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https://www.readbyqxmd.com/read/28821512/protocol-for-an-economic-evaluation-of-the-randomised-controlled-trial-of-culprit-lesion-only-pci-versus-immediate-multivessel-pci-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock-culprit-shock-trial
#1
Zahidul Quayyum, Andrew Briggs, Jose Robles-Zurita, Keith Oldroyd, Uwe Zeymer, Steffen Desch, Suzanne de Waha, Holger Thiele
INTRODUCTION: Emergency percutaneous coronary intervention (PCI) of the culprit lesion for patients with acute myocardial infarctions is an accepted practice. A majority of patients present with multivessel disease with additional relevant stenoses apart from the culprit lesion. In haemodynamically stable patients, there is increasing evidence from randomised trials to support the practice of immediate complete revascularisation. However, in the presence of cardiogenic shock, the optimal management strategy for additional non-culprit lesions is unknown...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28818854/nasal-midazolam-vs-ketamine-for-neonatal-intubation-in-the-delivery-room-a-randomised-trial
#2
Christophe Milési, Julien Baleine, Thibault Mura, Fernando Benito-Castro, Félicie Ferragu, Gérard Thiriez, Pierre Thévenot, Clémentine Combes, Ricardo Carbajal, Gilles Cambonie
OBJECTIVE: To compare the effectiveness of sedation by intranasal administration of midazolam (nMDZ) or ketamine (nKTM) for neonatal intubation. DESIGN: A multicentre, prospective, randomised, double-blind study. SETTING: Delivery rooms at four tertiary perinatal centres in France. PATIENTS: Preterm neonates with respiratory distress requiring non-emergent endotracheal intubation for surfactant instillation. INTERVENTIONS: Treatment was randomly allocated, with each neonate receiving a bolus of 0...
August 17, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28818853/interobserver-agreement-and-image-quality-of-functional-cardiac-ultrasound-measures-used-in-a-randomised-trial-of-delayed-cord-clamping-in-preterm-infants
#3
Himanshu Popat, Kristy P Robledo, Lucille Sebastian, Nicholas Evans, Andrew Gill, Martin Kluckow, Sanjay Sinhal, Koert de Waal, William Tarnow-Mordi, David Osborn
OBJECTIVE: Functional cardiac ultrasound measures are used clinically and in trials for assessing the haemodynamic status of newborn infants. Superior vena cava (SVC) flow and right ventricular output (RVO) are established measures of systemic blood flow on the first postnatal day. The objective was to assess image quality and interobserver agreement of these measures in preterm infants enrolled in a randomised trial of immediate versus delayed cord clamping. DESIGN AND SETTING: Image quality and interobserver agreement for SVC flow, RVO and ductus arteriosus (DA) size were assessed on measurements taken at 3-6, 6-12 and 20-28 hours for the first 10 infants enrolled at each of four sites (total 40)...
August 17, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28818667/endoconduits-with-pave-and-crack-technique-avoid-open-ilio-femoral-conduits-with-sustainable-mid-term-results
#4
G Asciutto, M Aronici, T Resch, B Sonesson, T Kristmundsson, N V Dias
OBJECTIVE/BACKGROUND: The objective was to evaluate the feasibility and mid-term outcomes of endoconduits (EC) with the "pave and crack" technique during endovascular aneurysm repair (EVAR) of varying complexity. METHODS: This was a retrospective study. All patients undergoing EC between July 2009 and October 2015 were included. The primary endpoint was technical success of the EC defined as the ability to successfully deliver the aortic stent graft through the EC without rupture, dissection, or thrombosis of the iliac or femoral arteries, and with the absence of haemodynamically significant blood loss related to the EC...
