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https://www.readbyqxmd.com/read/29685638/a-human-centered-approach-to-cv-care-infrastructure-development-in-uganda
#1
Christopher T Longenecker, Ankur Kalra, Emmy Okello, Peter Lwabi, John O Omagino, Cissy Kityo, Moses R Kamya, Allison R Webel, Daniel I Simon, Robert A Salata, Marco A Costa
In this case study, we describe an ongoing approach to develop sustainable acute and chronic cardiovascular care infrastructure in Uganda that involves patient and provider participation. Leveraging strong infrastructure for HIV/AIDS care delivery, University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University have partnered with U.S. and Ugandan collaborators to improve cardiovascular capabilities. The collaboration has solicited innovative solutions from patients and providers focusing on education and advanced training, penicillin supply, diagnostic strategy (e...
April 20, 2018: Global Heart
https://www.readbyqxmd.com/read/29629274/current-characteristics-of-dialysis-therapy-in-korea-2016-registry-data-focusing-on-diabetic-patients
#2
Dong-Chan Jin, Sung-Ro Yun, Seoung Woo Lee, Sang-Woong Han, Won Kim, Jongha Park, Yong-Kyun Kim
Diabetic nephropathy is the most frequent cause of end-stage renal disease worldwide. Dialysis patients with diabetes mellitus (DM) have more complications and shorter survival duration than non-DM dialysis patients, requiring more clinical attention and difficult management. The registry committee of the Korean Society of Nephrology has collected data about dialysis therapy in Korea through an on-line registry program and analyzed the characteristics of patients. A survey of dialysis patients in 2016 showed that 50...
March 2018: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29628189/development-of-a-congenital-cardiovascular-computed-tomography-imaging-registry-rationale-and-implementation
#3
B Kelly Han, Susan Casey, Dawn Witt, Jonathon Leipsic, Andrew Crean, Edward Nicol, Thomas Semple, James Shambrook, Ashwin Prakash, Puja Banka, Ross Garberich, Cynthia Rigsby, Anthony Hlavacek, John Lesser
BACKGROUND: The cumulative exposure and risk of anesthesia, vascular access, contrast agents and radiation is emerging as a significant lifelong burden in patients with congenital heart disease (CHD). Latest generation computerized tomographic (CT) scanners are increasingly used for high resolution cardiovascular imaging and have both hardware and post processing radiation dose reduction strategies that can be implemented. Currently, these dose reduction strategies are not uniformly applied and there is a large variability in radiation dose used for the performance of CT in CHD...
March 16, 2018: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29597214/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvement
#4
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29588811/effect-of-low-dose-aspirin-and-dipyridamole-on-primary-patency-of-arteriovenous-grafts-in-hemodialysis-patients-a-randomized-double-blind-placebo-controlled-trial
#5
Pouya Tayebi, Gholamhosein Kazemzadeh, Azin Banihashem, Hassan Ravari
Background: There is some evidence for the efficacy of antiplatelet therapies in increasing the vascular access patency duration or decreasing the thrombosis of arteriovenous grafts. Objective: To determine the effect of low dose aspirin and dipyridamole on primary patency of arteriovenous grafts in hemodialysis patients. Methods: This randomized, double-blind, placebo-controlled trial was done at Imam Reza Hospital in Mashhad, Iran from September 10, 2015 to July 05, 2016...
January 2018: Electronic Physician
https://www.readbyqxmd.com/read/29575678/impact-of-percutaneous-femoral-arteriotomy-closure-using-the-manta-tm-device-on-vascular-and-bleeding-complications-after-transcatheter-aortic-valve-replacement
#6
Rodney De Palma, Magnus Settergren, Andreas Rück, Rikard Linder, Nawzad Saleh
OBJECTIVES: To evaluate the feasibility of fully percutaneous closure using a novel collagen-based vascular closure device after transfemoral aortic valve replacement (TAVR). BACKGROUND: TAVR is utilized increasingly for the treatment of severe symptomatic aortic stenosis. Vascular complications related to access and closure dominate the adverse event profile of the procedure despite progressively reducing arteriotomy caliber. The advent of a novel collagen-based device (MANTATM ) and preliminary data suggest this could be used as a routine percutaneous closure device...
