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https://www.readbyqxmd.com/read/29150897/determining-best-outcomes-from-community-acquired-pneumonia-and-how-to-achieve-them
#1
REVIEW
Jane Hadfield, Lesley Bennett
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources...
November 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29150536/availability-sales-and-affordability-of-tobacco-cessation-medicines-in-kerala-india
#2
Smitha Sarma, Sivadasanpillai Harikrishnan, Abigail S Baldridge, Raji Devarajan, Aashna Mehta, Sakhtivel Selvaraj, Mohammed K Ali, Padinhare P Mohanan, Dorairaj Prabhakaran, Mark D Huffman
BACKGROUND: India is the world's second largest consumer of tobacco, but tobacco cessation remains uncommon due, at least in part, to underutilization of cessation pharmacotherapy. We evaluated the availability, sales, and affordability of nicotine replacement therapy, bupropion, and varenicline in the South Indian state of Kerala to understand potential reasons for underutilization. METHODS AND RESULTS: From November 2016 to April 2017, we collected data on availability, inventory, and pricing of cessation medication through a cross-sectional survey of 199 public, semiprivate (Karunya), and private pharmacies across 5 districts in Kerala using World Health Organization/Health Action International methodology...
November 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29150530/declining-rates-of-hospitalization-for-selected-cardiovascular-disease-conditions-among-adults-aged-%C3%A2-35-years-with-diagnosed-diabetes-u-s-1998-2014
#3
Nilka Ríos Burrows, YanFeng Li, Edward W Gregg, Linda S Geiss
OBJECTIVE: Reductions in heart attack and stroke hospitalizations are well documented in the U.S. population with diabetes. We extended trend analyses to other cardiovascular disease (CVD) conditions, including stroke by type, and used four additional years of data. RESEARCH DESIGN AND METHODS: Using 1998-2014 National (Nationwide) Inpatient Sample data, we estimated the number of discharges having acute coronary syndrome (ACS) (ICD-9 codes 410-411), cardiac dysrhythmia (427), heart failure (428), hemorrhagic stroke (430-432), or ischemic stroke (433...
November 17, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29150207/carotid-and-femoral-atherosclerosis-in-antiphospholipid-syndrome-equivalent-risk-with-diabetes-mellitus-in-a-case-control-study
#4
Evrydiki Kravvariti, George Konstantonis, Nikolas Tentolouris, Petros P Sfikakis, Maria G Tektonidou
BACKGROUND: Antiphospholipid syndrome (APS) may carry a worse prognosis for vascular complications when co-existing with subclinical atherosclerosis; however, the association between the two conditions remains ambiguous. METHODS: We evaluated ultrasonographic markers of subclinical atherosclerosis in carotid and femoral arteries of 86 patients with thrombotic APS [43 primary APS (PAPS), 43 systemic lupus erythematosus-associated APS (SLE/APS)], 86 patients with diabetes mellitus (DM) and 86 healthy controls, individually matched for age and gender, and investigated their associations with traditional and disease-related factors in APS...
October 23, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29150157/all-cause-mortality-following-an-acute-coronary-syndrome-12-year-follow-up-of-the-comprehensive-2002-new-zealand-acute-coronary-syndrome-audit
#5
Chris J Ellis, Greg D Gamble, Michael J A Williams, Phil Matsis, John M Elliott, Gerry Devlin, Stewart Mann, John K French, Harvey D White
BACKGROUND: To describe the long-term mortality of a complete national cohort of acute coronary syndrome (ACS) patients enrolled in 2002, to compare this with a national age, sex and Māori ethnicity matched population, and to assess the influence of baseline factors on the 12-year mortality. METHODS: We reviewed 721 patients with a discharge diagnosis of an ACS who were enrolled in the first New Zealand ACS audit group cohort over 14days in May 2002. We matched the cohort to the national mortality database using each patient's unique national identity number...
November 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29149097/acute-coronary-disease-prognosis-and-prevalence-of-risk-factors-in-young-adults
#6
REVIEW
Alvaro Gudiño Gomezjurado, Bianca Pujol Freitas, Flavia Contreira Longatto, Juliana Negrisoli, Gustavo Aguiar Sousa
Acute coronary disease is a rare entity in young people and is mostly related to atherosclerotic disease. However, other causes such as myocardial bridges, coronary artery dissection and antiphospholipid syndrome may be present. The prognosis of the disease in this group of patients is favorable; although women may have a higher morbidity because diagnosis and treatment can be delayed. The goal of this review is to update the knowledge about risk factors and prognosis of young patients with an acute coronary event compared to the older population...
