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https://www.readbyqxmd.com/read/29364732/improving-practice-guideline-adherence-through-peer-feedback-impact-of-an-ambulatory-cardiology-curriculum
#1
Karl M Richardson, Jai Singh, Dan Muñoz, Julie B Damp, Lisa A Mendes
PROBLEM: Graduate medical trainees must be prepared to practice in a quality-driven system that values adherence to and documentation of evidence-based care. Few validated approaches exist to teach these skills. Our objective was to develop, implement, and evaluate an ambulatory practice improvement curriculum capitalizing on peer feedback aimed at improving cardiology fellow guideline knowledge, adherence, and chart documentation. INTERVENTION: Four outpatient topics were reviewed in dedicated 1-hour sessions: stable ischemic heart disease, heart failure, atrial fibrillation, and aortic valvular disease...
January 24, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29362176/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-anticoagulation-during-cardiopulmonary-bypass
#2
Linda Shore-Lesserson, Robert A Baker, Victor A Ferraris, Philip E Greilich, David Fitzgerald, Philip Roman, John W Hammon
Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup...
February 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29350511/a-cost-effectiveness-analysis-of-cardiology-econsults-for-medicaid-patients
#3
Daren Anderson, Victor Villagra, Emil N Coman, Ianita Zlateva, Alex Hutchinson, Jose Villagra, J Nwando Olayiwola
OBJECTIVES: To evaluate the cost-effectiveness of electronic consultations (eConsults) for cardiology compared with traditional face-to-face consults. STUDY DESIGN: Cost-effectiveness analysis for a subset of Medicaid-insured patients in a cluster-randomized trial of eConsults versus the traditional face-to-face consultation process in a statewide federally qualified health center. METHODS: A total of 369 Medicaid patients were referred for cardiology consultations by primary care providers who were randomly assigned to use either eConsults or their usual face-to-face referral process...
January 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29346209/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-anticoagulation-during-cardiopulmonary-bypass
#4
Linda Shore-Lesserson, Robert A Baker, Victor A Ferraris, Philip E Greilich, David Fitzgerald, Philip Roman, John W Hammon
Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29315731/understanding-patients-and-spouses-experiences-of-patient-education-following-a-cardiac-event-and-eliciting-attitudes-and-preferences-towards-incorporating-cardiopulmonary-resuscitation-training-a-qualitative-study
#5
Susie Cartledge, Susan Feldman, Janet E Bray, Dion Stub, Judith Finn
AIM: To gain a comprehensive perspective about the experience of patient and spousal education following an acute cardiac event. The second objective was to elicit an understanding of patient and spousal attitudes, preferences and intentions towards future cardiopulmonary resuscitation training. BACKGROUND: Patients with cardiovascular disease require comprehensive patient and family education to ensure adequate long-term disease management. As cardiac patients are at risk of future cardiac events, including out-of-hospital cardiac arrest, providing cardiopulmonary resuscitation training to patients and family members has long been advocated...
January 9, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28705926/incidental-findings-on-myocardial-perfusion-spect-images
#6
REVIEW
Razi Muzaffar, Osama Raslan, Fatma Ahmed, Leonard Goldfarb, Barbara Sterkel, Medhat M Osman
Myocardial perfusion SPECT plays a crucial role in the diagnosis of coronary artery disease, providing a noninvasive tool to monitor ischemia and infarction. The findings can have a profound impact on diagnosis and management in these patients. However, incidental noncardiac findings on myocardial perfusion SPECT images can also affect management. These noncardiac subtleties are most often detected on the rotating raw SPECT images, which are often overlooked. The intent of this pictorial essay is to illustrate several subtle noncardiac abnormalities within nuclear cardiac imaging that can have an impact on patient management and follow-up...
September 2017: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/28691508/substantial-improvement-of-primary-cardiovascular-prevention-by-a-systematic-score-based-multimodal-approach-a-randomized-trial-the-preford-study
#7
Detlef Bernd Gysan, Stefanie Millentrup, Christian Albus, Birna Bjarnason-Wehrens, Joachim Latsch, Helmut Gohlke, Gerd Herold, Karl Wegscheider, Christian Heming, Melchior Seyfarth, Hans-Georg Predel
Trial design Prospective randomized multicentre interventional study. Methods Individual cardiovascular risk assessment in Ford Company, Germany employees ( n = 4.196), using the European Society of Cardiology-Systematic Coronary Risk Evaluation (ESC-SCORE) for classification into three risk groups. Subjects assigned to ESC high-risk group (ESC-SCORE ≥ 5%), without a history of cardiovascular disease were eligible for randomization to a multimodal 15-week intervention programme (INT) or to usual care and followed up for 36 months...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28667492/inflammation-cause-or-consequence-of-heart-failure-or-both
#8
REVIEW
Sophie Van Linthout, Carsten Tschöpe
PURPOSE OF REVIEW: With the intention to summarize the currently available evidence on the pathophysiological relevance of inflammation in heart failure, this review addresses the question whether inflammation is a cause or consequence of heart failure, or both. RECENT FINDINGS: This review discusses the diversity (sterile, para-inflammation, chronic inflammation) and sources of inflammation and gives an overview of how inflammation (local versus systemic) can trigger heart failure...
