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https://www.readbyqxmd.com/read/29054200/the-role-of-acute-circulatory-support-in-st-segment-elevation-myocardial-infarction-complicated-by-cardiogenic-shock
#1
REVIEW
Michele Esposito, Yousef Bader, Robert Pedicini, Catalina Breton, Andrew Mullin, Navin K Kapur
In the setting of ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock, three primary treatment objectives include providing circulatory support, ventricular unloading, and restoring myocardial perfusion. In addition to primary percutaneous coronary intervention, each of these three objectives can be achieved with appropriate use of an acute mechanical circulatory support (AMCS) pump. Over the past decade, utilization of percutaneously-delivered AMCS devices including the Impella axial-flow catheter, TandemHeart left atrial-to-femoral artery bypass system, and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has grown exponentially...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29052434/a-virtual-clinic-improves-pneumococcal-vaccination-coverage-among-patients-living-with-hiv-at-a-veterans-affairs-medical-center
#2
Charles M Burns, Richard E Banks, Brigid M Wilson, Rebecca R Carter, Robin L P Jump, Federico Perez
People living with the human immunodeficiency virus (HIV) should receive pneumococcal vaccinations as part of their routine health maintenance. Our goal was to create a "virtual clinic" to help increase rates of pneumococcal vaccination among people living with HIV without adding substantially to the workload of primary providers. We used administrative data from our Veterans Affairs (VA) medical center to identify a cohort of veterans living with HIV who were not current with either the 13-valent pneumococcal conjugate vaccine (PCV13), the 23-valent pneumococcal polysaccharide vaccine (PPSV23) or both...
October 20, 2017: AIDS Care
https://www.readbyqxmd.com/read/29050009/real-world-results-of-intravitreal-ranibizumab-bevacizumab-or-triamcinolone-for-diabetic-macular-edema
#3
İrem Koç, Sibel Kadayıfçılar, Bora Eldem
OBJECTIVE: To compare the visual and anatomical outcomes of intravitreal ranibizumab (group 1), bevacizumab (group 2), and triamcinolone (group 3) for center-involving diabetic macular edema. METHODS: We retrospectively enrolled 275 eyes of 208 consecutive patients. Visual acuity (VA) in Early Treatment Diabetic Retinopathy Study (ETDRS) letters and central macular thickness (CMT) values on optical coherence tomography were extracted. Reported side effects were noted...
October 20, 2017: Ophthalmologica. Journal International D'ophtalmologie
https://www.readbyqxmd.com/read/29049230/goniosynechialysis-combined-with-cataract-extraction-for-iridoschisis-a-case-report
#4
Zhipeng You, Yan Qin, Guodong Li, Ke Shi
RATIONALE: Iridoschisis is a rare eye disease. In this case report, we described the examination and diagnosis of a case of iridoschisis accompanied by secondary glaucoma. We also observed the effects of treating the patient with a combination of goniosynechialysis and cataract removal. PATIENT CONCERN: A 67-year-old female patient presented with decreased vision in both eyes. An eye examination indicated that visual acuities (VAs) were 20/100 and light perception in the right and left eyes, respectively...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29048985/commentary-impact-of-meningococcal-group-b-omv-vaccines-beyond-their-brief
#5
Helen Petousis-Harris
Meningococcal group B outer membrane vesicle vaccines have been used widely in Cuba, New Zealand, and Brazil. They are immunogenic and initially assessed largely by their ability to induce serum bactericidal activity. Measures of efficacy indicate good protection against homologous strains in older children and adults. Effectiveness appears broader than predicted by immunogenicity and efficacy studies. The recent discovery that meningococcal group B OMVs may protect against the related Neisseria species N.gonorrhoeae suggests more to these interesting antigen collections than meets the eye...
October 19, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29048073/effective-mode-field-diameter-for-few-mode-fibers-for-considering-splice-loss-characteristics
#6
Takashi Matsui, Kazuhide Nakajima, Taiji Sakamoto
We experimentally and numerically investigate the applicability of the conventional near-field pattern, far-field pattern (FFP), and variable aperture (VA) methods for measuring the effective mode-field diameter (MFD) of the higher-order modes, which can be used for accurately evaluating splice loss. We confirmed that the variation in the MFD values obtained with the FFP and VA methods can be converged by considering the minimum scanning angle and the minimum aperture angle, respectively, for both fundamental and higher-order modes...
