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https://www.readbyqxmd.com/read/29161389/innovations-in-management-of-cardiac-disease-drugs-treatment-strategies-and-technology
#1
P Foëx
Within the last generation, the management of patients with heart disease has been transformed by advances in drug treatments, interventions and diagnostic technologies. The management of arterial hypertension saw beta-blockers demoted from first- to third-line treatment. Recent studies suggest that the goal of treatment may have to change to lower systolic blood pressures to prevent long-term organ damage. Today less than 15% of coronary revascularizations are surgical and more than 85% are done by interventional cardiologists inserting coronary stents...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29152931/can-red-blood-cell-distribution-width-predict-outcome-after-cardiac-arrest
#2
Vito Fontana, Savino Spadaro, Paola Villois, Claudia Righy Shinotsuka, Alberto Fogagnolo, Leda Nobile, Jean-Louis Vincent, Jacques Creteur, Fabio S Taccone
BACKGROUND: In critically ill patients, high red blood cell distribution width (RDW) values have been associated with increased hospital mortality, but there are no data on the impact of RDW on outcomes of patients resuscitated from cardiac arrest (CA). The aim of this study was to investigate the relationship between RDW and long-term neurologic outcome in CA survivors. METHODS: We performed a retrospective analysis of an institutional database including all unconscious adult patients admitted to the intensive care unit (ICU) after non-traumatic CA between January 2007 and January 2015...
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29151811/prophylactic-plasma-transfusion-for-patients-undergoing-non-cardiac-surgery
#3
Jonathan Huber, Simon J Stanworth, Carolyn Doree, Marialena Trivella, Susan J Brunskill, Sally Hopewell, Kirstin L Wilkinson, Lise J Estcourt
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the clinical effectiveness and safety of prophylactic plasma transfusion for people with confirmed or presumed coagulopathy requiring non-cardiac surgery.
August 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29151453/diastolic-dysfunction-is-a-risk-of-perioperative-myocardial-injury-assessed-by-high-sensitivity-cardiac-troponin-t-in-elderly-patients-undergoing-non-cardiac-surgery
#4
Hironobu Toda, Kazufumi Nakamura, Koji Nakagawa, Atsuyuki Watanabe, Toru Miyoshi, Nobuhiro Nishii, Kazuyoshi Shimizu, Masao Hayashi, Hiroshi Morita, Hiroshi Morimatsu, Hiroshi Ito
BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is useful for detecting myocardial injury and is expected to become a prognostic marker in patients undergoing non-cardiac surgery. The aim of this pilot study evaluating the efficacy of β-blocker therapy in a perioperative setting (MAMACARI study) was to assess perioperative myocardial injury (PMI) in elderly patients with preserved ejection fraction (EF) undergoing non-cardiac surgery.Methods and Results:In this prospective observational cohort study of 151 consecutive patients with preserved EF and aged >60 years who underwent non-cardiac surgery, serum levels of hs-cTnT were measured before and on postoperative days 1 and 3 after surgery...
November 18, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#5
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29143088/the-association-of-preoperative-hematocrit-and-transfusion-with-mortality-in-patients-undergoing-elective-non-cardiac-surgery
#6
Rodney A Gabriel, Anthony I Clark, Albert P Nguyen, Ruth S Waterman, Ulrich H Schmidt
BACKGROUND: Patients with anemia frequently undergo surgery, as it is unclear at what threshold clinicians should consider delaying surgery for preoperative anemia optimization. The primary objective of this study was to determine whether there is an association of varying degrees of anemia and transfusion with 30-day mortality. METHODS: This is a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2013...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29138878/higher-cost-of-hospitalizations-for-non-cardiac-diagnoses-in-adults-with-congenital-heart-disease
#7
Michael D Seckeler, Ian D Thomas, Jennifer Andrews, Omar Meziab, Tabitha Moe, Elissa Heller, Scott E Klewer
Adults with congenital heart disease (CHD) are a rapidly increasing population and their impact on healthcare resources is not fully understood. The purpose of this study was to describe the costs of hospitalizations for non-cardiac disease for adults with CHD. We conducted a retrospective review of hospital discharge data from the University HealthSystem Consortium Clinical Data Base/Resource Manager from January 2011 through December 2013. Patients were ≥ 18 years old at admission with any ICD-9 code for moderate or high severity CHD; cardiac surgical admissions were excluded...
