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Costs Myocardial infarction

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https://www.readbyqxmd.com/read/28430850/trends-in-hospitalization-for-hypertensive-emergency-and-relationship-of-end-organ-damage-with-in-hospital-mortality
#1
Mahek Shah, Shantanu Patil, Brijesh Patel, Shilpkumar Arora, Nilay Patel, Lohit Garg, Sahil Agrawal, Larry Jacobs, Susan P Steigerwalt, Matthew W Martinez
BACKGROUND: There are no comprehensive guidelines on management of hypertensive emergency (HTNE) and complications. Despite advances in antihypertensive medications HTNE is accompanied with significant morbidity and mortality. METHODS: We queried the 2002-2012 nationwide inpatient sample database to identify patients with HTNE. Trends in incidence of HTNE and in-hospital mortality were analyzed. Logistic regression analysis was used to assess the relationship between end-organ complications and in-hospital mortality...
April 20, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28430735/sodium-tetradecyl-sulfate-a-review-of-clinical-uses
#2
Helena A Jenkinson, Kelly M Wilmas, Sirunya Silapunt
BACKGROUND: Sodium tetradecyl sulfate (STS) is Food and Drug Administration approved for treatment of varicose veins, but numerous other off-label applications have been reported. OBJECTIVE: To describe the clinical uses of STS, as well as efficacy and adverse effects. METHODS: Review of studies searchable on PubMed from 1938 to 2016 describing clinical uses of STS to determine efficacy and adverse effects associated with various applications...
April 19, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28427072/anti-vascular-endothelial-growth-factor-injections-the-new-standard-of-care-in-proliferative-diabetic-retinopathy
#3
Xintong Li, Marco A Zarbin, Neelakshi Bhagat
For decades, panretinal photocoagulation (PRP) has been the standard of care for the treatment of proliferative diabetic retinopathy (PDR). The relatively recent advent of anti-vascular endothelial growth factor (VEGF) formulations for intravitreal injection has provided a fresh perspective on PDR treatment, especially in eyes with concurrent diabetic macular edema (DME). The anti-VEGF agent ranibizumab has demonstrated a potentially protective effect on eyes with DME in terms of progression to PDR in the RIDE/RISE trials, as has aflibercept in the VIVID/VISTA trials...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427070/practical-lessons-from-protocol-t-for-the-management-of-diabetic-macular-edema
#4
Lekha Mukkamala, Neelakshi Bhagat, Marco Zarbin
PURPOSE: To review the results of Diabetic Retinopathy Clinical Research Network Protocol T, as applied to clinical practice. METHODS: Review of major publications reporting the results of Protocol T, a randomized single-masked (in year-1 only), multicenter clinical trial comparing aflibercept, bevacizumab, and ranibizumab as treatment option for center-involving diabetic macular edema (DME). The main outcome measures were change in visual acuity (VA), central subfield thickness (CST) on optical coherence tomography, cost effectiveness, burden of care, and safety...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28413630/patient-healthcare-trajectory-an-essential-monitoring-tool-a-systematic-review
#5
REVIEW
Jessica Pinaire, Jérôme Azé, Sandra Bringay, Paul Landais
BACKGROUND: Patient healthcare trajectory is a recent emergent topic in the literature, encompassing broad concepts. However, the rationale for studying patients' trajectories, and how this trajectory concept is defined remains a public health challenge. Our research was focused on patients' trajectories based on disease management and care, while also considering medico-economic aspects of the associated management. We illustrated this concept with an example: a myocardial infarction (MI) occurring in a patient's hospital trajectory of care...
December 2017: Health Information Science and Systems
https://www.readbyqxmd.com/read/28399375/understanding-the-value-of-individualized-information-the-impact-of-poor-calibration-or-discrimination-in-outcome-prediction-models
#6
Natalia Olchanski, Joshua T Cohen, Peter J Neumann, John B Wong, David Kent
BACKGROUND: Risk prediction models allow for the incorporation of individualized risk and clinical effectiveness information to identify patients for whom therapy is most appropriate and cost-effective. This approach has the potential to identify inefficient (or harmful) care in subgroups at different risks, even when the overall results appear favorable. Here, we explore the value of personalized risk information and the factors that influence it. METHODS: Using an expected value of individualized care (EVIC) framework, which monetizes the value of customizing care, we developed a general approach to calculate individualized incremental cost effectiveness ratios (ICERs) as a function of individual outcome risk...
April 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28389970/osteoporosis-a-discussion-on-the-past-5%C3%A2-years
#7
REVIEW
Kyle M Schweser, Brett D Crist
PURPOSE OF THE REVIEW: The purposes of this study are to examine the literature within the past 5 years regarding osteoporosis and offer a discussion on new topics and controversies. RECENT FINDINGS: Patient compliance with therapy remains an issue. The effectiveness of Vitamin D and calcium are being called into question Atypical femur fractures have been associated with bisphosphonate and denosumab use. Treatment is both surgical and pharmaceutical. A multidisciplinary approach to osteoporotic fractures is important and having some form of fracture liaison service (FLS) improves the efficacy of osteoporotic care and decreases secondary fractures...
