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https://www.readbyqxmd.com/read/28350939/the-advancing-role-of-neuromodulation-for-the-management-of-chronic-treatment-refractory-pain
#1
Mohammed F Shamji, Cecile De Vos, Ashwini Sharan
Neuropathic pain is a common cause of disability and health care utilization. While judicious pharmacotherapy and management of comorbid psychological distress can provide for improved quality of life, some patients with treatment-refractory disease require more invasive therapies. Spinal cord stimulation can provide for improvement in pain and decrease in medication utilization, with level 1 evidence supporting its use across various pain etiologies including persistent postoperative neuropathic pain, complex regional pain syndrome, chronic inoperable limb ischemia, treatment refractory angina, and painful diabetic neuropathy...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28342139/exploring-the-link-between-posttraumatic-stress-disorder-and-inflammation-related-medical-conditions-an-epidemiological-examination
#2
Jack Tsai, Jianxun Shen
There have been few epidemiological studies exploring the link between PTSD and inflammation using population-based samples. This study examined the relation between posttraumatic stress disorder (PTSD) and inflammation-related medical conditions using data from the 2013-2014 New York City Health and Nutrition Examination Survey. Using a representative sample of 1,527 residents in New York City, the association between PTSD and 17 inflammation-related medical conditions were examined. Bivariate and multivariable analyses were conducted, adjusting for demographic characteristics and lifetime depression...
March 25, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28339518/pain-interference-and-incident-medical-disorders-in-the-general-population
#3
Declan T Barry, Corey E Pilver Glenn, Rani A Hoff, Marc N Potenza
Objective. : To investigate the longitudinal relationship between pain interference and incident general medical conditions in a nationally representative sample. Methods. : Secondary data analysis comprising chi-square tests and binomial logistic regression analyses were performed on data obtained from the US National Epidemiologic Survey on Alcohol and Related Conditions from 34,465 adult respondents who completed wave 1 (2000-2001) and wave 2 (2004-2005) data collection...
October 20, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28296167/what-can-intracoronary-pressure-measurements-tell-us-about-flow-reserve-pressure-bounded-coronary-flow-reserve-and-example-application-to-the-randomized-defer-trial
#4
Frederik M Zimmermann, Nico H J Pijls, Bernard De Bruyne, G Jan-Willem Bech, Pepijn van Schaardenburgh, Richard L Kirkeeide, K Lance Gould, Nils P Johnson
OBJECTIVE: We propose a novel technique called pressure-bounded coronary flow reserve (pb-CFR) and demonstrate its application to the randomized DEFER trial. BACKGROUND: Intracoronary flow reserve assessment remains underutilized relative to pressure measurements partly due to less robust tools. METHODS: While rest and hyperemic intracoronary pressure measurements cannot quantify CFR exactly, they do provide upper and lower bounds. We validated pb-CFR invasively against traditional CFR, then applied it to high fractional flow reserve (FFR ≥ 0...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28274580/effect-of-part-time-cardiac-catheterization-facilities-in-patients-with-acute-myocardial-infarction
#5
Luciano Consuegra-Sánchez, Leticia Jaulent-Huertas, Marta Vicente-Gilabert, Ángela Díaz-Pastor, Germán Escudero-García, Nuria Alonso-Fernández, Francisco Javier Gil-Sánchez, Juan Martínez-Hernández, Juan Sanchis-Forés, José Galcerá-Tomás, Antonio Melgarejo-Moreno
BACKGROUND: Although the easy availability of invasive cardiac care facilities is associated with an increase in their use, their influence on outcomes is not clear. We sought to investigate whether a newly available cardiac catheterization laboratory (CCL) performing percutaneous coronary intervention (PCI) on a part-time (PT) basis might improve outcomes in patients with acute myocardial infarction (AMI). METHODS: This was an observational cohort study that included all consecutive patients with AMI admitted to a secondary-level hospital in Spain before and after the PT-CCL opened in January 2006: during 1998-2005 and 2006-2014, respectively...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28270107/incidence-of-cardiovascular-events-and-associated-risk-factors-in-kidney-transplant-patients-a-competing-risks-survival-analysis
#6
María Teresa Seoane-Pillado, Salvador Pita-Fernández, Francisco Valdés-Cañedo, Rocio Seijo-Bestilleiro, Sonia Pértega-Díaz, Constantino Fernández-Rivera, Ángel Alonso-Hernández, Cristina González-Martín, Vanesa Balboa-Barreiro
BACKGROUND: The high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality. The aim of this study is to determine the incidence of cardiovascular events and factors associated with cardiovascular events in these patients. METHODS: An observational ambispective follow-up study of renal transplant recipients (n = 2029) in the health district of A Coruña (Spain) during the period 1981-2011 was completed...
