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https://www.readbyqxmd.com/read/28633169/untapped-potential-performance-of-procedural-skills-in-the-family-medicine-clerkship
#1
Martina Kelly, Kelly M Everard, Lara Nixon, Alexander Chessman
BACKGROUND AND OBJECTIVES: While family medicine residency directors have expressed concern about low procedural skills proficiency among incoming residents, curricular recommendations do not provide widely accepted guidance. This study was designed to describe requirements and experiences in procedural skill training during the family medicine clerkship and test the hypothesis that more rural placements may support this training. METHODS: The survey was conducted as part of the CAFM Educational Research Alliance (CERA) Family Medicine Clerkship Director (CD) 2013 survey...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28630171/distinctive-left-ventricular-activations-associated-with-ecg-pattern-in-heart-failure-patients
#2
Nicolas Derval, Josselin Duchateau, Saagar Mahida, Romain Eschalier, Frederic Sacher, Joost Lumens, Hubert Cochet, Arnaud Denis, Xavier Pillois, Seigo Yamashita, Yuki Komatsu, Sylvain Ploux, Sana Amraoui, Adlane Zemmoura, Philippe Ritter, Mélèze Hocini, Michel Haissaguerre, Pierre Jaïs, Pierre Bordachar
BACKGROUND: In contrast to patients with left bundle branch block (LBBB), heart failure patients with narrow QRS and nonspecific intraventricular conduction delay (NICD) display a relatively limited response to cardiac resynchronization therapy. We sought to compare left ventricular (LV) activation patterns in heart failure patients with narrow QRS and NICD to patients with LBBB using high-density electroanatomic activation maps. METHODS AND RESULTS: Fifty-two heart failure patients (narrow QRS [n=18], LBBB [n=11], NICD [n=23]) underwent 3-dimensional electroanatomic mapping with a high density of mapping points (387±349 LV)...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28620319/vascular-endothelial-growth-factor-b-induces-a-distinct-electrophysiological-phenotype-in-mouse-heart
#3
Nikolay Naumenko, Jenni Huusko, Tomi Tuomainen, Jussi T Koivumäki, Mari Merentie, Erika Gurzeler, Kari Alitalo, Riikka Kivelä, Seppo Ylä-Herttuala, Pasi Tavi
Vascular endothelial growth factor B (VEGF-B) is a potent mediator of vascular, metabolic, growth, and stress responses in the heart, but the effects on cardiac muscle and cardiomyocyte function are not known. The purpose of this study was to assess the effects of VEGF-B on the energy metabolism, contractile, and electrophysiological properties of mouse cardiac muscle and cardiac muscle cells. In vivo and ex vivo analysis of cardiac-specific VEGF-B TG mice indicated that the contractile function of the TG hearts was normal...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28615177/direct-transport-to-a-percutaneous-cardiac-intervention-center-and-outcomes-in-patients-with-out-of-hospital-cardiac-arrest
#4
Kristian Kragholm, Carolina Malta Hansen, Matthew E Dupre, Ying Xian, Benjamin Strauss, Clark Tyson, Lisa Monk, Claire Corbett, Christopher B Fordyce, David A Pearson, Emil L Fosbøl, James G Jollis, Benjamin S Abella, Bryan McNally, Christopher B Granger
BACKGROUND: Practice guidelines recommend regional systems of care for out-of-hospital cardiac arrest. However, whether emergency medical services should bypass nonpercutaneous cardiac intervention (non-PCI) facilities and transport out-of-hospital cardiac arrest patients directly to PCI centers despite longer transport time remains unknown. METHODS AND RESULTS: Using the Cardiac Arrest Registry to Enhance Survival with geocoding of arrest location, we identified out-of-hospital cardiac arrest patients with prehospital return of spontaneous circulation and evaluated the association between direct transport to a PCI center and outcomes in North Carolina during 2012 to 2014...
June 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28606716/the-relation-between-given-volume-and-heart-rate-during-newborn-resuscitation
#5
J E Linde, J Schulz, J M Perlman, K Øymar, L Blacy, H Kidanto, H L Ersdal
BACKGROUND: During delivery room resuscitation of depressed newborns, provision of appropriate tidal volume (TV) with establishment of functional residual capacity (FRC) is essential for circulatory recovery. Effective positive pressure ventilation (PPV) is associated with a rapid increase in heart rate (HR). The relationship between delivery of TV and HR responses remains unclear. OBJECTIVES: The study objectives were to determine (1) the relationship between a given TV during initial PPV and HR responses of depressed newborns, and (2) the optimal delivered TV associated with a rapid increase in HR...
