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https://www.readbyqxmd.com/read/29145510/out-of-hospital-cardiac-arrests-in-switzerland-predictors-for-emergency-department-mortality-in-patients-with-rosc-or-on-going-cpr-on-admission-to-the-emergency-department
#1
Thomas C Sauter, Nora Iten, Patrik R Schwab, Wolf E Hautz, Meret E Ricklin, Aristomenis K Exadaktylos
BACKGROUND: One of the leading causes of death is out-of-hospital cardiac arrest (OHCA) with an in-hospital mortality of about 70%. To identify predictors for the high mortality of OHCA patients and especially for women, that are considered at high risk for in-hospital mortality, we evaluated one specific setting of in-hospital treatment after OHCA: the emergency department (ED). METHODS: Retrospective analysis of consecutive ED admissions with OHCA at the Inselspital Bern, Switzerland from 1st June 2012 to 31th Mai 2015...
2017: PloS One
https://www.readbyqxmd.com/read/29145433/maternal-folic-acid-supplementation-and-dietary-folate-intake-and-congenital-heart-defects
#2
Baohong Mao, Jie Qiu, Nan Zhao, Yawen Shao, Wei Dai, Xiaochun He, Hongmei Cui, Xiaojuan Lin, Ling Lv, Zhongfeng Tang, Sijuan Xu, Huang Huang, Min Zhou, Xiaoying Xu, Weitao Qiu, Qing Liu, Yawei Zhang
BACKGROUND: It has been reported that folic acid supplementation before and/or during pregnancy could reduce the risk of congenital heart defects (CHDs). However, the results from limited epidemiologic studies have been inconclusive. We investigated the associations between maternal folic acid supplementation, dietary folate intake, and the risk of CHDs. METHODS: A birth cohort study was conducted in 2010-2012 at the Gansu Provincial Maternity & Child Care Hospital in Lanzhou, China...
2017: PloS One
https://www.readbyqxmd.com/read/29144182/plasma-lyte-148-vs-hartmann-s-solution-for-cardiopulmonary-bypass-pump-prime-a-prospective-double-blind-randomized-trial
#3
Laurence Weinberg, Elizabeth Chiam, James Hooper, Frank Liskaser, Angela Kim Hawkins, Denise Massie, Andrew Ellis, Chong O Tan, David Story, Rinaldo Bellomo
BACKGROUND: The mechanisms of acid-base changes during cardiopulmonary bypass (CPB) remain unclear. We tested the hypothesis that, when used as CPB pump prime solutions, Plasma-Lyte 148 (PL) and Hartmann's solution (HS) have differential mechanisms of action in their contribution to acid-base changes. METHODS: We performed a prospective, double-blind, randomized trial in adult patients undergoing elective cardiac surgery with CPB. Participants received a CPB prime solution of 2000 mL, with either PL or HS...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29142955/improving-the-prediction-of-cardiac-surgery-associated-acute-kidney-injury
#4
Jordan Crosina, Jordyn Lerner, Julie Ho, Navdeep Tangri, Paul Komenda, Brett Hiebert, Nora Choi, Rakesh C Arora, Claudio Rigatto
Introduction: Acute kidney injury (AKI) is a potentially fatal complication of cardiac surgery. The inability to predict cardiac surgery-associated AKI is a major barrier to prevention and early treatment. Current clinical risk models for the prediction of cardiac surgery-associated AKI are insufficient, particularly in patients with preexisting kidney dysfunction. Methods: To identify intraoperative variables that might improve the performance of a validated clinical risk score (Cleveland Clinic Score, CCS) for the prediction of cardiac surgery-associated AKI, we conducted a prospective cohort study in 289 consecutive elective cardiac surgery patients at a tertiary care center...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29141770/outcomes-following-changing-from-a-two-tiered-to-a-three-tiered-hospital-rapid-response-system
#5
Winston Cheung
Objectives The aim of the present study was to determine whether changing a hospital rapid response system (RRS) from a two-tiered to a three-tiered model can reduce disruption to normal hospital routines while maintaining the same overall patient outcomes.Methods Staff at an Australian teaching hospital attending medical emergency team and cardiac arrest (MET/CA) calls were interviewed after the RRS was changed from a two-tiered to three-tiered model, and the results were compared with a study using the same methods conducted before the change...
