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cardiology, family medicine

Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
Alessio Mancini, Daniele Verdini, Giorgio La Vigna, Claudia Recanatini, Francesca Elena Lombardi, Simone Barocci
Nosocomial infections are one of the leading causes of morbidity and mortality in hospitalized patients. Studies of their prevalence in single institutions can reveal trends over time and help to identify risk factors. The aim of this study was to investigate the nosocomial infections trend and identify the prevalence of predominant bacterial microorganisms and their drug resistance patterns in an Italian tertiary care hospital. Infections were classified according to the Centres for Disease Control and Prevention definitions...
September 2016: New Microbiologica
Christine Sinsky, Lacey Colligan, Ling Li, Mirela Prgomet, Sam Reynolds, Lindsey Goeders, Johanna Westbrook, Michael Tutty, George Blike
Background: Little is known about how physician time is allocated in ambulatory care. Objective: To describe how physician time is spent in ambulatory practice. Design: Quantitative direct observational time and motion study (during office hours) and self-reported diary (after hours). Setting: U.S. ambulatory care in 4 specialties in 4 states (Illinois, New Hampshire, Virginia, and Washington). Participants: 57 U...
September 6, 2016: Annals of Internal Medicine
Valentina Favalli, Eliana Disabella, Mariadelfina Molinaro, Marilena Tagliani, Anna Scarabotto, Alessandra Serio, Maurizia Grasso, Nupoor Narula, Carmela Giorgianni, Clelia Caspani, Monica Concardi, Manuela Agozzino, Calogero Giordano, Alexandra Smirnova, Takahide Kodama, Lorenzo Giuliani, Elena Antoniazzi, Riccardo G Borroni, Camilla Vassallo, Filippo Mangione, Laura Scelsi, Stefano Ghio, Carlo Pellegrini, Marialuisa Zedde, Laura Fancellu, GianPietro Sechi, Antonello Ganau, Stefania Piga, Annarita Colucci, Daniela Concolino, Maria Teresa Di Mascio, Danilo Toni, Marina Diomedi, Claudio Rapezzi, Elena Biagini, Massimiliano Marini, Maurizia Rasura, Maurizio Melis, Antonia Nucera, Donata Guidetti, Michelangelo Mancuso, Umberto Scoditti, Pamela Cassini, Jagat Narula, Luigi Tavazzi, Eloisa Arbustini
BACKGROUND: Anderson-Fabry disease (AFD) is a rare X-linked lysosomal storage disease, caused by defects of the alpha-galactosidase A (GLA) gene. AFD can affect the heart, brain, kidney, eye, skin, peripheral nerves, and gastrointestinal tract. Cardiology (hypertrophic cardiomyopathy), neurology (cryptogenic stroke), and nephrology (end-stage renal failure) screening studies suggest the prevalence of GLA variants is 0.62%, with diagnosis confirmation in 0.12%. OBJECTIVES: This study sought to expand screening from these settings to include ophthalmology, dermatology, gastroenterology, internal medicine, pediatrics, and medical genetics to increase diagnostic yield and comprehensively evaluate organ involvement in AFD patients...
September 6, 2016: Journal of the American College of Cardiology
Anthony J Comerota, Robert J Min, Suman W Rathbun, Neil Khilnani, Thom Rooke, Thomas W Wakefield, Teresa L Carman, Fedor Lurie, Suresh Vedantham, Steven E Zimmet
BACKGROUND: In every field of medicine, comprehensive education should be delivered at the graduate level. Currently, no single specialty routinely provides a standardized comprehensive curriculum in venous and lymphatic disease. METHOD: The American Board of Venous & Lymphatic Medicine formed a task force, made up of experts from the specialties of dermatology, family practice, interventional radiology, interventional cardiology, phlebology, vascular medicine, and vascular surgery, to develop a consensus document describing the program requirements for fellowship medical education in venous and lymphatic medicine...
August 17, 2016: Phlebology
Robert M Wachter, Lee Goldman
Twenty years ago, we described the emergence of a new type of specialist that we called a "hospitalist." Since then, the number of hospitalists has grown from a few hundred to more than 50,000 (see graph) — making this new field substantially larger than any subspecialty of internal medicine (the..
September 15, 2016: New England Journal of Medicine
A Varga, C M Tatar, A Mitre, C Podoleanu, I Tilea
OBJECTIVE: Atrial fibrillation is one of the most frequent complications of hypertension. Proper management of this condition with anticoagulation treatment requires data of the atrial fibrillation events rate in hypertensive population. Adequate standards of safety and optimal level of anticoagulation for preventing further cerebrovascular events is the target of this pilot center. DESIGN AND METHOD: Medical records from a family medicine database practice were evaluated...