June 9, 2017: Resuscitation
https://www.readbyqxmd.com/read/28599797/variability-in-interpretation-of-the-electrocardiogram-in-athletes-another-limitation-in-pre-competitive-screening
#6
Hélder Dores, José Ferreira Santos, Paulo Dinis, Francisco Moscoso Costa, Lígia Mendes, José Monge, António Freitas, Pedro de Araújo Gonçalves, Nuno Cardim, Miguel Mendes
INTRODUCTION: Assessment of the electrocardiogram (ECG) in athletes remains controversial, with lack of standardization and difficulty in applying specific criteria in its interpretation. The purpose of this study was to assess variability in the interpretation of the ECG in athletes. METHODS: Twenty ECGs of competitive athletes were assessed by cardiologists and cardiology residents, 11 of them normal or with isolated physiological changes and nine pathological...
June 6, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28588014/different-approaches-for-catheter-ablation-of-para-hisian-accessory-pathways-implications-for-mapping-and-ablation
#7
Ming Liang, Zulu Wang, Yanchun Liang, Guitang Yang, Zhiqing Jin, Mingyu Sun, Yaling Han
BACKGROUND: Catheter ablation of para-Hisian accessory pathways (APs) can be challenging because of adjacent conduction tissue. Some different approaches for ablation, including the inferior vena cava approach (IVC-A), the noncoronary cusp approach (NCC-A), or the superior vena cava approach (SVC-A), have been reported. However, when should para-Hisian APs be mapped and ablated by the IVC-A, NCC-A, or SVC-A is not well established. METHODS AND RESULTS: This study included 55 consecutive patients (mean age, 53±11 years, 36 males) with para-Hisian APs...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28571189/evaluation-of-ecg-abnormalities-in-patients-with-asymptomatic-type-2-diabetes-mellitus
#8
Sahil Gupta, Rajeev Kumar Gupta, Malini Kulshrestha, Rajib Ratna Chaudhary
INTRODUCTION: Diabetes Mellitus (DM) is the most common chronic disease. DM is considered a Cardiovascular Disease (CVD) risk equivalent. Its macrovascular complications are associated with two-fold increased risk of premature atherosclerotic CVD. Most of the diabetics with cardiovascular involvement are asymptomatic. Electro Cardio Graph (ECG) abnormalities are found to be predictors of silent ischaemia in asymptomatic persons. An abnormal ECG response is associated with statistically significant high risk for cardiac mortality and morbidity...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28556418/phase-i-randomized-study-of-khk4083-an-anti-ox40-monoclonal-antibody-in-patients-with-mild-to-moderate-plaque-psoriasis
#9
K A Papp, M J Gooderham, G Girard, M Raman, V Strout
BACKGROUND: OX40 (CD134) is expressed in lesional but not healthy skin of patients with psoriasis. KHK4083 is a fully human monoclonal antibody against OX40. OBJECTIVE: The primary aim of this first-in-human phase 1 study was to determine the safety and tolerability of ascending single doses of KHK4083 in patients with mild to moderate plaque psoriasis. Secondary aims were to determine the pharmacokinetics and immunogenicity of KHK4083, and an exploratory objective was to assess clinical activity...
May 27, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28549576/response-to-ecg-may-2017
#10
Pablo Robles Velasco, Isabel Monedero Sánchez, Amador Rubio Caballero
No abstract text is available yet for this article.
June 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28548688/effects-of-orthostatism-and-hemodialysis-on-mean-heart-period-and-fractal-heart-rate-properties-of-chronic-renal-failure-patients
#11
Juan C Echeverría, Oscar Infante, Héctor Pérez-Grovas, Hortensia González, Marco V José, Claudia Lerma
The aim of this work was to evaluate the short-term fractal index (α1 ) of heart rate variability (HRV) in chronic renal failure (CRF) patients by identifying the effects of orthostatism and hemodialysis (HD), and by evaluating the correlation between α1 and the mean RR interval from sinus beats (meanNN). HRV time series were derived from ECG data of 19 CRF patients and 20 age-matched healthy subjects obtained at supine and orthostatic positions (lasting 5 min each). Data from CRF patients were collected before and after HD...