November 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29140555/withdrawn-electrical-cardioversion-for-atrial-fibrillation-and-flutter
#6
REVIEW
Gillian E Mead, Andrew Elder, Andrew D Flapan, John Cordina
BACKGROUND: Atrial fibrillation increases stroke risk and adversely affects cardiovascular haemodynamics. Electrical cardioversion may, by restoring sinus rhythm, improve cardiovascular haemodynamics, reduce the risk of stroke, and obviate the need for long-term anticoagulation. OBJECTIVES: To assess the effects of electrical cardioversion of atrial fibrillation or flutter on the risk of thromboembolic events, strokes and mortality (primary outcomes), the rate of cognitive decline, quality of life, the use of anticoagulants and the risk of re-hospitalisation (secondary outcomes) in adults (>18 years)...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29139189/clostridium-difficile-infection-in-hospitalized-octogenarian-patients
#7
Anca Trifan, Irina Girleanu, Carol Stanciu, Egidia Miftode, Camelia Cojocariu, Ana-Maria Singeap, Catalin Sfarti, Stefan Chiriac, Tudor Cuciureanu, Oana Stoica
AIM: To evaluate the risk factors and outcome of Clostridium difficile infection in hospitalized octogenarian patients. METHODS: A retrospective analysis of risk factors and outcome of C. difficile infection in hospitalized octogenarians was carried out at two academic centers in Romania from January 2014 to September 2016. Demographic, clinical and laboratory characteristics; antibiotics and proton pump inhibitors use in-hospital and 2 months before admission; comorbidities; length of hospital stay; treatment; and outcome were carefully collected from the patients' medical charts and compared with those from octogenarians hospitalized during the same period...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29138662/st-segment-elevation-after-blunt-chest-trauma-myocardial-contusion-with-normal-coronary-arteries-or-myocardial-infarction-following-coronary-lesions
#8
Amine Ghalem, Hanane Boussir, Kamal Ahsayan, Nabila Ismaili, Noha El Ouafi
Cardiac lesions secondary to blunt chest trauma vary from insignificant arrhythmias to fatal cardiac rupture. Of these, a distinction remains difficult; face to ST-segment elevation on ECG with positive cardiac biomarkers, is it a myocardial contusion or a genuine myocardial infarction (MI) secondary to coronary lesions? We report the case of a patient admitted for multiple trauma. Initial assessment showed an ST segment elevation on ECG, along with multiple fractures and abdominal injuries. We would like to discuss, through this case, the similarities and the differences between myocardial infarction due to coronary lesions and myocardial contusion in a traumatic context, but also emphasize the difficulty of striking the right balance between thrombotic and bleeding risks in this situation, and insist on the importance of a multidisciplinary and collegial reflexion so we can offer these patients the best care there is...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29138293/icare-acs-improving-care-processes-for-patients-with-suspected-acute-coronary-syndrome-a-study-of-cross-system-implementation-of-a-national-clinical-pathway
#9
Martin P Than, John W Pickering, Jeremy M Dryden, Sally J Lord, S Andrew Aitken, Sally J Aldous, Kate E Allan, Michael W Ardagh, John W N Bonning, Rosie Callender, Laura R E Chapman, Jonathan P Christiansen, Andre P J Cromhout, Louise Cullen, Joanne M Deely, Gerard P Devlin, Katherine A Ferrier, Christopher M Florkowski, Christopher M A Frampton, Peter M George, Gregory J Hamilton, Allan S Jaffe, Andrew J Kerr, G Luke Larkin, Richard M Makower, Timothy J E Matthews, William A Parsonage, W Frank Peacock, Bradley F Peckler, Nicholaas C van Pelt, Louise Poynton, A Mark Richards, Anthony G Scott, Mark B Simmonds, David Smyth, Oliver P Thomas, Andrew C Y To, Stephen A Du Toit, Richard W Troughton, Kim M Yates
BACKGROUND : Efforts to safely reduce length of stay for emergency department patients with symptoms suggestive of acute coronary syndrome (ACS) have had mixed success. Few system-wide efforts affecting multiple hospital emergency departments have ever been evaluated. We evaluated the effectiveness of a nationwide implementation of clinical pathways for potential ACS in disparate hospitals. METHODS : This was a multicenter pragmatic stepped-wedge before-and-after trial in 7 New Zealand acute care hospitals with 31 332 patients investigated for suspected ACS with serial troponin measurements...
