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https://www.readbyqxmd.com/read/28516485/simultaneous-measurement-of-t2-and-apparent-diffusion-coefficient-t2-adc-in-the-heart-with-motion-compensated-spin-echo-diffusion-weighted-imaging
#1
Eric Aliotta, Kévin Moulin, Zhaohuan Zhang, Daniel B Ennis
PURPOSE: To evaluate a technique for simultaneous quantitative T2 and apparent diffusion coefficient (ADC) mapping in the heart (T2 +ADC) using spin echo (SE) diffusion-weighted imaging (DWI). THEORY AND METHODS: T2 maps from T2 +ADC were compared with single-echo SE in phantoms and with T2 -prepared (T2 -prep) balanced steady-state free precession (bSSFP) in healthy volunteers. ADC maps from T2 +ADC were compared with conventional DWI in phantoms and in vivo. T2 +ADC was also demonstrated in a patient with acute myocardial infarction (MI)...
May 17, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28487318/impact-of-coronary-calcification-on-clinical-management-in-patients-with-acute-chest-pain
#2
Daniel O Bittner, Thomas Mayrhofer, Fabian Bamberg, Travis R Hallett, Sumbal Janjua, Daniel Addison, John T Nagurney, James E Udelson, Michael T Lu, Quynh A Truong, Pamela K Woodard, Judd E Hollander, Chadwick Miller, Anna Marie Chang, Harjit Singh, Harold Litt, Udo Hoffmann, Maros Ferencik
BACKGROUND: Coronary artery calcification (CAC) may impair diagnostic assessment of coronary computed tomography angiography (CTA). We determined whether CAC affects efficiency of coronary CTA in patients with suspected acute coronary syndrome (ACS). METHODS AND RESULTS: This is a pooled analysis of ACRIN-PA (American College of Radiology Imaging Network-Pennsylvania) 4005 and the ROMICAT-II trial (Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography) comparing an initial coronary CTA strategy to standard of care in acute chest pain patients...
May 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28485179/what-to-do-when-you-question-cardiac-troponin-values
#3
Johannes Mair, Bertil Lindahl, Christian Müller, Evangelos Giannitsis, Kurt Huber, Martin Möckel, Mario Plebani, Kristian Thygesen, Allan S Jaffe
High-sensitivity cardiac troponin assays enable cardiac troponin measurement with a high degree of analytical sensitivity and a low level of analytical imprecision at the low measuring range. One of the most important advantages of these new assays is that they allow novel, more rapid approaches for ruling in or ruling out acute myocardial infarctions. The increase in the early diagnostic sensitivity of high-sensitivity cardiac troponin assays comes at the cost of a reduced acute myocardial infarction specificity of the biomarker, because more patients with other causes of acute or chronic myocardial injury without overt myocardial ischaemia are detected than with previous cardiac troponin assays...
May 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28475261/impact-of-the-orthopaedic-nurse-practitioner-role-on-acute-hospital-length-of-stay-and-cost-savings-for-patients-with-hip-fracture-a-retrospective-cohort-study
#4
Linda L Coventry, Sharon Pickles, Michelle Sin, Amanda Towell, Margaret Giles, Kevin Murray, Di Twigg
AIMS: To compare acute hospital length of stay and cost-savings for patients with hip fracture before-and-after commencement of the Orthopaedic Nurse Practitioner and identify variables that increase length of stay in hospital. BACKGROUND: Globally, hip fractures are associated with significant morbidity and mortality. Whilst the practical benefits of the Orthopaedic Nurse Practitioner have been anecdotally shown, an analysis showing the cost-saving benefits has yet to be published...
May 5, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28473280/safety-of-early-performance-of-the-six-minute-walk-test-following-acute-myocardial-infarction-a-cross-sectional-study
#5
Lívia S Diniz, Victor R Neves, Ana C Starke, Marco P T Barbosa, Raquel R Britto, Antônio L P Ribeiro
BACKGROUND: The six-minute walk test (6MWT) is a simple, low cost, reliable, and valid method for evaluating the functional capacity of cardiac patients. However, its early use and safety following acute myocardial infarction (AMI) is recent and has been little investigated. OBJECTIVE: To evaluate and to compare the safety and the cardiac behavior of early performance of the 6MWT in patients following uncomplicated AMI up to 4 days or more than 4 days after the event...
April 8, 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28465288/thirty-day-readmissions-after-endovascular-or-surgical-therapy-for-critical-limb-ischemia-analysis-of-the-2013-2014-nationwide-readmissions-databases
#6
Dhaval Kolte, Kevin F Kennedy, Mehdi H Shishehbor, J Dawn Abbott, Sahil Khera, Peter A Soukas, Shafiq T Mamdani, Omar N Hyder, Douglas E Drachman, Herbert D Aronow
Background -Thirty-day readmission rates have gained increasing importance as a key quality metric. A significant number of patients are hospitalized for the management of critical limb ischemia (CLI), but limited data are available on the incidence, predictors, and causes of 30-day readmission after hospitalization for CLI. Methods -Hospitalizations for a primary diagnosis of CLI during which patients underwent endovascular or surgical therapy (revascularization and/or amputation) and were discharged alive were identified in the 2013-2014 Nationwide Readmissions Databases...