September 2016: Journal of Hypertension
Naheed Rajabali, Darryl Rolfson, Sean M Bagshaw
Frailty is a clearly emerging theme in acute care medicine, with obvious prognostic and health resource implications. "Frailty" is a term used to describe a multidimensional syndrome of loss of homeostatic reserves that gives rise to a vulnerability to adverse outcomes after relatively minor stressor events. This is conceptually simple, yet there has been little consensus on the operational definition. The gold standard method to diagnose frailty remains a comprehensive geriatric assessment; however, a variety of validated physical performance measures, judgement-based tools, and multidimensional scales are being applied in critical care, cardiology, and cardiac surgery settings, including open cardiac surgery and transcatheter aortic value replacement...
September 2016: Canadian Journal of Cardiology
Asma Kefi, Thara Larbi, Meya Abdallah, Amira El Ouni, Neil Bougacha, Kamel Bouslama, Saloua Hamzaoui, Skander M'rad
PURPOSE: There is wanting data regarding young ischemic stroke in developing countries, especially in Tunisia. The purpose of this study was to investigate risk factors and etiologies of young ischemic stroke in Tunisian and make a comparison with previous reports. MATERIALS AND METHODS: A total of 102 young ischemic stroke patients (15-45 years old) were admitted, between January 1996 and August 2007, to eleven departments of internal medicine in different Tunisian hospitals...
July 18, 2016: International Journal of Neuroscience
Mia Yang, Chiang-Hua Chang, Donald Carmichael, Esther S Oh, Julie P W Bynum
OBJECTIVES: To identify which clinical specialties are most central for care of people with dementia in the community and long-term care (LTC) settings. DESIGN: Cross-sectional analysis. PARTICIPANTS: Fee-for-service Medicare beneficiaries aged ≥65 years with dementia. MEASUREMENTS: Specialty, categorized into primary care (internal or family medicine, geriatrics, or nurse practitioners [NPs]) versus other specialties, of the predominant provider of care (PPC) for each patient, defined by providing the most ambulatory visits...
September 1, 2016: Journal of the American Medical Directors Association
Alessio Mancini, Daniele Verdini, Giorgio La Vigna, Claudia Recanatini, Francesca Elena Lombardi, Simone Barocci
Nosocomial infections are one of the leading causes of morbidity and mortality in hospitalized patients. Studies of their prevalence in single institutions can reveal trends over time and help to identify risk factors. The aim of this study was to investigate the nosocomial infections trend and identify the prevalence of predominant bacterial microorganisms and their drug resistance patterns in an Italian tertiary care hospital. Infections were classified according to the Centres for Disease Control and Prevention definitions...
June 10, 2016: New Microbiologica
Salim S Virani, Yashashwi Pokharel, Lynne Steinberg, Winston Chan, Julia M Akeroyd, Saqib Ali Gowani, Ankur Kalra, Venkateshwar Polsani, Michael D Miedema, Peter H Jones, Vijay Nambi, Laura A Petersen, Christie M Ballantyne
BACKGROUND: Providers' understanding of the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline in clinical practice is not known. METHODS: We designed a questionnaire, which was administered to internal medicine, family practice, cardiology, and endocrinology providers at 21 venues across the United States. We compared responses between providers in training or practice and between specialists (cardiology and endocrinology) and nonspecialists (internal medicine and family practice)...
May 2016: Journal of Clinical Lipidology
Lindy Willmott, Benjamin White, Cindy Gallois, Malcolm Parker, Nicholas Graves, Sarah Winch, Leonie Kaye Callaway, Nicole Shepherd, Eliana Close
OBJECTIVE: Futile treatment, which by definition cannot benefit a patient, is undesirable. This research investigated why doctors believe that treatment that they consider to be futile is sometimes provided at the end of a patient's life. DESIGN: Semistructured in-depth interviews. SETTING: Three large tertiary public hospitals in Brisbane, Australia. PARTICIPANTS: 96 doctors from emergency, intensive care, palliative care, oncology, renal medicine, internal medicine, respiratory medicine, surgery, cardiology, geriatric medicine and medical administration departments...
August 2016: Journal of Medical Ethics
Arun L Singh, Jeffrey C Klick, Courtney E McCracken, Kiran B Hebbar
BACKGROUND: Hospice and Palliative Medicine (HPM) competencies are of growing importance in training general pediatricians and pediatric sub-specialists. The Accreditation Council for Graduate Medical Education (ACGME) emphasized pediatric trainees should understand the "impact of chronic disease, terminal conditions and death on patients and their families." Currently, very little is known regarding pediatric trainee education in HPM. METHODS: We surveyed all 486 ACGME-accredited pediatric training program directors (PDs) - 200 in general pediatrics (GP), 57 in cardiology (CARD), 64 in critical care medicine (CCM), 69 in hematology-oncology (ONC) and 96 in neonatology (NICU)...