March 25, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29572627/functional-impairment-and-risk-of-mortality-in-patients-on-chronic-hemodialysis-results-of-the-lazio-dialysis-registry
#7
Maurizio Bossola, Claudia Marino, Anteo Di Napoli, Nera Agabiti, Luigi Tazza, Marina Davoli
BACKGROUND: Functional impairment is associated with adverse outcomes in older people, as well as in patients on chronic hemodialysis. The aim of this study was to evaluate if functional impairment represents a risk factor for reduced survival in patients on chronic hemodialysis. METHODS: All incident chronic hemodialysis patients of Lazio, a large region of central Italy, registered in the Dialysis and Transplant Lazio Region Registry (DTLRR) in the period 2008-2013 were considered eligible...
March 23, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29558570/vascular-access-specialist-teams-for-device-insertion-and-prevention-of-failure
#8
REVIEW
Peter J Carr, Niall S Higgins, Marie L Cooke, Gabor Mihala, Claire M Rickard
BACKGROUND: Most people admitted to hospitals worldwide require a vascular access device (VAD). Hundreds of millions of VADs are inserted annually in the USA with reports of over a billion peripheral intravenous catheters used annually worldwide. Numerous reports suggest that a team approach for the assessment, insertion, and maintenance of VADs improves clinical outcomes, the patient experience, and healthcare processes. OBJECTIVES: To compare the use of the vascular access specialist team (VAST) for VAD insertion and care to a generalist model approach for hospital or community participants requiring a VAD in terms of insertion success, device failure, and cost-effectiveness...
March 20, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29494777/prehospital-interventions-performed-on-pediatric-trauma-patients-in-iraq-and-afghanistan
#9
Steven G Schauer, Michael D April, Guyon J Hill, Jason F Naylor, Matthew A Borgman, Robert A De Lorenzo
BACKGROUND: United States (US) and coalition military medical units deployed to combat zones frequently encounter pediatric trauma patients. Pediatric patients may present unique challenges due to their anatomical and physiological characteristics and most military prehospital providers lack pediatric-specific training. A minimal amount of data exists to illuminate the prehospital care of pediatric patients in this environment. We describe the prehospital care of pediatric trauma patients in Iraq and Afghanistan...
March 1, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29473717/interventions-for-paracetamol-acetaminophen-overdose
#10
REVIEW
Angela L Chiew, Christian Gluud, Jesper Brok, Nick A Buckley
BACKGROUND: Paracetamol (acetaminophen) is the most widely used non-prescription analgesic in the world. Paracetamol is commonly taken in overdose either deliberately or unintentionally. In high-income countries, paracetamol toxicity is a common cause of acute liver injury. There are various interventions to treat paracetamol poisoning, depending on the clinical status of the person. These interventions include inhibiting the absorption of paracetamol from the gastrointestinal tract (decontamination), removal of paracetamol from the vascular system, and antidotes to prevent the formation of, or to detoxify, metabolites...
February 23, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29458366/inequity-in-dialysis-related-practices-and-outcomes-in-aotearoa-new-zealand-a-kaupapa-m%C3%A4-ori-analysis
#11
Tania Huria, Suetonia Palmer, Lutz Beckert, Jonathan Williman, Suzanne Pitama
BACKGROUND: In Aotearoa/New Zealand, Māori, as the indigenous people, experience chronic kidney disease at three times the rate of non-Māori, non-Pacific New Zealanders. Māori commence dialysis treatment for end-stage kidney disease at three times the rate of New Zealand European adults. To examine for evidence of inequity in dialysis-related incidence, treatment practices, and survival according to indigeneity in Aotearoa/New Zealand, utilising a Kaupapa Māori approach. METHODS: We conducted a retrospective cohort study involving adults who commenced treatment for end-stage kidney disease in Aotearoa/New Zealand between 2002 and 2011...
