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https://www.readbyqxmd.com/read/29141071/usefulness-of-total-12-lead-qrs-voltage-as-a-clue-to-diagnosis-of-patients-with-cardiac-sarcoidosis-severe-enough-to-warrant-orthotopic-heart-transplant
#1
William C Roberts, Tiffany M Becker, Shelley A Hall
Importance: Severe heart failure caused by cardiac sarcoidosis is difficult to diagnosis without biopsy. Objective: To assess whether total electrocardiographic 12-lead QRS voltage may be a clue to diagnosis. Design, Setting, Participants: Case-series study with cases collected at Baylor University Medical Center at Dallas, Dallas, Texas, from January 13, 2005, to January 24, 2017. The clinical records of 16 patients with severe heart failure caused by cardiac sarcoidosis were studied...
November 15, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29140804/exploration-of-predictive-biomarkers-for-sudden-unexplained-cardiac-death-in-nonelderly-people-a-case-control-study-with-biochemical-parameters-related-to-heart-failure
#2
Sakai Kentaro, Iwadate Kimiharu, Matsumoto Sari, Takasu Shojiro, Kanto Yuko
Sudden unexplained cardiac death (SUCD) can occasionally occur in nonelderly patients with epilepsy, psychiatric disorders, or no medical history. This study was conducted to aim to analyze whether values of the biomarkers for heart failure are associated with the SUCD. Serum concentrations of N-terminal probrain natriuretic peptide, high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor α were analyzed in 57 nonelderly patients with SUCD who was diagnosed at medicolegal autopsy. The subjects were divided into 3 subgroups according to the medical history: (1) epilepsy, (2) psychiatric disorders, and (3) no specific medical history...
November 15, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29140803/use-of-postmortem-computed-tomography-to-detect-bowel-obstruction-and-its-relationship-to-the-cause-of-death
#3
Dominic Gascho, Sarah Schaerli, Lucile Tuchtan-Torrents, Michael J Thali, Guillaume Gorincour
Bowel distension frequently indicates bowel obstruction, which is a common diagnosis in clinical radiology. Typically, symptoms and complaints lead to radiological examinations and the detection of the etiology. Untreated intestinal obstructions can lead to a fatal outcome through cardiac failure due to septic shock. Certain of these cases undergo medicolegal investigations depending on the case history, the condition of the decedent, the location of the finding, or recent visits to medical professionals. Computed tomography (CT) is a recommended method in clinical radiology for the detection of bowel obstruction, which is indicated by bowel distension and further radiological signs (eg, the whirl sign, which indicates a volvulus)...
November 15, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29139550/long-term-clinical-and-echocardiographic-outcomes-of-mitraclip-therapy-in-patients-non-responders-to-cardiac-resynchronization
#4
Valerio L Giaimo, Paolo Zappulla, Arianna Cirasa, Donatella Tempio, Maria Sanfilippo, Giulia Rapisarda, Danilo Trovato, Angelo Di Grazia, Claudio Liotta, Carmelo Grasso, Davide Capodanno, Corrado Tamburino, Valeria Calvi
OBJECTIVES: This study deals clinical and echocardiographic outcomes in cardiac resynchronization therapy (CRT) non-responders patients undergoing Mitraclip procedure. BACKGROUND: Functional mitral regurgitation (FMR) occurs in approximately one-third of heart failure (HF) patients. Resynchronization therapy may correct FMR in patients with HF, however significant FMR persists in 20-25% of CRT patients. METHODS: All patients included were previously treated with CRT for at least 6 months and remained classified as New York Heart Association (NYHA) functional class III or IV despite optimal medical therapy; the echocardiographic assessment showed lack of decrease of the left ventricular end systolic volume (LVESV) of at least 10% and residual moderate-to-severe or severe FMR...
November 15, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29139189/clostridium-difficile-infection-in-hospitalized-octogenarian-patients
#5
Anca Trifan, Irina Girleanu, Carol Stanciu, Egidia Miftode, Camelia Cojocariu, Ana-Maria Singeap, Catalin Sfarti, Stefan Chiriac, Tudor Cuciureanu, Oana Stoica
AIM: To evaluate the risk factors and outcome of Clostridium difficile infection in hospitalized octogenarian patients. METHODS: A retrospective analysis of risk factors and outcome of C. difficile infection in hospitalized octogenarians was carried out at two academic centers in Romania from January 2014 to September 2016. Demographic, clinical and laboratory characteristics; antibiotics and proton pump inhibitors use in-hospital and 2 months before admission; comorbidities; length of hospital stay; treatment; and outcome were carefully collected from the patients' medical charts and compared with those from octogenarians hospitalized during the same period...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29138974/medical-complications-and-mortality-in-octogenarians-undergoing-elective-spinal-fusion-surgeries
#6
Sharad Rajpal, E Lee Nelson, Alan T Villavicencio, Jayratna Telang, Roshan Kantha, Kara Beasley, Sigita Burneikiene
BACKGROUND: The consequences of suffering postoperative complications in elderly undergoing spinal surgeries may be different compared to younger patients. The primary objective of this study was to identify the types and frequency of medical complications and mortality rates in patients 80 years of age or older undergoing elective spinal fusion surgeries for degenerative spinal disease. METHODS: A prospective observational study with a retrospective chart review was performed, which included all consecutive patients ≥80 years old undergoing elective spinal fusion surgeries from May 2012 to August 2015...
