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https://www.readbyqxmd.com/read/27911381/a-novel-approach-for-the-administration-of-medications-and-fluids-in-emergency-scenarios-and-settings
#1
Akilesh Honasoge, Neal Lyons, Kathleen Hesse, Braden Parker, Robert Mokszycki, Kelly Wesselhoff, Rolla Sweis, Erik B Kulstad
The available routes of administration commonly used for medications and fluids in the acute care setting are generally limited to oral, intravenous, or intraosseous routes, but in many patients, particularly in the emergency or critical care settings, these routes are often unavailable or time-consuming to access. A novel device is now available that offers an easy route for administration of medications or fluids via rectal mucosal absorption (also referred to as proctoclysis in the case of fluid administration and subsequent absorption)...
November 9, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27909643/source-control-and-graft-preservation-using-negative-pressure-wound-therapy-with-antibiotic-instillation-a-case-report
#2
Victoria Gilbert, Timothy Kelly, Robert Grossi
Negative pressure wound therapy (NPWT) is widely used to treat many types of complex wounds, and the advent of the instillation and dwell time (NPWTi-d) technique has enhanced this system with the addition of automated treatment with topical solutions. In the field of vascular surgery, NPWT is utilized to help close wounds over underlying grafts; however keeping these wounds free of infection and avoiding large reoperation when infection occurs remains a challenge. In this case report we present a patient who required acute intervention for limb ischemia, with a large wound created in the groin for anastomosis of a prosthetic graft bypass...
October 31, 2016: Curēus
https://www.readbyqxmd.com/read/27903616/immediate-rule-out-of-acute-myocardial-infarction-using-electrocardiogram-and-baseline-high-sensitivity-troponin-i
#3
Johannes Tobias Neumann, Nils Arne Sörensen, Francisco Ojeda, Tjark Schwemer, Jonas Lehmacher, Saskia Gönner, Nikolas Jarsetz, Till Keller, Sarina Schaefer, Thomas Renné, Ulf Landmesser, Peter Clemmensen, Nataliya Makarova, Renate B Schnabel, Tanja Zeller, Mahir Karakas, John W Pickering, Martin Than, William Parsonage, Jaimi Greenslade, Louise Cullen, Dirk Westermann, Stefan Blankenberg
AIMS: Serial measurements of high-sensitivity troponin are used to rule out acute myocardial infarction (AMI) with an assay specific cutoff at the 99th percentile. Here, we evaluated the performance of a single admission troponin with a lower cutoff combined with a low risk electrocardiogram (ECG) to rule out AMI. METHODS: Troponin I measured with a high-sensitivity assay (hs-TnI) was determined at admission in 1040 patients presenting with suspected AMI (BACC study)...
November 30, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27896982/predictive-modeling-of-hospital-readmission-rates-using-electronic-medical-record-wide-machine-learning-a-case-study-using-mount-sinai-heart-failure-cohort
#4
Khader Shameer, Kipp W Johnson, Alexandre Yahi, Riccardo Miotto, L I Li, Doran Ricks, Jebakumar Jebakaran, Patricia Kovatch, Partho P Sengupta, Sengupta Gelijns, Alan Moskovitz, Bruce Darrow, David L David, Andrew Kasarskis, Nicholas P Tatonetti, Sean Pinney, Joel T Dudley
Reduction of preventable hospital readmissions that result from chronic or acute conditions like stroke, heart failure, myocardial infarction and pneumonia remains a significant challenge for improving the outcomes and decreasing the cost of healthcare delivery in the United States. Patient readmission rates are relatively high for conditions like heart failure (HF) despite the implementation of high-quality healthcare delivery operation guidelines created by regulatory authorities. Multiple predictive models are currently available to evaluate potential 30-day readmission rates of patients...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27894261/multimarker-approach-for-the-prediction-of-microvascular-obstruction-after-acute-st-segment-elevation-myocardial-infarction-a-prospective-observational-study
#5
Hans-Josef Feistritzer, Sebastian Johannes Reinstadler, Gert Klug, Martin Reindl, Sebastian Wöhrer, Christoph Brenner, Agnes Mayr, Johannes Mair, Bernhard Metzler
BACKGROUND: Presence of microvascular obstruction (MVO) derived from cardiac magnetic resonance (CMR) imaging is among the strongest outcome predictors after ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the comparative predictive values of different biomarkers for the occurrence of MVO in a large cohort of reperfused STEMI patients. METHODS: This study included 128 STEMI patients. CMR imaging was performed within the first week after infarction to assess infarct characteristics, including MVO...