March 7, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28265967/acc-aats-aha-ase-asnc-scai-scct-sts-2016-appropriate-use-criteria-for-coronary-revascularization-in-patients-with-acute-coronary-syndromes-a-report-of-the-american-college-of-cardiology-appropriate-use-criteria-task-force-american-association-for-thoracic-surgery
#7
Manesh R Patel, John H Calhoon, Gregory J Dehmer, James Aaron Grantham, Thomas M Maddox, David J Maron, Peter K Smith
The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and American Association for Thoracic Surgery, along with key specialty and subspecialty societies, have completed a 2-part revision of the appropriate use criteria (AUC) for coronary revascularization. In prior coronary revascularization AUC documents, indications for revascularization in acute coronary syndromes (ACS) and stable ischemic heart disease were combined into 1 document. To address the expanding clinical indications for coronary revascularization, and in an effort to align the subject matter with the most current American College of Cardiology/American Heart Association guidelines, the new AUC for coronary artery revascularization were separated into 2 documents addressing ACS and stable ischemic heart disease individually...
March 6, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28264619/advancements-in-pharmacotherapy-for-angina
#8
REVIEW
Ankur Jain, Islam Y Elgendy, Mohammad Al-Ani, Nayan Agarwal, Carl J Pepine
Angina pectoris is the most prevalent symptomatic manifestation of ischemic heart disease, frequently leads to a poor quality of life, and is a major cause of medical resource consumption. Since the early descriptions of nitrite and nitrate in the 19(th) century, there has been considerable advancement in the pharmacologic management of angina. Areas covered: Management of chronic angina is often challenging for clinicians. Despite introduction of several pharmacological agents in last few decades, a significant proportion of patients continue to experience symptoms (i...
April 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28132542/-atypical-complaint-in-myocardial-ischaemia-belching
#9
Nóra Turi-Kováts, Hrisula Arabadzisz, András Zsoldos, János Tomcsányi
While educating non-medical personnel on acute coronary syndrome we often emphasize the importance of early recognition and urgent transfer to acute cardiac center of patients with acute myocardial infarction. Aside from typical symptoms of chest tightness and pain radiating to shoulder, arm and jaw, angina often presents with atypical, non-cardiac complaints. These symptoms, often suggesting gastrointestinal problems, can sometimes mislead even the most experienced physicians. We would like to present the case of an 83-year-old woman with several decades long history of ischaemic heart disease, who recently developed a new anginal symptom: lound, uncontrollable belching...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28129736/identification-of-new-biosignatures-for-clinical-outcomes-in-stable-coronary-artery-disease-the-study-protocol-and-initial-observations-of-a-prospective-follow-up-study-in-taiwan
#10
Hsin-Bang Leu, Wei-Hsian Yin, Wei-Kung Tseng, Yen-Wen Wu, Tsung-Hsien Lin, Hung-I Yeh, Kuan-Cheng Chang, Ji-Hung Wang, Chau-Chung Wu, Jaw-Wen Chen
BACKGROUND: Either classic or novel biomarkers have not been well investigated for clinical outcomes of coronary artery disease (CAD) in Asian people especially ethnic Chinese. We reported here a prospective national-based follow-up study that aims to elucidate the clinical profiles and to identify the new biosignatures (especially the non-lipid profile and inflammatory biomakers) for future clinical outcomes in a sizable cohort of stable CAD patients in Taiwan. METHODS: A total of 2500 CAD patients under stable condition after successful percutaneous coronary intervention will be enrolled for clinical data collection and blood/urine sampling in northern, southern, western, or eastern part of Taiwan between 2012 and 2017...
January 28, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27935738/the-coronary-sinus-reducer-clinical-evidence-and-technical-aspects
#11
REVIEW
Francesco Giannini, Andrea Aurelio, Richard J Jabbour, Luca Ferri, Antonio Colombo, Azeem Latib
Chronic refractory angina is often a disabling condition, predominantly due to severe obstructive coronary artery disease, that is inadequately controlled by optimal medical therapy and not amenable to further percutaneous or surgical revascularization. mortality rates associated with this condition are relatively low in clinically stable patients. however, it is associated with a high hospitalization rate and a reduction in both exercise capacity and quality of life. due to the paucity of available treatment options, there is an unmet need for new therapies for these patients and for a reduction in the associated economic healthcare burden...