November 9, 2017: Medwave
https://www.readbyqxmd.com/read/29148241/peri-procedural-myocardial-infarction-plaques-and-patients-at-risk
#7
EDITORIAL
James A Goldstein
Patients with acute coronary syndrome are at risk for peri-procedural myocardial infarction (PMI) Lipid-laden plaques with thinned disrupted fibrous caps are most prone to PMI PMI is associated with worse outcome over time, though whether such damaging events are causal or instead reflect patients prone to future instability from non-culprit vulnerable plaques requires further delineation.
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29146760/blepharitis-as-an-early-sign-of-metabolic-syndrome-a-nationwide-population-based-study
#8
Chia-Yi Lee, Hung-Chi Chen, Hui-Wen Lin, Jing-Yang Huang, Shih-Chun Chao, Chao-Bin Yeh, Hung-Yu Lin, Shun-Fa Yang
BACKGROUND: To investigate the relationship between blepharitis and metabolic syndrome (MetS) by using the Longitudinal Health Insurance Database (LHID) of Taiwan. METHODS: This retrospective cohort study was conducted using data collected from the LHID for the period from 2009 to 2013. This study enrolled patients who received a diagnosis of blepharitis according to the International Classification of Diseases, Ninth Revision, diagnostic code. The exclusion criteria were legal blindness, eyeball removal, ocular tumours prior to the diagnosis of blepharitis, and patients diagnosed with blepharitis and initiated antibiotic treatment concurrently...
November 16, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29146627/single-session-versus-staged-procedures-for-elective-multivessel-percutaneous-coronary-intervention
#9
Toshiaki Toyota, Takeshi Morimoto, Hiroki Shiomi, Kyohei Yamaji, Kenji Ando, Koh Ono, Satoshi Shizuta, Naritatsu Saito, Takao Kato, Shuichiro Kaji, Yutaka Furukawa, Yoshihisa Nakagawa, Kazushige Kadota, Minoru Horie, Takeshi Kimura
OBJECTIVES: To clarify the effect of single-session multivessel percutaneous coronary intervention (PCI) strategy relative to the staged multivessel strategy on clinical outcomes in patients with stable coronary artery disease (CAD) or non-ST-elevation acute coronary syndrome. METHODS: In the Coronary REvascularisation Demonstrating Outcome Study in Kyoto PCI/coronary artery bypass grafting registry cohort-2, there were 2018 patients who underwent elective multivessel PCI...
November 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29146484/association-between-ischemic-and-bleeding-risk-scores-and-the-use-of-new-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome
#10
Pedro J Flores-Blanco, Francisco Cambronero-Sánchez, Sergio Raposeiras-Roubin, Emad Abu-Assi, Gunnar Leithold, Rafael Cobas-Paz, Ana I Rodríguez Serrano, Francisco Calvo-Iglesias, Mariano Valdés, James L Januzzi, Andrés Iñiguez-Romo, Sergio Manzano-Fernández
INTRODUCTION AND OBJECTIVES: Acute coronary syndrome (ACS) guidelines recommend the use of newer P2Y12 inhibitors (prasugrel and ticagrelor) over clopidogrel in patients with moderate-to-high ischemic risk, unless they have an increased bleeding risk. The aim of our study was to assess the GRACE risk score and the CRUSADE bleeding risk score relative to prescription of newer P2Y12 inhibitors at discharge in ACS patients. METHODS: Retrospective analysis of a multicenter ACS registry; 3515 consecutive patients were included...