November 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29137577/postoperative-troponin-measurement-as-a-screening-tool-for-adverse-cardiac-events-in-adult-patients-undergoing-moderate-or-major-non-cardiac-surgery
#8
D Coric, N A Smith
Elevated troponin levels within three days of surgery are strongly linked to major adverse cardiac events (MACE). However, the value of screening with troponin measurements is controversial. The extent to which this is done in routine practice is uncertain. We examined the medical records of all patients ≥45 years of age undergoing moderate or major non-cardiac surgery in our tertiary referral hospital over a six-month period. We determined how many patients had a troponin (TnT) measurement recorded in the first three days postoperatively, how many of these were abnormal, and the occurrence of MACE within 30 days...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29136314/syncope-prognosis-based-on-emergency-department-diagnosis-a-prospective-cohort-study
#9
Cristian Toarta, Muhammad Mukarram, Kirtana Arcot, Soo-Min Kim, Sarah Gaudet, Marco L A Sivilotti, Brian H Rowe, Venkatesh Thiruganasambandamoorthy
OBJECTIVE: Relatively little is known about outcomes after disposition among syncope patients assigned various diagnostic categories during emergency department (ED) evaluation. We sought to measure the outcomes among these groups within 30 days of the initial ED visit. METHODS: We prospectively enrolled adult syncope patients at six EDs and excluded patients with pre-syncope, persistent mental status changes, intoxication, seizure, and major trauma. Patient characteristics, ED management, diagnostic impression (presumed vasovagal, orthostatic, cardiac, or other/unknown) at the end of the ED visit and physicians' confidence in assigning the etiology were collected...
November 14, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29132619/a-statistical-analysis-based-recommender-model-for-heart-disease-patients
#10
Anam Mustaqeem, Syed Muhammad Anwar, Abdul Rashid Khan, Muhammad Majid
OBJECTIVES: An intelligent information technology based system could have a positive impact on the life-style of patients suffering from chronic diseases by providing useful health recommendations. In this paper, we have proposed a hybrid model that provides disease prediction and medical recommendations to cardiac patients. The first part aims at implementing a prediction model, that can identify the disease of a patient and classify it into one of the four output classes i.e., non-cardiac chest pain, silent ischemia, angina, and myocardial infarction...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29123561/mortality-prediction-in-status-epilepticus-with-the-apache-ii-score
#11
Jocelyn Y Cheng
A retrospective study was performed of adults admitted to the intensive care unit in order to determine the utility of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in predicting in-hospital mortality in intensive care unit patients with non-cardiac status epilepticus. The cohort consisted of 104 subjects, 50 (48.1%) male, 39 (37.5%) aged ≥65 years, with a mean APACHE II score of 17.88. Four models of the APACHE II system were assessed: numerical score, adjusted score mortality, category, and category mortality...
November 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29120733/heart-focused-anxiety-and-health-care-seeking-in-patients-with-non-cardiac-chest-pain-a-prospective-study
#12
Marie-Andrée Tremblay, Isabelle Denis, Stéphane Turcotte, Richard P Fleet, Patrick Archambault, Clermont E Dionne, Guillaume Foldes-Busque
OBJECTIVES: This study aimed to estimate the incidence of medical consultations six months after an emergency department (ED) consultation for non-cardiac chest pain (NCCP). It also investigated the role of heart-focused anxiety (HFA) and other factors in predicting an increased healthcare utilization in these patients. METHOD: This was a prospective study of 428 patients who came to an ED with NCCP. Patients completed an interview and questionnaires assessing HFA, psychological distress, the characteristics of NCCP, and comorbidities...