August 14, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28817484/levosimendan-in-acute-and-advanced-heart-failure-an-appraisal-of-the-clinical-database-and-evaluation-of-its-therapeutic-applications
#5
J Altenberger, F Gustafsson, V-P Harjola, K Karason, D Kindgen-Milles, M Kivikko, G Malfatto, Z Papp, J Parissis, P Pollesello, G Pölzl, C Tschöpe
The use of inotropes for correcting haemodynamic dysfunction in patients with congestive heart failure has been described over many decades. However, negative or insufficient data have been collected regarding the effects of cardiac glycosides, catecholamines and phosphodiesterase inhibitors on quality of life and survival. More recently, the calcium sensitizer and potassium channel-opener levosimendan has been proposed as a safer inodilator than traditional agents in some heart failure settings, such as Advanced Heart Failure...
August 15, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28817465/new-insights-into-the-recognition-classification-and-management-of-systemic-sclerosis-associated-pulmonary-hypertension
#6
Christopher J Mullin, Stephen C Mathai
PURPOSE OF REVIEW: Pulmonary hypertension is a common complication of systemic sclerosis (SSc), and remains a leading cause of morbidity and mortality. We will review recent developments in the recognition, classification and treatment of pulmonary hypertension in SSc. RECENT FINDINGS: Advances in screening for pulmonary arterial hypertension (PAH) and use of exercise haemodynamics may help to identify pulmonary vascular disease earlier in SSc. Recent studies have led to changes in recommendations for adjunct therapy and selection of pulmonary vasodilators for the treatment of SSc-associated PAH...
August 16, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28814580/ventrain-from-theory-to-practice-bridging-until-re-tracheostomy
#7
Bianca Maria Wahlen, Hassan Al-Thani, Ayman El-Menyar
Imminent upper airway obstruction due to life-threatening tracheal stenosis of any cause is challenging. A 77-year-old woman, with a history of temporal tracheostomy for prolonged mechanical ventilation, presented with life-threatening tracheal stenosis to the emergency department. After failed intubation with a 5.0 mm internal diameter endotracheal tube, the patient was ventilated via a tube exchanger using Ventrain. Ventrain is a manual ventilation device that, in addition to oxygen supply during inspiration, initiates expiration by actively removing gas from the lungs by suction...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28811127/attenuation-of-sunitinib-induced-cardiotoxicity-through-the-a3-adenosine-receptor-activation
#8
Hardip Sandhu, Samantha Cooper, Afthab Hussain, Christopher Mee, Helen Maddock
Sunitinib is an anti-cancer tyrosine kinase inhibitor associated with severe cardiotoxic adverse effects. Using rat Langendorff heart model and human acute myeloid leukemia 60 (HL60) cell line we detected the involvement of protein kinase C (PKC) α during Sunitinib-induced cardiotoxicity and the effect of Sunitinib on cancer progression. The cardioprotective and anti-cancer properties of the A3 adenosine receptor agonist 2-chloro-N6-(3-iodobenzyl)-adenosine-5'-N-methyluronamide (IB-MECA) were investigated...
August 12, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28803272/inpatient-monitoring-of-decompensated-heart-failure-what-is-needed
#9
REVIEW
Danish Ali, Prithwish Banerjee
PURPOSE OF REVIEW: Acute decompensated heart failure is a serious and common condition where close monitoring of symptoms, vital signs, haemodynamic and other markers are needed after the patient is admitted to hospital as the in-hospital outcome is poor. This review focuses on advances in the assessment and monitoring of these patients. RECENT FINDINGS: The adoption of the CHAMP acronym to identify precipitating factors and of the classification using wet-warm, wet-cold, dry-warm and dry-cold categories is an improvement regarding assessment...
August 12, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28801346/pan-ppar-agonist-iva337-is-effective-in-experimental-lung-fibrosis-and-pulmonary-hypertension
#10
Jerome Avouac, Irena Konstantinova, Christophe Guignabert, Sonia Pezet, Jeremy Sadoine, Thomas Guilbert, Anne Cauvet, Ly Tu, Jean-Michel Luccarini, Jean-Louis Junien, Pierre Broqua, Yannick Allanore
OBJECTIVE: To evaluate the antifibrotic effects of the pan-peroxisome proliferator-activated receptor (PPAR) agonist IVA337 in preclinical mouse models of pulmonary fibrosis and related pulmonary hypertension (PH). METHODS: IVA337 has been evaluated in the mouse model of bleomycin-induced pulmonary fibrosis and in Fra-2 transgenic mice, this latter being characterised by non-specific interstitial pneumonia and severe vascular remodelling of pulmonary arteries leading to PH...