November 14, 2017: Acta Neurochirurgica
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/29138292/impact-of-regionalization-of-st-elevation-myocardial-infarction-care-on-treatment-times-and-outcomes-for-emergency-medical-services-transported-patients-presenting-to-hospitals-with-percutaneous-coronary-intervention-mission-lifeline-accelerator-2
#8
James G Jollis, Hussein R Al-Khalidi, Mayme L Roettig, Peter B Berger, Claire C Corbett, Shannon Doerfler, Christopher B Fordyce, Timothy D Henry, Lori Hollowell, Zainab Magdon-Ismail, Ajar Kochar, James J McCarthy, Lisa Monk, Peter K O'Brien, Thomas D Rea, Jay Shavadia, Jacqueline Tamis-Holland, B Hadley Wilson, Khaled M Ziada, Christopher B Granger
Background: Regional variations in reperfusion times and mortality in patients with ST-segment elevation myocardial infarction (STEMI) are influenced by differences in coordinating care between emergency medical services (EMS) and hospitals. Building on the Accelerator-1 Project, we hypothesized that time to reperfusion could be further reduced with enhanced regional efforts. Methods: Between April 2015 and March 2017, we worked with 12 metropolitan regions across the United States with 132 PCI-capable hospitals and 946 EMS agencies...
November 14, 2017: Circulation
https://www.readbyqxmd.com/read/29138234/mesalazine-induced-myopericarditis-in-a-patient-with-ulcerative-colitis
#9
Jalal Asadi, Sanjay S Bhandari, Nauman Ahmed
A 25-year-old male with a background of ulcerative colitis presented with a two-week history of central chest pain. His ECG on presentation showed global T wave inversion with a peak troponin I of 165 ng/ml. Clinical diagnosis of myopericarditis/myocarditis was made. Echocardiography and cardiac MR confirmed the diagnosis. On detailed assessment of his medication history, mesalazine was suspected as an aetiological factor, with discontinuation resulting in an improvement in symptoms, inflammatory markers and cardiac enzymes...
November 14, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/29138224/short-term-metformin-and-exercise-training-effects-on-strength-aerobic-capacity-glycemic-control-and-mitochondrial-function-in-children-with-burn-injury
#10
Eric Rivas, David N Herndon, Craig Porter, Walter Meyer, Oscar E Suman
Severely burned children experience a chronic state of sympathetic nervous system activation that is associated with hypermetabolic/cardiac stress and muscle wasting. Metformin, a diabetes medication, helps control hyperglycemia in diabetic populations, and exercise has been shown to improve exercise strength and aerobic exercise capacity after severe burns. However, whether exercise improves glycemic control in burned children and whether combining exercise and metformin improves outcomes to a greater degree than exercise alone is unknown...
November 14, 2017: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#11
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
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
#12
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/29137066/a-coronary-artery-fistula-having-connection-between-2-coronary-arteries-and-the-left-ventricle-a-case-report
#13
Chang-Yeon Kim, Ji Yong Choi, Kee Sik Kim
RATIONALE: Cases of coronary artery fistula having a connection with the cardiac cavity are rare. Here, we report a case in which 2 coronary arteries empty into the left ventricular cavity together. PATIENT CONCERNS: A 63-year-old woman who was diagnosed as having hypertension 20 years prior presented with dyspnea. DIAGNOSES: The coronary angiography revealed coronary artery fistula. INTERVENTIONS: Chest X-ray showed pulmonary edema...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136331/risk-factor-management-in-a-contemporary-australian-population-at-increased-cardiovascular-disease-risk
#14
D J Campbell, J M Coller, F F Gong, M McGrady, D L Prior, U Boffa, L Shiel, D Liew, R Wolfe, A J Owen, H Krum, C M Reid
BACKGROUND: Effective management of cardiovascular and chronic kidney disease risk factors offers longer, healthier lives and savings in health care. We examined risk factor management in participants of the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study, a self-selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. METHODS: Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years...