May 26, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28548234/catheter-ablation-of-atrial-flutter-a-survey-focusing-on-post-ablation-oral-anticoagulation-management-and-ecg-monitoring
#12
Philipp Attanasio, Tabea Budde, Philipp Lacour, Abdul Shokor Parwani, Burkert Pieske, Florian Blaschke, Wilhelm Haverkamp, Leif-Hendrik Boldt, Martin Huemer
BACKGROUND: A considerable amount of patients with typical atrial flutter develops atrial fibrillation after CTI ablation. No uniform recommendations are available to guide anticoagulation regimes or ECG monitoring strategies after this procedure. METHODS: We conducted a web-based survey in electrophysiology (EP) centers in Germany, Switzerland and Austria. Responses were received from 47 centers. The survey was designed to investigate variations in management of the following: Ablation strategy, oral anticoagulation (OAC) management and ECG monitoring after successful cavotricuspid isthmus (CTI) ablation...
May 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28547175/influence-of-body-mass-index-and-type-of-low-level-exercise-on-the-side-effect-profile-of-regadenoson
#13
Carlos Salgado-Garcia, Amelia Jimenez-Heffernan, Juana Lopez-Martin, Manuela Molina-Mora, Tarik Aroui, Elena Sanchez de Mora, Carlos Ramos-Font, Francisco Rivera de Los Santos, Carlos Ruiz-Frutos
PURPOSE: Regadenoson, an A2A adenosine receptor pharmacologic stress agent for radionuclide myocardial perfusion imaging (MPI), is administered as a single, fixed dose. We studied the side effect profile of regadenoson combined with two types of low-level exercise, according to body mass index (BMI). METHODS: Three hundred and fifty-six patients (46.1% men, mean age 67.7±10.7 years, range 31-90 years) underwent regadenoson stress testing combined with low-level exercise...
May 25, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28545670/inhibitory-mechanism-of-five-natural-flavonoids-against-murine-norovirus
#14
Dong Joo Seo, Changsun Choi
BACKGROUND: Human noroviruses (HuNoV), which are responsible for acute gastroenteritis, are becoming a serious public health concern worldwide. Since no effective antiviral drug or vaccine for HuNoV has been developed yet, some natural extracts and their active components have been investigated for their ability to inhibit noroviruses. However, their exact antiviral mechanisms have not been investigated. PURPOSE: This study was performed to investigate the expression of interferon (IFN)-α, IFN-λ, tumor necrosis factor-α (TNF-α), Mx, and zinc finger CCCH type antiviral protein 1 (ZAP), 2'-5' oligo (A) synthetase (OAS), and inducible nitric oxide synthase (iNOS) in RAW 264...
July 1, 2017: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
https://www.readbyqxmd.com/read/28545575/impaired-chronotropic-response-to-physical-activities-in-heart-failure-patients
#15
Hong Shen, Jianrong Zhao, Xiaohong Zhou, Jingbo Li, Qing Wan, Jing Huang, Hui Li, Liqun Wu, Shungang Yang, Ping Wang
BACKGROUND: While exercise-based cardiac rehabilitation has a beneficial effect on heart failure hospitalization and mortality, it is limited by the presence of chronotropic incompetence (CI) in some patients. This study explored the feasibility of using wearable devices to assess impaired chronotropic response in heart failure patients. METHODS: Forty patients with heart failure (left ventricular ejection fraction, LVEF: 44.6 ± 5.8; age: 54.4 ± 11.7) received ECG Holter and accelerometer to monitor heart rate (HR) and physical activities during symptom-limited treadmill exercise testing, 6-min hall walk (6MHW), and 24-h daily living...
May 25, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28545487/inhaled-ambient-level-traffic-derived-particulates-decrease-cardiac-vagal-influence-and-baroreflexes-and-increase-arrhythmia-in-a-rat-model-of-metabolic-syndrome
#16
Alex P Carll, Samir M Crespo, Mauricio S Filho, Douglas H Zati, Brent A Coull, Edgar A Diaz, Rodrigo D Raimundo, Thomas N G Jaeger, Ana Laura Ricci-Vitor, Vasileios Papapostolou, Joy E Lawrence, David M Garner, Brigham S Perry, Jack R Harkema, John J Godleski
BACKGROUND: Epidemiological studies have linked exposures to ambient fine particulate matter (PM2.5) and traffic with autonomic nervous system imbalance (ANS) and cardiac pathophysiology, especially in individuals with preexisting disease. It is unclear whether metabolic syndrome (MetS) increases susceptibility to the effects of PM2.5. We hypothesized that exposure to traffic-derived primary and secondary organic aerosols (P + SOA) at ambient levels would cause autonomic and cardiovascular dysfunction in rats exhibiting features of MetS...