November 28, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27890099/potential-use-of-pericardial-ctni-mg-2-and-ca-2-in-the-forensic-investigation-of-seawater-drowning-in-greece-an-initial-assessment
#6
Aspasia Deliligka, Nikolaos Raikos, Fotios Chatzinikolaou, Ioannis Venizelos, Kyriakos Chatzopoulos, Antonis Goulas
The investigation of drowning constitutes one of the biggest problems in forensic practice. Elevated cardiac troponin I (cTnI) levels in biological fluids have been associated with myocardial damage, whereas increased Mg(2+) and Ca(2+) levels were found in cases of seawater drowning. The aim of this study was to examine the diagnostic utility of postmortem determination of cTnI, Mg(2+) and Ca(2+) in the pericardial fluid, in differentiating between cases of seawater drowning related to myocardial injury and those brought about by other causes...
November 2016: Legal Medicine
https://www.readbyqxmd.com/read/27882375/risk-factors-for-intracranial-haemorrhage-in-patients-with-pulmonary-embolism-treated-with-thrombolytic-therapy-development-of-the-pe-ch-score
#7
Saurav Chatterjee, Ido Weinberg, Robert W Yeh, Anasua Chakraborty, Partha Sardar, Mitchell D Weinberg, Christopher Kabrhel, Geoffrey D Barnes, Debabrata Mukherjee, Dharam Kumbhani, Riyaz Bashir, Anjali Vaidya, Akaya Smith, Barry Fuchs, Peter Groeneveld, Jay Giri
Pulmonary embolism (PE) is a major cause of morbidity and mortality world-wide, and the use of thrombolytic therapy has been associated with favourable clinical outcomes in certain patient subsets. These potential benefits are counterbalanced by the risk of bleeding complications, the most devastating of which is intracranial haemorrhage (ICH). We retrospectively evaluated 9703 patients from the 2003-2012 nationwide in-patient sample database (NIS) who received thrombolytics for PE. All patients with ICH during the PE hospitalisation were identified and a clinical risk score model was developed utilizing demographics and comorbidities...
November 24, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27881758/cardiac-rehabilitation-following-an-acute-coronary-syndrome-trends-in-referral-predictors-and-mortality-outcome-in-a-multicenter-national-registry-between-years-2006-2013-report-from-the-working-group-on-cardiac-rehabilitation-the-israeli-heart-society
#8
Fernando Chernomordik, Avi Sabbag, Boaz Tzur, Eran Kopel, Ronen Goldkorn, Shlomi Matetzky, Ilan Goldenberg, Nir Shlomo, Robert Klempfner
BACKGROUND: Utilization of cardiac rehabilitation is suboptimal. The aim of the study was to assess referral trends over the past decade, to identify predictors for referral to a cardiac rehabilitation program, and to evaluate the association with one-year mortality in a large national registry of acute coronary syndrome patients. DESIGN AND METHODS: Data were extracted from the Acute Coronary Syndrome Israeli Survey national surveys between 2006-2013. A total of 6551 patients discharged with a diagnosis of acute coronary syndrome were included...
November 23, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27881255/cost-effectiveness-analysis-of-ticagrelor-and-prasugrel-for-the-treatment-of-acute-coronary-syndrome
#9
Ying Jiao Zhao, Ai Leng Khoo, Liang Lin, Monica Teng, Tuck Seng Wu, Mark Y Chan, Boon Peng Lim
BACKGROUND: In the management of Asian patients with acute coronary syndrome (ACS), the comparative cost-effectiveness of ticagrelor and prasugrel, referenced to generic clopidogrel, is unknown. OBJECTIVE: To assess the cost-effectiveness of ticagrelor and prasugrel as compared with generic clopidogrel in patients with ACS in Singapore. METHODS: A Markov model simulating a typical cohort of 62-year-old patients with ACS was constructed from a patient's perspective over a lifetime horizon...
May 2016: Value in Health Regional Issues
https://www.readbyqxmd.com/read/27865485/comparison-of-the-effectiveness-of-stress-echocardiography-versus-myocardial-perfusion-imaging-in-patients-presenting-to-the-emergency-department-with-low-risk-chest-pain
#10
Rhian Davies, Guodong Liu, Christopher Sciamanna, William R Davidson, Douglas L Leslie, Andrew J Foy
The aim of this study was to compare clinically relevant cardiovascular outcomes and downstream resource utilization associated with stress echocardiography (SE) and myocardial perfusion imaging (MPI) in emergency department patients with low-risk chest pain. This was a retrospective analysis of health insurance claims data for a national sample of privately insured patients over the period January 1 to December 31, 2011. Subjects were selected who presented to the emergency department with a primary or secondary diagnosis of chest pain and underwent either SE or MPI...