November 14, 2017: Circulation
https://www.readbyqxmd.com/read/29138292/impact-of-regionalization-of-st-elevation-myocardial-infarction-care-on-treatment-times-and-outcomes-for-emergency-medical-services-transported-patients-presenting-to-hospitals-with-percutaneous-coronary-intervention-mission-lifeline-accelerator-2
#10
James G Jollis, Hussein R Al-Khalidi, Mayme L Roettig, Peter B Berger, Claire C Corbett, Shannon Doerfler, Christopher B Fordyce, Timothy D Henry, Lori Hollowell, Zainab Magdon-Ismail, Ajar Kochar, James J McCarthy, Lisa Monk, Peter K O'Brien, Thomas D Rea, Jay Shavadia, Jacqueline Tamis-Holland, B Hadley Wilson, Khaled M Ziada, Christopher B Granger
Background: Regional variations in reperfusion times and mortality in patients with ST-segment elevation myocardial infarction (STEMI) are influenced by differences in coordinating care between emergency medical services (EMS) and hospitals. Building on the Accelerator-1 Project, we hypothesized that time to reperfusion could be further reduced with enhanced regional efforts. Methods: Between April 2015 and March 2017, we worked with 12 metropolitan regions across the United States with 132 PCI-capable hospitals and 946 EMS agencies...
November 14, 2017: Circulation
https://www.readbyqxmd.com/read/29137093/an-incidental-encounter-of-a-rare-high-take-off-right-coronary-artery-a-case-report
#11
Xicheng Deng, Peng Huang, Wenjuan Chen, Xiaohui Yang, Qianjun Liu, Yunbin Xiao, Cheng He
RATIONALE: High take-off of the coronary arteries is a rare cardiac anatomic anomaly, which may occur independently or with other congenital heart defects. In the clinical setting, it is noteworthy as a cause of sudden cardiac death. Further, it is vital to identify such anomalies to avoid intraoperative catastrophes in surgeries for congenital heart defects. PATIENT CONCERNS: A II/6 systolic heart murmur on physical examination was incidentally found in a 9-year-old boy; he was confirmed to have a secundum-type atrial septal defect on echocardiography...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137066/a-coronary-artery-fistula-having-connection-between-2-coronary-arteries-and-the-left-ventricle-a-case-report
#12
Chang-Yeon Kim, Ji Yong Choi, Kee Sik Kim
RATIONALE: Cases of coronary artery fistula having a connection with the cardiac cavity are rare. Here, we report a case in which 2 coronary arteries empty into the left ventricular cavity together. PATIENT CONCERNS: A 63-year-old woman who was diagnosed as having hypertension 20 years prior presented with dyspnea. DIAGNOSES: The coronary angiography revealed coronary artery fistula. INTERVENTIONS: Chest X-ray showed pulmonary edema...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137044/outcomes-of-percutaneous-coronary-intervention-in-patients-with-coronary-chronic-total-occlusions-with-versus-without-type-2-diabetes-mellitus-a-systematic-review-and-meta-analysis
#13
Qiang Wang, Hao Liu, Jiawang Ding
BACKGROUND: Nowadays, due to advanced techniques and well-trained interventionists in catheter labs, new scientific research has shown percutaneous coronary intervention (PCI) to be a safe treatment procedure in patients with chronic total occlusion (CTO). However, no study has systematically compared PCI outcomes in CTO patients with versus without type 2 diabetes mellitus (T2DM). Therefore, through this meta-analysis we aimed to systematically solve this issue. METHODS: Between September 2016 and June 2017, the Cochrane Database of Randomized Trials, EMBASE, and MEDLINE databases were carefully searched for publications comparing PCI outcomes in CTO patients with versus without T2DM...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137024/effect-of-different-surgical-type-of-coronary-artery-bypass-grafting-on-kidney-injury-a-propensity-score-analysis
#14
Ming-Jen Chan, Cheng-Chia Lee, Shao-Wei Chen, Feng-Chun Tsai, Pyng-Jing Lin, Pei-Chun Fan, Hsiang-Hao Hsu, Ming-Yang Chang, Yung-Chang Chen, Chih-Hsiang Chang
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with a less favorable outcome. Off-pump surgery results in lower kidney dysfunction than conventional on-pump arrest surgery. On-pump arrest surgery results in a lower revascularization rate compared with off-pump surgery. On-pump beating heart (OPBH) CABG combines the advantages of beating heart surgery and cardiopulmonary bypass. This study compared the renal outcomes of 3 cardiac surgical methods. From January 2010 to December 2012, 373 patients who underwent on-pump CABG were enrolled...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137017/prognostic-value-of-glucose-metabolism-for-non-st-segment-elevation-infarction-patients-with-diabetes-mellitus-and-single-concomitant-chronic-total-occlusion-following-primary-percutaneous-coronary-intervention