February 20, 2018: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29393606/choice-of-vascular-access-in-primary-pci
#12
Francesco Tomassini, Fabio Tarantino, Enrico Cerrato, Giorgio Quadri, Cristina Rolfo, Ferdinando Varbella
Primary angioplasty (PPCI), introduced in the early '90s, has now become the preferred reperfusion strategy in ST-segment elevation myocardial infarction (STEMI). PPCI has traditionally been performed through transfemoral artery access (TFA) for about two decades. Such an access, however, has been associated to a not negligible rate of vascular complications and bleedings that, in turn, may significantly affect the overall prognosis. For this reason, transradial artery access (TRA), introduced by Campeau and coll...
February 1, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29359497/adoption-of-the-transradial-approach-for-percutaneous-coronary-intervention-and-rates-of-vascular-complications-following-transfemoral-procedures-insights-from-ncdr
#13
Marwan Badri, Timothy Shapiro, Yongfei Wang, Karl E Minges, Jeptha P Curtis, William A Gray
OBJECTIVES: This study was designed to examine the association between adopting the transradial approach for percutaneous coronary intervention (PCI) and rates of vascular complications following transfemoral PCI. BACKGROUND: Recent studies raised concerns that operators adopting the transradial approach may lose their transfemoral access skills and experience increased rates of vascular complications. METHODS: Retrospective analysis of data from the NCDR CathPCI Registry to examine the rates of vascular complications among physicians who were femoral operators (>90% of cases) in 2010-2011 and later adopted the transradial approach to PCI among low-, intermediate-, or high-level adopters (≤33%, 34-66%, and >66%, respectively) in 2014-2015...
January 23, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29354172/transcatheter-aortic-valve-implantation-at-a-high-volume-center-the-bad-rothenfelde-experience
#14
Marek Kowalski, Cornelia Deutsch, Steffen Hofmann, Norbert Franz, Michael Billion, Abbas Ferdosi, Peter Bramlage, Guram Imnadze, Henning Warnecke
Introduction: The "transfemoral (TF) first" approach to access route selection in transcatheter aortic valve implantation (TAVI) is popular; however, the risk of major vascular complications is substantial. The "best for TF" approach identifies only the patients with ideal anatomy for TF-TAVI, potentially minimizing complications. Aim: To characterize the outcomes of patients undergoing TAVI at a large-volume site that employs this approach. Material and methods: Patients who underwent TAVI at the Bad Rothenfelde Heart Centre between 2008 and 2016 were consecutively enrolled...
December 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29333494/ensuring-adequate-vascular-access-in-patients-with-major-trauma-a-quality-improvement-initiative
#15
Kevin Verhoeff, Rachelle Saybel, Pamela Mathura, Bonnie Tsang, Vanessa Fawcett, Sandy Widder
Ensuring adequate vascular access in major trauma patients prior to decompensative physiological processes is crucial to patient outcomes. Most protocols suggest achieving two 18-gauge or larger intravenous lines immediately in patients with major trauma. We discuss a quality improvement approach to ensure that >90% of patients with major trauma (as defined by an injury severity score ≥12) at a level one trauma centre receive timely and adequate fluid access. Applying Donabedian principles for process improvement, we used the Alberta Trauma Registry to perform a 4-month chart audit on patients with major trauma at the University of Alberta Hospital...
2018: BMJ open quality
https://www.readbyqxmd.com/read/29321117/emergency-department-resuscitation-of-pediatric-trauma-patients-in-iraq-and-afghanistan
#16
Steven G Schauer, Guyon J Hill, Jason F Naylor, Michael D April, Matthew Borgman, Vikhyat S Bebarta
BACKGROUND: Military hospital healthcare providers treated children during the recent conflicts in Afghanistan and Iraq. Compared to adults, pediatric patients present unique challenges during trauma resuscitations and have notably been discussed in few research reports. We seek to describe ED interventions performed on pediatric trauma patients in Iraq and Afghanistan. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients in Iraq and Afghanistan from January 2007 to January 2016...