January 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27903568/effects-of-transendocardial-delivery-of-bone-marrow-derived-cd133-cells-on-left-ventricle-perfusion-and-function-in-patients-with-refractory-angina-final-results-of-randomized-double-blinded-placebo-controlled-regent-vsel-trial
#12
Wojciech Wojakowski, Tomasz Jadczyk, Aleksandra Michalewska-Włudarczyk, Zofia Parma, Mirosław Markiewicz, Wojciech Rychlik, Magdalena Kostkiewicz, Katarzyna Gruszczyńska, Anna Błach, Monika Dzier Zak-Mietła, Wojciech Wańha, Joanna Ciosek, Beata Ochała, Łukasz Rzeszutko, Wiesław Cybulski, Łukasz Partyka, Wojciech Zasada, Witold Włudarczyk, Sebastian Dworowy, Wacław Kuczmik, Grzegorz Smolka, Tomasz Pawłowski, Andrzej Ochała, Michał Tendera
RATIONALE: New therapies for refractory angina are needed. OBJECTIVE: Assessment of transendocardial delivery of bone marrow CD133(+) cells in patients with refractory angina. METHODS AND RESULTS: Randomized, double-blinded, placebo-controlled trial enrolled 31 patients with recurrent Canadian Cardiovascular Society II-IV angina, despite optimal medical therapy, ≥1 myocardial segment with inducible ischemia in Tc-99m SPECT who underwent bone marrow biopsy and were allocated to cells (n=16) or placebo (n=15)...
February 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/27860148/a-review-of-rapid-access-cardiology-services-can-these-reduce-the-burden-of-acute-chest-pain-on-australian-and-new-zealand-health-services
#13
REVIEW
Harry Klimis, Aravinda Thiagalingam, Mikhail Altman, Emily Atkins, Gemma Figtree, Harry Lowe, N Wah Cheung, Pramesh Kovoor, A Robert Denniss, Clara K Chow
Chest pain is common and places a significant burden on hospital resources. Many patients with undifferentiated low to intermediate risk chest pain are admitted to hospital. Rapid Access Cardiology (RAC) services are hospital co-located cardiologist-led outpatient clinics that provide rapid assessment and immediate management but not long term management. This service model is described as part of chest pain management and the National Service Framework for coronary heart disease in the United Kingdom (UK)...
November 16, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27729662/-coronary-sinus-reducer-implantation-a-new-treatment-for-chronic-refractory-angina
#14
Francesco Giannini, Andrea Aurelio, Alaide Chieffo
Refractory angina is a chronic condition characterized by the presence of disabling symptoms due to severe obstructive coronary artery disease not improved by either optimal medical therapy and/or percutaneous or surgical revascularization. Mortality rates associated with this condition are quite low in clinically stable patients on optimal medical therapy. However, rehospitalization rates are high. In this subgroup of patients there is thus a clinical need for new therapies targeting an improvement of symptoms but taking into account the potential impact in terms of healthcare and costs...
October 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27686005/emerging-drugs-for-the-treatment-of-angina-pectoris
#15
Cher-Rin Chong, Gao J Ong, John D Horowitz
Angina pectoris, or symptomatic myocardial ischaemia, reflects an impairment of coronary blood flow, and usually a deficiency of available myocardial energetics. Treatment options vary with the precise cause, which may vary with regards to the roles of increased myocardial oxygen demand versus reduced supply. Traditionally, organic nitrates, β-adrenoceptor antagonists, and non-dihydropyridine calcium antagonists were the only commonly used prophylactic anti-anginal agents. However, many patients failed to respond adequately to such therapy, and/or were unsuitable for their use...
December 2016: Expert Opinion on Emerging Drugs
https://www.readbyqxmd.com/read/27612144/use-of-selective-serotonin-reuptake-inhibitors-and-risks-of-stroke-in-patients-with-obsessive-compulsive-disorder-a-population-based-study
#16
Che-Sheng Chu, Po-Han Chou, Ching-Heng Lin, Chin Cheng, Chia-Jui Tsai, Tsuo-Hung Lan, Min-Wei Huang, Gerald Nestadt
BACKGROUND: Previous research has suggested a link between antidepressants use and the development of cerebrovascular events, but there has never been any study investigating the risk of stroke in obsessive-compulsive disorder (OCD) patients treated with a selective serotonin reuptake inhibitor (SSRI). METHODS: A retrospective observational cohort study was conducted using data from the National Health Insurance Database of Taiwan between the year of 2001 and 2009...