December 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27864807/assessing-the-associations-between-awareness-of-myocardial-infarction-symptoms-socioeconomic-factors-and-cardiovascular-disease-risk-factors-through-regression-models
#11
Phoebe Tran, Murray A Mittleman
There are few studies that consider the association between awareness of symptoms of acute myocardial infarction (MI), socioeconomic factors (household income, sex, race/ethnicity, and educational attainment), and cardiovascular (CVD) risk factors. It is important to understand these associations because there is evidence that suggests that disparities in the awareness of MI symptoms lead to disparities in delays in receiving treatment and outcomes of patients with MI. The study was to determine if there are disparities in the awareness of different MI symptoms among different groups with respect to self-reported race, ethnicity, education, age, and income (i...
November 18, 2016: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/27864667/examining-the-impact-of-rehospitalization-on-healthcare-cost-of-myocardial-infarction-patients-in-beijing-a-retrospective-observational-study
#12
Li Yang, Yifei Liu, Liankui Wen, Jingjing Wu
INTRODUCTION: To examine the impact of rehospitalization on the healthcare expenditure of myocardial infarction (MI) patients in Beijing. METHODS: Retrospective data of MI patients were retrieved from the Beijing Medical Insurance Database, an administrative database of social medical reimbursement activities for the urban population in Beijing, China. Ten percent of patients diagnosed with MI from January 1 to December 31, 2012 were randomly selected and their first hospitalization was considered as the index event...
November 18, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27855810/computed-tomography-and-cardiac%C3%A2-magnetic-resonance-in-ischemic%C3%A2-heart%C3%A2-disease
#13
REVIEW
Marc R Dweck, Michelle C Williams, Alastair J Moss, David E Newby, Zahi A Fayad
Ischemic heart disease is a complex disease process caused by the development of coronary atherosclerosis, with downstream effects on the left ventricular myocardium. It is characterized by a long preclinical phase, abrupt development of myocardial infarction, and more chronic disease states such as stable angina and ischemic cardiomyopathy. Recent advances in computed tomography (CT) and cardiac magnetic resonance (CMR) now allow detailed imaging of each of these different phases of the disease, potentially allowing ischemic heart disease to be tracked during a patient's lifetime...
November 15, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27848189/the-impact-of-disability-and-social-determinants-of-health-on-condition-specific-readmissions-beyond-medicare-risk-adjustments-a-cohort-study
#14
Jennifer Meddings, Heidi Reichert, Shawna N Smith, Theodore J Iwashyna, Kenneth M Langa, Timothy P Hofer, Laurence F McMahon
BACKGROUND: Readmission rates after pneumonia, heart failure, and acute myocardial infarction hospitalizations are risk-adjusted for age, gender, and medical comorbidities and used to penalize hospitals. OBJECTIVE: To assess the impact of disability and social determinants of health on condition-specific readmissions beyond current risk adjustment. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of Medicare patients using 1) linked Health and Retirement Study-Medicare claims data (HRS-CMS) and 2) Healthcare Cost and Utilization Project State Inpatient Databases (Florida, Washington) linked with ZIP Code-level measures from the Census American Community Survey (ACS-HCUP)...
November 15, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27846641/prevalence-and-prognostic-implications-of-coronary-artery-calcification-in-low-risk-women-a-meta-analysis
#15
Maryam Kavousi, Chintan S Desai, Colby Ayers, Roger S Blumenthal, Matthew J Budoff, Amir-Abbas Mahabadi, M Arfan Ikram, Aad van der Lugt, Albert Hofman, Raimund Erbel, Amit Khera, Marie H Geisel, Karl-Heinz Jöckel, Nils Lehmann, Udo Hoffmann, Christopher J O'Donnell, Joseph M Massaro, Kiang Liu, Stefan Möhlenkamp, Hongyan Ning, Oscar H Franco, Philip Greenland
Importance: The role of coronary artery calcium (CAC) testing for guiding preventive strategies among women at low cardiovascular disease (CVD) risk based on the American College of Cardiology and American Heart Association CVD prevention guidelines is unclear. Objective: To assess the potential utility of CAC testing for CVD risk estimation and stratification among low-risk women. Design, Setting, and Participants: Women with 10-year atherosclerotic CVD (ASCVD) risk lower than 7...