April 26, 2016: American Journal of Hospice & Palliative Care
Barbara Cybulska, Andrzej Pająk, Piotr Ponikowski, Andrzej Rynkiewicz, Janina Stępińska, Beata Średniawa, Zbigniew Kalarus, Zbigniew Gaciong, Piotr Hoffman, Piotr Jankowski, Longina Kłosiewicz-Latoszek, Jarosław Kaźmierczak, Katarzyna Mitręga, Grzegorz Opolski
The severe hypercholesterolaemia can be recognised when low density lipoprotein cholesterol (LDL-C) serum levels are equal to or above 5 mmol/L (≥ 190 mg/dL). The prevalence of LDL-C ≥ 5 mmol/L is 3.8% in Polish population aged 18-79 years. Among these adults there are patients with familial hypercholesterolaemia (FH). According to meta-analysis of 6 Polish population surveys prevalence of heterozygous FH (HeFH) diagnosed using Dutch Lipid Clinic criteria is 0.4% (95% Cl 0.28-0.53%) in men and women aged 20-74 years, i...
2016: Kardiologia Polska
Fiona Cann, Michael Corbett, Dawn O'Sullivan, Stephen Tennant, Hazel Hailey, James Hk Grieve, Paul Broadhurst, Rosslyn Rankin, John Cs Dean
A phenotype driven approach to molecular autopsy based in a multidisciplinary team comprising clinical and laboratory genetics, forensic medicine and cardiology is described. Over a 13 year period, molecular autopsy was undertaken in 96 sudden cardiac death cases. 46 cases aged 1-40 years had normal hearts and suspected arrhythmic death. 7 (15%) had likely pathogenic variants in ion channelopathy genes (KCNQ1 (1), KCNH2 (4), SCN5A (1), RyR2(1)). 50 cases aged between 2 and 67 had a cardiomyopathy. 25 had Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), 10 Dilated Cardiomyopathy (DCM) and 15 Hypertrophic Cardiomyopathy (HCM)...
March 22, 2016: Clinical Genetics
Edward L Callachan, Alawi A Alsheikh-Ali, Stevan Bruijns, Lee A Wallis
INTRODUCTION: Physician perceptions about emergency medical services (EMS) are important determinants of improving pre-hospital care for cardiac emergencies. No data exist on physician attitudes towards EMS care of patients with ST-Elevation Myocardial Infarction (STEMI) in the Emirate of Abu Dhabi. OBJECTIVES: To describe the perceptions towards EMS among physicians caring for patients with STEMI in Abu Dhabi. METHODS: We surveyed a convenience sample of physicians involved in the care of patients with STEMI (emergency medicine, cardiology, cardiothoracic surgery and intensive care) in four government facilities with 24/7 Primary PCI in the Emirate of Abu Dhabi...
January 2016: Journal of the Saudi Heart Association
Andreas Petropoulos, Doris Ehringer-Schetitska, Peter Fritsch, Eero Jokinen, Robert Dalla Pozza, Renate Oberhoffer
OBJECTIVE: The burden of cardiac disease in childhood is unknown. It will be a sum of 1% of living births in the general population, suffering from Congenital Heart Disease (CHD) + approximately 2.5% of the general population suffering from bicuspid aortic valve diseases + an unknown higher prevalence of acquired diseases. Cardiomyopathies, arrhythmias - sudden cardiac death (SCD), rheumatic heard disease, hypertension and accelerating atherosclerosis are among the most frequent. Adding on, genetic syndromes including cardiac defects, endocarditis and myocarditis we can address a large pediatric population worldwide, suffering from heart disease...
September 2015: Hellenic Journal of Nuclear Medicine
Richard Češka
At the present time there are novel hypolipidemics registered globally (alirocumab was the first drug of this group in the world registered by an American drug agency FDA) and in Europe, which in many ways differ from the medicines administered until now. They are bringing another advancement in the treatment of disorders of lipid metabolism and in preventive cardiology. Alirocumab is a fully human monoclonal antibody to PCSK-9 enzyme (proprotein convertase subtilisin kexin-9). PCSK-9 enzyme plays an important role in the metabolism of LDL-cholesterol through affecting the breakdown and eventually the amount and activity of LDL-receptors...
November 2015: Vnitr̆ní Lékar̆ství
Zardasht Oqab, William F McIntyre, Kieran L Quinn, Tyler Lamb, Kenneth Quadros, Payam Yazdan-Ashoori, Erik van Oosten, Karen Chu, Jasmine Lamba, Walid Barake, Kiarash Mohajer, Jeffrey N Marr, Adrian Baranchuk
Atrial fibrillation (AF) is a common cardiac arrhythmia and is associated with an increased risk of ischemic stroke. The aim of this study was to identify practice patterns of Canadian resident physicians pertaining to stroke prevention in nonvalvular AF according to the Canadian Cardiovascular Society guidelines. A Web-based survey consisting of 16 multiple-choice questions was distributed to 11 academic centres. Questions involved identification of risks of stroke, bleeding, and selection of appropriate therapy in clinical scenarios that involve a patient with AF with a Congestive Heart Failure, Hypertension, Age, Diabetes, Stroke/Transient Ischemic Attack (CHADS2) score of 3 and no absolute contraindications to anticoagulation...
June 2016: Canadian Journal of Cardiology
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