October 26, 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29120036/rapid-assessment-with-physical-examination-in-dyspnoeic-cats-the-rapid-cat-study
#13
D Dickson, C J L Little, J Harris, M Rishniw
OBJECTIVES: To determine the underlying disease prevalence in acute feline dyspnoea and to examine whether historical and clinical examination findings can differentiate between acute cardiac and non-cardiac dyspnoea in cats in primary practice. MATERIALS AND METHODS: We prospectively enrolled cats presenting with dyspnoea for the first time to primary practice between June 1, 2011 and October 31, 2016. We collected signalment, historical and clinical data at presentation using a standard form...
November 9, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29119462/syncope-in-pediatric-practice
#14
REVIEW
Pratibha Singhi, Arushi Gahlot Saini
Syncope is defined as a sudden, self-limited loss of consciousness and postural tone followed by spontaneous and complete recovery without any neurological sequelae. It is one of the most common paroxysmal disorders in children and adolescents. The three major causes of syncope in children are neural, cardiovascular and other non-cardiovascular causes. The common unifying mechanism is transient global hypoperfusion of the brain. The diagnosis is primarily clinical and objective laboratory investigations add little to the diagnosis in children especially in neurocardiogenic subtype...
November 9, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29118891/systolic-anterior-motion-of-mitral-valve-subchordal-apparatus-a-rare-echocardiographic-pattern-in-non-obstructive-hypertrophic-cardiomyopathy
#15
Jezreel L Taquiso, Stephanie Martha O Obillos, Joerelle V Mojica, Lauro L Abrahan, Elleen C Cunanan, Jaime Alfonso M Aherrera, Jose Donato A Magno
Systolic anterior motion (SAM) of the mitral valve or chordate is one characteristic seen in hypertrophic cardiomyopathy (HCM) either in obstructive or non-obstructive phenotypes. More often than not, the obstruction is caused by valvular rather than chordal SAM. We describe the role of echocardiography in identifying the actual anatomical location of the mitral valve apparatus involved in SAM and in assessing consequent left ventricular outflow tract (LVOT) obstruction in an otherwise asymptomatic patient...
October 2017: Cardiology Research
https://www.readbyqxmd.com/read/29116212/causes-of-death-in-patients-with-severe-aortic-stenosis-an-observational-study
#16
Eri Minamino-Muta, Takao Kato, Takeshi Morimoto, Tomohiko Taniguchi, Hiroki Shiomi, Kenji Nakatsuma, Shinichi Shirai, Kenji Ando, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Makoto Miyake, Chisato Izumi, Hirokazu Mitsuoka, Masashi Kato, Yutaka Hirano, Shintaro Matsuda, Kazuya Nagao, Tsukasa Inada, Tomoyuki Murakami, Yasuyo Takeuchi, Keiichiro Yamane, Mamoru Toyofuku, Mitsuru Ishii, Moriaki Inoko, Tomoyuki Ikeda, Akihiro Komasa, Eiji Tada, Katsuhisa Ishii, Kozo Hotta, Nobuya Higashitani, Toshikazu Jinnai, Yoshihiro Kato, Yasutaka Inuzuka, Chiyo Maeda, Yuko Morikami, Naritatsu Saito, Ryuzo Sakata, Kenji Minatoya, Takeshi Kimura
Whether patients with severe aortic stenosis (AS) die because of AS-related causes is an important issue for the management of these patients. We used data from CURRENT AS registry, a Japanese multicenter registry, to assess the causes of death in severe AS patients and to identify the factors associated with non-cardiac mortality. We enrolled 3815 consecutive patients with a median follow-up of 1176 days; the 1449 overall deaths comprised 802 (55.3%) from cardiac and 647 (44.7%) from non-cardiac causes. Heart failure (HF) (25...
