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Acute heart failure in adults

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https://www.readbyqxmd.com/read/27920972/potentially-preventable-hospitalizations-for-acute-and-chronic-conditions-in-alaska-2010-2012
#1
Prabhu P Gounder, Sara M Seeman, Robert C Holman, Alice Rarig, Mary K McEwen, Claudia A Steiner, Michael L Bartholomew, Thomas W Hennessy
OBJECTIVE: The U.S. Agency for Healthcare Research and Quality's Prevention Quality Indicators comprise acute and chronic conditions for which hospitalization can be potentially prevented by high-quality ambulatory care. The Healthy Alaska 2020 initiative (HA2020) targeted reducing potentially preventable hospitalizations (PPH) for acute and chronic conditions among its health indicators. We estimated the PPH rate for adults aged ≥ 18 years in Alaska during 2010-2012. METHODS: We conducted a cross-sectional analysis of state-wide hospital discharge data obtained from the Healthcare Cost and Utilization Project and the Indian Health Service...
December 2016: Preventive Medicine Reports
https://www.readbyqxmd.com/read/27912923/predictors-of-30-day-mortality-in-patients-admitted-to-emergency-departments-for-acute-heart-failure
#2
Matthieu Marchetti, Antoine Benedetti, Olivier Mimoz, Jean-Yves Lardeur, Jérémy Guenezan, Nicolas Marjanovic
OBJECTIVES: Acute heart failure (AHF) is a leading cause of admission in emergency departments (ED). It is associated with significant in-hospital mortality, suggesting that there is room for improvement of care. Our aims were to investigate clinical patterns, biological characteristics and determinants of 30-day mortality. METHODS: We conducted a single site, retrospective review of adult patients (≥18years) admitted to ED for AHF over a 12-month period. Data collected included demographics, clinical, biological and outcomes data...
November 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27909035/randomised-controlled-pilot-study-to-investigate-the-effectiveness-of-thoracic-epidural-and-paravertebral-blockade-in-reducing-chronic-post-thoracotomy-pain-topic-feasibility-study-protocol
#3
Joyce Yeung, Teresa Melody, Amy Kerr, Babu Naidu, Lee Middleton, Kostas Tryposkiadis, Jane Daniels, Fang Gao
INTRODUCTION: Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27906998/explaining-the-decline-in-coronary-heart-disease-mortality-in-the-netherlands-between-1997-and-2007
#4
Carla Koopman, Ilonca Vaartjes, Ineke van Dis, W M Monique Verschuren, Peter Engelfriet, Edith M Heintjes, Anneke Blokstra, Dorly J H Deeg, Marjolein Visser, Michiel L Bots, Martin O'Flaherty, Simon Capewell
OBJECTIVE: We set out to determine what proportion of the mortality decline from 1997 to 2007 in coronary heart disease (CHD) in the Netherlands could be attributed to advances in medical treatment and to improvements in population-wide cardiovascular risk factors. METHODS: We used the IMPACT-SEC model. Nationwide information was obtained on changes between 1997 and 2007 in the use of 42 treatments and in cardiovascular risk factor levels in adults, aged 25 or over...
2016: PloS One
https://www.readbyqxmd.com/read/27899470/i-trach-validating-a-tool-for-predicting-prolonged-mechanical-ventilation
#5
Paul A Clark, Ryan C Inocencio, Christopher J Lettieri
PURPOSE: We previously developed a bedside model (I-TRACH), which used commonly obtained data at the time of intubation to predict the duration of mechanical ventilation (MV). We now sought to validate this in a prospective trial. METHODS: A prospective, observational study of 225 consecutive adult medical intensive care unit patients requiring MV. Utilizing the original 6 variables used in the I-TRACH model (Intubation in the ICU, Tachycardia [heart rate > 110], Renal dysfunction [blood urea nitrogen > 25], Acidemia [pH < 7...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27894126/brain-type-natriuretic-peptide-and-amino-terminal-pro-brain-type-natriuretic-peptide-discharge-thresholds-for-acute-decompensated-heart-failure-a-systematic-review
#6
Casey N McQuade, Marisa Mizus, Joyce W Wald, Lee Goldberg, Mariell Jessup, Craig A Umscheid
Background: Acute decompensated heart failure (ADHF) requiring hospitalization is associated with high postdischarge mortality and readmission rates. Purpose: To examine the association between achieving predischarge natriuretic peptide (NP) thresholds and mortality and readmission rates in adults hospitalized for ADHF. Data Sources: Multiple databases from 1947 to October 2016 (English-language studies only). Study Selection: Trials and observational studies that compared mortality and readmission outcomes between patients with ADHF achieving a specific predischarge NP goal and those not achieving the goal...