November 22, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27846007/carotid-intima-media-thickness-as-a-cardiovascular-risk-factor-and-imaging-pathway-of-atherosclerosis
#16
Osmar Antonio Centurión
Assessment of carotid intima-media thickness (IMT) has emerged as a simple and noninvasive technique for measuring atherosclerotic burden. Although serum biomarkers have been linked to the risk of developing atherosclerosis, carotid IMT has the theoretical advantage of directly visualizing a final consequence of the disease itself, namely atherosclerosis in the vessel wall. The current widespread application of carotid IMT measurements has been based on the validity, standardization, and reproducibility of the measurement and the evidence that an increased carotid IMT can be regarded as an attractive biomarker of atherosclerosis and of increased cardiovascular risk, potentially useful as a therapeutic target in those at increased cardiovascular risk...
December 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27843105/dual-imaging-stress-echocardiography-for-prognostic-assessment-of-high-risk-asymptomatic-patients-with-diabetes-mellitus
#17
Lauro Cortigiani, Sonia Gherardi, Michela Faggioni, Francesco Bovenzi, Eugenio Picano, Christina Petersen, Sabrina Molinaro, Rosa Sicari
BACKGROUND: In patients with diabetes, the utility of diagnostic screening cardiac tests in subjects without clinical coronary artery disease remains controversial. The aim of this study was to assess the prognostic meaning of dual-imaging stress echocardiography (conventional wall motion analysis and Doppler-derived coronary flow velocity reserve [CFVR] of the left anterior descending coronary artery) in high-risk asymptomatic individuals with diabetes. METHODS: This was a prospective analysis of 230 asymptomatic patients with diabetes (128 men; mean age, 66 ± 9 years) with no clinical evidence of coronary artery disease, no Q waves or deep negative waves on the electrocardiogram, and no wall motion abnormalities on resting echocardiography...
November 11, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27835698/a-simple-risk-stratification-model-for-st-elevation-myocardial-infarction-stemi-from-the-combination-of-blood-examination-variables-acute-myocardial-infarction-kyoto-multi-center-risk-study-group
#18
Kenji Yanishi, Takeshi Nakamura, Naohiko Nakanishi, Isao Yokota, Kan Zen, Tetsuhiro Yamano, Hirokazu Shiraishi, Takeshi Shirayama, Jun Shiraishi, Takahisa Sawada, Yoshio Kohno, Makoto Kitamura, Keizo Furukawa, Satoaki Matoba
BACKGROUND: Many mortality risk scoring tools exist among patients with ST-elevation Myocardial Infarction (STEMI). A risk stratification model that evaluates STEMI prognosis more simply and rapidly is preferred in clinical practice. METHODS AND FINDINGS: We developed a simple stratification model for blood examination by using the STEMI data of AMI-Kyoto registry in the derivation set (n = 1,060) and assessed its utility for mortality prediction in the validation set (n = 521)...
2016: PloS One
https://www.readbyqxmd.com/read/27832852/utility-of-the-gore-septal-occluder-in-transcatheter-closure-of-post-myocardial-infarct-ventricular-septal-defect-initial-experience
#19
Eduardo A Arias, Amit Bhan, Zhan Y Lim, Michael Mullen
No abstract text is available yet for this article.
November 14, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27821064/the-prognostic-utility-of-grace-risk-score-in-predictive-cardiovascular-event-rate-in-stemi-patients-with-successful-fibrinolysis-and-delay-intervention-in-non-pci-capable-hospital-a-retrospective-cohort-study
#20
Yotsawee Chotechuang, Arintaya Phrommintikul, Roungtiva Muenpa, Jayanton Patumanond, Tuanchai Chaichuen, Srun Kuanprasert, Noparat Thanachikun, Thanawat Benjanuwatra, Apichard Sukonthasarn
BACKGROUND: Fibrinolytic therapy is the main reperfusion therapy for most STEMI patients in several countries. Current practice guidelines recommended routine early pharmacoinvasive (within 3-24 h after successful fibrinolysis, however it cannot be performed in timely fashion due to limitation of PCI-capable hospitals. This study aimed to evaluate the prognostic utility of the GRACE score in patients receiving delayed intervention after successful fibrinolysis in non PCI-capable hospital...
November 8, 2016: BMC Cardiovascular Disorders
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