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Heart failure intensive care

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https://www.readbyqxmd.com/read/28526671/telehealth-interventions-to-support-self-management-of-long-term-conditions-a-systematic-metareview-of-diabetes-heart-failure-asthma-chronic-obstructive-pulmonary-disease-and-cancer
#1
REVIEW
Peter Hanlon, Luke Daines, Christine Campbell, Brian McKinstry, David Weller, Hilary Pinnock
BACKGROUND: Self-management support is one mechanism by which telehealth interventions have been proposed to facilitate management of long-term conditions. OBJECTIVE: The objectives of this metareview were to (1) assess the impact of telehealth interventions to support self-management on disease control and health care utilization, and (2) identify components of telehealth support and their impact on disease control and the process of self-management. Our goal was to synthesise evidence for telehealth-supported self-management of diabetes (types 1 and 2), heart failure, asthma, chronic obstructive pulmonary disease (COPD) and cancer to identify components of effective self-management support...
May 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28524035/-comparison-of-risk-of-death-between-older-and-non-older-critical-patients-in-icu-a-retrospective-cohort-study-of-consecutive-3-years
#2
Yeting Zhou, Daoming Tong, Shaodan Wang, Liansong Liu, Song Ye, Benwen Xu
OBJECTIVE: To investigate the risk of death between older and non-older critical patients in intensive care unit (ICU) in Shuyang People's Hospital. METHODS: A retrospective cohort study was conducted. The critical patients who aged 15 or above, and admitted to ICU of Shuyang People's Hospital from January 2014 to December 2016 were enrolled, and all the data was collected from the registration and electronic medical records in the ICU. The prevalence and causes of death in ICU critical patients during the study period were observed...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523862/transatlantic-medical-consultation-and-second-opinion-in-pediatric-cardiology-has-benefit-past-patient-care-a-case-study-in-videoconferencing
#3
Lubica Kovacikova, Martin Zahorec, Peter Skrak, Brian D Hanna, R Lee Vogel
BACKGROUND: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities. OBJECTIVE: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology. METHODS: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children's Hospital of Philadelphia (CHOP), USA...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28511557/impact-of-a-perioperative-prophylaxis-guideline-on-post-cardiothoracic-surgery-atrial-fibrillation
#4
Rosanna Li, C Michael White, Jola Mehmeti, Spencer T Martin, Laura C Hobbs
BACKGROUND: National practice guidelines do not provide clear recommendations on combination pharmacological regimens to reduce cardiothoracic surgery (CTS) postoperative atrial fibrillation (POAF). OBJECTIVE: This study examines if there is a reduction in POAF rates after implementing a perioperative prophylaxis guideline that includes amiodarone, β-blockers, and high-intensity statins. METHODS: Data were retrospectively collected on 400 adults (200 patients pre-guideline implementation and 200 patients post-guideline implementation) with a CHA2DS2-VASc (Congestive Heart Failure, Hypertension, Age, Diabetes Mellitus, and Vascular Disease) score of at least 3 points after CTS...
May 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28504982/characteristics-in-hospital-management-and-outcome-of-late-acute-st-elevation-myocardial-infarction-presenters
#5
Enrico Cerrato, Davide Forno, Silvia Ferro, Alessandra Chinaglia
BACKGROUND: Patients with delayed presentation of acute myocardial infarction with ST-segment elevation (STEMI) frequently have a poor prognosis but literature about acute complications in intensive cardiac care unit (ICCU) and in-hospital outcome are still limited. METHODS: All STEMI patients admitted to our institution between June 2007 and December 2013 were divided into patients presenting more than 12 h after symptom onset (lateSTEMI) and within 12 h (STEMI)...
