart failure treatments in recent years, selection of appropriate palliative medications as symptoms progress is challenging due to limited clinical studies in this patient population...
June 24, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28646442/variability-of-adverse-events-in-the-public-health-care-service-of-the-tuscany-region
#5
Sara Albolino, Riccardo Tartaglia, Tommaso Bellandi, Elisa Bianchini, Giancarlo Fabbro, Silvia Forni, Giulia Cernuschi, Annibale Biggeri
The objective of the study is to analyze the variation of adverse events (AEs) according to the different structure of hospitals. The study is a multicenter, retrospective study. It involves 4 teaching hospitals (THs) and 32 community hospitals, distributed in 12 local trusts (LTs), of the Tuscany Regional Healthcare Service (RHS). A random sample of the clinical records of patients admitted in LTs and THs in 2008 was selected from the database of the hospital discharge records of the centers. Among 11,293 clinical records included, a total of 354 adverse events were identified...
June 23, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28645301/the-sternal-management-accelerated-recovery-trial-s-m-a-r-t-standard-restrictive-versus-an-intervention-of-modified-sternal-precautions-following-cardiac-surgery-via-median-sternotomy-study-protocol-for-a-randomised-controlled-trial
#6
Md Ali Katijjahbe, Linda Denehy, Catherine L Granger, Alistair Royse, Colin Royse, Rebecca Bates, Sarah Logie, Sandy Clarke, Doa El-Ansary
BACKGROUND: The routine implementation of sternal precautions to prevent sternal complications that restrict the use of the upper limbs is currently worldwide practice following a median sternotomy. However, evidence is limited and drawn primarily from cadaver studies and orthopaedic research. Sternal precautions may delay recovery, prolong hospital discharge and be overly restrictive. Recent research has shown that upper limb exercise reduces post-operative sternal pain and results in minimal micromotion between the sternal edges as measured by ultrasound...
June 23, 2017: Trials
https://www.readbyqxmd.com/read/28645181/the-clinical-benefits-of-perioperative-antioxidant-vitamin-therapy-in-patients-undergoing-cardiac-surgery-a-meta-analysis
#7
Jun Geng, Ju Qian, Weijun Si, Hao Cheng, Fuhai Ji, Zhenya Shen
The clinical benefits of perioperative antioxidant vitamin therapy in cardiac patients remain controversial. Here, we conducted a meta-analysis to determine the strength of the evidence supporting the perioperative use of antioxidant vitamins in patients undergoing cardiac surgery. We searched 4 databases (PubMed, EMBASE, Science Citation Index and Cochrane Library) for randomized controlled trials that reported the effects of antioxidant vitamin therapy on patients undergoing cardiac surgery until 6 June 2016...
June 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28645011/transient-portal-venous-gas-associated-with-reversible-non-occlusive-mesenteric-ischemia-a-case-report
#8
Gaël Piton, Brice Paquette, Eric Delabrousse, Gilles Capellier
OBJECTIVES: To report the utility of abdominal ultrasonography (US) to identify the presence of portal venous gas (PVG) during non-occlusive mesenteric ischemia (NOMI), and to follow the disappearance of portal venous gas after resolution of the NOMI. DATA SOURCES: This was a clinical observation of a patient, with images of abdominal computed tomography (CT), and a video of portal venous gas identified by ultrasonography. DATA SYNTHESIS: We describe the case of an adult patient admitted to our ICU for NOMI developing 48h after cardiac surgery...
June 16, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28644591/a-heart-for-travel-travel-health-considerations-for-patients-with-heart-disease-and-cardiac-devices
#9
G Flaherty, S De Freitas
Cardiovascular disease is the leading cause of death in adult international travellers. Patients living with heart disease should receive specific, individualised pre-travel health advice. The purpose of this article is to provide evidence-based advice to physicians who are consulted by travellers with cardiovascular disease. Fitness-to-travel evaluation will often be conducted by the general practitioner but other medical specialists may also be consulted for advice. Patients with chronic medical conditions should purchase travel health insurance...