August 11, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28801175/mdma-and-brain-activity-during-neurocognitive-performance-an-overview-of-neuroimaging-studies-with-abstinent-ecstasy-users
#11
REVIEW
C A Roberts, B B Quednow, C Montgomery, A C Parrott
MDMA/Ecstasy has had a resurgence in popularity, with recent supplies comprising higher strength MDMA, potentially leading to increased drug-related harm. Neurocognitive problems have been widely reported in ecstasy users, equally some studies report null findings, and it remains unclear which factors underlie the development of neurocognitive impairments. This review covers the empirical research into brain activity during neurocognitive performance, using fMRI, fNIRS, and EEG. Our main conclusion is that chronic repeated use of recreational ecstasy can result in haemodynamic and electrophysiological changes that reflect recruitment of additional resources to perform cognitive tasks...
August 8, 2017: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/28799521/transcatheter-mitral-valve-replacement-long-term-outcomes-of-first-in-man-experience-with-an-apically-tethered-device-a-case-series-from-a-single-centre
#12
Alison Duncan, Anan Daqa, James Yeh, Simon Davies, Anselm Uebing, Cesare Quarto, Neil Moat
AIMS: Transcatheter mitral valve replacement (TMVR) is a novel technique for treating mitral regurgitation. We report 18-month/2-year outcomes of the 5 first-in-man patients undergoing chronic TMVR with the Tendyne device. METHODS AND RESULTS: Five patients (STS score 14%-23%) underwent TMVR using a Tendyne system under compassionate use at a single centre. 1 patient (who was noncompliant with anti-coagulation) died 9 months after TMVR following a cerebrovascular accident...
August 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28797555/to-log-roll-or-not-to-log-roll-that-is-the-question-a-review-of-the-use-of-the-log-roll-for-patients-with-pelvic-fractures
#13
REVIEW
Inês Filipa da Cunha Rodrigues
Pelvic fractures are one of the most serious injuries in polytrauma - massive haemorrhage is a major complication and the leading cause of death. The assessment and early management of these injuries in the Emergency Department (ED) focuses on the recognition of haemodynamic instability and should follow Advanced Trauma Life Support (ATLS) guidelines. The log-roll technique, although an accepted practice in trauma care, has been reported to be inadvisable when a pelvic fracture is suspected. This paper, which includes a case study, briefly explains the pathophysiology and initial management of pelvic fractures...
May 10, 2017: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28796601/time-dependent-behavior-of-microvascular-blood-flow-and-oxygenation-a-predictor-of-functional-outcomes
#14
Kasia Z Kuliga, Rodney Gush, Geraldine F Clough, Andrew J Chipperfield
OBJECTIVE: This study investigates the time-dependent behaviour and algorithmic complexity of low frequency, periodic oscillations in blood flux and oxygenation signals from the microvasculature. METHODS: Microvascular blood flux (BF) and oxygenation (OXY: oxyHb, deoxyHb, totalHb and SO2%) was recorded from 15 healthy young adult males using combined laser Doppler fluximetry and white light spectroscopy with local skin temperature clamped to 33C and during local thermal hyperaemia (LTH) at 43C...
August 7, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28796394/maternal-haemodynamics-in-normal-pregnancies-and-in-pregnancies-affected-by-pre-eclampsia
#15
Daniel Stott, Obianuju Nzelu, Kypros H Nicolaides, Nikos A Kametas
OBJECTIVES: To determine if in a high risk group in the first half of pregnancy, women who developed pre-eclampsia (PE) with fetal growth restriction (PE-FGR) demonstrate distinct haemodynamics compared to those with PE in the absence of FGR (PE-only). METHODS: Cardiac output (CO), peripheral vascular resistance (PVR) and mean arterial pressure (MAP) were measured at the first hospital visit at 9-24 weeks' gestation in 69 women who had chronic hypertension and 67 who had a hypertensive disorder in a previous pregnancy...
