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Acute heart failure in adults

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https://www.readbyqxmd.com/read/28920060/midkine-s-role-in-cardiac-pathology
#1
Kathleen C Woulfe, Carmen C Sucharov
Midkine (MDK) is a heparin-binding growth factor that is normally expressed in mid-gestational development mediating mesenchymal and epithelial interactions. As organisms age, expression of MDK diminishes; however, in adults, MDK expression is associated with acute and chronic pathologic conditions such as myocardial infarction and heart failure (HF). The role of MDK is not clear in cardiovascular disease and currently there is no consensus if it plays a beneficial or detrimental role in HF. The lack of clarity in the literature is exacerbated by differing roles that circulating and myocardial MDK play in signaling pathways in cardiomyocytes (some of which have yet to be elucidated)...
September 2017: Journal of Cardiovascular Development and Disease
https://www.readbyqxmd.com/read/28918171/the-association-between-delirium-and-sarcopenia-in-older-adult-patients-admitted-to-acute-geriatrics-units-results-from-the-glisten-multicenter-observational-study
#2
Giuseppe Bellelli, Antonella Zambon, Stefano Volpato, Pasquale Abete, Lara Bianchi, Mario Bo, Antonio Cherubini, Francesco Corica, Mauro Di Bari, Marcello Maggio, Giovanna Maria Manca, Maria Rosaria Rizzo, Andrea Rossi, Francesco Landi
BACKGROUND & AIMS: To date, studies assessing the relationship between sarcopenia and delirium, two of the most common geriatric syndromes, are lacking. We sought to explore this association by investigating the co-occurrence of these two conditions and the independent association between them in a population of hospitalized older adults. METHODS: Cross-sectional multicenter analysis of older adults consecutively admitted to 12 acute geriatric units (AGUs). Sarcopenia was assessed upon admission by evaluating the presence of low skeletal mass index (kg/m(2)), and either low handgrip strength or low walking speed (European Working Group on Sarcopenia in Older People, EWGSOP criteria)...
September 5, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28905701/outcomes-of-patients-with-severe-influenza-infection-admitted-to-intensive-care-units-a-retrospective-study-in-a-medical-centre
#3
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Kuo-Shu Yuan, Chin-Ming Chen
PURPOSE: This study assessed clinical manifestations and prognostic factors of critically ill patients with severe influenza admitted to the intensive care unit (ICU) in Taiwan's recent outbreak. METHODOLOGY: Patients admitted to ICU for severe influenza between January 1, 2015, and March 31, 2016, were identified and their medical records were retrospectively reviewed. The primary endpoints were outcomes and predictors of in-hospital mortality. RESULTS: There were 125 patients with an average Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 20...
September 14, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28887109/early-identification-of-patients-with-acute-decompensated-heart-failure
#4
Saul Blecker, David Sontag, Leora I Horwitz, Gilad Kuperman, Hannah Park, Alex Reyentovich, Stuart D Katz
BACKGROUND: Interventions to reduce readmissions following acute heart failure hospitalization require early identification of patients. The purpose of this study was to develop and test accuracies of various approaches to identify patients with acute decompensated heart failure (ADHF) using data derived from the electronic health record. METHODS AND RESULTS: We included 37,229 hospitalizations of adult patients at a single hospital in 2013-2015. We developed four algorithms to identify hospitalization with a principal discharge diagnosis of ADHF: 1) presence of one of three clinical characteristics; 2) logistic regression of 31 structured data elements; 3) machine learning with unstructured data; 4) machine learning with both structured and unstructured data...
September 5, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28881267/gamma-glutamyltransferase-and-cardiovascular-mortality-in-korean-adults-a-cohort-study
#5
Sang-Wook Yi, Sang-Hun Lee, Hee-Jin Hwang, Jee-Jeon Yi
BACKGROUND AND AIMS: Insufficient evidence has been reported on the associations between gamma-glutamyltransferase (GGT) and cardiovascular disease (CVD) mortality from studies with an adequate number of participants. METHODS: 512,990 Korean adults who participated in routine health examinations during the period 2002-2003 were followed up until 2013. Hazard ratios (HRs) were calculated after adjusting for potential confounders. RESULTS: Each 1-unit higher natural-log-transformed GGT (LogeGGT) level was associated with approximately 30-50% higher mortality risk of CVD (HR = 1...