May 12, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28501797/predictors-of-procedural-complications-in-adult-fontan-patients-undergoing-non-cardiac-procedures
#6
Alexander C Egbe, Arooj R Khan, Naser M Ammash, David W Barbara, William C Oliver, Sameh M Said, Emmanuel Akintoye, Carole A Warnes, Heidi M Connolly
OBJECTIVE: Limited data exist regarding the outcomes of non-cardiac procedures (NCPs) in adult patients after Fontan operations (Fontan patients). METHODS: To compare procedural outcomes after NCPs in Fontan patients with outcomes for two matched control groups: patients with repaired congenital heart disease and biventricular circulation (CHD-BiV) and patients with no heart disease (NHD). We defined cyanosis as oxygen saturation <90% and procedural hypoxia as saturation <80% or a decrease in saturation >10% from baseline...
May 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28501384/acute-heart-failure-in-the-emergency-department-the-safe-simeu-epidemiological-study
#7
Andrea Fabbri, Giulio Marchesini, Giorgio Carbone, Roberto Cosentini, Annamaria Ferrari, Mauro Chiesa, Alessio Bertini, Federico Rea
BACKGROUND: Patients with acute heart failure (AHF) have high rates of attendance to emergency departments (EDs), with significant health care costs. OBJECTIVES: We aimed to describe the clinical characteristics of patients attending Italian EDs for AHF and their diagnostic and therapeutic work-up. METHODS: We carried out a retrospective analysis on 2683 cases observed in six Italian EDs for AHF (January 2011 to June 2012). RESULTS: The median age of patients was 84 years (interquartile range 12), with females accounting for 55...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28482805/management-of-potentially-life-threatening-emergencies-at-74-primary-level-hospitals-in-mongolia-results-of-a-prospective-observational-multicenter-study
#8
Naranpurev Mendsaikhan, Davaa Gombo, Ganbold Lundeg, Christian Schmittinger, Martin W Dünser
BACKGROUND: While the capacities to care for and epidemiology of emergency and critically ill patients have been reported for secondary and tertiary level hospitals in Mongolia, no data exist for Mongolian primary level hospitals. METHODS: In this prospective, observational multicenter study, 74 primary level hospitals of Mongolia were included. We determined the capacities of these hospitals to manage medical emergencies. Furthermore, characteristics of patients presenting with potentially life-threatening emergencies to these hospitals were evaluated during a 6 month period...
May 8, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28468613/low-mean-perfusion-pressure-is-a-risk-factor-for-progression-of-acute-kidney-injury-in-critically-ill-patients-a-retrospective-analysis
#9
Marlies Ostermann, Anna Hall, Siobhan Crichton
BACKGROUND: The aim was to investigate whether mean perfusion pressure (MPP) calculated as the difference between mean arterial pressure (MAP) and central venous pressure (CVP) was associated with risk of progression from AKI I to AKI III in critically ill patients. METHODS: Retrospective analysis of adult patients admitted to a multi-disciplinary adult intensive care unit (ICU) between July 2007 and June 2009 who developed AKI I and in whom advanced haemodynamic monitoring was initiated within 12 h of diagnosis of AKI I...
May 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28462600/symptomatic-recovery-and-pharmacological-management-in-a-clinical-cohort-with-peripartum-cardiomyopathy
#10
Anders Barasa, Valentina Goloskokova, Lars Ladfors, Harshida Patel, Maria Schaufelberger
AIM: We aimed to characterize the clinical course with focus on pharmacological management of peripartum cardiomyopathy (PPCM) in Sweden. METHODS: Twenty-four consecutive patients were retrospectively identified among women presenting with PPCM in Western Sweden. Of these, 14 had concomitant preeclampsia. There was only one fatality. The mean (standard deviation) left ventricular ejection fraction (LVEF) at diagnosis was 35.0 ± 9.9%. Ten women, 47.6%, required intensive care unit (ICU) admission...
