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https://www.readbyqxmd.com/read/29136314/syncope-prognosis-based-on-emergency-department-diagnosis-a-prospective-cohort-study
#1
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/29120509/simulation-training-for-medical-emergencies-in-the-dental-setting-using-an-inexpensive-software-application
#2
N Kishimoto, N Mukai, Y Honda, Y Hirata, M Tanaka, Y Momota
INTRODUCTION: Every dental provider needs to be educated about medical emergencies to provide safe dental care. Simulation training is available with simulators such as advanced life support manikins and robot patients. However, the purchase and development costs of these simulators are high. We have developed a simulation training course on medical emergencies using an inexpensive software application. The purpose of this study was to evaluate the educational effectiveness of this course...
November 9, 2017: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
https://www.readbyqxmd.com/read/29116946/spinal-cord-injury-by-direct-damage-during-ct-guided-c7-transforaminal-epidural-steroid-injection-a-case-report
#3
Min Cheol Chang
Cervical transforaminal epidural steroid injection (TFESI) under the guidance of computed tomography (CT) can offer great anatomical resolution and precise needle placement in the axial plane. However, some complications, including blood pressure surge, allergic reactions, vasovagal syncope, and cerebral infarct, have been reported after CT-guided cervical TFESI. We report the first case of iatrogenic spinal cord injury (SCI) during a CT-guided cervical TFESI. A 67-year-old woman, upon receiving TFESI on Lt...
November 7, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29111992/cardiovascular-and-cerebral-hemodynamics-in-asymptomatic-healthy-subjects-with-without-abnormal-head-up-tilt-test-versus-recurrent-fainters
#4
Antonio González-Hermosillo, Manuel Sierra-Beltrán, Ulises López-Peña, Andrei Kostin, Guadalupe Hernández-Pacheco, Claudia Lerma
PURPOSE: The aim of this study was to compare hemodynamic and autonomic responses during head-up tilt test (HUTT) between healthy volunteers and patients with a history of fainting and confirmed vasovagal syncope. We hypothesize that the autonomic and hemodynamic physiologic responses remain intact during orthostatic stress in people without previous fainting and negative HUTT, but deteriorate similarly in patients with recurrent vasovagal syncope and in asymptomatic healthy subjects who develop a vasovagal response during HUTT...
October 27, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29110073/vasovagal-syncope-is-associated-with-poor-prognosis-in-patients-with-left-ventricular-dysfunction
#5
Yoshiaki Yamaguchi, Koichi Mizumaki, Kunihiro Nishida, Tamotsu Sakamoto, Yosuke Nakatani, Naoya Kataoka, Koichiro Kinugawa, Hiroshi Inoue
Vasovagal syncope (VVS) is known to have a benign prognosis and be associated with enhanced contraction and activation of the left ventricular (LV) mechanoreceptors. However, a little is known about VVS in patients with LV dysfunction. The present study aimed to investigate the prevalence and prognosis of VVS in patients with LV dysfunction. We enrolled 368 patients with unexplained syncope. In 7 of these patients, LV ejection fraction was lower than 40%. The results of a head-up tilt test (HUT) and the recurrence of syncope were compared between these 7 patients with LV dysfunction and the remaining patients...
November 6, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29102451/autonomic-dysfunction-in-cardiology-pathophysiology-investigation-and-management
#6
REVIEW
Amy C Arnold, Jessica Ng, Lucy Lei, Satish R Raj
Presyncope and syncope are common medical findings, with a > 40% estimated lifetime prevalence. These conditions are often elicited by postural stress and can be recurrent and accompanied by debilitating symptoms of cerebral hypoperfusion. Therefore, it is critical for physicians to become familiar with the diagnosis and treatment of common underlying causes of presyncope and syncope. In some patients, altered postural hemodynamic responses result from a failure of compensatory autonomic nervous system reflex mechanisms...
September 14, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29089967/a-risk-prediction-score-model-for-predicting-occurrence-of-post-pci-vasovagal-reflex-syndrome-a-single-center-study-in-chinese-population
#7
Hai-Yan Li, Yu-Tao Guo, Cui Tian, Chao-Qun Song, Yang Mu, Yang Li, Yun-Dai Chen
BACKGROUND: The vasovagal reflex syndrome (VVRS) is common in the patients undergoing percutaneous coronary intervention (PCI). However, prediction and prevention of the risk for the VVRS have not been completely fulfilled. This study was conducted to develop a Risk Prediction Score Model to identify the determinants of VVRS in a large Chinese population cohort receiving PCI. METHODS: From the hospital electronic medical database, we identified 3550 patients who received PCI (78...