August 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28492084/prehospital-triage-of-patients-suffering-severe-dyspnoea-using-n-terminal-pro-brain-natriuretic-peptide-the-prebnp-trial-a-randomised-controlled-clinical-trial
#9
Morten T Bøtker, Maren T Jørgensen, Carsten Stengaard, Sophie-Charlott Seidenfaden, Mona Tarpgaard, Asger Granfeldt, Tanja Ø Mortensen, Thorbjørn Grøfte, Kristian D Friesgaard, Rikke Mærkedahl, Anette B Pedersen, Simon Lundorff, Troels Martin Hansen, Hans Kirkegaard, Erika F Christensen, Christian J Terkelsen
PURPOSE: The purpose of this study was to examine whether the addition of brain natriuretic peptide measurement to the routine diagnostic work-up by prehospital critical care team physicians improves triage in patients with severe dyspnoea. METHODS: Prehospital critical care team physicians randomly assigned patients older than 18 years with severe dyspnoea to routine diagnostic work-up or diagnostic work-up with incorporated point-of-care N-terminal pro-brain natriuretic peptide (NT-proBNP) measurement...
May 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28347451/the-role-of-computerized-diagnostic-proposals-in-the-interpretation-of-the-12-lead-electrocardiogram-by-cardiology-and-non-cardiology-fellows
#10
Tomas Novotny, Raymond Bond, Irena Andrsova, Lumir Koc, Martina Sisakova, Dewar Finlay, Daniel Guldenring, Jindrich Spinar, Marek Malik
INTRODUCTION: Most contemporary 12-lead electrocardiogram (ECG) devices offer computerized diagnostic proposals. The reliability of these automated diagnoses is limited. It has been suggested that incorrect computer advice can influence physician decision-making. This study analyzed the role of diagnostic proposals in the decision process by a group of fellows of cardiology and other internal medicine subspecialties. MATERIALS AND METHODS: A set of 100 clinical 12-lead ECG tracings was selected covering both normal cases and common abnormalities...
May 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28344147/evaluation-of-deprescribing-amiodarone-after-new-onset-atrial-fibrillation-in-critical-illness
#11
Areerut Leelathanalerk, Wannisa Dongtai, Yvonne Huckleberry, Brian Kopp, John Bloom, Joseph Alpert
BACKGROUND: Recent studies have shed light on the continued prescription of inpatient medications upon hospital discharge, despite the original intent of short-term inpatient therapy. Amiodarone, an antiarrhythmic associated with significant adverse effects with long-term use, is commonly used for new-onset atrial fibrillation in critical illness (NAFCI). Although it is often preferred in this setting of hemodynamic instability, a prescription for long-term use should be carefully considered, preferably by a cardiologist...
July 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28166827/the-polypill-approach-an-innovative-strategy-to-improve-cardiovascular-health-in-europe
#12
REVIEW
Valentín Fuster, Francesc Gambús, Aldo Patriciello, Margaretha Hamrin, Diederick E Grobbee
BACKGROUND: Cardiovascular disease (CVD) is a major cause of disability and premature death. Despite European guidelines advocating the use of medical therapies in CVD, many patients still do not achieve the guideline-recommended treatment, which highlights the need for change and innovations in this field. This requirement has been widely recognised by the national ministries of health, several European cardiology societies, and the European Parliament, who support the initiation of strategies to improve and promote cardiovascular health...
February 7, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28137935/meal-timing-and-frequency-implications-for-cardiovascular-disease-prevention-a-scientific-statement-from-the-american-heart-association
#13
REVIEW
Marie-Pierre St-Onge, Jamy Ard, Monica L Baskin, Stephanie E Chiuve, Heather M Johnson, Penny Kris-Etherton, Krista Varady
Eating patterns are increasingly varied. Typical breakfast, lunch, and dinner meals are difficult to distinguish because skipping meals and snacking have become more prevalent. Such eating styles can have various effects on cardiometabolic health markers, namely obesity, lipid profile, insulin resistance, and blood pressure. In this statement, we review the cardiometabolic health effects of specific eating patterns: skipping breakfast, intermittent fasting, meal frequency (number of daily eating occasions), and timing of eating occasions...
February 28, 2017: Circulation
https://www.readbyqxmd.com/read/28089498/anticoagulants-in-ischemia-guided-management-of-non-st-elevation-acute-coronary-syndromes
#14
REVIEW
Martin Mayer
BACKGROUND: The most recent joint guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) on the management of non-ST-elevation acute coronary syndromes (NSTE-ACS) are a result of a substantial and considered undertaking, and those involved deserve much recognition for their efforts. However, the handling of anticoagulants seems somewhat inadequate, and this is a highly-relevant matter when managing NSTE-ACS. OBJECTIVE OF THE REVIEW: Among areas of potential uncertainty, emergency medicine professionals might still be left wondering about the particulars of anticoagulant therapy when pursuing ischemia-guided management of NSTE-ACS (that is, managing NSTE-ACS without an intent for early invasive measures, such as coronary angiography and revascularization)...