May 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28461706/possibilities-for-modifying-risk-factors-for-the-development-of-hospital-acquired-pneumonia-in-intensive-care-patients-results-of-a-retrospective-observational-study
#11
Radovan Uvizl, Milan Kolar, Tomas Herkel, Michaela Vobrova, Katerina Langova
BACKGROUND: Hospital-acquired pneumonia (HAP) development is affected by a range of risk factors. METHODS: A retrospective, observational study processing data on all consecutive intensive care patients older than 18 years of age between 1 January 2011 and 31 December 2015. The aim was to determine the incidence of potential risk factors and their impact on the development of HAP. RESULTS: A total of 2229 patients. The overall mortality was 24...
April 26, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28458528/significance-of-nt-pro-bnp-in-acute-exacerbation-of-copd-patients-without-underlying-left-ventricular-dysfunction
#12
Muhammad Adrish, Varalaxmi Bhavani Nannaka, Edison J Cano, Bharat Bajantri, Gilda Diaz-Fuentes
BACKGROUND: B-type natriuretic peptide (BNP) and the N-terminal fragment of pro-BNP (NT-pro-BNP) are established biomarkers of heart failure. Increased levels of natriuretic peptide (NP) have been associated with poor outcomes in acute exacerbation of COPD (AECOPD); however, most studies did not address the conditions that can also increase NT-pro-BNP levels. We aimed to determine if NT-pro-BNP levels correlate with outcomes of AECOPD in patients without heart failure and other conditions that can affect NT-pro-BNP levels...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28454562/diagnosis-and-outcomes-of-acute-kidney-injury-using-surrogate-and-imputation-methods-for-missing-preadmission-creatinine-values
#13
Amélie Bernier-Jean, William Beaubien-Souligny, Rémi Goupil, François Madore, François Paquette, Stéphan Troyanov, Josée Bouchard
BACKGROUND: Missing preadmission serum creatinine (SCr) values are a common obstacle to assess acute kidney injury (AKI) diagnosis and outcomes. The Kidney Disease Improving Global Outcomes (KDIGO) guidelines suggest using a SCr computed from the Modification of Diet in Renal Disease (MDRD) with an estimated glomerular filtration rate of 75 ml/min/1.73 m(2). We aimed to identify the best surrogate method for baseline SCr to assess AKI diagnosis and outcomes. METHODS: We compared the use of 1) first SCr at hospital admission 2) minimal SCr over 2 weeks after intensive care unit admission 3) MDRD computed SCr and 4) Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) computed SCr to assess AKI diagnosis and outcomes...
April 28, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28449624/an-economic-analysis-of-tolvaptan-compared-with-fluid-restriction-among-hospitalized-patients-with-hyponatremia
#14
Varun Ramamohan, Deirdre Mladsi, Naoko Ronquest, Siddhesh Kamat, Susan Boklage
OBJECTIVE: The vasopressin-receptor antagonist tolvaptan is used for the treatment of hyponatremia (HN) in hospitalized patients with congestive heart failure (CHF) or syndrome of inappropriate antidiuretic hormone secretion (SIADH). The objective of this economic modeling study was to assess the potential cost and health outcomes associated with tolvaptan in comparison with fluid restriction (FR). METHODS: A decision-analytic model was developed to estimate potential cost and health outcomes associated with tolvaptan compared with FR among hospitalized CHF and SIADH patients with severe HN (serum sodium [SS] levels < 125 mEq/L)...