November 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29135862/management-of-sigmoid-sinus-associated-pulsatile-tinnitus-a-systematic-review-of-the-literature
#15
Alan C Wang, Avery N Nelson, Cassandra Pino, Peter F Svider, Robert S Hong, Eleanor Chan
OBJECTIVES: Although studies demonstrate 4 to 20% of patients with pulsatile tinnitus (PT) have associated sigmoid sinus anomalies, no consensus exists regarding optimal management. Our objective was to perform a systematic review exploring surgical and endovascular intervention of PT caused by sigmoid sinus anomalies. DATA SOURCES/EXTRACTION: A systematic review was performed using the Preferred Reporting Systems for Systematic Reviews and Meta-Analysis guidelines for reporting of results, with a target population encompassing patients with PT and either sigmoid sinus diverticulum or sigmoid wall dehiscence...
December 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29135717/traditional-versus-hybrid-outpatient-cardiac-rehabilitation-a-comparison-of-patient-outcomes
#16
Jacqueline Gabelhouse, Neil Eves, Sherry L Grace, R Colin Reid, Cristina M Caperchione
PURPOSE: Due to the suboptimal uptake of cardiac rehabilitation (CR), alternative models have been proposed. This study compared the effectiveness of a traditional supervised program in a medical setting versus a hybrid CR model, where patients transition to unsupervised programming. METHODS: This was a prospective, 2-arm, nonrandomized study. Health-related quality of life (HRQoL), functional capacity, physical activity, diet, smoking, blood pressure, lipids, blood glucose, anthropometrics, and depressive symptoms were assessed before and after the 8-week program models...
November 9, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29135622/troponin-limit-of-detection-plus-cardiac-risk-stratification-scores-to-rule-out-acute-myocardial-infarction-and-30-day-major-adverse-cardiac-events-in-ed-patients
#17
Mitchell D Datlow, Kelly M Gray, Adriel Watts, Deborah B Diercks, Bryn E Mumma
When screening for acute myocardial infarction (AMI), troponin levels below the 99th percentile, including those below the limit of detection (LOD), are considered normal. We hypothesized that a low-risk HEART score (0-3) or ACS Pretest Probability Assessment <2% plus a single troponin below the LOD would rule out both AMI and 30-day major adverse cardiac events (MACE). We studied all patients who presented to a single academic emergency department and received a troponin I (Siemens Ultra Troponin I) from September 1, 2013, to November 13, 2013 (n=888)...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135522/determinants-of-long-term-neurological-recovery-patterns-relative-to-hospital-discharge-among-cardiac-arrest-survivors
#18
Sachin Agarwal, Alex Presciutti, William Roth, Elizabeth Matthews, Ashley Rodriguez, David J Roh, Soojin Park, Jan Claassen, Ronald M Lazar
OBJECTIVE: To explore factors associated with neurological recovery at 1 year relative to hospital discharge after cardiac arrest. DESIGN: Observational, retrospective review of a prospectively collected cohort. SETTING: Medical or surgical ICUs in a single tertiary care center. PATIENTS: Older than 18 years, resuscitated following either in-hospital or out-of-hospital cardiac arrest and considered for targeted temperature management between 2007 and 2013...
November 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29134668/factors-affecting-patient-reported-outcomes-after-red-blood-cell-transfusion-in-medical-patients
#19
Ka Lok Luke Chan, Wai Man Vivien Mak, Yat Hung Tam, Kwok Kuen Harold Lee
BACKGROUND: Physical variables like mortality or cardiac events were used to evaluate the requirement of red blood cell (RBC) transfusion. However, patient-reported outcomes (PROs) of blood transfusion recipients were seldom assessed. The health-related quality of life (HRQoL) of patients before and after RBC transfusion was compared in this study. STUDY DESIGN AND METHODS: The study period was February to June 2016. Standardized generic and anemia symptom-specific HRQoL instruments were administered to patients receiving RBC transfusion in the medical unit of a single center...
November 13, 2017: Transfusion
https://www.readbyqxmd.com/read/29134534/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-jcvsd-1-mission-and-history-of-jcvsd
#20
Shinichi Takamoto, Noboru Motomura, Hiroaki Miyata, Hiroyuki Tsukihara
The Japan Cardiovascular Surgery Database (JCVSD) was created in 2000 with the support of the Society of Thoracic Surgeons (STS). The STS database content was translated to Japanese using the same disease criteria and in 2001, data entry for adult cardiac surgeries was initiated online using the University Hospital Medical Information Network (UMIN). In 2008, data entry for congenital heart surgeries was initiated in the congenital section of JCVSD and preoperative expected mortality (JapanSCORE) in adult cardiovascular surgeries was first calculated using the risk model of JCVSD...
November 13, 2017: General Thoracic and Cardiovascular Surgery
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