May 25, 2017: Particle and Fibre Toxicology
https://www.readbyqxmd.com/read/28543265/stricter-criteria-for-left-bundle-branch-block-diagnosis-do-not-improve-response-to-crt
#17
Emanuele Bertaglia, Federico Migliore, Anna Baritussio, Antonio De Simone, Albino Reggiani, Domenico Pecora, Antonio D'Onofrio, Antonio Rapacciuolo, Gianluca Savarese, Attilio Pierantozzi, Biondino Marenna, Franco Ruffa, Monica Campari, Maurizio Malacrida, Giuseppe Stabile
BACKGROUND: Cardiac resynchronization therapy (CRT) has proved to be effective in patients with heart failure and left bundle branch block (LBBB). Recently, new ECG criteria have been proposed for the diagnosis of LBBB. These criteria are stricter than the current American Heart Association (AHA) criteria. We assessed the rate of echocardiographic response to CRT in patients with traditional LBBB versus patients who met the new criteria (strict LBBB). METHODS: Consecutive patients undergoing CRT were enrolled in the CRT MORE registry...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28543106/the-concept-of-triple-wavefront-fusion-during-biventricular-pacing-using-the-egm-to-produce-the-best-acute-hemodynamic-improvement-in-crt
#18
Iris A H Ter Horst, Margot D Bogaard, Anton E Tuinenburg, Thomas P Mast, Teun P de Boer, Pieter A Doevendans, Mathias Meine
BACKGROUND: Previous reports suggest that Biventricular pacing (BiVp) fused with intrinsic conduction (BiVp-fusion, triple wavefront fusion) is associated with improved resynchronization compared to pure-BiVp in cardiac resynchronization therapy (CRT). This study aimed to assess the association between acute hemodynamic benefit of CRT and signs of BiVp-fusion by using a novel EGM-based method. METHODS: In 17 patients undergoing CRT implantation, 28 combinations of atrioventricular (AV) and interventricular (VV) delays were applied while invasively measuring acute hemodynamic response based on maximum rate of LV pressure rise (LV dP/dtmax ) to assess optimal BiVp settings...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28533740/correlation-of-ventricular-arrhythmogenesis-with-neuronal-remodeling-of-cardiac-postganglionic-parasympathetic-neurons-in-the-late-stage-of-heart-failure-after-myocardial-infarction
#19
Dongze Zhang, Huiyin Tu, Chaojun Wang, Liang Cao, Robert L Muelleman, Michael C Wadman, Yu-Long Li
Introduction: Ventricular arrhythmia is a major cause of sudden cardiac death in patients with chronic heart failure (CHF). Our recent study demonstrates that N-type Ca(2+) currents in intracardiac ganglionic neurons are reduced in the late stage of CHF rats. Rat intracardiac ganglia are divided into the atrioventricular ganglion (AVG) and sinoatrial ganglion. Only AVG nerve terminals innervate the ventricular myocardium. In this study, we tested the correlation of electrical remodeling in AVG neurons with ventricular arrhythmogenesis in CHF rats...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28527921/drug-induced-fatal-arrhythmias-acquired-long-qt-and-brugada-syndromes
#20
REVIEW
Isik Turker, Tomohiko Ai, Hideki Itoh, Minoru Horie
Since the early 1990s, the concept of primary "inherited" arrhythmia syndromes or ion channelopathies has evolved rapidly as a result of revolutionary progresses made in molecular genetics. Alterations in genes coding for membrane proteins such as ion channels or their associated proteins responsible for the generation of cardiac action potentials (AP) have been shown to cause specific malfunctions which eventually lead to cardiac arrhythmias. These arrhythmic disorders include congenital long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, short QT syndrome, progressive cardiac conduction disease, etc...
May 17, 2017: Pharmacology & Therapeutics
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