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https://www.readbyqxmd.com/read/29349708/cost-effectiveness-of-empagliflozin-for-the-treatment-of-patients-with-type-2-diabetes-mellitus-at-increased-cardiovascular-risk-in-greece
#1
George Gourzoulidis, Charalampos Tzanetakos, Ioannis Ioannidis, Apostolos Tsapas, Georgia Kourlaba, Giannis Papageorgiou, Nikos Maniadakis
BACKGROUND AND OBJECTIVE: Type 2 diabetes mellitus (T2DM) is frequently associated with co-morbidities that exacerbate cardiovascular (CV) risk. CV disease is the leading cause of death in people with diabetes across the world and accounts for approximately half the deaths in the T2DM population. Hence, the objective of present study was to evaluate the cost-effectiveness of empagliflozin, in addition to standard of care (SoC), for the treatment of adult patients with T2DM and high CV risk in Greece...
January 18, 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29347987/determinants-of-long-term-outcome-in-icu-survivors-results-from-the-frog-icu-study
#2
Etienne Gayat, Alain Cariou, Nicolas Deye, Antoine Vieillard-Baron, Samir Jaber, Charles Damoisel, Qin Lu, Xavier Monnet, Isabelle Rennuit, Elie Azoulay, Marc Léone, Heikel Oueslati, Bertrand Guidet, Diane Friedman, Antoine Tesnière, Romain Sonneville, Philippe Montravers, Sébastien Pili-Floury, Jean-Yves Lefrant, Jacques Duranteau, Pierre-François Laterre, Nicolas Brechot, Karine Chevreul, Morgane Michel, Bernard Cholley, Matthieu Legrand, Jean-Marie Launay, Eric Vicaut, Mervyn Singer, Matthieu Resche-Rigon, Alexandre Mebazaa
BACKGROUND: Intensive care unit (ICU) survivors have reduced long-term survival compared to the general population. Identifying parameters at ICU discharge that are associated with poor long-term outcomes may prove useful in targeting an at-risk population. The main objective of the study was to identify clinical and biological determinants of death in the year following ICU discharge. METHODS: FROG-ICU was a prospective, observational, multicenter cohort study of ICU survivors followed 1 year after discharge, including 21 medical, surgical or mixed ICUs in France and Belgium...
January 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29344082/implementing-guidelines-on-physical-health-in-the-acute-mental-health-setting-a-quality-improvement-approach
#3
Stuart Green, Ed Beveridge, Liz Evans, Jenny Trite, Sandra Jayacodi, Rachel Evered, Caroline Parker, Luca Polledri, Emily Tabb, John Green, Anton Manickam, Joanna Williams, Rebecca Deere, Bill Tiplady
Background: In the UK, life expectancy for people living with a serious mental illness, such as schizophrenia and bipolar disorder, is reduced by 15-20 years compared with the general population. In recent years, evidence based guidelines/policies designed to improve their physical health have been published, yet a gap remains between recommendations and practice. This case study describes how guidelines to support physical health were implemented using a quality improvement approach...
2018: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/29340541/safety-criteria-to-start-early-mobilization-in-intensive-care-units-systematic-review
#4
Thais Martins Albanaz da Conceição, Ana Inês Gonzáles, Fernanda Cabral Xavier Sarmento de Figueiredo, Danielle Soares Rocha Vieira, Daiana Cristine Bündchen
Mobilization of critically ill patients admitted to intensive care units should be performed based on safety criteria. The aim of the present review was to establish which safety criteria are most often used to start early mobilization for patients under mechanical ventilation admitted to intensive care units. Articles were searched in the PubMed, PEDro, LILACS, Cochrane and CINAHL databases; randomized and quasi-randomized clinical trials, cohort studies, comparative studies with or without simultaneous controls, case series with 10 or more consecutive cases and descriptive studies were included...