2016: PloS One
https://www.readbyqxmd.com/read/27595692/rationale-and-design-of-a-randomized-trial-of-automated-hovering-for-post-myocardial-infarction-patients-the-heartstrong-program
#17
Andrea B Troxel, David A Asch, Shivan J Mehta, Laurie Norton, Devon Taylor, Tirza A Calderon, Raymond Lim, Jingsan Zhu, Daniel M Kolansky, Brian M Drachman, Kevin G Volpp
BACKGROUND: Coronary artery disease is the single leading cause of death in the United States, and medications can significantly reduce the rate of repeat cardiovascular events and treatment procedures. Adherence to these medications, however, is very low. METHODS: HeartStrong is a national randomized trial offering 3 innovations. First, the intervention is built on concepts from behavioral economics that we expect to enhance its effectiveness. Second, the implementation of the trial takes advantage of new technology, including wireless pill bottles and remote feedback, to substantially automate procedures...
September 2016: American Heart Journal
https://www.readbyqxmd.com/read/27574412/chest-pain-after-percutaneous-coronary-intervention-in-patients-with-stable-angina
#18
Chao-Chien Chang, Yueh-Chung Chen, Eng-Thiam Ong, Wei-Cheng Chen, Chia-Hsiu Chang, Kuan-Jen Chen, Cheng-Wen Chiang
BACKGROUND: Percutaneous coronary intervention (PCI) has been widely used to treat acute coronary syndrome but is only recommended as an additional treatment to medical therapy and risk modification in patients with refractory or progressing angina. The number of PCI in this patient population is still increasing. Post-PCI chest pain (PPCP) is one of the common problems of PCI. Its presentation and causes in patients with stable angina are poorly understood. PATIENTS AND METHODS: This study retrospectively collected clinical information of 167 patients who had stable angina and underwent elective PCI, including 70 patients with PPCP 24 hours after procedure and 97 patients without PPCP...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27574382/ranolazine-therapy-reduces-non-st-segment-elevation-myocardial-infarction-and-unstable-angina-in-coronary-disease-patients-with-angina
#19
Gary L Murray, Joseph Colombo
High sympathetic tone and cardiac autonomic neuropathy (CAN) are associated with major adverse cardiac events (MACE). We have shown ranolazine (RAN) improves autonomic function. RAN was introduced to 51 successive anginal CD patients (RANCD). A control group of 54 successive nonanginal CD patients (NORANCD) continued baseline therapy. Mean study duration was 6.1 years, which included semi-annual autonomic function measures (ANX 3.0, ANSAR Medical Technologies, Inc., Philadelphia, PA) and yearly myocardial perfusion SPECT studies (MPI)...
September 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27571048/cpap-for-prevention-of-cardiovascular-events-in-obstructive-sleep-apnea
#20
RANDOMIZED CONTROLLED TRIAL
R Doug McEvoy, Nick A Antic, Emma Heeley, Yuanming Luo, Qiong Ou, Xilong Zhang, Olga Mediano, Rui Chen, Luciano F Drager, Zhihong Liu, Guofang Chen, Baoliang Du, Nigel McArdle, Sutapa Mukherjee, Manjari Tripathi, Laurent Billot, Qiang Li, Geraldo Lorenzi-Filho, Ferran Barbe, Susan Redline, Jiguang Wang, Hisatomi Arima, Bruce Neal, David P White, Ron R Grunstein, Nanshan Zhong, Craig S Anderson
BACKGROUND: Obstructive sleep apnea is associated with an increased risk of cardiovascular events; whether treatment with continuous positive airway pressure (CPAP) prevents major cardiovascular events is uncertain. METHODS: After a 1-week run-in period during which the participants used sham CPAP, we randomly assigned 2717 eligible adults between 45 and 75 years of age who had moderate-to-severe obstructive sleep apnea and coronary or cerebrovascular disease to receive CPAP treatment plus usual care (CPAP group) or usual care alone (usual-care group)...
September 8, 2016: New England Journal of Medicine
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