November 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29102362/drug-eluting-stents-in-elderly-patients-with-coronary-artery-disease-senior-a-randomised-single-blind-trial
#17
Olivier Varenne, Stéphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Josepa Mauri Ferre, Philippe Commeau, Emmanuel Teiger, Kris Bogaerts, Manel Sabate, Marie-Claude Morice, Peter R Sinnaeve
BACKGROUND: Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The aim of this study was to compare outcomes between these two types of stents with a short duration of DAPT in such patients. METHODS: In this randomised single-blind trial, we recruited patients from 44 centres in nine countries. Patients were eligible if they were aged 75 years or older; had stable angina, silent ischaemia, or an acute coronary syndrome; and had at least one coronary artery with a stenosis of at least 70% (≥50% for the left main stem) deemed eligible for percutaneous coronary intervention (PCI)...
October 31, 2017: Lancet
https://www.readbyqxmd.com/read/29094488/maternal-report-of-fever-from-cold-or-flu-during-early-pregnancy-and-the-risk-for-noncardiac-birth-defects-national-birth-defects-prevention-study-1997-2011
#18
Dorothy Kim Waller, Syed Shahrukh Hashmi, Adrienne T Hoyt, Hao T Duong, Sarah C Tinker, Michael Shayne Gallaway, Richard S Olney, Richard H Finnell, Jacqueline Tauber Hecht, Mark A Canfield
BACKGROUND: As maternal fever affects approximately 6-8% of early pregnancies, it is important to expand upon previous observations of an association between maternal fever and birth defects. METHODS: We analyzed data from the National Birth Defects Prevention Study, a multistate, case-control study of major structural birth defects. Telephone interviews were completed by mothers of cases (n = 17,162) and controls (n = 10,127). Using multivariable logistic regression, we assessed the association between maternal self-report of cold or flu with fever and cold or flu without fever during early pregnancy and 30 categories of non-cardiac birth defects...
November 2, 2017: Birth defects research
https://www.readbyqxmd.com/read/29089579/transfemoral-transcatheter-aortic-valve-implantation-in-patients-with-end-stage-renal-disease-and-kidney-transplant-recipients
#19
Fadi Al-Rashid, Anja Bienholz, Heike Annelie Hildebrandt, Polycarpos-Christos Patsalis, Matthias Totzeck, Andreas Kribben, Daniel Wendt, Heinz Jakob, Alexander Lind, Rolf Alexander Jánosi, Tienush Rassaf, Philipp Kahlert
Transcatheter aortic valve implantation (TAVI) has evolved to a treatment of choice in high-risk patients and is therefore ideal for patients with advanced chronic kidney disease, as patients with end-stage renal disease and kidney transplant recipients. Especially, outcome of this special patient group is very important. 22 patients with chronic kidney disease stage 5 undergoing intermittent hemodialysis treatment (CKD 5D) and 8 kidney transplant recipients (KT) with severe aortic valve stenosis underwent transfemoral TAVI...
October 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29068807/antiarrhythmic-effects-of-combining-dofetilide-and-ranolazine-in-a-model-of-acutely-induced-atrial-fibrillation-in-horses
#20
Helena Carstensen, Line Kjær, Maria Mathilde Haugaard, Mette Flethøj, Eva Zander Hesselkilde, Jørgen K Kanters, Steen Pehrson, Rikke Buhl, Thomas Jespersen
BACKGROUND: Antiarrhythmic compounds against atrial fibrillation (AF) often have reduced efficacy and may display cardiac and/or non-cardiac toxicity. Efficacy can be improved by combining two compounds with distinct mechanisms, and it may be possible to use lower doses of each compound, thereby reducing the likelihood of adverse side-effects. The purpose of this study was to investigate whether the effective doses of dofetilide and ranolazine can be reduced if the drugs are combined...
October 25, 2017: Journal of Cardiovascular Pharmacology
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