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Acute heart failure in adults

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https://www.readbyqxmd.com/read/28435488/clinician-performed-bedside-ultrasound-in-improving-diagnostic-accuracy-in-patients-presenting-to-the-ed-with-acute-dyspnea
#1
Dimitrios Papanagnou, Michael Secko, John Gullett, Michael Stone, Shahriar Zehtabchi
INTRODUCTION: Diagnosing acute dyspnea is a critical action performed by emergency physicians (EP). It has been shown that ultrasound (US) can be incorporated into the work-up of the dyspneic patient; but there is little data demonstrating its effect on decision-making. We sought to examine the impact of a bedside, clinician-performed cardiopulmonary US protocol on the clinical impression of EPs evaluating dyspneic patients, and to measure the change in physician confidence with the leading diagnosis before and after US...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#2
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28414679/misses-opportunity-tof-diagnoses-in-4th-decade-of-life
#3
O Baniahmad, T Jarreau, A Johnson
CASE: A 40 year old woman with a history of HIV, congestive heart failure secondary to an unknown congenital heart defect, and hypertension presented to our emergency department with worsening edema. On room air, oxygen saturation was 55 percent . On 5L of oxygen via nasal cannula, oxygen saturation was 88 percent . Physical examination was notable for central cyanosis, facial and lid edema, a II/VI holosystolic murmur across right chest radiating to entire right back hemithorax, decreased breath sounds at bases with pulmonary crackles, clubbing of fingers and edema of bilateral lower extremities...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28409741/impact-of-comorbidities-among-medicaid-enrollees-with-chronic-obstructive-pulmonary-disease-united-states-2009
#4
Gloria Westney, Marilyn G Foreman, Junjun Xu, Marshaleen Henriques King, Eric Flenaugh, George Rust
INTRODUCTION: Multimorbidity, the presence of 2 or more chronic conditions, frequently affects people with chronic obstructive pulmonary disease (COPD). Many have high-cost, highly complex conditions that have a substantial impact on state Medicaid programs. We quantified the cost of Medicaid-insured patients with COPD co-diagnosed with other chronic disorders. METHODS: We used nationally representative Medicaid claims data to analyze the impact of comorbidities (other chronic conditions) on the disease burden, emergency department (ED) use, hospitalizations, and total health care costs among 291,978 adult COPD patients...
April 13, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28409501/successful-treatment-of-fulminant-lyme-myocarditis-with-mechanical-circulatory-support-in-a-young-male-adult-a-case-report
#5
Željko Župan, Dino Mijatović, Igor Medved, Snježana Kraljić, Jurica Juranić, Berislav Barbalić, Marin Oštrić
We describe the case of fulminant myocarditis due to Lyme disease and use of mechanical circulatory support (MCS) for the treatment of the Lyme carditis associated with refractory cardiogenic shock. Fulminant Lyme myocarditis in young adult male patient led to a sudden onset of acute, severe biventricular heart failure with progressive cardiogenic shock, and multiorgan failure immediately after admission.
April 14, 2017: Croatian Medical Journal
https://www.readbyqxmd.com/read/28403620/altered-mental-status-predicts-mortality-in-cardiogenic-shock-results-from-the-cardshock-study
#6
Anu Kataja, Tuukka Tarvasmäki, Johan Lassus, Lars Køber, Alessandro Sionis, Jindrich Spinar, John Parissis, Valentina Carubelli, Jose Cardoso, Marek Banaszewski, Rossella Marino, Markku S Nieminen, Alexandre Mebazaa, Veli-Pekka Harjola
BACKGROUND: Altered mental status is among the signs of hypoperfusion in cardiogenic shock, the most severe form of acute heart failure. The aim of this study was to investigate the prevalence of altered mental status, to identify factors associating with it, and to assess the prognostic significance of altered mental status in cardiogenic shock. METHODS: Mental status was assessed at presentation of shock in 215 adult cardiogenic shock patients in a multinational, prospective, observational study...
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28400369/in-utero-particulate-matter-exposure-produces-heart-failure-electrical-remodeling-and-epigenetic-changes-at-adulthood
#7
Vineeta Tanwar, Matthew W Gorr, Markus Velten, Clayton M Eichenseer, Victor P Long, Ingrid M Bonilla, Vikram Shettigar, Mark T Ziolo, Jonathan P Davis, Stephen H Baine, Cynthia A Carnes, Loren E Wold
BACKGROUND: Particulate matter (PM; PM2.5 [PM with diameters of <2.5 μm]) exposure during development is strongly associated with adverse cardiovascular outcomes at adulthood. In the present study, we tested the hypothesis that in utero PM2.5 exposure alone could alter cardiac structure and function at adulthood. METHODS AND RESULTS: Female FVB mice were exposed either to filtered air or PM2.5 at an average concentration of 73.61 μg/m(3) for 6 h/day, 7 days/week throughout pregnancy...