November 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29145303/epicardial-radiofrequency-catheter-ablation-of-brugada-syndrome-with-electrical-storm-during-ventricular-fibrillation-a-case-report
#11
Shufen Jiang, Xiaomeng Yin, Chang Dong, Yunlong Xia, Jinqiu Liu
RATIONALE: Brugada syndrome (BrS) is characterized by ST segment elevation at the J point ≥2 mm in the right precordial electrocardiogram (ECG) leads, in the absence of structural heart disease, electrolyte disturbances, or ischemia. It is a well-described cause of sudden death in young patients, especially in the age of between 30 and 40 years old. Here, we reported an unusual case of electrical storm (ES) of ventricular fibrillation (VF) caused by BrS with complete right bundle-branch block (CRBBB) in a 75-year-old male patient...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144175/pregnancy-associated-plasma-protein-a-as-a-prognostic-biomarker-of-all-cause-mortality-and-cardiovascular-events-in-patients-presenting-with-chest-pain-a-systematic-review
#12
Christos A Papanastasiou, Damianos G Kokkinidis, Evangelos K Oikonomou, Vasileios G Mantziaris, T Raymond Foley, Theodoros D Karamitsos, Stephen W Waldo, Ehrin J Armstrong
AIM: Novel biomarkers have been proposed for identification of patients at greater risk of future adverse events among those presenting with chest pain. In this review, we aim to elucidate the ability of pregnancy associated plasma protein-A (PAPP-A) to predict mortality and other cardiovascular events in this patient population. METHODS: A literature search of the electronic databases Medline, Scopus, Cochrane Library and ClinicalTrials.gov was performed in order to identify studies investigating the utility of PAPP-A to predict mortality and adverse cardiovascular events in patients with chest pain...
November 16, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29142492/early-changes-in-platelet-size-and-number-in-patients-with-acute-coronary-syndrome
#13
Zora Sušilović Grabovac, Darija Baković, Mislav Lozo, Irena Pintarić, Željko Dujić
A strong relationship exists between acute coronary syndrome (ACS) and platelets (PLTs) volume. Mean platelet volume (MPV) is a parameter of PLT functions and a marker for increased PLT activation. The aim of this study was to determine early changes in number of total PLT and MPV in different manifestation of ACS and to find out predictive value of MPV in the spectrum of ACS. This was a prospective study. One hundred thirty-four ACS patients were enrolled, 76 of them finished the study. PLT and MPV in patients with unstable angina, non-ST elevation, and ST elevation myocardial infarctions were determined on arrival and 1, 3, 72 hours, and 7 days after the admission to hospital...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29141503/association-of-the-genetic-and-traditional-risk-factors-of-ischaemic-heart-disease-with-stemi-and-nstemi-development
#14
Diana Žaliaduonytė-Pekšienė, Vaiva Lesauskaitė, Rasa Liutkevičienė, Vytenis Tamakauskas, Vilius Kviesulaitis, Giedrė Šinkūnaitė-Maršalkienė, Sandrita Šimonytė, Simonita Mačiulskytė, Eglė Tamulevičiūtė-Prascienė, Olivija Gustienė, Abdonas Tamošiūnas, Remigijus Žaliūnas
INTRODUCTION: To evaluate the influence of traditional risk factors of ischaemic heart disease and genetic factors to predict different types of acute coronary syndromes. MATERIALS AND METHODS: Five hundred and twenty-three patients with acute coronary syndromes (393 with ST elevation myocardial infarction (STEMI) and 130 with non-ST elevation myocardial infarction (NSTEMI)) comprised the study group. The control group consisted of 645 subjects free from symptoms of ischaemic heart disease and stroke...
October 2017: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/29140107/a-cross-sectional-study-of-ethnicity-based-differences-in-treatment-seeking-for-symptoms-of-acute-coronary-syndrome
#15
Emma Iacoe, Pamela A Ratner, Sabrina T Wong, Martha H Mackay
BACKGROUND: Patient-related delays in acquiring medical care for symptoms of acute coronary syndrome remain unacceptably long. Many clinical and sociodemographic characteristics associated with treatment-seeking delay are known; however, ethnicity has not been extensively evaluated. OBJECTIVE: The purpose of this study was to examine ethnicity-based differences in the time-to-treatment-seeking intervals of patients experiencing symptoms of acute coronary syndrome...