October 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29339300/robotic-surgery-in-elderly-and-very-elderly-gynecologic-cancer-patients
#5
Valerio Gallotta, Carmine Conte, Marco D'Indinosante, Alex Federico, Antonella Biscione, Giuseppe Vizzielli, Carolina Bottoni, Maria Vittoria Carbone, Francesco Legge, Stefano Uccella, Pierpaolo Ciocchetti, Andrea Russo, Lorenzo Polidori, Giovanni Scambia, Gabriella Ferrandina
STUDY OBJECTIVE: To investigate feasibility, safety and short-term outcomes of robotic surgery (RS) for gynecological oncologic indications (cervical, endometrial and ovarian cancer) in elderly patients, especially women aged from 65 to 74 (Elderly group - EG), compared to women ≥ 75 (Very Elderly group - VEG). DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Catholic University of the Sacred Hearth, Rome, Italy...
January 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29337985/increased-risk-of-ischemic-heart-disease-hypertension-and-type-2-diabetes-in-women-with-previous-gestational-diabetes-mellitus-a-target-group-in-general-practice-for-preventive-interventions-a-population-based-cohort-study
#6
Barbara Daly, Konstantinos A Toulis, Neil Thomas, Krishna Gokhale, James Martin, Jonathan Webber, Deepi Keerthy, Kate Jolly, Ponnusamy Saravanan, Krishnarajah Nirantharakumar
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with developing type 2 diabetes, but very few studies have examined its effect on developing cardiovascular disease. METHODS AND FINDINGS: We conducted a retrospective cohort study utilizing a large primary care database in the United Kingdom. From 1 February 1990 to 15 May 2016, 9,118 women diagnosed with GDM were identified and randomly matched with 37,281 control women by age and timing of pregnancy (up to 3 months)...
January 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29337172/organ-support-therapy-in-the-intensive-care-unit-and-return-to-work-in-out-of-hospital-cardiac-arrest-survivors-a-nationwide-cohort-study
#7
Signe Riddersholm, Kristian Kragholm, Rikke Nørmark Mortensen, Steen Moller Hansen, Mads Wissenberg, Freddy K Lippert, Christian Torp-Pedersen, Christian F Christiansen, Bodil Steen Rasmussen
AIM: With increased survival after out-of-hospital cardiac arrest (OHCA), impact of the post-resuscitation course has become important. Among 30-day OHCA survivors, we investigated associations between organ support therapy in the Intensive Care Unit (ICU) and return to work. METHODS: This Danish nationwide cohort-study included 30-day-OHCA-survivors who were employed prior to arrest. We linked OHCA data to information on in-hospital care and return to work. For patients admitted to an ICU and based on renal replacement therapy (RRT), cardiovascular support and mechanical ventilation, we assessed the prognostic value of organ support therapies in multivariable Cox regression models...
January 11, 2018: Resuscitation
https://www.readbyqxmd.com/read/29332420/activated-factor-7-versus-4-factor-prothrombin-complex-concentrate-for-critical-bleeding-post-cardiac-surgery
#8
Sarah L Mehringer, Zachary Klick, Jonathan Bain, Elizabeth B McNeely, Sreekumar Subramanian, Lawrence J Pass, Davis Drinkwater, V Seenu Reddy
BACKGROUND: Recombinant and plasma-derived factor products, such as activated factor seven (rFVIIa) and four-factor prothrombin complex concentrate (4-factor PCC), have been used off-label for bleeding after cardiac surgery, but little evidence has been published regarding their efficacy and safety. OBJECTIVE: To determine whether there is a difference in chest tube output in patients who have received 4-factor PCC or rFVIIa for critical postoperative bleeding associated with cardiovascular surgery...
January 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29332153/vasoactive-inotropic-score-as-a-predictor-of-morbidity-and-mortality-in-adults-after-cardiac-surgery-with-cardiopulmonary-bypass
#9
Yumiko Yamazaki, Koji Oba, Yoshiro Matsui, Yuji Morimoto
PURPOSE: The vasoactive-inotropic score (VIS) is a scale showing the amount of vasoactive and inotropic support. Recently, it was suggested that the VIS after cardiac surgery predicts morbidity and mortality in infants. The purpose of this study was to evaluate the VIS at the end of surgery as a predictor of morbidity and mortality in adult cardiac surgery. METHODS: A retrospective cohort study of 129 adult cardiac surgery patients was performed at a university hospital...