April 7, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28385304/functional-testing-or-coronary-computed-tomography-angiography-in-patients-with-stable%C3%A2-coronary-artery-disease
#8
Mads E Jørgensen, Charlotte Andersson, Bjarne L Nørgaard, Jawdat Abdulla, Jacqueline B Shreibati, Christian Torp-Pedersen, Gunnar H Gislason, Richard E Shaw, Mark A Hlatky
BACKGROUND: The choice of either anatomical or functional noninvasive testing to evaluate suspected coronary artery disease might affect subsequent clinical management and outcomes. OBJECTIVES: This study analyzed the association of initial noninvasive cardiac testing in outpatients with stable symptoms, with subsequent use of medications, invasive procedures, and clinical outcomes. METHODS: We studied patients enrolled in a Danish nationwide register who underwent initial noninvasive cardiac testing with either coronary computed tomography angiography (CTA) or functional testing (exercise electrocardiography or nuclear stress testing) from 2009 to 2015...
April 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28379825/the-july-effect-a-look-at-july-medical-admissions-in-teaching-hospitals
#9
Lisa D Mims, Maribeth Porter, Kit N Simpson, Peter J Carek
PURPOSE: We examined the effect of admission for myocardial infarction, heart failure, or pneumonia during the first academic quarter compared with all other quarters in teaching versus nonteaching hospitals on length of stay, cost, and mortality. METHODS: Using data 2011 Nationwide Inpatient Sample, multivariable modeling with an interaction term was used to test teaching hospital effect by academic quarter. Logistic regression was used for mortality and log-transformed linear models for cost and length of stay...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28376710/electrocardiographic-changes-mimicking-acute-coronary-syndrome-in-a-large-intracranial-tumour-a-diagnostic-dilemma
#10
Nilukshana Yogendranathan, H M M T B Herath, S P Pahalagamage, Aruna Kulatunga
BACKGROUND: ST elevation Myocardial infarction is a medical emergency. A variety of noncardiac conditions had been known to mimic the ECG changes that are seen in acute coronary syndrome. Although the common ECG changes that are documented with raised intracranial pressure are T inversions, prolongation of QT interval and sinus bradycardia, ST elevation or depression, arrhythmias and prominent U waves have also been recognized. However, ST elevations in association with primary intracranial tumours are rarely reported...
April 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28374179/revascularization-for-advanced-coronary-artery-disease-in-type-2-diabetic-patients-choosing-wisely-between-pci-and-surgery
#11
REVIEW
Louai Razzouk, Frederick Feit, Michael E Farkouh
PURPOSE OF REVIEW: Patients with type 2 diabetes mellitus (T2DM) are at an increased risk of systemic atherosclerosis and advanced coronary artery disease (CAD). Herein, we review clinical trials comparing surgical to percutaneous revascularization in the context of the unique pathophysiology in this patient population, and seek to answer the question of optimal strategy of revascularization. RECENT FINDINGS: Early studies showed a signal towards benefit of surgical revascularization over percutaneous revascularization in this group, but there was a paucity of randomized clinical trials (RCT) to directly support this finding...
May 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28366472/mice-or-nice-an-economic-evaluation-of-clinical-decision-rules-in-the-diagnosis-of-heart-failure-in-primary-care
#12
Mark Monahan, Pelham Barton, Clare J Taylor, Andrea K Roalfe, F D Richard Hobbs, Martin Cowie, Russell Davis, Jon Deeks, Jonathan Mant, Deborah McCahon, Theresa McDonagh, George Sutton, Lynda Tait
BACKGROUND: Detection and treatment of heart failure (HF) can improve quality of life and reduce premature mortality. However, symptoms such as breathlessness are common in primary care, have a variety of causes and not all patients require cardiac imaging. In systems where healthcare resources are limited, ensuring those patients who are likely to have HF undergo appropriate and timely investigation is vital. DESIGN: A decision tree was developed to assess the cost-effectiveness of using the MICE (Male, Infarction, Crepitations, Edema) decision rule compared to other diagnostic strategies to identify HF patients presenting to primary care...
March 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28361110/patterns-of-care-and-outcomes-in-cardiovascular-disease-after-kidney-transplantation-in-the-united-states
#13
Amit K Mathur, Yu-Hui Chang, D Eric Steidley, Raymond Heilman, Narjeet Khurmi, Nabil Wasif, David Etzioni, Adyr A Moss
BACKGROUND: Cardiovascular disease (CVD) is an important driver of mortality after kidney transplantation. Its broader impact on posttransplant health care utilization in US hospitals is unknown. METHODS: We used administrative claims data from the Nationwide Inpatient Sample and the American Hospital Association Annual Survey to identify hospitalizations for kidney transplant patients with a cardiovascular diagnosis from 2005 to 2011. CVD hospitalizations were stratified by transplant hospital status to characterize patterns in inpatient health care utilization and outcomes...