November 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29138794/noninvasive-cardiac-testing-vs-clinical-evaluation-alone-in-acute-chest-pain-a-secondary-analysis-of-the-romicat-ii-randomized-clinical-trial
#16
Samuel W Reinhardt, Chien-Jung Lin, Eric Novak, David L Brown
Importance: The incremental benefit of noninvasive testing in addition to clinical evaluation (history, physical examination, an electrocardiogram [ECG], and biomarker assessment) vs clinical evaluation alone for patients who present to the emergency department (ED) with acute chest pain is unknown. Objective: To examine differences in outcomes with clinical evaluation and noninvasive testing (coronary computed tomographic angiography [CCTA] or stress testing) vs clinical evaluation alone...
November 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29138293/icare-acs-improving-care-processes-for-patients-with-suspected-acute-coronary-syndrome-a-study-of-cross-system-implementation-of-a-national-clinical-pathway
#17
Martin P Than, John W Pickering, Jeremy M Dryden, Sally J Lord, S Andrew Aitken, Sally J Aldous, Kate E Allan, Michael W Ardagh, John W N Bonning, Rosie Callender, Laura R E Chapman, Jonathan P Christiansen, Andre P J Cromhout, Louise Cullen, Joanne M Deely, Gerard P Devlin, Katherine A Ferrier, Christopher M Florkowski, Christopher M A Frampton, Peter M George, Gregory J Hamilton, Allan S Jaffe, Andrew J Kerr, G Luke Larkin, Richard M Makower, Timothy J E Matthews, William A Parsonage, W Frank Peacock, Bradley F Peckler, Nicholaas C van Pelt, Louise Poynton, A Mark Richards, Anthony G Scott, Mark B Simmonds, David Smyth, Oliver P Thomas, Andrew C Y To, Stephen A Du Toit, Richard W Troughton, Kim M Yates
BACKGROUND : Efforts to safely reduce length of stay for emergency department patients with symptoms suggestive of acute coronary syndrome (ACS) have had mixed success. Few system-wide efforts affecting multiple hospital emergency departments have ever been evaluated. We evaluated the effectiveness of a nationwide implementation of clinical pathways for potential ACS in disparate hospitals. METHODS : This was a multicenter pragmatic stepped-wedge before-and-after trial in 7 New Zealand acute care hospitals with 31 332 patients investigated for suspected ACS with serial troponin measurements...
November 14, 2017: Circulation
https://www.readbyqxmd.com/read/29138181/one-year-outcome-of-intensive-insulin-therapy-combined-to-glucose-insulin-potassium-in-acute-coronary-syndrome-a-randomized-controlled-study
#18
Wahid Bouida, Kaouthar Beltaief, Mohamed Amine Msolli, Nasri Bzeouich, Adel Sekma, Malek Echeikh, Malek Mzali, Hamdi Boubaker, Mohamed Habib Grissa, Riadh Boukef, Mohsen Hassine, Zohra Dridi, Asma Belguith, Fadhel Najjar, Ines Khochtali, Semir Nouira
BACKGROUND: A number of factors may offset the cardioprotective effects of glucose-insulin-potassium (GIK) on outcome of patients with acute coronary syndrome, such as hyperglycemia induced by this cocktail infusion. We performed a study to evaluate the effect of intensive insulin therapy in association with GIK on 1-year outcome in patients hospitalized for acute coronary syndrome. METHODS AND RESULTS: In a randomized prospective controlled trial we included 772 patients with non-ST-segment elevation acute coronary syndrome...
November 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29135625/impact-of-sex-on-long-term-clinical-outcomes-after-percutaneous-coronary-intervention
#19
Seyed-Mohammad Ghoreyshi-Hefzabad, Seyed-Ebrahim Kassaian, Shahrbanoo Kheirkhah-Sabetghadam, Arash Jalali, Hamidreza Poorhosseini, Mohammad Reza Movahed, Ebrahim Nematipour, Mojtaba Salarifar, Mohammad Alidoosti, Seyedeharezoo Ghoreyshi-Hefzabad, Farshid Alaeddini, Saeed Sadeghian, Masoumeh Lotfi-Tokaldany
AIMS: To evaluate the impact of sex on long-term clinical outcomes after percutaneous coronary intervention (PCI). METHODS: In a large prospective cohort, 5664 patients (1716 women and 3948 men) who underwent PCI in a tertiary cardiac center between March 2007 and March 2010 were enrolled. Patients were followed up for median of 74.3 months. We compared the occurrence of long-term mortality, myocardial infarction (MI), and repeated revascularization between 2 sexes...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#20
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
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