November 29, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27881100/high-prevalence-of-non-steroidal-anti-inflammatory-drug-use-among-acute-kidney-injury-survivors-in-the-southern-community-cohort-study
#7
Loren Lipworth, Khaled Abdel-Kader, Jennifer Morse, Thomas G Stewart, Edmond K Kabagambe, Sharidan K Parr, Kelly A Birdwell, Michael E Matheny, Adriana M Hung, William J Blot, T Alp Ikizler, Edward D Siew
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and have been linked to acute kidney injury (AKI), chronic kidney disease (CKD) and cardiovascular disease (CVD). Patients who survive an AKI episode are at risk for future adverse kidney and cardiovascular outcomes. The objective of our study was to examine the prevalence and predictors of NSAID use among AKI survivors. METHODS: The Southern Community Cohort Study is a prospective study of low-income adults aged 40-79 in the southeastern US...
November 24, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27874977/relationship-between-age-and-trajectories-of-rehospitalization-risk-in-older-adults
#8
Kumar Dharmarajan, Angela Hsieh, Rachel P Dreyer, Jack Welsh, Li Qin, Harlan M Krumholz
OBJECTIVES: To characterize the magnitude and duration of risk of rehospitalization according to age after hospitalization for heart failure (HF), acute myocardial infarction (AMI), or pneumonia. DESIGN: Retrospective cohort study. SETTING: U.S. hospitals (n = 4,767). PARTICIPANTS: All Medicare fee-for-service beneficiaries aged 65 and older surviving hospitalization for HF, AMI, or pneumonia between October 2012 and December 2013...
November 22, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27868320/predictors-of-rehospitalization-among-older-adults-results-of-the-crime-study
#9
Federica Sganga, Francesco Landi, Stefano Volpato, Antonio Cherubini, Carmelinda Ruggiero, Andrea Corsonello, Paolo Fabbietti, Fabrizia Lattanzio, Ester Manes Gravina, Roberto Bernabei, Graziano Onder
AIM: To assess the predictors of readmission among older adults hospitalized in acute care wards. METHODS: A prospective cohort study was carried out among 921 hospitalized older adults participating in the CRiteria to Assess Appropriate Medication Use among Elderly Complex Patients (CRIME) project. The primary outcome of the study was rehospitalization within 1 year after discharge from acute care hospitals. We assessed the participants with a questionnaire including 350 items about demographic, social and clinical characteristics...
November 21, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27856091/a-clinical-risk-prediction-tool-for-6-month-mortality-after-dialysis-initiation-among-older-adults
#10
James P Wick, Tanvir C Turin, Peter D Faris, Jennifer M MacRae, Robert G Weaver, Marcello Tonelli, Braden J Manns, Brenda R Hemmelgarn
BACKGROUND: Information on an individual's risk for death following dialysis therapy initiation may inform the decision to initiate maintenance dialysis for older adults. We derived and validated a clinical risk prediction tool for all-cause mortality among older adults during the first 6 months of maintenance dialysis treatment. STUDY DESIGN: Prediction model using retrospective administrative and clinical data. SETTING & PARTICIPANTS: We linked administrative and clinical data to define a cohort of 2,199 older adults (age ≥ 65 years) in Alberta, Canada, who initiated maintenance dialysis therapy (excluding acute kidney injury) in May 2003 to March 2012...