August 26, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28869885/development-and-validation-of-a-prognostic-index-for-6-and-12-month-mortality-in-hospitalized-older-adults
#6
Eva Gallego González, Francisco Javier Ortiz Alonso, Maria Teresa Vidán Astiz, Selene Soria Felix, Verónica García Cárdenas, John Omonte Guzmán, Pedro Abizanda, Maria Isabel Valadés Malagón, Silvia Oreja Sevilla, José Antonio Serra Rexach
BACKGROUND/AIM: Estimation of mortality in elderly patients is difficult yet very important when planning care. Previous tools are complicated or do no take into account some major determinants of mortality (i.e., frailty). We designed a simple, accurate, and non-disease-specific tool to predict individual mortality risk after hospital discharge in older adults. METHODS: Patients admitted to the Acute Geriatric Unit were assessed at adission and at discharge and contacted 6 and 12 months later...
July 23, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28844513/outcomes-of-nonagenarians-admitted-to-the-cardiac-intensive-care-unit-by-the-elders-risk-assessment-score-for-long-term-mortality-risk-stratification
#7
Andrew N Rosenbaum, Niyada Naksuk, Shahyar M Gharacholou, Jorge A Brenes-Salazar
There are limited data on outcomes of older adults admitted to cardiac intensive care units (CICU), and there are no data on outcomes after admission to the CICU in nonagenarians. Our purpose was to identify whether the Elders Risk Assessment (ERA) index could risk stratify older adults after CICU admission. We retrospectively identified 453 nonagenarians admitted to the CICU between 2004 and 2013. End points included mortality, length of stay, incidence of delirium, and discharge disposition. Average age of the cohort was 92 ± 2 years, and the average ERA score was 13 ± 6...
July 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28828019/chronic-pain-in-chronic-heart-failure-a-review-article
#8
REVIEW
Mohammad Javad Alemzadeh-Ansari, Mohammad Mostafa Ansari-Ramandi, Nasim Naderi
Heart failure (HF) is one of the main causes of death and disability in the world. The prevalence of HF in developed countries is between 1% and 2% of the adult population and approximately between 6% and 10% in the elderly, giving rise to high costs of care and treatment. Indeed, in the United States, the direct and indirect costs exceeded 23 billion dollars in 2002. HF is typically characterized by periods of acute symptoms followed by returns to nearly asymptomatic periods. As dyspnea and fatigue are considered the signature symptoms of HF, other symptoms such as pain go unnoticed...
April 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/28807581/right-heart-function-during-and-after-community-acquired-pneumonia-in-adults
#9
Kevin E Boczar, Vicente F Corrales-Medina, Ian G Burwash, Julio A Chirinos, Girish Dwivedi
BACKGROUND: New-onset or worsening heart failure is the most common extra-pulmonary complication of community-acquired pneumonia (CAP) during the first 30 days after diagnosis. METHODS: We evaluated the changes in the right ventricular function amongst adult CAP survivors from the time of acute infection to its resolution. We performed comprehensive transthoracic echocardiographic examinations to assess right heart function during the acute illness and the convalescent period (four to six weeks after hospital discharge)...
July 27, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28805234/prognostic-factors-for-mortality-due-to-pneumonia-among-adults-from-different-age-groups-in-singapore-and-mortality-predictions-based-on-psi-and-curb-65
#10
Zoe Xz Zhang, Yang Yong, Wan C Tan, Liang Shen, Han Seong Ng, Kok Yong Fong
INTRODUCTION: Pneumonia is associated with considerable mortality. However, the information on age-specific prognostic factors for death from pneumonia is limited. METHODS: Patients hospitalised with a diagnosis of pneumonia through the emergency department were stratified into three age groups: 18-64 years; 65-84 years; and ≥ 85 years. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to evaluate prognostic factors for mortality and the performance of pneumonia severity scoring tools for mortality prediction...