January 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29280551/predictors-of-patient-radiation-exposure-during-transcatheter-aortic-valve-replacement
#17
Andrew M Goldsweig, Kevin F Kennedy, Dhaval Kolte, J Dawn Abbott, Paul C Gordon, Barry L Sharaf, Frank W Sellke, Afshin Ehsan, Neel R Sodha, Frank Rutar, Herbert D Aronow
BACKGROUND: Transcatheter aortic valve replacement (TAVR) exposes patients to radiation. OBJECTIVES: We sought to identify factors associated with higher radiation exposure and to quantify their relative influence, which may inform reduction of this hazard. METHODS: All TAVR procedures at Rhode Island Hospital between March 20, 2012 and February 12, 2017 were included. Procedures were performed by two co-primary operators using a Siemens Artis Zeego system...
December 27, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29251207/perioperative-outcomes-from-the-prospective-multicenter-least-invasive-fast-track-evar-life-registry
#18
Zvonimir Krajcer, Venkatesh G Ramaiah, Esteban A Henao, D Chris Metzger, Wayne K Nelson, Mohammed M Moursi, Hiranya A Rajasinghe, Raed Al-Dallow, Larry E Miller
PURPOSE: To determine the feasibility, perioperative resource utilization, and safety of a fast-track endovascular aneurysm repair (EVAR) protocol in well-selected patients. METHODS: Between October 2014 and May 2016, the LIFE (Least Invasive Fast-track EVAR) registry ( ClinicalTrials.gov identifier NCT02224794) enrolled 250 patients (mean age 73±8 years; 208 men) in a fast-track EVAR protocol comprised of bilateral percutaneous access using the 14-F Ovation stent-graft, no general anesthesia, no intensive care unit (ICU) admission, and next-day discharge...
February 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29230568/ankle-brachial-pressure-index-as-a-predictor-of-the-2-year-outcome-after-transcatheter-aortic-valve-replacement-data-from-the-japanese-ocean-tavi-registry
#19
Masahiro Yamawaki, Motoharu Araki, Tsutomu Ito, Yosuke Honda, Takahiro Tokuda, Yoshiaki Ito, Hiroshi Ueno, Kazuki Mizutani, Minoru Tabata, Akihiro Higashimori, Norio Tada, Kensuke Takagi, Futoshi Yamanaka, Toru Naganuma, Yusuke Watanabe, Masanori Yamamoto, Shinichi Shirai, Kentaro Hayashida
Peripheral artery disease plays a pivotal role for access site selection in transcatheter aortic valve replacement (TAVR). Abnormal ankle-brachial index (ABI) is a generalized mortality marker in many cardiovascular scenarios. However, the long-term outcomes in high-risk TAVR populations remain unclear. We investigated the association between low ABI and 2-year outcome after TAVR. Of 1613 patients enrolled in the OCEAN-TAVI registry, 1458 (90.4%) who underwent ABI before TAVR were divided into groups: patients with (1) ABI ≥ 0...
December 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29192721/haemodialysis-vascular-access-current-practices-amongst-indian-nephrologists
#20
Dinesh Bansal, Vijay Kher, Krishan Lal Gupta, Debasish Banerjee, Vivekanand Jha
INTRODUCTION: Despite the growing number of haemodialysis (HD) patients in India, little is known about vascular access practice. We investigated the use and cost of different vascular accesses by Indian nephrologists. METHODS: An online survey was emailed to 920 Indian nephrologists and 388 (42.1%) responded; 98.5% of whom were responsible for managing dialysis patients, 98% in hospitals. RESULTS: Sixty-four percent of patients initiated renal replacement therapy with HD, 7% with peritoneal dialysis, 10% kidney transplantation and 19% conservative care...
November 25, 2017: Journal of Vascular Access
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