May 2, 2017: Circulation
https://www.readbyqxmd.com/read/28441172/intravascular-ultrasound-and-outcomes-after-drug-eluting-stent-implantation
#7
Gary S Mintz
There have been nine published randomized trials and 30 registry studies comparing intravascular ultrasound (IVUS)-guided drug-eluting stent implantation versus conventional angiographic guidance. These trials and registries have been evaluated and summarized in (i) eight meta-analyses that included from nine to 18 registries and from one to seven randomized trials and (ii) four meta-analyses that included from three to eight randomized trials. Although with one exception no two meta-analyses have included the same trials or studies, in each meta-analysis, IVUS guidance was associated with a reduction in major adverse cardiac events as well as secondary hard endpoints of death (primarily cardiovascular mortality), myocardial infarction, and stent thrombosis, especially in randomized trial meta-analyses...
June 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#8
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28430850/trends-in-hospitalization-for-hypertensive-emergency-and-relationship-of-end-organ-damage-with-in-hospital-mortality
#9
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/28414559/evaluating-the-cost-and-utility-of-mandating-schools-to-stock-epinephrine-auto-injectors
#10
Chelsea Steffens, Benjamin Clement, William Fales, Ahel El Haj Chehade, Kevin Putman, Robert Swor
BACKGROUND: The Michigan Legislature mandated that all public schools stock epinephrine auto-injectors (EAIs). A minimal amount is known regarding the incremental value of EAIs in schools. Our primary objective was to describe the frequency of administration of epinephrine for EMS patients with acute allergic reactions in public schools. Our secondary objective was to estimate the cost of mandating public schools to stock EAIs. METHODS: We performed a retrospective cohort study of EMS cases with an impression of allergic reaction and who received epinephrine recorded in the 2014 Michigan EMS Information System (MI-EMSIS)...
April 17, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28376710/electrocardiographic-changes-mimicking-acute-coronary-syndrome-in-a-large-intracranial-tumour-a-diagnostic-dilemma
#11
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/28343597/national-trends-and-in-hospital-outcomes-in-pregnant-women-with-heart-disease-in-the-united-states
#12
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/28291783/oesophageal-heat-exchangers-with-a-diameter-of-11mm-or-14-7mm-are-equally-effective-and-safe-for-targeted-temperature-management
#13
Daniel C Schroeder, Maria Guschlbauer, Alexandra C Maul, Daniel A Cremer, Ingrid Becker, David de la Puente Bethencourt, Peter Paal, Stephan A Padosch, Wolfgang A Wetsch, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
BACKGROUND: Targeted temperature management (TTM) is widely used in critical care settings for conditions including hepatic encephalopathy, hypoxic ischemic encephalopathy, meningitis, myocardial infarction, paediatric cardiac arrest, spinal cord injury, traumatic brain injury, ischemic stroke and sepsis. Furthermore, TTM is a key treatment for patients after out-of-hospital cardiac-arrest (OHCA). However, the optimal cooling method, which is quick, safe and cost-effective still remains controversial...
2017: PloS One
https://www.readbyqxmd.com/read/28288193/nonalcoholic-fatty-liver-disease-and-increased-risk-of-1-year-all-cause-and-cardiac-hospital-readmissions-in-elderly-patients-admitted-for-acute-heart-failure
#14
Filippo Valbusa, Stefano Bonapace, Davide Agnoletti, Luca Scala, Cristina Grillo, Pietro Arduini, Emanuela Turcato, Alessandro Mantovani, Giacomo Zoppini, Guido Arcaro, Christopher Byrne, Giovanni Targher
Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for heart failure (HF). Although some progress has been made in improving survival among patients admitted for HF, the rates of hospital readmissions and the related costs continue to rise dramatically. We sought to examine whether NAFLD and its severity (diagnosed at hospital admission) was independently associated with a higher risk of 1-year all-cause and cardiac re-hospitalization in patients admitted for acute HF. We studied 212 elderly patients who were consecutively admitted with acute HF to the Hospital of Negrar (Verona) over a 1-year period...