August 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29079986/percutaneous-image-guided-core-biopsy-of-solid-renal-masses-analysis-of-safety-efficacy-pathologic-interpretation-and-clinical-significance
#8
Nisha Alle, Nelly Tan, Julie Huss, Jiatoi Huang, Allan Pantuck, Steven S Raman
PURPOSE: To determine the efficacy, safety and clinical utility of CT and US-guided percutaneous renal mass biopsy. MATERIALS AND METHODS: A retrospective IRB-approved, HIPAA-compliant study of a cohort of 183 consecutive patients who underwent percutaneous, CT or US-guided renal mass biopsy (RMB) from March 2002 through December 2012 was performed. RMB was performed in 183 consecutive patients for suspected solid renal mass of whom 14/183 (7.7%) were excluded because biopsies were performed at an outside institution, medical records were incomplete, or lesions were poorly visualized...
October 27, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29076173/fear-of-donation-related-stimuli-is-reported-across-different-levels-of-donation-experience
#9
Christopher R France, Janis L France
BACKGROUND: This study aimed to characterize the extent of donation-related fears among donors with different levels of donation experience. STUDY DESIGN AND METHODS: A sample of 1054 recent donors (48.3% female; mean ± SD age 33.1 ± 9.8 years) completed an anonymous, online survey of their fear of donation-related stimuli, including blood, needles, pain, and fainting. Respondents also provided information regarding demographics, pain, and vasovagal symptoms associated with their recent donation and confidence and intention with respect to a future donation...
October 26, 2017: Transfusion
https://www.readbyqxmd.com/read/29075075/a-study-on-the-effect-of-pre-donation-salt-loading-on-vasovagal-reactions-in-young-college-going-whole-blood-donors
#10
Suchet Sachdev, Lakhvinder Singh, Ratti Ram Sharma, Neelam Marwaha
INTRODUCTION: The pathophysiology of vasovagal reactions (VVRs) involves both psychological and physiological components. Strategies which could allay physiological changes include interventions like pre-donation water intake and applied muscle tension have been published, however salt loading has not been tested. MATERIALS AND METHODS: Cross sectional study enrolling 1000 young college going whole blood donors with intervention 250 ml of salted loaded water or plain water as placebo...
December 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/29060649/multivariate-symbolic-dynamics-for-analysis-of-respiratory-cardiovascular-interactions
#11
S Reulecke, S Charleston-Villalobos, A Voss, R Gonzalez-Camarena, M Gaitan-Gonzalez, J Gonzalez-Hermosillo, G Hernandez-Pacheco, T Aljama-Corrales
In this work, a nonlinear method to study multivariate interactions, called multivariate symbolic dynamics (MSD), was introduced. The usefulness of this technique was studied on respiratory-cardiovascular data from young women with vasovagal syncope (VVS) and from healthy subjects. The study included 16 female patients diagnosed with VVS and 24 age-matched healthy subjects (12 women). All subjects were enrolled in a head-up tilt (HUT) test, breathing normally, including 5 min of supine position and 18 to 28 min of 70° orthostatic phase...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29045956/-co-morbidity-of-vasovagal-syncope-and-postural-tachycardia-syndrome-with-allergic-diseases-in-children
#12
Y Liao, Q Y Zhang, H X Li, Y L Wang, P Liu, J B DU
OBJECTIVE: To explore the clinical characteristics of the co-morbidity of vasovagal syncope (VVS) and postural tachycardia syndrome (POTS) with allergic diseases in children. METHODS: A re-trospective analysis was launched to summarize the clinical data of children with VVS and POTS. They were divided into allergic group and non-allergic group according to the history of allergic diseases. The participants' clinical characteristics were compared between allergic group and non-allergic group using independent sample t test or rank sum test; composition comparisons were completed by Chi-square test...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29045952/-progress-in-diagnosis-and-management-of-syncope-in-children
#13
W R Xu, Y Liao, H F Jin, Q Y Zhang, C S Tang, J B DU
Syncope is a common emergency of children and adolescents, which has serious influence on the quality of life. Neurally-mediated syncope, including postural tachycardia syndrome, vasovagal syncope, orthostatic hypotension and orthostatic hypertension, is the main cause of syncope in children and adolescents. The main manifestations of neurally-mediated syncope are diverse, such as dizziness, headache, chest tightness, chest pain, pale complexion, fatigue, pre-syncope and syncope. Although the clinical manifestations are similar, each subtype of syncope has its hemodynamic feature and optimal treatment option...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29036615/monitoring-of-cerebral-oximetry-during-head-up-tilt-test-in-adults-with-history-of-syncope-and-orthostatic-intolerance
#14
E Bachus, H Holm, V Hamrefors, O Melander, R Sutton, M Magnusson, A Fedorowski
Aims: We applied near-infrared-spectroscopy (NIRS) to measure absolute frontal cerebral tissue oxygen saturation (SctO2) during head-up tilt test (HUT) in patients investigated for unexplained syncope. Methods and results: Synchronized non-invasive beat-to-beat haemodynamic monitoring, ECG, SctO2 (NIRS; normal range: 60-80%), and peripheral oxygen saturation (left hand, SpO2) were applied during HUT in a random sample of patients with unexplained syncope. Tracings of 54 patients (mean-age: 55 ± 19 years, 39% male) with negative HUT, vasovagal syncope (VVS), or orthostatic hypotension (OH) were analysed...