August 14, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28801528/epidemiology-and-natural-history-of-the-cardiorenal-syndromes-in-a-cohort-with-echocardiography
#11
Thomas A Mavrakanas, Aisha Khattak, Karandeep Singh, David M Charytan
BACKGROUND AND OBJECTIVES: It is unknown whether echocardiographic parameters are independently associated with the cardiorenal syndrome. No direct comparison of the natural history of various cardiorenal syndrome types has been conducted. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our retrospective cohort study enrolled adult patients with at least one transthoracic echocardiography between 2004 and 2014 at a single health care system. Information on comorbidities was extracted using condition-specific diagnostic codes...
August 11, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28798077/cardiovascular-susceptibility-to-in-vivo-ischemic-myocardial-injury-in-male-and-female-rat-offspring-exposed-to-prenatal-hypoxia
#12
Amin Shah, Nobutoshi Matsumura, Anita Quon, Jude S Morton, Jason R B Dyck, Sandra T Davidge
Intrauterine growth restriction (IUGR) following prenatal hypoxia exposure leads to a higher risk of developing cardiovascular disease (CVD) in later life. Our aim was to evaluate cardiac susceptibility and its pathophysiological mechanisms following acute myocardial infarction (MI) in adult rat offspring exposed to prenatal hypoxia. Male and female rat offspring, which experienced normoxia (21% O2) or hypoxia (11% O2) in utero underwent sham or MI surgery at 12 weeks of age. Echocardiographic data revealed that both sexes had systolic dysfunction following MI surgery, independent of prenatal hypoxia...
September 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28760891/influence-of-beta-lactam-infusion-strategy-on-acute-kidney-injury
#13
Sarah E Cotner, W Cliff Rutter, Donna R Burgess, Katie L Wallace, Craig A Martin, David S Burgess
Background Limited literature is available assessing nephrotoxicity with prolonged beta-lactam infusions. This study compared the incidence of acute kidney injury (AKI) associated with a prolonged beta-lactam infusion (PI) or an intermittent infusion.Methods. This was a retrospective, matched cohort study at an academic medical center from July 2006 to September 2015. Adult patients who received piperacillin-tazobactam (TZP), cefepime (FEP), or meropenem (MEM) for at least 48 hours were evaluated. Patients were excluded for pre-existing renal dysfunction or pregnancy...
July 31, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28758715/serial-sonographic-assessment-of-pulmonary-edema-in-patients-with-hypertensive-acute-heart-failure
#14
Jennifer L Martindale, Michael Secko, John F Kilpatrick, Ian S deSouza, Lorenzo Paladino, Andrew Aherne, Ninfa Mehta, Alyssa Conigiliaro, Richard Sinert
OBJECTIVES: Objective measures of clinical improvement in patients with acute heart failure (AHF) are lacking. The aim of this study was to determine whether repeated lung sonography could semiquantitatively capture changes in pulmonary edema (B-lines) in patients with hypertensive AHF early in the course of treatment. METHODS: We conducted a feasibility study in a cohort of adults with acute onset of dyspnea, severe hypertension in the field or at triage (systolic blood pressure ≥ 180 mm Hg), and a presumptive diagnosis of AHF...
July 31, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28755159/managing-hypertension-in-the-elderly-what-is-different-what-is-the-same
#15
REVIEW
Wilbert S Aronow
PURPOSE OF REVIEW: The goal is to discuss management of hypertension in the elderly. RECENT FINDINGS: At 3.14-year follow-up of 2636 persons ≥75 years in the Systolic Blood Pressure Intervention Trial (SPRINT), compared with a systolic blood pressure (SBP) goal of <140 mmHg, a SBP goal of <120 mmHg reduced the primary endpoint of myocardial infarction, other acute coronary syndrome, stroke, heart failure, or cardiovascular death by 34% (p = 0.001), all-cause mortality by 33% (p = 0...