January 13, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29329764/-analysis-of-mortality-and-hospital-stay-in-cardiac-surgery-in-mexico-2015-data-from-the-national-cardiology-institute
#10
Alejandra Rodríguez-Hernández, Martha García-Torres, Eduardo Bucio Reta, Francisco Martín Baranda-Tovar
OBJECTIVE: To analyse hospital mortality in patients subjected to cardiac surgery in Mexico during the year 2015, and identify the mortality risks factors, and its correlation with days of hospital stay in the cardiovascular intensive care unit. METHOD: The database of Cardiovascular Intensive Care of the National Institute of Cardiology was examined for this cases and controls study that included only adult patients subjected to cardiac surgery during the year 2015...
January 9, 2018: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/29324494/myocardial-protection-by-glucose-insulin-potassium-in-moderate-to-high-risk-patients-undergoing-elective-on-pump-cardiac-surgery-a-randomized-controlled-trial
#11
Christoph Ellenberger, Tornike Sologashvili, Lukas Kreienbühl, Mustafa Cikirikcioglu, John Diaper, Marc Licker
BACKGROUND: Low cardiac output syndrome is a main cause of death after cardiac surgery. We sought to assess the impact of glucose-insulin-potassium (GIK) to enhance myocardial protection in moderate- to high-risk patients undergoing on-pump heart surgery. METHODS: A randomized controlled trial was performed in adult patients (Bernstein-Parsonnet score >7) scheduled for elective aortic valve replacement and/or coronary artery bypass surgery. Patients were randomized to GIK (20 IU of insulin, 10 mEq of potassium chloride in 50 mL of glucose 40%) or saline infusion given over 60 minutes on anesthetic induction...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29321113/top-cited-publications-on-point-of-care-ultrasound-the-evolution-of-research-trends
#12
Shao-Feng Liao, Pai-Jung Chen, Chung-Hsien Chaou, Ching-Hsing Lee
STUDY OBJECTIVES: Point-of-care ultrasound (POCUS) has been a rapidly growing and broadly used modality in recent decades. The purpose of this study was to determine how POCUS is incorporated into clinical medicine by analyzing trends of use in the published literature. METHODS: POCUS-related publications were retrieved from the Web of Science (WoS) database. The search results were ranked according to the number of times an article was cited during three time frames and average annual number of citations...
January 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29316474/spinal-versus-general-anesthesia-for-lumbar-spine-surgery-in-high-risk-patients-perioperative-hemodynamic-stability-complications-and-costs
#13
Michael Finsterwald, Marco Muster, Mazda Farshad, Andrea Saporito, Muriel Brada, José A Aguirre
OBJECTIVE: More stable perioperative hemodynamic conditions, lower costs and a lower perioperative complication rate were reported in young healthy patients undergoing lumbar spine surgery in spinal anesthesia (SA) compared to general anesthesia (GA). However, the benefits of SA in high risk patients (ASA≥II suffering from cardiovascular and/or pulmonary pathologies) undergoing this surgery are unclear. Our objective was to analyze whether SA leads to an improved perioperative hemodynamic stability and to a more cost-effective management compared to GA in high risk patients undergoing this surgery...
January 6, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29310390/takotsubo-cardiomyopathy-caused-by-acute-respiratory-stress-from-extubation-a-case-report
#14
Kohei Taniguchi, Syogo Takashima, Ryo Iida, Koshi Ota, Masahiko Nitta, Kazushi Sakane, Tomohiro Fujisaka, Nobukazu Ishizaka, Osamu Umegaki, Kazuhisa Uchiyama, Akira Takasu
RATIONAL: Takotsubo cardiomyopathy (TCM) is a transient systolic dysfunction of the left ventricular apex without stenosis of coronary arteries and is induced by various psychological and physical factors. TCM sometimes causes lethal complications such as arrhythmia, thrombogenesis, and even cardiac rupture, and thus it should be diagnosed appropriately and managed carefully. Intensive care unit (ICU) patients are exposed to overstress during the treatment process and therefore can are at potential risk for TCM...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29306775/longitudinal-change-instead-of-baseline-testosterone-predicts-depressive-symptoms
#15
Hanna Kische, Lars Pieper, John Venz, Jens Klotsche, Winfried März, Uwe Koch-Gromus, David Pittrow, Hendrik Lehnert, Sigmund Silber, G K Stalla, Andreas M Zeiher, Hans-Ulrich Wittchen, Robin Haring
BACKGROUND: The association between total testosterone (T) and depression mostly relies on single sex hormone assessment and remains inconclusive. Thus, we investigated the comparative predictive performance of baseline T and change in T with development of depressive symptoms and incident depressive episodes. METHODS: We used data from 6493 primary care patients (2653 men and 3840 women) of the DETECT study (Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment), including four-year follow-up, repeated immunoassay-based measurement of serum T and depressive symptoms assessed by the Depression Screening Questionnaire (DSQ)...