September 10, 2017: Applied Optics
https://www.readbyqxmd.com/read/29047323/cooking-classes-a-diabetes-self-management-support-intervention-enhancing-clinical-values
#7
Cally Byrne, Neal Kurmas, Christopher J Burant, Anne Utech, Alison Steiber, Mary Julius
Purpose The purpose of this study is to examine the relationship between Healthy Teaching Kitchen (HTK) attendance among veterans who are diagnosed with type 2 diabetes mellitus (T2DM) and clinical outcomes as measured by A1C and blood pressure. Methods This retrospective chart review collected data from veterans with T2DM who participated in the Diabetes Self-Management Support (DSMS) HTK program at the Louis Stokes Cleveland VA Medical Center (LSCVAMC) between February 2013 and May 2016. Data collected included demographic information, frequency of DSMS HTK attendance, 3 A1C values, and 3 blood pressure values...
October 1, 2017: Diabetes Educator
https://www.readbyqxmd.com/read/29047076/increased-rates-of-documented-alcohol-counseling-in-primary-care-more-counseling-or-just-more-documentation
#8
Douglas Berger, Gwen T Lapham, Susan M Shortreed, Eric J Hawkins, Anna D Rubinsky, Emily C Williams, Carol E Achtmeyer, Daniel R Kivlahan, Katharine A Bradley
BACKGROUND: Clinical performance measures often require documentation of patient counseling by healthcare providers. Little is known about whether such measures encourage delivery of counseling or merely its documentation. OBJECTIVE: To assess changes in provider documentation of alcohol counseling and patient report of receiving alcohol counseling in the Veterans Administration (VA) from 2009 to 2012. DESIGN: Retrospective time-series analysis...
October 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29045943/reference-ranges-for-fetal-atrioventricular-and-ventriculoatrial-time-intervals-and-their-ratios-during-normal-pregnancy
#9
Beatrice Mosimann, Georgios Arampatzis, Sofia Amylidi-Mohr, Anice Bessire, Marialuigia Spinelli, Petros Koumoutsakos, Daniel Surbek, Luigi Raio
BACKGROUND: The diagnostic assessment of fetal arrhythmias relies on the measurements of atrioventricular (AV) and ventriculoatrial (VA) time intervals. Pulsed Doppler over in- and outflow of the left ventricle and tissue Doppler imaging are well-described methods, while Doppler measurements between the left brachiocephalic vein and the aortic arch are less investigated. The aim of this study was to compare these methods of measurement, to find influencing factors on AV and VA times and their ratio, and to create reference ranges...
October 19, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29045920/the-association-of-alcohol-consumption-patterns-with-self-rated-physical-health-and-psychiatric-distress-among-afghanistan-and-iraq-era-u-s-veterans
#10
Patrick S Calhoun, Sarah M Wilson, Eric A Dedert, Katherine C Cunningham, Thomas K Burroughs, Terrell A Hicks, Jean C Beckham, Harold S Kudler, Kristy Straits-Troster
Alcohol misuse is associated with negative mental and physical health outcomes, which presents a public health concern in veterans. However, less is known regarding outcomes among veterans with low to moderate alcohol consumption. This study included veterans with military service in Iraq and/or Afghanistan (N = 1083) who resided in the VA Mid-Atlantic region catchment area (North Carolina, Virginia, and parts of West Virginia). Participants completed a mailed survey that inquired about demographics, past-year alcohol consumption, self-rated physical health, and psychiatric symptoms...