September 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29033777/unusual-clinical-presentation-of-hemobilia-with-recurrent-vasovagal-episodes
#15
Abhinav Tiwari, Tariq Hammad, Himani Sharma, Khola Qamar, Mohammad Saud Khan, Zubair Khan, Ali Nawras, Thomas Sodeman
Hemobilia is caused by the abnormal connection between a blood vessel and the bile duct, which is usually iatrogenic and caused by hepatobiliary procedures. The classic triad of hemobilia includes biliary colic, obstructive jaundice, and gastrointestinal bleeding. We present the case of an 80-year-old man who had laparoscopic cholecystectomy complicated by hemobilia. He had an unusual presentation of hemobilia in the form of transient vasovagal episodes in addition to abdominal pain and hematochezia.
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28991754/temporal-analysis-of-cardiovascular-and-respiratory-complexity-by-multiscale-entropy-based-on-symbolic-dynamics
#16
Sina Reulecke, Sonia Charleston Villalobos, Andreas Voss, Ramon Gonzalez-Camarena, Jesus Antonio Gonzalez-Hermosillo, Jatziri Gaitan, Guadalupe Hernandez-Pacheco, Rico Schroeder, Tomas Aljama-Corrales
The effect of an orthostatic stress on cardiovascular and respiratory complexity was investigated to detect impaired autonomic regulation in patients with vasovagal syncope (VVS). Sixteen female patients and 12 age-matched healthy female subjects were enrolled in a passive 70° head-up tilt test. Also, 12 age-matched healthy male subjects were enrolled to study gender differences. Analysis was performed dynamically using various short-term (5 min) windows shifted by 1 min as well as by 20 min of orthostatic phase (OP) to evaluate local and global complexity...
October 9, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28971792/modification-of-tubeless-percutaneous-nephrolithotomy-with-a-ureteropelvic-junction-stent
#17
Tian C Zhou, Joshua M Stern
INTRODUCTION: To introduce the ureteropelvic junction stent as a safe and effective modification to tubeless percutaneous nephrolithotomy for select patients to maintain antegrade access to the collecting system. MATERIALS AND METHODS: From April 2014 to December 2015, 31 patients underwent modified tubeless percutaneous nephrolithotomy with ureteropelvic junction (UPJ) stent left in situ and an extraction string coming out the nephrostomy tract. Primary study endpoints included complications, emergency department visits, or re-admissions...
October 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28958870/predictive-value-of-very-low-frequency-at-spectral-analysis-among-patients-with-unexplained-syncope-assessed-by-head-up-tilt-testing
#18
Michela Anna Pia Ciliberti, Francesco Santoro, Luigi Flavio Massimiliano Di Martino, Antonio Cosimo Rinaldi, Giuseppe Salvemini, Francesco Cipriani, Antonio Ivano Triggiani, Fiorenzo Moscatelli, Anna Valenzano, Matteo Di Biase, Natale Daniele Brunetti, Giuseppe Cibelli
BACKGROUND: The role of heart rate variability (HRV) in the prediction of vasovagal syncope during head-up tilt testing (HUTt) is unclear. AIM: To evaluate the ability of the spectral components of HRV at rest to predict vasovagal syncope among patients with unexplained syncope referred for HUTt. METHODS: Twenty-six consecutive patients with unexplained syncope were enrolled in the study. All patients underwent HRV evaluation at rest (very low frequency [VLF], low frequency [LF], high frequency [HF] and LF/HF ratio) and during HUTt...
September 25, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28958329/vasovagal-syncope-to-pace-or-not-to-pace
#19
EDITORIAL
Brian Olshansky
No abstract text is available yet for this article.
October 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28958328/dual-chamber-pacing-with-closed%C3%A2-loop%C3%A2-stimulation-in-recurrent%C3%A2-reflex%C3%A2-vasovagal-syncope-the-spain-study
#20
RANDOMIZED CONTROLLED TRIAL
Gonzalo Baron-Esquivias, Carlos A Morillo, Angel Moya-Mitjans, Jesus Martinez-Alday, Ricardo Ruiz-Granell, Javier Lacunza-Ruiz, Roberto Garcia-Civera, Encarnacion Gutierrez-Carretero, Rafael Romero-Garrido
BACKGROUND: Pacing in vasovagal syncope remains controversial. OBJECTIVES: The authors evaluated dual-chamber pacing with closed loop stimulation (DDD-CLS) in patients with cardioinhibitory vasovagal syncope. METHODS: This randomized, double-blind, controlled study included Canadian and Spanish patients age ≥40 years, with high burden syncope (≥5 episodes, ≥2 episodes in the past year), and a cardioinhibitory head-up tilt test (bradycardia <40 beats/min for 10 s or asystole >3 s)...
October 3, 2017: Journal of the American College of Cardiology
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