2017: PloS One
https://www.readbyqxmd.com/read/28279251/oral-anticoagulants-for-primary-prevention-treatment-and-secondary-prevention-of-venous-thromboembolic-disease-and-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#15
Jonathan Ac Sterne, Pritesh N Bodalia, Peter A Bryden, Philippa A Davies, Jose A López-López, George N Okoli, Howard Hz Thom, Deborah M Caldwell, Sofia Dias, Diane Eaton, Julian Pt Higgins, Will Hollingworth, Chris Salisbury, Jelena Savović, Reecha Sofat, Annya Stephens-Boal, Nicky J Welton, Aroon D Hingorani
BACKGROUND: Warfarin is effective for stroke prevention in atrial fibrillation (AF), but anticoagulation is underused in clinical care. The risk of venous thromboembolic disease during hospitalisation can be reduced by low-molecular-weight heparin (LMWH): warfarin is the most frequently prescribed anticoagulant for treatment and secondary prevention of venous thromboembolism (VTE). Warfarin-related bleeding is a major reason for hospitalisation for adverse drug effects. Warfarin is cheap but therapeutic monitoring increases treatment costs...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28267469/acute-coronary-syndrome-quality-improvement-in-kerala-acs-quik-rationale-and-design-for-a-cluster-randomized-stepped-wedge-trial
#16
Mark D Huffman, Padinhare Purayil Mohanan, Raji Devarajan, Abigail S Baldridge, Dimple Kondal, Lihui Zhao, Mumtaj Ali, Donald M Lloyd-Jones, Dorairaj Prabhakaran
Ischemic heart disease is the leading cause of death in India, and there are likely more myocardial infarctions in India than in any other country in the world. We have previously reported heterogeneous care for patients with myocardial infarction in Kerala, a state in southern India, including both gaps in optimal care and inappropriate care. Based on that prior work, limitations from previous nonrandomized quality improvement studies and promising gains in process of care measures demonstrated from previous randomized trials, we and the Cardiological Society of India-Kerala chapter sought to develop, implement, and evaluate a quality improvement intervention to improve process of care measures and clinical outcomes for these patients...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28250684/acute-st-segment-elevation-myocardial-infarction-the-prognostic-importance-of-lead-augmented-vector-right-and-leads-v7-v9
#17
Veeresh Patil Hebbal, Huliyurdurga Srinivasasetty Natraj Setty, Cholenahalli Manjunath Sathvik, Vikram Patil, Sarthak Sahoo, Cholenahalli Nanjappa Manjunath
BACKGROUND: Acute myocardial infarction (MI) is associated with high mortality and among survivors have high morbidity. Electrocardiogram (ECG), a cost-effective and easily available, has traditionally been used not only just for diagnosis of MI but also for culprit vessel recognition and for prognostication. However, the role of lead augmented vector right (aVR) and leads V7-V9 in acute MI are often neglected in clinical practice. We studied the role of lead aVR and leads V7-V9 in ST-elevation MI (STEMI) patients...
January 2017: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/28228576/ten-year-temporal-trends-in-medical-complications-after-acute-intracerebral-hemorrhage-in-the-united-states
#18
Fadar Oliver Otite, Priyank Khandelwal, Amer M Malik, Seemant Chaturvedi, Ralph L Sacco, Jose G Romano
BACKGROUND AND PURPOSE: Data on medical complications after intracerebral hemorrhage (ICH) are sparse. We assessed trends in the prevalence of urinary tract infection, pneumonia, sepsis, deep venous thrombosis (DVT), pulmonary embolism, acute renal failure (ARF), and acute myocardial infarction after ICH in the United States. METHODS: A total of 575 211 adult ICH cases were identified from the 2004 to 2013 Nationwide Inpatient Sample. Weighted complication risks were computed by sex and mechanical ventilation status...
February 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28219665/comparison-of-hospital-outcome-of-transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-diabetes-mellitus-from-the-nationwide-inpatient-sample
#19
Tomo Ando, Emmanuel Akintoye, Tesfaye Telila, Alexandros Briasoulis, Hisato Takagi, David P Slovut, Theodore Schreiber, Cindy L Grines, Luis Afonso
The comparative outcomes of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in diabetes mellitus (DM) patients are scarce. We aimed to assess and compare the outcomes of TAVR versus SAVR in DM patients using the Nationwide Inpatient Sample database from 2011 to 2013. A complete case analysis was performed for the multivariate analysis and cases with missing data were excluded. The primary end point was in-patient all-cause mortality and secondary outcomes were perioperative complications...
April 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28208030/intensive-care-unit-admission-and-survival-among-older-patients-with-chronic-obstructive-pulmonary-disease-heart-failure-or-myocardial-infarction
#20
Thomas S Valley, Michael W Sjoding, Andrew M Ryan, Theodore J Iwashyna, Colin R Cooke
RATIONALE: Admission to an intensive care unit (ICU) may be beneficial to pneumonia patients with uncertain ICU needs; however, evidence regarding the association between ICU admission and mortality for other common conditions is largely unknown. OBJECTIVES: To estimate the relationship between ICU admission and outcomes for hospitalized patients with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), or acute myocardial infarction (AMI)...
February 16, 2017: Annals of the American Thoracic Society
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