December 21, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29300285/sacral-skin-temperature-assessed-by-thermal-imaging-role-of-patient-vascular-attributes
#16
Harvey N Mayrovitz, Paige E Spagna, Martha C Taylor
PURPOSE: The purpose of this study was to test the hypothesis that temperature differentials measured by thermal imaging of sacral versus a remote skin area in critically ill patients differentiate those with significant vascular disease and risk for pressure injury of the sacral area. DESIGN: Prospective cohort study. SUBJECTS AND SETTING: The sample comprised 100 patients (58 men, 42 women) with mean ± SD ages of 70.4 ± 14.4 and 74.0 ± 14...
January 2018: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29299816/housing-and-food-insecurity-care-access-and-health-status-among-the-chronically-ill-an-analysis-of-the-behavioral-risk-factor-surveillance-system
#17
Paniz Charkhchi, Soudabeh Fazeli Dehkordy, Ruth C Carlos
BACKGROUND: The proportion of the United States population with chronic illness continues to rise. Understanding the determinants of quality of care-particularly social determinants-is critical to the provision of care in this population. OBJECTIVE: To estimate the prevalence of housing and food insecurity among persons with common chronic conditions and to assess the independent effects of chronic illness and sociodemographic characteristics on (1) housing and food insecurity, and (2) health care access hardship and health status...
January 3, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29298368/a-brief-drug-class-review-considerations-for-statin-use-toxicity-and-drug-interactions
#18
James M Wooten
For approximately 30 years, statins have been effectively used to control cholesterol, thereby reducing the morbidity and mortality associated with cardiovascular disease. Evidence-based recommendations regarding how these drugs are dosed and used have changed significantly through the years. There are seven statins approved for use in the United States, and although the mechanism of action pertaining to cholesterol reduction is the same for all statins, each has its own specific pharmacologic profile. One unique aspect of statin dosing is understanding the potential drug interactions associated with statin use; interactions can occur with all statins, but the mechanism and type of interaction can vary significantly among drugs...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29297004/comparison-of-five-major-guidelines-for-statin-use-in-primary-prevention-in-a-contemporary-general-population
#19
Martin Bødtker Mortensen, Børge Grønne Nordestgaard
Background: Five major organizations recently published guidelines for using statins to prevent atherosclerotic cardiovascular disease (ASCVD): in 2013, the American College of Cardiology/American Heart Association (ACC/AHA); in 2014, the United Kingdom's National Institute for Health and Care Excellence (NICE); and in 2016, the Canadian Cardiovascular Society (CCS), the U.S. Preventive Services Task Force (USPSTF), and the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS)...
January 2, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29290495/national-trends-in-open-surgical-endovascular-and-branched-fenestrated-endovascular-aortic-aneurysm-repair-in-medicare-patients
#20
Bjoern D Suckow, Philip P Goodney, Jesse A Columbo, Ravinder Kang, David H Stone, Art Sedrakyan, Jack L Cronenwett, Mark F Fillinger
BACKGROUND: Open repair effectively prevents rupture for patients with abdominal aortic aneurysm (AAA) and is commonly studied as a metric reflecting hospital and surgeon expertise in cardiovascular care. However, given recent advances in endovascular aneurysm repair (EVAR), such as branched-fenestrated EVAR, it is unknown how commonly open surgical repair is still used in everyday practice. METHODS: We analyzed trends in open AAA repair, EVAR, and branched-fenestrated EVAR for AAA in Medicare beneficiaries from 2003 to 2013...
December 28, 2017: Journal of Vascular Surgery
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