#15
Zhi Xing, Lei Zhang, Zhiqiang Liu, Pengyi He, Yuchun Yang, Muhuyati Wulasihan
Glucose metabolism status may play a predictive role in the severity of the complications among patients with type 2 diabetes mellitus (DM). However, few studies have focused on the prognostic value of glycosylated hemoglobin (HbA1c) and Homeostatic Model Assessment 2 for Insulin Resistance (HOMA2-IR) in patients with DM, non-ST-segment elevation infarction (NSTEMI), and single concomitant chronic total occlusion (CTO) following primary percutaneous coronary intervention (PCI). Short- and long-term prognostic value of HbA1c and HOMA2-IR in patients with DM with NSTEMI and single CTO who received primary percutaneous transluminal coronary intervention (pPCI)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136712/-long-term-outcome-and-prognostic-factors-in-pregnant-women-with-pulmonary-arterial-hypertension-associated-with-congenital-heart-disease
#16
Q T Ou, J K Lu, J Zhang, Y Chen, Q Li, J L Zhang
Objective: To investigate the perinatal outcome, risk factors and long-term outcome of pregnancy complicated with pulmonary arterial hypertension(PAH) and congenital heart diseases (CHD). Methods: Clinical data of 110 pregnant women who were diagnosed as PAH-CHD were retrospectively analyzed in the Department of Obstetrics and Gynecology and Surgical Intensive Care Unit at Beijing Anzhen Hospital from 2004 to 2013. The survival and treatment status were followed up. Results: 110 subjects consisted of 11 mild PAH, 33 moderate and 66 severe ones...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29136331/risk-factor-management-in-a-contemporary-australian-population-at-increased-cardiovascular-disease-risk
#17
D J Campbell, J M Coller, F F Gong, M McGrady, D L Prior, U Boffa, L Shiel, D Liew, R Wolfe, A J Owen, H Krum, C M Reid
BACKGROUND: Effective management of cardiovascular and chronic kidney disease risk factors offers longer, healthier lives and savings in health care. We examined risk factor management in participants of the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study, a self-selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. METHODS: Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years...
November 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29135751/perceptions-experiences-and-preferences-of-patients-receiving-a-clinician-s-touch-during-intimate-care-and-procedures-a-qualitative-systematic-review
#18
Chad O'Lynn, Adam Cooper, Lisa Blackwell
BACKGROUND: Clinical practice frequently involves the practitioner touching patients' bodies in areas that are highly personal. If inappropriately performed, such intimate touch may result in much anxiety, confusion and misinterpretation. Examination of evidence is necessary to guide practice in this area to mitigate risks and foster optimal clinician-patient relations and care. OBJECTIVES: The objective of this qualitative systematic review was to identify and synthesize findings on the perceptions, experiences and preferences of patients receiving a clinician's touch during intimate care and procedures INCLUSION CRITERIA TYPES OF PARTICIPANTS: The current review considered studies that included patients who had received a clinician's touch during intimate care and procedures...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#19
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135618/pathway-for-the-management-of-hyperglycemia-in-the-cardiac-care-unit
#20
Seyed Hamed Hosseini Dehkordi, Jeanine Albu, Emad F Aziz, Eyal Herzog
Inpatient hyperglycemia has been associated with increased morbidity and mortality in critically ill patients. Optimal control of blood glucose (BG) levels using insulin infusion protocols has been shown to improve clinical outcomes. Protocols have been developed to prescribe a safe and effective rate of insulin infusion for optimal control of BG levels; however, a major obstacle in their implementation is their complexity. We have revised and updated our previously published pathway for the management of hyperglycemia, which introduces the "wheel" concept for insulin dosing...
December 2017: Critical Pathways in Cardiology
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