September 28, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29045633/ventricular-arrhythmia-and-sudden-cardiac-death-in-fabry-disease-a-systematic-review-of-risk-factors-in-clinical-practice
#11
Shanat Baig, Nicky C Edward, Dipak Kotecha, Boyang Liu, Sabrina Nordin, Rebecca Kozor, James C Moon, Tarekegn Geberhiwot, Richard P Steeds
Fabry disease (FD) is an X-linked lysosomal storage disorder caused by deficiency of α-galactosidase A enzyme. Cardiovascular (CV) disease is a common cause of mortality in FD, in particular as a result of heart failure and arrhythmia, with a significant proportion of events categorized as sudden. There are no clear models for risk prediction in FD. This systematic review aims to identify the risk factors for ventricular arrhythmia (VA) and sudden cardiac deaths (SCD) in FD. A systematic search was performed following PRISMA guidelines of EMBASE, Medline, PubMed, Web of Science, and Cochrane from inception to August 2016, focusing on identification of risk factors for the development of VA or SCD...
October 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29045064/epidemiology-and-burden-of-influenza-in-the-u-s-department-of-veterans-affairs
#12
Cynthia Lucero-Obusan, Patricia L Schirmer, Aaron Wendelboe, Gina Oda, Mark Holodniy
We describe influenza activity in the US Veterans Affairs (VA) population for the 2010-2011 through 2015-2016 seasons and compare with national CDC FluView data. VA confirmed influenza cases ranged from 1,005-11,506 per season; triage calls from 6,090-10,346; outpatient visits from 3,849-13,406; antiviral prescriptions from 3,650-32,826; hospitalizations from 546-4,673; and deaths in hospitalized patients from 17-139. Peak activity was generally the same as observed nationally by the CDC. For the seasons analyzed, correlation between VA and CDC %ILI visits (r=0...
October 16, 2017: Influenza and Other Respiratory Viruses
https://www.readbyqxmd.com/read/29044979/real-world-visual-outcomes-in-patients-with-neovascular-age-related-macular-degeneration-receiving-aflibercept-at-fixed-intervals-as-per-uk-license
#13
Mehmet Ozturk, Martin L Harris, Vuong Nguyen, Daniel Barthelmes, Mark C Gillies, Hemal Mehta
IMPORTANCE: To assess the impact of injection frequency on visual outcomes in patients with neovascular age-related macular degeneration (nAMD) treated with intravitreal aflibercept. BACKGROUND: The UK license for treatment of nAMD with aflibercept is based on the VIEW protocol. We tested the hypothesis that patients receiving fewer than the 8 recommended injections in the first year would experience worse visual outcomes. DESIGN: Retrospective, single-centre observational study...
October 17, 2017: Clinical & Experimental Ophthalmology
https://www.readbyqxmd.com/read/29044720/observational-comparative-effectiveness-of-pharmaceutical-treatments-for-obesity-within-the-veterans-health-administration
#14
Ted R Grabarczyk
STUDY OBJECTIVE: To compare the effectiveness of weight-management medications used to assist with weight loss in real-world clinical practice in the Veterans Health Administration (VHA). DESIGN: Retrospective, multicenter, observational cohort study. DATA SOURCE: National VA Corporate Data Warehouse. PATIENTS: A total of 66,035 VA patients aged 18 years or older with a body mass index of 25 kg/m(2) or greater who had an initial fill for a study medication (orlistat [6153 patients], phentermine [304 patients], lorcaserin [298 patients], or phentermine-topiramate extended release [233 patients]) or participation in the VA's MOVE! weight management program with at least three total visits in a clinic coded as a MOVE clinic in the subsequent 24 weeks (59,047 patients) between January 1, 2012 and July 1, 2016...
October 17, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29043594/specialty-care-access-network-extension-of-community-healthcare-outcomes-model-program-for-liver-disease-improves-specialty-care-access
#15
Lisa M Glass, Akbar K Waljee, Heather McCurdy, Grace L Su, Anne Sales
BACKGROUND AND AIMS: To improve subspecialty access, VA Ann Arbor Healthcare System (VAAAHS) implemented the first Specialty Care Access Network (SCAN)-Extension of Community Healthcare Outcomes (ECHO) in chronic liver disease. SCAN-ECHO Liver links primary care providers (PCPs) to hepatologists via secure video-teleconferencing. We aim to describe characteristics of participants (PCPs) and patients (clinical question and diagnosis) in SCAN-ECHO Liver. METHODS: This is a prospective study of the VAAAHS SCAN-ECHO Liver (June 10, 2011-March 31, 2015)...