December 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28644091/prevention-of-cardiovascular-disease-in-patients-with-familial-hypercholesterolaemia-the-role-of-pcsk9-inhibitors
#10
Ivan Pećin, Merel L Hartgers, G Kees Hovingh, Ricardo Dent, Željko Reiner
Familial hypercholesterolaemia is an autosomal dominant inherited disorder characterised by elevated low-density lipoprotein cholesterol levels and consequently an increased risk of atherosclerotic cardiovascular disease (ASCVD). Familial hypercholesterolaemia is relatively common, but is often underdiagnosed and undertreated. Cardiologists are likely to encounter many individuals with familial hypercholesterolaemia; however, patients presenting with premature ASCVD are rarely screened for familial hypercholesterolaemia and fasting lipid levels are infrequently documented...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#11
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28643745/adjuvant-hypofractionated-radiation-in-carcinoma-breast-photon-versus-electron-comparison-of-treatment-outcome
#12
G Prameela Chelakkot, Rahul Ravind, K Sruthi, Namrata Chigurupati, Sanketh Kotne, Raghavendra Holla, Ram Madhavan, M Dinesh
BACKGROUND: Breast cancer tissue is sensitive to hypofractionation. This is an analysis of patients treated with hypofractionated protocols since 2009, at our tertiary cancer center. METHODS: Details of breast cancer patients treated with adjuvant hypofractionated external beam radiation therapy (EBRT) from January 2009 to December 2014 were retrieved and analyzed. RESULTS: One thousand seven hundred and eighty patients received adjuvant EBRT during this period...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28643322/difficulties-in-funding-of-va-ecmo-therapy-for-patients-with-severe-accidental-hypothermia
#13
Sylweriusz Kosiński, Tomasz Darocha, Anna Jarosz, Aleksandra Czerw, Paweł Podsiadło, Tomasz Sanak, Robert Gałązkowski, Jacek Piątek, Janusz Konstanty-Kalandyk, Mirosław Ziętkiewicz, Krzysztof Kusza, Łukasz J Krzych, Rafał Drwiła
BACKGROUND: Severe accidental hypothermia is defined as a core temperature below 28 Celsius degrees. Within the last years, the issue of accidental hypothermia and accompanying cardiac arrest has been broadly discussed and European Resuscitation Council (ERC) Guidelines underline the importance of Extracorporeal Rewarming (ECR) in treatment of severely hypothermic victims. The study aimed to evaluate the actual costs of ECR with VA-ECMO and of further management in the Intensive Care Unit of patients admitted to the Severe Accidental Hypothermia Centre in Cracow, Poland...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28642833/creating-a-biomarker-panel-for-early-detection-of-chemotherapy-related-cardiac-dysfunction-in-breast-cancer-patients
#14
Krithika Srikanthan, Rebecca Klug, Maria Tirona, Ellen Thompson, Haresh Visweshwar, Nitin Puri, Joseph Shapiro, Komal Sodhi
Cardiotoxicity is an important issue for breast cancer patients receiving anthracycline-trastuzumab therapy in the adjuvant setting. Studies show that 3-36% of patients receiving anthracyclines and/or trastuzumab experience chemotherapy related cardiac dysfunction (CRCD) and approximately 17% of patients must stop chemotherapy due to the consequences of CRCD. There is currently no standardized, clinically verified way to detect CRCD early, but common practices include serial echocardiography and troponin measurements, which can be timely, costly, and not always available in areas where health care resources are scarce...
March 2017: Journal of Clinical & Experimental Cardiology
https://www.readbyqxmd.com/read/28641827/isoflurane-and-the-coronary-steal-controversy-of-the-1980s-origin-resolution-and-legacy
#15
George J Crystal
Isoflurane was introduced for general clinical use in North America in 1981. Shortly thereafter, in 1983, a study suggested that the anesthetic was a potent coronary vasodilator that could cause coronary steal and myocardial ischemia in patients with coronary artery disease. Myocardial ischemia results from small-vessel dilation which leads to increased blood flow to well-perfused myocardium and decreased blood flow to myocardium with borderline perfusion. This action of isoflurane raised concerns and threatened its use...