February 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28347513/cost-effectiveness-of-maintaining-daily-intake-of-oat-%C3%AE-glucan-for-coronary-heart-disease-primary-prevention
#14
Stephanie R Earnshaw, Cheryl L McDade, YiFang Chu, Lisa E Fleige, John L Sievenpiper
PURPOSE: Oat β-glucan reduces cholesterol levels and thus reduces the risk for coronary heart disease (CHD). However, its economic impact has not been well studied. We examined the economic impact of daily intake of ≥3 g of oat β-glucan in primary prevention of CHD in patients receiving statins or no pharmacologic treatment. METHODS: A decision model was developed to compare costs and outcomes associated with lowering cholesterol levels with no pharmacologic treatment and normal diet, no pharmacologic treatment plus ≥3 g/d of oat β-glucan, and statin therapy plus ≥3 g/d of oat β-glucan...
March 25, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28346238/management-of-hypertension-in-2017-targets-and-therapies
#15
Monica Ahluwalia, Sripal Bangalore
PURPOSE OF REVIEW: Approximately one-fourth of the adult population is diagnosed with hypertension, which has been associated with increased cardiovascular morbidity and mortality including cardiovascular death, myocardial infarction, heart failure and stroke. Early detection and treatment is a key and can lead to a significant reduction in cardiovascular morbidity and mortality. RECENT FINDINGS: In this review, we discuss the management and treatment strategies in patients with hypertension in the current era...
March 24, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28345538/current-trends-for-st-segment-elevation-myocardial-infarction-during-the-past-5-years-in-rural-areas-of-china-s-liaoning-province-a-multicenter-study
#16
Guang-Xiao Li, Bo Zhou, Guo-Xian Qi, Bo Zhang, Da-Ming Jiang, Gui-Mei Wu, Bing Ma, Peng Zhang, Qiong-Rui Zhao, Juan Li, Ying Li, Jing-Pu Shi
BACKGROUND: Since 2010, two versions of National Guidelines aimed at promoting the management of ST-segment elevation myocardial infarction (STEMI) have been formulated by the Chinese Society of Cardiology. However, little is known about the changes in clinical characteristics, management, and in-hospital outcomes in rural areas. METHODS: In the present multicenter, cross-sectional study, participants were enrolled from rural hospitals located in Liaoning province in Northeast China, during two different periods (from June 2009 to June 2010 and from January 2015 to December 2015)...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28343597/national-trends-and-in-hospital-outcomes-in-pregnant-women-with-heart-disease-in-the-united-states
#17
Fabio V Lima, Jie Yang, Jianjin Xu, Kathleen Stergiopoulos
Investigation of trends and outcomes in heart disease (HD) and pregnancy has been limited. We chose to identify the prevalence, trends, and outcomes of pregnant women with different forms of HD in the United States. Healthcare Cost and Utilization Project's National Inpatient Sample was screened for hospital admissions for delivery in pregnant women with HD from 2003 to 2012. Maternal clinical characteristics and outcomes were identified in women with and without HD, and in HD subtypes: congenital (CHD), valvular HD, cardiomyopathy, and pulmonary hypertension (PH)...
February 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28341926/risks-associated-with-antiretroviral-treatment-for-human-immunodeficiency-virus-hiv-qualitative-analysis-of-social-media-data-and-health-state-utility-valuation
#18
Louis S Matza, Karen C Chung, Katherine J Kim, Trena M Paulus, Evan W Davies, Katie D Stewart, Grace A McComsey, Marshall W Fordyce
PURPOSE: Despite benefits of antiretroviral therapies (ART), people with HIV infection have increased risk of cardiovascular disease, kidney disease, and low bone mineral density. Some ARTs increase risk of these events. The purpose of this study was to examine patients' perspectives of these risks and estimate health state utilities associated with these risks for use in cost-utility models. METHODS: Qualitative thematic analysis was conducted to examine messages posted to the POZ/AIDSmeds Internet community forums, focusing on bone, kidney, and cardiovascular side effects and risks of HIV/AIDS medications...
March 24, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28323231/carotid-endarterectomy-in-the-southern-california-vascular-outcomes-improvement-collaborative
#19
Kaelan Chan, Ahmed Abouzamzam, Karen Woo
OBJECTIVE: The objective of this study is to examine the variation in practice patterns and associated outcomes for carotid endarterectomy (CEA) within the Southern California Vascular Outcomes Improvement Collaborative (So Cal VOICe), a regional quality group of the Vascular Quality Initiative (VQI). METHODS: All cases entered in the CEA registry by the So Cal VOICe were included in the study. RESULTS: From September 2010 through September 2015, 1110 CEA cases were entered by nine centers in the So Cal VOICe...
March 17, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28319269/withdrawn-trimetazidine-for-stable-angina
#20
REVIEW
Agustín Ciapponi, Rudolf Pizarro, Jeff Harrison
BACKGROUND: Patients with stable angina not controlled by monotherapy with nitrates, beta blockers, or calcium channel blockers are often treated with combinations of these drugs. There may be adverse effects from, or contraindications to, the use of combinations. In low risk groups, medical treatment appears to be as good an option as percutaneous transluminal coronary angioplasty in terms of averting myocardial infarction, death, or subsequent revascularization. Revascularization procedures are too costly or inaccessible for many patients in developing countries therefore effective and safe medical treatment is needed...
March 20, 2017: Cochrane Database of Systematic Reviews
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