April 28, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28449477/continuous-administration-of-recombinant-human-b-type-natriuretic-peptide-can-improve-heart-and-renal-function-in-patients-after-cardiopulmonary-bypass-surgery
#15
Shiguan Le, Jian Xiao, Wei Li, Jing Wang, Qing Wang, Wang Xi, Jibin Xu, Zhinong Wang
BACKGROUND: Any cardiac surgery under cardiopulmonary bypass (CPB) will induce ischemia-reperfusion injury and systematic inflammatory response, which may lead to exacerbation. Conventional therapy strategy is to use inotropes, diuretics and vasodilator drugs, yet, the therapeutic effects of which need to be improved. Recombinant human B-type natriuretic peptide (rhBNP) has been shown to be efficacious in the treatment of acute decompensated heart failure and acute myocardial infarction...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28442772/discriminative-and-distinct-phenotyping-by-constrained-tensor-factorization
#16
Yejin Kim, Robert El-Kareh, Jimeng Sun, Hwanjo Yu, Xiaoqian Jiang
Adoption of Electronic Health Record (EHR) systems has led to collection of massive healthcare data, which creates oppor- tunities and challenges to study them. Computational phenotyping offers a promising way to convert the sparse and complex data into meaningful concepts that are interpretable to healthcare givers to make use of them. We propose a novel su- pervised nonnegative tensor factorization methodology that derives discriminative and distinct phenotypes. We represented co-occurrence of diagnoses and prescriptions in EHRs as a third-order tensor, and decomposed it using the CP algorithm...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28437859/multiple-sclerosis-broke-my-heart
#17
Géraldine Androdias, Emilien Bernard, Damien Biotti, Nicolas Collongues, Françoise Durand-Dubief, Julie Pique, Ingrid Sanchez, Clément Delmas, Jacques Ninet, Romain Marignier, Sandra Vukusic
We report 5 cases of acute heart failure (AHF) related to multiple sclerosis (MS) relapses. AHF was inaugural in 3 patients, always preceded or accompanied by signs of brainstem dysfunction; it was severe, requiring intensive care management. Echocardiography showed left ventricular hypokinesis. No other cause of AHF has been found. All patients showed a new medullary lesion on brain magnetic resonance imaging. All had rapid and complete recovery of ventricular function after intravenous corticosteroids. We concluded that the cases represent a takotsubo phenomenon...
April 24, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28437212/the-impact-of-communication-skills-training-on-cardiology-fellows-and-attending-physicians-perceived-comfort-with-difficult-conversations
#18
Kathryn Berlacher, Robert M Arnold, Eva Reitschuler-Cross, Jeffrey Teuteberg, Winifred Teuteberg
BACKGROUND: Cardiologists need to decide which treatments are appropriate for seriously ill patients and whether they align with patient goals. Reconciling medical options with patients' wishes requires skilled communication. Although there is evidence that communication is teachable, few cardiologists receive formal training. OBJECTIVE: To demonstrate that providing communication skills training to cardiologists is feasible and improves their perceived preparedness (PP) for leading difficult conversations...
March 1, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28425965/comparison-of-cpap-and-hfnc-in-management-of-bronchiolitis-in-infants-and-young-children
#19
Majken Bisgaard Pedersen, Signe Vahlkvist
Continuous positive airway pressure (CPAP) has been used in infants with bronchiolitis for decades. Recently, high flow nasal cannula (HFNC) therapy was introduced We conducted a retrospective study of treatment with CPAP vs. HFNC between 2013 and 2015, comparing the development in respiratory rate, fraction of inspired oxygen (FiO2) and heart rate, treatment failure, duration of treatment, and length of hospital stay. A sample size of 49 children were included. Median age was 1.9 months. Median baseline pCO₂ was 7...
April 20, 2017: Children
https://www.readbyqxmd.com/read/28420471/-mixed-venous-arterial-carbon-dioxide-difference-combined-with-passive-leg-raising-in-guiding-volume-management-for-patients-post-off-pump-coronary-artery-bypass-grafting
#20
Likun Huo, Peijun Li, Chang Xie, Chenglei Yan, Jie Li
OBJECTIVE: To investigate whether mixed venous-arterial carbon dioxide difference (Pv-aCO2) combined with passive leg raising (PLR) could better guide volume management for patients post off-pump coronary artery bypass grafting (OPCABG). METHODS: Eighty patients experienced OPCABG, and admitted to Tianjin Chest Hospital from June 1st to October 1st in 2016 were enrolled. They were randomly divided into two groups: observation group given Pv-aCO2 combined with PLR directed therapy and control group given central venous pressure (CVP) directed therapy, 40 cases in each group...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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