April 2017: Journal of Anesthesia History
https://www.readbyqxmd.com/read/28640768/perceptions-of-cardiology-administrators-about-cardiac-rehabilitation-in-south-america-and-the-caribbean
#16
Gabriela Lima de Melo Ghisi, Raquel Britto, Thaianne Cavalcante Servio, Claudia Victoria Anchique Santos, Rosalia Fernandez, Eduardo Rivas-Estany, Claudio Santibañez, Graciela Gonzalez, Gerard Burdiat, Francisco Lopez-Jimenez, Artur Haddad Herdy, Sherry L Grace
BACKGROUND: Cardiac rehabilitation (CR) programs can address the cardiovascular disease epidemic in South America. However, there are factors limiting CR access at the patient, provider, and system levels. The latter 2 have not been extensively studied. The objective of this study was to investigate cardiology administrator's awareness and knowledge of CR and perceptions regarding resources for CR. METHODS: This study was cross-sectional and observational in design...
July 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28640510/paediatric-intensive-care-nurses-decision-making-around-gastric-residual-volume-measurement
#17
Lyvonne N Tume, Lynne Latten, Lindsay Kenworthy
BACKGROUND: Measuring gastric residual volume (GRV) to guide enteral feeding is a common nursing practice in intensive care units, yet little evidence supports this practice. In addition, this practice has been shown to potentially contribute to inadequate energy delivery in intensive care, which remains a problem in critically ill children. AIMS: We aimed to explore paediatric intensive care nurses' decision-making surrounding this practice. METHODS: This is a cross-sectional electronic survey in a single mixed general and cardiac surgical PICU in the UK...
June 22, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28640019/mini-fluid-challenge-of-100-ml-of-crystalloid-predicts-fluid-responsiveness-in-the-operating-room
#18
Matthieu Biais, Hugues de Courson, Romain Lanchon, Bruno Pereira, Guillaume Bardonneau, Marion Griton, Musa Sesay, Karine Nouette-Gaulain
BACKGROUND: Mini-fluid challenge of 100 ml colloids is thought to predict the effects of larger amounts of fluid (500 ml) in intensive care units. This study sought to determine whether a low quantity of crystalloid (50 and 100 ml) could predict the effects of 250 ml crystalloid in mechanically ventilated patients in the operating room. METHODS: A total of 44 mechanically ventilated patients undergoing neurosurgery were included. Volume expansion (250 ml saline 0...
June 21, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28639987/antithrombotic-strategies-in-the-catheterization-laboratory-for-patients-with-acute-coronary-syndromes-undergoing-percutaneous-coronary-interventions-insights-from-the-employed-antithrombotic-therapies-in-patients-with-acute-coronary-syndromes-hospitalized
#19
Leonardo De Luca, Giuseppe Musumeci, Sergio Leonardi, Lucio Gonzini, Claudio Cavallini, Paolo Calabrò, Ciro Mauro, Luisa Cacciavillani, Stefano Savonitto, Stefano De Servi
AIMS: In the last decades, several new therapies have emerged for the treatment of acute coronary syndromes (ACS). We sought to describe real-world patterns of use of antithrombotic treatments in the catheterization laboratory for ACS patients undergoing percutaneous coronary interventions (PCI). METHODS: EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in ACS patients in Italy...
July 20, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28639730/evaluation-of-thoracic-radiographs-as-a-screening-test-for-dogs-and-cats-admitted-to-a-tertiary-care-veterinary-hospital-for-noncardiopulmonary-disease
#20
Christine L Keyserling, Yekaterina Buriko, Bridget M Lyons, Kenneth J Drobatz, Anthony J Fischetti
Thoracic radiographs are used as a screening tool for dogs and cats with a variety of disorders that have no clinical signs associated with thoracic structures. However, this practice has never been supported by an evidence-based study. The objective of this retrospective observational study was to determine if certain canine and feline populations have a higher proportion of radiographic abnormalities, and whether any of these abnormalities are associated with patient hospitalization and outcome. Patients were excluded if current or previous examinations revealed evidence of primary respiratory or cardiac disease, malignant neoplasia, or an abnormal breathing pattern consistent with pulmonary pathology...
June 22, 2017: Veterinary Radiology & Ultrasound
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