August 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28754745/cardiovascular-susceptibility-to-in-vivo-ischemic-myocardial-injury-in-male-and-female-rat-offspring-exposed-to-prenatal-hypoxia
#16
Amin Shah, Nobutoshi Matsumura, Anita Quon, Jude Sally Morton, Jason Dyck, Sandra Thomas Davidge
Intrauterine growth restriction following prenatal hypoxia exposure leads to a higher risk of developing cardiovascular disease in later life. Our aim was to evaluate cardiac susceptibility and its pathophysiological mechanisms following acute myocardial infarction (MI) in adult rat offspring exposed to prenatal hypoxia. Male and female rat offspring which experienced normoxia (21% O2) or hypoxia (11% O2) in utero underwent sham or MI surgery at 12 weeks of age. Echocardiographic data revealed that both sexes had systolic dysfunction following MI surgery, independent of prenatal hypoxia...
July 28, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28743566/mortality-prediction-in-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-after-cardiac-surgery
#17
Inga Skarupskienė, Dalia Adukauskienė, Jurgita Kuzminskienė, Laima Rimkutė, Vilma Balčiuvienė, Edita Žiginskienė, Vytautas Kuzminskis, Agnė Adukauskaitė, Daiva Pentiokinienė, Inga Arūnė Bumblytė
BACKGROUND AND OBJECTIVE: Acute kidney injury (AKI) is a common and potentially serious postoperative complication after cardiac surgery, and it remains a cause of major morbidity and mortality. The aim of our study was to assess the prognostic illness severity score and to estimate the significant risk factors for poor outcome of patients with AKI requiring renal replacement therapy (RRT) after cardiac surgery. MATERIALS AND METHODS: We retrospectively analyzed data of adult (>18 years) patients (n=111) who underwent open heart surgery and had developed AKI with need for RRT...
July 14, 2017: Medicina
https://www.readbyqxmd.com/read/28737066/%C3%AE-blockade-in-heart-failure-with-reduced-ejection-fraction-does-heart-rate-control-influence-readmissions
#18
Ryan E Owens, Jennifer D Twilla, Timothy H Self, Abdulrahman I Alshaya, Carlvin J Metra, Carolyn Cummings, Carrie S Oliphant
BACKGROUND: Raised resting heart rate (HR), >70 beats per minute (bpm), has been shown to be a risk factor for adverse cardiovascular outcomes and hospital readmissions, specifically in patients with heart failure with reduced ejection fraction (HF rEF). Given their mortality benefit, β-blockers are recommended in HF rEF, with a goal to titrate to a maximum tolerated dose rather than a specific HR target. OBJECTIVE: To determine the impact of optimal HR control achievement prior to hospital discharge on hospital readmissions in patients with HF rEF receiving β-blockade...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28727607/new-onset-heart-failure-and-mortality-in-hospital-survivors-of-sepsis-related-left-ventricular-dysfunction
#19
Saraschandra Vallabhajosyula, Jacob C Jentzer, Jeffrey B Geske, Mukesh Kumar, Ankit Sakhuja, Akhil Singhal, Joseph T Poterucha, Kianoush Kashani, Joseph G Murphy, Ognjen Gajic, Rahul Kashyap
BACKGROUND: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72 hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28726061/advances-in-psychotherapy-for-depressed-older-adults
#20
REVIEW
Patrick J Raue, Amanda R McGovern, Dimitris N Kiosses, Jo Anne Sirey
PURPOSE OF REVIEW: We review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings. RECENT FINDINGS: Recent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including COPD, heart failure, Parkinson's disease, stroke and other acute conditions, cognitive impairment, and suicide risk...
September 2017: Current Psychiatry Reports
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