November 14, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27851838/trends-and-outcomes-of-pulmonary-arterial-hypertension-related-hospitalizations-in-the-united-states-analysis-of-the-nationwide-inpatient-sample-database-from-2001-through-2012
#11
Vidhu Anand, Samit S Roy, Stephen L Archer, E Kenneth Weir, Sushil Kumar Garg, Sue Duval, Thenappan Thenappan
Importance: Recent trends and outcomes of pulmonary arterial hypertension (PAH)-related hospitalization in adults in the United States are unknown. Objective: To examine the characteristics of PAH-related hospitalizations. Design, Setting, and Participants: We analyzed the National Inpatient Sample database for all adult patients (≥18 years old) with PAH as the principal discharge diagnosis from January 1, 2001, through December 31, 2012...
November 16, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27833563/heart-failure-induced-by-perinatal-ablation-of-cardiac-myosin-light-chain-kinase
#12
Yasmin F K Islam, Ryan Joseph, Rajib R Chowdhury, Robert H Anderson, Hideko Kasahara
Background: Germline knockout mice are invaluable in understanding the function of the targeted genes. Sometimes, however, unexpected phenotypes are encountered, due in part to the activation of compensatory mechanisms. Germline ablation of cardiac myosin light chain kinase (cMLCK) causes mild cardiac dysfunction with cardiomyocyte hypertrophy, whereas ablation in adult hearts results in acute heart failure with cardiomyocyte atrophy. We hypothesized that compensation after ablation of cMLCK is dependent on developmental staging and perinatal-onset of cMLCK ablation will result in more evident heart failure than germline ablation, but less profound when compared to adult-onset ablation...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27821636/potentially-preventable-hospitalization-among-patients-with-ckd-and-high-inpatient-use
#13
Paul E Ronksley, Brenda R Hemmelgarn, Braden J Manns, James Wick, Matthew T James, Pietro Ravani, Robert R Quinn, Nairne Scott-Douglas, Richard Lewanczuk, Marcello Tonelli
BACKGROUND AND OBJECTIVES: Although patients with CKD are commonly hospitalized, little is known about those with frequent hospitalization and/or longer lengths of stay (high inpatient use). The objective of this study was to explore clinical characteristics, patterns of hospital use, and potentially preventable acute care encounters among patients with CKD with at least one hospitalization. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We identified all adults with nondialysis CKD (eGFR<60 ml/min per 1...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27821147/hemodynamic-management-and-outcomes-of-patients-admitted-to-emergency-department-with-heart-failure
#14
Pierre-Géraud Claret, Ian G Stiell, Justin W Yan, Catherine M Clement, Brian H Rowe, Lisa A Calder, Jeffrey J Perry
BACKGROUND: Heart failure is one of the leading reasons for hospitalization in developed countries. Our goal was to describe the hemodynamic vital signs (heart rate and systolic blood pressure) of patients presenting to the emergency department (ED) with heart failure and to describe the frequency of adverse events for patients presenting with various heart rate and systolic blood pressure values. METHOD: We conducted two prospective cohort studies of heart failure conducted at six Canadian teaching hospital sites and this study was a secondary analysis of these data...
November 7, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27821094/outcomes-risk-factors-and-health-burden-of-contrast-induced-acute-kidney-injury-an-observational-study-of-one-million-hospitalizations-with-image-guided-cardiovascular-procedures
#15
Pierre Aubry, Georges Brillet, Laura Catella, Aurélie Schmidt, Stève Bénard
BACKGROUND: Despite the use of low-osmolar contrast media that have significantly reduced the occurrence of severe adverse reactions, contrast-induced (CI) acute kidney injury (AKI) remains the third cause of AKI in hospitals. We sought to estimate the frequency of CI-AKI among hospitalized patients undergoing image-guided cardiovascular procedures, to quantify the effect of risk factors on the development of this complication and to assess relative organizational and economic burden in healthcare...