March 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27924467/indian-pediatric-postgraduate-s-perspective-on-future-career-intentions
#15
Latha M Sneha, Manipriya Ravindran, Rekha Kumar, Padmasani Venkatraman, Julius Scott, LakshmiNarayan Kannan
OBJECTIVE: To determine the factors that influence Pediatric residents to pursue a subspecialty career and establish their choice of future workplace. METHODS: The present questionnaire based study was conducted during a National level pediatric post graduate exam refresher course in Chennai, India and involved Pediatric residents from all parts of India. Datas was analysed with the statistical package for social sciences (SPSS, version 18.0). RESULTS: Seventy five respondents participated in the study...
March 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27923390/the-rapid-ctca-trial-rapid-assessment-of-potential-ischaemic-heart-disease-with-ctca-a-multicentre-parallel-group-randomised-trial-to-compare-early-computerised-tomography-coronary-angiography-versus-standard-care-in-patients-presenting-with-suspected-or-confirmed
#16
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Lumine Na, Steff C Lewis, Praveen Thokala, David E Newby
BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27864247/impact-of-a-pharmacist-delivered-discharge-and-follow-up-intervention-for-patients-with-acute-coronary-syndromes-in-qatar-a-study-protocol-for-a-randomised-controlled-trial
#17
Amani Zidan, Ahmed Awaisu, Nadir Kheir, Ziyad Mahfoud, Rasha Kaddoura, Sumaya AlYafei, Maguy Saffouh El Hajj
INTRODUCTION: Acute coronary syndrome (ACS) is one of the leading causes of morbidity and mortality worldwide. Secondary cardiovascular risk reduction therapy (consisting of an aspirin, a β-blocker, an ACE inhibitor or an angiotensin II receptor blocker and a statin) is needed for all patients with ACS. Less than 80% of patients with ACS in Qatar use this combination after discharge. This study is aimed to evaluate the effectiveness of clinical pharmacist-delivered intervention at discharge and tailored follow-up postdischarge on decreasing hospital readmissions, emergency department (ED) visits and mortality among patients with ACS...
November 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27855108/diagnostic-rules-and-algorithms-for-the-diagnosis-of-non-acute-heart-failure-in-patients-80%C3%A2-years-of-age-and-older-a-diagnostic-accuracy-and-validation-study
#18
Miek Smeets, Jan Degryse, Stefan Janssens, Catharina Matheï, Pierre Wallemacq, Jean-Louis Vanoverschelde, Bert Aertgeerts, Bert Vaes
OBJECTIVES: Different diagnostic algorithms for non-acute heart failure (HF) exist. Our aim was to compare the ability of these algorithms to identify HF in symptomatic patients aged 80 years and older and identify those patients at highest risk for mortality. DESIGN: Diagnostic accuracy and validation study. SETTING: General practice, Belgium. PARTICIPANTS: 365 patients with HF symptoms aged 80 years and older (BELFRAIL cohort)...
October 6, 2016: BMJ Open
https://www.readbyqxmd.com/read/27555292/transgenerational-cardiology-one-way-to-a-baby-s-heart-is-through-the-mother
#19
REVIEW
Patrick Y Jay, Ehiole Akhirome, Rachel A Magnan, M Rebecca Zhang, Lillian Kang, Yidan Qin, Nelson Ugwu, Suk Dev Regmi, Julie M Nogee, James M Cheverud
Despite decades of progress, congenital heart disease remains a major cause of mortality and suffering in children and young adults. Prevention would be ideal, but formidable biological and technical hurdles face any intervention that seeks to target the main causes, genetic mutations in the embryo. Other factors, however, significantly modify the total risk in individuals who carry mutations. Investigation of these factors could lead to an alternative approach to prevention. To define the risk modifiers, our group has taken an "experimental epidemiologic" approach via inbred mouse strain crosses...
November 5, 2016: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/27533269/analysis-of-the-discrepancies-identified-during-medication-reconciliation-on-patient-admission-in-cardiology-units-a-descriptive-study
#20
Natália Fracaro Lombardi, Antonio Eduardo Matoso Mendes, Rosa Camila Lucchetta, Wálleri Christini Torelli Reis, Maria Luiza Drechsel Fávero, Cassyano Januário Correr
OBJECTIVES: this observational study aimed to describe the discrepancies identified during medication reconciliation on patient admission to cardiology units in a large hospital. METHODS: the medication history of patients was collected within 48 hours after admission, and intentional and unintentional discrepancies were classified as omission, duplication, dose, frequency, timing, and route of drug administration. RESULTS: most of the patients evaluated were women (58...
August 15, 2016: Revista Latino-americana de Enfermagem
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