April 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#8
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28363684/effect-of-spironolactone-on-the-risks-of-mortality-and-hospitalization-for-heart-failure-in-pre-dialysis-advanced-chronic-kidney-disease-a-nationwide-population-based-study
#9
Wei-Cheng Tseng, Jia-Sin Liu, Szu-Chun Hung, Ko-Lin Kuo, Yu-Hsin Chen, Der-Cherng Tarng, Chih-Cheng Hsu
BACKGROUND: Spironolactone has been shown to reduce cardiovascular death in patients with mild-to-moderate chronic kidney disease (CKD), but its risks and benefits in advanced CKD remain unsettled. We aimed to assess whether spironolactone reduces cardiovascular mortality and morbidity in pre-dialysis stage 5 CKD patients. METHODS: Using Taiwan's National Health Insurance Research Database from January 2000 to June 2009, we enrolled 27,213 pre-dialysis stage 5 CKD adult patients, in whom 1363 patients were treated with spironolactone (user) and 25,850 were not (nonuser)...
March 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28363066/congestive-heart-failure-associated-with-pregnancy-in-okapi-okapia-johnstoni
#10
Joshua D Warren, Copper Aitken-Palmer, Alan D Weldon, Joseph P Flanagan, Lauren L Howard, Michael M Garner, Scott B Citino
Acute signs associated with cardiovascular disease occurred in three pregnant okapi ( Okapia johnstoni ) during early to midgestation and progressed to congestive heart failure. Congestive heart failure was diagnosed antemortem using echocardiography and plasma cardiac troponin levels. Clinical signs included decreased activity, hyporexia, tachypnea, dyspnea, flared nostrils, and productive coughing with copious amounts of foamy nasal discharge. Parenteral and oral treatment with furosemide, enalapril, and spironolactone controlled clinical signs in the three okapi allowing each to carry out one pregnancy to term...
March 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28356923/the-guy-s-and-st-thomas-s-nhs-foundation-trust-home-service-an-overview-of-a-new-service
#11
Geraldine A Lee, Karen Titchener
Hospital in the home is a relatively new concept within the UK healthcare system. The Guy's and St Thomas's NHS Foundation Trust (GSTT) @home service 'Bringing hospital care to your home' was commissioned by Lambeth and Southwark CCG in 2014 to provide acute care in the patients' place of residence by facilitating rapid discharge from hospital. The service is designed for 260-280 referrals each month from local hospitals, London Ambulance Service, GPs, district nurses and palliative care services. The GSTT@home provides intensive care for a short episode through multidisciplinary team work with the aim of returning the patient to their prior health status following an acute episode of ill health...
March 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/28343276/an-updated-review-of-cardiac-devices-in-heart-failure
#12
REVIEW
C Murphy, H Zafar, F Sharif
BACKGROUND: Heart failure has the highest rates of adult hospitalisations, the highest mortality rates and significant costs associated with its care. The cost of heart failure is expected continue to grow on a global scale, with $108 billion spent on heart failure in 2012. Mortality rates are high, with incident cases of heart failure resulting in 30% 1-year mortality, and in hospital mortality of acute heart failure, 28%. METHODS AND RESULTS: This article reviews the devices currently in use for the treatment of heart failure, as well as those that are under investigation...
March 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28331287/does-remifentanil-attenuate-renal-ischemia-reperfusion-injury-better-than-dexmedetomidine-in-rat-kidney
#13
E Erkılıç, E Kesimci, F Alaybeyoğlu, I Kılınç, R Tural, A Yazgan, T Gümüş, A Sepici Dinçel, E G Dumlu, O Kanbak
BACKGROUND: Ischemia-reperfusion (I/R) injury is a common cause of patient morbidity and mortality in the perioperative period. Patients undergoing long-lasting, abdominal, and urogenital surgeries with risk factors such as advanced age, peripheral artery disease, diabetes mellitus, renovascular disease, and congestive heart failure are candidates for acute kidney injury (AKI) due to impaired renal perfusion and decreased functional renal reserve. Pharmacological agents with multiple functions and anti-oxidative and anti-inflammation properties may be promising preventative strategies for AKI...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28331015/association-between-clinically-recorded-alcohol-consumption-and-initial-presentation-of-12-cardiovascular-diseases-population-based-cohort-study-using-linked-health-records
#14
Steven Bell, Marina Daskalopoulou, Eleni Rapsomaniki, Julie George, Annie Britton, Martin Bobak, Juan P Casas, Caroline E Dale, Spiros Denaxas, Anoop D Shah, Harry Hemingway
Objectives To investigate the association between alcohol consumption and cardiovascular disease at higher resolution by examining the initial lifetime presentation of 12 cardiac, cerebrovascular, abdominal, or peripheral vascular diseases among five categories of consumption.Design Population based cohort study of linked electronic health records covering primary care, hospital admissions, and mortality in 1997-2010 (median follow-up six years).Setting CALIBER (ClinicAl research using LInked Bespoke studies and Electronic health Records)...