November 8, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27816124/anesthetic-management-of-the-adult-patient-with-concomitant-cardiac-and-pulmonary-disease
#16
REVIEW
Misty A Radosevich, Daniel R Brown
Several common diseases of the cardiac and pulmonary systems and the interactions of the two in disease and anesthetic management are discussed. Management of these disease processes in isolation is reviewed and how the management of one organ system impacts another is then explored. For example, in a patient with acute lung injury and right heart failure, lung-protective ventilation may directly conflict with strategies to minimize right heart afterload. Such challenging clinical scenarios require appreciation of each disease entity, their appropriate management, and the balance between competing priorities...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27783382/short-term-effects-of-neuromuscular-blockade-on-global-and-regional-lung-mechanics-oxygenation-and-ventilation-in-pediatric-acute-hypoxemic-respiratory-failure
#17
Marlon E F Wilsterman, Pauline de Jager, Robert Blokpoel, Inez Frerichs, Sandra K Dijkstra, Marcel J I J Albers, Johannes G M Burgerhof, Dick G Markhorst, Martin C J Kneyber
BACKGROUND: Neuromuscular blockade (NMB) has been shown to improve outcome in acute respiratory distress syndrome (ARDS) in adults, challenging maintaining spontaneous breathing when there is severe lung injury. We tested in a prospective physiological study the hypothesis that continuous administration of NMB agents in mechanically ventilated children with severe acute hypoxemic respiratory failure (AHRF) improves the oxygenation index without a redistribution of tidal volume V T toward non-dependent lung zones...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27755392/the-hospital-score-predicts-potentially-preventable-30-day-readmissions-in-conditions-targeted-by-the-hospital-readmissions-reduction-program
#18
Robert E Burke, Jeffrey L Schnipper, Mark V Williams, Edmondo J Robinson, Eduard E Vasilevskis, Sunil Kripalani, Joshua P Metlay, Grant S Fletcher, Andrew D Auerbach, Jacques D Donzé
BACKGROUND/OBJECTIVES: New tools to accurately identify potentially preventable 30-day readmissions are needed. The HOSPITAL score has been internationally validated for medical inpatients, but its performance in select conditions targeted by the Hospital Readmission Reduction Program (HRRP) is unknown. DESIGN: Retrospective cohort study. SETTING: Six geographically diverse medical centers. PARTICIPANTS/EXPOSURES: All consecutive adult medical patients discharged alive in 2011 with 1 of the 4 medical conditions targeted by the HRRP (acute myocardial infarction, chronic obstructive pulmonary disease, pneumonia, and heart failure) were included...
October 14, 2016: Medical Care
https://www.readbyqxmd.com/read/27754202/apsh-yi-01-effects-of-different-classes-of-anti-hypertensive-agents-on-survival-in-patients-with-uncomplicated-hypertension
#19
Chan Joo Lee, Jaewon Oh, Sang-Hak Lee, Seok-Min Kang, Donghoon Choi, Hyeon-Chang Kim, Sungha Park
OBJECTIVE: In most cases, the 5 first line drugs are recommended for management of hypertension without preference for one or the other. However, it is unclear whether different classes of anti-hypertensive agents have different effect on survival in low risk, uncomplicated hypertension. The aim of this study was to evaluate effects of 4 classes of first line anti-hypertensive agents on improving survival in patients with low risk, uncomplicated hypertension. DESIGN AND METHOD: Adult hypertensive patients without chronic kidney disease, end stage renal disease, diabetes mellitus, acute coronary syndrome, and heart failure in 2002 were selected from Korean National Health Insurance sample cohort consisting of one million subjects...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754188/sp-05-1-should-the-target-for-blood-pressure-reduction-be-lower-in-adults-with-hypertension-and-a-history-of-cardiovascular-disease
#20
Paul Whelton
BACKGROUND: Choice of the optimal target for blood pressure (BP) reduction during treatment of patients with hypertension, including those with underlying co-morbid conditions, is an important challenge in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) was designed to provide guidance in selection of a Systolic BP target during treatment of hypertension. METHODS: Adults ≥50 years old with hypertension and at least one additional risk factor for cardiovascular disease (CVD), but excluding persons with diabetes mellitus, prior stroke, or advanced chronic kidney disease (CKD) were randomly assigned to intensive therapy (intensive), targeting a systolic BP (SBP) <120 mmHg, or standard therapy (standard), targeting a SBP <140 mmHg...
September 2016: Journal of Hypertension
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