October 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29042749/a-review-of-results-after-implantation-of-a-secondary-intraocular-lens-to-correct-residual-refractive-error-after-cataract-surgery
#16
Kjell Gunnar Gundersen, Rick Potvin
PURPOSE: The purpose of this study was to provide clinical outcomes data related to secondary intraocular lens (IOL) implantation for the correction of residual refractive error after cataract surgery. PATIENTS AND METHODS: A chart review was conducted to identify all eyes implanted with the monofocal spherical or toric AddOn(®) secondary IOL. Data were collated from charts where uncomplicated initial cataract surgery was completed. Measures of interest included the original IOL implanted, the postoperative refractive error (before secondary IOL implantation) and the associated corrected and uncorrected visual acuities (VAs)...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29042345/the-association-of-patient-factors-digital-access-and-online-behavior-on-sustained-patient-portal-use-a-prospective-cohort-of-enrolled-users
#17
Susan S Woods, Christopher W Forsberg, Erin C Schwartz, Kim M Nazi, Judith H Hibbard, Thomas K Houston, Martha Gerrity
BACKGROUND: As electronic health records and computerized workflows expand, there are unprecedented opportunities to digitally connect with patients using secure portals. To realize the value of patient portals, initial reach across populations will need to be demonstrated, as well as sustained usage over time. OBJECTIVE: The study aim was to identify patient factors associated with short-term and long-term portal usage after patients registered to access all portal functions...
October 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29041888/-diffusion-capacity-of-the-lung-and-maladaptive-post-infarction-remodeling-of-the-heart
#18
N V Karetnikova, L O Barbarash, V M Katsyuba, M O Polikutina, S Y Slepynina
OBJECTIVE: To assess the association of the lowering of diffusion capacity of the lung and maladaptive remodeling of the heart in a year after myocardial infarction (MI). MATERIALS AND METHODS: We included into this study 107 patients with ST elevation MI (STEMI). Examination of all patients on 7-12 th days included echocardiography (echoCG), spirography, body plethysmography, and determination of lung diffusion capacity. After one year of observation in 87 patients (81...
August 2017: Kardiologiia
https://www.readbyqxmd.com/read/29040883/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-for-emergency-cardiac-support
#19
Terri Sun, Andrew Guy, Amandeep Sidhu, Gordon Finlayson, Brian Grunau, Lillian Ding, Saida Harle, Leith Dewar, Richard Cook, Hussein D Kanji
PURPOSE: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may provide benefit to patients in refractory cardiac arrest and cardiogenic shock. We aim to summarize our center's 6-year experience with resuscitative VA-ECMO. MATERIALS AND METHODS: A retrospective medical record review (April 2009 to 2015) was performed on consecutive non-cardiotomy patients who were managed with VA-ECMO due to refractory in- or out-of-hospital cardiac (IHCA/OHCA) arrest (E-CPR) or refractory cardiogenic shock (E-CS) with or without preceding cardiac arrest...
October 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29040035/long-term-efficacy-and-safety-of-interferon-alpha-2a-in-the-treatment-of-chinese-patients-with-beh%C3%A3-et-s-uveitis-not-responding-to-conventional-therapy
#20
Peizeng Yang, Guo Huang, Liping Du, Zi Ye, Ke Hu, Chaokui Wang, Jian Qi, Liang Liang, Lili Wu, Qingfeng Cao, Aize Kijlstra
PURPOSE: To investigate the long-term efficacy and safety of interferon alpha-2a (IFNα-2a) in Chinese patients with Behçet's uveitis (BU) refractory to conventional therapy. METHODS: In a prospective observational cohort study, 127 patients were treated with an initial dosage of 3 million units per day in the first three months, followed by gradual tapering of the dose. RESULTS: After 3 months of treatment, IFNα-2a was shown to be effective in 115 cases (91%)...
October 17, 2017: Ocular Immunology and Inflammation
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