March 22, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28329459/nineteen-years-of-adult-congenital-heart-surgery-in-a-single-center
#15
Madurra Perinpanayagam, Signe H Larsen, Kristian Emmertsen, Marianne B Møller, Vibeke E Hjortdal
BACKGROUND: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort. METHODS: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329345/prevalence-and-clinical-correlates-of-sarcopenia-identified-according-to-the-ewgsop-definition-and-diagnostic-algorithm-in-hospitalized-older-people-the-glisten-study
#16
Lara Bianchi, Pasquale Abete, Giuseppe Bellelli, Mario Bo, Antonio Cherubini, Francesco Corica, Mauro Di Bari, Marcello Maggio, Giovanna Maria Manca, Maria Rosaria Rizzo, Andrea P Rossi, Francesco Landi, Stefano Volpato
Background: Prevalence of sarcopenia is substantial in most geriatrics settings, but estimates vary greatly across studies because of difference in population characteristics, diagnostic criteria, and methods used to assess muscle mass, muscle strength, and physical performance. We investigated the feasibility of the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm assessment in hospitalized older adults and analyzed prevalence and clinical correlates of sarcopenia...
January 21, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28324597/the-burden-of-chronic-heart-failure-in-primary-care-in-italy
#17
Carlo Piccinni, Ippazio Cosimo Antonazzo, Monica Simonetti, Marco Giovanni Mennuni, Damiano Parretti, Claudio Cricelli, Delia Colombo, Mihaela Nica, Iacopo Cricelli, Francesco Lapi
INTRODUCTION: Chronic heart failure (CHF) is a major public health concern. From a public health perspective, the epidemiology of CHF needs to be distinguished from that of its related acute form. Data stemming from primary care are crucial to better know and update the prevalence and incidence rates of CHF. AIM: To update the epidemiology of CHF in an Italian primary care setting and to describe socio-demographic, lifestyle, and clinical characteristics of these patients...
March 21, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28315072/direct-myosin-activation-by-omecamtiv-mecarbil-for-heart-failure-with-reduced-ejection-fraction
#18
Mitchell A Psotka, John R Teerlink
Myosin is the indispensable molecular motor that utilizes chemical energy to produce force for contraction within the cardiac myocyte. Myosin activity is gated by intracellular calcium levels which are regulated by multiple upstream signaling cascades that can be altered for clinical utility using inotropic medications. In contrast to clinically available cardiac inotropes, omecamtiv mecarbil is a novel direct myosin activator developed to augment left ventricular systolic function without the undesirable secondary effects of altered calcium homeostasis...
March 18, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28296811/new-onset-atrial-fibrillation-in-the-critically-ill
#19
Travis J Moss, James Forrest Calland, Kyle B Enfield, Diana C Gomez-Manjarres, Caroline Ruminski, John P DiMarco, Douglas E Lake, J Randall Moorman
OBJECTIVE: To determine the association of new-onset atrial fibrillation with outcomes, including ICU length of stay and survival. DESIGN: Retrospective cohort of ICU admissions. We found atrial fibrillation using automated detection (≥ 90 s in 30 min) and classed as new-onset if there was no prior diagnosis of atrial fibrillation. We identified determinants of new-onset atrial fibrillation and, using propensity matching, characterized its impact on outcomes...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28285867/a-modified-lung-and-cardiac-ultrasound-protocol-saves-time-and-rules-in-the-diagnosis-of-acute-heart-failure
#20
Frances M Russell, Robert R Ehrman
BACKGROUND: Multiorgan ultrasound (US), which includes evaluation of the lungs and heart, is an accurate method that outperforms clinical gestalt for diagnosing acutely decompensated heart failure (ADHF). A known barrier to ultrasound use is the time needed to perform these examinations. OBJECTIVE: The primary goal of this study was to determine the test characteristics of a modified lung and cardiac US (LuCUS) protocol for the accurate diagnosis of ADHF. METHODS: This was a secondary analysis of a prospective observational study that enrolled adult patients presenting to the emergency department with undifferentiated dyspnea...
March 9, 2017: Journal of Emergency Medicine
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