August 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28794530/retrospective-analysis-of-post-operative-coagulopathy-after-major-hepatic-resection-at-a-tertiary-care-centre-in-northern-india
#16
Shweta A Singh, P Vivekananthan, Ankur Sharma, Sandeep Sharma, Kishore Gs Bharathy
BACKGROUND AND AIMS: Hepatic resection is a major surgery associated with intraoperative massive fluid shifts, blood loss, haemodynamic instability and risk of development of post-hepatectomy liver failure. Hepatic resection predisposes the patient to coagulopathy as well as venous thrombosis. However, due to the development of deranged coagulation profile post-operatively, there is a dilemma in starting thromboprophylaxis. Our aim in this study was to determine the incidence of coagulopathy in patients undergoing major hepatectomy...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28794527/the-effect-of-addition-of-dexamethasone-to-levobupivacaine-in-parturients-receiving-combined-spinal-epidural-for-analgesia-for-vaginal-delivery
#17
Amr Samir Wahdan, Ahmed Ibrahim El-Sakka, Hassan Mostafa Ismail Gaafar
BACKGROUND AND AIMS: Regional analgesia is commonly used for the relief of labour pain, Prolongation of analgesia can be achieved by adjuvant medications. The aim of this randomised controlled trial was to evaluate the efficacy of intrathecal levobupivacaine with dexamethasone for labour analgesia. METHODS: A total of 80 females were included in this study, all were primigravidas undergoing vaginal delivery with cervical dilatation ≥4 cm and 50% or more effacement...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28793036/effect-of-mild-hypothermia-on-renal-ischemia-reperfusion-injury-after-cardiopulmonary-resuscitation-in-a-swine-model
#18
Wei Yuan, Jun-Yuan Wu, Yong-Zhen Zhao, Jie Li, Jie-Bin Li, Zhen-Hua Li, Chun-Sheng Li
Purpose: To investigate the effect of intravascular cooling on renal function after resuscitation. Methods: Twenty four pigs were randomized into three groups (n=8 in each group): therapeutic hypothermia group (TH group), normothermia group (NH group) and sham operation group (SHAM group). After 6 minutes of untreated VF, CPR was performed. Upon ROSC, the TH group received the intravascular cooling. The NH and SHAM group did not undergo therapeutic hypothermia. Haemodynamic parameters were recorded...
July 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28792230/exercise-capacity-and-haemodynamic-response-among-12-327-individuals-with-cardio-metabolic-risk-factors-undergoing-treadmill-exercise
#19
Christina Chrysohoou, John Skoumas, Georgios Georgiopoulos, Catherine Liontou, Georgia Vogiatzi, Konstantinos Tsioufis, Stamatios Lerakis, Dimitrios Soulis, Christos Pitsavos, Dimitris Tousoulis
Aims Haemodynamic parameters during and after exercise test seem to have a role in predicting cardiovascular events. We sought to evaluate the potential different responses in exercise capacity, heart rate and blood pressure levels in relation to major cardiovascular disease risk factors, among individuals undergoing exercise tolerance testing. Methods and results Consecutive individuals ( N = 12,327), aged 55 ± 11.8 years, underwent exercise tolerance testing, using the Bruce protocol. Obese participants showed higher values of peak systolic and diastolic blood pressure ( p < 0...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28790101/splenic-rupture-following-synchronised-direct-current-cardioversion
#20
Nicholas Kaufman, David Ferraro
Atraumatic rupture of the normal spleen is a rare entity. Often, a triggering factor or minor physical event can be ascribed as the aetiology for rupture, including coughing, vomiting or minor medical procedures not involving the spleen. A 65-year-old man who was hospitalised for eosinophilic pneumonia developed haemodynamically unstable atrial flutter that necessitated urgent synchronised direct current cardioversion (DCCV). Two hours after successful cardioversion, he developed signs of an acute abdomen with free intraperitoneal fluid identified on bedside ultrasonography...
August 7, 2017: BMJ Case Reports
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